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Singer et al. (2022) argue that the current lexical shift within autism research towards more neutral terminology hinders accurate scientific description of the wide range of autistic experiences, particularly within clinical and medical contexts. In this Letter to the Editor, we present an examination and criticism of these claims. This letter is authored and co-signed by a diverse group of autistic researchers, scholars, clinicians, and self-advocates with a wide range of clinical presentation and support needs, as well as non-autistic researchers, scholars, clinicians, and loved ones of autistic people.

The coordinators of the International Committee of Representatives of Indexing Societies (ICRIS) report on the 2018 ICRIS triennial meeting, which was held immediately before the China Society of I...

Background: Good collateral flow has been shown to have better outcomes after acute ischemic stroke (AIS), including for patients receiving IV thrombolysis (IVT) and mechanical thrombectomy (MT). Hypothesis: In patients with AIS who undergo MT, good collateral flow is associated with better functional independence measure (FIM) change. Design/Methods: Data was collected retrospectively for patients who presented with AIS and were treated with MT. A total of 54 patients from 4 inpatient rehabilitation facility (IRF) locations between April 2017 and August 2019 were included. Collateral score was collected from angiograms and CT angiogram (CTA) in cases where an angiogram was not available. FIM change was defined as the difference in FIM at admission to IRF and discharge from IRF. Regression analyses were conducted to estimate the relationship between collateral score and FIM change. The predictors in the model included collateral score, FIM at admission to IRF, age at onset, and gender. Logistic regression was used for categorical variables and linear regression was applied for continuous variables. Statistical significance level was set at 0.05. Collaterals were scored from 0 to 4, with 0 to 2 being poor and good collateral flow defined as scores 3 and 4. The primary outcome of this study was FIM change. Results: The mean age was 70.4 years, and 54.5% was female. Regression analyses did not show any significant differences in FIM change in patients with collaterals ranging from poor to good p = 0.807 (Table 1), when adjusted for age, gender, and severity as represented by FIM at admission to IRF. Conclusion: In this patient cohort, good collateral flow was not associated with improvement in FIM change.

Introduction: We sought to predict the course and rate of functional improvement and length of stay (LOS) in patients with ischemic and hemorrhagic strokes admitted to inpatient rehabilitation facilities(IRF). Aim: To study the course and associating factors affecting functional outcomes among a large cohort of stroke patients admitted to IRFs. Methods: The cohort consists of stroke patients admitted to 5 IRFs in Houston, between 4/17-8/19. Higher order polynomial (quartic, cubic, quadratic) regressions were fitted to predict the temporal relationship between FIM score improvement and LOS, and based on goodness of fit statistics, cubic polynomial fit was selected. Effects of interactions were tested and later dropped from the final model because of non-statistical significance. Models were adjusted for age, gender, stroke type (hemorrhagic vs ischemic), and stroke severity based on NIHSS. Results: The demographics of patients are presented in table 1. Among 679 patients, the univariate analyses reflected that age (F=24.2, p p p Conclusion: Patient’s age, ischemic vs hemorrhagic stroke were the most significant predictors when deriving the relationship between total FIM score and LOS while adjusting for stroke severity and patient’s gender, which plateaued after 2 weeks of IRF stay.

Research Objectives To describe geographic disparities in the number of Texas outpatient rehabilitation clinics (ORC) seeing adult stroke patients. Design We surveyed potential clinics by phone and asked if they offered physical therapy (PT), occupational therapy (OT), or speech therapy (SLP) to adult stroke patients in an outpatient setting and if they were using tele-rehab (TR). Responses were aggregated by county (N=240) and grouped by the percentage of the population living in a rural area: not-rural (N= 104, under 50% rural), mostly-rural (N = 78, over 50% rural), and all-rural (N = 58, 100% rural). We estimated incidence from aggregated 2019 hospitalization data and used population data, such as rurality and broadband use, from the U.S. Census. Descriptive statistics and maps were produced in R. Setting Outpatient rehabilitation clinics. Participants We identified and attempted to contact 1,091 potential respondents by searching public online information. Interventions Not applicable. Main Outcome Measures The number of clinics offering PT, OT, SLP, and TR for stroke patients in each county; stroke patients discharged home per 1,000. Results 71% of all-rural counties had zero ORC treating stroke patients, compared to 24% for mostly-rural counties and 19% for not-rural counties, a significant difference (p Conclusions Geographic disparities exist in stroke rehabilitation availability. Most all-rural counties do not have clinics. Mapping our data shows low availability overlapping with higher discharge rates and lower broadband services. Additional data on rehabilitation utilization, clinic distance, and internet use will further detail access to stroke rehabilitation in Texas. Author(s) Disclosures No disclosures to report.

