Severity of Child Autistic Symptoms and Parenting Stress in Mothers of Children with Autism Spectrum Disorder in Japan and USA: Cross-Cultural Differences

The purpose of this study was to compare the relationship between parenting stress and autistic symptom severity in the U.S. and Japan. Fifty-two U.S. and 51 Japanese mothers of children aged 2-12 with autism completed measures of parenting stress and child characteristics, including the parenting stress index (PSI), the social communication questionnaire (SCQ), and social responsiveness scale-2 (SRS-2). There was a nonlinear relationship between the child\u27s autistic symptom severity and parenting stress in both countries. We also found some cultural differences: in the parent domain, the relationships between children\u27s SCQ scores and PSI scores differed significantly between the U.S. and Japan. Our findings suggest that autistic severity symptom scores may reflect cross-cultural differences in parenting beliefs, views toward autism, and response styles for evaluating children\u27s behavior. The findings also suggest that parents need support regardless of the child\u27s autism severity, including those with mild to moderate symptoms. Expanding on this line of research and understanding cultural influences on parenting stress may help service providers and agencies offer more culturally sensitive services, parent-education courses, and intervention programs

Factors associated With Blood Mercury Concentrations and their interactions With Three Glutathione S-Transferase Genes (Gstt1, Gstm1, and Gstp1): an Exposure assessment Study of Typically Developing Jamaican Children

BACKGROUND: Jamaican soil is abundant in heavy metals including mercury (Hg). Due to availability and ease of access, fish is a traditional dietary component in Jamaica and a significant source of Hg exposure. Mercury is a xenobiotic and known neuro-toxicant that affects children\u27s neurodevelopment. Human glutathione S-transferase (GST) genes, including GSTT1, GSTM1, and GSTP1, affect Hg conjugation and elimination mechanisms. METHODS: In this exposure assessment study we used data from 375 typically developing (TD) 2-8-year-old Jamaican children to explore the association between environmental Hg exposure, GST genes, and their interaction effects on blood Hg concentrations (BHgCs). We used multivariable general linear models (GLMs). RESULTS: We identified the child\u27s age, consumption of saltwater fish, canned fish (sardine, mackerel), string beans, grain, and starches (pasta, macaroni, noodles) as the environmental factors significantly associated with BHgCs (all P \u3c 0.05). A significant interaction between consumption of canned fish (sardine, mackerel) and GSTP1 in relation to BHgC using either a co-dominant or recessive genetic model (overall interaction P = 0.01 and P \u3c 0.01, respectively) indicated that consumption of canned fish (sardine, mackerel) was significantly associated with higher mean BHgC only among children with the GSTP1 Ile105Val, Ile/Ile [Ratio of mean Hg (95% CI) = 1.59 (1.09, 2.32), P = 0.02] and Ile/Val [Ratio of mean Hg (95% CI) = 1.46 (1.12, 1.91), P = 0.01] genotypes. CONCLUSIONS: Since this is the first study from Jamaica to report these findings, replication in other populations is recommended

Factors associated With Blood Mercury Concentrations and their interactions With Three Glutathione S-Transferase Genes (Gstt1, Gstm1, and Gstp1): an Exposure assessment Study of Typically Developing Jamaican Children

BACKGROUND: Jamaican soil is abundant in heavy metals including mercury (Hg). Due to availability and ease of access, fish is a traditional dietary component in Jamaica and a significant source of Hg exposure. Mercury is a xenobiotic and known neuro-toxicant that affects children\u27s neurodevelopment. Human glutathione S-transferase (GST) genes, including GSTT1, GSTM1, and GSTP1, affect Hg conjugation and elimination mechanisms. METHODS: In this exposure assessment study we used data from 375 typically developing (TD) 2-8-year-old Jamaican children to explore the association between environmental Hg exposure, GST genes, and their interaction effects on blood Hg concentrations (BHgCs). We used multivariable general linear models (GLMs). RESULTS: We identified the child\u27s age, consumption of saltwater fish, canned fish (sardine, mackerel), string beans, grain, and starches (pasta, macaroni, noodles) as the environmental factors significantly associated with BHgCs (all P \u3c 0.05). A significant interaction between consumption of canned fish (sardine, mackerel) and GSTP1 in relation to BHgC using either a co-dominant or recessive genetic model (overall interaction P = 0.01 and P \u3c 0.01, respectively) indicated that consumption of canned fish (sardine, mackerel) was significantly associated with higher mean BHgC only among children with the GSTP1 Ile105Val, Ile/Ile [Ratio of mean Hg (95% CI) = 1.59 (1.09, 2.32), P = 0.02] and Ile/Val [Ratio of mean Hg (95% CI) = 1.46 (1.12, 1.91), P = 0.01] genotypes. CONCLUSIONS: Since this is the first study from Jamaica to report these findings, replication in other populations is recommended

