1. Bloch C, Tepest R, Koeroglu S, Feikes K, Jording M, Vogeley K, Falter-Wagner CM. Interacting with autistic virtual characters: intrapersonal synchrony of nonverbal behavior affects participants’ perception. Eur Arch Psychiatry Clin Neurosci;2024 (Jan 25)

Temporal coordination of communicative behavior is not only located between but also within interaction partners (e.g., gaze and gestures). This intrapersonal synchrony (IaPS) is assumed to constitute interpersonal alignment. Studies show systematic variations in IaPS in individuals with autism, which may affect the degree of interpersonal temporal coordination. In the current study, we reversed the approach and mapped the measured nonverbal behavior of interactants with and without ASD from a previous study onto virtual characters to study the effects of the differential IaPS on observers (N = 68), both with and without ASD (crossed design). During a communication task with both characters, who indicated targets with gaze and delayed pointing gestures, we measured response times, gaze behavior, and post hoc impression formation. Results show that character behavior indicative of ASD resulted in overall enlarged decoding times in observers and this effect was even pronounced in observers with ASD. A classification of observer’s gaze types indicated differentiated decoding strategies. Whereas non-autistic observers presented with a rather consistent eyes-focused strategy associated with efficient and fast responses, observers with ASD presented with highly variable decoding strategies. In contrast to communication efficiency, impression formation was not influenced by IaPS. The results underline the importance of timing differences in both production and perception processes during multimodal nonverbal communication in interactants with and without ASD. In essence, the current findings locate the manifestation of reduced reciprocity in autism not merely in the person, but in the interactional dynamics of dyads.

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2. Conti MV, Santero S, Breda C, Basilico S, de Filippo G, Luzzi A, Voto L, Cavagnola R, Tomasinelli CE, Cena H. Autism Spectrum Disorder and collective catering service: results of the pilot study FOOD-AUT. Front Nutr;2023;10:1298469.

OBJECTIVE: Individuals with Autism Spectrum Disorder (ASD) often exhibit a low dietary diversity due to food selectivity that leads them to a marked preference for high-energy-density food, exposing them to risk of malnutrition. Despite these aspects, specific recommendations and targeted menus for this population are missing. The pilot study FOOD-AUT addresses this issue by developing canteen menus meeting the nutritional and sensory needs of adults with ASD, aiming to reduce their food selectivity, and consequently improving their health. METHODS: The project, funded by Gruppo Pellegrini S.p.A, was conducted at the daycare service of Sacra Famiglia Onlus Foundation, between March-2022 to March-2023. The study was divided into two phases. Observational phase: a comparison was made between the enrolled subjects’ nutritional needs and the nutrient content of the administered menus during the daycare service. Then mealtime compliance was assessed using standardized meal evaluation forms, both quantitative and qualitative. Intervention phase: canteen menus targeted to the individuals’ nutritional and sensory needs were administered and their acceptability was evaluated. RESULTS: Twenty-two individuals with ASD, aged 19-48, 72.7% males, were enrolled. Overweight and obesity prevalence were 54.5 and 18.2%, respectively. The observational phase showed how the most accepted foods had specific sensorial characteristics in line with the scientific literature. Adapting the menus improved food acceptance and reduced food waste. CONCLUSION: The results highlighted the need for adapted menus and greater attention to the way meals are delivered and consumed to improve nutritional status and therefore health of this population at increased risk of malnutrition. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov, unique identifier: NCT05978895.

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3. Diebo BG, Balmaceno-Criss M, Lafage R, Daher M, Singh M, Hamilton DK, Smith JS, Eastlack RK, Fessler R, Gum JL, Gupta MC, Hostin R, Kebaish KM, Lewis S, Line BG, Nunley PD, Mundis GM, Passias PG, Protopsaltis TS, Turner J, Buell T, Scheer JK, Mullin J, Soroceanu A, Ames CP, Bess S, Shaffrey CI, Lenke LG, Schwab FJ, Lafage V, Burton DC, Daniels AH. Lumbar Lordosis Redistribution and Segmental Correction in Adult Spinal Deformity (ASD): Does it Matter?. Spine (Phila Pa 1976);2024 (Jan 25)

STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: Evaluate the impact of correcting to normative segmental lordosis values on post-operative outcomes. BACKGROUND: Restoring lumbar lordosis magnitude is crucial in adult spinal deformity surgery, but the optimal location and segmental distribution remains unclear. METHODS: Patients were grouped based on offset to normative segmental lordosis values, extracted from recent publications. Matched patients were within 10% of the cohort’s mean offset, less than or over 10% were under- and over-corrected. Surgical technique, PROMs, and surgical complications were compared across groups at baseline and 2-year. RESULTS: 510 patients with an average age of 64.6, mean CCI 2.08, and average follow-up of 25 months. L4-5 was least likely to be matched (19.1%), while L4-S1 was the most likely (24.3%). More patients were overcorrected at proximal levels (T10-L2; Undercorrected, U: 32.2% vs. Matched, M: 21.7% vs. Overcorrected, O: 46.1%) and undercorrected at distal levels (L4-S1: U: 39.0% vs. M: 24.3% vs. O: 36.8%). Postoperative ODI was comparable across correction groups at all spinal levels except at L4-S1 and T10-L2/L4-S1, where overcorrected patients and matched were better than undercorrected (U: 32.1 vs. M: 25.4 vs. O: 26.5, P=0.005; U: 36.2 vs. M: 24.2 vs. O: 26.8, P=0.001; respectively). Patients overcorrected at T10-L2 experienced higher rates of proximal junctional failure (PJF) (U: 16.0% vs. M: 15.6% vs. O: 32.8%, P<0.001) and had greater posterior inclination of the upper instrumented vertebra (UIV) (U: -9.2±9.4° vs. M: -9.6±9.1° vs. O: -12.2±10.0°, P<0.001), whereas undercorrection at these levels led to higher rates of revision for implant failure (U: 14.2% vs. M: 7.3% vs. O: 6.4%, P=0.025). CONCLUSIONS: Patients undergoing fusion for adult spinal deformity suffer higher rates of PJF with overcorrection and increased rates of implant failure with undercorrection based on normative segmental lordosis. LEVEL OF EVIDENCE: IV.

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4. Iannuccelli M, Vitriolo A, Licata L, Lo Surdo P, Contino S, Cheroni C, Capocefalo D, Castagnoli L, Testa G, Cesareni G, Perfetto L. Correction: Curation of causal interactions mediated by genes associated with autism accelerates the understanding of gene-phenotype relationships underlying neurodevelopmental disorders. Mol Psychiatry;2024 (Jan 24)

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5. Jang Y, Choi H, Yoo S, Park H, Park BY. Structural connectome alterations between individuals with autism and neurotypical controls using feature representation learning. Behav Brain Funct;2024 (Jan 24);20(1):2.

Autism spectrum disorder is one of the most common neurodevelopmental conditions associated with sensory and social communication impairments. Previous neuroimaging studies reported that atypical nodal- or network-level functional brain organization in individuals with autism was associated with autistic behaviors. Although dimensionality reduction techniques have the potential to uncover new biomarkers, the analysis of whole-brain structural connectome abnormalities in a low-dimensional latent space is underinvestigated. In this study, we utilized autoencoder-based feature representation learning for diffusion magnetic resonance imaging-based structural connectivity in 80 individuals with autism and 61 neurotypical controls that passed strict quality controls. We generated low-dimensional latent features using the autoencoder model for each group and adopted an integrated gradient approach to assess the contribution of the input data for predicting latent features during the encoding process. Subsequently, we compared the integrated gradient values between individuals with autism and neurotypical controls and observed differences within the transmodal regions and between the sensory and limbic systems. Finally, we identified significant associations between integrated gradient values and communication abilities in individuals with autism. Our findings provide insights into the whole-brain structural connectome in autism and may help identify potential biomarkers for autistic connectopathy.

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6. Kamp-Becker I. Autism spectrum disorder in ICD-11-a critical reflection of its possible impact on clinical practice and research. Mol Psychiatry;2024 (Jan 25)

This perspective article compares and contrasts the conceptualization of Autism Spectrum Disorder (ASD) in ICD-11 and DSM-5. By guiding the user through the ICD-11 text, it is argued that, in contrast to DSM-5, ICD-11 allows a high variety in symptom combinations, which results in an operationalization of ASD that is in favor of an extreme diverse picture, yet possibly at the expense of precision, including unforeseeable effects on clinical practice, care, and research. The clinical utility is questionable as this conceptualization can hardly be differentiated from other mental disorders and autism-like traits. It moves away from an observable, behavioral, and neurodevelopmental disorder to a disorder of inner experience that can hardly be measured objectively. It contains many vague and subjective concepts that lead to non-falsifiable diagnoses. This bears a large danger of false positive diagnoses, of further increased prevalence rates, limitations of access to ASD-specific services and of increasing the non-specificity of treatments. For research, the hypothesis is that the specificity of ASD will be reduced and this will additional increase the already high heterogeneity with the effect that replication of studies will be hampered. This could limit our understanding of etiology and biological pathways of ASD and bears the risk that precision medicine, i.e., a targeted approach for individual treatment strategies based on precise diagnostic markers, is more far from becoming reality. Thus, a more precise, quantitative description and more objective measurement of symptoms are suggested that define the clinical ASD phenotype. Identification of core ASD subtypes/endophenotypes and a precise description of symptoms is the necessary next step to advance diagnostic classification systems. Therefore, employing a more finely grained, objective, clinical symptom characterization which is more relatable to neurobehavioral concepts is of central significance.

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7. Lacroix A, Harquel S, Mermillod M, Garrido M, Barbosa L, Vercueil L, Aleysson D, Dutheil F, Kovarski K, Gomot M. Sex modulation of faces prediction error in the autistic brain. Commun Biol;2024 (Jan 25);7(1):127.

