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\"A new team of misfits are given a second chance at life by the mysterious figure \"The Professor\"...but only if they're willing to explore the most unknown reaches of the universe. Seeking a set of powerful artifacts, the team must defeat a rival group of explorers to combine them...or the world as we know it could end.\"-- Provided by publisher.

Telehealth is a potential solution to limited access to specialized services for children with autism spectrum disorder (ASD) in rural areas. We conducted a feasibility trial of parent training with children ages 3–8 with ASD and disruptive behavior from rural communities. Fourteen children (mean age 5.8 ± 1.7) from four telehealth sites enrolled. Thirteen families (92.9%) completed treatment, with 91.6% of core sessions attended. Therapists attained 98% fidelity to the manual and 93% of expected outcome measures were collected at week 24. Eleven of 14 (78.6%) participants were rated as much/very much improved. Parent training via telehealth was acceptable to parents and treatment could be delivered reliably by therapists. Preliminary efficacy findings suggests further study is justified.

Viability of saliva samples stored for longer than 28 days has not been reported in the literature. The COVID-19 pandemic has spawned new research evaluating various sample types, thus large biobanks have been started. Residual saliva samples from university student surveillance testing were retested on SalivaDirect and compared with original RT-PCR (cycle threshold values) and quantitative antigen values for each month in storage. We conclude that saliva samples stored at -80°C are still viable in detecting SARS-CoV-2 after 12 months of storage, establishing the validity of these samples for future testing.

Monozygotic twins show high concordance in eye- and mouth-looking, and this behaviour is markedly reduced in toddlers with autism spectrum disorder. An infant's view of the social scene An early and critical aspect of infant development is visual exploration of socially relevant stimuli such as faces and biological motion. Warren Jones and colleagues present an eye-tracking study of both typically developing children and those with autism to show that several aspects of visual social engagement, including propensity to look at facial features, as well as spatial and temporal dynamics of gaze, are highly heritable. Some measures of social visual engagement that are most highly heritable, such as attention to faces, are also those that most clearly distinguish typically developing children from those with autism. The authors propose social visual engagement as a neurodevelopmental endophenotype that is not just relevant for autism, but also broader population-wide variation. Long before infants reach, crawl or walk, they explore the world by looking: they look to learn and to engage 1 , giving preferential attention to social stimuli, including faces 2 , face-like stimuli 3 and biological motion 4 . This capacity—social visual engagement—shapes typical infant development from birth 5 and is pathognomonically impaired in children affected by autism 6 . Here we show that variation in viewing of social scenes, including levels of preferential attention and the timing, direction and targeting of individual eye movements, is strongly influenced by genetic factors, with effects directly traceable to the active seeking of social information 7 . In a series of eye-tracking experiments conducted with 338 toddlers, including 166 epidemiologically ascertained twins (enrolled by representative sampling from the general population), 88 non-twins with autism and 84 singleton controls, we find high monozygotic twin–twin concordance (0.91) and relatively low dizygotic concordance (0.35). Moreover, the characteristics that are the most highly heritable, preferential attention to eye and mouth regions of the face, are also those that are differentially decreased in children with autism ( χ 2  = 64.03, P  < 0.0001). These results implicate social visual engagement as a neurodevelopmental endophenotype not only for autism, but also for population-wide variation in social-information seeking 8 . In addition, these results reveal a means of human biological niche construction, with phenotypic differences emerging from the interaction of individual genotypes with early life experience 7 .

