Evaluating C-Reactive Protein Associated Risk of Cardiovascular Disease in Patients with Autism Spectrum Disorder

This study examines the relationship between C-reactive protein (CRP) levels and cardiovascular disease (CVD) risk in 293 patients with Autism Spectrum Disorder (ASD) from the Rowan-Virtua Regional Integrated Special Needs Center (RISN Center). Baseline CRP values were gathered from EMR and evaluated for CVD risk. ASD patients have increased prevalence of CVD risk factors, and the literature demonstrates a strong relationship between CRP and CVD risk in this population. Patients were stratified by severity of ASD to investigate potential differences. Severe limitations in EMR data and overall sample size limited the generalizability and significance of this study. Larger scale studies with ample serum CRP values are needed to adequately assess CVD risk in the RISN Center’s ASD patient population. Regular monitoring and evaluation of CRP levels in ASD patients could lead to better management of cardiovascular health in patients with ASD

The Correlation Between Serum C-Reactive Protein Level and Risk of Future Cardiovascular Disease: A Neurodivergent Population Dilemma

Extensive research on neurotypical (NT) populations has demonstrated that a chronically elevated level of serum C Reactive Protein (CRP) is a strong predictor of future cardiovascular disease (CVD). Interestingly, many neurodivergent (ND) populations experience chronically elevated CRP levels higher than NT controls. Current research is concerned with establishing the significance of this relationship to accurately predict CVD risk for potentially at risk ND patients. To contribute to this gap in knowledge, the Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population will be studied to identify trends in baseline serum CRP levels across a multitude of ND conditions. A clinical risk assessment scale, specifically designed for treating ND populations, will be developed based on the significance of the results of this study

Perinatal Experiences of People with Autism Spectrum Disorders: A Preliminary Scoping Review

Autism Spectrum Disorder (ASD) is a developmental disorder that is diagnosed in early childhood, typically in people who are assigned male at birth. However, this diagnosis and the sensory and behavioral divergence that comes with ASD stay with people throughout their lives. Based on the DSM-V diagnostic criteria and the history of how Autism and Autism Spectrum Disorders were first identified, many people who do not identify as male and/or present atypically do not receive a formal diagnosis until later in life or self-diagnose. This in turn has led to a lack of research in both populations that do not identify as cisgender male and in adult healthcare for people with ASD. This preliminary scoping review focuses on the perinatal (pregnancy, birth, and postnatal) experiences of people with Autism Spectrum Disorders. Currently there are very limited quantitative and qualitative studies exploring this topic and there are significant gaps in provider knowledge of atypical and/or adult presentations of ASD. In this review, I looked at papers published in English and available through the PubMed database that focused on one of the following three themes: perinatal experiences of the ASD population, healthcare experiences in general of the ASD population, and perinatal experiences of people with disabilities in general. After performing a scoping review of 6 papers, most people with ASD had increased sensitivity to sensory and physical stimuli during pregnancy, felt unprepared to address their body’s signals during birth, and unprepared to cope with the physical postnatal symptoms and sensory sensitivities associated with breastfeeding. Surprising to note was that many parents with ASD felt that their increased sensory sensitivities strengthened their response to the baby’s cues. All these sensory/physical experiences went unrecognized for the most part by physicians as the patients with ASD felt pressure to act in a socially normative way and many did not disclose their diagnosis to the physician whether due to a lack of formal diagnosis and/or due to fear of a negative impact on their healthcare interactions. This lack of disclosure and masking of behaviors led to patient needs being underestimated by the healthcare team and the development of multiple communication barriers such as lack of adjustment to patient needs whether it be via providing an advocate or different methods of providing information. These barriers highlighted the gaps in physician knowledge on how ASD is a spectrum and has many different manifestations and their ignorance in how to properly address and adapt to patient symptoms of meltdown/shutdown/sensory overload. Participants in all the papers reviewed emphasized that continuity of care and physician willingness to adjust to patient needs contributed to improved health outcomes. Recommendations made for medical training and physicians included increased training on ASD, diversity in how information is provided, and adjusting to individual patient needs. However, current research is very limited and most had multinational or populations outside of the USA in their studies. Future studies must focus on elucidating barriers specific to the USA and gauging physician knowledge of ASD and their perceptions of that population

