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Veerman LK, Fjermestad KW, Vatne TM, Sterkenburg PS, Derks SD, Brouwer-van Dijken AA, Willemen AM. Cultural applicability and desirability of 'Broodles': The first serious game intervention for siblings of children with disabilities. PEC Innov 2024; 4:100277. [PMID: 38590338 PMCID: PMC11000116 DOI: 10.1016/j.pecinn.2024.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
Objective Serious games can serve as easily accessible interventions to support siblings of children with disabilities, who are at risk of developing mental health problems. The Dutch serious game 'Broodles' was developed for siblings aged 6-9 years. The current study aims to assess the cultural applicability, desirability, feasibility, and acceptability of 'Broodles' in Norway. Methods Norwegian siblings (N = 16) aged 6-13 years and parents (N = 12) of children with intellectual disabilities assessed the game. Their feedback data from interviews and questionnaires were sorted using a model of engagement factors in serious games. Results At pre-use, participants showed interest in the game, and after initial use the participants were overall positive about the format, content and objectives, including validation of emotions and recognition. The participants had suggestions for improved engagement and feasibility. Conclusion The game was found to be culturally applicable, desirable and acceptable, although Norwegian translation is necessary for further evaluation. Recommendations to enhance engagement were provided, including suggestions to play the game with parents or in a group. Innovation This initial assessment of the serious game Broodles in a non-Dutch setting shows promise for an innovative way of supporting siblings of children with disabilities.
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Affiliation(s)
- Linda K.M. Veerman
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
| | - Krister W. Fjermestad
- University of Oslo, Boks 1072 Blindern, 0316, Oslo, Norway
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, 1404, Siggerud, Norway
| | - Torun M. Vatne
- University of Oslo, Boks 1072 Blindern, 0316, Oslo, Norway
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, 1404, Siggerud, Norway
| | - Paula S. Sterkenburg
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
- Bartiméus, Oude Arnhemse Bovenweg 3, 3941 XM, Doorn, the Netherlands
| | - Suzanne D.M. Derks
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
| | | | - Agnes M. Willemen
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
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Cullinan J, O'Brien T, Yacoub E. What explains regional variation in privately provided out-of-area residential placement costs for people with intellectual disability in Ireland? J Intellect Disabil Res 2024; 68:537-551. [PMID: 38445773 DOI: 10.1111/jir.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Expenditure on residential placements for people with intellectual disability (ID) in Ireland is considerable and expected to increase. Despite this, there is limited evidence on the factors driving variation in privately provided 'out-of-area' residential placement costs, including across Community Health Organisations (CHOs)/regions. This is important to help inform the delivery of services at best value. METHODS We analyse unit cost data from 2019 for a sample of 278 high-cost publicly funded privately provided out-of-area residential placements for people with ID in Ireland. We undertake univariate analysis of the relationship between costs and a wide range of variables using t-tests and one-way analysis of variance. We employ multivariable regression analysis to examine how raw differentials in unit costs across regions can be accounted for by individual-level characteristics. RESULTS We estimate average unit costs of €264 170 per annum in our sample. The univariate analysis shows considerable variation in costs across a range of personal, disability, psychiatry/psychological, forensic issues, behaviour and supports and plans related variables. We also find wide variation in average unit costs across CHOs/regions (F = 4.58, P < 0.001), ranging from €213 380 to €331 880. The multivariable analysis shows that regional differences remain even after accounting for a wide range of individual characteristics that influence costs. CONCLUSIONS Our analysis shows that while the majority of differences in costs across regions can be explained, there is potential for cost savings in the provision of high-cost publicly funded out-of-area residential placements in Ireland. Overall this can help to develop and implement a more sustainable disability residential funding model in a context of rising demand for services. It also has potential implications for the approach to procurement of services.
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Affiliation(s)
- J Cullinan
- Discipline of Economics, School of Business and Economics, University of Galway, Galway, Ireland
| | - T O'Brien
- National Disability Operations Team, Health Service Executive, Dublin, Ireland
| | - E Yacoub
- National Clinical Lead: Mental Health in Intellectual Disability, Health Service Executive, Dublin, Ireland
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Mestre TD, Lopes MJ, Mestre DM, Ferreira RF, Costa AP, Caldeira EV. Impact of family-centered care in families with children with intellectual disability: A systematic review. Heliyon 2024; 10:e28241. [PMID: 38560242 PMCID: PMC10981057 DOI: 10.1016/j.heliyon.2024.e28241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
Background Family-Centered Care (FCC) is an approach to healthcare planning, delivery and evaluation, based on beneficial partnerships between health professionals, patients and families. FCC may be particularly relevant for families with children with intellectual disability (ID), given their needs of continuum care. Objective To identify which components of the FCC are practiced and which health outcomes are considered effective in families with children with ID. Method A systematic review guided by the PRISMA STATEMENT 2020 approach and the STROBE reporting guidelines was performed on specific databases through the EBSCOhost Web platform: MEDLINE with Full Text, CINAHL PLUS with Full Text, Academic Search Complete and Psychology and Behavioral Sciences Collection. Peer-reviewed articles published in English or Portuguese languages from 2018 to September 2023 were retrieved. Methodological quality was established using the Quality Assessment Tool for Observational, Cohort and Cross-Sectional Studies - NHLBI, NIH. Results Ten studies met the eligibility criteria and were synthetized. The results revealed nine components, reflecting the way FCC was developed: shared decision-making; family education; respect for culture; family engagement; recognition of the family's needs, characteristics and interests; specialized care support; social and emotional support; family functionality; and family seen as a unit. The health outcomes demonstrate effective gains in improving children's health through family satisfaction with health services. Also achieved psychological and social benefits, with improved family well-being and quality of life, favoring family empowerment. Conclusions The evidence suggests that FCC components involves an effective partnership between the family and health professionals as the main key in developing care plans, as well as the experience that the family unit brings to the delivery of care. FCC approach include all family members as decision-makers, providing emotional, physical and instrumental levels of support. Health outcomes emerged in three strands; for children with ID, families and health services.
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Affiliation(s)
- Teresa Dionísio Mestre
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Manuel José Lopes
- Comprehensive Health Research Centre [CHRC], Portugal
- University of Évora – Health Department, Portugal
| | | | - Rogério Ferrinho Ferreira
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Ana Pedro Costa
- Comprehensive Health Research Centre [CHRC], Portugal
- Local Health Unit of Lower Alentejo [ULSBA], Beja, Portugal
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Yee KS, Alexanderian D, Martin S, Olayinka-Amao B, Whiteman DAH. Clinical investigator perspectives on patient outcomes in children with neuronopathic mucopolysaccharidosis II during intrathecal idursulfase-IT treatment. Orphanet J Rare Dis 2024; 19:158. [PMID: 38610004 PMCID: PMC11015594 DOI: 10.1186/s13023-024-03147-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Mucopolysaccharidosis II (MPS II) is a rare lysosomal storage disease characterized by iduronate-2-sulfatase gene (IDS) deficiency and downstream glycosaminoglycan accumulation. Two-thirds of patients present with neuronopathic disease and evaluating cognitive function in these patients is challenging owing to limitations of currently available tests. During the clinical development of intrathecal idursulfase (idursulfase-IT), regulatory authorities requested qualitative data to further understand the neurocognitive changes observed by the investigators through the clinical trials. RESULTS This qualitative study consisted of semi-structured interviews with all nine of the principal investigators who participated in the idursulfase-IT phase 2/3 (NCT02055118) and extension (NCT02412787) trials. These investigators enrolled the 56 patients with neuronopathic MPS II who qualified for the extension phase of the trial. The investigators were asked to rate the disease status of their patients. Of the 56 patients, 49 (88%) were rated as having disease that was improved/improving, stabilized or slowing progression compared with the expected outcomes with no treatment. Three patients were rated as worsening, while the remaining four patients were considered to have slowing progression or worsening disease. Similar results were demonstrated for patients aged from 3 to under 6 years at baseline, with 33 of 39 patients (85%) rated as having disease that was improved/improving, stabilized or slowing progression. Of the seven patients rated with slowing progression/worsening or worsening disease, five of them had an IDS variant other than missense, while two had a missense class variant. All the assigned improved/improving ratings were in patients receiving idursulfase-IT from the start of the phase 2/3 trial. Moreover, patients under 3 years of age at baseline were all rated as either improved/improving or stabilized disease. In a blinded review of patient profiles, investigators were requested to assign a disease status rating to 18 patients with large IDS deletions; 67% of these patients were rated as improved/improving or stabilized disease. CONCLUSIONS This qualitative analysis provides a snapshot of clinicians' considerations when evaluating treatment in patients with neuronopathic MPS II, compared with the expected decline in cognitive function in the absence of treatment. The results highlight the importance of robust assessment tools in treatment evaluation.
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Affiliation(s)
- Karen S Yee
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
- Present affiliation: Alexion Pharmaceuticals, Inc., AstraZeneca Rare Disease, Boston, MA, USA
| | - David Alexanderian
- Takeda Development Center Americas, Inc., Lexington, MA, USA
- Present affiliation: Merck, Boston, MA, USA
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Valdez-Martínez E, Márquez-González H, Bedolla M. [Non-therapeutic hysterectomy in Mexican young females with intellectual disability: a problematized reality]. GAC MED MEX 2024. [PMID: 38588533 DOI: 10.24875/gmm.23000460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/12/2024] [Indexed: 04/10/2024] Open
Abstract
Background Non-therapeutic hysterectomy in girls and adolescents with intellectual disability (ID) is an acceptable practice, even when there is a lack of prescriptive ethical reason. Objectives To determine the magnitude of the practice of hysterectomy in girls and adolescents with ID, and explore the emic factors associated with this procedure. Material and methods Multicenter, intersectoral study with a mixed methods design. Results The quantitative results showed that 50 of 234 reported hysterectomies corresponded to females with ID. Average age at the time of surgery was 15 ± 2.9 years. Prophylactic abdominal hysterectomy was the most common procedure, and the justifications for it were "fertility control", "menstrual hygiene management", and "risk of sexual abuse". A qualitative analysis of 15 focus groups revealed that parents' main concern was how to manage their daughters' index disease and reproductive health; they perceived menstruation positively; they expressed their fear of dying and leaving them without support, and emphasized fertility control; none of them approved hysterectomy. Conclusions The bodies that define health policies need to create a new philosophy that avoids the reductionist approach of current biomedical model, which separates (in the health-disease process) our interdependence with other humans.
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Affiliation(s)
- Edith Valdez-Martínez
- Unidad de Investigación Médica en Epidemiología Clínica, Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Horacio Márquez-González
- Servicio de Investigación Clínica, Hospital Infantil de México "Federico Gómez", Ciudad de México, México
| | - Miguel Bedolla
- Investigador independiente, San Antonio, Texas, Estados Unidos
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Sahly AN, Sierra-Marquez J, Bungert-Plümke S, Franzen A, Mougharbel L, Berrahmoune S, Dassi C, Poulin C, Srour M, Guzman RE, Myers KA. Genotype-phenotype correlation in CLCN4-related developmental and epileptic encephalopathy. Hum Genet 2024:10.1007/s00439-024-02668-z. [PMID: 38578438 DOI: 10.1007/s00439-024-02668-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024]
Abstract
CLCN4-related disorder is a rare X-linked neurodevelopmental condition with a pathogenic mechanism yet to be elucidated. CLCN4 encodes the vesicular 2Cl-/H+ exchanger ClC-4, and CLCN4 pathogenic variants frequently result in altered ClC-4 transport activity. The precise cellular and molecular function of ClC-4 remains unknown; however, together with ClC-3, ClC-4 is thought to have a role in the ion homeostasis of endosomes and intracellular trafficking. We reviewed our research database for patients with CLCN4 variants and epilepsy, and performed thorough phenotyping. We examined the functional properties of the variants in mammalian cells using patch-clamp electrophysiology, protein biochemistry, and confocal fluorescence microscopy. Three male patients with developmental and epileptic encephalopathy were identified, with differing phenotypes. Patients #1 and #2 had normal growth parameters and normal-appearing brains on MRI, while patient #3 had microcephaly, microsomia, complete agenesis of the corpus callosum and cerebellar and brainstem hypoplasia. The p.(Gly342Arg) variant of patient #1 significantly impaired ClC-4's heterodimerization capability with ClC-3 and suppressed anion currents. The p.(Ile549Leu) variant of patient #2 and p.(Asp89Asn) variant of patient #3 both shift the voltage dependency of transport activation by 20 mV to more hyperpolarizing potentials, relative to the wild-type, with p.(Asp89Asn) favouring higher transport activity. We concluded that p.(Gly342Arg) carried by patient #1 and the p.(Ile549Leu) expressed by patient #2 impair ClC-4 transport function, while the p.(Asp89Asn) variant results in a gain-of-transport function; all three variants result in epilepsy and global developmental impairment, but with differences in epilepsy presentation, growth parameters, and presence or absence of brain malformations.
