1. Biagioli V, Matera M, Cavecchia I, Di Pierro F, Zerbinati N, Striano P. Gut Microbiota and Autism: Unlocking Connections. Nutrients. 2025; 17(23).

Background: Autism Spectrum Disorder (ASD) is a multifactorial neurodevelopmental condition in which genetic predisposition interacts with environmental factors. Among these, the gut microbiota has emerged as a crucial modulator of the microbiota-gut-brain axis (MGBA), influencing neuroinflammation, neurotransmission, and behavior. This review aims to provide an updated and integrative overview of the relationship between gut microbiota, diet, and neurodevelopment in ASD. Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science for articles published between 2010 and 2025. Original studies, systematic reviews, and meta-analyses in English were included. Results: Evidence from human and animal studies supports a strong association between gut dysbiosis and ASD-related behaviors. Alterations in microbial composition, characterized by reduced Bifidobacterium and Prevotella and increased Clostridium spp., have been linked to impaired intestinal barrier function, chronic inflammation, and altered production of microbial metabolites such as short-chain fatty acids and tryptophan derivatives. Discussion: Maternal dysbiosis, nutritional imbalances, and perinatal stressors may further modulate fetal neurodevelopment through immune and epigenetic pathways. Emerging data suggest that dietary modulation, targeted nutritional interventions, functional foods, prebiotics, probiotics, and postbiotics could help restore microbial balance and improve neurobehavioral outcomes. Conclusions: The gut microbiota represents a key biological interface between environment, metabolism, and neurodevelopment. It is, therefore, necessary to transform current knowledge about the microbiota and neurodevelopment into clinical, social, and health actions that offer real solutions to people with ASD and their families. From this perspective, focusing on prevention, promoting healthy lifestyles, and integrating new technologies represent the true tools for building a more sustainable and inclusive healthcare system.

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2. Bjørklund G. Zinc deficiency and zinc/copper ratio imbalance in autism spectrum disorder: a reanalysis of six multinational studies. Biometals. 2025.

Disturbances in zinc (Zn) and copper (Cu) homeostasis have emerged as reproducible biochemical features of autism spectrum disorder (ASD). This study presents an integrative reanalysis of six investigations (2014-2025) encompassing serum, whole-blood, and plasma measurements in ASD cases and controls, and one supplementation trial. Three case-control studies reporting mean ± SD values in circulating matrices were meta-analyzed. Circulating Zn levels were significantly lower in ASD (fixed-effect Hedges’ g = -0.95; 95% CI -1.22 to -0.68; Q = 1.72, p = 0.42; I(2) = 0%; Egger intercept = 4.86, one-sided p = 0.044). The Zn/Cu ratio showed greater dispersion (random-effects g = -1.28; 95% CI -2.59 to 0.03; Q = 39.5, p < 0.001; I(2) = 95%), driven primarily by one cohort (leave-one-out g = -0.63; 95% CI -0.99 to -0.26). In Brazilian subjects, plasma Zn and Cu fell within reference ranges, consistent with short-term plasma buffering of marginal deficits. In an Egyptian 12-week oral elemental Zn intervention in children with ASD, serum Cu fell by ~8%, circulating metallothionein (MT) protein increased, and CARS and TGMD-2 motor scores improved. MT-1A gene expression changed with Zn. Taken together, the evidence indicates that Zn insufficiency and altered Cu homeostasis are recurring features of ASD and that oral elemental Zn lowers serum Cu and increases MT.

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3. Cazares C, Hutton A, Paez G, Trauner D, Voytek B. Cannabidiol blood metabolite levels after cannabidiol treatment are associated with broadband EEG changes and improvements in visuomotor and non-verbal cognitive abilities in boys with autism requiring higher levels of support. medRxiv. 2025.

