Design, Setting, and Participants Multicenter, randomized, open-label, clinical trial conducted in 41 intensive care units ICUs in Brazil. Final follow-up was completed on July 21, The trial was stopped early following publication of a related study before reaching the planned sample size of patients.
Main Outcomes and Measures The primary outcome was ventilator-free days during the first 28 days, defined as being alive and free from mechanical ventilation. Secondary outcomes were all-cause mortality at 28 days, clinical status of patients at day 15 using a 6-point ordinal scale ranging from 1, not hospitalized to 6, death , ICU-free days during the first 28 days, mechanical ventilation duration at 28 days, and Sequential Organ Failure Assessment SOFA scores range, , with higher scores indicating greater organ dysfunction at 48 hours, 72 hours, and 7 days.
Patients randomized to the dexamethasone group had a mean 6. At 7 days, patients in the dexamethasone group had a mean SOFA score of 6. There was no significant difference in the prespecified secondary outcomes of all-cause mortality at 28 days, ICU-free days during the first 28 days, mechanical ventilation duration at 28 days, or the 6-point ordinal scale at 15 days.
Thirty-three patients Conclusions and Relevance Among patients with COVID and moderate or severe ARDS, use of intravenous dexamethasone plus standard care compared with standard care alone resulted in a statistically significant increase in the number of ventilator-free days days alive and free of mechanical ventilation over 28 days.
Trial Registration ClinicalTrials. Furthermore, an uncontrolled inflammatory state is frequent with COVID 7 , 8 and may contribute to multiorgan failure in these patients. Corticosteroids might exert an effect in controlling this exacerbated response. The hypothesis was that dexamethasone would increase the number of days alive and free from mechanical ventilation during the first 28 days.
We conducted an investigator-initiated, multicenter, randomized, open-label, clinical trial in 41 intensive care units ICUs in Brazil.
The trial protocol Supplement 1 and the statistical analysis plan were submitted for publication before the first interim analysis 16 Supplement 2. The study was approved at the Brazilian Health Regulatory Agency, the Brazilian National Commission for Research Ethics, and all ethics committees at the participating sites. The trial was overseen by an external and independent data and safety monitoring committee DSMC.
Patients were enrolled who were at least 18 years old, had confirmed or suspected COVID infection eMethods in Supplement 3 , and were receiving mechanical ventilation within 48 hours of meeting criteria for moderate to severe ARDS with partial pressure of arterial blood oxygen to fraction of inspired oxygen Pa o 2 :F io 2 ratio of or less. During the study period we refined some of the inclusion and exclusion criteria.
Full details are provided in Supplement 3. Randomization was performed through an online web-based system 18 using computer-generated random numbers and blocks of 2 and 4, unknown to the investigators, and was stratified by center. The group treatment was disclosed to the investigator only after all information regarding patient enrollment was recorded in the online system eMethods in Supplement 3. Eligible patients were randomly assigned in a ratio to receive dexamethasone 20 mg intravenously once daily for 5 days, followed by 10 mg intravenously once daily for additional 5 days or until ICU discharge, whichever occurred first, plus standard care.
Patients in the control group received standard care only. Physicians, patients, and individuals who assessed the outcomes were not blinded for the assigned treatment.
Each study center was encouraged to follow the best practice guidelines and their institutional protocol for the care of critically ill patients with COVID All clinical interventions, such as use of antibiotics, ventilatory strategy, laboratory testing, and hemodynamic management were left at the discretion of the ICU team for both groups.
Protocol adherence was assessed daily until day The use of nonstudy corticosteroids was permitted in the control group for usual ICU indications, such as bronchospasm and refractory septic shock. Data on demographic characteristics, physiological variables, corticosteroid use before randomization, timing from ARDS diagnosis to randomization, insulin use for hyperglycemia, and other clinical and laboratory data were collected.
Use of neuromuscular blocking agents, prone positioning, and extracorporeal membrane oxygenation ECMO were collected daily through day Use of mechanical ventilation and other oxygen supportive therapies high-flow nasal cannula, noninvasive positive pressure ventilation, and use of supplemental oxygen were collected daily through 28 days.
Diagnosis of new infections were reported daily through day Individual patient data on infections were adjudicated by a blinded investigator eMethods in Supplement 3. Patients were followed up for 28 days after randomization or until hospital discharge, whichever occurred first.
