Prevalence and Demographic Profiles of Food Insecure College Students at Main and Satellite Campuses in Northwestern USA.

Background: Recent studies demonstrated that food insecurity rates among college students surpass that of the general population. Both academic and health implications have been associated with food insecurity. Aim: This study compared the prevalence of food insecurity among students at three satellite campuses with those at the main campus of a 4-year, public university. Methods: In this cross-sectional design study, data were collected for four weeks using an anonymous, online questionnaire (10 demographic questions plus the USDA's Adult Food Security Survey 10-item module). A sample of 983 students was recruited from the 9064 undergraduate and graduate students attending a state university. Chi-square tests were used to assess demographic differences between food insecure students on the main and satellite campuses. Logistic regression was performed to evaluate the odds of food insecurity by campus (satellite vs. main), after controlling for demographics. Statistical significance was assessed at P < 0.05. Results: Bivariate results indicated the rate of food insecurity was significantly higher on the main campus (45%) than on the satellite campuses (34%, P = 0.007). However, after controlling for demographics there was no difference in the odds of food insecurity by campus (P = 0.239). Conclusion: The study findings are novel as no other studies compared the prevalence of food insecurity among students attending satellite campuses compared with those at the main campus. After controlling for demographics, type of campus (satellite vs. main) was not a significant factor in the odds of food insecurity.

Estimating County Level Health Indicators Using Spatial Microsimulation.

Given the importance of understanding health outcomes at fine spatial scales, iterative proportional fitting (IPF), a form of small area estimation, was applied to a fixed number of health-related variables (obesity, overweight, diabetes) taken from regionalized 2019 survey responses (n = 5474) from the Idaho Behavioral Risk Factor Surveillance System (BRFSS). Using associated county-level American Community Survey (ACS) census data, a set of constraints, which included age categorization, race, sex, and education level, were used to create county-level weighting matrices for each variable, for each of the seven (7) Idaho public health districts. Using an optimized modeling construction technique, we identified significant constraints and grouping splits for each variable/region, resulting in estimates that were internally and externally validated. Externally validated model results for the most populated counties showed correlations ranging from .79 to .85, with p values all below .05. Estimates indicated higher levels of obesity and overweight individuals for midsouth and southwestern Idaho counties, with a cluster of higher diabetes estimates in the center of the state (Gooding, Lincoln, Minidoka, and Jerome counties). Alternative external sources for health outcomes aligned extremely well with our estimates, with wider confidence intervals in more rural counties with sparse populations.

Increasing Incidence of Invasive Group A Streptococcus Disease, Idaho, USA, 2008-2019.

We investigated invasive group A Streptococcus epidemiology in Idaho, USA, during 2008-2019 using surveillance data, medical record review, and emm (M protein gene) typing results. Incidence increased from 1.04 to 4.76 cases/100,000 persons during 2008-2019. emm 1, 12, 28, 11, and 4 were the most common types, and 2 outbreaks were identified. We examined changes in distribution of clinical syndrome, patient demographics, and risk factors by comparing 2008-2013 baseline with 2014-2019 data. Incidence was higher among all age groups during 2014-2019. Streptococcal toxic shock syndrome increased from 0% to 6.4% of cases (p = 0.02). We identified no differences in distribution of demographic or risk factors between periods. Results indicated that invasive group A Streptococcus is increasing among the general population of Idaho. Ongoing surveillance of state-level invasive group A Streptococcus cases could help identify outbreaks, track regional trends in incidence, and monitor circulating emm types.

Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA.

