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Autism spectrum disorder (ASD) is an increasingly common neurodevelopmental disorder that has a wide variety of etiologies. Patients with autism have deficits in social communication and restricted and repetitive behaviors and interests. Cognitive abilities are variable ranging from profound intellectual disability to above average intellectual capabilities. In addition, medical comorbidities such as gastrointestinal dysfunction, sleep disorders, and seizures are frequently diagnosed. Though there is no cure for autism, on-going research in genetic etiologies and novel therapeutic applications are being studied. ASD is a lifelong condition that has varied clinical presentations across the life span of an individual and requires a multifaceted and diverse team of providers to manage the differing challenges that arise as patients grow and develop.

Pitt-Hopkins syndrome (PTHS) is a rare, genetic disorder caused by a molecular variant of TCF4 which is involved in embryologic neuronal differentiation. PTHS is characterized by syndromic facies, psychomotor delay, and intellectual disability. Other associated features include early-onset myopia, seizures, constipation, and hyperventilation-apneic spells. Many also meet criteria for autism spectrum disorder. Here the authors present a series of 23 PTHS patients with molecularly confirmed TCF4 variants and describe 3 unique individuals. The first carries a small deletion but does not exhibit the typical facial features nor the typical pattern of developmental delay. The second exhibits typical facial features, but has attained more advanced motor and verbal skills than other reported cases to date. The third displays typical features of PTHS, however inherited a large chromosomal duplication involving TCF4 from his unaffected father with somatic mosaicism. To the authors’ knowledge, this is the first chromosomal duplication case reported to date.

In this pilot study, we evaluated the long-term neurodevelopmental outcomes in neonatal and pediatric patients supported by extracorporeal membrane oxygenation (ECMO) and aimed to identify the role of post-ECMO magnetic resonance imaging (MRI) in predicting neurodevelopmental outcomes. Twenty-nine patients were evaluated using the Ages and Stages Questionnaire, Third Edition (ASQ-3) screening tool. Thirteen were evaluated during their visit at the neurodevelopmental clinic and 16 were interviewed via phone. We also reviewed the post-ECMO MRI brain of these patients and scored the severity of their injury based on the neuroimaging findings. In our cohort of 29 patients, 10 patients (34%) had developmental delay. Of those with developmental delay, 80% were newborns. Sixty-seven percent of patients with developmental delay had moderate to severe MRI abnormalities as compared with only 18% with no developmental deficits (p = 0.03). The younger the age at the time of placement on ECMO, the higher the chances of impaired neurodevelopmental outcome. Long-term follow-up of patients who have survived ECMO, with standardized neuropsychologic testing and post-ECMO imaging, should become the standard of care to improve long-term outcomes. Significant abnormalities on brain MRIs done before discharge correlated with developmental delay on follow-up.

This study was undertaken to establish how the current level of cognitive and academic functioning in adults might correlate with the previous testing performed at a small private school in Dallas, Texas, that serves students with learning disabilities. Each of the 40 participants had been evaluated as students 20 to 25 years previously using the standard cognitive and achievement tests accepted in practice during the 1970s. Additionally, the medical director of the school, a neurologist, had evaluated each student for neurologic and behavioral disorders. At the time of follow-up, the participants were administered a battery of intellectual and achievement measures commensurate with the previous testing and a detailed neurologic and neurobehavioral examination was performed. A significant correlation was found between the original and the current test scores, confirming both that learning disabilities persist into adulthood and that children with affective illness have a significant risk for later recurrent affective illness episodes.

Guided by a transactional stress and coping model, this study examined the contribution of cognitive appraisal processes to diabetes adherence behavior among adolescents 12 to 18 years old (n = 40). Multiple hierarchical regression analyses indicated that esteem related to physical appearance accounted for a significant 16% of the variance in checking one's blood sugar. Perceived control when ill and attributional style for negative events each accounted for significant increments of variance as well (10 and 6%, respectively), yielding a total of 32% of the variance explained by appraisal processes. Results suggest that adolescents who (a) have a negative perception of their bodies, (b) perceive little internal control over health when ill, and (c) have an external attributional style for negative events were at greatest risk for poor compliance as indicated by less frequent checking of blood sugar.

