Use of Memantine in Autism Spectrum Disorder: a Case Report

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder of varying severity and phenotypic expression that is characterized by persistent deficits in social relatedness, communication skills, and interfering repetitive behaviors. Associated behavioral pathology can include inattention, aggression, irritability, hyperactivity, anxiety, and self-injury. Currently, FDAapproved treatments exist to treat secondary symptoms but not core symptomatology. The etiology of autism and other ASD is thought to be multifactorial but is not well understood. Some studies suggest that glutamate excitotoxicity may play a role in the pathogenesis of ASD. Memantine, an NMDAreceptor antagonist, could potentially address core symptoms in ASD by targeting disease-specific pathophysiology. Our patient, an 11-year-old Caucasian male, began treatment with memantine following parental request after learning of a phase II clinical trial utilizing the drug for treatment in autism. Following one month of receiving memantine 5mg daily the patient reportedly began showing increased verbal communication at home. Despite the patient not exhibiting verbal communication on patient interview at the clinic, the guardians reported that the patient had begun using 30 plus newly learned words, and had learned to communicate via sign language. Continued improvement in communication was noted over the course of one year of treatment with memantine. Memantine is not yet approved for treatment of ASD. However, in this case it appeared effective for treating core deficits in verbal and non-verbal communication in a child with autism

Creative destruction in science

Drawing on the concept of a gale of creative destruction in a capitalistic economy, we argue that initiatives to assess the robustness of findings in the organizational literature should aim to simultaneously test competing ideas operating in the same theoretical space. In other words, replication efforts should seek not just to support or question the original findings, but also to replace them with revised, stronger theories with greater explanatory power. Achieving this will typically require adding new measures, conditions, and subject populations to research designs, in order to carry out conceptual tests of multiple theories in addition to directly replicating the original findings. To illustrate the value of the creative destruction approach for theory pruning in organizational scholarship, we describe recent replication initiatives re-examining culture and work morality, working parents\u2019 reasoning about day care options, and gender discrimination in hiring decisions. Significance statement It is becoming increasingly clear that many, if not most, published research findings across scientific fields are not readily replicable when the same method is repeated. Although extremely valuable, failed replications risk leaving a theoretical void\u2014 reducing confidence the original theoretical prediction is true, but not replacing it with positive evidence in favor of an alternative theory. We introduce the creative destruction approach to replication, which combines theory pruning methods from the field of management with emerging best practices from the open science movement, with the aim of making replications as generative as possible. In effect, we advocate for a Replication 2.0 movement in which the goal shifts from checking on the reliability of past findings to actively engaging in competitive theory testing and theory building. Scientific transparency statement The materials, code, and data for this article are posted publicly on the Open Science Framework, with links provided in the article

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Effects of prenatal care on maternal postpartum behaviors

Prenatal care, First trimester care, Smoking, Postpartum smoking, Well-baby care, Pediatric care, Breastfeeding,  I12, J13,

Genetic variants and pathways implicated in a pediatric inflammatory bowel disease cohort

In the United States, approximately 5% of individuals with inflammatory bowel disease (IBD) are younger than 20 years old. Studies of pediatric cohorts can provide unique insights into genetic architecture of IBD, which includes Crohn's disease (CD) and ulcerative colitis (UC). Large genome-wide association studies have found more than 200 IBD-associated loci but explain a minority of disease variance for CD and UC. We sought to characterize the contribution of rare variants to disease development, comparing exome sequencing of 368 pediatric IBD patients to publicly available exome sequencing (dbGaP) and aggregate frequency data (ExAC). Using dbGaP data, we performed logistic regression for common variants and optimal unified association tests (SKAT-O) for rare, likely-deleterious variants. We further compared rare variants to ExAC counts with Fisher's exact tests. We did pathway enrichment analysis on the most significant genes from each comparison. Many variants overlapped with known IBD-associated genes (e.g. NOD2). Rare variants were enriched in CD-associated loci (p = 0.009) and showed suggestive enrichment in neutrophil function genes (p = 0.05). Pathway enrichment implicated immune-related pathways, especially cell killing and apoptosis. Variants in extracellular matrix genes also emerged as an important theme in our analysis