Factors Associated With Blood Mercury Concentrations and Their Interactions With Three Glutathione S-Transferase Genes (GSTT1, GSTM1, and GSTP1): An Exposure Assessment Study of Typically Developing Jamaican Children

BACKGROUND: Jamaican soil is abundant in heavy metals including mercury (Hg). Due to availability and ease of access, fish is a traditional dietary component in Jamaica and a significant source of Hg exposure. Mercury is a xenobiotic and known neuro-toxicant that affects children\u27s neurodevelopment. Human glutathione S-transferase (GST) genes, including GSTT1, GSTM1, and GSTP1, affect Hg conjugation and elimination mechanisms. METHODS: In this exposure assessment study we used data from 375 typically developing (TD) 2-8-year-old Jamaican children to explore the association between environmental Hg exposure, GST genes, and their interaction effects on blood Hg concentrations (BHgCs). We used multivariable general linear models (GLMs). RESULTS: We identified the child\u27s age, consumption of saltwater fish, canned fish (sardine, mackerel), string beans, grain, and starches (pasta, macaroni, noodles) as the environmental factors significantly associated with BHgCs (all P \u3c 0.05). A significant interaction between consumption of canned fish (sardine, mackerel) and GSTP1 in relation to BHgC using either a co-dominant or recessive genetic model (overall interaction P = 0.01 and P \u3c 0.01, respectively) indicated that consumption of canned fish (sardine, mackerel) was significantly associated with higher mean BHgC only among children with the GSTP1 Ile105Val, Ile/Ile [Ratio of mean Hg (95% CI) = 1.59 (1.09, 2.32), P = 0.02] and Ile/Val [Ratio of mean Hg (95% CI) = 1.46 (1.12, 1.91), P = 0.01] genotypes. CONCLUSIONS: Since this is the first study from Jamaica to report these findings, replication in other populations is recommended

Additive and interactive associations of Environmental and Sociodemographic Factors With the Genotypes of Three Glutathione S-Transferase Genes in Relation to the Blood arsenic Concentrations of Children in Jamaica

Arsenic (As) is a metalloid that has been classified as a xenobiotic with toxic effects on human beings, especially on children. Since the soil in Jamaica contains As, dietary intake is considered the main source of As exposure in Jamaicans. In addition, glutathione S-transferase (GST) genes, includin

Volatile Anesthetic and Outcome in Acute Trauma Care: Planned Secondary Analysis of the PROPPR Study

BACKGROUND: This retrospective analysis of prospectively collected data from the PROPPR study describes volatile anesthetic use in severely injured trauma patients undergoing anesthesia. METHODS: After exclusions, 402 subjects were reviewed of the original 680, and 292 had complete data available for analysis. Anesthesia was not protocolized, so analysis was of contemporary practice. RESULTS: The small group who received no volatile anesthetic (n = 25) had greater injury burden (Glasgow Coma Scale CONCLUSION: In this acutely injured trauma population, choice of volatile anesthetic did not appear to influence short-term mortality and morbidity. Subjects who received no volatile were more severely injured with greater mortality, representing hemodynamic compromise where volatile agent was limited until stable. As anesthetic was not protocolized, these findings that choice of specific volatile was not associated with short-term survival require prospective, randomized evaluation

Metabolomic Profiles in Jamaican Children With and Without Autism Spectrum Disorder

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a wide range of behavioral and cognitive impairments. While genetic and environmental factors are known to contribute to its etiology, the underlying metabolic perturbations associated with ASD which can potentially connect genetic and environmental factors, remain poorly understood. Therefore, we conducted a metabolomic case-control study and performed a comprehensive analysis to identify significant alterations in metabolite profiles between children with ASD and typically developing (TD) controls. OBJECTIVE: To elucidate potential metabolomic signatures associated with ASD in children and identify specific metabolites that may serve as biomarkers for the disorder. METHODS: We conducted metabolomic profiling on plasma samples from participants in the second phase of Epidemiological Research on Autism in Jamaica (ERAJ-2), which was a 1:1 age (±6 months)-and sex-matched cohort of 200 children with ASD and 200 TD controls (2-8 years old). Using high-throughput liquid chromatography-mass spectrometry techniques, we performed a targeted metabolite analysis, encompassing amino acids, lipids, carbohydrates, and other key metabolic compounds. After quality control and imputation of missing values, we performed univariable and multivariable analysis using normalized metabolites while adjusting for covariates, age, sex, socioeconomic status, and child\u27s parish of birth. RESULTS: Our findings revealed unique metabolic patterns in children with ASD for four metabolites compared to TD controls. Notably, three of these metabolites were fatty acids, including myristoleic acid, eicosatetraenoic acid, and octadecenoic acid. Additionally, the amino acid sarcosine exhibited a significant association with ASD. CONCLUSIONS: These findings highlight the role of metabolites in the etiology of ASD and suggest opportunities for the development of targeted interventions