Objectives To determine safety and efficacy of the 5HT 1A serotonin partial agonist buspirone on core autism and associated features in children with autism spectrum disorder (ASD). Study design Children 2-6 years of age with ASD (N = 166) were randomized to receive placebo or 2.5 or 5.0 mg of buspirone twice daily. The primary objective was to evaluate the effects of 24 weeks of buspirone on the Autism Diagnostic Observation Schedule (ADOS) Composite Total Score. Secondary objectives included evaluating the effects of buspirone on social competence, repetitive behaviors, language, sensory dysfunction, and anxiety and to assess side effects. Positron emission tomography measures of tryptophan metabolism and blood serotonin concentrations were assessed as predictors of buspirone efficacy. Results There was no difference in the ADOS Composite Total Score between baseline and 24 weeks among the 3 treatment groups ( P = .400); however, the ADOS Restricted and Repetitive Behavior score showed a time-by-treatment effect ( P = .006); the 2.5-mg buspirone group showed significant improvement ( P = .003), whereas placebo and 5.0-mg buspirone groups showed no change. Children in the 2.5-mg buspirone group were more likely to improve if they had fewer foci of increased brain tryptophan metabolism on positron emission tomography ( P = .018) or if they showed normal levels of blood serotonin ( P = .044). Adverse events did not differ significantly among treatment groups. Conclusions Treatment with 2.5 mg of buspirone in young children with ASD might be a useful adjunct therapy to target restrictive and repetitive behaviors in conjunction with behavioral interventions. Trial registration ClinicalTrials.gov: NCT00873509.

Response surface methodology was used to visualize the interactive effects of de tergent concentration, agitation time, and wash temperature on removal of soil from fabrics. Plots of the whiteness index of fabrics after repeated soiling and laundering indicated that maximum whiteness occurred at approximately 0.20% detergent con centration. The wash temperature required for maximum whiteness varied with fabric type. Changes in length of agitation time within the limits of the study had a minor effect on soil removal. Labeled components of synthetic sebum could be completely removed from acrylic and nylon fabrics. Both polar and nonpolar components became trapped in the cotton fibers. Removal of nonpolar triolein from polyester was in complete and decreased as wash temperature increased. Particulate soil, as measured by x-ray fluorescence of silicon, could be completely removed from all fabrics except the acrylic.

The objectives of this study were to evaluate the effect of line drying on smooth ness and stiffness of fabrics, to determine whether consumer acceptance of fabric appearance and hand is related to certain economic and attitudinal factors, and to evaluate changes in the laundering process that would optimize the appear ance and hand of line-dried fabrics. Smoothness and stiffness of fabrics were measured after machine, line, and modified line-drying treatments. Consumer participants rated the acceptability of fabric appearance and hand, and responded to questions about their attitudes toward energy conservation and environmental concern. In most cases, line-dried fabrics were significantly stiffer than machine- dried fabrics but were equally acceptable with respect to hand. Line drying re sulted in a more wrinkled appearance which was less acceptable than the ap pearance of machine-dried fabrics. Factors which were related to the acceptance of fabric appearance were knowledge of the cost of machine drying, the fastid iousness of the individual, and attitude toward conservation. Briefly tumbling previously line-dried fabrics in a machine dryer resulted in appearance and hand that would have been acceptable to most consumer participants while still saving energy.

Samples of cotton, polyester and nylon fabrics were soiled by application of synthetic sebum and clay and then laundered at various combinations of hot, warm and cold wash and rinse water temperatures. The temperature of the rinse water did not affect the amount of soil removed from the fabrics. More soil was generally removed with hot wash water than with warm or cold water. The soil was more readily removed from the nylon than from the cotton or polyester fabrics. All wash/rinse treatments removed soil to a level that would probably be acceptable to most consumers.

We studied the relationship between presence of Type A behavior pattern and glycemic response to stress in children with insulin dependent diabetes mellitus (IDDM). Twelve male (six Type A and six Type B) and nine female (four Type A and five Type B) insulin-dependent diabetic patients between the ages of 8 and 16 years received a standard meal and blood glucose values were assessed two hours later. All subjects then played a competitive videogame for 10 minutes following which blood glucose was assessed again. Preprandial and postprandial blood glucose values did not differ between the groups. However, only Type A subjects showed a hyperglycemic response to the videogame stress. Type A subjects also demonstrated significantly higher glycohemoglobin values. In order to assure that this effect was due to a differential response to stress and not simply a difference in metabolic response to a meal, a second study was conducted in which blood glucose values were assessed at one, two and three hours following a standard meal. No significant differences in postprandial blood glucose values were observed between Type A and Type B subjects. These data support previous research which has suggested that some but not all patients with IDDM show a hyperglycemic response to stress.

