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Although individuals with intellectual disability (ID) and/or limited language ability make up a significant proportion of those with autism spectrum disorder (ASD), they are routinely excluded from ASD research. As a result, this vulnerable population is prevented from participating in and deriving full benefit from research. In this commentary, we expand upon points made by McCracken and colleagues (this issue), who describe several opportunities for improvement in drug development for ASD related to the inclusion of individuals with ID and/or limited language ability.

Acinar cell carcinoma (ACC) is a very rare tumor of the exocrine pancreas, representing less than 1% of all pancreatic malignancies. The majority of data regarding ACC are limited to small case series.

This is a retrospective study conducted at a large healthcare system from 1996 to 2019. Patients with pathologically confirmed ACC were included, and demographic data, tumor characteristics, and treatment outcomes were abstracted by chart review. Survival curves were obtained by using the Kaplan-Meier method and compared using the log-rank test.

Sixty-six patients with ACC were identified. The median patient age at diagnosis was 64, and 42% presented with metastatic disease. The majority presented with abdominal pain or pancreatitis (69%), and laboratory parameters did not correlate with tumor size, metastatic disease, or survival. Several somatic abnormalities were noted in tumors (BRCA2, TP53, and mismatch-repair genes). In patients with localized disease that underwent resection, the median time to devancreatic ACC patients often present with advanced disease. Surgery was associated with survival benefit among patients presenting with localized disease. The use of FOLFOX or FOLFIRINOX chemotherapy regimens was associated with improved OS in metastatic patients. These data add to our knowledge in this rare malignancy, and improves understanding about the genomic underpinnings, prognosis and treatment for acinar cancers.

Gestational diabetes mellitus (GDM), hyperglycemia diagnosed during pregnancy, is one of the most common medical complications of pregnancy, treated primarily by diet and pharmacotherapy, if indicated. It is well-established that GDM increases the risk of adverse pregnancy outcomes and long-term complications in mothers and infants. Galectin-3 (Gal-3) is important in processes of cell growth, differentiation, inflammation, and fibrosis. We evaluated Gal-3 expression in pregnancies complicated by GDM as a parameter that might explain how GDM influences early onset of future complications.

Forty-four women with GDM and 40 with normal pregnancy (NP) were recruited during delivery admission. Blood samples were obtained from parturients and umbilical cords blood, as well as placental tissue for analysis. Gal-3 mRNA expression was increased in maternal blood samples and placental tissue of women with GDM compared to NP. In GDM, Gal-3 mRNA was decreased in cord blood compared to maternal blood and placental tissue. Gal-3 GDM placental protein expression was increased compared to NP. Immunostaining revealed that Gal-3 is upregulated in GDM placental extravillous trophoblast. ELISA of Gal-3 maternal serum levels between GDM and NP were similar.

Gal-3 is strongly expressed at molecular levels (mRNA and protein expression) in GDM maternal blood and placental tissue, and decreased in cord blood. These findings highlight the role of the placenta in protecting the fetus from potential Gal-3 damage. Selleckchem Chaetocin Gal-3 expression at mRNA and protein levels might be influenced by diabetes, even if blood glucose is balanced by medication or diet.

Gal-3 is strongly expressed at molecular levels (mRNA and protein expression) in GDM maternal blood and placental tissue, and decreased in cord blood. These findings highlight the role of the placenta in protecting the fetus from potential Gal-3 damage. Gal-3 expression at mRNA and protein levels might be influenced by diabetes, even if blood glucose is balanced by medication or diet.

Early life exposures could be pertinent risk factors of cardiometabolic diseases in adulthood. We assessed the prospective associations of early life factors with markers of cardiometabolic risk among healthy German adults.

We examined 348 term-born DONALD Study participants with measurement of fasting blood at the age of 18-24 years to assess metabolic indices fatty liver index (FLI), hepatic steatosis index (HSI), pro-inflammatory score and insulin sensitivity (HOMA2-%S). Early life factors (maternal weight in early pregnancy, maternal early pregnancy BMI, gestational weight gain (GWG), maternal age, birth weight and full breastfeeding (>17 weeks)) were assessed at enrolment of the offspring into the study. Multivariable linear regression models were used to analyze associations between early life factors and markers of cardiometabolic risk in early adulthood with adjustment for potential confounders. A higher early pregnancy BMI was related to notably higher levels of offspring FLI, HSI, pro-inflammatory score and a lower HOMA2-%S (all p<0.0001). Similarly, a higher gestational weight gain was associated with a higher FLI (p=0.044), HSI (p=0.016), pro-inflammatory score (p=0.032) and a lower HOMA2-%S among females (p=0.034). Full breastfeeding was associated with a lower adult FLI (p=0.037). A casual mediation analysis showed that these associations were mediated by offspring adult waist circumference (WC).

This study suggests that early pregnancy BMI, gestational weight gain, and full breastfeeding are relevant for offspring markers of cardiometabolic risk which seems to be mediated by body composition in young adulthood.