Human interferon-induced transmembrane (IFITM) proteins inhibit the fusion of a broad spectrum of enveloped viruses, both when expressed in target cells and when present in infected cells. Upon expression in infected cells, IFITMs incorporate into progeny virions and reduce their infectivity by a poorly understood mechanism. Since only a few envelope glycoproteins (Envs) are present on HIV-1 particles, and Env clustering has been proposed to be essential for optimal infectivity, we asked if IFITM protein incorporation modulates HIV-1 Env clustering. The incorporation of two members of the IFITM family, IFITM1 and IFITM3, into HIV-1 pseudoviruses correlated with a marked reduction of infectivity. Super-resolution imaging of Env distribution on single HIV-1 pseudoviruses did not reveal significant effects of IFITMs on Env clustering. However, IFITM3 reduced the Env processing and incorporation into virions relative to the control and IFITM1-containing viruses. These results show that, in addition to interfering with the Env function, IFITM3 restricts HIV-1 Env cleavage and incorporation into virions. The lack of notable effect of IFITMs on Env clustering supports alternative restriction mechanisms, such as modification of the properties of the viral membrane.

Preferential attention to biological motion is an early-emerging mechanism of adaptive action that plays a critical role in social development. The present study provides a comprehensive longitudinal mapping of developmental change in preferential attention to biological motion in 116 infants at 7 longitudinal time points. Tested repeatedly from 2 until 24 months of age, results reveal that preferential attention to biological motion changes considerably during the first months of life. Previously reported preferences in both neonates and older infants are absent in the second month but do reemerge by month 3 and become increasingly pronounced during the subsequent two years. These results highlight the second month of life as a potentially critical transition period in social visual engagement.

Dermatomyositis (DM) and juvenile dermatomyositis (JDM) are inflammatory myopathies affecting multiple organs, including muscle and skin. Calcinosis is a complication of DM/JDM that causes significant morbidity; however, few tools exist to assess calcinosis in DM/JDM patients This study aimed to evaluate the reliability of durometry measurements to assess the firmness of calcinosis lesions in DM and JDM patients. Calcinosis firmness was measured using a handheld digital durometer. Six investigators across 3 institutions examined DM/JDM calcinosis lesions by durometry, as well as control readings in healthy unaffected skin/subcutaneous tissue in similar anatomic areas, recording three readings per site. Intra-rater and inter-rater intraclass correlations were evaluated. We enrolled 57 patients and gathered 709 measurements (443 calcinosis lesions; 266 control lesions) over eleven anatomic regions. Intra-rater reliability was high across sites, while inter-rater reliability varied, being moderate to good in most areas, but poor in the thigh and anterior calf. Durometry readings were higher in calcinosis lesions than control sites overall. Measurements moderately correlated with qualitative physician assessments. Due to our study's cross-sectional nature, we could not assess calcinosis over time. Durometry is a novel, reliable, quantitative measure in assessing and characterizing targeted calcinosis lesions of DM/JDM patients.

PURPOSE: To examine demographic and clinical characteristics of sleep problems in autistic children. METHODS: Parents of 1,185 children (mean age 9.8 ± 2.0, range 3–12 years; 80.3% boys) were recruited from the Simons Powering Autism Research (SPARK) database for the online survey. Caregivers completed the 21-item, unidimensional Pediatric Autism Insomnia Rating Scale (PAIRS), the Aberrant Behavior Checklist (ABC), the Social Communication Questionnaire (SCQ), a demographic form and a question on chronotype. We set a PAIRS score of ≥ 33 (75th percentile in this sample) to define insomnia as a clinical concern. RESULTS: The PAIRS mean was 21.8 ± 15 (range 0 to 63); 304 children were rated ≥ 33. PAIRS mean scores were higher in girls than boys (23.5 ± 14.7 vs. 21.3 ± 15.0, p = 0.044), in children ages 3–7 than those ages 8–12, (23.8 ± 15.4 vs. 21.2 ± 14.8, p = 0.022), in non-verbal children than verbal children (28.5 ± 14.7 vs. 20.5 ± 14.7, p < 0.001), and in children with evening chronotype than those with morning or neither preference (23.3 ± 14.8 vs. 20.8 ± 19.7, p < 0.01). Children with parent-reported below average IQ and children of parents without a college degree also had higher PAIRS scores. Those with ≥ 33 on PAIRS had higher scores on all ABC subscales. Unadjusted and adjusted logistic regression modeling showed that higher ABC Hyperactivity, ABC Social Withdrawal, and ABC Irritability scores, parent-reported below average IQ, and an evening chronotype significantly increased the odds of being rated ≥ 33 on the PAIRS. CONCLUSION: PAIRS can be used for insomnia screening, as an outcome measure in clinical trials and in clinical care for autistic children.