Oral cannabidiol (CBD) treatment has been suggested to alleviate severe symptoms of autism spectrum disorder (ASD). While many CBD preparations have been studied in clinical trials involving ASD, none has used purified CBD preparations or preparations approved by the U.S. Food and Drug Administration, nor have they focused on children with ASD with higher support needs. Previous studies have identified several candidate electrophysiological biomarkers of cognitive and behavioral disabilities in ASD, with emerging biomarkers including periodic (oscillatory) and aperiodic measures of neural activity. We analyzed electroencephalography (EEG) recordings from 24 boys with ASD and higher support needs (aged 7-14 years) from a prior double-blind, placebo-controlled, crossover Phase II Clinical Trial ( NCT04517799 ) that investigated whether 8 weeks of daily CBD treatment (up to 20 mg/kg/day) improved severe behavioral problems, measured at baseline, post-CBD, post-placebo, and post-washout. Using linear mixed effect models, we found that aperiodic EEG measures varied with CBD metabolite levels in blood, as evidenced by a larger aperiodic offset across the scalp and a decreased aperiodic exponent across occipital electrodes. Furthermore, CBD metabolite levels in blood had a positive association with receptive vocabulary, nonverbal intelligence and visuomotor coordination. Our data suggest that this daily CBD preparation and administration schedule produced mixed effects, with some children showing improvements in cognitive and behavioral abilities while others demonstrated limited changes. Our findings support the inclusion of aperiodic EEG measures alongside traditional oscillatory EEG measures as candidate biomarkers for tracking the variable clinical impact of purified CBD treatment in children with ASD.

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4. Chandran S, Shetty H, Mathew A, Rao V, Mysore A. A Qualitative, multitiered operational research model for teenagers and young adults with autism: Actionable insights from an Indian context. Indian J Psychiatry. 2025; 67(11): 1040-58.

BACKGROUND: Teenagers and young adults (TYA) with autism spectrum disorder (ASD) in India face systemic barriers in education, employment, and healthcare, worsened by the lack of culturally tailored services. AIM: This study aimed to design and validate a culturally sensitive assessment framework for TYA with ASD, incorporating expert and caregiver input to identify barriers and inform scalable interventions. METHODS: Using an operational research design, we integrated real-time interventions with a three-tiered assessment framework (clinical, home-based, and community evaluations). Forty-three participants aged ≥14 years were recruited via convenience sampling. Standardized tools (Vineland Adaptive Behavior Scale-2, DSM-5 Clinician-Rated Severity, Wechsler Abbreviated Scale of Intelligence-II) and structured interviews guided individualized interventions, including behavioral, pharmacological, and vocational strategies. Manual thematic analysis with inter-coder reliability provided qualitative insights. RESULTS: Significant psychiatric comorbidities were found in 82.9% of participants [e.g. Intellectual Disability, Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety], alongside high school dropout rates (31.7%) due to the behavioral and academic challenges, and limited vocational training access (17%). Gender disparities showed males with externalizing behaviors and females often underdiagnosed due to internalizing symptoms. Families reported financial strain, caregiver burnout, and social isolation, with siblings experiencing both neglect and support roles. Thematic analysis highlighted needs for family support networks, sexuality education, and vocational day centers, leading to targeted services launched in November 2024. CONCLUSION: This study, one of India’s first to combine multidisciplinary assessments with real-time interventions, offers a replicable framework for scalable, family-centered ASD care. It underscores the need for adaptive policies and targeted interventions to address systemic barriers in education, mental health, and vocational integration for TYA with ASD.

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5. Cheak-Zamora N, Smith J, Howard M, Malow B, Sohl K, Mazurek M. The Power of ECHO Autism: Improving Confidence and Holistic Care for Autistic Adults. J Intellect Disabil Res. 2025.