The edge abrasion of durable-press cotton and the deposit build-up on the cotton and a nylon fabric were determined after repeated launderings with phosphate and carbonate detergents and builders. When soft water was used there were no differences in amount of abrasion or deposit. The use of hard water with carbonate products resulted in accelerated edge abrasion on the cotton, and a heavy calcium deposit on both fabrics was indicated from weight change, spectro photometer analyses, and SEM examination. Fabrics laundered with phosphate products in hard water had less abra sion and deposit than those washed with carbonate detergent or builder, but more than samples laundered in aoft water. Detergents and builders of the same type resulted in similar amounts of fabric deterioration, but detergents formed more deposit than the corresponding builder.

The performance of denim fabrics made from open end and ring spun yarns was compared ly a wear study and by aboratory measurements. For the wear study the fabrics were made into boys' jeans and were warn for a total of 26 wash/wear cycles. The results of both the laboratory tests and the wear study indicated that the ring spun fal ric was more durable than the open end fabric. However, the differences were small, and durability of both fabrics way accept able to consumers. Evaluation of the garments during the wear study was based on abrasion standards developed in the laboratory and the U. S. Army's General Equipment Test Activity system.

The major objective of this study was to evaluate consumers' perception of color change in fabrics and to determine at what stage consumers judge the fabrics to be unacceptable for intended use because of color change. Colored fabrics representing varying amounts of col or change were shown to consumers at six different geographic locations. The majority of the consumers were able to perceive a color change equal to Step 4–5 on the Gray Scale for most samples. Color changes greater than Step 4 were not acceptable if the samples repre sented fabric in one garment. If the change was uniform throughout the garment, color changes up to Step 2 were acceptable to the consumer. There were no differences in the con sumers' perception or acceptance due to age or social status. There was some indication of differences in acceptance due to geographic locations.

Longitudinal changes in glycosylated hemoglobin concentration (GlyHb) and glycosylated serum protein concentration (GSP) in both normal pregnancy and pregnancy complicated by gestational diabetes were determined using affinity chromatography, a method in which nonenzymatically glycosylated proteins are specifically measured. At 7–10 wk gestation, GlyHb in women who developed diabetes (N = 21) was higher than GlyHb in normal women (N = 49) (6.7 ± 0.2% versus 5.7 ± 0.2%, respectively, P < 0.001) and remained elevated throughout gestation. In normal pregnancy, GlyHb decreased to a nadir at 23–26 wk and returned to baseline concentration by 31–34 wk. In gestational diabetes, there was an initial increase in GlyHb to 7.1 ± 0.5% at 11–14 wk followed by a steady decrease. At 7–10 wk, GSP in women who developed diabetes was not elevated compared with normal concentration, although at 11–14 wk there was significant difference between the two groups (P < 0.02). In normal women, GSP remained constant throughout gestation. In gestational diabetes, GSP decreased to early pregnancy values (P < 0.02). Glycosylated blood proteins were elevated in early gestation in women who developed gestational diabetes and may have predictive value in identifying women who will develop diabetes in pregnancy.

In a wear study of polyesterlcotton durable-press trousers, the laundry process was found to cause approximately half of the total edge abrasion. No significant differences in amount of edge abrasion were found among trousers laundered by different methods. Laboratory studies using polyesterlcotton fabrics indicated that the least abrasion occurred when simulated cuff samples were washed wrong side out, with slow agitation speed, or with a shortened wash cycle. Studies using 100 percent cotton durable-press fabrics indicated that an increase in tumble drying time resulted in a significant increase in amount of edge abrasion. Turning samples wrong side out, shortening the wash period, and using slow agitation speed tended to reduce the amount of edge abrasion. Edge abrasion was evaluated by comparison of samples with photographic standards and examination of samples with the scanning electron microscope.