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Affiliation(s)
- Ahmed N Sahly
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurosciences, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia
| | - Juan Sierra-Marquez
- Institute of Biological Information Processing; Biological Molecular and Cell Physiology (IBI-1), Molecular and Cell Physiology, Research Center Jülich , GmbH Leo-Brandt-Strasse 1, 52428, Jülich, Germany
- Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stefanie Bungert-Plümke
- Institute of Biological Information Processing; Biological Molecular and Cell Physiology (IBI-1), Molecular and Cell Physiology, Research Center Jülich , GmbH Leo-Brandt-Strasse 1, 52428, Jülich, Germany
| | - Arne Franzen
- Institute of Biological Information Processing; Biological Molecular and Cell Physiology (IBI-1), Molecular and Cell Physiology, Research Center Jülich , GmbH Leo-Brandt-Strasse 1, 52428, Jülich, Germany
| | - Lina Mougharbel
- Research Institute of the McGill University Medical Centre, Montreal, QC, Canada
| | - Saoussen Berrahmoune
- Research Institute of the McGill University Medical Centre, Montreal, QC, Canada
| | - Christelle Dassi
- Research Institute of the McGill University Medical Centre, Montreal, QC, Canada
| | - Chantal Poulin
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, PQ, H4A 3J1, Canada
| | - Myriam Srour
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
- Research Institute of the McGill University Medical Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, PQ, H4A 3J1, Canada
| | - Raul E Guzman
- Institute of Biological Information Processing; Biological Molecular and Cell Physiology (IBI-1), Molecular and Cell Physiology, Research Center Jülich , GmbH Leo-Brandt-Strasse 1, 52428, Jülich, Germany.
| | - Kenneth A Myers
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
- Research Institute of the McGill University Medical Centre, Montreal, QC, Canada.
- Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, PQ, H4A 3J1, Canada.
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Samarasekera S. Managing patients with Intellectual Disability and Epilepsy in the Acute Medical Setting. Clin Med (Lond) 2024:100039. [PMID: 38583804 DOI: 10.1016/j.clinme.2024.100039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- Shanika Samarasekera
- Department of Neurology, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom..
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Würfel LM, Potthoff A, Nambiar S, Skaletz-Rorowski A. Missed opportunities for HIV testing and sexual health-related challenges in an individual with intellectual disability: a case report. AIDS Res Ther 2024; 21:20. [PMID: 38581028 PMCID: PMC10996268 DOI: 10.1186/s12981-024-00606-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/19/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND HIV testing remains an important tool in identifying people living with HIV/AIDS (PLWHA). An early diagnosis of HIV can lead to a prolonged life expectancy if treatment is initiated promptly. Indicator conditions can be the first sign of an HIV infection and should therefore be recognised and consequently a HIV test should be carried out. Testing should occur in all individuals as sexuality can be experienced by everyone, and stigma can lead to the exclusion of vulnerable groups, leading to a gap in diagnosis and treatment [1, 2]. CASE PRESENTATION A 63-year-old man, who identifies as bisexual and has had an intellectual disability since birth, presented at our health care centre for HIV testing. A decade ago, the patient was diagnosed with Stage III Diffuse Large B-cell Non-Hodgkin Lymphoma, an AIDS defining cancer. The patient presented at a Haematology and Oncology department 3 months prior, due to a weight loss of 10 kg over the past 5 months. Oral thrush, an HIV-indicator condition, had been diagnosed by the otolaryngologists shortly before. During this medical evaluation, pancytopenia was identified. Despite the presence of indicator conditions, the patient was never tested for HIV in the past. Staff members from the care facility for intellectually disabled suggested conducting a HIV test in our clinic through the public health department, where HIV positivity was revealed. The AIDS-defining diagnosis, along with a CD4 + cell count of 41/µl, suggests a prolonged period of HIV positivity. CONCLUSION Due to the presence of existing indicator conditions, an earlier HIV diagnosis was possible. We contend that most of the recent illnesses could have been prevented if earlier testing had been carried out. Therefore, patients presenting with AIDS indicator conditions, including those with mental disabilities, should be given the opportunity to be tested for HIV. HIV/AIDS trainings should be made available to health care professionals as well as to personnel interacting with vulnerable groups.
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Affiliation(s)
- Lina Martina Würfel
- WIR-Walk In Ruhr - Center for Sexual Health and Medicine, Große Beckstraße 12, 44787, Bochum, Germany
- Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr-Universität Bochum, Bochum, Germany
| | - Anja Potthoff
- WIR-Walk In Ruhr - Center for Sexual Health and Medicine, Große Beckstraße 12, 44787, Bochum, Germany
- Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr-Universität Bochum, Bochum, Germany
| | - Sandeep Nambiar
- WIR-Walk In Ruhr - Center for Sexual Health and Medicine, Große Beckstraße 12, 44787, Bochum, Germany
| | - Adriane Skaletz-Rorowski
- WIR-Walk In Ruhr - Center for Sexual Health and Medicine, Große Beckstraße 12, 44787, Bochum, Germany.
- Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr-Universität Bochum, Bochum, Germany.
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McGlinchey E, Corrigan S, Sheerin F, Yap ML. Embracing authenticity and challenging norms: Including people with an intellectual disability as lecturers in third level intellectual disability nursing programmes. Nurse Educ Today 2024; 138:106206. [PMID: 38598869 DOI: 10.1016/j.nedt.2024.106206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
UNDERREPRESENTATION OF VOICES FROM PEOPLE WITH INTELLECTUAL DISABILITY IN NURSE EDUCATION: In the Republic of Ireland and the United Kingdom, university level programmes for intellectual disability nurses have traditionally incorporated the perspectives of people with intellectual disabilities but have been delivered by non-disabled educators. Perspectives are interpreted through the lens of the non-disabled person, with the voices of people with intellectual disabilities rarely heard. AN ALTERNATIVE APPROACH: INCLUDING PEOPLE WITH INTELLECTUAL DISABILITY AS EDUCATORS: In this article, an alternative approach is proposed that addresses this problem by including individuals with intellectual disabilities as educators within university programmes. Such inclusion will benefit students, academics, and ultimately the individuals who will receive health and social care from these nurses. Many countries have seen legislative and policy changes promoting inclusion for people with an intellectual disability. These are welcomed, but if they are to have a meaningful impact, societal attitudes and perceptions towards people with intellectual disabilities must be challenged. Drawing upon the concepts of social reconstruction and the ideologies of Paulo Freire and John Dewey, we argue that education can catalyze societal transformation. By including individuals with intellectual disabilities as educators in undergraduate programmes, such as nursing, traditional hierarchies of educators can be challenged, and students can learn from experts with lived experiences. This approach fosters critical thinking, reflection, and the development of authentic and informed healthcare professionals. The experiences of a co-author with a lived experience of intellectual disability as an educator, highlights the positive impact of such inclusion on students' perspectives, understanding, and empathy.
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Affiliation(s)
- Eimear McGlinchey
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Ireland; School of Nursing and Midwifery, Trinity College Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, University of California San Francisco, United States of America.
| | - Stephanie Corrigan
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Ireland
| | - Fintan Sheerin
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Ireland; School of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Mei Lin Yap
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Ireland
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Mahmoud NF, Mohammed Z, Mohammed HO, Lotfy AMM. Validation of the Arabic Version of Feeding Handicap Index for Children with Developmental Disabilities (A-FHI-C). J Autism Dev Disord 2024:10.1007/s10803-024-06289-3. [PMID: 38564065 DOI: 10.1007/s10803-024-06289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 04/04/2024]
Abstract
Children with developmental disabilities have different feeding and swallowing problems. The purposes of the present study were to develop an Arabic version of the FHI-C and to evaluate its validity, consistency, and reliability in Arabic children with developmental disabilities for assessing how feeding and swallowing problems impair the physical, functional, and emotional aspects of children's lives. A prospective study including 113 children [62 children with autism spectrum disorder (ASD), 24 with cerebral palsy (CP), 27 with intellectual disability (ID)], in the age range of 2 to 10 years, selected randomly from the swallowing clinic, phoniatrics unit, Otorhinolaryngology department, University hospital between September 2023 and December 2023 complaining of feeding and swallowing problems. Validity was established by comparing patients` scores to typically developed controls (31 children). For test-retest reliability, forty parents filled out the A-FHI-C again two weeks after their initial visit. Cronbach's alpha for A-FHI-C was 0.986, indicating good internal consistency. Intraclass correlation showed 0.850 with a 95% confidence interval from 0.779 to 0.898. All three clinical groups had significantly higher total FHI-C and FHI-C domain scores than the control group, indicating good validation. A-FHI-C was found to have significantly high test-retest reliability. The current study indicates that in children with ASD, CP, ID, feeding problems are more prevalent than children who are typically developed. The scores obtained can be used by phoniatricans to evaluate feeding problems and monitor the progress of the therapy plan in children with developmental disorders.
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Affiliation(s)
- Nesreen Fathi Mahmoud
- Phoniatrics Unit-Department of ENT, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
| | - Zeinab Mohammed
- Department of Public Health and Community Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Hassnaa Othman Mohammed
- Medical Studies Department for children, Faculty of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt
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Wachtel LE, Escher J, Halladay A, Lutz A, Satriale GM, Westover A, Lopez-Arvizu C. Profound Autism: An Imperative Diagnosis. Pediatr Clin North Am 2024; 71:301-313. [PMID: 38423722 DOI: 10.1016/j.pcl.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Profound autism refers to a subset of individuals with autism spectrum disorder who have an intellectual disability with an intelligence quotient less than 50 and minimal-to-no language and require 24-hour supervision and assistance with activities of daily living. The general pediatrician will invariably work with autistic children across the spectrum and will likely encounter youth with profound autism. Awareness of profound autism as a real entity describing autistic children with concomitant intellectual disability and language impairment who require 24-hour care is the first step in developing a solid pediatric home for these youth.
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Affiliation(s)
| | - Jill Escher
- Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Alycia Halladay
- Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Amy Lutz
- Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Gloria M Satriale
- Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
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Morison LD, Van Reyk O, Baker E, Ruaud L, Couque N, Verloes A, Amor DJ, Morgan AT. Beyond 'speech delay': Expanding the phenotype of BRPF1-related disorder. Eur J Med Genet 2024; 68:104923. [PMID: 38346666 DOI: 10.1016/j.ejmg.2024.104923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/07/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
Pathogenic variants in BRPF1 cause intellectual disability, ptosis and facial dysmorphism. Speech and language deficits have been identified as a manifestation of BRPF1-related disorder but have not been systematically characterized. We provide a comprehensive delineation of speech and language abilities in BRPF1-related disorder and expand the phenotype. Speech and language, and health and medical history were assessed in 15 participants (male = 10, median age = 7 years 4 months) with 14 BRPF1 variants. Language disorders were common (11/12), and most had mild to moderate deficits across receptive, expressive, written, and social-pragmatic domains. Speech disorders were frequent (7/9), including phonological delay (6/9) and disorder (3/9), and childhood apraxia of speech (3/9). All those tested for cognitive abilities had a FSIQ ≥70 (4/4). Participants had vision impairment (13/15), fine (8/15) and gross motor delay (10/15) which often resolved in later childhood, infant feeding impairment (8/15), and infant hypotonia (9/15). We have implicated BRPF1-related disorder as causative for speech and language disorder, including childhood apraxia of speech. Adaptive behavior and cognition were strengths when compared to other monogenic neurodevelopmental chromatin-related disorders. The universal involvement of speech and language impairment is noteable, relative to the high degree of phenotypic variability in BRPF1-related disorder.
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Affiliation(s)
- Lottie D Morison
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Australia; Speech and Language, Murdoch Children's Research Institute, Parkville, Australia.
| | - Olivia Van Reyk
- Speech and Language, Murdoch Children's Research Institute, Parkville, Australia.
| | - Emma Baker
- Speech and Language, Murdoch Children's Research Institute, Parkville, Australia; School of Psychology and Public Health, La Trobe University, Bundoora, Australia.
| | - Lyse Ruaud
- Department of Genetics, APHP-Robert Debré University Hospital, Paris, France; INSERM UMR1141, Neurodiderot, University of Paris Cité, Paris, France.
| | - Nathalie Couque
- Department of Genetics, APHP-Robert Debré University Hospital, Paris, France; Département de Génétique - UF de Génétique Moléculaire, Hôpital Robert Debré, Paris, France.
| | - Alain Verloes
- Department of Genetics, APHP-Robert Debré University Hospital, Paris, France; Medical School, Paris Cité University, Paris, France.
| | - David J Amor
- Speech and Language, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Royal Children's Hospital, Parkville, Australia.
| | - Angela T Morgan
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Australia; Speech and Language, Murdoch Children's Research Institute, Parkville, Australia; Royal Children's Hospital, Parkville, Australia.
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Garavelis KN, Hayes N, Rose TA, Maloney M, Liddle K, Moritz K, Gullo M, Gullo HL, McMah R, Heussler H, Reid N. Exploring the experience of service users following attendance at a student-led interprofessional neurodevelopmental clinic. Disabil Rehabil 2024; 46:1298-1308. [PMID: 37029616 DOI: 10.1080/09638288.2023.2193430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE The aim of the current study was to understand service users' experiences at a recently established student-led interprofessional neurodevelopmental clinic for children and adolescents with suspected or confirmed prenatal alcohol exposure. METHOD Semi-structured interviews were completed at 3-months post-clinic attendance with 10 service users: eight parents/caregivers and two youth workers/case managers. Interview data were analysed thematically using NVivo12. RESULTS Four main themes were developed: (1) clinic attendance seen as a positive event; (2) validation, clarification, and relief, but also challenges post-assessment; (3) need for further support and importance of advocacy; and (4) drawing on lived experiences for future service improvements. CONCLUSIONS The current study demonstrated that service users reported benefits from tailored services delivered by student practitioners that were validating, supportive, and holistic. Findings from the current study can inform the development and implementation of future innovative service delivery models for individuals with suspected or confirmed prenatal alcohol exposure.