BACKGROUND: Autistic adults describe difficulties accessing high-quality primary care services. Primary care practitioners (PCPs) report a lack of confidence and knowledge in working with autistic adults. The Extension for Community Healthcare Outcomes (ECHO) model is a longitudinal clinician education program that utilises a ‘hub and spoke’ model, community-building strategies and peer case-based learning to improve the care of patients with medical complexity. METHODS: The present study utilised the ECHO model (‘ECHO Autism Adult Healthcare’) to train PCPs in how to best care for autistic adults. We used a qualitative approach to examine the PCPs’ subjective experiences of participating in the training. We used a qualitative descriptive framework to explore the experiences of 22 PCPs who completed the ECHO Autism Adult Healthcare program. Semi-structured Zoom interviews examined the support and education needs of PCPs and the benefits and challenges of the program. Three researchers worked collaboratively to code transcripts, testing inter-rater reliability to establish reliability and coding consistency. RESULTS: Four themes were identified: (1) the benefits of hearing from a wide range of perspectives, (2) establishing and supporting an interactive and engaging climate, (3) building a sense of community and (4) the meaningfulness and usability of resources and information. Overall, participants appreciated the multidisciplinary hub team members’ expertise, especially those with lived experiences. Several participants enjoyed the ECHO format, as it encourages active discussion and engagement. PCPs indicated that they felt connected with the hub team and participants. They remarked on the usefulness of provided resources and their ability to implement them into clinical care. CONCLUSION: These results can guide the development and implementation of future training programs. The ECHO model has the potential to become a best practice for delivering medical education. Broad implementation of the ECHO model shows significant benefits for PCPs and patients with medical complexity compared to more traditional forms of CME.

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6. Furukawa M, Wada-Hiraike O, Enomoto Y, Tsuchimochi S, Iriyama T, Sasabuchi Y, Yasunaga H, Hirota Y, Osuga Y. Association of maternal endometriosis with autism spectrum disorder in offspring: a retrospective cohort study. BMC Pregnancy Childbirth. 2025.

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7. Güleç A, Gerik-Celebi HB, Demiral M. Concomitant Mosaic Turner Syndrome and Congenital Adrenal Hyperplasia in 1 of 3 Patients of USP9X Variant-Associated Autism Spectrum Disorder. Mol Syndromol. 2025; 16(6): 615-23.

INTRODUCTION: X-linked intellectual developmental disorder 99 (XLID99) is a rare neurodevelopmental disorder associated with mutations in the USP9X gene. This study reports on 3 patients diagnosed with autism spectrum disorder (ASD), highlighting novel genetic findings. CASE PRESENTATION: Among the 3 patients, two male siblings exhibited a novel USP9X gene missense variant, while the third, a female, presented a unique deletion of the USP9X gene alongside adrenal insufficiency and mosaic Turner syndrome. This variant has not been reported in public databases and may influence ASD development. CONCLUSION: This report documents the first instance of a triple diagnosis of XLID99, Turner syndrome, and congenital adrenal hyperplasia. Findings underline the significance of genetic evaluation in ASD for identifying rare and complex diagnoses.

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8. Itagaki T, Sakata KI, Sato J, Hasebe A. Comment on Retuerto et al. Analysis of Gut Bacterial and Fungal Microbiota in Children with Autism Spectrum Disorder and Their Non-Autistic Siblings. Nutrients 2024, 16, 3004. Nutrients. 2025; 17(23).

We would like to comment on the recently published article by Retuerto et al […].

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9. Kahonde C, Modula MJ. Parenting Among People With Intellectual and Developmental Disabilities in South Africa. J Appl Res Intellect Disabil. 2025; 38(6): e70156.

BACKGROUND: Research on intellectual and developmental disabilities is increasing in South Africa. However, sexuality and reproductive health, particularly parenthood for people with intellectual and developmental disabilities and supporting policies and health systems, are neglected areas. METHODS: This brief report was guided by a desktop search of literature from South Africa on definitions and perspectives on intellectual and developmental disabilities, services and societal attitudes on sexuality and parenthood. The subheadings used in the report were used to do a scoping of evidence on each topic. RESULTS: Although some research has been conducted on intellectual and developmental disabilities and sexuality, a direct focus on parenting, for example lived experiences of people with intellectual and developmental disabilities, services and parenting outcomes is lacking. CONCLUSION: Researchers, policy makers and relevant practitioners must recognise parenting as a human right for people with intellectual and developmental disabilities and prioritise parenting in research, policy and practice.

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10. Kopańska M, Łucka I, Siegel M, Trojniak J, Pąchalska M. From ARFID to Binge Eating: A Review of the Sensory, Behavioral, and Gut-Brain Axis Mechanisms Driving Co-Occurring Eating Disorders in Children and Adolescents with Autism Spectrum Disorder. Nutrients. 2025; 17(23).