The primary outcome was ventilator-free days during the first 28 days, defined as the number of days alive and free from mechanical ventilation for at least 48 consecutive hours.
Nonsurvivors at day 28 were considered to have no ventilator-free days. More details on the definitions are provided in the eMethods section of Supplement 3. For post hoc analyses, we evaluated the components of ventilator-free days during the first 28 days, the cumulative proportions of the 6-point ordinal scale at 15 days, and the outcome of discharge from hospital alive within 28 days. For patients who died, the number of ventilator-free days was 0; for patients who were alive, the ventilator-free days were the days they did not require mechanical ventilation.
No reliable data were available at the trial design to allow for an accurate sample size calculation. Before the first interim analysis, without any study data review and after discussing the protocol with the DSMC, the study steering committee decided to increase the sample size to patients based on necessary adjustments regarding the uncertainty about the normality of the distribution of ventilator-free days.
Two preplanned interim analyses for efficacy and safety evaluation after 96 and patients with complete follow-up were programmed. To estimate treatment effects on the primary outcome, a generalized linear model was used with inflated beta-binomial distribution, with center as random effect and adjusted for age and the Pa o 2 :F io 2 ratio at randomization. The all-cause mortality rate at 28 days was analyzed using a mixed Cox model, with centers as the random effects.
The treatment effect on the SOFA score at 48 hours, 72 hours, and 7 days after randomization was analyzed by a linear mixed model with patients as random effects adjusted for the baseline SOFA score. For the clinical status of patients, if the proportional odds assumption was met, a mixed ordinal logistic regression was used.
All secondary outcomes were adjusted for age and the Pa o 2 :F io 2 ratio to increase statistical power and improve the efficiency of the analysis. Further details on model assumptions and model fit are provided in the eMethods section of Supplement 3. All patients were included in the primary analysis.
There was no loss to follow-up, and data on the primary outcome, mortality within 28 days, clinical status at day 15, ICU-free days at 28 days, and mechanical ventilation duration were available for all patients. We assessed the consistency of the primary analysis results through prespecified sensitivity analyses considering the per-protocol population, patients who received corticosteroids vs patients who did not as-treated population , patients with confirmed COVID, and patients with confirmed or probable COVID eMethods in Supplement 3.
Patients were analyzed according to their randomization groups, and no adjustments for multiplicity were performed. Thus, the results of secondary outcomes and subgroup analyses should be interpreted as exploratory.
A 2-sided P value of less than. All analyses were performed using the R software version 4. Science is the subject whose concept should be very clear in order to score high in the AP intermediate result Find below the detailed AP Intermediate syllabus and marking scheme for Mathematics. Complex number as an ordered pair of real numbers- fundamental operations, Geometrical and Polar Representation of complex numbers in Argand plane- Argand diagram, etc.
Quadratic expressions, equations in one variable, Quadratic inequations, etc. The relation between the roots and coefficients in an equation, Solving the equations when two or more roots of it are connected by certain relation, Transformation of equations - Reciprocal Equations, etc. Fundamental Principle of counting - linear and circular permutations, Permutations with constraint repetitions, etc.
Binomial theorem for a positive integral index, Approximations using Binomial theorem, etc. Random experiments and events, Axiomatic approach and addition theorem of probability, etc.
Students are advised to go through the same and prepare accordingly. Position of a point in the plane of a circle — the power of a point-definition of tangent-length of a tangent, Relative position of two circles- circles touching each other externally, etc.
The angle between two intersecting circles, Radical axis of two circles, radical centre, Intersection of a line and a Circle, etc. Conic sections —Parabola- equation of the parabola in standard form, Equations of tangent and normal at a point on the parabola, different forms of a parabola- parametric equations, etc. Equation of tangent and normal at a point on the ellipse, Equation of ellipse in standard form- Parametric equations, etc. Equations of tangent and normal at a point on the hyperbola, Equation of hyperbola in standard form- Parametric equations, etc.
Integration- Partial fractions method, Reduction formulae, Integration as the inverse process of differentiation- Standard forms -properties of integrals, etc. Definite Integral as the limit of a sum, Interpretation of Definite Integral as an area, Properties, Reduction formulae. Application of Definite integral to areas, etc. Formation of differential equation-Degree and order of an ordinary differential equation, Non - Homogeneous differential equation, etc.
