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People on the autism spectrum can learn about autism from various sources, likely differing in the information, portrayal, and discussion they offer. The present study investigates where autistic people learn about autism, and whether their information source is associated with their level of autism knowledge, perceptions of stigma, and development and expression of an autism identity. A survey of 198 Australian adults with an autism diagnosis showed that learning about autism from conventional sources (e.g., professionals, parents) was associated with more internalised stigma, lower endorsement of special abilities and autism identity, whereas online blogs and social media showed the opposite pattern as well as more accurate knowledge of autism. The findings raise questions about how authoritative sources of information discuss autism.

Autistic adults experience high rates of unemployment, yet research investigating what predicts employment success produces inconsistent results. By utilising longitudinal person-oriented analyses, this study aimed to identify employment trajectories of autistic adults to better understand what may predict stable autistic employment. Participants were 2449 autistic adults (1077 men, 1352 women, 20 non-binary, M = 42.25 years, SD = 14.24), recruited via the Netherlands Autism Register. Latent class analysis utilising employment status across eight annual waves was used to identify longitudinal employment profiles. Fit indices and the interpretability of results indicated a four-class model best fit the data, with profiles reflecting stable unemployment (n = 1189), stable employment (n = 801), early unemployment increasing in probability of employment (n = 183) and high probability of employment reducing across time to low employment (n = 134). Multinominal analyses suggested that compared to the 'stable unemployment' group, membership in the 'stable employment' profile was predicted by fewer autistic traits, lower age, male gender, higher education and diagnosis age, and fewer co-occurring conditions. Higher education predicted both other profiles, with lower age and fewer co-occurring conditions predicting membership in the increasing employment class. Taken together, findings highlight the utility of person-oriented approaches in understanding the longitudinal challenges autistic adults experience maintaining employment and identifies key areas of support.

Industry-led employment programmes have emerged to transition autistic people into employment and meet industry labour needs. However, theoretical research is limited in this area, often failing to appreciate the influence of the broader employment ecosystem. In this study, we interviewed 33 autistic employees (n = 29 males, M[subscript age] = 29.00 years) from two industry-led employment programmes regarding their experience of the programme's supports, relationships and impact. We used qualitative content analysis to identify five themes: (1) working involves multiple job tasks that evolve as the employment context changes; (2) workplace relations are diverse and shaped by the type of work and the work environment; (3) workplace needs evolve as autistic individuals navigate the work environment; (4) developing a professional identity in the workplace through mastery and integration; and (5) recommendations for the development of supportive workplace environments for autistic individuals. We describe the way that factors within (e.g. training) and outside the two employment programmes changed and interacted over time to contribute to the participant's work experience and professional identity. Building on ecological systems theory, our unique contribution to the literature is a new model capturing individual and workplace factors that contribute to the work experience of autistic people who participate in industry employment programmes.

Abstract Alterations in subcortical brain regions are linked to motor and non-motor symptoms in Parkinson’s disease (PD). However, associations between clinical expression and regional morphological abnormalities of the basal ganglia, thalamus, amygdala and hippocampus are not well established. We analyzed 3D T1-weighted brain MRI and clinical data from 2525 individuals with PD and 1326 controls from 22 global sources in the ENIGMA-PD consortium. We investigated disease effects using mass univariate and multivariate models on the medial thickness of 27,120 vertices of seven bilateral subcortical structures. Shape differences were observed across all Hoehn and Yahr (HY) stages, as well as correlations with motor and cognitive symptoms. Notably, we observed incrementally thinner putamen from HY1, caudate nucleus and amygdala from HY2, hippocampus, nucleus accumbens, and thalamus from HY3, and globus pallidus from HY4–5. Subregions of the thalami were thicker in HY1 and HY2. Largely congruent patterns were associated with a longer time since diagnosis and worse motor symptoms and cognitive performance. Multivariate regression revealed patterns predictive of disease stage. These cross-sectional findings provide new insights into PD subcortical degeneration by demonstrating patterns of disease stage-specific morphology, largely consistent with ongoing degeneration.