The purpose of the study was to investigate the relationship of fiber content and fabric properties to the subjective evaluation of comfort of socks and to determine the subjective evaluations and laboratory measurements that best predict comfort. Socks made from all synthetic or predominantly cotton fibers were worn during exercise. Laboratory measurements were made on samples of sock fabrics which had been washed but not worn. Subjective evaluations obtained from the participants during the wear study indicated that the socks made from synthetic fibers were slightly more comfortable than the predominantly cotton socks. Prior to the wear study the majority of participants had indicated that they would select cotton socks for maximum comfort. The subjective evaluations of sock softness and foot dryness were found to be the significant determinants of comfort. Neither fiber content nor any of the laboratory measurements (weight, thickness, moisture absorption, air permeability, compressibility, and compressional resiliency) were found to be good predictors of comfort.

To assess the relationship between comfort and moisture transport properties of warm-up suit fabrics, a wear study was designed in which physiological and subjective measurements were obtained from subjects wearing warm-up suits under controlled conditions of exercise and environment. During the wear study, the subjects were under moderate heat stress in the warm environment and under no heat stress in the cool environment. Three fabrics were used in the study. Two of the fabrics were similar in thickness and insulative value but differed in ability to absorb and transport moisture. The other fabric had moisture properties that were similar to one of the above fabrics, but it was thinner and had a lower insulative value. Under cool environmental conditions the three fabrics provided similar levels of comfort. When the wearers were subjected to moderate heat stress, they were most comfortable when wearing either the thinnest fabric or the fabric which absorbed and transported the most moisture. Comparisons between the two fabrics with similar insulative values indicated that the under garments contained less moisture and the wearers felt drier when wearing the suit which had better moisture transport properties. Laboratory measurements of liquid transport and drop absorption were the best predictors of subjective eval uations of wetness and differences in the amounts of moisture in the garments when worn under conditions of moderate heat stress.

A series of fabric swatches depicting various levels of soil removal were presented to consumers, with one-half of the subjects being given energy requirements to obtain each level of soil removal. A whiteness index of 50 was found to be the minimum acceptable level of soil removal. Information on resources required to obtain the various levels of soil removal did not change the minimum level of acceptance. Attitudes of consumers concerning ecological issues, obtained from a questionnaire, did not correlate with consumers' acceptance scores. There was some indication from the questionnaire data that consumers might be willing to make some trade-offs for monetary savings in place of maximum levels of soil removal. The level of acceptance of soil removal was most closely related to attitude toward cleanliness and neatness.

In the laundry process relatively high wash temperatures have traditionally been used for optimum soil removal. The use of lower wash temperatures could result in a substantial reduction in the amount of energy used in laundering. One of the purposes of this study was to determine soil removal at a range of wash temperatures with detergents of different formulations from cotton, polyester, and cotton/polyester fabrics. A second purpose was to evaluate the use of x-ray fluorescence analysis as a quantitative measure for determining particulate soil removal from fabrics. The samples were soiled by application of clay and either unlabeled or doubly-labeled synthetic sebum. Removal of oily soil was determined by measuring the radioactivity of the samples. Clay removal was measured by x-tay fluorescence analyses of iron and silicon, and overall soil removal was measured by changes in reflectance. Both clay and oily soil appeared to be best removed from cotton fabrics by higher wash temperatures. Low wash temperatures were best in removing the nonpolar fraction (triolein) of oily soil from polyester. Use of phosphate-built anionic detergents generally resulted in better soil removal than other types, regardless of wash temperature. Wash temperatures as low as 10°C gave acceptable soil-removal levels. Iron content varied with clay-particle size, thus silicon was the preferred indicator of clay content of fabrics.

A model for quality grading of textile products was developed which included weaghtang fac tors based on the importance of end-use properties as perceived by consumers, standards based on laboratory measurements of these properties, and the expected wear-life of the product. Children's clothing was the textile product used in developing the model. A questionnaire was distributed to parents of nursery school and elementary school-age children to obtain the needed consumer input. In the questionnaire the consumers rated the importance of end-use properties for various categories of children's clothing, and indicated the expected wear-life of these items. Significant differences were found in the ratings of the importance of the end-use properties for each of the seven categories of clothing. The model for quality grading was then developed utilizing the data from the questionnaire. Also used in the model were laboratory measurements of the end-use properties and perfor mance standards. The desirability function was used to transform data from different labor atory measurements and performance standards into a single value. The model was then tested using four pairs of boys' jeans, similar in appearance but differing in price. The two lowest priced garments were found to be of the lowest grade, but the top-priced garment was the same grade as the next lower-priced garment.