The Maternal Obstetrics, Perinatal and Postnatal Factors Associated with Autism Spectrum Disorder in Jamaica

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with no well-understood etiology. Genetic factors and environmental exposures during the crucial stages of neurodevelopment may have potential role in ASD. In this study, the possible role of maternal obstetric (parity, diabetes and preeclampsia), perinatal (cesarean delivery, premature birth, and low birth weight), and postnatal (breastfeeding and its duration) factors in ASD were investigated in Jamaican children. A secondary data analysis was performed using data from the “Epidemiological Research on Autism in Jamaica (ERAJ)” study, which enrolled 343 pairs of age- and sex-matched ASD cases and typically developing controls. Conditional logistic regression analyses were used to assess the possible association of maternal obstetric, perinatal and postnatal factors with ASD while controlling for potential confounders. Additionally, interactions between the main exposures and the potential confounders were explored in relation to ASD. Matched Odds Ratios (MORs) and 95% Confidence Intervals are reported.^ Our findings suggest that the parish of residence may be an effect modifier for the association of maternal parity, and cesarean delivery with ASD in Jamaican children. Specifically, among children from mainly urban Kingston parish, the odds of ASD was 80% lower when mothers with parity ≥ 2 were compared to nulliparous mothers after adjusting for age of parents at child birth (adjusted MOR (95% CI): 0.20 (0.09-0.45), P \u3c0.001). Also, cesarean delivery was associated with higher odds of ASD among children from Kingston parish after adjusting for age of parents at child birth (adjusted MOR (95% CI) = 2.34 (1.19-4.61), P=0.013). Whereas these associations were not significant among children from other parishes. Additionally, although not statistically significant at 0.05 level, the association between low birth weight and ASD appeared to be different by the socioeconomic status (SES) after adjusting for age of mother at child birth (adjusted MOR (95% CI): 1.79 (0.89-3.64), P = 0.1 for low SES and 0.64 (0.30-1.36), P = 0.248 for high SES). Finally, the maternal age was found to be a possible effect modifier for the association between breastfeeding duration and ASD. Specifically, among mothers who were aged ≥ 35 years, the association between breastfeeding duration and ASD was marginally significant when breastfeeding for \u3e3-6, \u3e6-12, and \u3e12 months were compared to 0-3 months of breastfeeding (MOR (95%CI): 0.30 (0.09-1.09), P = 0.067; 0.44 (0.14-1.38), P = 0.159); and 0.35 (0.11-1.12), P = 0.076, respectively). Findings of this study suggest that the association of maternal, perinatal, and postnatal characteristics with ASD may vary by the area of residence and sociodemographic characteristics of the families in Jamaica. These findings require replication in future studies.

Retrograde Trans-Femoral Approach for Successful Per- cutaneous Angioplasty in a Diabetic Patient with Ischemic Hand Ulcer: A Case Report

Hand ischemia is a rare complication of diabetes and some other chronic vascular diseases. Critical hand ischemia causes painful limbs and disability and requires urgent revascularization. There have been a few reports of successful trans-brachial percutaneous angioplasty in the upper extremity in the radial or ulnar artery. Herein, we report the results of the endovascular treatment of a 68-year-old diabetic patient with an ischemic hand ulcer due to the severe stenotic lesions of the infra-brachial arteries. The patient underwent successful angioplasty via the retrograde trans-femoral technique to avoid the drawbacks. At the first week of post-procedural follow-up, the patient’s finger was warm with a well–healing wound and reduced pain. In the next two months, he had no complaint of pain or active ulceration; the ulcer was well healed, and the hand was warm. The present case shows that history taking and physical examination should be followed by upper-extremity arteriography for the evaluation of hand ischemia. The trans-femoral approach enabled us to perform percutaneous catheterization for both diagnostic and interventional purposes. Not only is this strategy useful even for the severe stenotic disease of the distal parts of below-the-elbow arteries but also it avoids the unpleasant complications of antegrade brachial cannulation