Abstract Aboveground biomass density (AGBD) estimates from Earth Observation (EO) can be presented with the consistency standards mandated by United Nations Framework Convention on Climate Change (UNFCCC). This article delivers AGBD estimates, in the format of Intergovernmental Panel on Climate Change (IPCC) Tier 1 values for natural forests, sourced from National Aeronautics and Space Administration’s (NASA’s) Global Ecosystem Dynamics Investigation (GEDI) and Ice, Cloud and land Elevation Satellite (ICESat-2), and European Space Agency’s (ESA’s) Climate Change Initiative (CCI). It also provides the underlying classification used by the IPCC as geospatial layers, delineating global forests by ecozones, continents and status (primary, young (≤20 years) and old secondary (>20 years)). The approaches leverage complementary strengths of various EO-derived datasets that are compiled in an open-science framework through the Multi-mission Algorithm and Analysis Platform (MAAP). This transparency and flexibility enables the adoption of any new incoming datasets in the framework in the future. The EO-based AGBD estimates are expected to be an independent contribution to the IPCC Emission Factors Database in support of UNFCCC processes, and the forest classification expected to support the generation of other policy-relevant datasets while reflecting ongoing shifts in global forests with climate change.

* Context.--In 2018 the College of American Pathologists Diagnostic Immunology and Flow Cytometry Committee designed and implemented a new plasma cell neoplasia flow cytometry proficiency testing program--PCNEO--to allow clinical flow cytometry laboratories to monitor and assess their performance compared with a peer group. Objective.--To report the results from the first 4 years of the PCNEO program. Design.--Program participants were sent 2 sets of challenges per year, each including 1 wet challenge and 2 dry challenges, with associated clinical and laboratory findings. The wet challenges were composed of myeloma cell line specimens (with or without dilution in preserved whole blood) for flow cytometric analysis. The dry (paper) challenges were composed of clinical case summaries and images of flow cytometric test results from various flow cytometry laboratories of committee members. Results.--A total of 116 to 145 laboratories from 17 countries enrolled in the proficiency testing program. For the wet challenges, almost all participants (97%-100%; cumulative, 98.2%) correctly identified the presence of neoplastic plasma cell populations based on flow cytometric analysis of undiluted myeloma cell lines. Slightly fewer participants (89.0%-97.4%; cumulative, 95.2%) correctly identified the presence of neoplastic plasma cell populations based on flow cytometric analysis of diluted myeloma cell lines (10% or 50% dilutions into peripheral blood) intended to better represent a typical clinical sample. There was generally agreement among 80% or more of participants for positive or negative staining for CD38, CD138, CD19, CD20, and surface and cytoplasmic k and X light chains. Similarly, 84% to 100% of participants were able to correctly identify the presence of neoplastic plasma cell populations in paper challenges, including the presence of small, neoplastic plasma cell populations (0.01%-5.0% clonal plasma cells) and the presence of nonneoplastic plasma cell populations (correctly identified by 91 %-96% of participants). Conclusions.--Participant performance in the new proficiency testing program was excellent overall, with the vast majority of participants able to perform flow cytometric analysis and identify neoplastic plasma cell populations and to identify small plasma cell clones or expanded populations of reactive plasma cells in dry challenge flow cytometry results. This program will allow laboratories to verify the accuracy of their testing program and test interpretations for the assessment of patients suspected of having a plasma cell neoplasm. (Arch Pathol Lab Med. 2024;148:699-704; doi: 10.5858/arpa. 2023-0035-CP), The Diagnostic Immunology and Flow Cytometry Committee (DIFCC) acts as an expert scientific and educational resource for the College of American Pathologists in diagnostic immunology and flow cytometry clinical testing. [...]

We present a cost-benefit analysis of an Australian Government sponsored 3-year supported employment program for autistic adults--the DXC Dandelion Program--in the information and communications technology sector. We explored the range of direct costs associated with running the program, benefits to participants, and avoided costs to the government. Estimates were based on data from 56 (86% men; M[subscript age] = 25.28, standard deviation [SD] = 8.36 years) autistic participants in the program. The program generated a high benefit ratio for government, mainly driven by increases in wage rates and hours worked and avoiding welfare and unemployment benefit payments. Participants received the largest benefit through wages and access to the labor market, with most participants transitioning into productive, open employment following program completion. The results from the model are robust; the benefit ratio remained above 1.0 even when higher discount rates were applied. In sum, our analysis identifies potential economic savings associated with supported employment programs that provide pathways for otherwise unemployed or under-employed autistic adults to enter the workforce.