SARS-CoV-2 likely emerged from an animal reservoir. However, the frequency of and risk factors for interspecies transmission remain unclear. We conducted a community-based study in Idaho, USA, of pets in households that had >1 confirmed SARS-CoV-2 infections in humans. Among 119 dogs and 57 cats, clinical signs consistent with SARS-CoV-2 were reported for 20 dogs (21%) and 19 cats (39%). Of 81 dogs and 32 cats sampled, 40% of dogs and 43% of cats were seropositive, and 5% of dogs and 8% of cats were PCR positive. This discordance might be caused by delays in sampling. Respondents commonly reported close human‒animal contact and willingness to take measures to prevent transmission to their pets. Reported preventive measures showed a slightly protective but nonsignificant trend for both illness and seropositivity in pets. Sharing of beds and bowls had slight harmful effects, reaching statistical significance for sharing bowls and seropositivity.

Social Vulnerability to Irrigation Water Loss: Assessing the Effects of Water Policy Change on Farmers in Idaho, USA.

In the Eastern Snake Plain of Idaho, increasing rates of groundwater extraction for irrigation have corresponded with the adoption of more efficient irrigation technologies; higher use and lower incidental recharge have led to increasing groundwater scarcity. This paper assesses farmer vulnerability to a water resource policy that responds to that scarcity by reducing availability of groundwater for irrigation by 4-20%. Using results from a household survey of impacted farmers, we examine vulnerability in two stages, contributing to theorization of farmer vulnerability in a changing climate as well as producing important regional policy insights. The first stage, multimodel selection and inference, analyzes the primary predictors of two forms of vulnerability to groundwater scarcity among this population of farmers. The second stage, a segmentation analysis, highlights policy-relevant variation in adaptive capacity and in vulnerability predictors across the population. Individual-level results indicate that key indicators of vulnerability include several dimensions of adaptive capacity and sensitivity. At the population level, we find that reductions in sensitivity may play an important role in reducing farmer vulnerability. Accelerating global environmental change will require agriculture in arid and semi-arid regions to adapt to shifts in water availability. As water resources shift, institutional contexts and policy landscapes will shift in parallel, as seen with the reduction in groundwater availability in our case study. These institutional shifts may change the face of adaptation and farmer vulnerability in unexpected ways. Our results indicate that such institutional shifts could lean on efforts to enhance farmer adaptive capacity or reduce farmer sensitivity as mechanisms for reducing farmer vulnerability to adaptation policy changes.

Building a biomedical pipeline: the impact of the Idaho IDeA INBRE summer research experience at a primarily undergraduate institution.

Idaho Institutional Development Award (IDeA) Network for Biomedical Research Excellence (INBRE) aims to build biomedical research capacity and enhance the scientific and technology knowledge of the Idaho workforce. A key INBRE Program at The College of Idaho, a primarily undergraduate institution of 1,100 students, is a 10-wk summer fellows research experience. This report documents outcomes from 2005 to present, including demographic trends, faculty and student research productivity, self-reported gains, educational attainment, and career outcomes. Of 103 participants, 83.7% were from Idaho, 26.7% from rural areas, and 23.9% first-generation college students. Faculty and student research productivity (conference presentations and peer-reviewed publications) increased threefold. We found that 91.4% of fellows entered a scientific- or healthcare-related career and that 70.7% completed or are currently enrolled in postgraduate training (51.7% doctoral and 19.0% master's level). Anonymous surveys were uniformly positive, with gains in self-confidence and independent laboratory work. Open-ended responses indicated students valued mentoring efforts and improved awareness of scientific opportunities and competitive preparation for postgraduate training. Lastly, we observed that student research involvement increased college-wide during the award period. These data suggest that the summer fellows program is successfully meeting National Institutes of Health IDeA goals and serving as a pipeline to future health research careers and a scientifically trained Idaho workforce.

Performance Characteristics of the Abbott Architect SARS-CoV-2 IgG Assay and Seroprevalence in Boise, Idaho.