Students must go through the AP Intermediate Physics syllabus mentioned below. We have also provided important topics for the convenience of the students. Transverse and longitudinal waves, Displacement relation in a progressive wave, The speed of a travelling wave, The principle of superposition of waves, Reflection of waves, Beats, Doppler effect, etc. Potential Energy in an External Field, etc.
Ray Optics and Optical Instruments - Reflection of light by spherical mirrors, the mirror equation. Scattering of the light reddish appearance of the sun at sunrise and sunset and blue colours of the sky. Current Electricity - Colour code for carbon resistors, series and parallel combinations of resistors.
Magnetism and Matter - Magnetic field intensity due to a magnetic dipole Bar magnet along its axis and perpendicular to its axis Bar magnet as an equivalent solenoid , the dipole in a uniform magnetic field Magnetic properties of materials Para, dia and Ferro and its examples, permanent. Nuclei - Radio activity alpha, beta and gamma particles and their properties Law of radioactive decay, half-life and mean a life of a Radioactive material, Binding energy per nucleon and its variation with mass number.
Semiconductor electronics: materials, devices and simple circuits Purpose of P-N junction diode 1. Zener diode and their characteristics 2. Zener diode as voltage regulators. Chemistry is a subject that needs thorough study. Students are advised to refer to the table below to know the complete AP Intermediate Chemistry syllabus along with important topics. Electrical properties-conduction of electricity in metals, etc. Nernst equation- electrochemical cell and Gibbs energy of the cell.
Adsorption and absorption, mechanism of adsorption-types of adsorption characteristics of physisorption - adsorption from solution phase applications of adsorption, Emulsions, etc. The occurrence of metals, magnetic separation, froth floatation, leaching,. Extraction of crude metal from concentrated ore-conversion to. Occurrence- electronic configuration, atomic and ionic radii,. Occurrence, electronic configuration, atomic and ionic radii,.
Types of polymerization reactions addition polymerization or chain growth polymerization-ionic. Enzymes: Enzymes, mechanism of enzyme action, Hormones: Definition, different. Chemicals in food artificial sweetening agents, food preservatives, Drug-enzyme. Classification and nomenclature, Nature of C-X bond, by the addition of hydrogen halides and halogens to alkenes-by halogen. Nomenclature and structure of carbonyl group, Preparation of aldehydes and ketones- 1 by oxidation of.
Methods of preparation of diazonium salts by diazotization ,. Physical properties, Chemical reactions: Reactions involving displacement of nitrogen, reactions involving retention of the diazo group. Structure and nomenclature of cyanides and isocyanides, etc. Find the detailed AP Intermediate Botany syllabus in the table mentioned below.
Study according to the AP intermediate time- table to plan the study time efficiently. Also, study important topics with the utmost concentration in order to score high. The concentration of Substrate, Classification and Nomenclature of Enzymes, etc. Primary treatment, Secondary treatment or Biological treatment, Microbes as Biofertilizers, Challenges posed by Microbes, etc.
Below mentioned is the AP Zoology syllabus for 12th. Know the important topics and make the study time table accordingly. The calorific value of proteins, carbohydrates and fats, etc. Human circulatory system — a structure of the human heart and. Fertilization, Embryo development up to blastocyst formation, implantation, etc. Hardy-Weinberg law; Types of Natural Selection; Gene flow and genetic drift; Variations mutations and genetic recombination , etc.
Animal Husbandry 8. Poultry Farm management 8. Bee Keeping 8. Fishery management. Click here to download the AP Intermediate Civics syllabus We have provided the detailed syllabus of Commerce Part A and B. Find the picture of the syllabus below. Find the AP syllabus of Economics in the table given below and study after referring to the prescribed syllabus. Students should also solve AP intermediate question papers to know the trend of questions asked in the exam.
Chapter 8: Environment and Sustainable Economic Development. Education, Environment, Agricultural sector, Industrial sector, etc. National Income 3. A questioning, speculative tone. So your tone will often be tentative and open, demonstrating a willingness to entertain, try out, accept, and reject various ideas as your essay progresses from beginning to end, maybe even asking questions for which you can provide no direct answers.