Inflammatory Marker Levels among Patients Diagnosed with Autism Spectrum Disorder and Congenital Heart Defects

Autism Spectrum Disorder (ASD) and congenital heart defects (CHD) are conditions that both confer an immense increase in standard of care, and utilization of medical resources addressing comorbidities. One shared symptom that has been consistently cited is inflammation. This review sought to explore the levels of Tumor Necrosis Factor- (TNF-) and Interleukin-6 (IL-6) between patients diagnosed as having either ASD or CHD. By compiling published data containing the mean values of these two inflammatory markers within these populations, it was shown that while both have significantly elevated levels compared to a phenotypically normal demographic, there is no significant difference between IL-6 levels in ASD vs. CHD patients. However, there are significantly higher levels of TNF- in CHD patients compared to ASD patients. Understanding the relationship of inflammatory markers would help guide better treatments and outcomes in ASD population, especially to those with CHD

Investigating the Link Between Preeclampsia/Eclampsia in Mothers and Cardiovascular Risk Among Their Neurodivergent Children

Preeclampsia/Eclampsia are common gestational conditions among pregnant women. These individuals have hypertension after 20 weeks of gestation, proteinuria/end-stage organ disease, and may have seizures. These conditions can put the mother and fetus at risk.1,2 A review of literature investigates whether an association exists between congenital heart defects (CHD), and maternal preeclampsia/eclampsia in the neurotypical and neurodivergent population. The Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population was used to investigate whether maternal preeclampsia/eclampsia is indicative of higher congenital heart disease (CHD) in their neurodivergent children to achieve better quality of care. As a first step towards exploring the relationship between preeclampsia/eclampsia and CHD in the neurodivergent population, the current literature was reviewed. Retrospective Chart Reviews were also conducted. Preliminary data indicates that common congenital cardiac anomalies among the neurodivergent population whose mothers experienced preeclampsia/eclampsia are Tetralogy of Fallot, Bicuspid Aortic Valve, Atrial Septal Defect, Ventricular Septal Defect, and Pulmonic Stenosis. More studies need to be done on the neurodivergent population to determine whether a strong association exists between congenital cardiovascular anomalies and maternal preeclampsia/eclampsia

Is There an Association Between Preeclampsia/Eclampsia and Congenital Heart Disease Among the Neurodivergent Population?

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart disease (CHD) in their neurodivergent children to achieve better quality of care. As a first step towards exploring the relationship between preeclampsia/eclampsia and CHD in the neurodivergent population, the current literature was reviewed. The results and the emergent future plan of research are presented

Vitamin Level Differences Across the ASD Spectrum

Background: In the United States, 2.7% of children are diagnosed with Autism Spectrum Disorder (ASD). Environmental factors such as vitamin levels, including D, B9, and B12, may have a significant impact on the risk of development. Children conceived in winter months, with low sunlight and Vitamin D levels, have a higher risk of developing ASD. Vitamin B12 deficiency is generally linked with an increased risk of neurodevelopmental disorders. Additionally, vitamin B9 deficiency of a mother during gestation is linked to a higher risk of her child developing ASD. Purpose: To assess potential differences in vitamin levels between patients of differing severities of ASD. Methods: An analysis of vitamin level data for 295 RISN patients with ASD was conducted. Patients on vitamin supplementation at the time labs were drawn were filtered out. For each vitamin, patients were categorized based on ASD severity level. Using R-Studio, a one-way ANOVA Kruskal-Wallis test between the groups was conducted to determine statistically significant differences. Results: On analysis, there were no statistically significant differences (p-value = 0.4309) in Vitamin D levels for patients with different severities of ASD. There were no statistically significant differences (p-value = 0.8801) in Vitamin B9 levels between these patients. Additionally, there were no statistically significant differences (p-value = 0.9744) in Vitamin D levels for patients with these different severities of ASD. This indicates, across these three vitamin types, that vitamin concentrations tend to be consistent across patients with ASD. Conclusions: It may be important to consider repeat studies of this premise, as the sample size, among other factors, may have an influence on the outcome. The lack of notable difference in vitamin level between severities may indicate that severity is unrelated to vitamin level, or that severity is influenced by vitamins in a concentration-independent way, such as processing and receptor sensitivity. Future research should focus on obtaining thorough vitamin labs for patients longitudinally. This will allow for paired analysis of different vitamin levels. It also encourages research into vitamin level changes in patients over time and how it may be related to behavioral changes

