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In this study, we aimed to compare the early literacy skills and home literacy environment (HLE) of children on the autism spectrum and typically developing (TD) children, and to determine the predictors of early literacy skills in children on the autism spectrum. The sample in this study consisted of 30 children on the autism spectrum and 31 TD children whose receptive language ages were matched. Results indicated that children on the autism spectrum had significantly higher letter knowledge and significantly lower phonological awareness and vocabulary compared with TD children. No significant difference was found between the groups in terms of the HLE. Moreover, nonverbal cognitive ability predicted letter knowledge, and language and working memory predicted both vocabulary and phonological awareness.Parents of children diagnosed with autism spectrum disorders (ASD) express concern about raising their children bilingually, and often hear advice from professionals against the use of bilingualism. The current study examined the relation between bilingualism and the language and social communication skills of toddlers diagnosed with ASD (N = 353) in the US, while controlling for socioeconomic risk factors. Structural equation modeling showed no differences in language skills between bilingual Spanish-English speaking children and monolingual English-speaking (p = .596) or monolingual Spanish-speaking (p = .963) children and showed a bilingual advantage on socialization skills when comparing bilingual and monolingual English-speaking children (p = .001). Parents of autistic children exposed to Spanish and English should be encouraged to raise their child bilingually if it best suits familial needs.The Eyberg Child Behavior Inventory (ECBI) is a frequently used measure to assess interfering behaviors in children and psychometric properties have recently been examined in children with autism spectrum disorder (ASD). There is a need to confirm the identified factors and examine the factor structure in a racially/ethnically diverse, community-based sample. The current study conducts a psychometric analysis of the ECBI in a sample of children with ASD receiving publicly-funded mental health services. Data were collected from 201 children with ASD ages 5-13 years (60% Hispanic/Latinx) participating in a community effectiveness trial. Confirmatory factor analysis indicated poor model fit using previously identified factors and a new four-factor solution was identified. Clinical and research implications of these findings are discussed.Childhood maltreatment is a toxic stressor that occurs in the family context and is related to adverse outcomes including elevations in internalizing symptomology and externalizing symptomology. In the present study, we tested the role of threat and deprivation dimensions of child maltreatment in the etiology of comorbid psychopathology in emerging adulthood. Additionally, we investigated emotion regulation and emotion lability/negativity as mechanisms underlying the relationship between child maltreatment dimensions and emerging adult psychopathology. To address these aims, we used a longitudinal sample of emerging adults (N = 413, Mage = 19.67, 78.0% Black, 51.1% female) who had previously participated in research assessments at age 10-12. Using a person-centered approach with latent profile analysis, we identified three classes of emerging adulthood psychopathology characterized by different levels of symptom severity and comorbidity between internalizing and externalizing symptoms. Emerging adults who experienced deprivation only, compared to those who were not maltreated, were more likely to belong to a comorbid and severe psychopathology class versus the other identified psychopathology classes. There was also a significant indirect pathway from experiences of both threat and deprivation to a high externalizing class via emotion lability/negativity. Our results contribute to current models of childhood adversity and psychopathology and have implications for interventions to prevent psychopathology among emerging adults exposed to child maltreatment.

This study aims to reduce mortality and morbidity by analyzing the factors associated with blunt chest trauma.

In this study, 1020 patients with blunt thoracic trauma were analyzed retrospectively. Major surgeries, complications, admission to intensive care unit, intubation, mortality, prolonged hospital stay were considered poor clinical outcomes. Independent variables were compared with clinical outcomes and analyzed.

The mean age was 52.7 ± 19.1. Complications (p = 0.028) and mortality (p < 0.001) were higher in patients aged 65years and older than those aged 65years and younger. Severe chest wall injuries, hemopneumothorax, and pulmonary contusions were associated with poor clinical outcomes (OR = 2474, p = 0.001, OR = 2229, p < 0.001 and OR = 2229, p < 0.001, respectively). The variable most related to poor clinical outcomes was New Injury Severity Score (p < 0.001, OR = 8.37).

The most associated factor with poor clinical outcomes was injury severity. Prompt treatment of blunt chest trauma with timely chest tube thoracostomy or surgical treatment when necessary, optimal pain control, and chest physiotherapy will reduce mortality.

