Autism spectrum disorder (ASD) in children is associated with increased risks of overweight/obesity and underweight, altered nutrient profile, and abnormal feeding behaviors. This systematic review ...aimed to elucidate the literature on the nutritional status of children with ASD in the Middle East North Africa (MENA) region, by providing a summary and assessment of the body of evidence. A systematic review of English and Arabic publications up to November 2020 was conducted of five databases in addition to the grey literature, which include a nutrition-related parameter, from both experimental and observational study designs. Children with ASD (ASD-C) between 2 and 19 years in the MENA Region were the target population. For risk of bias, the Academy of Nutrition and Dietetics' Quality Criteria Checklist (QCC) was adopted. The number of published articles was grossly limited. Forty-three articles were included, of which only four articles reported a low risk of bias; therefore, the results were interpreted in light of methodological limitations. Both overweight and underweight were common in ASD-C, although not consistently different than typically developing children. Nutrient inadequacies of energy, protein, omega-3, and others; deficiencies in serum iron indicators and calcium, as well as vitamins B12, B9, and D levels; and higher levels of homocysteine and omega-6/omega-3 ratios were reported. Feeding behavior problems were also common in ASD-C. Understanding nutritional requirements and food preferences can guide the planning of the appropriate comprehensive interventions for ASD-C. Various nutritional and behavioral concerns were identified in the included studies; however, they were subject to methodological weaknesses, which limited the generalizability of these results. Future research is warranted that must be directed to finding strong evidence using robust study designs on nutritional status and feeding behaviors of ASD-C, with a particular emphasis on the MENA Region.
Pancreatic ductal adenocarcinoma (PDAC) remains a lethal disease with a 5-year survival rate of 4%. A key hallmark of PDAC is extensive stromal involvement, which makes capturing precise ...tumor-specific molecular information difficult. Here we have overcome this problem by applying blind source separation to a diverse collection of PDAC gene expression microarray data, including data from primary tumor, metastatic and normal samples. By digitally separating tumor, stromal and normal gene expression, we have identified and validated two tumor subtypes, including a 'basal-like' subtype that has worse outcome and is molecularly similar to basal tumors in bladder and breast cancers. Furthermore, we define 'normal' and 'activated' stromal subtypes, which are independently prognostic. Our results provide new insights into the molecular composition of PDAC, which may be used to tailor therapies or provide decision support in a clinical setting where the choice and timing of therapies are critical.
Past research suggests that children, particularly those with autism spectrum disorder, with general behavioral inflexibility to objects, persons, and environments may be at risk for feeding ...problems. However, questions remain about whether feeding problems are better predicted by behavioral inflexibility or sensory sensitivity, and whether general or food-specific measures are stronger predictors. The present study compared two types of behavioral inflexibility (general, food-specific) and two types of sensory sensitivity (food touch, temperature) for their association with children’s feeding problems. Participants were 372 children and their parents who completed surveys on their children’s demographics, as well as measures of behavioral inflexibility, sensory sensitivity, and feeding problems. The children, all referred to a feeding clinic were 71.8% male and had a mean age of 71.53 months. For this sample, 33. 7% had autism spectrum disorder (ASD), 28.7% had special needs other than ASD, and 37.5% had no special needs. ANCOVAs examined child demographics (age, weight status, medical problems, gender, special needs status) for their associations with each measure of inflexibility and sensitivity, finding that ASD was associated with more general and food-specific inflexibility, and younger age was associated with more food touch sensitivity. Hierarchical multiple regressions, which controlled for demographics, including ASD diagnosis, compared the four measures of inflexibility and sensitivity as predictors for each feeding problem. These analyses found food-specific behavioral inflexibility was the only significant predictor of all three feeding problems. Results suggest reducing the severity of children’s feeding problems, clinicians focus on increasing behavioral flexibility as it relates to food.
Once a significant cause of morbidity and mortality, health care providers rarely see primary pellagra in developed countries where fortification of foods with niacin is commonplace and niacin‐rich ...foods are generally widely available. We report a ten‐year‐old boy with autism spectrum disorder who presented with photosensitive dermatitis which resolved after vitamin supplementation and dietary changes. In this child, the pellagra developed as the result of a long‐term pattern of selective eating. Restricted diets, even to the point of nutrient deficiencies, are well‐documented among children with autism spectrum disorders (ASD).
The purpose of the present study was to provide a revised and more psychometrically-examined version of the Parent Mealtime Action Scale (PMAS-R), then to examine how well the PMAS-R subscales ...explained variance for four variables relevant in clinical settings. Study participants included 238 parents of children referred to a hospital-based feeding program (72.3% male children; mean age = 72.2 months; 80 with autism spectrum disorder, 77 with other special needs, 81 with no special needs). Parents completed questionnaires to report child demographics and diet habits. Parents also used a five-point rating instead of the original three-point rating to report their usage of the 31 PMAS feeding practices. Using five-point ratings, the nine subscales of the PMAS-R demonstrated improved internal reliability and test-retest reliability compared to those published for the original PMAS. ANCOVA indicated that special needs status was the child demographic variable most associated with PMAS-R feeding practices. Hierarchical multiple regression revealed that after controlling for child demographics, the nine PMAS-R subscales explained 26–49% of the variance for four variables of clinical interest (fruit and vegetable consumption, snack consumption, total food variety, and weight status). These variables of clinical interest were most often associated with “permissive” feeding practices including low Daily Fruit and Vegetable (FV) Availability, rarely using Insistence on Eating during meals, often using Many Food Choices, and often using Child-Selected Meals. The present study provides a more psychometrically-sound measure of child feeding practices, documents the association between “permissive feeding” and variables of clinical interest, and identifies specific parent practices included in “permissive feeding”.