Choose a subject you want to explore. Make a list of things that you think about, wonder about, find puzzling or annoying. Explore your subject in detail. Reflections often include descriptive details that provide a base for the speculations to come. Back away. Ask yourself why your subject matters: why is it important or intriguing or otherwise significant? Your goal is to think on screen or paper about your subject, to see where it leads you. Think about how to keep readers with you.
Reflections must be carefully crafted so that readers can follow your train of thought. Ways of organizing a reflective essay. Reflections may be organized in many ways because they mimic the way we think, sometimes associating one idea with another in ways that make sense but do not necessarily follow the kinds of logical progression found in academic arguments or reports. Here are two ways you might organize a reflection.
To read an example reflective essay, go to digital. You may be assigned to create annotated bibliographies to weigh the potential usefulness of sources and to document your search efforts. This chapter describes the key elements of an annotated bibliography and provides tips for writing two kinds of annotations: descriptive and evaluative. Doherty, Thomas. Unwin Hyman, A historical discussion of the identification of teenagers as a targeted film market.
Foster, Harold M. An evaluation of the potential of using teen films such as Sixteen Candles and The Karate Kid to instruct adolescents on the difference between film as communication and film as exploitation. They are often helpful in assessing how useful a source will be for your own writing.
Gore, A. An inconvenient truth: The planetary emergency of global warming and what we can do about it. New York, NY: Rodale. It centers on how the atmosphere is very thin and how greenhouse gases such as carbon dioxide are making it thicker. The thicker atmosphere traps more infrared radiation, causing warming of the Earth.
He includes several examples of problems caused by global warming. Penguins and polar bears are at risk because the glaciers they call home are quickly melting. Coral reefs are being bleached and destroyed when their inhabitants overheat and leave. For example, many highways in Alaska are only frozen enough to be driven on fewer than 80 days of the year.
In China and elsewhere, recordsetting floods and droughts are taking place. Hurricanes are on the rise. It is useful because it relies on scientific data that can be referred to easily and it provides a solid foundation for me to build on. For example, it explains how carbon dioxide is produced and how it is currently affecting plants and animals. This evidence could potentially help my research on how humans are biologically affected by global warming. It will also help me structure my essay, using its general information to lead into the specifics of my topic.
For example, I could introduce the issue by explaining the thinness of the atmosphere and the effect of greenhouse gases, then focus on carbon dioxide and its effects on organisms.
A concise description of the work. Relevant commentary. If you write an evaluative bibliography, your comments should be relevant to your purpose and audience. To achieve relevance, consider what questions a potential reader might have about the sources. Consistent presentation. All annotations should be consistent in content, sentence structure, and format.
If one annotation is written in complete sentences, they should all be. Decide what sources to include. Though you may be tempted to include every source you find, a better strategy is to include only those sources that you or your readers may find useful in researching your topic.
Is this source relevant to your topic? Is it general or specialized? Are the author and the publisher or sponsor reputable? Does the source present enough evidence? Does it show any particular bias? Does the source reflect current thinking or research? Decide whether the bibliography should be descriptive or evaluative. Read carefully. To quickly determine whether a source is likely to serve your needs, first check the publisher or sponsor; then read the preface, abstract, or introduction; skim the table of contents or the headings; and read the parts that relate specifically to your topic.
Research the writer, if necessary. In any case, information about the writer should take up no more than one sentence in your annotation. Summarize the work. Sumarize it as objectively as possible: even if you are writing an evaluative annotation, you can evaluate the central point of a work better by stating it clearly first.
You may find, however, that some parts are useful while others are not, and your evaluation should reflect that mix. Ways of organizing an annotated bibliography. Depending on their purpose, annotated bibliographies may or may not include an introduction. State scope. List first List second List third List final alphabeti- alphabeti- alphabeti- alphabeti- cal entry, cal entry, cal entry, cal entry, and anno- and anno- and anno- and anno- tate it. Sometimes an annotated bibliography needs to be organized into several subject areas or genres, periods, or some other category ; if so, the entries are listed alphabetically within each category.
Category 2 alphabetically, and annotate them. List entries Explain category 2. To read an example annotated bibliography, go to digital. You may be required to include an abstract in a report or as a preview of a presentation you plan to give at an academic or professional conference.