Background: Autism spectrum disorder (ASD) constitutes a heterogeneous neurodevelopmental condition frequently accompanied by considerable disturbances in feeding behavior and nutritional balance. These difficulties arise from complex and multifactorial mechanisms, exerting a significant impact on physical health, metabolic homeostasis, and psychosocial functioning. The present review aims to provide a critical synthesis of current evidence regarding the underlying biological and behavioral mechanisms of feeding difficulties in ASD and to delineate the spectrum of comorbid eating disorders within this population. Methods: A narrative review of the peer-reviewed scientific literature was undertaken, emphasizing studies investigating the interrelationship between ASD and nutritional functioning in pediatric and adolescent populations. Particular focus was placed on research exploring sensory processing abnormalities, gut microbiota alterations, and the clinical manifestation of eating disorders in individuals with ASD. Results: The analysis revealed that sensory hypersensitivity, behavioral inflexibility, and disturbances within the gut-brain axis constitute principal determinants of atypical eating patterns in ASD. Individuals on the autism spectrum frequently exhibit pronounced food selectivity, neophobia, and symptoms consistent with Avoidant/Restrictive Food Intake Disorder (ARFID). Furthermore, an increased prevalence of anorexia nervosa and orthorexia nervosa has been documented, likely reflecting shared cognitive and behavioral features with ASD. « Emotional eating » tendencies and a marked preference for high-caloric, energy-dense foods-often potentiated by psychopharmacological treatment and reduced physical activity-further contribute to an elevated risk of overweight and obesity. Conclusions: Children and adolescents with ASD display a bimodal distribution of body mass, encompassing both undernutrition and obesity, indicative of a multifaceted interplay among sensory, behavioral, cognitive, and metabolic determinants. A comprehensive understanding of this heterogeneity is crucial for the development of individualized, evidence-based interventions integrating nutritional management with behavioral and psychotherapeutic approaches.

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11. Lokray S, Zikopoulos B, Yazdanbakhsh A. Structural changes in autism reflect atypical brain network organization and phenotypical heterogeneity: a hybrid deep network approach. bioRxiv. 2025.

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by heterogeneity in social and emotional responses, language, and behavior. Assessments such as the Social Responsiveness Scale (SRS) can quantify this variability but understanding underlying mechanisms and identifying distinct and shared atypical organization and function of brain networks remains a challenge. Convolutional Neural Networks (CNNs) have been used to analyze imaging data. However, the relationship between structural brain changes observed in structural MRI (sMRI), the affected brain functional networks inferred from these structural changes, and their connection to ASD phenotypes and scores still requires systematic investigation. In this study, we ensembled 3D CNNs with other artificial intelligence (AI) methods to conduct a comprehensive analysis of macrostructural changes in ASD. We found consistently dominant involvement of (a) the left hemisphere, (b) the frontal and temporal lobe, and (c) the default mode, salience, and language networks in ASD. Our findings highlighted brain network similarities and differences between high and low severity ASD and showed that typically developed brains fall at the low-severity end of the high-to-low severity spectrum of ASD. Our systematic AI approach utilized the phenotypic heterogeneity and spectral nature of ASD to uncover significant structural changes across brain regions and functional networks, correlating the structural, functional, and phenotypical heterogeneity of individuals with ASD. This enabled us to identify known and novel global and local brain region and network changes in ASD in relation to phenotypes and clinical scores that can guide diagnostic subtyping.

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12. Mandorfer M, Jachs M, Carvalho T, Reiberger T. Editorial: ICG-R15 by PDD-A Simple Dynamic Tool for Refining Risk Stratification in Compensated Advanced Chronic Liver Disease. Authors’ Reply. Aliment Pharmacol Ther. 2025.

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13. McCalla K, McGuire JF. Optimizing cognitive Behavioral therapy to treat anxiety among youth with autism spectrum disorders. Expert Rev Neurother. 2025.