Health Benefits of Saccharomyces boulardii as a Probiotic

Saccharomyces boulardii (SB), a budding yeast, within the Saccharomyces genus. It commonly used as a probiotic that has been isolated from lychee and mangosteen fruit. S. boulardii is not known to acquire resistant genes and does not last in the intestine after 3-5 days of discontinuing the ingestion. The clinical efficacy of this probiotic yeast is known to improve various diarrhea such as pediatric diarrhea, antibiotic-associated diarrhea, acute diarrhea, and traveler’s diarrhea. Additionally, when used as an adjuvant to treatment for Helicobacter pylori and Clostridium difficile infections, it improves bacterial eradication, prevents relapse, reduces adverse reactions and treatment-associated diarrhea. Several animal studies have shown that Saccharomyces boulardii can alleviate certain psychological and behavioral conditions through the brain-gut axis and modulate gut microbiome composition. There is bidirectional communication between the brain and gut which is carried out by various pathways like neuronal, endocrine, metabolic and immune. Alterations to composition and function of the microbiota are related to many stress related psychiatric disorders. This is evident in Irritable bowel syndrome (IBS), a gut-brain axis disorder that shares high levels of psychiatric comorbidities including anxiety and depression. The mechanism of how this happens is still unclear; however many studies support the view that the gut brain axis is key link between certain gastrointestinal and psychiatric disorders. Individually these disorders also share similar pathophysiology for example changes in monoamine levels and inflammatory states

Variables Contributing to The Psychosocial Strain on Caregivers of Patients with Autism Spectrum Disorder

This research, conducted at the Rowan-Virtua Integrated Special Needs (RISN) Center, Sewell, New Jersey, explores the psychosocial strain on caregivers of patients with Autism Spectrum Disorder (ASD). Utilizing the Caregiver Burden Inventory (CBI), we assessed multiple psychosocial dimensions, including time dependency, emotional health, development, social relationships, and physical health. Data was extracted from a total of 295 patient charts; this poster analyzes the initial sample of 99 patients by incorporating demographic variables and caregiver burden scores into a tailored database for comprehensive analysis. Our findings reveal a statistically significant correlation between the age of patients and increased developmental scores in the CBI, suggesting that older patients tend to impose higher developmental demands on caregivers. Gender analysis showed no significant correlation with CBI scores. The study underscores the persistent psychosocial challenges faced by caregivers, pointing to the necessity for enhanced supportive measures and further research into the factors influencing caregiver burden. This ongoing project continues to expand with the aim of contributing to better-informed care strategies for both ASD patients and their caregivers

VC-Dimension of Hyperplanes over Finite Fields

Let $\mathbb{F}_q^d$ be the $d$-dimensional vector space over the finite field with $q$ elements. For a subset $E\subseteq \mathbb{F}_q^d$ and a fixed nonzero $t\in \mathbb{F}_q$, let $\mathcal{H}_t(E)=\{h_y: y\in E\}$, where $h_y$ is the indicator function of the set $\{x\in E: x\cdot y=t\}$. Two of the authors, with Maxwell Sun, showed in the case $d=3$ that if $|E|\geq Cq^{\frac{11}{4}}$ and $q$ is sufficiently large, then the VC-dimension of $\mathcal{H}_t(E)$ is 3. In this paper, we generalize the result to arbitrary dimension and improve the exponent in the case $d=3$.Comment: 9 pages, 1 figur