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When COVID-19 disrupted autism spectrum disorder research globally, many clinical trials of behavioral interventions pivoted to telehealth. Telehealth has the potential to increase geographic reach and improve racial/ethnic diversity in research. This matters because most autism spectrum disorder intervention studies have primarily included White, upper-middle-income families from North America and Europe. Participant homogeneity limits our ability to identify what types of intervention works in which context for which populations. Importantly, telehealth needs to “fit” the local context, and in particular, include strategies that factor in the “digital divide.” This short report details contextual considerations and pre-implementation pragmatic adaptations in two autism spectrum disorder clinical trials that include Early Start Denver Model–informed caregiver coaching in the United States and South Africa. By comparing and contrasting how implementation context informed the telehealth pivot in these two clinical trials in different hemispheres, we highlight equity considerations for adaption. The pandemic is an opportunity to understand how remote intervention can “fit” diverse contexts, while providing valid scientific results. It is however important that adaptations be documented and feasibility of the adapted approach be tracked. COVID-19-related telehealth adaptations of behavioral interventions could facilitate the development of new strategies with wider global impact. Lay abstract COVID-19 caused many autism spectrum disorder caregiver-coaching studies to move to telehealth. Telehealth can increase the diversity of people who take part in research. This matters because most autism spectrum disorder studies have included people who have resources, are White, and live in North America and Europe. When study participants are similar, it is hard to understand which interventions can help different types of people who live in different parts of the world. While telehealth may allow more people to take part in research, it needs to “fit” the local context and consider the “digital divide” because many people around the world have no access to computers and the Internet. This short report describes changes to two research studies that include caregiver coaching based on the Early Start Denver Model in the United States and South Africa. We describe how the local context, including technology and Internet access, guided the telehealth approach. By doing so, we highlight ways to make telehealth available to more people around the world. The pandemic can help us understand how telehealth can “fit” diverse places and support high-quality research. It is important that study changes are tracked and we assess how well the changes work. COVID-19 telehealth changes to caregiver coaching can result in new ways to reach more people around the world.

The quality of the information provided in post-transplant follow-up is necessary to obtain a coherent and exploitable database. Since the beginning of 2017, three forms (Med-B-allograft) have been available: the first month (Day 0), Day 100 (second report) and an annual follow-up report. Recommendations for follow-up were addressed in the 2014 harmonization workshop, "Harmonization of Data Coding…". However, it is sometimes difficult to determine which data to specify in ProMISe for post-transplantation. The objective of this workshop was to clarify certain situations and/or items.

INTRODUCTION While the native arteriovenous fistula (AVF) is the preferred dialysis access, it is a matter of debate for individuals older than 80 years due to reduced primary patency rates. MATERIALS AND METHODS We initiated a single-center, observational retrospective analysis of adult dialysis patients from January 2015 to December 2018. We included all patients older than 70 years with a minimum of 12 months of follow-up, beginning from the AVF creation. Patients were separated into two groups, octogenarians (> 80 years old) and controls (70 - 79 years old). The primary end point was the primary patency (the interval from arteriovenous access creation to the first intervention). The secondary end point were the complications at 3 months (failures of puncture, canceled dialysis sessions, local hematoma, AVF bleeding). RESULTS 29 patients (octogenarian = 17, control = 12) were included in the analysis. The AVF radio-cephalic was the most common vascular access in each group. Primary patency was comparable between groups, but octogenarians required 40% more procedures to obtain or maintain patency. Overall, a functional AVF was obtained for all patients except in cases of complications such as hematomas, which were more frequent in octogenarians compared to controls (25 vs. 82%, p

Background Hemodialysis patients are at risk of intradialytic hypotension ( IDH ), which is associated with mortality and cardiovascular and neurological events. The use of biomarkers of volemia such as relative change in protidemia and BNP (B‐natriuretic peptide) levels to predict IDH remains unknown. Methods and Results We conducted a prospective observational study, which enrolled 170 chronic hemodialysis patients in a single center from September 2015 to March 2016. BNP and the relative change of protidemia level (Δprotidemia=postdialysis protidemia−predialysis protidemia) were measured monthly over 6 months. A logistic mixed regression model was used to define the best biomarkers that predict the 30‐day risk of IDH . Receiver operating characteristic analysis area under the curve was used to define the cutoff values of Δprotidemia that predict IDH A logistic mixed model reveals that Δprotidemia predicts the 30‐day risk of IDH but not BNP or age; odds ratio=1.12, 95% CI 1.08‐1.17), odds ratio=0.81, 95% CI (0.64; 1.07) and odds ratio =0.015 95% CI (0.99; 1.03), respectively. Adding the ultrafiltration rate did not improve the model. A receiver operating characteristic curve analysis showed that Δprotidemia of 10 g/L allowed for discrimination of the patients with IDH (area under the curve= 0.67; 95% CI 0.62‐0.72, P CI 0.63‐0.76) in a subgroup of hemodialysis with BNP Conclusions Relative change in protidemia level (Δprotidemia) outperforms BNP and ultrafiltration rate as a predictor for 30‐day risk of IDH . These results should be confirmed by a prospective study.