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Affiliation(s)
- Khari Nicola Garavelis
- Child Health Research Centre, The University of Queensland, Brisbane, South Brisbane, Australia
| | - Nicole Hayes
- Child Health Research Centre, The University of Queensland, Brisbane, South Brisbane, Australia
| | - Tanya A Rose
- The University of Queensland, Brisbane, Australia
| | - Maree Maloney
- Child Health Research Centre, The University of Queensland, Brisbane, South Brisbane, Australia
| | - Karen Liddle
- Faculty of Medicine, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Karen Moritz
- Faculty of Medicine, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Matthew Gullo
- National Centre for Youth Substance Abuse Research, The University of Queensland, Saint Lucia, Australia
| | - Hannah L Gullo
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, St Lucia Campus, Brisbane, Australia
| | - Rebeccah McMah
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, St Lucia Campus, Brisbane, Australia
| | - Helen Heussler
- Faculty of Medicine, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Natasha Reid
- Child Health Program, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
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14
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Benevides TW, Datta B, Jaremski J, McKee M. Prevalence of intellectual disability among adults born in the 1980s and 1990s in the United States. J Intellect Disabil Res 2024; 68:377-384. [PMID: 38234197 DOI: 10.1111/jir.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Prevalence of intellectual disability (ID) is currently estimated through parent report on surveys of children. It is difficult to estimate the number of adults living with ID in the United States because no comprehensive survey or surveillance allows for identification. The purpose of this study was to estimate the prevalence and number of adults with ID born between 1980 and 1999 using multiple years of the National Health Interview Survey (NHIS) and Census data. METHODS We concatenated the NHIS from 1997-2016 that evaluated parental response about whether a child aged 3-17 years had an ID. Using weighted survey analyses, we estimated the prevalence of ID among individuals across four birth cohorts-(1) 1980-1984, (2) 1985-1989, (3) 1990-1994, and (4) 1995-1999. The number of adults with ID was then extrapolated by applying these prevalence rates to Census population estimates (as of 1 July 2021) of respective birth cohorts. RESULTS Weighted prevalence of ID varied by birth cohort, sex, race and ethnicity, and US Census Bureau regions. The overall prevalence rate was 1.066 [95% confidence interval (CI): 0.831-1.302] for adults born between 1980 and 1984, 0.772 (CI: 0.654-0.891) for adults born between 1985 and 1989, 0.774 (0.675-0.874) for adults born between 1990 and 1994, and 1.069 (CI: 0.898-1.240) for adults born between 1995 and 1999. Overall, we estimate that 818 564 adults with ID who were approximately 21-41 years were living in the United States as of 2021. CONCLUSIONS This study provides researchers examining adult health outcomes with an estimated denominator of young and middle-aged adults living with ID in the United States. Policymakers can use this information to support justification for resource and service needs, and clinicians may benefit from understanding that ID is a lifelong developmental condition often with additional physical, emotional and developmental needs requiring tailored care.
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Affiliation(s)
- T W Benevides
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - B Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - J Jaremski
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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Zupo R, Castellana F, Boero G, Matera E, Colacicco G, Piscitelli P, Clodoveo ML, Rondanelli M, Panza F, Lozupone M, Sardone R. Processed foods and diet quality in pregnancy may affect child neurodevelopment disorders: a narrative review. Nutr Neurosci 2024; 27:361-381. [PMID: 37039128 DOI: 10.1080/1028415x.2023.2197709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To review the evidence on the association between maternal exposure to ultra-processed food (UPF) categories, UPF diet items, and overall diet quality, as assessed by recognized dietary indices, and neurodevelopmental outcomes in offspring. METHODS PubMed, MEDLINE, EMBASE, Scopus, Ovid, and Scholar databases were searched for original articles on female gestational exposure to UPF categories, individual elements of the UPF diet, or indices of diet quality, in relation to outcomes regarding their offspring's neurocognitive development, according to neuropsychometric and behavioral scales, anthropometric/psychomotor indices, and symptoms/diagnosis of neurodevelopmental disorders (NDDs). RESULTS Fourteen articles were selected and underwent the quantitative analysis. Six of these examined diet quality, and eight exposure to UPF categories or specific UPF foods. The maternal population was adult (18+). Child cognitive development was negatively impacted by a diet featuring many processed foods, saturated fats, and sugars. Conversely, a Med-diet led to better neurodevelopment, particularly verbal intelligence and executive functions, in middle childhood. DISCUSSION A maternal diet with many UPFs, saturated fats, and total sugars (especially those added or hidden in packaged carbonated beverages) can adversely affect a child's cognitive development. Knowledge needs to be further extended and managed from a prevention perspective in light of the well-known negative effects of UPFs on human health in all age groups.
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Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni Boero
- Complex Structure of Neurology, SS Annunziata Hospital, Taranto, Italy
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University "A. Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Giuseppe Colacicco
- Department of Translational Biomedicine and Neuroscience (DiBrain), niversity "Aldo Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | | | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, Department of Public Health, 27100 Pavia, Italy
- IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Francesco Panza
- Department of Translational Biomedicine and Neuroscience (DiBrain), niversity "Aldo Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience (DiBrain), niversity "Aldo Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
- Local Healthcare Authority of Taranto, Italy
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16
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Kapoor M, Ambade M, Ravi S, Subramanian SV. Age- and Gender-Specific Prevalence of Intellectually Disabled Population in India. J Autism Dev Disord 2024; 54:1594-1604. [PMID: 36637589 DOI: 10.1007/s10803-022-05849-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 01/14/2023]
Abstract
Intellectual disability in India is substantially under-reported, especially amongst females. This study quantifies the prevalence and gender bias in household reporting of intellectual disability by estimating the age-and-gender specific prevalence of the intellectually disabled by education, Socio-Demographic Index (SDI) score, place of residence, (rural/urban) and income of household head. We estimated prevalence (per 100,000) at 179 (95% CI: 173 to 185) for males and 120 (95% CI: 115 to 125) for females. Gender differences declined sharply with increased education, was higher for lower ages and low income and varied little by state development. Under-identification and under-reporting due to stigma are two plausible reasons for the gender differences in prevalence that increase with age.
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Affiliation(s)
- Mudit Kapoor
- Economics and Planning Unit, Indian Statistical Institute, New Delhi 110016, India
| | - Mayanka Ambade
- Laxmi Mittal and Family South Asia Institute, Harvard University, 110001, New Delhi, India
| | | | - S V Subramanian
- Harvard Center for Population and Development Studies, 9 Bow Street, 02138, Cambridge, MA, USA.
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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17
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Oda Y, Furutani C, Kawano R, Murakami J, Mizota Y, Okada Y, Nikawa H. Comparison of dental plaque flora between intellectually disabled patients and healthy individuals: a cross-sectional study. Odontology 2024; 112:588-600. [PMID: 37462789 DOI: 10.1007/s10266-023-00837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 07/04/2023] [Indexed: 03/12/2024]
Abstract
Periodontal diseases, including gingivitis, are highly prevalent in individuals with intellectual disability (ID). In particular, gingivitis can be difficult to cure owing to the lack of patient cooperation. Here, we evaluated differences in the oral bacterial flora between individuals with ID (n = 16) and healthy controls (n = 14) to facilitate the development of strategies for the prevention of periodontal disease in people with ID. Our results showed no significant difference in the number of decayed, missing, and filled teeth between the two groups. However, there were significant differences in the median papillary-marginal-attached index, plaque index, and gingival index between groups (P < 0.0001). Additionally, the mean probing depth in the ID group was significantly higher than that in the control group (P < 0.0001). The diversity of oral flora in people with ID and concurrent gingivitis was significantly lower than that of healthy individuals without periodontal disease. The relative abundances of Tannerella spp. and Treponema spp. were significantly higher in the ID group than in the control group at the genus level (P = 0.0383 and 0.0432, respectively), whereas that of Porphyromonas spp. was significantly lower in the ID group (P < 0.0001). Overall, our findings provided important insights into differences in the oral microbiota between patients with ID and healthy controls.
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Affiliation(s)
- Yuki Oda
- Department of Special Care Dentistry, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Chiaki Furutani
- Department of Special Care Dentistry, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Reo Kawano
- Center for Integrated Medical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Jumpei Murakami
- Division of Special Care Dentistry, Osaka University Dental Hospital, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yuika Mizota
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yoshiyuki Okada
- Department of Special Care Dentistry, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hiroki Nikawa
- Department of Oral Biology and Engineering, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
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18
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Díaz-Faes DA, Codina M, Pereda N. Identifying victimization clusters across people with intellectual disabilities: A latent class analysis. Disabil Health J 2024; 17:101573. [PMID: 38072748 DOI: 10.1016/j.dhjo.2023.101573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND Research has shown high rates of victimization among people with intellectual disabilities (ID), but victimization clusters have been barely explored. OBJECTIVE We address the gap by examining how reported victimization experiences are grouped into different classes and identifying differences in the characteristics of the individuals in each class. METHODS We conducted a cross-sectional self-report study with a sample of adults with an ID diagnosis (n = 260). We gathered data about the participants' victimization experiences and socio-demographics, and then subjected the data to latent class analysis (LCA). RESULTS Three different classes were detected: High victimization (n = 27, 10.4 %); medium victimization, low sexual (n = 97, 37.3 %); and low victimization (n = 136, 52.3 %). The results highlight the experiences of sexual and physical victimization among the high-victimization class, in which women are overrepresented, and physical victimization among the medium-victimization class. The study also found that experiences of assault and bias attacks occur to a varying extent across all three classes. The LCA and poly-victimization methods showed substantial agreement but also differences when identifying the most victimized participants. In addition, we detected significant differences between classes in gender, type of school attended, place of residence, legal incapacity, type of support needed, secondary disability and poly-victimization status. CONCLUSION We identified distinct underlying ingroup patterns of victimization and sociodemographic inter-class differences that contribute to a better understanding of victimization within the population in question. The results have prevention and intervention implications for caregivers and providers of services for people with ID.
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Affiliation(s)
- Diego A Díaz-Faes
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, Universitat de Barcelona, Spain.
| | - Marta Codina
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, Universitat de Barcelona, Spain
| | - Noemí Pereda
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, Universitat de Barcelona, Spain
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19
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Sapiets SJ, Hastings RP, Totsika V. Predictors of Access to Early Support in Families of Children with Suspected or Diagnosed Developmental Disabilities in the United Kingdom. J Autism Dev Disord 2024; 54:1628-1641. [PMID: 37142908 PMCID: PMC10159231 DOI: 10.1007/s10803-023-05996-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/06/2023]
Abstract
This study examined predictors of access to early support amongst families of 0-6-year-old children with suspected or diagnosed developmental disabilities in the United Kingdom. Using survey data from 673 families, multiple regression models were fitted for three outcomes: intervention access, access to early support sources, and unmet need for early support sources. Developmental disability diagnosis and caregiver educational level were associated with intervention access and early support access. Early support access was also associated with child physical health, adaptive skills, caregiver ethnicity, informal support, and statutory statement of special educational needs. Unmet need for early support was associated with economic deprivation, the number of household caregivers, and informal support. Multiple factors influence access to early support. Key implications include enhancing processes for formal identification of need, addressing socioeconomic disparities (e.g., reducing inequalities, increasing funding for services), and providing more accessible services (e.g., coordinating support across services, flexible service provision).
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Affiliation(s)
- Suzi J Sapiets
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, CV4 7AL, UK.
- Tizard Centre, University of Kent, Canterbury, Kent, CT2 7NZ, UK.
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Monash Medical Centre, Monash University, Block P, Level 3 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Monash Medical Centre, Monash University, Block P, Level 3 246 Clayton Rd, Clayton, VIC, 3168, Australia
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK
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20
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Baum A, Chan K, Sachedina A, Grover SR. Factors Predicting Removals of the Levonorgestrel-Releasing Intrauterine System in an Adolescent Cohort. J Pediatr Adolesc Gynecol 2024; 37:171-176. [PMID: 38128876 DOI: 10.1016/j.jpag.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/23/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Use of 52-mg levonorgestrel intrauterine system (LNG-IUS) in adolescents for heavy menstrual bleeding (HMB), dysmenorrhea, and contraception has increased, yet little is known about the factors predicting removal and dissatisfaction in adolescents. The aim of this study was to identify factors predicting LNG-IUS removal in adolescents. METHODS This was a retrospective cohort study including all adolescents (9-19 years) who underwent LNG-IUS insertion between 2012 and 2021 (n = 536). A medical record review was conducted and data were collated on medical and gynecological history, age, indications for insertion, complications, expulsions, and removals. The data were analyzed using χ2 tests. RESULTS Indications for LNG-IUS insertions (n = 536) among 517 individual patients (n = 517) included menstrual management (n = 142), HMB alone (n = 118), HMB and pelvic pain/dysmenorrhea (n = 105), dysmenorrhea/pelvic pain alone (n = 47), and contraception (n = 16). Associated diagnoses included intellectual disability (44.29%, 229/517), chronic pain conditions (12.77%, 66/517), and additional mental health concerns (24.37%, 126/517). Patient dissatisfaction with LNG-IUS led to removal in 61 (11.38%), mostly for pain or persistent bleeding. Higher removal rates occurred in those with associated chronic pain conditions (46.97%, χ2 = 55.9, P < .05), mental health concerns (16.67%, χ2 = 5.06, P < .05), and bleeding disorders (26.32%, χ2 = 5.09, P < .05). Among the cohort with an intellectual disability, lower rates of removal occurred (5.7%, χ2 = 11.2, P < .05). Whereas the LNG-IUS removal rate among gender-diverse youth was 23.07%, this was not statistically significant. Younger age was also not associated with a statistically significant increase in removals (13.72%, χ2 = 0.73, P > .05). DISCUSSION Adolescents have a low dissatisfaction and removal rate (11.38%) of LNG-IUS. Chronic pain, bleeding tendency, and mental health concerns are associated with higher removal rates and intellectual disability with lower rates. These findings are useful in counselling patients and families about LNG-IUS.