INTRODUCTION: Anxiety disorders are among the most common co-occurring mental health conditions for autistic youth. While sometimes challenging to recognize, symptoms of anxiety can cause significant distress, functional impairment, and lead to a reduced quality of life. Thus, the effective treatment of co-occurring anxiety among autistic youth has considerable clinical importance. Cognitive behavioral therapy (CBT) has been shown to effectively treat clinically significant anxiety among children and adolescents, with specific modifications made to address challenges that often accompany autism spectrum disorders (ASD). AREAS COVERED: The authors have based this article on a comprehensive literature search that identified the extant evidence-based literature on CBT for anxiety among autistic youth in randomized controlled trials (RCTs). This review identified and synthesized modifications used to enhance treatment engagement and therapeutic efficacy. EXPERT OPINION: There are several evidence-based CBT protocols for autistic youth with anxiety disorders which include key modifications. Given the limited training opportunities in CBT for autistic youth, these protocol provide an initial framework for therapists to use when implementing CBT to treat anxiety disorders among autistic youth. It can also provide a path forward for personalized treatment approaches among this vulnerable and underserved population, as well as future directions for treatment (e.g. CBT protocols for depression).

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14. Peltekidi A, Jotautis V, Tzitiridou-Chatzopoulou M, Georgakopoulou VE, Sousamli A, Diamanti A, Vivilaki V, Orovou E, Sarantaki A. Maternal Smoking During Pregnancy and Risk of Autism Spectrum Disorder in Offspring: A Systematic Review and Meta-Analysis. J Clin Med. 2025; 14(23).

Background/Objectives: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by persistent social-communication deficits and repetitive behaviors. While genetic factors play a major role, prenatal environmental exposures may also contribute. Maternal smoking during pregnancy is a known risk factor for adverse perinatal outcomes, but its association with ASD remains unclear. Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. A comprehensive literature search was performed in PubMed, Embase, Web of Science, Scopus, PsycINFO, and Google Scholar up to September 2025. Eligible observational studies evaluated maternal active smoking during pregnancy and ASD diagnosis in offspring. Effect estimates were pooled using a random-effects model and expressed as relative risks (RR) with 95% confidence intervals (CI). Heterogeneity was quantified using I(2), with subgroup and sensitivity analyses performed. Results: Twenty-one studies including several million mother-child pairs met the inclusion criteria. The pooled RR for ASD associated with maternal smoking was 1.01 (95% CI: 0.95-1.08), indicating no significant association. Subgroup and sensitivity analyses confirmed the robustness of the findings, with no evidence of publication bias. Conclusions: Maternal smoking during pregnancy does not appear to increase ASD risk in offspring. Nevertheless, smoking cessation remains critical due to established adverse fetal effects.

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15. Pultsina KI, Kozunova GL, Chernyshev BV, Prokofyev AO, Tretyakova VD, Novikov AY, Rytikova AM, Stroganova TA. Neural adaptation to expected uncertainty in neurotypical adults and high-functioning adults with autism spectrum disorder. Cogn Affect Behav Neurosci. 2025.

The ability to adjust brain resources to manage expected uncertainty is hypothesized to be impaired in autism spectrum disorder (ASD), although the evidence remains limited. To investigate this, we studied 29 neurotypical (NT) and 29 high-functioning adults with ASD performing a probabilistic two-alternative value-based task while undergoing magnetoencephalography (MEG) and pupillometry. The task comprised five sequential blocks with stable reward probabilities (70%:30%), but varying stimulus pairs and reward values, enabling assessment of behavioral and neural adaptation to expected uncertainty. We analyzed a hit rate of advantageous choices, response times, and computational measures of prior belief strength and precision. To examine cortical activation during decision-making, we used MEG source reconstruction to quantify α-β oscillation suppression in decision-relevant cortical regions within the predecision time window. Linear mixed models assessed trial-by-trial effects. Behaviorally, ASD participants exhibited lower overall belief precision but intact probabilistic rule generalization, showing gradual performance improvement and strengthening of prior beliefs across blocks. However, unlike NT individuals, they did not show progressive downscaling of neural activation during decision-making or reduction in neural response to feedback signals as performance improved. Furthermore, on a trial-by-trial basis, increased belief precision in ASD was not associated with reduced cortical activation, a pattern observed in NT individuals. These findings suggest an atypically rigid and enhanced allocation of neural resources to advantageous decisions in individuals with ASD, although they, as NT individuals, rationally judge such decisions as optimal. This pattern may reflect an aversive response to the irreducible uncertainty inherent in probabilistic decision-making.