Forecasting the dynamics of alteration in materials, in particular the timescale of degradation, is relevant to preventive conservation, and great deal of effort has gone into developing new models...

The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.

A escrita deste trabalho é resultado de evento promovido no Instituto Federal de Educação, Ciência e Tecnologia Farroupilha, Campus Panambi, e propõe-se a relatar a experiência desenvolvida no ano de 2015 pela Coordenação de Ações Inclusivas (CAI) a fim de provocar discussões a partir da exibição de filmes nacionais com temáticas específicas do campo da inclusão. No denominado CineViver, propôs-se três eventos durante o ano letivo, um por núcleo que compõe a coordenação, NUGEDIS (Núcleo de Gênero e Diversidade Sexual), NEABI (Núcleo de Estudos Afro-brasileiros e Indígenas) e NAPNE (Núcleo de Atendimento às Pessoas com Necessidades Especiais) em atendimento à Lei 13006/2014 que prevê a exibição de pelo menos duas horas de cinema nacional por mês nas escolas. Será feito, nesta escrita, percurso pelo campo do cinema e educação para, a seguir, relatar a experiência vivenciada nos três momentos em que foram exibidos os filmes escolhidos: “A história de todos nós”, “Hoje eu quero voltar sozinho” e “Refugiados na América Latina: a saída é a fuga”. Por fim, serão apresentadas as considerações finais e possibilidades futuras para se trabalhar o cinema na instituição.

International audience; The large range of stable oxygen isotope values of phosphate-bearing minerals and dissolved phosphate of inorganic or organic origin requires the availability of in-house produced calibrated silver phosphate of which isotopic ratios must closely bracket those of studied samples. We propose a simple protocol to synthesise Ag3PO4 in a wide range of oxygen isotope compositions based on the equilibrium isotopic fractionation factor and the kinetics and temperature of isotopic exchange in the phosphate-water system. Ag3PO4 crystals were obtained from KH2PO4 that was dissolved in water of known oxygen isotope composition. Isotopic exchange between dissolved phosphate and water took place at a desired and constant temperature into PYREX (TM) tubes that were placed in a high precision oven for defined run-times. Samples were withdrawn at desired times, quenched in cold water and precipitated as Ag3PO4. We provide a calculation sheet that computes the delta O-18 of precipitated Ag3PO4 as a function of time, temperature and delta O-18 of both reactants KH2PO4 and H2O at t = 0. Predicted oxygen isotope compositions of synthesised silver phosphate range from -7 to +31 parts per thousand VSMOW for a temperature range comprised between 110 and 130 degrees C and a range of water delta O-18 from -20 to +15 parts per thousand VSMOW.

Background: Coaching caregivers to deliver Naturalistic Developmental Behavioral Intervention (NDBI) strategies to their young child with autism spectrum disorder (ASD) could help address the provider capacity barrier in sub-Saharan Africa. However, the behavioral and developmental research that underpins NDBIs is overwhelmingly drawn from high resource settings. Therefore, our understanding of joint activity routines, including play and family routines in which NDBI strategies are embedded, may have limited applicability in low resource, culturally diverse environments. Important questions remain on how to adapt NDBIs to be relevant in the family lives in these settings. This study aimed to elicit descriptions of joint activity routines from caregivers of young children with ASD in South Africa, to understand whether an NDBI-informed caregiver coaching could ‘fit’ within the multicultural, multilingual South African context. Methods: Four focus groups were conducted with 22 caregivers of young children with ASD who were recruited from the Western Cape Education Department autism waiting list. Data were analyzed through directed content analysis, which uses inductive methods to determine salient themes and subthemes. The predetermined initial coding classifications were based on joint activity routine categories of object-based play, sensory social routines, and family routines. Results: Participants’ descriptions of caregiver-child interactions aligned with a-priori joint activity routine categories. During object-based play, caregivers engaged in turn-taking, taught developmental skills (for example cognitive, language, and fine motor skills), and participated in child-directed activities. During sensory social routines, caregivers described active, physical play, awareness of child affect, increased child expressive language, and willingness to engage with different play partners. During family routines, caregivers detailed child participation in mealtime and bath time. Conclusions: These data suggest that South African caregivers of young children with ASD use joint activity routines to engage their children and teach them new skills, thus suggesting a degree of ‘fit’ between South African caregiver-child interactions and an NDBI-informed caregiver coaching approach. However, more information on family routines and which caregiver interacts with the young child with ASD during these routines would help tailor these interventions for low-resource African settings.

