Examining variability in Naturalistic Developmental Behavioral Intervention strategy use in caregivers of children with autism spectrum disorders.

BACKGROUND: Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver-mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. METHODS: We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI-CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. RESULTS: Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. CONCLUSIONS: Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted.

Effect of illite pretreatment on germinated Brown rice with Special Reference to amino acids, antioxidants, texture, and mineral elements.

The pretreatment process of various foods has been reported to improve their nutritional properties. The soaking of brown rice improves the texture and nutrients, which are crucial for cooking and maintaining its high functional value. Illite, a clay mineral, has recently been discovered to improve the nutritional value of seeds. Based on these findings, we soaked brown rice with different concentrations of illite solution for different durations and allowed the germination to perform analyses. Soaking the brown rice for 6 h with a germination period of 48 h was determined to be the optimal condition because of its higher sprout length. In addition, this optimal condition had improved textural characteristics such as reduced hardness, gumminess, chewiness, and cohesiveness, and it also had increased adhesiveness and stabilized resilience and springiness. The treatment solutions were free from heavy metal contaminants, whereas the mineral contents such as K, Ca, Fe, Mg, and Na were significantly increased with the increase in illite concentration. Moreover, our results showed that illite treatment could preserve the color appearance and seed germination. The ratio of essential amino acids to non-essential amino acids and antioxidants (phenolic contentγ-oryzanol, and flavonoid) of germinated brown rice was considerably increased with illite treatment. In germinated brown rice, an increase in DPPH and superoxide dismutase levels, a slight decrease in flavonoids, and no difference in polyphenol content were observed. These findings suggest that pre-soaking brown rice seeds with the appropriate concentration of illite could enhance their nutritional properties, which might attract consumers' interest to include this in their daily diet.

Assessing Amounts of Genetic Variability in Key Horticultural Traits Underlying Core Korean Breeding Lines of Cut Chrysanthemums.

The cut chrysanthemum holds one of the most substantial segments of the global floriculture market, particularly in Korea. We conducted a detailed assessment of the genetic structures across the cut chrysanthemum breeding lines in Korea. Using standard and spray chrysanthemum breeding lines from leading Korean research institutes, we first compared the variability of 12 horticultural traits, revealing a wide range of variation for most traits. We found that the overall flower diameter (OFD) and ray floret length (RFL) showed a solid positive relationship, regardless of the type. From a multivariate approach, OFD, RFL, and ray floret width (RFW) show consistently high association. Genotypic and phenotypic coefficients of variation analyses further indicated the significant genetic control over most traits. However, certain traits, like the volume of flowers (VF) in standard types, are more influenced by environments. Lastly, our analysis demonstrated substantial variability in broad-sense heritability (H); plant height (PH) consistently showed high H in both types. But the number of side branches (NOSB) and VF exhibited inconsistent H scores. These findings highlight the need for type-specific breeding strategies and modulating environmental management to optimize the trait expressions depending on the H scores, which offers significant implications for future breeding strategies.

Evaluation of the reliability and validity of the upright head roll test for lateral semicircular canal benign paroxysmal positional vertigo.

BACKGROUND: The upright head roll test (UHRT) is a recently introduced diagnostic maneuver for lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV). OBJECTIVE: This study aimed to evaluate the reliability and validity of the UHRT. METHODS: Two separate studies were conducted. Study 1 analyzed 827 results of videonystagmography (VNG) to assess UHRT reliability, and Study 2 analyzed 130 LSC-BPPV cases to evaluate UHRT validity. RESULTS: The inter-test reliability between UHRT and the supine head roll test (SHRT) showed substantial agreement (Cohen's kappa = 0.753) in direction-changing positional nystagmus (DCPN) and almost perfect agreement (Cohen's kappa = 0.836) in distinguishing the direction of DCPN. The validity assessment of UHRT showed high accuracy in diagnosing LSC-BPPV (80.0%) and in differentiating the variant types (74.6%). UHRT was highly accurate in diagnosing the canalolithiasis type in LSC-BPPV patients (Cohen's kappa = 0.835); however, it showed only moderate accuracy in diagnosing the cupulolithiasis type (Cohen's kappa = 0.415). The intensity of nystagmus in UHRT was relatively weaker than that in SHRT (P < 0.05). CONCLUSION: UHRT is a reliable test for diagnosing LSC-BPPV and distinguishing subtypes. However, UHRT has a limitation in discriminating the affected side owing to a weaker intensity of nystagmus than SHRT.