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Affiliation(s)
- Alexandra Baum
- Department of Gynaecology, Joan Kirner Women's and Children's Hospital, St. Albans, Australia.
| | - Kiri Chan
- Department of Gynaecology, Royal Children's Hospital, Parkville, Australia
| | - Aalia Sachedina
- Department of Gynaecology, Royal Children's Hospital, Parkville, Australia; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Sonia R Grover
- Department of Gynaecology, Royal Children's Hospital, Parkville, Australia; University of Melbourne, Melbourne, Australia
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21
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Brown HK, Mitra M. Perinatal health framework for people with intellectual disability. Disabil Health J 2024; 17:101576. [PMID: 38216418 DOI: 10.1016/j.dhjo.2023.101576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/14/2024]
Abstract
We propose a framework for guiding research on perinatal health in people with intellectual disability (ID). We developed this framework based on the perinatal health framework for people with physical disabilities, American Association on Intellectual and Developmental Disabilities conceptual framework of human functioning, disability reproductive justice framework, trauma-informed care, and socio-ecological model. The framework reflects health outcomes of birthing people with ID and their infants that result from interactions of factors across the life course at policy (health, social, and disability policies), community (attitudes, social and physical environment), institutional (health care delivery-related factors, access to information/resources), interpersonal (social determinants of health/histories of trauma, social support, interactions with service-providers), and individual levels (demographics, intellectual functioning, adaptive behavior, health conditions, genetic factors, psychosocial factors, health behaviors). This framework will facilitate research to identify factors leading to perinatal health disparities in people with ID and development and evaluation of resources to address them.
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Affiliation(s)
- Hilary K Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
| | - Monika Mitra
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
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22
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Klein Haneveld MJ, Hieltjes IJ, Langendam MW, Cornel MC, Gaasterland CMW, van Eeghen AM. Improving care for rare genetic neurodevelopmental disorders: A systematic review and critical appraisal of clinical practice guidelines using AGREE II. Genet Med 2024; 26:101071. [PMID: 38224026 DOI: 10.1016/j.gim.2024.101071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/16/2024] Open
Abstract
PURPOSE Rare genetic neurodevelopmental disorders associated with intellectual disability require lifelong multidisciplinary care. Clinical practice guidelines may support healthcare professionals in their daily practice, but guideline development for rare conditions can be challenging. In this systematic review, the characteristics and methodological quality of internationally published recommendations for this population are described to provide an overview of current guidelines and inform future efforts of European Reference Network ITHACA (Intellectual disability, TeleHealth, Autism, and Congenital Anomalies). METHODS MEDLINE, Embase, and Orphanet were systematically searched to identify guidelines for conditions classified as "rare genetic intellectual disability" (ORPHA:183757). Methodological quality was assessed using the Appraisal of Guidelines, Research, and Evaluation II tool. RESULTS Seventy internationally published guidelines, addressing the diagnosis and/or management of 28 conditions, were included. The methodological rigor of development was highly variable with limited reporting of literature searches and consensus methods. Stakeholder involvement and editorial independence varied as well. Implementation was rarely addressed. CONCLUSION Comprehensive, high-quality guidelines are lacking for many rare genetic neurodevelopmental disorders. Use and transparent reporting of sound development methodologies, active involvement of affected individuals and families, robust conflict of interest procedures, and attention to implementation are vital for enhancing the impact of clinical practice recommendations.
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Affiliation(s)
- Mirthe J Klein Haneveld
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands; European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability ERN-ITHACA, Clinical Genetics Department, Robert Debré University Hospital, Paris, France; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Iméze J Hieltjes
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands; Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands
| | - Miranda W Langendam
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Martina C Cornel
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Human Genetics, Amsterdam, The Netherlands
| | - Charlotte M W Gaasterland
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands; European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability ERN-ITHACA, Clinical Genetics Department, Robert Debré University Hospital, Paris, France; Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands
| | - Agnies M van Eeghen
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands; European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability ERN-ITHACA, Clinical Genetics Department, Robert Debré University Hospital, Paris, France; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands.
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23
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Khoddam S, Kamal N, Shiri A, Jafari Khamirani H, Manoochehri J, Dianatpour M, Tabei SMB, Dastgheib SA. Two siblings with PEX11B-related peroxisome biogenesis disorder. Eur J Med Genet 2024; 68:104928. [PMID: 38423277 DOI: 10.1016/j.ejmg.2024.104928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/08/2024] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
The PEX11β gene contains four exons and encodes peroxisomal membrane protein 11β, which is involved in peroxisome proliferation and division. Pathogenic variants in this gene result in a rare genetic disorder with autosomal recessive inheritance called peroxisome biogenesis disorder 14B (MIM: 614920). Here, we report two affected siblings with a novel variant (NM_003846: c.11G > A, p. Trp4Ter) in the PEX11β gene that was identified by whole exome sequencing and confirmed by Sanger sequencing. The proband is a 22-year-old Iranian female who was born to consanguineous parents. The homozygous variant (NM_003846: c.11G > A, p. Trp4Ter) in the PEX11β gene was identified in the proband, who presented with cataracts, strabismus, nystagmus, intellectual disability, developmental delay, speech disorders, dry skin, and behavioral problems. Her younger affected brother, who had the same homozygous variant, suffered from similar but slightly milder symptoms. This paper reports the seventh family in the world with novel pathogenic variants in the PEX11β gene as the cause of peroxisome biogenesis disorder 14B. Additionally, the phenotypes of the previously reported patients are reviewed. Some of the phenotypes, such as bilateral congenital cataracts and intellectual disability, were present in all patients. However, other observed symptoms in previous cases, such as abnormal gait, myopia, abnormal muscle strength, hearing loss, gastrointestinal problems, skeletal disorders, and seizures, were not observed in the patients of this study. Further studies on this disorder could be valuable in determining the precise phenotype characteristics of this disease.
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Affiliation(s)
- Somayeh Khoddam
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Kamal
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirmasoud Shiri
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Jamal Manoochehri
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Dianatpour
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran; Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Bagher Tabei
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran; Maternal-fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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24
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Yi S, Tang X, Zhang Q, Liang Y, Huang J, Zhang S, Huang L, Yi S, Huang M, Qin Z, Luo J. A nonsense CC2D1A variant is associated with congenital anomalies, motor delay, hypotonia, and slight deformities. Heliyon 2024; 10:e27946. [PMID: 38496842 PMCID: PMC10944275 DOI: 10.1016/j.heliyon.2024.e27946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024] Open
Abstract
Background Autosomal recessive intellectual developmental disorder-3 is caused by homozygous or compound heterozygous mutations in the CC2D1A gene. The disorder is characterized by intellectual disability (ID) and autism spectrum disorder (ASD). To date, 39 patients from 17 families with CC2D1A -related disorders have been reported worldwide, in whom only six pathogenic or likely pathogenic loss-of-function variants and three variants of uncertain significance (VUS) in the CC2D1A gene have been identified in these patients. Methods We described a patient with ID from a non-consanguineous Chinese family and whole-exome sequencing (WES) was used to identify the causative gene. Results The patient presented with severe ID and ASD, speech impairment, motor delay, hypotonia, slight facial anomalies, and finger deformities. Threatened abortion and abnormal fetal movements occurred during pregnancy with the proband but not his older healthy sister. WES analysis identified a homozygous nonsense variant, c.736C > T (p.Gln246Ter), in the CC2D1A gene. In addition, six novel likely pathogenic CC2D1A variants were identified by a retrospective review of the in-house database. Conclusions This study expands the genetic and clinical spectra of CC2D1A-associated disorders, and may aid in increasing awareness of this rare condition. Our findings have provided new insights into the clinical heterogeneity of the disease and further phenotype-genotype correlation, which could help to offer scope for more accurate genetic testing and counseling to affected families.
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Affiliation(s)
- Sheng Yi
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xianglian Tang
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiang Zhang
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yu Liang
- Department of Pathology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jing Huang
- Department of Obstetrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shujie Zhang
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Limei Huang
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shang Yi
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Minpan Huang
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zailong Qin
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jingsi Luo
- Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Ohtsubo T, Mizoguchi Y, Aita C, Imamura Y, Kobayashi M, Kunitake Y, Tateishi H, Ueno T, Monji A. Relationship between serum cortisol levels, stereotypies, and the presence of autism spectrum disorder in patients with severe intellectual disability. Sci Rep 2024; 14:7139. [PMID: 38531943 DOI: 10.1038/s41598-024-57459-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
Stereotypies are one of the diagnostic criteria for autism spectrum disorder (ASD) and are common to both ASD and intellectual disability (ID). Previous studies have been inconclusive, with some showing a positive correlation between stereotypies and cortisol, while others have shown a negative correlation. We hypothesised and investigated the presence of ASD as one of the variables involved in this discrepancy. We tested the following hypotheses on serum cortisol in a total of 84 hospitalised patients with severe ID and ASD with severe ID. Hypothesis (1) Higher levels of stereotypies are associated with higher levels of serum cortisol. Hypothesis (2) The presence of ASD will moderate the association between stereotypies and high serum cortisol levels. The results of the analysis supported hypotheses (1) and (2). We also found that in the population with ID, serum cortisol levels were significantly lower in the ASD group compared to the non-ASD group. The present findings that the association between stereotypies and serum cortisol levels in people with severe ID is moderated by the presence of ASD suggest that the stress response system may function differently in people with ID and ASD than in the general population.
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Affiliation(s)
- Takeru Ohtsubo
- Department of Psychiatry, National Hospital Organization Hizen Psychiatric Medical Center, 160 Mitsu, Yoshinogari, Kanzaki, Saga, 842-0192, Japan.
| | - Yoshito Mizoguchi
- Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Chie Aita
- Department of Psychiatry, National Hospital Organization Hizen Psychiatric Medical Center, 160 Mitsu, Yoshinogari, Kanzaki, Saga, 842-0192, Japan
| | - Yoshiomi Imamura
- Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Momoko Kobayashi
- Department of Psychiatry, National Hospital Organization Hizen Psychiatric Medical Center, 160 Mitsu, Yoshinogari, Kanzaki, Saga, 842-0192, Japan
- Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Yutaka Kunitake
- Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Hiroshi Tateishi
- Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Takefumi Ueno
- Department of Psychiatry, National Hospital Organization Hizen Psychiatric Medical Center, 160 Mitsu, Yoshinogari, Kanzaki, Saga, 842-0192, Japan
| | - Akira Monji
- Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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26
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Xie C, Kessi M, Yin F, Peng J. Roles of KCNA2 in Neurological Diseases: from Physiology to Pathology. Mol Neurobiol 2024:10.1007/s12035-024-04120-9. [PMID: 38517617 DOI: 10.1007/s12035-024-04120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
Potassium voltage-gated channel subfamily a member 2 (Kv1.2, encoded by KCNA2) is highly expressed in the central and peripheral nervous systems. Based on the patch clamp studies, gain-of function (GOF), loss-of-function (LOF), and a mixed type (GOF/LOF) variants can cause different conditions/disorders. KCNA2-related neurological diseases include epilepsy, intellectual disability (ID), attention deficit/hyperactive disorder (ADHD), autism spectrum disorder (ASD), pain as well as autoimmune and movement disorders. Currently, the molecular mechanisms for the reported variants in causing diverse disorders are unknown. Consequently, this review brings up to date the related information regarding the structure and function of Kv1.2 channel, expression patterns, neuronal localizations, and tetramerization as well as important cell and animal models. In addition, it provides updates on human genetic variants, genotype-phenotype correlations especially highlighting the deep insight into clinical prognosis of KCNA2-related developmental and epileptic encephalopathy, mechanisms, and the potential treatment targets for all KCNA2-related neurological disorders.
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Affiliation(s)
- Changning Xie
- Department of Pediatrics, Xiangya Hospital, Central South University, Xiangya Road 87, Hunan, Changsha, 410008, China
| | - Miriam Kessi
- Department of Pediatrics, Xiangya Hospital, Central South University, Xiangya Road 87, Hunan, Changsha, 410008, China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Xiangya Road 87, Hunan, Changsha, 410008, China
| | - Jing Peng
- Department of Pediatrics, Xiangya Hospital, Central South University, Xiangya Road 87, Hunan, Changsha, 410008, China.
- Hunan Intellectual and Development Disabilities Research Center, Hunan, Changsha, 410008, China.
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27
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Bosman W, Franken GAC, de Las Heras J, Madariaga L, Barakat TS, Oostenbrink R, van Slegtenhorst M, Perdomo-Ramírez A, Claverie-Martín F, van Eerde AM, Vargas-Poussou R, Dubourg LD, González-Recio I, Martínez-Cruz LA, de Baaij JHF, Hoenderop JGJ. Hypomagnesaemia with varying degrees of extrarenal symptoms as a consequence of heterozygous CNNM2 variants. Sci Rep 2024; 14:6917. [PMID: 38519529 PMCID: PMC10959950 DOI: 10.1038/s41598-024-57061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
Variants in the CNNM2 gene are causative for hypomagnesaemia, seizures and intellectual disability, although the phenotypes can be variable. This study aims to understand the genotype-phenotype relationship in affected individuals with CNNM2 variants by phenotypic, functional and structural analysis of new as well as previously reported variants. This results in the identification of seven variants that significantly affect CNNM2-mediated Mg2+ transport. Pathogenicity of these variants is further supported by structural modelling, which predicts CNNM2 structure to be affected by all of them. Strikingly, seizures and intellectual disability are absent in 4 out of 7 cases, indicating these phenotypes are caused either by specific CNNM2 variant only or by additional risk factors. Moreover, in line with sporadic observations from previous reports, CNNM2 variants might be associated with disturbances in parathyroid hormone and Ca2+ homeostasis.
