"It's Really Complicated": Engaging Key Stakeholders to Inform a Novel Parent-led Sexual Health Education Program for Autistic Youth.

Autistic adolescents frequently encounter difficulties in managing changes associated with puberty, sexuality, and relationships, and parents may be a useful source of sexual and reproductive health education (SRE) for this population. Despite this, few evidence-based programs exist to support parents in this role. Thus, there is a need for the development of such programs, particularly those incorporating the lived experiences of key stakeholders.

Consensus definition and diagnostic criteria for neonatal encephalopathy-study protocol for a real-time modified delphi study.

Background: 'Neonatal encephalopathy' (NE) describes a group of conditions in term infants presenting in the earliest days after birth with disturbed neurological function of cerebral origin. NE is aetiologically heterogenous; one cause is peripartum hypoxic ischaemia. Lack of uniformity in the terminology used to describe NE and its diagnostic criteria creates difficulty in the design and interpretation of research and complicates communication with families.

Improving Access to Diagnostic Evaluations for Developmental Disabilities Through an Initial Assessment Model.

Objective: This study aimed to evaluate a novel model of care to improve access to diagnostic evaluations for autism spectrum disorder and/or developmental delays for school-age children.

Methods: An "initial assessment" (IA) model for children aged 7 to 9 years was implemented at a large regional pediatric hospital. Referral patterns and the number of patients evaluated with the IA model were obtained through the electronic health record (EHR).

Rate Discrimination Training May Partially Restore Temporal Processing Abilities from Age-Related Deficits.

The ability to understand speech in complex environments depends on the brain's ability to preserve the precise timing characteristics of the speech signal. Age-related declines in temporal processing may contribute to the older adult's experience of communication difficulty in challenging listening conditions. This study's purpose was to evaluate the effects of rate discrimination training on auditory temporal processing.

The Role of Maternal Anxiety in Treatment Response for Youth with ASD and Co-occurring Anxiety.

Anxiety disorders occur at higher rates in youth with ASD than in neurotypical youth. Although the efficacy of CBT for anxiety in children with ASD is widely supported, factors that influence treatment outcomes are not well understood. This study examined the role of maternal anxiety in treatment outcomes for youth with ASD.

Effects of aging and hearing loss on perceptual and electrophysiological measures of pulse-rate discrimination.

Auditory temporal processing declines with age, leading to potential deleterious effects on communication. In young normal-hearing listeners, perceptual rate discrimination is rate limited around 300 Hz. It is not known whether this rate limitation is similar in older listeners with hearing loss.

Ingestion of Bifidobacterium longum changes miRNA levels in the brains of mice.

The purpose of this research is to investigate the relationship between the microbiota of the gastrointestinal (GI) system and relative gene expression of miRNAs and mRNAs in the brain. C57BL/6 mice and Balb/c mice are fed Bifidobacterium longum, a well-characterized probiotic bacterial species shown to change behavior and improve sociability of Balb/c mice. After feeding, RNA was extracted from whole brains and PCR arrays were utilized to determine changes in the gene expression of brain-specific miRNAs.

Recovery from forward masking in cochlear implant listeners: Effects of age and the electrode-neuron interface.

Older adults exhibit deficits in auditory temporal processing relative to younger listeners. These age-related temporal processing difficulties may be further exacerbated in older adults with cochlear implant (CIs) when CI electrodes poorly interface with their target auditory neurons. The aim of this study was to evaluate the potential interaction between chronological age and the estimated quality of the electrode-neuron interface (ENI) on psychophysical forward masking recovery, a measure that reflects single-channel temporal processing abilities.

Comparing Rapid and Traditional Forward-Masked Spatial Tuning Curves in Cochlear-Implant Users.

A rapid forward-masked spatial tuning curve measurement procedure, based on Bekesy tracking, was adapted and evaluated for use with cochlear implants. Twelve postlingually-deafened adult cochlear-implant users participated. Spatial tuning curves using the new procedure and using a traditional forced-choice adaptive procedure resulted in similar estimates of parameters.

Current Focusing to Reduce Channel Interaction for Distant Electrodes in Cochlear Implant Programs.