Coronavirus disease 2019 (COVID-19), the novel respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with severe morbidity and mortality. The rollout of diagnostic testing in the United States was slow, leading to numerous cases that were not tested for SARS-CoV-2 in February and March 2020 and necessitating the use of serological testing to determine past infections. Here, we evaluated the Abbott SARS-CoV-2 IgG test for detection of anti-SARS-CoV-2 IgG antibodies by testing 3 distinct patient populations. We tested 1,020 serum specimens collected prior to SARS-CoV-2 circulation in the United States and found one false positive, indicating a specificity of 99.90%. We tested 125 patients who tested reverse transcription-PCR (RT-PCR) positive for SARS-CoV-2 for whom 689 excess serum specimens were available and found that sensitivity reached 100% at day 17 after symptom onset and day 13 after PCR positivity. Alternative index value thresholds for positivity resulted in 100% sensitivity and 100% specificity in this cohort. We tested specimens from 4,856 individuals from Boise, ID, collected over 1 week in April 2020 as part of the Crush the Curve initiative and detected 87 positives for a positivity rate of 1.79%. These data demonstrate excellent analytical performance of the Abbott SARS-CoV-2 IgG test as well as the limited circulation of the virus in the western United States. We expect that the availability of high-quality serological testing will be a key tool in the fight against SARS-CoV-2.

Rangeland Fire Protection Associations as disaster response organisations.

Rangeland Fire Protection Associations (RFPAs) are volunteer-based groups of trained private landowners who are authorised to respond to events in partnership with governmental agencies. This study analysed the functioning and structure of RFPAs in Idaho and Oregon in the western United States to characterise this under-researched model of disaster response. RFPAs represent an expanding type of disaster response organisation that interfaces with established fire suppression entities, yet 'emergent behaviour' manifested in some RFPA response actions. This appeared to lessen and mediate with time, as well as due to recognition of the issues, increased experience of fires, and training that fostered new mutual understandings. There is a need for continued examination of the effect of repeat experience in developing the characteristics of disaster response organisations. In addition, it is crucial to know how the interface between established and other types of organisations may be enhanced to make cooperative disaster response more effective.

Increasing phylogenetic stochasticity at high elevations on summits across a remote North American wilderness.

PREMISE: At the intersection of ecology and evolutionary biology, community phylogenetics can provide insights into overarching biodiversity patterns, particularly in remote and understudied ecosystems. To understand community assembly of the high alpine flora in the Sawtooth National Forest, USA, we analyzed phylogenetic structure within and between nine summit communities. METHODS: We used high-throughput sequencing to supplement existing data and infer a nearly completely sampled community phylogeny of the alpine vascular flora. We calculated mean nearest taxon distance (MNTD) and mean pairwise distance (MPD) to quantify phylogenetic divergence within summits, and assessed whether maximum elevation explains phylogenetic structure. To evaluate similarities between summits, we quantified phylogenetic turnover, taking into consideration microhabitats (talus vs. meadows). RESULTS: We found different patterns of community phylogenetic structure within the six most species-rich orders, but across all vascular plants phylogenetic structure was largely not different from random. There was a significant negative correlation between elevation and tree-wide phylogenetic diversity (MPD) within summits: overdispersion degraded as elevation increased. Between summits, we found high phylogenetic turnover driven by greater niche heterogeneity on summits with alpine meadows. CONCLUSIONS: Our results provide further evidence that stochastic processes may also play an important role in the assembly of vascular plant communities in high alpine habitats at regional scales. However, order-specific patterns suggest that adaptations are still important for assembly of specific sectors of the plant tree of life. Further studies quantifying functional diversity will be important in disentangling the interplay of eco-evolutionary processes that likely shape broad community phylogenetic patterns in extreme environments.

Tracking a half century of media reporting on gray wolves.