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16. Retuerto M, Al-Shakhshir H, Herrada J, McCormick TS, Ghannoum MA. Reply to Itagaki et al. Comment on « Retuerto et al. Analysis of Gut Bacterial and Fungal Microbiota in Children with Autism Spectrum Disorder and Their Non-Autistic Siblings. Nutrients 2024, 16, 3004 ». Nutrients. 2025; 17(23).

Thank you for your commentary on our recent article, « Analysis of Gut Bacterial and Fungal Microbiota in Children with Autism Spectrum Disorder and Their Non-Autistic Siblings » (Retuerto et al […].

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17. Risberg A, Edner A. Long-Term Beneficial Effects of Dog Assisted Therapy on Depressive Symptoms in a Patient with Atypical Autism. Int Med Case Rep J. 2025; 18: 1553-6.

This single-case study was conducted on a 34-year-old woman diagnosed with therapy-resistant depression and co-occurring atypical autism. The subject had been kept on the same medications for eight years despite her condition not improving and at the same time experiencing side effects. Previous studies and patient experiences suggest that many physicians are reluctant to end prescribed medication even if the patient is experiencing inadequate benefits and questionable effects. Co-occurring diseases often share overlapping symptoms, which can make accurate diagnosis and treatment more challenging, such as for patients with depression and autism. The problem becomes even more complicated when looking into the long-term treatment of depression occurring alongside autism spectrum disorder (ASD). The focus of conducting this case study was to determine the effect of DAT on a patient with confirmed therapy-resistant depression and ASD and if DAT would provide long-term benefit for the subject. The study’s results indicate that the patient experienced both quick improvement and long-term positive outcomes of DAT and is now in her 10th-year symptom-free.

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18. Rouphael M, Bitar T, Alarcan H, Gerges P, Sacre Y, Andres CR, Hleihel W. Exploration of Homocysteine Metabolism and Genetics in Autism Spectrum Disorder. Nutrients. 2025; 17(23).

BACKGROUND: Understanding the genetic and metabolic profiles of individuals diagnosed with Autism Spectrum Disorder (ASD) is important for clarifying the biological characteristics of this complex disorder. OBJECTIVES: Given the limited data available for the Lebanese population, this case-control study aimed to investigate the association between common MTHFR variants and ASD risk and to examine differences in homocysteine metabolism between Lebanese individuals with ASD and neurotypical controls. METHODS: From June 2022 to June 2023, 86 individuals with ASD and 86 controls matched for age and sex were recruited. Genotyping of the rs1801133 and rs1801131 variants and biochemical measurements were performed, followed by comparative statistical analyses. RESULTS: Our results showed no significant association between the rs1801133 or rs1801131 variants and ASD risk (p > 0.05). However, the sample size was not sufficient to rule out small genetic effects. Metabolic analyses revealed significantly higher homocysteine concentrations and lower vitamin B9 levels in the ASD group (p < 0.0001), while vitamin B12, fasting glucose, and lipid profiles did not differ significantly between groups (p > 0.05). Among individuals with ASD, the TT genotype of rs1801133 was associated with elevated homocysteine concentrations (OR = 9.10, p = 0.014), whereas neither MTHFR variant was associated with vitamin B12 or B9 levels in ASD or control participants. CONCLUSIONS: Future research directions could focus on exploring the role of key enzymes associated with hyperhomocysteinemia in individuals with ASD and on replicating these preliminary findings in larger, adequately powered cohorts.

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19. Salloum-Asfar S, Ltaief SM, Taha RZ, Nour-Eldine W, Abdulla SA, Al-Shammari AR. Correction: Salloum-Asfar et al. MicroRNA Profiling Identifies Age-Associated MicroRNAs and Potential Biomarkers for Early Diagnosis of Autism. Int. J. Mol. Sci. 2025, 26, 2044. Int J Mol Sci. 2025; 26(23).

The authors wish to make the following corrections to this paper […].