Abstract Background In most countries engaged on the last mile towards malaria elimination, residual transmission mainly persists among vulnerable populations represented by isolated and mobile (often cross-border) communities. These populations are sometimes involved in informal or even illegal activities. In regions with Plasmodium vivax transmission, the specific biology of this parasite poses additional difficulties related to the need for a radical treatment against hypnozoites to prevent relapses. Among hard-to-reach communities, case management, a pillar of elimination strategy, is deficient: acute malaria attacks often occur in remote areas, where there is limited access to care, and drugs acquired outside formal healthcare are often inadequately used for treatment, which typically does not include radical treatment against P. vivax. For these reasons, P. vivax circulation among these communities represents one of the main challenges for malaria elimination in many non-African countries. The objective of this article is to describe the protocol of the CUREMA study, which aims to meet the challenge of targeting malaria in hard-to-reach populations with a focus on P. vivax. Results CUREMA is a multi-centre, international public health intervention research project. The study population is represented by persons involved in artisanal and small-scale gold mining who are active and mobile in the Guiana Shield, deep inside the Amazon Forest. The CUREMA project includes a complex intervention composed of a package of actions: (1) health education activities; (2) targeted administration of treatment against P. vivax after screening against G6PD deficiency to asymptomatic persons considered at risk of silently carrying the parasite; (3) distribution of a self-testing and self-treatment kit (malakit) associated with user training for self-management of malaria symptoms occurring while in extreme isolation. These actions are offered by community health workers at settlements and neighbourhoods (often cross-border) that represent transit and logistic bases of gold miners. The study relies on hybrid design, aiming to evaluate both the effectiveness of the intervention on malaria transmission with a pre/post quasi-experimental design, and its implementation with a mixed methods approach. Conclusions The purpose of this study is to experiment an intervention that addresses both Plasmodium falciparum and P. vivax malaria elimination in a mobile and isolated population and to produce results that can be transferred to many contexts facing the same challenges around the world.

Abstract Background Individuals on the autism spectrum commonly have differences from non-autistic people in expressing their emotions using communicative behaviors, such as facial expressions. However, it is not yet clear if this reduced expressivity stems from reduced physiological reactivity in emotional contexts or if individuals react internally, but do not show these reactions externally to others. We hypothesized that autism is characterized by a discordance between in-the-moment internal psychophysiological arousal and external communicative expressions of emotion. Methods Forty-one children on the autism spectrum and 39 non-autistic, typically developing (TD) children of two age groups (2–4 and 8–12 years) participated in a low-level stress task whilst wearing a wireless electrocardiogram. Children’s negative emotional expressions (facial, vocal, bodily) were coded following standardized protocols. Alexithymia traits were assessed using the Children’s Alexithymia Measure with school-aged children only. Data analyses involved ANOVAs, correlations, and sensitivity analyses. Results There were no group differences in physiological arousal (heart rate) or in communicative expressions of stress to the stress task. For TD preschoolers, physiological arousal during the stress task was associated with vocal expressions and for TD school-aged children, they were associated with facial and bodily expressions. By contrast, for children on the autism spectrum, physiological arousal during the stress tasks was not associated with communicative expressions across age groups. Conclusions Our findings suggest that children on the autism spectrum might experience emotional disconcordance, in that their physiological arousal does not align with their communicative expressions. Therefore, the internally experienced stress of children on the autism spectrum may be inadvertently missed by teachers and caregivers and, consequently, learning opportunities for teaching emotional communication and regulation may be also missed. Our results support the use of wearable biosensors to facilitate such interventions in children on the autism spectrum.

Objective: This study aimed to examine the trends in gender, ethnicity and less-than-full-time (LTFT) training in reconstructive plastic surgery from 2009 to 2020 in the UK by comparing them to overall surgical specialties. Methods: We analysed NHS Digital workforce data from 2009 to 2020 by examining trends in gender, ethnicity and LTFT working among reconstructive plastic surgery consultants and registrars and comparing them to overall surgical specialties. Data were analysed using linear regression models. Results: The percentage of female reconstructive plastic surgery consultants and registrars increased significantly over the period, with reconstructive plastic surgery groups having higher percentages of females than overall surgical specialties. LTFT working trends varied, with declining trends among consultants and increasing trends among registrars. Ethnicity trends were complex, varying between different ethnic categories and between consultants and registrars, but showing an increase in diversity within the workforce. Conclusion: The demographics of reconstructive plastic surgeons in the UK became more diverse from 2009 to 2020 with trends indicating that this will continue in the future. However, there were significant variations among the different groups and levels of seniority, suggesting the need for targeted interventions to promote diversity and inclusivity in surgical specialties.