Natural resource and wildlife managers must balance the disparate priorities of a diversity of stakeholders. To manage these priorities, a firm understanding of topics salient to the public is needed. The media often report on issues of importance to the public; therefore, these reports may be a useful measure of public interest. However, efficient methods for distinguishing diverse topics related to a wildlife management issue reported in the media and changes in the salience of those topics have been lacking. We used latent Dirichlet allocation, a Bayesian mixture model, to quantitatively assess the salience of topics surrounding the gray wolf (Canis lupus), which was reintroduced to Idaho (U.S.A.) in 1995. We analyzed articles published from 1960 to 2015 in an Idaho newspaper. We identified 6 distinct topics associated with gray wolves: policy, hunting, biological status, implementation of management, recovery, and human-wolf conflict. The salience of topics pre- and postreintroduction of wolves (1995) and pre- and postdelisting of wolves from the U.S. Endangered Species Act (2009) differed significantly, underscoring that these events were turning points in how issues were being publicly discussed and framed. Articles written by the local reporters were more likely to report on topics regarding conflict between humans and wolves, whereas articles sourced from a national outlet reported more on topics pertaining to wolf policy and biological status. In the context of managing a contentious, far-ranging, and long-lived wildlife species, our methods can help guide the location and timing of a suite of management strategies (e.g., media relation plans and stakeholder engagement) that promote human-wildlife coexistence across different landscapes.

Seguimiento de Medio Siglo de Reportes Mediáticos sobre Lobos Grises Resumen Los administradores de los recursos naturales y de la fauna deben balancear las prioridades discrepantes de una diversidad de accionistas. Para manejar estas prioridades se requiere de un entendimiento firme de los temas destacados para el público. Los medios frecuentemente reportan sobre temas de importancia para el público; por lo tanto, estos reportajes pueden ser una medida útil del interés del público. Sin embargo, hoy en día se carece de métodos eficientes para distinguir diferentes temas relacionados con un tema de manejo de fauna reportado en los medios y para reconocer los cambios en la prominencia de estos temas. Usamos la asignación latente Dirichlet, un modelo de mezcla bayesiana, para evaluar cuantitativamente la prominencia de los temas circundantes al lobo gris (Canis lupus), el cual fue reintroducido a Idaho (E.U.A.) en 1995. Analizamos artículos publicados en un periódico de Idaho desde 1960 y hasta 2015. Identificamos seis temas distintos asociados con el lobo gris: política, caza, estado biológico, implementación del manejo, recuperación, y conflicto humano-lobos. La prominencia de los temas previa y posterior a la introducción de los lobos (1995) y previa y posterior al retiro de los lobos del Acta de Especies Amenazadas de E.U.A (2009) varió significativamente, resaltando que estos eventos fueron puntos críticos para cómo se discutían y enmarcaban estos temas. Los artículos escritos por los reporteros locales tuvieron una mayor probabilidad de tratar temas sobre el conflicto entre humanos y lobos, mientras que los artículos surgidos en alguna fuente nacional reportaron más sobre temas correspondientes a la política y al estado biológico de los lobos. En el contexto de una especie silvestre contenciosa, de una extensión amplia y un ciclo de vida largo, nuestros métodos pueden ayudar a guiar la ubicación y el momento de un conjunto de estrategias de manejo (p. ej.: planes de relación de medios y compromiso de los accionistas) que promueva la coexistencia entre humanos y fauna a lo largo de diferentes paisajes.

A Post-Suicide Survey: The Perspective We Have Been Missing.

Background: Suicide is a major problem in the United States and in the state of Idaho. Prevention data are lacking for suicide primarily because information about those who completed suicide is not attainable. There are no published data from surveying the family members of the deceased. Our objective was to learn more about those who died by suicide by surveying family members or close contacts of the deceased. Methods: We conducted a descriptive study using a 77-question survey to obtain information about those who died by suicide, with the survey being completed by their loved ones. Survey questions addressed the deceased's demographics, employment, mental health, substance use, access to lethal means, cultural and religious beliefs, relationships, etc. The survey was distributed in Southeast Idaho for 3 months. Results: Results showed that those who died by suicide in Southeast Idaho were predominantly: White (95%), male (77%), had no previous hospitalization for mental illness (76%), had a firearm in their home (66%), their religious beliefs matched those in their family and community (73%), they did not alert others or seek medical help (79%), had attempted suicide before (55%), had high stress in their most recent relationship (55%), or had current legal issues (54%). Firearms were the most common means of death (51%). Conclusion: In Southeast Idaho, our data suggested those at the highest risk of suicide were White men who previously attempted suicide, were experiencing a relationship change, had legal trouble, and had quick access to a firearm in their home. Suicide prevention efforts should be focused on these risk factors.

