Sensory processing atypicalities are frequent in Autism Spectrum Disorder (ASD) and neurodevelopmental disorders (NDD). Different domains of sensory processing appear to be differentially altered in ...these disorders. In this study, we explored the sensory profile of two clinical cohorts, in comparison with a sample of typically developing children.
Behavioral responses to sensory stimuli were assessed using the Sensory Processing Measure (parent-report questionnaire). We included 121 ASD children, 17 carriers of the 16p11.2 deletion (Del 16p11.2) and 45 typically developing (TD) children. All participants were aged between 2 and 12 years. Additional measures included the Tactile Defensiveness and Discrimination Test-Revised, Wechsler Intelligence Scales and Autism Diagnostic Observation Schedule (ADOS-2). Statistical analyses included MANCOVA and regression analyses.
ASD children score significantly higher on all SPM subscales compared to TD. Del16p11.2 also scored higher than TD on all subscales except for tactile and olfactory/taste processing, in which they score similarly to TD. When assessing sensory modulation patterns (hyper-, hypo-responsiveness and seeking), ASD did not significantly differ from del16p11.2. Both groups had significantly higher scores across all patterns than the TD group. There was no significant association between the SPM Touch subscale and the TDDT-R.
Sensory processing was assessed using a parent-report questionnaire. Even though it captures observable behavior, a questionnaire does not assess sensory processing in all its complexity. The sample size of the genetic cohort and the small subset of ASD children with TDDT-R data render some of our results exploratory. Divergence between SPM Touch and TDDT-R raises important questions about the nature of the process that is assessed.
Touch and olfaction/taste seem to be particularly affected in ASD children compared to del16p11.2. These results indicate that parent report measures can provide a useful perspective on behavioral expression. Sensory phenotyping, when combined with neurobiological and psychophysical methods, might have the potential to provide a better understanding of the sensory processing in ASD and in other NDD.
Tracheal intubation is common in the care of critically ill adults and is frequently complicated by hypotension, cardiac arrest, or death. We aimed to evaluate administration of an intravenous fluid ...bolus to prevent cardiovascular collapse during intubation of critically ill adults.
We did a pragmatic, multicentre, unblinded, randomised trial in nine sites (eight ICUs and one emergency department) around the USA. Critically ill adults (≥18 years) undergoing tracheal intubation were randomly assigned (1:1, block sizes of 2, 4, and 6, stratified by study site) to either an intravenous infusion of 500 mL of crystalloid solution or no fluid bolus. The primary outcome, assessed in the intention-to-treat population, was cardiovascular collapse, defined as a new systolic blood pressure <65 mm Hg; new or increased vasopressor receipt between induction and 2 min after tracheal intubation; or cardiac arrest or death within 1 h of tracheal intubation. Adverse events were assessed in the as-treated population. This trial, which is now complete, is registered with ClinicalTrials.gov, number NCT03026777.
Patients were enrolled from Feb 6, 2017, to Jan 9, 2018, when the data and safety monitoring board stopped the trial on the basis of futility. By trial termination, 337 (63%) of 537 screened adults had been randomly assigned. Cardiovascular collapse occurred in 33 (20%) of 168 patients in the fluid bolus group compared with 31 (18%) of 169 patients in the no fluid bolus group (absolute difference 1·3% 95% CI -7·1% to 9·7%; p=0·76). The individual components of the cardiovascular collapse composite outcome did not differ between groups (new systolic blood pressure <65 mm Hg 11 7% in the bolus group vs ten 6% in the no-bolus group, new or increased vasopressor 32 19% vs 31 18%, cardiac arrest within 1 h seven 4% vs two 1%, death within 1 h of intubation two 1% vs one 1%). In-hospital mortality was not significantly different in the fluid bolus group (48 29%) compared with no fluid bolus (59 35%).
Administration of an intravenous fluid bolus did not decrease the overall incidence of cardiovascular collapse during tracheal intubation of critically ill adults compared with no fluid bolus in this trial.
US National Institutes of Health.
This volume developed from a Workshop on Natural Locomotion in Fluids and on Surfaces: Swimming, Flying, and Sliding which was held at the Institute for Mathematics and its Applications (IMA) at the ...University of Minnesota, from June 1-5, 2010. The subject matter ranged widely from observational data to theoretical mechanics, and reflected the broad scope of the workshop. In both the prepared presentations and in the informal discussions, the workshop engaged exchanges across disciplines and invited a lively interaction between modelers and observers. The articles in this volume were invited and fully refereed. They provide a representative if necessarily incomplete account of the field of natural locomotion during a period of rapid growth and expansion. The papers presented at the workshop, and the contributions to the present volume, can be roughly divided into those pertaining to swimming on the scale of marine organisms, swimming of microorganisms at low Reynolds numbers, animal flight, and sliding and other related examples of locomotion.
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