This chapter provides tips for writing three common kinds: informative, descriptive, and proposal. That one paragraph must mention all the main points or parts of the paper: a description of the study or project, its methods, the results, and the conclusions. Here is an example of the abstract accompanying a seven-page essay that appeared in in the Journal of Clinical Psychology: The relationship between boredom proneness and health-symptom reporting was examined.
The results suggest that boredom proneness may be an important element to consider when assessing symptom reporting. Implications for determining the effects of boredom proneness on psychological- and physicalhealth symptoms, as well as the application in clinical settings, are discussed. They usually do not summarize the entire paper, give or discuss results, or set out the conclusion or its implications.
The findings and their application in clinical settings are discussed. You prepare them to persuade someone to let you write on a topic, pursue a project, conduct an experiment, or present a paper at a scholarly conference; often the abstract is written before the paper itself.
Titles and other aspects of the proposal deliberately reflect the theme of the proposed work, and you may use the future tense to describe work not yet completed. Here is a possible proposal for doing research on boredom and health problems: Undergraduate students will complete the Boredom Proneness Scale and the Hopkins Symptom Checklist. A multiple analysis of covariance will be performed to determine the relationship between boredom-proneness total scores and ratings on the five subscales of the Hopkins Symptom Checklist ObsessiveCompulsive, Somatization, Anxiety, Interpersonal Sensitivity, and Depression.
An informative abstract includes enough information to substitute for the report itself; a descriptive abstract offers only enough information to let the audience decide whether to read further; and a proposal abstract gives an overview of the planned work. Objective description. Abstracts present information on the contents of a report or a proposed study; they do not present arguments about or personal perspectives on those contents.
Unless you are writing a proposal abstract, you should write the paper first. You can then use the finished work as the guide for the abstract, which should follow the same basic structure. Copy and paste key statements. Copy and paste those sentences into a new document to create a rough draft.
Pare down the rough draft. Introduce the overall scope of your study, and include any other information that seems crucial to understanding your work. Conform to any length requirements. In general, an informative abstract should be at most 10 percent as long as the original and no longer than the maximum length allowed.
Descriptive abstracts should be shorter still, and proposal abstracts should conform to the requirements of the organization calling for the proposal. Ways of organizing an abstract [An informative abstract] State conclusions of study.
State Summarize nature of method of study. State implications of study. To read an example abstract, go to digital. We read cookbooks to find out how to make brownies; we read textbooks to learn about history, biology, and other academic topics.
And as writers, we read our own drafts to make sure they say what we mean. In other words, we read for many different purposes. Following are some strategies for reading with a critical eye.
It always helps to approach new information in the context of what we already know. List any terms or phrases that come to mind, and group them into categories. Then, or after reading a few paragraphs, list any questions that you expect, want, or hope to be answered as you read, and number them according to their importance to you.
Finally, after you read the whole text, list what you learned from it. Preview the text. Start by skimming to get the basic ideas; read the title and subtitle, any headings, the first and last paragraphs, the first sentences of all the other paragraphs.
Study any visuals. Think about your initial response. Read the text to get a sense of it; then jot down brief notes about your initial reaction, and think about why you reacted as you did. What aspects of the text account for this reaction? Highlight key words and phrases, connect ideas with lines or symbols, and write comments or questions in the margins.
What you annotate depends on your purpose. One simple way of annotating is to use a coding system, such as a check mark to indicate passages that confirm what you already thought, an X for ones that contradict your previous thinking, a question mark for ones that are puzzling or confusing, an exclamation point or asterisk for ones that strike you as important, and so on. You might also circle new words that you need to look up.
Play the believing and doubting game. Analyze how the text works. Outline the text paragraph by paragraph. Are there any patterns in the topics the writer addresses? How has the writer arranged ideas, and how does that arrangement develop the topic? Identify patterns. Look for notable patterns in the text: recurring words and their synonyms, repeated phrases and metaphors, and types of sentences.
Does the author rely on any particular writing strategies? Is the evidence offered more opinion than fact? Is there a predominant pattern to how sources are presented? As quotations? In visual texts, are there any patterns of color, shape, and line? Consider the larger context. What other arguments is he or she responding to? Who is cited? Be persistent with difficult texts.