Comparison of posttreatment stability after total mandibular arch distalization with mini-implants and mandibular setback surgery.

OBJECTIVES: To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those by mandibular setback surgery (MSS). MATERIALS AND METHODS: The samples included 40 Class III adults, 20 treated by TMAD using buccal interradicular mini-implants and 20 treated with MSS. Lateral cephalograms were taken at pretreatment, posttreatment, and at least 1-year follow-up, and 24 variables were compared using statistical analysis. RESULTS: Mandibular first molars moved distally 1.9 mm with intrusion of 1.1 mm after treatment in the TMAD group. The mandibular incisors moved distally by 2.3 mm. The MSS group exhibited a significant skeletal change of the mandible, whereas the TMAD group did not. During retention, there were no skeletal or dental changes other than 0.6 mm labial movement of the mandibular incisors (P < .05) in the MSS group. There was 1.4° of mesial tipping (P < .01) and 0.4 mm of mesial movement of the mandibular molars and 1.9° of labial tipping (P < .001) and 0.8 mm of mesial movement of the mandibular incisors in the TMAD group. These dental changes were not significantly different between the two groups. CONCLUSIONS: The TMAD group showed a slightly decreased overjet with labial tipping of the mandibular incisors and mesial tipping of the first molars during retention. Posttreatment stability of the mandibular dentition was not significantly different between the groups. It can be useful to plan camouflage treatment by TMAD with mini-implants in mild-to-moderate Class III patients.

The effect of surface treatment and low-temperature degradation on flexural strength of additive manufactured zirconia.

This study aimed to assess the effect of low-temperature degradation (LTD) and surface treatment on the flexural strength of additive-manufactured (AM) zirconia by comparison to subtractive-manufactured (SM) zirconia. Disc-shaped zirconia specimens were fabricated using AM and SM technology, and each group was assigned to 3 subgroups according to the type of surface treatment: control, sandblasting (SB), and 9% hydrofluoric acid etching (HF). The groups were then further divided into 2 subgroups: unaged and aged. Biaxial flexural strength, crystal phase, surface topography, and surface roughness were measured to evaluate the mechanical properties. Statistical analyses were performed with 3-way ANOVA, followed by the comparison of means with Bonferroni post hoc analyses. The means and standard deviations of the biaxial flexural strength and Weibull parameters were calculated with descriptive statistics. All SM groups showed significantly greater flexural strength than the AM groups (p < .05), and LTD did not affect flexural strength except for the SMHF group (p < .05). After LTD, monoclinic phases (m-phase) were found in all groups, and SEM images showed grain pullout due to zirconia volume expansion in both control groups. Sandblasting significantly affected flexural strength (p < .05), whereas the HF group did not affect flexural strength except in the SMHF group after LTD (p < .05). No significant difference was observed in the surface roughness of AM compared to SM groups conditioned with the same surface treatment regardless of LTD. AM zirconia has comparable mechanical properties to SM zirconia, regardless of low-temperature degradation and surface treatment, which indicates the potential of the AM technique for clinical applications.

Detection of thiocyanate in postmortem blood of a fatal potassium thiocyanate-poisoning patient using gas chromatography-mass spectrometry.

Thiocyanate is an inorganic compound used in industrial applications. Here, we report a case of suicidal death due to acute thiocyanate overdose. A 44-year-old man who consumed an unknown amount of thiocyanate solution was transferred to the emergency room and died 2 h after admission. An autopsy was performed 2 days after death. General toxicological analysis of blood using gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry found no drug or alcohol. Quantification using GC-MS post-derivatization with pentafluorobenzyl bromide revealed 2,290 and 1,920 mg/L of thiocyanate in the heart and femoral blood samples, respectively. Thus, the cause of death was attributed to thiocyanate overdose. This study provides useful information for the interpretation of thiocyanate-related fatalities.