International audience; We demonstrate an improved method based on continuous‐flow elemental analyser pyrolysis isotopic ratio mass spectrometry (CF‐EA‐PY‐IRMS) to measure the 2H/1H ratios of water trapped in halite crystals. Two challenges to overcome are the low hydrogen concentration of samples (10‐50 μmol H2·g−1) and the high chloride concentration released when reacting halite in an elemental analyser. We describe an optimization procedure for determining the 2H/1H ratio of this trapped water with an acceptable accuracy. This technique involves the use of a high‐temperature Cr reactor to quantitatively convert H2O into H2. The initial step was performed on halite crystals precipitated from a water reservoir where 2H/1H ratios were monitored from its initial stage until the end of evaporation. The 2H/1H isotopic analyses were automated online in continuous‐flow mode. Precision of the method was determined for those “synthetic” samples with hydrogen concentrations ranging from 0.2 to 0.5 wt%. 2H/1H isotopic ratios of evaporating waters bracket the compositions of water inclusions. The formation of fluid inclusions is not instantaneous and records the isotopic signature of the residual waters across a time range during which the isotopic values of the water still evolve. This property explains why the δ2HVSMOW standard deviation of ±5‰ (2σ) observed for 10‐mg aliquots of halite exceeds the instrumental error (about ±1.5‰ 2σ) determined on the basis of IAEA‐CH7, NBS 30, and NBS 22 references along with calibrated waters with and without added halite crystals. We also applied this method to Mesoproterozoic (1.4 Ga) and Neoproterozoic (0.8 Ga) halite samples with relatively low hydrogen concentrations (300‐1500 ppm). The measured δ2HVSMOW values for Precambrian waters range from −89‰ to −54‰. We propose that this technique offers a new perspective and great potential for palaeoenvironmental reconstructions based on the 2H/1H analyses of water trapped in halite.

Aim Clinical interpretation of B-type natriuretic peptide (BNP) levels in haemodialysis (HD) patients for fluid management remains elusive. Methods We conducted a retrospective observational monocentric study. We built a mathematical model to predict BNP levels, using multiple linear regressions. Fifteen clinical/biological characteristics associated with BNP variation were selected. A first cohort of 150 prevalent HD (from September 2015 to March 2016) was used to build several models. The best model proposed was internally validated in an independent cohort of 75 incidents HD (from March 2016 to December 2017). Results In cohort 1, mean BNP level was 630 +/- 717 ng/mL. Cardiac disease (CD - stable coronary artery disease and/or atrial fibrillation) was present in 45% of patients. The final model includes age, systolic blood pressure, albumin, CD, normo-hydrated weight (NHW) and the fluid overload (FO) assessed by bio-impedancemetry. The correlation between the measured and the predicted log-BNP was 0.567 and 0.543 in cohorts 1 and 2, respectively. Age (beta = 3.175e(-2),P < 0.001), CD (beta = 5.243e(-1),P < 0.001) and FO (beta = 1.227e(-1),P < 0.001) contribute most significantly to the BNP level, respectively, but within a certain range. We observed a logistic relationship between BNP and age between 30 and 60 years, after which this relationship was lost. BNP level was inversely correlated with NHW independently of CD. Finally, our model allows us to predict the BNP level according to the FO. Conclusion We developed a mathematical model capable of predicting the BNP level in HD. Our results show the complex contribution of age, CD and FO on BNP level.

CARADERM is a French national network that includes patients with rare skin adnexal neoplasms. The present paper describes only the adnexal neoplasm part of this network. The primary objective of CARADERM is to improve medical care for malignant skin adnexal neoplasms. A multidisciplinary review group and a centralized pathological review group have been set up.A dual network of clinicians and pathologists has been set up. Data are recorded in a secure database.The CARADERM network comprises of 38 clinical centres and 22 pathology centres. Between 2014 and 2017, 1598 patients with an adnexal neoplasm were included. Data of interest were documented in 80% of cases. Median patient age was 72 years. Major histological subtypes were sweat gland carcinomas (50%), hair follicle carcinomas (37.7%), and sebaceous gland carcinomas (9.8%). Surgery was the first-line treatment for 81% of patients, including 76.9% with standard surgical margin analysis, and 5.5% with exhaustive margin analysis. 920 patients (57.6%) underwent a national pathology review process.The CARADERM network aims at providing assistance in difficult situations concerning diagnosis and care in skin adnexal neoplasms. Analysis of the CARADERM data should allow the creation of a prognostic classification of these rare neoplasms together with recommendations. A national multidisciplinary consensus exists. Translational and therapeutic research is ongoing.The CARADERM network is currently recruiting and more data should lead to improved knowledge of these tumours in the coming years.