Speech understanding abilities are highly variable among cochlear implant (CI) listeners. Poor electrode-neuron interfaces (ENIs) caused by sparse neural survival or distant electrode placement may lead to increased channel interaction and reduced speech perception. Currently, it is not possible to directly measure neural survival in CI listeners; therefore, obtaining information about electrode position is an alternative approach to assessing ENIs.

Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates.

Background And Objective: Early identification of neonates at risk for brain injury is important to start appropriate intervention. Urinary metabolomics is a source of potential, noninvasive biomarkers of brain disease. We studied the urinary metabolic profile at 2 and 10 days in preterm neonates with normal/mild and moderate/severe MRI abnormalities at term equivalent age.

Psychophysical Tuning Curves as a Correlate of Electrode Position in Cochlear Implant Listeners.

Speech understanding abilities vary widely among cochlear implant (CI) listeners. A potential source of this variability is the electrode-neuron interface (ENI), which includes peripheral factors such as electrode position and integrity of remaining spiral ganglion neurons. Suboptimal positioning of the electrode array has been associated with poorer speech outcomes; however, postoperative computerized tomography (CT) scans are often not available to clinicians.

Safe Patient Handling and Mobility: Development and Implementation of a Large-Scale Education Program.

This article addresses the development, implementation, and evaluation of an education program for safe patient handling and mobility at a large academic medical center. The ultimate goal of the program was to increase safety during patient mobility/transfer and reduce nursing staff injury from lifting/pulling. This comprehensive program was designed on the basis of the principles of prework, application, and support at the point of care.

Mortality among infants with evolving bronchopulmonary dysplasia increases with major surgery and with pulmonary hypertension.

Objective: To assess whether mortality in patients with evolving bronchopulmonary dysplasia (BPD, defined as ⩾28 days of oxygen exposure with lung disease) is independently associated with pulmonary arterial hypertension (PAH) and surgery.

Study Design: Single institution retrospective birth cohort of preterm infants with gestational age (GA) 23 to 36 weeks, and evolving BPD delivered between 2001 and 2014. Surgery was classified as minor or major using published criteria.

Assessing the Electrode-Neuron Interface with the Electrically Evoked Compound Action Potential, Electrode Position, and Behavioral Thresholds.

Variability in speech perception scores among cochlear implant listeners may largely reflect the variable efficacy of implant electrodes to convey stimulus information to the auditory nerve. In the present study, three metrics were applied to assess the quality of the electrode-neuron interface of individual cochlear implant channels: the electrically evoked compound action potential (ECAP), the estimation of electrode position using computerized tomography (CT), and behavioral thresholds using focused stimulation. The primary motivation of this approach is to evaluate the ECAP as a site-specific measure of the electrode-neuron interface in the context of two peripheral factors that likely contribute to degraded perception: large electrode-to-modiolus distance and reduced neural density.

Is delirium being detected in emergency?

Objective: To report on the use of Delirium Care Pathways to screen for and recognise delirium by Aged Care Services in Emergency Teams (ASETs) at five metropolitan hospitals in New South Wales, Australia. Knowledge of delirium and the use of Delirium Care Pathways are vital to ensure that older people presenting with delirium receive best practice care.

Methods: An audit of 205 randomly selected medical records of clients over 65 years presenting to an ASET was conducted.

Distributed flow estimation and closed-loop control of an underwater vehicle with a multi-modal artificial lateral line.

Bio-inspired sensing modalities enhance the ability of autonomous vehicles to characterize and respond to their environment. This paper concerns the lateral line of cartilaginous and bony fish, which is sensitive to fluid motion and allows fish to sense oncoming flow and the presence of walls or obstacles. The lateral line consists of two types of sensing modalities: canal neuromasts measure approximate pressure gradients, whereas superficial neuromasts measure local flow velocities.

Impact of hypothermia on predictors of poor outcome: how do we decide to redirect care?

Therapeutic hypothermia is now considered the standard of care for neonates with neonatal encephalopathy due to perinatal asphyxia. Outcomes following hypothermia treatment are favorable, as demonstrated in recent meta-analyses, but 45-50% of these neonates still suffer major disability or die due to global multi-organ injury or after redirection of care from life support due to severe brain injury. The ability to determine which patients are at highest risk of severe neurologic impairment and death and those in whom redirection of care should be considered is limited.