Lateral interactions between CD276 and CD147 are essential for stemness in breast cancer: a novel insight from proximal proteome analysis.

Oncogenic cell-surface membrane proteins contribute to the phenotypic and functional characteristics of cancer stem cells (CSCs). We employed a proximity-labeling proteomic approach to quantitatively analyze the cell-surface membrane proteins in close proximity to CD147 in CSCs. Furthermore, we compared CSCs to non-CSCs to identify CSC-specific cell-surface membrane proteins that are closely interact with CD147 and revealed that lateral interaction between CD147 and CD276 concealed within the lipid raft microdomain in CSCs, confers resistance to docetaxel, a commonly used chemotherapy agent for various cancer types, including metastatic breast cancer. Moreover, we investigated the clinical relevance of CD147 and CD276 co-expression in HER2+ breast cancer (BC) and triple-negative breast cancer patients who underwent chemotherapy. We observed poor disease-free survival and Overall survival rates in patients of CD147 and CD276 (p = 0.04 and 0.08, respectively). Subsequent immunohistochemical analysis in independent cohorts of HER2+ BC support for the association between co-expression of CD147 and CD276 and a poor response to chemotherapy. Collectively, our study suggests that the lateral interaction between CD147 and its proximal partners, such as CD276, may serve as a poor prognostic factor in BC and a predictive marker for the critical phenotypic determinant of BC stemness.

Short-term outcomes of Early versus conventional adjuvant chemotherapy in stage III colon cancer: randomized clinical trial.

BACKGROUND: Evidence is lacking regarding the earliest timing of initiating adjuvant chemotherapy to maximize its efficacy safely. A trial was designed and conducted to evaluate the safety and oncological efficacy of early adjuvant chemotherapy compared with conventional adjuvant chemotherapy. The short-term outcomes are reported here. METHODS: A multicentre, randomized (1 : 1), open-label, phase III trial was conducted comparing early adjuvant chemotherapy with conventional adjuvant chemotherapy in patients with stage III colon cancer. Patients who underwent radical surgery who had stage III colon cancer confirmed by histopathological assessment were screened and randomized into the early adjuvant chemotherapy arm or the conventional adjuvant chemotherapy arm. The primary endpoint was 3-year disease-free survival. The adjuvant chemotherapy with FOLFOX was delivered between postoperative day 10 and 14 in the early adjuvant chemotherapy arm, and between postoperative day 24 and 28 in the conventional adjuvant chemotherapy arm. Toxicity and quality of life were evaluated. RESULTS: Between 9 September 2011 and 6 March 2020, 443 patients consented to randomization at eight sites. The intention-to-treat population included 423 patients (209 in the early adjuvant chemotherapy arm and 214 in the conventional adjuvant chemotherapy arm), and the safety population included 380 patients (192 in the early adjuvant chemotherapy arm and 188 in the conventional adjuvant chemotherapy arm). There was no statistically significant difference in overall toxicity (28.1 per cent in the early adjuvant chemotherapy arm and 28.2 per cent in the conventional adjuvant chemotherapy arm, P = 0.244), surgical complications, and quality of life between the two arms. CONCLUSION: Adjuvant chemotherapy can be safely initiated 2 weeks after surgery with toxicity and quality of life comparable to conventional adjuvant chemotherapy for stage III colon cancer.

Mechanical properties of additively manufactured zirconia with alumina air abrasion surface treatment.