The identification of modern restoration products with portable instrumentation will enable conservators and conservation scientists to gain information in a shorter time and at a reduced cost, compared to standard micro-destructive techniques. This study employs portable Visible Near-Infrared Fibre Optics Reflectance Spectrometry (Vis-NIR-FORS) as a diagnostic tool to identify and classify the considered products. We assembled a large library made of the most commonly used industrial products in the field of cultural heritage. Thirty products were applied in different concentrations on different substrates (e.g., marble, mortar, polychrome plaster, modern mural painting), and mock-up samples were investigated through Vis-NIR-FORS in the 350–2200 nm range. We then applied several statistical techniques and modern machine learning algorithms such as clustering to the entire database, to quantify the degree of correlation among different spectra. We show how using a multivariate, robust statistical approach can increase the signal-to-noise ratio, thus leading to a more precise identification and localisation of these products. Finally, the proposed procedure was also applied to spectra collected in situ on mural paintings.

International audience; Aim: Clinical interpretation of B-Type Natriuretic Peptide (BNP) levels in hemodialysis patients (HD) for fluid management remains elusive.Method: We conducted a retrospective observational monocentric study. We built a mathematical model to predict BNP levels, using multiple linear regressions. Fifteen clinical/biological associated with BNP variation were selected. A first cohort of 150 prevalent HD (from September 2015 to march 2016) was used to build several models. Thebest model proposed was internally validated in an independent cohort of 62 incidents HD (from March 2016 to September 2017).Results: In cohort 1, mean BNP Level was 630±717 ng/ml. Cardiac disease (CD = Stable Coronary Artery Disease and/or Atrial Fibrillation) was present in 45% of patient. The final model includes: Age, systolic Blood Pressure (sBP), Albumin, CD, Normo-hydrated Weight (NHW) and the Fluid Overload (FO) assessed by bio-impedancemetry. The correlationbetween the measured and the predicted log-BNP was 0.567 and 0.543 in cohort-1 and 2 respectively. Age (β=3.175e-2, p

Introduction Les données concernant la COVID-19 sont limitées chez les patients hémodialysés chroniques. Dans cette étude, nous avons voulu identifier les marqueurs cliniques et biologiques associés aux formes sévères de COVID-19. Description Il s’agit d’une étude prospective, observationnelle dans 4 centres de dialyse. Du 19/03 au 19/05/20, 62 patients hémodialysés chroniques sur 612 ont été diagnostiqués COVID-19, par RT-PCR et/ou tomodensitométrie (TDM) thoracique. Chaque patient a bénéficié d’un suivi biologique spécifique hebdomadaire. Méthodes Les données épidémiologiques et cliniques des patients issues du dossier médical informatisé ont été collectées lors du diagnostic de l’infection. Les résultats de NFS, CRP, ferritine, fibrinogène, LDH, bilan hépatique ont été analysés de j0 à j14, avec comme référence les résultats du suivi mensuel précédent l’infection. Les formes sévères étaient définies par l’oxygénodépendance, l’admission en réanimation ou le décès. Un modèle de Cox a été utilisé pour déterminer les facteurs prédictifs associés aux formes sévères. Résultats Au total, 45 % des patients ont développé une forme sévère de COVID-19, et 10 % sont décédés. En comparaison avec les formes non sévères, les formes sévères ont eu plus de fièvre (93 % vs 56 %, p 3,7 à j7 était le facteur prédictif majeur d’une évolution vers une forme sévère (AHR 4,28, IC95 % [1,52–12], p

The quality of the information provided in post-transplant follow-up is necessary to obtain a coherent and exploitable database. Since the beginning of 2017, three forms (Med-B-allograft) have been available: the first month (Day 0), Day 100 (second report) and an annual follow-up report. Recommendations for follow-up were addressed in the 2014 harmonization workshop, "Harmonization of Data Coding…". However, it is sometimes difficult to determine which data to specify in ProMISe for post-transplantation. The objective of this workshop was to clarify certain situations and/or items.