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Affiliation(s)
- Willem Bosman
- Department of Medical BioSciences, Radboudumc, Nijmegen, The Netherlands
| | - Gijs A C Franken
- Department of Medical BioSciences, Radboudumc, Nijmegen, The Netherlands
| | - Javier de Las Heras
- Division of Pediatric Metabolism, Cruces University Hospital, CIBER-ER, Metab-ERN, University of the Basque Country (UPV/EHU), Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Leire Madariaga
- Pediatric Nephrology Department, Cruces University Hospital, CIBERDEM, CIBER-ER, Endo-ERN, Biocruces Bizkaia Health Research Institute and University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - Tahsin Stefan Barakat
- Deparment of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Discovery Unit, Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands
| | - Rianne Oostenbrink
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands
- Department of General Pediatrics, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Ana Perdomo-Ramírez
- Unidad de Investigación, Renal Tube Group, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Félix Claverie-Martín
- Unidad de Investigación, Renal Tube Group, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Rosa Vargas-Poussou
- Service de medecine genomique des maladies rares, AP-HP, universite Paris Cité, Paris, France
- Centre de reference des maladies renales hereditaires de l'enfant et de l'adulte MARHEA, hopital Européen Georges Pompidou, Paris, France
- CNRS, centre de recherche des Cordeliers, Inserm UMRS 1138, Sorbonne universite, universite Paris Cité, Paris, France
| | - Laurence Derain Dubourg
- Hôpital Édouard Herriot, Hospices civils de Lyon, service de nephrologie, dialyse, hypertension et exploration fonctionnelle renale, Lyon, France
- Centre de reference des maladies renales rares et phosphocalciques, Nephrogones, Hôpital Femme-Mère-Enfant Bron, Bron, France
- Faculté de medecine Lyon est, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Irene González-Recio
- Center for Cooperative Research in Biosciences (CIC bioGUNE), Bizkaia Science and Technology Park, Derio, Bizkaia, Spain
| | - Luis Alfonso Martínez-Cruz
- Center for Cooperative Research in Biosciences (CIC bioGUNE), Bizkaia Science and Technology Park, Derio, Bizkaia, Spain
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28
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Benarous X, Walesa S, Guilé JM, Cravero C, Consoli A, Cohen D, Young H, Labelle R, Lahaye H. A systematic review of the psychometric properties of tools for measuring depression in youths with intellectual disability. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02405-x. [PMID: 38509427 DOI: 10.1007/s00787-024-02405-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/19/2024] [Indexed: 03/22/2024]
Abstract
While youths with intellectual disability (ID) have increased vulnerability for depressive disorders, cognitive problems and combined functional barriers make them less prone to receive adequate treatments. A systematic review of the literature was conducted (PROSPERO Registration number: CRD42022347703) based on several databases from 1980 to 2022 to examine the quality of tools for measuring depression in children and adolescents with ID. The COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) checklist was used to assess several psychometric domains. Twelve studies evaluated the properties of six tools for measuring depression in youths with ID. The Center for Epidemiologic Studies Depression Scale-Intellectual Disability (CESD-ID) was the only scale with at least five domains of psychometric properties assessed to have strong or moderate evidence. Based on the reviewed findings, tools specifically developed for populations with developmental disabilities should be considered first in order to screen depression in youths with ID. Much work is required to confirm their validity in clinical samples with patients with a complex form of developmental disabilities. As a complement to self- and caregivers-report questionnaires, clinician rating scales were considered useful to catch the full picture of depression in youths with ID, in particular associated behavioral expressions. Their validity received little scrutiny and certainly deserve more attention to improve care practice of youths with ID.
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Affiliation(s)
- Xavier Benarous
- Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France.
| | | | | | - Cora Cravero
- Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - Angèle Consoli
- Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - David Cohen
- Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | | | - Real Labelle
- Université du Québec À Montréal, Montréal, Canada
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29
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Kats DJ, Donelan K, Banerjee S, de Graaf G, Skladzien E, Hooper BT, Mordi R, Mykhailenko T, Buckley F, Santoro SL, Patsiogiannis V, Krell K, Haugen K, Skotko BG. Results of inaugural international Down Syndrome Societal Services and Supports survey. Genet Med 2024:101114. [PMID: 38512346 DOI: 10.1016/j.gim.2024.101114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE We previously designed the Down Syndrome Societal Services and Supports Survey (DS-4S) to measure country-specific supports for people with Down syndrome (DS) across multiple life domains (healthcare, education, policy, independence, and community inclusion). We now report and analyze the results. METHODS We partnered with international DS consortia, who distributed the DS-4S to 154 cumulative members representing over 100 countries. Organizations were included if they had a holistic focus on the lives of people with DS and if at least 50% of their members either have DS or are family members of people with DS. Factor analysis was used to analyze the results. RESULTS We received survey responses from 55 different organizations in 50 countries who met inclusion criteria. Each country had complete data for at least 4 of the 5 domains. The lowest 5 scores were from countries in Africa and Asia; the highest 5 scores were in Europe and North America. CONCLUSION The responses to the DS-4S stratified countries within each surveyed domain. The DS-4S can now be used to track countries' progress over time and to determine which countries have best practices that might be replicated. We will publish the results and update them biennially at www.DownSyndromeQualityOfLife.com.
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Affiliation(s)
- Daniel J Kats
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Karen Donelan
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA; Health Policy Research Center, The Mongan Institute, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Harvard University, Boston, MA
| | - Souvik Banerjee
- Department of Economics, Indian Institute of Technology Bombay, Powai, Mumbai, India
| | - Gert de Graaf
- Dutch Down Syndrome Foundation, Meppel, The Netherlands
| | | | | | - Rose Mordi
- Down Syndrome Foundation Nigeria, Lagos, Nigeria
| | | | - Frank Buckley
- Down Syndrome Education International, Kirkby Lonsdale, Cumbria, United Kingdom
| | - Stephanie L Santoro
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Vasiliki Patsiogiannis
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Kavita Krell
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Kelsey Haugen
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
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30
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Teo T, Koh HC, Mohd Zambri N, Zaccario ML, Sossin KM, Wong CM. Ethnic Group Differences in the Timing of Autism Diagnosis, Intellectual Disability, and Educational Placement of Autistic Children in Singapore. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01957-7. [PMID: 38489087 DOI: 10.1007/s40615-024-01957-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/17/2024]
Abstract
AIM Given Singapore's distinct multicultural identity, this study examined the hypotheses that there may be ethnic group differences in diagnosis and outcomes in autistic children in Singapore. METHODS Retrospective data were obtained from medical records of all children born between 2008 and 2011 who were diagnosed with clinical or confirmed autism. One-way ANOVAs and regression analyses were used to analyze data. RESULTS Data from 2577 medical records were extracted. There were more boys (82.5%) and ethnic group distribution was Chinese (67%), Malay (14%), Indian (10%), and Others (10%). Chinese children were more likely to present at a developmental clinic with concerns 3-4 months younger compared to Malay children and those from Other Races (F(3, 2038) = 9.58, p < .001, Cohen's F = 0.12). Chinese children were also more likely to receive an autism diagnosis approximately 3 months younger compared to Malay children. Fewer autistic Chinese children were diagnosed with co-occurring intellectual disability (13.1%) while there were almost twice more Malay children than expected with co-occurring intellectual disability (29.9%) (χ2 (3) = 55.17, p < .001). There are correspondingly more Malay children on the autism spectrum who attend special education schools. Possible confounding variables such as household income level and mother's level of education were identified in some of these findings. CONCLUSION Several significant ethnic group differences in autistic children in Singapore exist that warrant more investigation into possible causes and support systems needed, with implications for other ethnically diverse nations.
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Affiliation(s)
| | - Hwan Cui Koh
- KK Women's and Children's Hospital, Singapore, Singapore
| | | | | | | | - Chui Mae Wong
- KK Women's and Children's Hospital, Singapore, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Singapore, Singapore.
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Taghizadeh Z, Farmahini Farahani M, Nourollahpour Shiadeh M, Qaderi K. Caregivers' concerns about the sexual and reproductive health of women with intellectual disability in Iran: a qualitative study. Reprod Health 2024; 21:35. [PMID: 38475824 DOI: 10.1186/s12978-024-01765-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Women with intellectual disability (ID) have many sexual and reproductive problems. This study was conducted to explain the sexual and reproductive health considerations of women with ID from the perspective of their caregivers in a qualitative approach. METHODS This study was a qualitative research conducted with a content analysis approach in Iran. The sampling method used was targeted sampling with maximum possible variation, which was continued until data saturation. For data collection, in-depth and semi-structured interviews were conducted with 21 participants, including 8 mothers, 6 caregivers, and 7 specialist caregivers who had experience working with women with intellectual disabilities. Data analysis was conducted using the conventional content analysis method proposed by Zhang and Wildemuth. RESULTS Two main themes, four categories and 12 subcategories emerged from the data analysis. The themes include "Reproductive health concerns" and" "Sexual health concerns". This means that this group of women has many problems with menstrual hygiene and vaginal infections. On the other hand, caregivers were concerned about the manifestations of unconventional sexual behaviors and difficulties in controlling sexual behaviors as well as the risk of sexual abuse. CONCLUSION The results of the present study show that it is not only necessary to provide women with ID with practical instructions on menstrual hygiene and sexual self-care, but also that regular examinations of the reproductive system by obstetricians or midwives, especially in care centers, seem essential.
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Affiliation(s)
- Ziba Taghizadeh
- Reproductive Health and Midwifery Department, Nursing and Midwifery Care Research Center, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Farmahini Farahani
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran.
| | | | - Kowsar Qaderi
- Midwifery Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Yee KS, Lewis S, Evans E, Romano C, Alexanderian D. Caregiver experiences and observations of intrathecal idursulfase-IT treatment in a phase 2/3 trial in pediatric patients with neuronopathic mucopolysaccharidosis II. Orphanet J Rare Dis 2024; 19:110. [PMID: 38462612 PMCID: PMC10926613 DOI: 10.1186/s13023-024-03034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/19/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Approximately two-thirds of patients with mucopolysaccharidosis II (MPS II) have a severe, neuronopathic phenotype, characterized by somatic, cognitive, and behavioral issues. Current standard of care for the treatment of MPS II is enzyme replacement therapy with intravenous recombinant human iduronate-2-sulfatase (idursulfase). To target cognitive manifestations of MPS II, idursulfase has been formulated for intrathecal administration into the cerebrospinal fluid (idursulfase-IT). In accordance with recommendations for patient-focused drug development, semi-structured interviews were conducted to assess caregiver experiences and observations in a 52-week phase 2/3 trial of idursulfase-IT, in addition to intravenous idursulfase in pediatric patients with neuronopathic MPS II, or a substudy which enrolled patients younger than 3 years old, all of whom received idursulfase-IT. RESULTS Overall, 46 caregivers providing care for 50 children (mean [range] age 7.9 [3-17] years at interview) took part in a single 60-min exit interview; six of these children had participated in the substudy. Qualitative and quantitative data were obtained demonstrating the burden of MPS II experienced by caregivers and their families. Following participation in the trials, 39 (78%) of the children were reported by their caregivers to have experienced improvements in the symptoms and impact of disease. Of those with improvements, 37 (95%) experienced cognitive improvements and 26 (67%) experienced emotional/behavioral improvements. Overall, 43 children (86%) were rated by caregivers as having moderate or severe symptoms before the trials; after the trials, 28 children (56%) were considered to have mild or no symptoms. For the six children who participated in the substudy, these proportions were 83% and 100%, respectively. Caregivers' qualitative descriptions of trial experiences suggested improvements in children's verbal and non-verbal functioning and spatial and motor skills, as well as a positive impact on family life. CONCLUSIONS This study revealed caregiver-reported improvements in children's MPS II symptoms and the impact of the disease on patients and their families. There was a trend for cognitive improvement and a reduction in severity of MPS II symptoms. After many years of extensive review and regulatory discussions of idursulfase-IT, the clinical trial data were found to be insufficient to meet the evidentiary standard to support regulatory filings.
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Affiliation(s)
- Karen S Yee
- Takeda Development Center Americas, Inc., Cambridge, MA, USA.
| | - Sandy Lewis
- RTI Health Solutions, Research Triangle Park, Raleigh, NC, USA
| | - Emily Evans
- RTI Health Solutions, Research Triangle Park, Raleigh, NC, USA
| | - Carla Romano
- RTI Health Solutions, Research Triangle Park, Raleigh, NC, USA
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de Masfrand S, Cogné B, Nizon M, Deb W, Goldenberg A, Lecoquierre F, Nicolas G, Bournez M, Vitobello A, Mau-Them FT, le Guyader G, Bilan F, Bauer P, Zweier C, Piard J, Pasquier L, Bézieau S, Gerard B, Faivre L, Saugier-Veber P, Piton A, Isidor B. Penetrance, variable expressivity and monogenic neurodevelopmental disorders. Eur J Med Genet 2024:104932. [PMID: 38453051 DOI: 10.1016/j.ejmg.2024.104932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Incomplete penetrance is observed for most monogenic diseases. However, for neurodevelopmental disorders, the interpretation of single and multi-nucleotide variants (SNV/MNVs) is usually based on the paradigm of complete penetrance. METHOD From 2020 to 2022, we proposed a collaboration study with the French molecular diagnosis for intellectual disability network. The aim was to recruit families for whom the index case, diagnosed with a neurodevelopmental disorder, was carrying a pathogenic or likely pathogenic variant for an OMIM morbid gene and inherited from an asymptomatic parent. Grandparents were analyzed when available for segregation study. RESULTS We identified 12 patients affected by a monogenic neurodevelopmental disorder caused by likely pathogenic or pathogenic variant (SNV/MNV) inherited from an asymptomatic parent. These genes were usually associated with de novo variants. The patients carried different variants (1 splice-site variant, 4 nonsense and 7 frameshift) in 11 genes: CAMTA1, MBD5, KMT2C, KMT2E, ZMIZ1, MN1, NDUFB11, CUL3, MED13, ARID2 and RERE. Grandparents have been tested in 6 families, and each time the variant was confirmed de novo in the healthy carrier parent. CONCLUSION Incomplete penetrance for SNV and MNV in neurodevelopmental disorders might be more frequent than previously thought. This point is crucial to consider for interpretation of variants, family investigation, genetic counseling, and prenatal diagnosis. Molecular mechanisms underlying this incomplete penetrance still need to be identified.