This study aimed to evaluate the mechanical properties of zirconia fabricated using additive manufacturing technology and compare them to those of zirconia fabricated using subtractive manufacturing technology. Sixty disc-shaped specimens were fabricated for the additive (n = 30) and subtractive manufacturing groups (n = 30), and each group was divided into two subgroups according to their air-abrasion surface treatment: control (n = 15) and air-abrasion groups (n = 15). Mechanical properties including the flexural strength (FS), Vickers hardness, and surface roughness were determined, and the values were analyzed by one-way ANOVA and Tukey's post hoc test (α = 0.05). X-ray diffraction and scanning electron microscopy were used for phase analysis and surface topography evaluation, respectively. The SMA group exhibited the highest FS (1144.97 ± 168.1 MPa), followed by the SMC (944.58 ± 141.38 MPa), AMA (905.02 ± 111.38 MPa), and AMC groups (763.55 ± 68.69 MPa). The Weibull distribution showed the highest scale value (1213.55 MPa) in the SMA group, with the highest shape value in the AMA group (11.69). A monoclinic peak was not detected in both the AMC and SMC groups, but after air abrasion, the monoclinic phase content ([Formula: see text]) reached 9% in the AMA group, exceeding that in the SMA group (7%). The AM groups exhibited statistically lower FS values than those of the SM groups under the same surface treatment (p < 0.05). Air-abrasion surface treatment increased the monoclinic phase content and FS (p < 0.05) in both the additive and subtractive groups, while it increased the surface roughness (p < 0.05) only in the additive group and did not affect the Vickers hardness in either group. For zirconia manufactured using additive technology, the mechanical properties are comparable to those of zirconia manufactured using subtractive technology.

Behavioral predictors associated with HIV screening needs in gay Korean men during the COVID-19 pandemic.

During the pandemic, the capacity of medical resources focused on testing, diagnosing and treating COVID-19 has severely limited public access to health care. In particular, HIV screening, for which homosexual males in Korea received free and anonymous testing at public health centers, was completely halted. This study investigated behavioral predictors related to the HIV screening needs of Korean male homosexuals during the pandemic. Data were collected by conducting a web survey targeting members of the largest homosexual portal site in Korea with support from the National Research Foundation of Korea (n = 1,005). The key independent variables are COVID-19-related characteristics and sexual risk behavior. The moderating variable is health information search behavior, and the dependent variable is the need for HIV screening. For a statistical analysis, a hierarchical multiple logistic regression analysis was conducted while controlling for potential confounding variables. According to the results of this study, the need for HIV screening was 0.928 times lower for older people (p<0.05, 95% CI = 0.966-0.998). However, if the respondent had a primary partner, the need for HIV screening was 1.459 times higher (p<0.01, 95% CI = 1.071-1.989). In addition, the need for screening was 1.773 times higher for those who preferred anal intercourse (p<0.01, 95% CI = 1.261-2.494) and 2.034 times higher (p<0.01, 95% CI = 1.337-3.095) if there was a history of being diagnosed with an STD. Finally, health information-seeking behavior was marginally significant. This study revealed that male Korean homosexuals who were young, preferred anal sex with a primary partner, and who had a history of a sexually transmitted disease had a high need for HIV screening at public health centers. They are more likely to be susceptible to HIV infection because they are usually consistent with gay men, characterized by risky behavior. Therefore, an intervention strategy that provides health information using a communication campaign is needed.

Enhanced primary ciliogenesis via mitochondrial oxidative stress activates AKT to prevent neurotoxicity in HSPA9/mortalin-depleted SH-SY5Y cells.

The primary cilium, an antenna-like structure on the cell surface, acts as a mechanical and chemical sensory organelle. Primary cilia play critical roles in sensing the extracellular environment to coordinate various developmental and homeostatic signaling pathways. Here, we showed that the depletion of heat shock protein family A member 9 (HSPA9)/mortalin stimulates primary ciliogenesis in SH-SY5Y cells. The downregulation of HSPA9 enhances mitochondrial stress by increasing mitochondrial fragmentation and mitochondrial reactive oxygen species (mtROS) generation. Notably, the inhibition of either mtROS production or mitochondrial fission significantly suppressed the increase in primary ciliogenesis in HSPA9-depleted cells. In addition, enhanced primary ciliogenesis contributed to cell survival by activating AKT in SH-SY5Y cells. The abrogation of ciliogenesis through the depletion of IFT88 potentiated neurotoxicity in HSPA9-knockdown cells. Furthermore, both caspase-3 activation and cell death were increased by MK-2206, an AKT inhibitor, in HSPA9-depleted cells. Taken together, our results suggest that enhanced primary ciliogenesis plays an important role in preventing neurotoxicity caused by the loss of HSPA9 in SH-SY5Y cells.