A cotton fabric was artificially soiled and laundered with two different types of detergents at two different wash tem peratures. Samples laundered at 140°F were rated by subjective evaluations to be whiter, softer, and smoother than fabric laundered in unheated water. The type of detergent did not affect the softness or smoothness of the fabric. Sam ples laundered in regular detergent were judged to be whiter than those laundered in cold-water detergent. Little dif ference in breaking strength, elongation, and dimensional change of the fabric due to laundering variables was noted. Data are given on the cost of heating water and detergent. Samples were laundered at six locations and differences in water quality are reported.

Using correlation and stepwise multiple regression techniques, the garment wear scores from a wear study of men's polyester/cotton durable-press trousers were found to be related to: (1) an estimate of the physical activity of the wearer during the wear period, (2) the wearer's height and weight, and (3) Thurstone temperament scores for Dominant and Vigorous. For this sample of 22 men, the resulting regression equation accounted for 67% of the wear score variability. The correlation between the wearer's estimate of the severity of wear and the garment wear score was low. The addition of Thurstone temperament scores for Active, Impulsive, Dominant and Reflective improved the prediction of the regression equation and indicated the importance of personality characteristics in the evaluation of wear.

Thermal insulation, thickness, and volume of air per unit area of fabric have been determined for single and multiple layers of fabrics. A comparison of the thermal in sulation and thickness values obtained by the actual measurement of multiple layers of fabrics to those obtained by adding the values of the individual fabrics involved has been made. In addition, thermal insulation data for the single and multiple layers of fabrics were plotted against the values for the other properties to show the relationships that exist.

The whitening effect of a fluorescent dye applied from organic solvents to white wool was investigated. Optimum conditions for applying C. I. Fluorescent Brightening Agent #68 from perchlorethylene and Stoddard solvent at room temperature were developed. Visual evaluation in daylight and under ultraviolet light showed a marked improvement in whiteness after application of the dye to white wool fabrics. The fastness of the dye to conditions encountered during use was found to be satisfactory.

The serviceability of a minimum care type garment was studied. Men's slacks made from 65% Dacron 2 and 35% rayon fabric were worn a total of 750 hours. After every 150 hours of wear, half of these garments were drycleaned and half home laundered. The garments were evaluated by both the wearers and members of the research staff after each wear period and after each cleaning. The slacks were found to be generally serviceable after wear and cleaning. The drycleaned and pressed garments were consistently rated as having a better appearance than the laundered and pressed garments, It was necessary to press the laundered slacks before they were acceptable for wear.

A study was made of the retention of a doubly labelled synthetic sebum mixture by durable-press cotton and polyester/cotton fabrics after soiling and laundering. The laundry conditions were ineffective in removing the labelled, oily soil components (tristearin, octadecanol, cholesterol, stearic acid, and oleic acid) from the fabrics. After one soiling and laundering, more tristearin was retained by the fabrics than the other four soil components. The untreated cotton retained significantly less tristearin than DP cotton and the untreated and DP polyester/cotton fabrics. In contrast, after several soilings and launderings, both tristearin and the polar components accumulated on the fabrics and untreated cotton retained significantly more of these components than the other three fabrics.

The effect of a durable-press finish and fiber content on the removal of a synthetic sebum during repeated soiling and laundering cycles was investigated, using glyceryl tristearate 14carbon to detect residual soil. Although the untreated cotton fabric retained less soil after one soiling-laundering cycle, significantly more tagged soil could be extracted from the untreated cotton fabric than from the durable-press cotton, the durable-press polyester/cotton blend, or the untreated polyester/cotton blend after 30 cycles.

A study was made of the effect of abrasion on the retention of oily soil by cotton and polyester/cotton durable press fabrics. One set of samples was abraded in the Accelerotor, and the other set was abraded by laundering. The abraded fabrics were then soiled with a radioactive labeled oily soil and laundered for a total of ten treatments. Samples abraded in the Accelerotor to a weight loss of approximately 20% had soil retention properties significantly different from the controls or samples that had received milder abrasive treatments. The severely abraded cotton samples showed a decrease, while the blend samples showed an increase in the amount of the 3H fraction of the soil retained.