The most associated factor with poor clinical outcomes was injury severity. Prompt treatment of blunt chest trauma with timely chest tube thoracostomy or surgical treatment when necessary, optimal pain control, and chest physiotherapy will reduce mortality.This paper introduces a new graphical tool the mean deviation concentration curve. Using a unified approach, we derive the associated dominance conditions that identify robust rankings of absolute socioeconomic health inequality for all indices obeying Bleichrodt and van Doorslaer's (J Health Econ 25945-957, 2006) principle of income-related health transfer. We also derive dominance conditions that are compatible with other transfer principles available in the literature. To make the identification of all robust orderings implementable using survey data, we discuss statistical inference for these dominance tests. To illustrate the empirical relevance of the proposed approach, we compare joint distributions of income and health-related behavior in the United States.Chemotherapy-induced neuropathic pain is a major clinical problem with limited treatment options. Here, we show that metformin relieves bortezomib (BTZ)-evoked induction and maintenance of neuropathic pain by preventing the reduction in the expression of Beclin-1, an autophagy marker, in the spinal dorsal horn. Application of rapamycin or 3-methyladenine, autophagy inducer and inhibitor, respectively, affected the mechanical allodynia differently. Co-application of 3-methyladenine and metformin partially inhibited the effect of metformin in recovering Beclin-1 expression and in reducing the pain behavior in rats subjected to BTZ treatment. BTZ treatment also reduced the expression of AMPKa2 in the dorsal horn, which was recovered by metformin treatment. Overexpression of AMPKa2 attenuated the BTZ-evoked reduction in Beclin-1 expression and mechanical allodynia, whereas intrathecal injection of AMPKa2 siRNA decreased the Beclin-1 expression and induced mechanical allodynia in naive rats. Moreover, BTZ treatment increased the GATA3 expression in the dorsal horn, and GATA3 siRNA attenuated the AMPKa2 downregulation and mechanical allodynia induced by BTZ. Chromatin immunoprecipitation further showed that BTZ induced an increased recruitment of GATA3 to multiple sites in the AMPKa2 promoter region. Furthermore, decreased acetylation and increased methylation of histone H3 in the AMPKa2 promoter in the spinal dorsal horn was detected after BTZ treatment. Our findings suggest that metformin may regulate AMPKa2-mediated autophagy in the dorsal horn and alleviate the behavioral hypersensitivity induced by BTZ.Functional constipation (FCon) is one of the common functional gastrointestinal disorders (FGID). Previous studies reported alterations in cortical morphometry as well as changes in white matter (WM) fiber tracts and thalamo-limbic/parietal structural connectivity (SC). However, whether patients with FCon are implicated in changes in gray matter (GM) volume and associated SC remains unclear. Voxel-based morphometry (VBM) was first employed to examine differences in GM volume between 48 patients with FCon and 52 healthy controls (HC). HDAC inhibitor Diffusion tensor imaging (DTI) with probabilistic tractography analysis was then employed to explore alterations in SC of these regions. Results showed abdominal symptoms were positively correlated with anxiety (SAS). Two sample t-test showed patients with FCon had decreased GM volumes in the right middle frontal gyrus (MFG_R), left insula (INS_L), and anterior cingulate cortex (ACC, PFWE  less then  0.05) which were negatively correlated with abdominal symptoms and difficulty of defecation respectively. Seed-based SC analysis showed patients with FCon had decreased fractional anisotropy of the ACC-right MFG and bilateral INS-MFG tracts. These findings reflect FCon is associated with changes in GM volumes and corresponding SC in brain regions within the salience network.Due to cost and participant burden, neuroimaging studies are often performed in relatively small samples of voluntary participants. This may lead to selection bias. It is important to identify factors associated with participation in neuroimaging studies and understand their effect on outcome measures. We investigated the effect of postoperative delirium on long-term (over 48 months) cognitive decline (LTCD) in 560 older surgical patients (≥ 70 years), including a nested MRI cohort (n = 146). We observed a discrepancy in the effect of delirium on cognitive decline as a function of MRI participation. Although overall difference in cognitive decline due to delirium was not greater than what might be expected due to chance (p = .21), in the non-MRI group delirium was associated with a faster pace of LTCD (-0.063, 95% CI -0.094 to -0.032, p  less then  .001); while in the MRI group the effect of delirium was less and not significant (-0.023, 95% CI -0.076, 0.030, p = .39). Since this limits our ability to investigate the neural correlates of delirium and cognitive decline using MRI data, we attempted to mitigate the observed discrepancy using inverse probability weighting for MRI participation. The approach was not successful and the difference of the effect of delirium in slope was essentially unchanged. There was no evidence that the MRI sub-group experienced delirium that differed in severity relative to MRI non-participants. We could not attribute the observed discrepancy to selection bias based on measured factors. It may reflect a power issue due to the smaller MRI subsample or selection bias from unmeasured factors.

To report disease control and treatment-related side effects among adult patients with craniopharyngioma treated with radiotherapy.

We performed a single-institution review of adult patients (> 21years old) with craniopharyngioma treated with radiotherapy either definitively or postoperatively for gross residual disease. We report disease control, survival, and radiotherapy-related side effects.

A total of 49 adult patients with craniopharyngioma were included, 27 of whom were treated at initial presentation and 22 for recurrent disease following initial surgery and observation. Overall, 77% received radiotherapy postoperatively (either after primary surgery or surgery for recurrence). With a median clinical and radiographic follow-up of 4.2 (range, 0.4-21.6) years and 3.0 (range, 0-21.5) years, the 5- and 10-year local control rates were 100 and 94%, respectively. The 5- and 10-year overall survival rates were 80 and 66%, respectively. Eleven percent of patients experienced grade 2 vision deterioration and 18% suffered grade 2 endocrinopathies following radiotherapy.

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