Recent research suggests that autistic females may have superior socio-cognitive abilities compared to autistic males, potentially contributing to underdiagnosis in females. However, it remains unclear whether these differences arise from distinct neurophysiological functioning in autistic males and females. This study addresses this question by presenting 41 autistic and 48 non-autistic adults with a spatially filtered faces oddball paradigm. Analysis of event-related potentials from scalp electroencephalography reveal a neurophysiological profile in autistic females that fell between those of autistic males and non-autistic females, highlighting sex differences in autism from the initial stages of face processing. This finding underscores the urgent need to explore neurophysiological sex differences in autism and encourages efforts toward a better comprehension of compensation mechanism and a clearer definition of what is meant by camouflaging.

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8. Li C, Cheung WC, Burke MM, Taylor JL, DaWalt LS. Examining the associations among knowledge, empowerment, and advocacy among parents of transition-aged youth with autism. Autism;2024 (Jan 25):13623613231221126.

Parents of individuals with autism face many challenges in finding appropriate services and support for their children, and they also play an important role in advocating for their children’s rights and needs. Despite the increasing availability of advocacy programs, it is still uncertain how to best encourage parents to advocate for their children. This study explored the connection between parents’ knowledge and sense of empowerment, and how these factors relate to three types of advocacy activities (i.e. individual, peer, and systemic). The findings reveal that feeling empowered has a greater impact on advocacy than simply having knowledge. In addition, the study found that individual advocacy correlates to more peer advocacy, which also correlates to more systemic advocacy. These results can help researchers and professionals to better develop programs to increase parent advocacy and, in turn, help improve the lives of individuals with autism.

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9. Napolitano A, Guerrera S, Lucignani M, Parrillo C, Baldassari G, Bottino F, Moltoni G, Espagnet MCR, Talamanca LF, Valeri G, Vicari S. Assessing cortical features in early stage ASD children. Front Psychiatry;2023;14:1098265.

Autism Spectrum Disorder (ASD) is defined as a neurodevelopmental disorder largely investigated in the neurologic field. Recently, neuroimaging studies have been conducted in order to investigate cerebral morphologic alterations in ASD patients, demonstrating an atypical brain development before the clinical manifestations of the disorder. Cortical Thickness (CT) and Local Gyrification Index (LGI) distribution for ASD children were investigated in this study, with the aim to evaluate possible relationship between brain measures and individual characteristics (i.e., IQ and verbal ability). 3D T1-w sequences from 129 ASD and 58 age-matched Healthy Controls (HC) were acquired and processed in order to assess CT and LGI for each subject. Intergroup differences between ASD and HC were investigated, including analyses of 2 ASD subgroups, split according to patient verbal ability and IQ. When compared to HC, ASD showed increased CT and LGI within several brain areas, both as an overall group and as verbal ability an IQ subgroups. Moreover, when comparing language characteristics of the ASD subjects, those patients with verbal ability exhibit significant CT and LGI increase was found within the occipital lobe of right hemisphere. No significant results occurred when comparing ASD patients according to their IQ value. These results support the hypothesis of abnormal brain maturation in ASD since early childhood with differences among clinical subgroups suggesting different anatomical substrates underlying an aberrant connectivity.

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10. Pineo T. Journal of hospital medicine. Have you considered autism?. J Hosp Med;2024 (Jan 25)

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11. Yangdol P, Kalra N, Tyagi R, Khatri A, Sabherwal P, Goyal T. Three-dimensional Printing Technology: Patient-friendly and Time-saving Approach for Space Management in an Autistic Child in COVID-19 Times. Int J Clin Pediatr Dent;2023 (Nov);16(Suppl 3):321-326.

AIM AND OBJECTIVE: The present case report comprehensively illustrates the use of a novel digital three-dimensional (3D) printed band and loop space maintainer [computer-aided design and computer-aided manufacturing (CAD/CAM)] for the guidance of eruption with their distinctive attribute of reduced chairside time in a home-schooled autistic child. BACKGROUND: Three-dimensional (3D) printing is a promising and emerging technology in the arena of dentistry based on CAD/CAM. It has led to the production of customized 3D objects or patient-specific prostheses with accurate results achieved in a time-saving manner. 3D printing has been employed in several latitudes of dentistry; however, the applications are few in the field of pediatric dentistry. CASE DESCRIPTION: The paper describes the space management of an autistic child for the missing mandibular left primary second molar through the novel technique of 3D printed band and loop space maintainer. CLINICAL SIGNIFICANCE: The novel technique has definite advantages, including high precision, accuracy, fast production, and reduced patient exposure to dentists and vice versa, which has been the need of the hour since the advent of the coronavirus disease of 2019 (COVID-19) pandemic. CONCLUSION: Three-dimensional (3D) printing minimizes dental aerosol-generated exposure by decreasing chairside procedural time and minimizing procedural sitting. The cost-benefit analysis, as applied to the Indian scenario, has also been computed, which makes it equally acceptable. Moreover, 3D printing reduces material waste production, offering a greener and environmentally friendly option in the coming years. The future of pediatric dentistry will evolve with signs of progress in the latest materials and technologies. HOW TO CITE THIS ARTICLE: Yangdol P, Kalra N, Tyagi R, et al. Three-dimensional Printing Technology: Patient-friendly and Time-saving Approach for Space Management in an Autistic Child in COVID-19 Times. Int J Clin Pediatr Dent 2023;16(S-3):S321-S326.

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