The University of California Davis School of Medicine is one of six University of California medical schools in the state of California, and is associated with University of California, Davis.
BACKGROUND:The relationship between prenatal exposure to low-level air pollution and child autism spectrum disorder (ASD) is unclear. OBJECTIVE:To examine associations of prenatal air pollution exposure with autism. METHODS:We analyzed data from 8,035 mother-child pairs from 44 United States cohorts in the Environmental influences on Child Health Outcomes (ECHO) Cohort. Fine particulate matter (PM2.5), nitrogen dioxide (NO2), and 8-h-max ozone (O3) levels were estimated at residential addresses during pregnancy. Parents rated children's autism-related traits using the Social Responsiveness Scale (SRS) (mean age 9.4 years, SD = 3.6) and reported physician-diagnosed ASD. We examined associations of the three air pollutants with SRS scores (10th, 50th, and 90th quantiles) using quantile regression and with ASD diagnosis using logistic regression. Models were run within census divisions, and coefficients were pooled in a meta-analysis. RESULTS:Average (SD) pregnancy exposures were 9.3 μg/m3 (2.7) for PM2.5, 21.8 ppb (8.8) for NO2, and 40.3 ppb (5.5) for O3, with variations across census divisions. The median SRS T-score was 46 (IQR = 41 to 52), and 444 children (5.5%) had an ASD diagnosis. Higher PM2.5 was associated with higher SRS scores at the 10th quantile (β = 0.74, 95% CI: 0.09, 1.40) but not at the median or highest quantile. The association between PM2.5 and ASD diagnosis was highly heterogeneous, with associations present in the South Central, Mountain, and Pacific census divisions. Heterogeneity was also high in the association between NO2 and SRS at the median and only in the mid-Atlantic, West North Central, and South Atlantic census divisions. Higher O3 was associated with higher SRS scores at the median (β per IQR increment = 0.83, 95% CI: 0.05, 1.61) and highest quantile (β = 2.19, 95% CI: 0.06, 4.32) in the meta-analysis. Higher O3 also was associated with ASD. DISCUSSION:Associations with ASD outcomes were present even at low levels of air pollutants.
Socioeconomic factors, such as poverty, can significantly impact developmental outcomes. While well-studied in neurotypical children, limited research exists on the impact of these factors on autistic children's development, especially in early childhood. We examined the relationships between two socioeconomic factors, household income and parental education, with cognitive and behavioral profiles in a sample of 308 autistic children aged 2-3.5 years. We found that higher household income and parental education level were significantly associated with higher language abilities and lower externalizing behaviors. Moreover, autistic children from families with below-average income had lower language abilities compared to those from families with average or above-average income. The effects of household income and parental education level remained significant even after controlling for one another. Our findings suggest that lower parental education level and household income, particularly among families from the lowest economic backgrounds, significantly impact language abilities in young autistic children and may contribute to the development of externalizing behaviors, a pattern similar to that observed in non-autistic children. Given that early language abilities are predictive of adulthood outcomes in autism, these findings underscore the importance of supporting socioeconomic stability in the first two to three years of life for autistic children and providing appropriate early interventions to promote language development.
BACKGROUND:The purpose of this study was to estimate the prevalence and number of cerebral microbleeds (CMBs) in a Hispanic and Latino cohort from various self-identified backgrounds and test associations with age, vascular risk factors, APOE (apolipoprotein E), and cognitive function. METHODS:The 3T brain magnetic resonance imaging exams were obtained on SOL-INCA-MRI (Study of Latinos-Investigation of Neurocognitive Aging-MRI) magnetic resonance imaging study participants, a community-based study. CMB number was counted and categorized as: (1) any CMB, (2) lobar only, (3) deep only, (4) mixed, (5) deep+mixed, and (6) lobar+mixed. We examined whether prevalence of CMBs varied by age, sex, education, Hispanic background, cardiovascular risk factors (hypertension, diabetes, Framingham Risk Score), APOE genotype, and cognition. RESULTS:A total of 2455 participants were included who were 63.0±8.4 years of age, 67.9% women, and 62.2% high school education or higher. CMBs prevalence was 11.7% (8.3% lobar only, 2.0% deep only, 1.4% mixed locations). After adjusting for age, sex, and education, a high Framingham Risk Score was associated with the presence of CMBs of all types, except lobar only. Prevalent stroke/transient ischemic attack was associated with higher likelihood of deep-only CMBs. For participants with cognitive impairment, the adjusted prevalence of mixed CMBs (2.2% versus 1.1%, P=0.023) and deep-only+mixed CMBs (5.2% versus 3.1%, P=0.010) was significantly higher compared with cognitively normal. Cognitive impairment was significantly associated with higher total CMB count (rate ratio, 1.46 [95% CI, 1.14-1.87]; P=0.003). No significant associations were found between diabetes, APOE4, and any CMB type. CONCLUSIONS:High vascular risk scores, self-reported history of stroke/transient ischemic attack, and cognitive status were associated with a higher likelihood of CMBs, especially in deep regions.
Pilot fatigue and the Window of Circadian Low (WOCL) gained unprecedented public attention following the aviation crisis of November–December 2025, yet their scientific basis remains poorly understood. This article synthesizes evidence from chronobiology, sleep science, and aviation human-factors to clarify the mechanisms linking circadian rhythms, sleep debt, and pilot performance. It traces the historical development of the concept of pilot fatigue, outlines its multi-factorial neurobehavioral consequences, and explains its regulation through Borbély’s Two-Process Model of sleep. Particular emphasis is placed on the primary WOCL (02:00–06:00) and the secondary afternoon circadian dip, highlighting their physiological significance and operational relevance. Regulatory incorporation of WOCL into fatigue risk management and flight time limitation frameworks is critically reviewed, emphasizing its central role in aviation safety.
OBJECTIVE:Middle ear neuroendocrine tumors (MeNETs) are rare lesions that may mimic more common middle ear pathology. Although typically indolent, they have potential for local invasion and delayed recurrence. This study aims to expand understanding of MeNETs by characterizing their presentation, management, histopathology, and long-term outcomes. STUDY DESIGN:Retrospective case series. SETTING:Two tertiary, university-affiliated medical centers. METHODS:Five patients with histologically confirmed MeNETs were identified through retrospective chart review. Data collected included demographics, presenting symptoms, imaging, operative reports, pathology, and follow-up. Histological evaluation involved hematoxylin and eosin staining and immunohistochemistry. RESULTS:All patients presented with unilateral middle ear symptoms such as hearing loss, tinnitus, or otalgia. Imaging demonstrated soft tissue masses in the middle ear cavity, occasionally with ossicular erosion. All underwent tympanomastoidectomy, and each required at least 1 additional operation, either a second-look or revision for residual or recurrent disease. Histopathology confirmed low-grade neuroendocrine tumors with characteristic immunostaining, and no metastases were identified. Two patients developed delayed local recurrence years after initial surgery. CONCLUSION:MeNETs are uncommon, low-grade tumors that can be mistaken for other middle ear lesions. Management requires surgical excision, and revision surgery is frequently necessary. While overall prognosis is favorable, the potential for delayed recurrence underscores the importance of long-term follow-up and consideration of a planned second-look procedure. This case series contributes to the limited literature guiding diagnosis and treatment of these rare tumors.