A π-Bridge Spacer Embedded Electron Donor-Acceptor Polymer for Flexible Electrochromic Zn-Ion Batteries.

Zinc-ion batteries (ZIBs) have drawn much attention for next-generation energy storage for smart and wearable electronics due to their high theoretical gravimetric/volumetric energy capacities, safety from explosive hazards, and cost-effectiveness. However, current state-of-the-art ZIBs lack the energy capacity necessary to facilitate smart functionalities for intelligent electronics. In this work, a "π-bridge spacer"-embedded electron donor-acceptor polymer cathode combined with a Zn2+ -ion-conducting electrolyte is proposed for a smart and flexible ZIB to provide high electrochromic-electrochemical performances. The π-bridge spacer endows the polymeric skeleton with improved physical ion accessibility and sensitive charge transfer through the cycles, providing extremely stable cyclability with high specific capacity (110 mAh g-1 ) at very fast rates (8 A g-1 ) and large coloration efficiency (79.8 cm2  C-1 ) under severe mechanical deformation over a long period. These results are markedly outstanding compared to the topological analogue without the π-bridge spacer (80 mAh g-1 at current density of 8 A g-1 , 63.0 cm2  C-1 ). The design to incorporate a π-bridge spacer realizes notable electrochromism behaviors and high electrochemical performance, which sheds light on the rational development of multifunctional flexible-ZIBs with color visualization properties for widespread usage in powering smart electronics.

Molecular and network-level mechanisms explaining individual differences in autism spectrum disorder.

The mechanisms underlying phenotypic heterogeneity in autism spectrum disorder (ASD) are not well understood. Using a large neuroimaging dataset, we identified three latent dimensions of functional brain network connectivity that predicted individual differences in ASD behaviors and were stable in cross-validation. Clustering along these three dimensions revealed four reproducible ASD subgroups with distinct functional connectivity alterations in ASD-related networks and clinical symptom profiles that were reproducible in an independent sample. By integrating neuroimaging data with normative gene expression data from two independent transcriptomic atlases, we found that within each subgroup, ASD-related functional connectivity was explained by regional differences in the expression of distinct ASD-related gene sets. These gene sets were differentially associated with distinct molecular signaling pathways involving immune and synapse function, G-protein-coupled receptor signaling, protein synthesis and other processes. Collectively, our findings delineate atypical connectivity patterns underlying different forms of ASD that implicate distinct molecular signaling mechanisms.

Rehabilitation of severe dentofacial deformity after early radiotherapy of retinoblastoma: a case report.

BACKGROUND: Retinoblastoma is an intraocular cancer of infancy and childhood, which has been treated with radiation therapy and chemotherapy. Radiation on growing patients can cause deterioration in maxillofacial growth and development that leads to severe skeletal discrepancies between the maxilla and mandible, and dental problems such as crossbite, openbite, and hypodontia. CASE PRESENTATION: We present the case of a 19-year-old Korean man with chewing disability and dentofacial deformities. He had undergone enucleation of the right eye and radiation therapy of the left eye due to retinoblastoma 100 days after birth. Subsequently, he received cancer therapy for the secondary nasopharyngeal cancer at the age of 11 years. He was diagnosed with severe skeletal deformity including sagittal, transverse, and vertical growth deficiency of the maxilla and midface, and with class III malocclusion, severe anterior and posterior crossbite, posterior openbite, multiple missing upper incisors, right premolars, and second molars, and impaction of the lower right second molars. To restore impaired functions and esthetics of the jaw and dentition, the orthodontic treatment combined with two jaw surgery was performed. At the end of surgical orthodontics, dental implants were placed for prosthetic treatment of missing teeth. Additional plastic surgery for zygoma elevation was done with calvarial bone graft followed by fat graft. Facial esthetics and occlusal functions of patient were favorably enhanced with the improvement of skeletal discrepancy and the rehabilitation of maxillary dentition by prosthetic work. At the 2-year follow-up, the skeletal and dental relationships and implant prosthetics were well maintained. CONCLUSION: In an adult patient with dentofacial deformities caused by early cancer therapy in the head and neck area, interdisciplinary interventions including additional plastic surgery of zygoma depression and prosthetic work of missing teeth as well as surgical-orthodontic treatment could establish favorable facial esthetics and oral rehabilitation.