Pneumococcal disease is a major contributor to global childhood morbidity and mortality and is more common in low- and middle-income countries (LMICs) than in high-income countries. Pneumococcal carriage is a prerequisite for pneumococcal disease. Pneumococcal conjugate vaccine reduces vaccine-type carriage and disease. However, pneumococcal carriage and disease persist, and it is important to identify other potentially modifiable factors associated with pneumococcal carriage and determine if risk factors differ between low, middle, and high-income countries. This information may help inform pneumococcal disease prevention programs. This systematic literature review describes factors associated with pneumococcal carriage stratified by country income status and summarises pneumococcal carriage rates for included studies. We undertook a systematic search of English-language pneumococcal nasopharyngeal carriage studies up to 30thJune 2021. Peer-reviewed studies reporting factors associated with overall pneumococcal nasopharyngeal carriage in healthy, community-based study populations were eligible for inclusion. Two researchers independently reviewed studies to determine eligibility. Results are presented as narrative summaries. This review is registered with PROSPERO, CRD42020186914. Eighty-two studies were included, and 46 (56%) were conducted in LMICs. There was heterogeneity in the factors assessed in each study. Factors positively associated with pneumococcal carriage in all income classification were young age, ethnicity, symptoms of respiratory tract infection, childcare attendance, living with young children, poverty, exposure to smoke, season, and co-colonisation with other pathogens. Breastfeeding and antibiotic use were protective against carriage in all income classifications. Median (interquartile range) pneumococcal carriage rates differed by income classification, ranging from 51% (19.3–70.2%), 38.5% (19.3–51.6%), 31.5% (19.0–51.0%), 28.5% (16.8–35.4%), (P= 0.005) in low-, lower-middle, upper-middle, and high-income classifications, respectively. Our findings suggest that where measured, factors associated with pneumococcal nasopharyngeal carriage are similar across income classifications, despite the highest pneumococcal carriage rates being in low-income classifications. Reducing viral transmission through vaccination and public health interventions to address social determinants of health would play an important role.

Research Objectives To investigate the rehabilitation outcomes of patients with COVID-19, admitted to an in-hospital inpatient rehabilitation unit. Design Case series method. All patients were followed up by phone call six months after discharge. Setting In-hospital Inpatient Rehabilitation Unit. Participants Subjects included three male patients in the age range of 55-65 with underlying medical conditions after COVID-19 infection with a mean acute hospital stay of 39 days. Interventions All three patients received services from an interdisciplinary team led by a physical medicine and rehabilitation specialist. Interventions were focused on managing ongoing medical issues, weaning off of supplemental oxygen, restorative and compensatory training to improve independence with functional mobility, activities of daily living, assessment and treatment of dysphagia, speech/voice, and cognitive-communication deficits. Main Outcome Measures Six-minute Walk Test, 10-meter Walk Test, GG codes, Berg Balance Scale, MRC sum score, Montreal Cognitive Asessment, Dynamometry and 9-hole Peg Test. Results The average length of stay at the rehabilitation unit was 21 days. The distance on six-minute walk has improved from being unable to walk for six minutes on admission to an average of 921 feet at a speed of 1.05m/s. Two out of three patients remained at medium risk of falls requiring use of assistive devices for mobility. Persisting dysphagia and dependence on supplemental oxygen was an issue for one patient. All three patients discharged home with support from family members and no episode of readmission to hospital within six months after discharge. Conclusions Ongoing fatigue, cognitive impairment and reduced endurance demonstrates the impact of COVID-19 on multiple organ systems in the body. Intensive inpatient rehabilitation is beneficial to accelerate recovery process, while managing ongoing medical issues. Author(s) Disclosures Russell ME: Speakers Bureau for Allergan and Merz. LIjo, Hamilton, Wren: Nothing to disclose.