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Affiliation(s)
- Servane de Masfrand
- Nantes Université, CHU Nantes, Service de Génétique Médicale, 44000, Nantes, France.
| | - Benjamin Cogné
- Nantes Université, CHU Nantes, Service de Génétique Médicale, 44000, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, L'institut Du Thorax, 44000 Nantes, France
| | - Mathilde Nizon
- Nantes Université, CHU Nantes, Service de Génétique Médicale, 44000, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, L'institut Du Thorax, 44000 Nantes, France
| | - Wallid Deb
- Nantes Université, CHU Nantes, Service de Génétique Médicale, 44000, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, L'institut Du Thorax, 44000 Nantes, France
| | - Alice Goldenberg
- CHU Rouen, Service de Génétique et Centre de Référence pour Les Troubles Du Développement, 76183, Rouen, France
| | - François Lecoquierre
- CHU Rouen, Service de Génétique et Centre de Référence pour Les Troubles Du Développement, 76183, Rouen, France
| | - Gaël Nicolas
- CHU Rouen, Service de Génétique et Centre de Référence pour Les Troubles Du Développement, 76183, Rouen, France
| | - Marie Bournez
- Centre de Référence Anomalies Du Développement et Syndromes Malformatifs, FHU TRANSLAD, CHU Dijon, 21000, Dijon, France
| | - Antonio Vitobello
- Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, CHU Dijon Bourgogne, Dijon, France; Génétique des Anomalies Du Développement, INSERM 123, Université de Bourgogne, Dijon, France
| | - Frédéric Tran Mau-Them
- Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, CHU Dijon Bourgogne, Dijon, France; Génétique des Anomalies Du Développement, INSERM 123, Université de Bourgogne, Dijon, France
| | - Gwenaël le Guyader
- Service de Génétique Clinique, Centre de Compétence Maladies Rares Anomalies Du Développement, CHU de Poitiers, Poitiers, France
| | - Frédéric Bilan
- Service de Génétique Clinique, Centre de Compétence Maladies Rares Anomalies Du Développement, CHU de Poitiers, Poitiers, France
| | | | | | - Juliette Piard
- Centre de Génétique Humaine and Integrative and Cognitive Neuroscience Research Unit EA481, Université de Franche-Comté, Besançon, France
| | | | - Stéphane Bézieau
- Nantes Université, CHU Nantes, Service de Génétique Médicale, 44000, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, L'institut Du Thorax, 44000 Nantes, France
| | - Bénédicte Gerard
- Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Laurence Faivre
- Centre de Référence Anomalies Du Développement et Syndromes Malformatifs, FHU TRANSLAD, CHU Dijon, 21000, Dijon, France; Génétique des Anomalies Du Développement, INSERM 123, Université de Bourgogne, Dijon, France
| | - Pascale Saugier-Veber
- CHU Rouen, Service de Génétique et Centre de Référence pour Les Troubles Du Développement, 76183, Rouen, France
| | - Amélie Piton
- Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Bertrand Isidor
- Nantes Université, CHU Nantes, Service de Génétique Médicale, 44000, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, L'institut Du Thorax, 44000 Nantes, France.
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Houben F, den Heijer CD, Dukers-Muijrers NH, Smeets-Peels C, Hoebe CJ. Perceived barriers and facilitators to infection prevention and control in Dutch residential care facilities for people with intellectual and developmental disabilities: a cross-sectional study. BMC Public Health 2024; 24:704. [PMID: 38443810 PMCID: PMC10916042 DOI: 10.1186/s12889-024-18159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Adequate implementation of infection prevention and control (IPC) in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is crucial to safeguarding this vulnerable population. Studies in this field are scarce. This study aimed to identify perceived barriers to and facilitators of IPC among professionals working in these settings, along with recommendations to improve IPC, to inform the development of targeted interventions. METHODS We administered an online questionnaire to 319 professionals from 16 Dutch RCFs for people with IDDs (March 2021-March 2022). Perceived multilevel barriers and facilitators (guideline, client, interpersonal, organisational, care sector, and policy level) were measured on a 5-point Likert scale (totally disagree-totally agree). Recommendations were assessed using a 5-point Likert scale (not at all helpful-extremely helpful), supplemented by an open-ended question. Barriers, facilitators, and recommendations were analysed by descriptive statistics. Open answers to recommendations were analysed through thematic coding. RESULTS Barriers to IPC implementation included the client group (e.g., lack of hygiene awareness) (63%), competing values between IPC and the home-like environment (42%), high work pressure (39%), and the overwhelming quantity of IPC guidelines/protocols (33%). Facilitators included perceived social support on IPC between professionals and from supervisors (90% and 80%, respectively), procedural clarity of IPC guidelines/protocols (83%), and the sense of urgency for IPC in the organisation (74%). Main recommendations included the implementation of clear IPC policies and regulations (86%), the development of a practical IPC guideline (84%), and the introduction of structural IPC education and training programmes (for new staff members) (85%). Professionals also emphasised the need for IPC improvement efforts to be tailored to the local care context, and to involve clients and their relatives. CONCLUSIONS To improve IPC in disability care settings, multifaceted strategies should be adopted. Initial efforts should involve clients (and relatives), develop a practical and context-specific IPC guideline, encourage social support among colleagues through interprofessional coaching, reduce workload, and foster an IPC culture including shared responsibility within the organisation.
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Affiliation(s)
- Famke Houben
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD, Maastricht, P.O. box 616, The Netherlands.
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, 6400 AA, Heerlen, P.O. box 33, The Netherlands.
| | - Casper Dj den Heijer
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD, Maastricht, P.O. box 616, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, 6400 AA, Heerlen, P.O. box 33, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), 6202 AZ, Maastricht, P.O. box 5800, The Netherlands
| | - Nicole Htm Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, 6400 AA, Heerlen, P.O. box 33, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD, Maastricht, P.O. box 616, The Netherlands
| | | | - Christian Jpa Hoebe
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD, Maastricht, P.O. box 616, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, 6400 AA, Heerlen, P.O. box 33, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), 6202 AZ, Maastricht, P.O. box 5800, The Netherlands
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Gil N, Cox A, Whitaker KL, Kerrison RS. Cancer risk-factor and symptom awareness among adults with intellectual disabilities, paid and unpaid carers, and healthcare practitioners: a scoping review. J Intellect Disabil Res 2024; 68:193-211. [PMID: 38057951 DOI: 10.1111/jir.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND The physical health of people with intellectual disabilities (ID) has been identified as an area of ongoing concern and priority. Research has increasingly focused on cancer, with studies indicating that people with ID are at an increased risk of cancer and of mortality, compared with the general population. This review aims to systematically identify and synthesise the published academic literature exploring cancer risk-factor and symptom awareness among people with IDs, carers and healthcare professionals. METHODS In line with Arksey and O'Malley's (2005) framework for scoping reviews, five incremental stages were followed: (1) identifying research question, (2) identifying relevant studies, (3) study selection, (4) extracting and charting of data, and (5) collating, summarising and reporting results. Findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews (PRISMA-Scr). RESULTS The search strategy identified 352 records, 16 records met all eligibility criteria and were included for review. The studies address a range of areas including knowledge and awareness of cancer risk-factors and symptoms and interventions to promote awareness of cancer. CONCLUSIONS Cancer risk-factor and symptom awareness is low among adults with ID, paid and unpaid carers and healthcare practitioners (HCPs). Theoretically underpinned, co-designed tools and interventions to improve awareness are lacking. There is uncertainty surrounding how to best support people with ID in raising cancer awareness, even within the professional healthcare environment. There is a predominance of research on breast cancer awareness. Future studies focusing on other cancers are needed to build a complete picture of awareness among adults with IDs, paid and unpaid carers, and HCPs.
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Affiliation(s)
- N Gil
- School of Health Sciences, University of Surrey, Guildford, UK
| | - A Cox
- School of Health Sciences, University of Surrey, Guildford, UK
| | - K L Whitaker
- School of Health Sciences, University of Surrey, Guildford, UK
| | - R S Kerrison
- School of Health Sciences, University of Surrey, Guildford, UK
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Yang JH, Liu ZG, Liu CL, Zhang MR, Jia YL, Zhai QX, He MF, He N, Qiao JD. MED12 variants associated with X-linked recessive partial epilepsy without intellectual disability. Seizure 2024; 116:30-36. [PMID: 36894399 DOI: 10.1016/j.seizure.2023.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES The MED12 gene encodes mediator complex subunit 12, which is a component of the mediator complex involved in the transcriptional regulation of nearly all RNA polymerase II-dependent genes. MED12 variants have previously been associated with developmental disorders with or without nonspecific intellectual disability. This study aims to explore the association between MED12 variants and epilepsy. MATERIALS AND METHODS Trios-based whole-exome sequencing was performed in a cohort of 349 unrelated cases with partial (focal) epilepsy without acquired causes. The genotype-phenotype correlations of MED12 variants were analyzed. RESULTS Five hemizygous missense MED12 variants, including c.958A>G/p.Ile320Val, c.1757G>A/p.Ser586Asn, c.2138C>T/p.Pro713Leu, c.3379T>C/p.Ser1127Pro, and c.4219A>C/p.Met1407Leu were identified in five unrelated males with partial epilepsy. All patients showed infrequent focal seizures and achieved seizure free without developmental abnormalities or intellectual disability. All the hemizygous variants were inherited from asymptomatic mothers (consistent with the X-linked recessive inheritance pattern) and were absent in the general population. The two variants with damaging hydrogen bonds were associated with early-onset seizures. Further genotype-phenotype analysis revealed that congenital anomaly disorder (Hardikar syndrome) was associated with (de novo) destructive variants in an X-linked dominant inheritance pattern, whereas epilepsy was associated with missense variants in an X-linked recessive inheritance pattern. Phenotypic features of intellectual disability appeared as the intermediate phenotype in terms of both genotype and inheritance. Epilepsy-related variants were located at the MED12-LCEWAV domain and the regions between MED12-LCEWAV and MED12-POL. CONCLUSION MED12 is a potentially causative gene for X-linked recessive partial epilepsy without developmental or intellectual abnormalities. The genotype-phenotype correlation of MED12 variants explains the phenotypic variations and can help the genetic diagnosis.
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Affiliation(s)
- Jie-Hua Yang
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Department of Neurology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhi-Gang Liu
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China
| | - Chun-Ling Liu
- Department of Neurology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ming-Rui Zhang
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yan-Lu Jia
- Department of Neurology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiong-Xiang Zhai
- Department of pediatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ming-Feng He
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Na He
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
| | - Jing-Da Qiao
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
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Ye ZL, Yan HJ, Guo QH, Zhang SQ, Luo S, Lian YJ, Ma YQ, Lu XG, Liu XR, Shen NX, Gao LD, Chen Z, Shi YW. NEXMIF variants are associated with epilepsy with or without intellectual disability. Seizure 2024; 116:93-99. [PMID: 37643945 DOI: 10.1016/j.seizure.2023.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/09/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Variants in NEXMIF had been reported associated with intellectual disability (ID) without epilepsy or developmental epileptic encephalopathy (DEE). It is unkown whether NEXMIF variants are associated with epilepsy without ID. This study aims to explore the phenotypic spectrum of NEXMIF and the genotype-phenotype correlations. MATERIALS AND METHODS Trio-based whole-exome sequencing was performed in patients with epilepsy. Previously reported NEXMIF variants were systematically reviewed to analyze the genotype-phenotype correlations. RESULTS Six variants were identified in seven unrelated cases with epilepsy, including two de novo null variants and four hemizygous missense variants. The two de novo variants were absent in all populations of gnomAD and four hemizygous missense variants were absent in male controls of gnomAD. The two patients with de novo null variants exhibited severe developmental epileptic encephalopathy. While, the patients with hemizygous missense variants had mild focal epilepsy with favorable outcome. Analysis of previously reported cases revealed that males with missense variants presented significantly higher percentage of normal intellectual development and later onset age of seizure than those with null variants, indicating a genotype-phenotype correlation. CONCLUSION This study suggested that NEXMIF variants were potentially associated with pure epilepsy with or without intellectual disability. The spectrum of epileptic phenotypes ranged from the mild epilepsy to severe developmental epileptic encephalopathy, where the epileptic phenotypes variability are potentially associated with patients' gender and variant type.
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Affiliation(s)
- Zi-Long Ye
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China
| | - Hong-Jun Yan
- Epilepsy Center, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Qing-Hui Guo
- Department of Pediatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Shu-Qian Zhang
- Department of Pediatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Sheng Luo
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China
| | - Ya-Jun Lian
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yun-Qing Ma
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Guo Lu
- Epilepsy Center and Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiao-Rong Liu
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China
| | - Nan-Xiang Shen
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China
| | - Liang-Di Gao
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China
| | - Zheng Chen
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yi-Wu Shi
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China.