This study suggests that early pregnancy BMI, gestational weight gain, and full breastfeeding are relevant for offspring markers of cardiometabolic risk which seems to be mediated by body composition in young adulthood.

Modern technology created a borderless world that generated a new covert psychological form of bullying conveyed through electronic mediums. link2 Cyberbullying phenomenon could infiltrate adolescents' personal life and undermine their psychological health status. This study aimed to investigate the relationship between Egyptian adolescents' exposure to cyberbullying and their sense of emotional security and psychological capital profile.

A descriptive correlational study was carried out at eight youth centers in Alexandria, Egypt. A random selection of 400 adolescents completed the Cyberbullying Exposure and Psychological Capital Questionnaires. link3 They also rated their emotions on the Security-Insecurity Inventory.

The total mean score of emotional security among adolescents cybervictims was 68.34 ± 27.83 compared to 109.16 ± 24.63 for those who did not expose to cyberbullying (t = -12.16, P < 0.001). Likewise, the total mean score of the psychological capital profile was low among cybervictims (61.76 ± 2.6bullying phenomenon. Cyberbullying could be combated by adopting school-based interventions and parents' guidelines. Schools should offer anti-cyberbullying programs, while the nurse should instruct parents to keep an open channel of communication with their children, indirectly supervise their online behaviors, remain vigilant for the indicators of cybervictimization, and intervene when necessary. The nurses also play a crucial role in equipping the adolescents with the proper way to handle such problems.Total body mapping comprises photographic documentation of the entire body surface followed by digital dermatoscopy of selected melanocytic lesions, aiming to compare their evolution over time and identify new lesions. As this is an exam based on comparative analysis of serial dermoscopic body images, standardization of the technique for performing total body mapping is essential. Prepared by specialists from the Brazilian Society of Dermatology, using the modified Delphi method, this article provides recommendations for carrying out total body mapping in Brazil, regarding its indications, technical aspects, and the issuing of the report.

Patients with hypertrophic cardiomyopathy (HCM) and an identified sarcomere mutation have worse outcomes than those without though the underlying mechanism is incompletely understood. The presence of replacement fibrosis measured by late gadolinium enhancement (LGE) and diffuse fibrosis measured by extracellular volume (ECV) using cardiac magnetic resonance imaging (CMR) are associated with ventricular arrhythmias and cardiac mortality. We aimed to associate these two forms of fibrosis with identified sarcomere mutations.

Three hundred and thirty-six (336) patients with HCM underwent CMR at a single quaternary referral centre between January 2012 and February 2017. Genetic testing was performed in 73 of these patients, yielding an identified sarcomeric mutation in 29 (G+), no mutation in 39 (G-), and a variant of unknown significance (VUS) in five. LGE was more prevalent in G+ compared to G- patients (86 vs. 56%, OR 4.3, p=0.01) and was more extensive (7.5±5.5% of [left ventricular] LV mass vs. 3.0±3.0%, p<0.001). Global ECV from myocardial segments excluding LGE was similar among both groups (26.9±2.9 vs. 25.6±2.8%, p=0.46). However, in G+ patients ECV was greater in the hypertrophied regions of the basal anteroseptum (30.2±7.0 vs. 26.8±3.6%, p=0.004) and basal inferoseptum (28.1±4.3 vs. 26.2±2.9%, p=0.005).

Genotyped HCM patients with an identified sarcomere mutation have greater LGE and greater regional, but not global, ECV than HCM patients without an identified mutation. This difference in fibrosis may contribute to worse outcomes in patients with an identified HCM mutation.

Genotyped HCM patients with an identified sarcomere mutation have greater LGE and greater regional, but not global, ECV than HCM patients without an identified mutation. This difference in fibrosis may contribute to worse outcomes in patients with an identified HCM mutation.

To explore the dietary practices and decision-making process among Chinese breast cancer (BCA) survivors.

Using a grounded theory approach, this qualitative study involved individual semi-structured interviews with 30 BCA survivors. All interviews were audio-recorded and transcribed verbatim for analysis.

Most of the participants reported making long-term diet modification. Key themes were grouped into three stages (1) Motivation, (2) Diet modification, and (3) Maintenance. Most participants reported to be motivated by cancer causal attributions formulated through the evaluation of past dietary habits. Others embarked on changes out of compliance to social expectations. BCA survivors interviewed were willing to make trade-offs for health, but also influenced by peer and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a crucial barrier to adopting healthy eating. Lastly, maintenance of newly formed dietary habits was reinforced by positive feedback but hindered by a lack of both self-efficacy and social support.

While the majority of BCA survivors expressed willingness to improve their diets, changes made were often inconsistent with existing dietary recommendations.

Future interventions may target factors at different decision-making stages guiding evaluation of past diet, building self-efficacy and giving approval to encourage maintenance of healthy dietary behaviors.

Future interventions may target factors at different decision-making stages guiding evaluation of past diet, building self-efficacy and giving approval to encourage maintenance of healthy dietary behaviors.