Background In simulation-based education, debriefing is necessary to promote knowledge acquisition and skill application. Rapid Cycle Deliberate Practice (RCDP) and Traditional Reflective Debriefing (TRD) are based in learning theories of deliberate practice and reflective learning, respectively. In this study, we compared the effectiveness of TRD versus RCDP on acquisition of conceptual knowledge and teamwork skills among interdisciplinary learners in the pediatric emergency department. Methods One hundred sixty-four learners including emergency department attending physicians, fellows, nurses, medical technicians, paramedics, and respiratory therapists, participated in 28 in-situ simulation workshops over 2 months. Groups were quasi-randomized to receive RCDP or TRD debriefing. Learners completed a multiple-choice test to assess teamwork knowledge. The TEAM Assessment Tool assessed team performance before and after debriefing. Primary outcomes were teamwork knowledge and team performance. Results Average pre-intervention baseline knowledge assessment scores were high in both groups (TRD mean 90.5 (SD 12.7), RCDP mean 88.7 (SD 15.5). Post-test scores showed small improvements in both groups (TRD mean 93.2 (SD 12.2), RCDP mean 89.9 (SD 13.8), as indicated by effect sizes (ES = 0.21 and 0.09, for TRD and RCDP, respectively). Assessment of team performance demonstrated a significant improvement in mean scores from pre-assessment to post-assessment for all TEAM Assessment skills in both TRD and RCDP arms, based on p -values (all p  < 0.01) and effect sizes (all ES > 0.8). While pre-post improvements in TEAM scores were generally higher in the RCDP group based on effect sizes, analysis did not indicate either debriefing approach as meaningfully improved over the other. Conclusions Our study did not demonstrate that either TRD versus RCDP was meaningfully better in teamwork knowledge acquisition or improving skill application and performance. As such, we propose Reflective Deliberate Practice as a framework for future study to allow learners to reflect on learning and practice in action.

Background Epidemiological data on childhood idiopathic nephrotic syndrome (INS) are limited. We estimated childhood INS incidence in a racially and ethnically diverse U.S. population and performed a meta-analysis of published reports to examine differences by race, ethnicity, and time. Methods One hundred seventy-five children aged 1–17 years living in the Atlanta Metropolitan Statistical Area (MSA) between 2013 and 2018 were identified by retrospective chart review. Annual INS incidence was estimated by dividing cases by population data from the Georgia Department of Public Health. We calculated pooled incidence estimates using random-effects regression models in a meta-analysis of the current and prior studies. Subgroup incidence estimates by race, ethnicity, and time were compared and tested for heterogeneity. Results One hundred seventy-five children aged 1–17 were diagnosed with INS between 2013 and 2018 in the Atlanta MSA. Average annual incidence was 2.13/100,000 (95% CI, 1.83–2.47). Twenty-four studies were included in meta-analysis. Our study was the only one to report incidence for Hispanic children, 2.13/100,000/y (95% CI, 1.40–3.10). In meta-analysis, incidence was highest in Asian children (7.14/ 100,000/y; 95% CI, 4.73–9.54), followed by Black (3.53/100,000/y; 95% CI, 2.93–4.12), and Caucasian (1.83/100,000/y; 95% CI, 1.52–2.14). Annual incidence in the U.S. was stable comparing studies performed before and after 1984, 2.05 vs. 2.26/100,000 ( p 0.08). Conclusions Risk of INS may be higher among Asian and Black children compared to White children. Incidence appears stable over time in the U.S. Future studies should use standardized methodology and assess the contribution of demographic and genetic factors to INS incidence and long-term outcomes. Graphic abstract