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Elias ER, Orth LE, Li A, Xu L, Jones SM, Rizzo WB. Cholic acid increases plasma cholesterol in Smith-Lemli-Opitz syndrome: A pilot study. Mol Genet Metab Rep 2024; 38:101030. [PMID: 38077958 PMCID: PMC10698565 DOI: 10.1016/j.ymgmr.2023.101030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 02/12/2024] Open
Abstract
Background Smith-Lemli-Opitz syndrome (SLOS) is an inherited disorder of cholesterol biosynthesis associated with congenital malformations, growth delay, intellectual disability and behavior problems. SLOS is caused by bi-allelic mutations in DHCR7, which lead to reduced activity of 7-dehydrocholesterol reductase that catalyzes the last step in cholesterol biosynthesis. Symptoms of SLOS are thought to be due to cholesterol deficiency and accumulation of its precursor 7-dehydrocholesterol (7-DHC) and 8-dehydrocholesterol (8-DHC), and toxic oxysterols. Therapy for SLOS often includes dietary cholesterol supplementation, but lipids are poorly absorbed from the diet, possibly due to impaired bile acid synthesis. We hypothesized that bile acid supplementation with cholic acid would improve dietary cholesterol absorption and raise plasma cholesterol levels. Methods Twelve SLOS subjects (10 M, 2F, ages 2-27 years) who had plasma cholesterol ≤125 mg/dL were treated with cholic acid (10 mg/kg/day) divided twice daily for 2 months. Plasma cholesterol, 7-DHC and 8-DHC were measured by GC-MS. Oxysterols were measured by ultra-high-performance LC-MS/MS. Data were analyzed using paired t-tests. Results At baseline, plasma cholesterol was 75 ± 24 mg/dL (mean ± SD; range 43-125, n = 12). After 2 months on cholic acid, mean plasma cholesterol increased to 97 ± 29 mg/dL (p = 0.011). Eleven of 12 subjects showed an increase in plasma cholesterol that varied from 3.8% to 85.7% (mean 38.7 ± 23.3%). 7-Hydroxycholesterol decreased by 20.6% on average (p = 0.013) but no significant changes were seen in 7-DHC or 8-DHC. Mean body weight tended to increase (3.6% p = 0.069). Subjects tolerated cholic acid well and experienced no drug-related adverse events. Conclusions In this pilot study, cholic acid supplementation was well tolerated and safe and resulted in an increase in plasma cholesterol in most SLOS subjects. Further controlled longitudinal studies are needed to look for the sustainability of the biochemical effect and possible clinical benefits.
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Affiliation(s)
- Ellen R. Elias
- Department of Pediatrics, Children's Hospital Colorado, Aurora, CO, USA
| | - Lucas E. Orth
- Department of Pharmacy, Children's Hospital Colorado, Aurora, CO, USA
| | - Amy Li
- Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA
| | - Libin Xu
- Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA
| | - Sara M. Jones
- Department of Pediatrics and Child Health Research Institute, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, NE, USA
| | - William B. Rizzo
- Department of Pediatrics and Child Health Research Institute, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, NE, USA
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Pang N, Li K, Tan S, Chen M, He F, Chen C, Yang L, Zhang C, Deng X, Yang L, Mao L, Wang G, Duan H, Wang X, Zhang W, Guo H, Peng J, Yin F, Xia K. Targeted sequencing identifies risk variants in 202 candidate genes for neurodevelopmental disorders. Gene 2024; 897:148071. [PMID: 38081334 DOI: 10.1016/j.gene.2023.148071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/17/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
With the continuous deepening of genetic research on neurodevelopmental disorders (NDDs), more patients have been identified the causal or candidate genes. However, it is still urgent needed to increase the sample size to confirm the associations between variants and clinical manifestations. We previously performed molecular inversion probe sequencing of autism spectrum disorder (ASD) candidate genes in 1543 ASD patients. In this study, we used the same method to detect de novo variants (DNVs) in 665 NDD patients with intellectual disability (ID) and/or epilepsy (EP) for genetic analysis and diagnosis. We compared findings from ID/EP and ASD patients to improve our understanding of different subgroups of NDDs. We identified 72 novel variants and 39 DNVs. A totally of 5.71 % (38/665) of the patients were genetically diagnosed by this sequencing strategy. ID/EP patients demonstrated a higher prevalence of likely gene disruptive DNVs in ASD genes than the healthy population. Regarding high-risk genes, SCN1A and CKDL5 were more frequently mutated in ID/EP patients than in ASD patients. Our data provide an overview of the mutation burden in ID/EP patients from the perspective of high risk ASD genes, indicating the differences and association of NDDs subgroups.
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Affiliation(s)
- Nan Pang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Kuokuo Li
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410078, China; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Senwei Tan
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410078, China
| | - Meilin Chen
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410078, China
| | - Fang He
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Chen Chen
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Lifen Yang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Ciliu Zhang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiaolu Deng
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Li Yang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Leilei Mao
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Guoli Wang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Haolin Duan
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiaole Wang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Wen Zhang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hui Guo
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410078, China
| | - Jing Peng
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China.
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China; Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha 410008, China.
| | - Kun Xia
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410078, China; Hengyang Medical School, 421001, University of South, China.
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Kurt A, Kürtüncü M. The effectiveness of sexual health and development education given to children with intellectual disabilities: A randomized controlled study. J Pediatr Nurs 2024; 75:e49-e57. [PMID: 38199932 DOI: 10.1016/j.pedn.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE The purpose of this study is to determine the effectiveness of an educational program implemented to support the sexual health and development of children with intellectual disabilities, using the Mastery Learning Model, on their knowledge of sexual health and development, as well as on their mothers' awareness of their children's sexual development. METHOD This study was conducted as a randomized controlled trial with 48 children who have intellectual disabilities, divided into two groups: an education group (n = 24) and a control group (n = 24). The program implemented was a sexual health and development education program based on the Mastery Learning Model. The data collection tools used were 'The Sexual Development Characteristics of Children with Adolescent Intellectual Disability Scale' for mothers and 'The Sexual Development Knowledge Assessment Scale for Children with Intellectual Disabilities' for children. RESULTS Following the educational program, the children in the education group demonstrated an increase in knowledge regarding their sexual development and health. Additionally, the mothers in the education group showed an increased awareness of their children's sexual health and development. One month after implementing the education program, which utilized mastery learning, the children in the education group exhibited a greater level of knowledge compared to the control group. CONCLUSION This study utilized the Mastery Learning Model to achieve effective and comprehensive sexual health and development education for children with intellectual disabilities. PRACTICE IMPLICATIONS Pediatric and school nurses are recommended to use the Mastery Learning Model for sexual health education in clinics and school health practices.
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Affiliation(s)
- Aylin Kurt
- Bartın University, Faculty of Health Sciences, Nursing Department, Pediatric Nursing, Bartın, Turkey.
| | - Meltem Kürtüncü
- Zonguldak Bülent Ecevit University, Faculty of Health Sciences, Nursing Department, Pediatric Nursing, Zonguldak, Turkey.
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Aljuraysi S, Platt M, Pulix M, Poptani H, Plagge A. Microcephaly with a disproportionate hippocampal reduction, stem cell loss and neuronal lipid droplet symptoms in Trappc9 KO mice. Neurobiol Dis 2024; 192:106431. [PMID: 38331351 DOI: 10.1016/j.nbd.2024.106431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/10/2024] Open
Abstract
Mutations of the human TRAFFICKING PROTEIN PARTICLE COMPLEX SUBUNIT 9 (TRAPPC9) cause a neurodevelopmental disorder characterised by microcephaly and intellectual disability. Trappc9 constitutes a subunit specific to the intracellular membrane-associated TrappII complex. The TrappII complex interacts with Rab11 and Rab18, the latter being specifically associated with lipid droplets (LDs). Here we used non-invasive imaging to characterise Trappc9 knock-out (KO) mice as a model of the human hereditary disorder. KOs developed postnatal microcephaly with many grey and white matter regions being affected. In vivo magnetic resonance imaging (MRI) identified a disproportionately stronger volume reduction in the hippocampus, which was associated with a significant loss of Sox2-positive neural stem and progenitor cells. Diffusion tensor imaging indicated a reduced organisation or integrity of white matter areas. Trappc9 KOs displayed behavioural abnormalities in several tests related to exploration, learning and memory. Trappc9-deficient primary hippocampal neurons accumulated a larger LD volume per cell following Oleic Acid stimulation, and the coating of LDs by Perilipin-2 was much reduced. Additionally, Trappc9 KOs developed obesity, which was significantly more severe in females than in males. Our findings indicate that, beyond previously reported Rab11-related vesicle transport defects, dysfunctions in LD homeostasis might contribute to the neurobiological symptoms of Trappc9 deficiency.
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Affiliation(s)
- Sultan Aljuraysi
- Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mark Platt
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; Centre for Preclinical Imaging, University of Liverpool, Liverpool, UK
| | - Michela Pulix
- Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Harish Poptani
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; Centre for Preclinical Imaging, University of Liverpool, Liverpool, UK.
| | - Antonius Plagge
- Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; Centre for Preclinical Imaging, University of Liverpool, Liverpool, UK.
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Alarifi S, Denne L, Hastings RP. Challenging behaviour and its correlates in preschool-aged children with an intellectual disability in Saudi Arabia. J Intellect Disabil Res 2024; 68:264-276. [PMID: 38052235 DOI: 10.1111/jir.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 08/10/2023] [Accepted: 11/05/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Young children with an intellectual disability have a higher risk of developing challenging behaviour (CB). Early identification of risk factors for CB allows for earlier intervention. The aim of the current study was to assess the prevalence and correlates of CB in preschool-aged children with an intellectual disability in Riyadh (Saudi Arabia). METHODS One hundred twenty parents of preschool-aged (3-6 years old) children who had been diagnosed (DSM-5 criteria) with an intellectual disability completed an online cross-sectional survey that included demographic, CB and child adaptive skills measures. The relationship between CB and 15 potential correlates (e.g. gender and degree of disability) was examined using independent samples t-tests and chi-squared tests. RESULTS Most preschool-aged (3-6 years old) children with an intellectual disability exhibited CB (78.8%, 95% CI [70.3, 85.8]), with a 63.2% prevalence rate for self-injurious behaviours (95% C [53.8, 72.0]), a 57.6% rate for aggressive destructive behaviours (95% CI [48.2, 66.7]) and a 25% rate for stereotypy (95% CI [17.7, 34.0]). The likelihood of a child engaging in self-injurious and stereotyped behaviours was higher in those with autism and intellectual disability. Children with Down syndrome displayed fewer stereotyped behaviours. Low adaptive skill levels were associated with increased overall CB, self-injurious and stereotyped behaviours. CONCLUSIONS The identified correlates of CB in this population and cultural context align with the international evidence base. Findings have implications for the importance of early systematic screening of CB in preschool-aged children in Saudi Arabia and other similar contexts. Preventative measures are suggested for preschool-aged children with an intellectual disability who are more likely to demonstrate CB, such as those with autism and poor adaptive behaviours.
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Affiliation(s)
- S Alarifi
- Centre for Research in Intellectual and Developmental Disabilities, Faculty of Social Sciences, University of Warwick, Coventry, UK
- Special Education Department, College of Education, Imam Mohammad Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia
| | - L Denne
- Centre for Research in Intellectual and Developmental Disabilities, Faculty of Social Sciences, University of Warwick, Coventry, UK
| | - R P Hastings
- Centre for Research in Intellectual and Developmental Disabilities, Faculty of Social Sciences, University of Warwick, Coventry, UK
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Smith JR, Hopkins CE, Xiong J, Luccarelli J, Shultz E, Vandekar S. Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis. J Autism Dev Disord 2024; 54:963-982. [PMID: 36528758 PMCID: PMC10276173 DOI: 10.1007/s10803-022-05868-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Autism spectrum disorder (ASD) and intellectual disability (ID) are heterogenous and prevalent conditions which may occur in isolation or as a co-morbidity. Psychiatric co-morbidity is common with limited treatment options. Preliminary research into electroconvulsive therapy (ECT) for these conditions has been encouraging. Thus, further research in this patient population is warranted. We conducted a 10-year retrospective review of the electronic medical record and identified intellectually capable individuals with ASD (IC-ASD), and those with ASD+ID or ID who received at least three ECT treatments. 32 patients were identified of which 30 (94%) experienced positive clinical response, defined as a clinical global impression-improvement (CGI-I) score of 3 or less. The average retrospective CGI-I score across all groups was 1.97, and results of a t-test performed on CGI-I scores indicated improvement across all groups [t = - 16.54, df = 31, p < 0.001, 95% CI = (1.72, 2.22)]. No significant adverse events were identified based on clinical documentation. Our findings further support previous ECT research in this patient population.
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Affiliation(s)
- Joshua R Smith
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center at Village of Vanderbilt, 1500 21st Avenue South, Suite 2200, Nashville, TN, 37212, USA.
- Vanderbilt Kennedy Center, Vanderbilt University, 110 Magnolia Circle, Nashville, TN, 37203, USA.
| | - Corey E Hopkins
- Division of General Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave South, Nashville, TN, 37212, USA
| | - Jiangmei Xiong
- Department of Biostatistics, Vanderbilt University, 2424 West End Avenue, Suite 1100, Nashville, TN, 37203, USA
| | - James Luccarelli
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Elizabeth Shultz
- Division of General Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave South, Nashville, TN, 37212, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University, 2424 West End Avenue, Suite 1100, Nashville, TN, 37203, USA
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Rahikkala E, Väisänen T, Ojala L, Pohjola P, Toivonen M, Parkkola R, Haanpää MK. Report of a Novel Homozygous Intragenic DCC Duplication and a Review of Literature of Developmental Split-Brain Syndrome aka Horizontal Gaze Palsy with Progressive Scoliosis-2 with Impaired Intellectual Development Syndrome. Mol Syndromol 2024; 15:149-155. [PMID: 38585553 PMCID: PMC10996338 DOI: 10.1159/000534772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/20/2023] [Indexed: 04/09/2024] Open
Abstract
Introduction Horizontal gaze palsy with progressive scoliosis-2 (HGPPS2, MIM 617542) with impaired intellectual development aka developmental split-brain syndrome is an ultra-rare congenital disorder caused by pathogenic biallelic variants in the deleted in colorectal cancer (DCC) gene. Case Presentation We report the clinical and genetic characterization of a Syrian patient with a HGPPS2 phenotype and review the previously published cases of HGPPS2. The genetic screening was performed using exome sequencing on Illumina platform. Genetic analysis revealed a novel DCC c.(?_1912)_(2359_?)dup, p.(Ser788Tyrfs*4) variant segregating recessively in the family. This type of variant has not been described previously in the HGPPS2 patients. To date, including the case reported here, three different homozygous pathogenic frameshift variants, one homozygous missense variant, and an intragenic duplication in the DCC gene have been reported in 8 patients with the HGPPS2 syndrome. Conclusion The analysis of duplications and deletions in the DCC should be included in the routine genetic diagnostic evaluation of patients with suspected HGPPS2. This report expands the knowledge of phenotypic and genotypic spectrum of pathogenic variants causing HGPPS2.