The Impact of the COVID-19 Pandemic on Patient Disparities in Long-Term Opioid Therapy.

BACKGROUND: The COVID-19 pandemic disrupted how primary care patients with chronic pain received care. Our study sought to understand how long-term opioid therapy (LtOT) for chronic pain changed over the course of the pandemic overall and for different demographic subgroups. METHODS: We used data from electronic health records of 64 primary care clinics across Washington state and Idaho to identify patients who had a chronic pain diagnosis and were receiving long-term opioid therapy. We defined 10-month periods in 2019 to 2021 as prepandemic, early pandemic and late pandemic and used generalized estimating equations analysis to compare across these time periods and demographic characteristics. RESULTS: We found a proportional decrease in LtOT for chronic pain in the early months of the pandemic (OR = 0.94, P = .007) followed by an increase late pandemic (OR = 1.08, P = .002). Comparing late pandemic to prepandemic, identifying as Asian or Black, having fewer comorbidities, or living in an urban area were associated with higher likelihood of being prescribed LtOT. DISCUSSION: The use of LtOT for chronic pain in primary care has increased from before to after the COVID-19 pandemic with racial/ethnic and geographic disparities. Future research is needed to understand these disparities in LtOT and their effect on patient outcomes.

The Ability of Primary Care Practices to Measure and Report on Care Quality.

BACKGROUND: Creating useful clinical quality measure (CQM) reports in a busy primary care practice is known to depend on the capability of the electronic health record (EHR). Two other domains may also contribute: supportive leadership to prioritize the work and commit the necessary resources, and individuals with the necessary health information technology (IT) skills to do so. Here we describe the results of an assessment of the above 3 domains and their associations with successful CQM reporting during an initiative to improve smaller primary care practices' cardiovascular disease CQMs. METHODS: The study took place within an AHRQ EvidenceNOW initiative of external support for smaller practices across Washington, Oregon and Idaho. Practice facilitators who provided this support completed an assessment of the 3 domains previously described for each of their assigned practices. Practices submitted 3 CQMs to the study team: appropriate aspirin prescribing, use of statins when indicated, blood pressure control, and tobacco screening/cessation. RESULTS: Practices with advanced EHR reporting capability were more likely to report 2 or more CQMs. Only one-third of practices were "advanced" in this domain, and this domain had the highest proportion of practices (39.1%) assessed as "basic." The presence of advanced leadership or advanced skills did not appreciably increase the proportion of practices that reported 2 or more CQMs. CONCLUSIONS: Our findings support previous reports of limited EHR reporting capabilities within smaller practices but extend these findings by demonstrating that practices with advanced capabilities in this domain are more likely to produce CQM reports.

Development and validation of a GT-seq panel for genetic monitoring in a threatened species using minimally invasive sampling.

Minimally invasive samples are often the best option for collecting genetic material from species of conservation concern, but they perform poorly in many genomic sequencing methods due to their tendency to yield low DNA quality and quantity. Genotyping-in-thousands by sequencing (GT-seq) is a powerful amplicon sequencing method that can genotype large numbers of variable-quality samples at a standardized set of single nucleotide polymorphism (SNP) loci. Here, we develop, optimize, and validate a GT-seq panel for the federally threatened northern Idaho ground squirrel (Urocitellus brunneus) to provide a standardized approach for future genetic monitoring and assessment of recovery goals using minimally invasive samples. The optimized panel consists of 224 neutral and 81 putatively adaptive SNPs. DNA collected from buccal swabs from 2016 to 2020 had 73% genotyping success, while samples collected from hair from 2002 to 2006 had little to no DNA remaining and did not genotype successfully. We evaluated our GT-seq panel by measuring genotype discordance rates compared to RADseq and whole-genome sequencing. GT-seq and other sequencing methods had similar population diversity and F ST estimates, but GT-seq consistently called more heterozygotes than expected, resulting in negative F IS values at the population level. Genetic ancestry assignment was consistent when estimated with different sequencing methods and numbers of loci. Our GT-seq panel is an effective and efficient genotyping tool that will aid in the monitoring and recovery of this threatened species, and our results provide insights for applying GT-seq for minimally invasive DNA sampling techniques in other rare animals.