Abstract Background Drugs targeting angiogenesis and immunotherapy have transformed outcomes in renal cancer but may contribute to progressive kidney disease. Methods We linked healthcare databases in the West of Scotland (spanning 2010–2020) to identify adults with renal cancer who received one or both classes of drugs. Over two years following initiation, estimated glomerular filtration rate (eGFR) slope was modelled using linear mixed-effects models. Additional renal outcomes used competing risk regression considering the competing risk of death. Results Amongst 357 adults (62.5% male; median age 63.0 years, IQI 55.0–71.0), there was no significant change in eGFR (annual eGFR change +1.03 mL/min/1.73 m²/year, 95%CI −1.64 to +3.70), nor in subgroups of patients who had nephrectomy, metastatic cancer or an eGFR

Abstract The progression of Parkinson’s disease (PD) is associated with microstructural alterations in neural pathways, contributing to both motor and cognitive decline. However, conflicting findings have emerged due to the use of heterogeneous methods in small studies. Here we performed a large diffusion MRI study in PD, integrating data from 17 cohorts worldwide, to identify stage-specific profiles of white matter differences. Diffusion-weighted MRI data from 1654 participants diagnosed with PD (age: 20–89 years; 33% female) and 885 controls (age: 19–84 years; 47% female) were analyzed using the ENIGMA-DTI protocol to evaluate white matter microstructure. Skeletonized maps of fractional anisotropy (FA) and mean diffusivity (MD) were compared across Hoehn and Yahr (HY) disease groups and controls to reveal the profile of white matter alterations at different stages. We found an enhanced, more widespread pattern of microstructural alterations with each stage of PD, with eventually lower FA and higher MD in almost all regions of interest: Cohen’s d effect sizes reached d = −1.01 for FA differences in the fornix at PD HY Stage 4/5. The early PD signature in HY stage 1 included higher FA and lower MD across the entire white matter skeleton, in a direction opposite to that typical of other neurodegenerative diseases. FA and MD were associated with motor and non-motor clinical dysfunction. While overridden by degenerative changes in the later stages of PD, early PD is associated with paradoxically higher FA and lower MD in PD, consistent with early compensatory changes associated with the disorder.

Autistic people face many challenges entering the workforce, for example, during job interviews where performance is reliant on particular social skills. To be competitive during job interviews, autistic people may experience pressure to conceal or 'camouflage' their autistic traits and behaviour. This qualitative study used semi-structured interviews to explore the job interview experiences of 10 autistic people. Based on the literature, we were curious as to whether participants would report behaviour consistent with the camouflaging hypothesis. Thematic analysis identified six themes reflecting individual and environmental factors. Participants reported engaging in camouflaging behaviour during job interviews, with external factors (e.g. avoid being treated differently) cited as the primary reason. Participants reported that camouflaging required effort, leading to stress, anxiety, exhaustion and feeling 'burnt out'. They expressed a desire for an inclusive, understanding and accommodating environment where they would feel more comfortable disclosing their diagnosis without feeling they needed to conceal their autistic traits and behaviour. These preliminary findings add to the current literature regarding autism, camouflaging and employment.

The world in 2024 faces numerous interlinked crises, including climate change and water shortages, rising geopolitical tensions, and a new awareness of the risks of pandemics. These crises reverse decades of incremental development progress and humanity’s aspirations embodied in the 2030 Agenda for Sustainable Development, necessitating a more active and collaborative participation of development stakeholders. The magnitude of challenges points to the need for transformational approaches to releasing the potential of stakeholders, which requires building on and extending beyond current best practices in participation and capacity strengthening. What is most needed today is a balanced assessment of the complexity of human nature and a vision that recognizes the prosocial potential of people to harmonize the pursuit of personal interests with a willingness to contribute to social and collective development goals. Prosociality is a capacity that all stakeholders can strengthen—from individuals to institutions to communities (including different forms of social groupings). These stakeholders can become empowered as active protagonists of development, with the potential to work synergistically to achieve the Sustainable Development Goals (SDGs). In order to work with these protagonists, it is important to view them systematically in terms of key characteristics such as their antecedent knowledge, values and culture, stance, agency, roles, relationships, and learning.

Prior research has studied preferences for identity- or person-first language among persons with an autism diagnosis. The current study differs from this previous body of research by specifically examining quantitative predictors of language preferences through a social identity theoretical approach, thereby leading to a better understanding of psychological and social factors that might underlie language use and preference within the autistic community. Australian adults with an autism diagnosis (N = 198) completed the measures of autism knowledge, internalised stigma, and autism identity to determine whether these factors predict language preference. Results indicated a stronger autism identity was associated with a preference for identity-first terms (autistic/autistic person) and finding these less offensive. Contrastingly, stigma was associated with finding identity-first language less favourable and more offensive. Person-first terms (e.g. person with autism) were not associated with any of the predictors. Together, these findings suggest decision-making around identity-first language is influenced by a strong sense of autistic identity and experiences of stigma.