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20. Trancón LL, López-Resa P. Indicators Used to Identify ARFID: A Cross-Sectional Study with Professionals in Spain. Nutrients. 2025; 17(23).

Background/Objectives: Avoidant/Restrictive Food Intake Disorder (ARFID) frequently co-occurs with Autism Spectrum Disorder (ASD), yet its detection and assessment remain challenging. This study aimed to analyze terminology and professionals’ views on features and indicators related to ARFID among Spanish professionals working with autistic individuals, identifying potential gaps and training needs. Methods: A cross-sectional study was conducted with 194 professionals (62 speech therapists, 62 psychologists, and 70 occupational therapists) from different regions of Spain, who completed a 13-item questionnaire on their familiarity with terminology, definitions, and features they consider indicative to ARFID. Descriptive analyses and chi-square tests were applied to explore interprofessional differences. Results: Significant differences emerged across disciplines (p < 0.001). Psychologists showed greater familiarity with DSM-5 diagnostic criteria (78%), while speech-language therapists (72%) and occupational therapists (69%) more frequently endorsed sensory, oromotor, and behavioral features as relevant. Across all groups, 61% reported uncertainty about ARFID diagnostic criteria, and only 34% reported familiarity with validated assessment tools. Conclusions: Spanish professionals working with ASD populations demonstrate heterogeneous and generally limited understanding of the features they associate with ARFID, with discipline-specific approaches to assessment. These findings provide initial evidence in Spanish-speaking contexts and underscore the need for structured training and validated Spanish-adapted instruments to support early and accurate ARFID identification.

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21. van Asselt A, Roke Y. Co-creating the Stress Autism Mate (SAM): development of an mHealth application for autistic adults using a design thinking approach. Health Psychol Behav Med. 2025; 13(1): 2597607.

BACKGROUND: Mobile health (mHealth) applications are becoming increasingly popular for delivering mental health support, yet insights on how to tailor them effectively for autistic individuals remain limited. METHODS: This paper describes the co-creation process of the Stress Autism Mate (SAM), a free, evidence-based stress management application for autistic adults. RESULTS: Development was guided by the five stages of the Design Thinking framework: Empathise, Define, Ideate, Prototype, and Test. Various challenges encountered over seven years of development are outlined, along with the iterative refinements made to address them. Based on continuous feedback from autistic adults, development emphasised a minimalist, predictable interface, essential personalisation options, and stress-related insights readily applicable to daily life. DISCUSSION: The lessons learned may offer practical guidance for designing tailored mHealth applications for autistic adults and other populations with specific needs or preferences.

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22. Wallenberger YH, Uljarevic M, Chetcuti L, Putnam SP. Processes Associated with the Development of Depression in Autistic Individuals: A Narrative Review. Healthcare (Basel). 2025; 13(23).

Autistic individuals are disproportionately likely to experience mental health challenges during their lifetime, with depressive disorders being particularly common. High rates of depression among autistic individuals are a particular matter of clinical and policy concern, given the well-established links between depression and a range of negative outcomes, including suicidality. By proposing a novel integrative model, we aim to synthesize existing knowledge and prompt innovation in previously under-explored areas. In this narrative review, we first briefly discuss the prevalence of depression in autism, potential differences in how depression may present in autistic vs. non-autistic populations, and conceptual considerations for research on co-occurring autism and mental health challenges. We then provide a summary of cognitive, developmental, and clinical factors that have been identified through previous studies as important contributors to elevated rates and severity of depression in autistic individuals. Several, often closely interrelated, factors may affect the development and maintenance of depression in this population, including core autism features as well as cognitive and emotional experiences that are common in autistic individuals but not part of the diagnostic criteria for autism. Further, we propose a conceptual integration of the noted factors, specifying potential patterns of their interrelatedness. Finally, we put forward conceptual and empirical strategies for formally testing and refining our proposed model, and describe its implications for research, clinical practice, and societal reform.

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23. Zhu Y, Li J. Editorial: ICG-R15 by PDD-A Simple Dynamic Tool for Refining Risk Stratification in Compensated Advanced Chronic Liver Disease. Aliment Pharmacol Ther. 2025.

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