Stress in autism (STREAM): A study protocol on the role of circadian activity, sleep quality and sensory reactivity.

Mental health issues are markedly increased in individuals with autism, making it the number one research priority by stakeholders. There is a crucial need to use personalized approaches to understand the underpinnings of mental illness in autism and consequently, to address individual needs. Based on the risk factors identified in typical mental research, we propose the following themes central to mental health issues in autism: sleep difficulties and stress. Indeed, the prevalence of manifold circadian disruptions and sleep difficulties in autism, alongside stress related to sensory overload, forms an integral part of autistic symptomatology. This proof-of-concept study protocol outlines an innovative, individualised approach towards investigating the interrelationships between stress indices, sleep and circadian activation patterns, and sensory sensitivity in autism. Embracing an individualized methodology, we aim to collect 14 days of data per participant from 20 individuals with autism diagnoses and 20 without. Participants' sleep will be monitored using wearable EEG headbands and a sleep diary. Diurnal tracking of heart rate and electrodermal activity through wearables will serve as proxies of stress. Those objective data will be synchronized with subjective experience traces collected throughout the day using the Temporal Experience Tracing (TET) method. TET facilitates the quantification of relevant aspects of individual experience states, such as stress or sensory sensitivities, by providing a continuous multidimensional description of subjective experiences. Capturing the dynamics of subjective experiences phase-locked to neural and physiological proxies both between and within individuals, this approach has the potential to contribute to our understanding of critical issues in autism, including sleep problems, sensory reactivity and stress. The planned strives to provide a pathway towards developing a more nuanced and individualized approach to addressing mental health in autism.

Diastolic blood pressure changes during episodes of autonomic dysreflexia.

Objective: The current diagnostic criteria of autonomic dysreflexia (AD) is based solely on systolic blood pressure (SBP) increases from baseline without regard to changes in diastolic blood pressure (DBP). During urodynamics in persons with SCI at or above the sixth thoracic level (T6), we evaluated diastolic blood pressure (DBP) changes related with AD episodes.Design: Retrospective review of blood pressures recorded during urodynamics.Setting: Outpatient SCI urology program in a free standing rehabilitation center.Participants: Persons with spinal cord injury at or above the T6 level.Interventions: Urodynamic procedures performed between August 2018 to January 2019, as well as their prior testing for up to 10 years.Outcome Measures: Systolic and diastolic blood pressures were recorded during the procedure and episodes of AD defined as SBP >20 mmHg above baseline.Results: Seventy individuals accounting for 282 urodynamic tests were reviewed. AD occurred in 43.3% (122/282) of all urodynamics tests. The mean maximum SBP and DBP increase from baseline for those with AD were 35.5 ± 10.9 mmHg and 19.0±9.4 mmHg, respectively. There was a concomitant rise of DBP >10 mmHg with a SBP rise of >20 mmHg in 76.2% (93/122) of urodynamic tests. An elevation of DBP >10 mmHg was recorded in 23.8% (38/160) of urodynamics that did not have AD by the SBP definition.Conclusion: DBP increments of >10 mmHg with concurrent SBP increases of >20 mmHg occurs in the majority of AD episodes. Given the significance of cardiovascular complications in chronic SCI, further work is warranted to determine the significance of DBP elevations for defining AD.

Sexual harassment and feeding inhibition between two invasive dengue vectors.

Two invasive mosquitoes, Aedes aegypti and Aedes albopictus, have been interacting during the course of a rapid range expansion by A. albopictus. We investigated the potential for interspecific feeding interference by male mosquitoes interacting with females within and between these species. A. aegypti feeding on both sugar and blood was suppressed when females of this species were exposed to A. albopictus males, but no change was observed when exposed to conspecifics. A. albopictus feeding was not affected by males of either species. The potential consequences of these behaviors are discussed within the context of other known interspecific effects, all of which appear to favor the displacement of A. aegypti by A. albopictus.

Divided and reunited maxillary artery: developmental and clinical considerations.

We describe an anatomical variation of the right maxillary artery, discovered during dissection of a male human cadaver. The right maxillary artery bifurcates into unequal superficial (larger) and deep (smaller) divisions. Each division gives off several branches that distribute to the muscles of mastication, facial structures, and teeth. The superficial and deep divisions then reunite to form a complete loop, before giving off terminal branches in the pterygopalatine fossa. The entire arterial loop lies superficial to the branches of the mandibular nerve. This case provides further evidence for a network of vascular rings that surround soft tissue structures in the developing infratemporal fossa. Persistence of all or part of these rings determines adult anatomy. Extreme anatomical variations such as this one may complicate major procedures such as radical maxillectomy, as well as simple procedures such as inferior alveolar nerve blocks.