Transmission of brucellosis from elk to cattle and bison, Greater Yellowstone area, U.S.A., 2002-2012.

Bovine brucellosis has been nearly eliminated from livestock in the United States. Bison and elk in the Greater Yellowstone Area remain reservoirs for the disease. During 1990-2002, no known cases occurred in Greater Yellowstone Area livestock. Since then, 17 transmission events from wildlife to livestock have been investigated.

Impact Evaluation of a Resident-Driven Research Training Workshop in Idaho: A Feasibility Study.

Objectives: Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal Medicine and Family Medicine. Methods: Workshop comprised of expert presentations, with assessment of difference in knowledge with a pretest and post-test. The sessions were organized around the core competencies of Institute of Medicine. Suggestions were also gathered from the audience. A pretest and post-test based on 13 questions was administered to the participants to assess change in research-related knowledge. Comments and suggestions of the participants were also recorded. Wilcoxon rank test was applied to determine statistical difference across each question and cumulative knowledge score. Conventional content analysis was applied to explore the comments and feedback. Results: The mean score of participants improved across all 12 questions. Statistically significant results were observed for the questions about types of studies qualifying as qualitative research. The cumulative score of participants increased in the post-test from 8.57 to 9.35. The participants gained new knowledge (94.3%), and felt more comfortable in application of research methods (74.3%). Encouraging feedback was obtained from the audience. They stated that they had benefited from the workshop and felt more prepared and motivated to indulge in scholarly activities. Conclusion: The study shows improvement in research-related knowledge of clinical residents attending a 1-day training workshop. We recommend inclusion of such workshops in the curriculum of residents for skill building and enhanced indulgence in research activities in order to prepare them as future leaders in quality improvement, health policy, and hospital administration.

Backpack satellite transmitters reduce survival but not nesting propensity or success of greater sage-grouse.

Telemetry technology is ubiquitous for studying the behavior and demography of wildlife, including the use of traditional very high frequency (VHF) radio telemetry and more recent methods that record animal locations using global positioning systems (GPS). Satellite-based GPS telemetry allows researchers to collect high spatial-temporal resolution data remotely but may also come with additional costs. For example, recent studies from the southern Great Basin suggested GPS transmitters attached via backpacks may reduce the survival of greater sage-grouse (Centrocercus urophasianus) relative to VHF transmitters attached via collars that have been in use for decades. While some evidence suggests GPS backpacks reduce survival, no studies have examined the effects of GPS backpacks on breeding behavior and success. Therefore, we compared survival, breeding behavior, and nest success of sage-grouse hens marked with both VHF collars and GPS backpack transmitter over a 7-year period in central Idaho, USA. GPS backpacks reduced spring-summer survival of sage-grouse hens relative to hens with VHF collars, where daily mortality probability was 68%-82% higher from March 1 to August 1. Yet satellite GPS backpacks did not consistently affect nest success or the likelihood or timing of nest initiation relative to VHF collars. Daily nest survival varied annually and with timing of nest initiation and nest age, but marginal effects of transmitter type were statistically insignificant and interactions between transmitter type and study year produced no meaningful patterns. Our results corroborate recent studies for the effect of satellite GPS backpacks on sage-grouse survival, but also suggest that these transmitters do not appear to affect components of fecundity. Our results therefore add important context to recent debate surrounding the effects of GPS backpacks on sage-grouse, and the relative strengths and weaknesses of different transmitter types for understanding behavior and population dynamics.

