Vicarious Effort-Based Decision-Making in Autism Spectrum Disorders

This study investigated vicarious effort-based decision-making in 50 adolescents with autism spectrum disorders (ASD) compared to 32 controls using the Effort Expenditure for Rewards Task. Participants made choices to win money for themselves or for another person. When choosing for themselves, the ASD group exhibited relatively similar patterns of effort-based decision-making across reward parameters. However, when choosing for another person, the ASD group demonstrated relatively decreased sensitivity to reward magnitude, particularly in the high magnitude condition. Finally, patterns of responding in the ASD group were related to individual differences in consummatory pleasure capacity. These findings indicate atypical vicarious effort-based decision-making in ASD and more broadly add to the growing body of literature addressing social reward processing deficits in ASD

Stationary bike injuries Prompting Emergency Department presentation in pediatric patients: an epidemiological study

Objectives: Potential harms of stationary bike injuries in pediatric patients have been highlighted in the literature, but prior work is limited to case series and without population-level analysis. This study\u27s purpose is to examine the epidemiology of pediatric stationary bike injuries occurring in the US over the last decade using a national database. Methods: Injuries resulting from stationary bike use in pediatric patients from 2012-2021 were identified using coding from the National Electronic Injury Surveillance System (NEISS) database. Patient demographics, injury characteristics, and case narratives were examined. National annual estimates of injury frequency/incidence were calculated using weighting and survey package in R. Univariate analyses were used to compare injuries among groups. Results: We identified 525 stationary bike injuries representing an estimated total of 15,509 injuries in the population. Pediatric patients sustained an average of 1,551 injuries annually, with an estimated yearly increase of 288 injuries (p \u3c 0.01) after 2019. While males sustained more injuries, there were age dependent differences in frequency of injuries between sexes (p \u3c 0.01). The lower extremity was the most commonly injured body region overall, but children under 5 sustained more injuries to the head/neck and upper extremity. The most common overall injury type was lacerations, while fractures predominated the 5-9 year old age group. Fifty six percent of injuries were sustained not while riding the bike, most notably among children under 10. Conclusion: Our findings indicate the impact of stationary bike injury in the pediatric population is not insignificant and most injuries are related to improper play rather than traditional exercise use. Gender and age-related patterns differed in regards to the type and mechanism of injury sustained. Children under 5 sustain a disproportionate amount of injuries to the head, neck and upper extremity. As stationary bikes grow in popularity, preventative measures should be considered to reduce injuries to young children

Perioperative Pain Management Practices Vary Across Time and Setting for Pediatric ACL Reconstruction: Trends From a National Database in the United States.

BackgroundSurgical and anesthetic techniques have enabled a shift to the ambulatory setting for the majority of patients with anterior cruciate ligament (ACL) tears. While this change likely reflects improvements in acute pain management, little is known about national trends in pediatric perioperative pain management after ACL reconstruction (ACLR).PurposeTo describe recent trends in the United States in perioperative pain management for pediatric ACLR.Study designCross-sectional study; Level of evidence, 3.MethodsPediatric patients (age, ≤18 years) who underwent ACLR with peripheral nerve blocks between January 2008 and December 2017 were identified in the Pediatric Health Information System database. We modeled the use of oral and intravenous analgesic medications over time using Bayesian logistic mixed models. Models were adjusted for patient age, sex, race, primary payer, and treatment setting (ambulatory, observation, or inpatient).ResultsThe study criteria produced a sample of 18,605 patients. Older children were more likely to receive intravenous acetaminophen, intravenous ketorolac, and oral and intravenous opioids. Younger children were more likely to receive ibuprofen. In our adjusted logistic model, treatment setting was found to be an independent predictor of the utilization of all medications. We found an increase in the overall utilization of oral acetaminophen (adjusted odds ratio [adj OR], 1.14 [95% CI, 1.04-1.23]), intravenous acetaminophen (adj OR, 1.42 [95% CI, 1.22-1.65]), and oral opioids (adj OR, 1.16 [95% CI, 1.06-1.28]) over the study period at a typical hospital. We found significant heterogeneity in medication use across hospitals, with the most heterogeneity in intravenous acetaminophen. Other studied descriptive variables did not appear to predict practices.ConclusionAfter adjusting for patient characteristics and treatment settings, pain management strategies varied among hospitals and over time. Patient age and treatment setting predicted practices. Regional anesthesia, opioid medications, and intravenous ketorolac remained the mainstays of treatment, while intravenous acetaminophen emerged in use over the course of the study period. The variability in the pain management of pediatric patients undergoing ACLR suggests that further study is necessary to establish the most effective means of perioperative pain management in these patients