The present study developed the 22-item Sensory Eating Problems Scale (SEPS) to measure sensory aspects for children surrounding eating, documented psychometrics of SEPS subscales, and examined their ...association with mealtime behavior problems. Study participants were 449 caretakers of children referred to feeding clinics, including children in three special needs status groups: autism spectrum disorder (ASD), other special needs, and no special needs. Caretakers completed surveys to report children's demographics, four measures of children's mealtime behavior problems, and five-point ratings for how often children showed various sensory feeding reactions. Exploratory factor analysis of the sensory feeding items identified six SEPS subscales with acceptable goodness-of-fit, internal reliability, and test-retest reliability: Food Touch Aversion, Single Food Focus, Gagging, Temperature Sensitivity, Expulsion, and Overstuffing. ANCOVAs revealed that child demographics most associated with higher SEPS subscale scores were younger age and special needs. Multiple regression analyses found that children's mealtime behavior problems were most often associated with SEPS subscales of Food Touch Aversion, Single Food Focus, Expulsion, and Overstuffing, with the set of six subscales explaining 18–44% of variance in mealtime behavior problems. Suggestions for how clinicians and researchers may find the SEPS useful for assessment and intervention are provided.
Streambank erosion is a major contributor to watershed suspended sediments and phosphorus exports in many regions, but in Iowa and other midwestern states, the load contribution from streambanks is ...not considered by state nutrient reduction strategies. The study’s objectives were to evaluate the annual bank erosion rates measured in Iowa using erosion pins and aerial imagery and assess how recession rates vary across space, time, and stream order. The overall goal was to determine whether there are global similarities to these streambank recession rates that could be generalized and scaled up for regional assessments using data from Iowa-based erosion pin studies and original research on stream migration rates. At the erosion pin sites, the recession rates averaged approximately 11 cm yr−1 in third-order streams and, when combined with stream migration analyses, we observed scaling associated with bank recession rates at longer time scales across a range of stream orders. More bank recession occurs in larger streams and rivers with greater discharge from larger watershed areas and an increase in stream power. Variations in these bank recession rates were observed in Iowa landform regions mainly due to differences in geology and the composition of the streambank sediments. The study’s results provide a temporal and spatial context for evaluating streambank recession in Iowa and the glaciated Midwest.
Summary
Human bocavirus messenger RNA detection in nasopharyngeal specimens from children with community-acquired pneumonia (CAP) but not in asymptomatic children undergoing elective outpatient ...surgery supports the pathogenic role for this virus in CAP and may be a more specific target for diagnostic testing.
Abstract
Background
The role of human bocavirus (HBoV) in respiratory illness is uncertain. HBoV genomic DNA is frequently detected in both ill and healthy children. We hypothesized that spliced viral capsid messenger RNA (mRNA) produced during active replication might be a better marker for acute infection.
Methods
As part of the Etiology of Pneumonia in the Community (EPIC) study, children aged <18 years who were hospitalized with community-acquired pneumonia (CAP) and children asymptomatic at the time of elective outpatient surgery (controls) were enrolled. Nasopharyngeal/oropharyngeal specimens were tested for HBoV mRNA and genomic DNA by quantitative polymerase chain reaction.
Results
HBoV DNA was detected in 10.4% of 1295 patients with CAP and 7.5% of 721 controls (odds ratio OR, 1.4 95% confidence interval {CI}, 1.0–2.0); HBoV mRNA was detected in 2.1% and 0.4%, respectively (OR, 5.1 95% CI, 1.6–26). When adjusted for age, enrollment month, and detection of other respiratory viruses, HBoV mRNA detection (adjusted OR, 7.6 95% CI, 1.5–38.4) but not DNA (adjusted OR, 1.2 95% CI, .6–2.4) was associated with CAP. Among children with no other pathogens detected, HBoV mRNA (OR, 9.6 95% CI, 1.9–82) was strongly associated with CAP.
Conclusions
Detection of HBoV mRNA but not DNA was associated with CAP, supporting a pathogenic role for HBoV in CAP. HBoV mRNA could be a useful target for diagnostic testing.
We determined the molecular characteristics of methicillin-resistant staphylococci from animals and staff at a small animal and equine hospital. Methicillin-resistant Staphylococcus aureus (MRSA) ...identical to human EMRSA-15 was found in dogs and hospital staff. In contrast, 5 distinct MRSA strains were isolated from horses but not from hospital staff.
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