Highlights d Mice harboring human ASD, but not TD, microbiomes exhibit ASD-like behaviors d ASD and TD microbiota produce differential metabolome profiles in mice d Extensive alternative splicing of risk genes in brains of mice with ASD microbiota d BTBR mice treated with 5AV or taurine improved repetitive and social behaviors

for the Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Investigative Team IMPORTANCE Clinical trials suggest that higher doses of task-oriented training are superior to current clinical practice for patients with stroke with upper extremity motor deficits. OBJECTIVE To compare the efficacy of a structured, task-oriented motor training program vs usual and customary occupational therapy (UCC) during stroke rehabilitation. DESIGN, SETTING, AND PARTICIPANTS Phase 3, pragmatic, single-blind randomized trial among 361 participants with moderate motor impairment recruited from 7 US hospitals over 44 months, treated in the outpatient setting from June 2009 to March 2014. INTERVENTIONS Structured, task-oriented upper extremity training (Accelerated Skill Acquisition Program [ASAP]; n = 119); dose-equivalent occupational therapy (DEUCC; n = 120); or monitoring-only occupational therapy (UCC; n = 122). The DEUCC group was prescribed 30 onehour sessions over 10 weeks; the UCC group was only monitored, without specification of dose. MAIN OUTCOMES AND MEASURES The primary outcome was 12-month change in log-transformed Wolf Motor Function Test time score (WMFT, consisting of a mean of 15 timed arm movements and hand dexterity tasks). Secondary outcomes were change in WMFT time score (minimal clinically important difference [MCID] = 19 seconds) and proportion of patients improving Ն25 points on the Stroke Impact Scale (SIS) hand function score (MCID = 17.8 points).RESULTS Among the 361 randomized patients (mean age, 60.7 years; 56% men; 42% African American; mean time since stroke onset, 46 days), 304 (84%) completed the 12-month primary outcome assessment; in intention-to-treat analysis, mean group change scores (log WMFT, baseline to 12 months) were, for the ASAP group,

This pilot and feasibility study examined the impact of a sensory adapted dental environment (SADE) to reduce distress, sensory discomfort, and perception of pain during oral prophylaxis for children with autism spectrum disorder (ASD). Participants were 44 children ages 6-12 (n=22 typical, n=22 ASD). In an experimental crossover design, each participant underwent two professional dental cleanings, one in a regular dental environment (RDE) and one in a SADE, administered in a randomized and counterbalanced order three to four months apart. Outcomes included measures of physiological anxiety, behavioral distress, pain intensity, and sensory discomfort. Both groups exhibited decreased physiological anxiety and reported lower pain and sensory discomfort in the SADE condition compared to RDE, indicating a beneficial effect of the SADE.

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Background & Aims Pancreatitis is the most common serious complication of endoscopic retrograde cholangiopancreatography (ERCP). We performed a pilot study to determine whether aggressive peri-procedural hydration with lactated Ringer’s solution reduces the incidence of pancreatitis following ERCP. Methods Patients who underwent first-time ERCP were randomly assigned to groups (2:1) that received aggressive hydration with lactated Ringer’s solution (3 cc/kg/hr during the procedure, a 20 cc/kg bolus after the procedure, and 3cc/kg/hr for 8 hours following the procedure, n=39) or standard hydration with the same solution (1.5 cc/kg/hr during and for 8 hrs after procedure, n=23). Serum levels of amylase, visual analog pain scores (scale of 0–10), and volume overload were assessed at baseline and 2, 8, and 24 hrs after ERCP. The primary endpoint, post-ERCP pancreatitis was defined as hyperamylasemia (level of amylase > 3 times the upper limit of normal) and increased epigastric pain (≥3 points on visual analog scale) persisting for ≥24 hrs after the procedure. Secondary endpoints included hyper-amylasemia, increased pain, and volume overload. Results None of the patients who received aggressive hydration developed post-ERCP pancreatitis, compared with 17% of patients who received standard hydration (P=.016). Hyperamylasemia developed in 23% of patients who received aggressive hydration vs 39% of those who received standard hydration (P=.116, non-significant); increased epigastric pain developed in 8% of patients who received aggressive hydration vs 22% of those who received standard hydration (P=.146, non-significant). No patients had evidence of volume overload. Conclusions Based on a pilot study, aggressive intravenous hydration with lactated Ringer’s solution appears to reduce the development of post-ERCP pancreatitis and is not associated with volume overload. ClinicalTrials.gov number, NCT 01758549