Does the timing of insulin pump therapy initiation after type 1 diabetes onset have an impact on glycemic control?

Background: Continuous subcutaneous insulin infusion (CSII) mimics physiologic insulin release better than multiple daily injection (MDI) therapy and allows for greater flexibility in food intake and physical activity. Given these benefits, it raises the question "Is it required to wait to offer CSII to patients with type 1 diabetes (T1D) only after MDI therapy has failed"? This study sought to determine if starting CSII in patients with T1D within 1 year of diagnosis results in better long-term glycemic control than starting it later.

Methods: This retrospective observational study was conducted in a tertiary-care medical center.

Megalencephaly-capillary malformation (MCAP) and megalencephaly-polydactyly-polymicrogyria-hydrocephalus (MPPH) syndromes: two closely related disorders of brain overgrowth and abnormal brain and body morphogenesis.

The macrocephaly-capillary malformation syndrome (M-CM), which we here propose to rename the megalencephaly-capillary malformation syndrome (MCAP; alternatively the megalencephaly-capillary malformation-polymicrogyria syndrome), and the more recently described megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome (MPPH) are two megalencephaly (MEG) disorders that involve a unique constellation of physical and neuroimaging anomalies. We compare the features in 42 patients evaluated for physical and neuroimaging characteristics of MCAP and MPPH and propose a more global view of these syndromes based on classes of developmental abnormalities that include primary MEG and growth dysregulation, developmental vascular anomalies (primarily capillary malformations), distal limb anomalies (such as syndactyly and polydactyly), cortical brain malformations (most distinctively polymicrogyria, PMG), and variable connective tissue dysplasia. Based on these classes of developmental abnormalities, we propose that MCAP diagnostic criteria include progressive MEG with either vascular anomalies or syndactyly.

Preparing difficult clients to return to work.

Objective: Investigate the effect of the symptom magnification syndrome (SMS) behavior pattern on industrial rehabilitation on return to work and maintenance at work.

Participants: A sample of 99 clients with active workers' compensation claims was studied; 25 identified as having SMS.

Methods: A protocol-driven functional capacity evaluation (FCE) was administered and the presence of SMS was determined from a standard protocol that considered 13 factors.

"Nanoscale lattice fence" in a metal-organic framework: interplay between hinged topology and highly anisotropic thermal response.

A thermoresponsive, 3D hinged metal-organic framework (HMOF-1) assembled from meso-tetra(4-pyridyl)porphine and CdI(2) exhibits a 3D "lattice fence" topology with extraordinary thermal expansion and shrinkage. A simple structural model is established to elucidate such a drastic thermal response. The hinged structure model presented here can also be applied to other "lattice fence" topologies with little or no modification, depending on the symmetry of the molecular building blocks.

Transcriptome analysis of epithelial and stromal contributions to mammogenesis in three week prepartum cows.

Transcriptome analysis of bovine mammary development has provided insight into regulation of mammogenesis. However, previous studies primarily examined expression of epithelial and stromal tissues combined, and consequently did not account for tissue specific contribution to mammary development. Our objective was to identify differences in gene expression in epithelial and intralobular stromal compartments.

Triptolide is an inhibitor of RNA polymerase I and II-dependent transcription leading predominantly to down-regulation of short-lived mRNA.

Triptolide, a natural product extracted from the Chinese plant Tripterygium wilfordii, possesses antitumor properties. Despite numerous reports showing the proapoptotic capacity and the inhibition of NF-kappaB-mediated transcription by triptolide, the identity of its cellular target is still unknown. To clarify its mechanism of action, we further investigated the effect of triptolide on RNA synthesis in the human non-small cell lung cancer cell line A549.

Congenital hyperreninemic hypoaldosteronism in Israel: sequence analysis of CYP11B2 gene.

Background/aims: Isolated aldosterone biosynthesis defect causing congenital hyperreninemic hypoaldosteronism with otherwise normal adrenal function usually results from aldosterone synthase deficiency. Patients present with manifestations of mineralocorticoid deficiency during the first weeks of life. The largest numbers of cases have been described in Iranian Jews, who carried concomitantly two homozygous missense mutations (R181W and V386A).