Integration of reconfigurable microchannels into aligned three-dimensional neural networks for spatially controllable neuromodulation.

Anisotropically organized neural networks are indispensable routes for functional connectivity in the brain, which remains largely unknown. While prevailing animal models require additional preparation and stimulation-applying devices and have exhibited limited capabilities regarding localized stimulation, no in vitro platform exists that permits spatiotemporal control of chemo-stimulation in anisotropic three-dimensional (3D) neural networks. We present the integration of microchannels seamlessly into a fibril-aligned 3D scaffold by adapting a single fabrication principle. We investigated the underlying physics of elastic microchannels' ridges and interfacial sol-gel transition of collagen under compression to determine a critical window of geometry and strain. We demonstrated the spatiotemporally resolved neuromodulation in an aligned 3D neural network by local deliveries of KCl and Ca2+ signal inhibitors, such as tetrodotoxin, nifedipine, and mibefradil, and also visualized Ca2+ signal propagation with a speed of ~3.7 µm/s. We anticipate that our technology will pave the way to elucidate functional connectivity and neurological diseases associated with transsynaptic propagation.

Correlation between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients in South Korea: a prospective cohort study.

PURPOSE: This study investigated correlations between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients. METHODS: With parental consent, 84 children who were placed under moderate or deep sedation with chloral hydrate for examinations from November 19, 2020 to July 9, 2022 were recruited. RESULTS: Patients' average age was 19.9 months. Pediatric neurology patients and those who underwent electroencephalography took significantly longer to achieve sedation with chloral hydrate. There was a negative correlation between the time to achieve sedation and actual sleep time within 24 hours prior to the examination. Positive correlations were found between the actual sleep time 24 hours prior to the examination and the second dose per weight, as well as between the sedation recovery time and awake hours before the examination. CONCLUSION: Sleep restriction is not an effective adjuvant therapy for chloral hydrate sedation in children, and sedation effects vary according to pediatric patients' characteristics. Therefore, it would be possible to reduce the unnecessary efforts of caregivers who restrict children's sleep for examinations. It is more important to educate parents about safe sedation than about sleep restriction.

CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions.

BACKGROUND: Heterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services. METHODS: Using a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups. RESULTS: Clustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup. LIMITATIONS: Notable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic. CONCLUSIONS: Concomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis.

Comparison of treatment effects between two types of facemasks in early Class III patients.

OBJECTIVE: To compare the short-term treatment effects between two types of facemasks in skeletal Class III patients. MATERIALS AND METHODS: This retrospective study included 40 skeletal Class III subjects (mean age: 7.7 years) who had been treated with protraction facemasks with forehead straps (PFFS) or Petit type facemasks (PTF). Lateral cephalograms were analyzed at pretreatment (T1) and posttreatment (T2) with an average interval of 9 months. RESULTS: At T1, PFFS and PTF groups showed similar sagittal, vertical dentoskeletal patterns. From T1 to T2, both groups presented significant forward movement of the maxilla, posterior movement and clockwise rotation of the mandible (all p < .001), labioversion of the maxillary incisors, and linguoversion of the mandibular incisors. They showed increased overjet (p < .001). Although there were no significant differences in the number of changes in most dentoskeletal variables between the two groups, the PFFS group showed more anterior rotation of the palatal plane and backward rotation of the mandible compared to the PTF group, resulting in a significant decrease (-0.42 mm) in overbite (p < .05). CONCLUSIONS: Both PFFS and PTF showed no significant differences in most skeletal and dental changes, except for overbite. These findings might be helpful for clinicians in selecting the types of facemasks for growing Class III malocclusion patients.