Townsendialemhiensis (Asteraceae, Astereae): A narrowly endemic new species from Idaho, USA.

Townsendialemhiensis (Asteraceae) is described from the Lemhi Valley of east-central Idaho. From a genus with weak intrinsic isolating barriers, T.lemhiensis remains distinct apparently due to apomixis and to its isolation and habitat specialization on spatially limited occurrences of ashy white soils in the Lemhi Valley. Despite similarities to T.spathulata, this new species differs in its persistent pappus, fewer series of phyllaries and sericeous rather than long woolly hairs.

U.S. Lawsuit Claims Federal Law Can Require Emergency Abortions.

In the wake of the U.S. Supreme Court's overruling of Roe vs. Wade, states are passing very strict antiabortion laws that the Biden administration is arguing violate the federal Emergency Medical Treatment and Active Labor Act (EMTALA) because those state laws do not permit emergency life-saving abortions that federal law says must be available to patients. The Biden administration has filed suit against Idaho to have portions of its state law invalidated, and Texas has filed suit against the Biden administration, arguing that its interpretation of EMTALA as requiring that abortions be available to patients in some emergency circumstances amounts to an unconstitutional overreach by the federal government. These suits, and others related to them, may redefine health-related federalism in the United States.

Craniofacial Malformations as Fundamental Diagnostic Tools in Syndromic Entities.

Background: A long list of syndromic entities can be diagnosed immediately through scrutinizing the clinical phenotype of the craniofacial features. The latter should be assisted via proper radiological interpretations. Patients and Methods: Different children aged from 1 month to 12 years were referred to our departments seeking orthopedic advice. Primarily, all received variable false diagnoses in other institutes. Two unrelated boys of one month and 12 months were falsely diagnosed as having positional plagiocephaly associated with contractures of idiopathic origin. Two unrelated boys of 14 months and 2 years were diagnosed with pseudo-hydrocephalus and non-specific syndrome, and were referred to explore their skeletal development. Two unrelated girls of 4 years old and 12 years old presented with multiple contractures were referred because of progressive scoliosis. A 4-year-old girl was referred with a false provisional diagnosis of facial diplegia. All children underwent detailed clinical, radiological and tomographic phenotypic characterizations and genetic testing, respectively. Results: Idaho syndrome (craniosynostosis associated with multiple dislocations) was the final diagnosis in the two unrelated boys with plagiocephaly and multiple contractures. Two children falsely diagnosed with pseudo-hydrocephalus and non-specific syndrome, were diagnosed with Silver-Russell syndrome (RSS). Contractural arachnodactyly Beals (CAB) was confirmed as the definitive diagnosis in the two unrelated girls with progressive scoliosis and multiple contractures. Parry-Romberg syndrome (PRS) associated with congenital lumbar kyphosis was the final diagnosis of the girl with the diagnosis of facial diplegia. Hypomethylation of ICR1 was confirmed in the RSS patients. Whole exome sequencing (WES) revealed a heterozygous mutation in the PRS patients. WES and array-CGH showed that no relevant variants or copy number variations (CNV) were identified in the CAB patients. Conclusions: On the one hand, newborn children can manifest diverse forms of abnormal craniofacial features, which are usually associated with either major or minor dysmorphic stigmata. A cleft lip/ palate is a major craniofacial malformation, and frontal bossing or a disproportionate craniofacial contour can be falsely considered as a transient plagiocephaly, which is spontaneously resolved by time. On the other hand, many physicians fall into the problem of deeming a countless number of diseases, such as contractures, as an idiopathic or non-specific syndrome. The latter stems from limited clinical experience. Therefore, failing to establish between the onset of the deformity and other inexplicit abnormal features that the patient or their immediate families or relatives carry is the final outcome. In this study, we used, for the first time, a reconstruction CT scan to further delineate the congenital disruption of the craniofacial anatomy and the other skeletal malformation complex.