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Affiliation(s)
- Elisa Rahikkala
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
| | - Taneli Väisänen
- Department of Clinical Genetics, Turku University Hospital, Turku, Finland
- Department of Genomics, Turku University Hospital, Turku, Finland
| | - Liisa Ojala
- Department of Ophthalmology, Turku University Hospital, Turku, Finland
| | - Pia Pohjola
- Department of Genomics, Turku University Hospital, Turku, Finland
| | - Minna Toivonen
- Department of Genomics, Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Maria K. Haanpää
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Clinical Genetics, Turku University Hospital, Turku, Finland
- Department of Genomics, Turku University Hospital, Turku, Finland
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Kachouri H, Jouira G, Laatar R, Borji R, Rebai H, Sahli S. Different types of combined training programs to improve postural balance in single and dual tasks in children with intellectual disability. J Intellect Disabil 2024; 28:225-239. [PMID: 36571852 DOI: 10.1177/17446295221148585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The study explored the effects of two combined training (Strength-Proprioceptive versus Cognitive-Balance) programs on postural balance during single-task and dual-task conditions in children with intellectual disability. The postural balance and the second cognitive-task performances were evaluated before and after 8-week of training in two groups: Strength-Proprioceptive Group (n = 12) and Cognitive-Balance Group (n = 10). Results showed that, in both groups and regardless of the training effect, the postural balance performance was significantly (p < 0.05) altered in the dual-task condition compared to the single-task one. After-training session, postural balance performance was improved significantly (p < 0.001) for all task conditions. After training session, the second cognitive-task performance was improved in the Strength-Proprioceptive Group (p < 0.001) and Cognitive-Balance Groupe (p < 0.05). In conclusion, the combined training programs, Strength-Proprioceptive and Cognitive-Balance, improved postural balance performance in single-task and dual-task conditions in children with intellectual disability.
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Affiliation(s)
- Hiba Kachouri
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Ghada Jouira
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Rabeb Laatar
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Rihab Borji
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
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Chopra M, Savatt JM, Bingaman TI, Good ME, Morgan A, Cooney C, Rossel AM, VanHoute B, Cordova I, Mahida S, Lanzotti V, Baldridge D, Gurnett CA, Piven J, Hazlett H, Pomeroy SL, Sahin M, Payne PRO, Riggs ER, Constantino JN. Clinical variants paired with phenotype: A rich resource for brain gene curation. Genet Med 2024; 26:101035. [PMID: 38059438 PMCID: PMC10939875 DOI: 10.1016/j.gim.2023.101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE Clinically ascertained variants are under-utilized in neurodevelopmental disorder research. We established the Brain Gene Registry (BGR) to coregister clinically identified variants in putative brain genes with participant phenotypes. Here, we report 179 genetic variants in the first 179 BGR registrants and analyze the proportion that were novel to ClinVar at the time of entry and those that were absent in other disease databases. METHODS From 10 academically affiliated institutions, 179 individuals with 179 variants were enrolled into the BGR. Variants were cross-referenced for previous presence in ClinVar and for presence in 6 other genetic databases. RESULTS Of 179 variants in 76 genes, 76 (42.5%) were novel to ClinVar, and 62 (34.6%) were absent from all databases analyzed. Of the 103 variants present in ClinVar, 37 (35.9%) were uncertain (ClinVar aggregate classification of variant of uncertain significance or conflicting classifications). For 5 variants, the aggregate ClinVar classification was inconsistent with the interpretation from the BGR site-provided classification. CONCLUSION A significant proportion of clinical variants that are novel or uncertain are not shared, limiting the evidence base for new gene-disease relationships. Registration of paired clinical genetic test results with phenotype has the potential to advance knowledge of the relationships between genes and neurodevelopmental disorders.
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Affiliation(s)
- Maya Chopra
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital; Boston, MA; Department of Neurology, Boston Children's Hospital Intellectual Disability and Research Center; Harvard Medical School; Boston, MA.
| | - Juliann M Savatt
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Taylor I Bingaman
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Molly E Good
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Alexis Morgan
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Caitlin Cooney
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Allison M Rossel
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Bryanna VanHoute
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Ineke Cordova
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - Sonal Mahida
- Department of Neurology, Boston Children's Hospital Intellectual Disability and Research Center; Harvard Medical School; Boston, MA
| | - Virginia Lanzotti
- Washington University School of Medicine Intellectual and Developmental Disability Research Center, St. Louis, MO
| | - Dustin Baldridge
- Washington University School of Medicine Intellectual and Developmental Disability Research Center, St. Louis, MO
| | - Christina A Gurnett
- Washington University School of Medicine Intellectual and Developmental Disability Research Center, St. Louis, MO
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina Intellectual and Developmental Disability Research Center, Chapel Hill, NC
| | - Heather Hazlett
- Department of Psychiatry, University of North Carolina Intellectual and Developmental Disability Research Center, Chapel Hill, NC
| | - Scott L Pomeroy
- Department of Neurology, Boston Children's Hospital Intellectual Disability and Research Center; Harvard Medical School; Boston, MA
| | - Mustafa Sahin
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital; Boston, MA; Department of Neurology, Boston Children's Hospital Intellectual Disability and Research Center; Harvard Medical School; Boston, MA
| | - Philip R O Payne
- Institute for Informatics Washington University in St. Louis, St. Louis, MO
| | - Erin Rooney Riggs
- Autism and Developmental Medicine Institute, Geisinger, Danville, PA
| | - John N Constantino
- Division of Behavioural and Mental Health, Children's Healthcare of Atlanta, Departments of Psychiatry and Paediatrics, Emory University, Atlanta, GA
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O'Brien KE, Rosen MW, Ernst SD. Obstetric and Gynecologic Care for Individuals with Disabilities. Obstet Gynecol Clin North Am 2024; 51:43-56. [PMID: 38267130 DOI: 10.1016/j.ogc.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
This article explores the inequities experienced by individuals with disabilities when accessing obstetric and gynecologic care. The unique needs, abilities, and barriers to care are reviewed, as well as recommendations for provision of care to people with disabilities.
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Affiliation(s)
- Kathleen E O'Brien
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA.
| | - Monica Woll Rosen
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA
| | - Susan Dwyer Ernst
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA
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Donnelly MG, Karsten AM. Resolving Barriers to Continence for Children with Disabilities: Steps Toward Evidence-Based Practice. Behav Anal Pract 2024; 17:157-175. [PMID: 38405293 PMCID: PMC10891011 DOI: 10.1007/s40617-023-00891-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 02/27/2024] Open
Abstract
Behavior-analytic toilet training (BATT) methods to support urine continence have been reviewed and replicated in numerous studies. Despite empirical validations of BATT, children with disabilities may not experience successful toilet training nor access the associated health and social benefits of urinary continence. It is possible these outcomes are partially due to practical barriers that arise throughout urine training. In practice, barriers may interfere with toilet training to the extent that training is postponed or discontinued, resulting in long-term incontinence and other related problems. Examples of barriers include problem behavior, excessive urine retention, recurrent accidents, and excessive or insufficient independent self-initiations to toilet. Researchers have sometimes described strategies to address these types of barriers. However, practitioners may not be aware of these strategies because they are secondary to the purpose of an investigation and may only apply to a subset of participants. The purpose of this review article is to synthesize the collection of barrier solutions described in published research on urine training for children with developmental disabilities. Results may assist practitioners in modifying BATT according to an evidence-based practice framework until their clients overcome barriers to achieve urine continence.
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Affiliation(s)
- Maeve G. Donnelly
- Western New England University, Springfield, MA USA
- Northeastern University, Boston, MA USA
| | - Amanda M. Karsten
- Western New England University, Springfield, MA USA
- Grand Valley State University, Allendale, MI USA
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Mero Piedra AL, Pesthy O, Marton K. Effects of a physical education intervention on attention and inhibitory control in Ecuadorian children with intellectual disabilities. J Intellect Disabil 2024; 28:261-274. [PMID: 37458606 DOI: 10.1177/17446295231189018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background: Studies on physical activity interventions indicated a facilitative effect on cognitive performance in persons with intellectual disabilities; however, research is scarce, especially in low/middle-income countries. Aim: We explored the effects of a 6-week enriched physical education program on inhibitory control and attention functions in Ecuadorian children with intellectual disabilities. Methods: Thirty children with mild intellectual disabilities (10-14 years old) were randomly assigned to an intervention or control group. Before and after the intervention, attention and inhibitory control were measured using computer-based nonverbal tasks. Results: The findings showed significantly more accurate and faster responses in the vigilance task in the intervention group than in the controls. There were no significant intervention-related changes in inhibitory control; however, there were more prominent accuracy tendencies toward improvement in the intervention group. Conclusions: Results provide evidence of the potential of physical activity programs to enhance attention in this population, which could serve as a mediator for inhibitory control.
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Affiliation(s)
| | - Orsolya Pesthy
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary; Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Klara Marton
- MTA-ELTE Language-Learning Disorders Research Group, Bárczi Gusztáv Faculty of Special Needs Education, Eötvös Loránd University, Budapest, Hungary; Brooklyn College, City University of New York, Brooklyn, NY, USA; Graduate School and University Center, City University of New York, New York, NY, USA
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50
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van der Laan L, Karimi K, Rooney K, Lauffer P, McConkey H, Caro P, Relator R, Levy MA, Bhai P, Mignot C, Keren B, Briuglia S, Sobering AK, Li D, Vissers LELM, Dingemans AJM, Valenzuela I, Verberne EA, Misra-Isrie M, Zwijnenburg PJG, Waisfisz Q, Alders M, Sailer S, Schaaf CP, Mannens MMAM, Sadikovic B, van Haelst MM, Henneman P. DNA methylation episignature, extension of the clinical features, and comparative epigenomic profiling of Hao-Fountain syndrome caused by variants in USP7. Genet Med 2024; 26:101050. [PMID: 38126281 DOI: 10.1016/j.gim.2023.101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Hao-Fountain syndrome (HAFOUS) is a neurodevelopmental disorder caused by pathogenic variants in USP7. HAFOUS is characterized by developmental delay, intellectual disability, speech delay, behavioral abnormalities, autism spectrum disorder, seizures, hypogonadism, and mild dysmorphic features. We investigated the phenotype of 18 participants with HAFOUS and performed DNA methylation (DNAm) analysis, aiming to generate a diagnostic biomarker. Furthermore, we performed comparative analysis with known episignatures to gain more insight into the molecular pathophysiology of HAFOUS. METHODS We assessed genomic DNAm profiles of 18 individuals with pathogenic variants and variants of uncertain significance (VUS) in USP7 to map and validate a specific episignature. The comparison between the USP7 cohort and 56 rare genetic disorders with earlier reported DNAm episignatures was performed with statistical and functional correlation. RESULTS We mapped a sensitive and specific DNAm episignature for pathogenic variants in USP7 and utilized this to reclassify the VUS. Comparative epigenomic analysis showed evidence of HAFOUS similarity to a number of other rare genetic episignature disorders. CONCLUSION We discovered a sensitive and specific DNAm episignature as a robust diagnostic biomarker for HAFOUS that enables VUS reclassification in USP7. We also expand the phenotypic spectrum of 9 new and 5 previously reported individuals with HAFOUS.
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Affiliation(s)
- Liselot van der Laan
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Karim Karimi
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Kathleen Rooney
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Peter Lauffer
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Haley McConkey
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Pilar Caro
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Raissa Relator
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada
| | - Michael A Levy
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada
| | - Pratibha Bhai
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada
| | - Cyril Mignot
- APHP Sorbonne Université, Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Hôpital Armand Trousseau, Paris, France AND Centre de Référence Déficiences Intellectuelles de Causes Rares, Paris, France
| | - Boris Keren
- APHP Sorbonne Université, Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Silvana Briuglia
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrew K Sobering
- AU/UGA Medical Partnership Campus of the Medical College of Georgia, Athens, Georgia; Windward Islands Research and Education Foundation, True Blue, St. George's, Grenada; St. George's University School of Medicine, Department of Biochemistry, Grenada
| | - Dong Li
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA; Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, University of Pennsylvania Perelman school of Medicine, Philadelphia, PA
| | - Lisenka E L M Vissers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Irene Valenzuela
- Àrea de Genètica Clínica i Malalties Minoritàries, Hospital Vall d'Hebron, Barcelona, Spain
| | - Eline A Verberne
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mala Misra-Isrie
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Petra J G Zwijnenburg
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Quinten Waisfisz
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mariëlle Alders
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sebastian Sailer
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | | | - Marcel M A M Mannens
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Bekim Sadikovic
- Verspeeten Clinical Genome Centre, London Health Science Centre, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
| | - Mieke M van Haelst
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Henneman
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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