Previous studies suggested that the assessment of hemoglobin A1 (HbA1) concentration was a poor indicator of diabetes in pregnancy. However, HbA1 was measured by ion exchange chromatography, which is subject to spurious alterations. To reevaluate the use of glycosylated hemoglobin concentration (GlyHb) as an indicator of gestational diabetes, 64 women at 10 to 15 weeks' gestation were studied by measuring GlyHb by a specific affinity chromatography assay, and blood glucose concentration was determined one hour post a 50-g oral glucose load. Gestational diabetes developed in 15 women in whom GlyHb (7.4 +/- 0.2%) was greater than in normal pregnant women (5.7 +/- 0.1%, P less than .001). If a GlyHb of 6.3% were chosen as the threshold for diagnostic evaluation for diabetes, only 6.7% of the gestational diabetics would have missed diagnosis. Of normal women, 14.2% would have been subjected to glucose tolerance test. GlyHb elevation was associated with the birth of infants large for gestational age. The assessment of GlyHb by affinity chromatography between 10 and 15 weeks' gestation may be a sensitive predictor of patients who will develop gestational diabetes.

The usefulness of concentrations of glycosylated serum protein and glycosylated hemoglobin in monitoring glycemic control during pregnancy complicated by diabetes was evaluated by correlation of these parameters with fasting and 2-hour postprandial glucose concentrations of the previous 7 days. Glycosylated serum protein correlated with both fasting (r = 0.798, p less than 0.01, n = 71) and postprandial (r = 0.846, p less than 0.01, n = 69) blood glucose concentrations. Glycosylated hemoglobin also correlated with fasting (r = 0.571, p less than 0.01, n = 71) and postprandial (r = 0.510, p less than 0.01, n = 74) blood glucose concentrations. Monitoring glycosylated serum protein during pregnancy complicated by diabetes is clinically feasible and allows frequent reappraisal of diabetic control.

Previous studies have indicated an association of fetal macrosomia with mild degrees of glucose intolerance in late pregnancy. To determine whether glycosylated hemoglobin concentration in early gestation was related to fetal outcome, 48 pregnant women with normal glucose tolerance and 21 women with gestational diabetes were studied. Glycosylated hemoglobin concentration was determined by a specific aminophenylboronic acid assay, and mean glycosylated hemoglobin concentration was calculated from two or three determinations before 17 weeks' gestation. The incidence of infants large for gestational age was 10% in nondiabetic women with glycosylated hemoglobin concentration of less than 6.0%. With glycosylated hemoglobin concentration of 6.0% to 6.9%, the incidence of infants who were large for gestational age was increased in both nondiabetic women (75%, p less than 0.01) and diabetic women (40%, p less than 0.01). With glycosylated hemoglobin concentration of greater than 7.0%, 36% of infants of diabetic women were large for gestational age. The incidence of hyperbilirubinemia was 2.5% in the infants of nondiabetic women with glycosylated hemoglobin concentration of 6.0%. With glycosylated hemoglobin concentration of 6.0% to 6.9%, hyperbilirubinemia was increased in both the infants of nondiabetic women (38%, p less than 0.01) and diabetic women (30%, p less than 0.01). With glycosylated hemoglobin concentration of greater than 7.0%, hyperbilirubinemia was present in 27% of infants of diabetic mothers. The current study suggests that glycosylated hemoglobin concentration elevation in early gestation is associated with perinatal morbidity.

Nonenzymatic glycosylation of albumin was associated with an increased catabolic rate and decreased protein half-life in both normal and diabetic animals. The fractional catabolic rate of glycosylated albumin was increased significantly over albumin, from 0.100 +/- 0.004/day to 0.131 +/- 0.007/day in normal animals and from 0.104 +/- 0.004/day to 0.138 +/- 0.007/day when these animals were made diabetic with alloxan. The half-lives of Alb and GlyAlb in normal dogs were 6.81 +/- 0.12 days and 4.97 +/- 0.21 days, respectively. In diabetic animals, the half-lives of Alb and GlyAlb were 7.48 +/- 0.21 and 5.21 +/- 0.24 days, respectively. The increased catabolism of GlyAlb may reflect chronic increased extravasation of glycosylated plasma proteins, which are known to be increased in diabetes, into the microvascular wall.