For texts that are especially challenging or uninteresting, first try skimming the headings, the abstract or introduction, and the conclusion to look for something that relates to knowledge you already have. As a critical reader, you need to look closely at the argument a text makes. Does his or her language include you, or not? Hint: if you see the word we, do you feel included?
So learning to read and interpret visual texts is just as necessary as it is for written texts. Take visuals seriously. When they appear as part of a written text, they may introduce information not discussed elsewhere in the text.
It might also help to think about its purpose: Why did the writer include it? What information does it add or emphasize? What argument is it making? How to read charts and graphs. A line graph, for example, usually contains certain elements: title, legend, x-axis, y-axis, and source information. Figure 1 shows one such graph taken from a sociology textbook. Other types of charts and graphs include some of these same elements.
But the specific elements vary according to the different Legend: Explains the symbols used. Here, colors show the different categories. X-axis: Defines the dependent variable something that changes depending on other factors. Women in the labor force as a percent of the total labor force both men and women age sixteen and over.
For example, the chart in Figure 2, from the same textbook, includes elements of both bar and line graphs to depict two trends at once: the red line shows the percentage of women who were in the US labor force from to , and the blue bars show the percentage of US workers who were women during that same period. Both trends are shown in two-year increments.
To make sense of this chart, you need to read the title, the y-axis labels, and the labels and their definitions carefully. Research Research is formalized curiosity. It is poking and prying with a purpose. We search the web for information about a new computer, ask friends about the best place to get coffee, try on several pairs of jeans before deciding which ones to buy.
Will you need to provide background information? What kinds of evidence will your audience find persuasive? What attitudes do they hold, and how can you best appeal to them? If so, which media will best reach your audience, and how will they affect the kind of information you search for? Is there a due date? How much time will your project take, and how can you best schedule your time in order to complete it?
If the assignment offers only broad guidelines, identify the requirements and range of possibilities, and define your topic within those constraints. As you consider topics, look to narrow your focus to be specific enough to cover in a research paper. Reference librarians can direct you to the most appropriate reference works, and library catalogs and databases provide sources that have been selected by experts. General encyclopedias and other reference works can provide an overview of your topic, while more specialized encyclopedias cover subjects in greater depth and provide other scholarly references for further research.
Some databases include documentation entries in several styles that you can simply copy and paste. Generate a list of questions beginning with What? Who should determine when and where fracking can be done? Should fracking be expanded?
Select one question, and use it to help guide your research. Drafting a tentative thesis. Here are three tentative thesis statements, each one based on a previous research question about fracking: By injecting sand, water, and chemicals into rock, fracking may pollute drinking water and air. The federal government should strictly regulate the production of natural gas by fracking. Fracking can greatly increase our supplies of natural gas, but other methods of producing energy should still be pursued.
A tentative thesis will help guide your research, but you should be ready to revise it as you continue to learn about your subject and consider many points of view. Which sources you turn to will depend on your topic.
For a report on career opportunities in psychology, you might interview someone working in the field. Primary sources are original works, such as historical documents, literary works, eyewitness accounts, diaries, letters, and lab studies, as well as your own original field research. Secondary sources include scholarly books and articles, reviews, biographies, and other works that interpret or discuss primary sources. Whether a source is considered primary or secondary sometimes depends on your topic and purpose.
Scholarly and popular sources. Popular sources, on the other hand, are written for a general audience, and while they may discuss scholarly research, they are more likely to summarize that research than to report on it in detail.
Catchy, provocative titles usually signal that a source is popular, not scholarly. Scholarly sources are written by authors with academic credentials; popular sources are most often written by journalists or staff writers. Includes an abstract. Multiple authors who are academics.
Author not an academic. Consider how much prior knowledge readers are assumed to have. Are specialized terms defined, and are the people cited identified in some way? Look as well at the detail: scholarly sources describe methods and give more detail, often in the form of numerical data; popular sources give less detail, often in the form of anecdotes. Scholarly sources are published by academic journals, university presses, and professional organizations such as the Modern Language Association; popular sources are published by general interest magazines such as Time or Fortune or trade publishers such as Norton or Penguin.
Scholarly journal articles often begin with an abstract or summary of the article; popular magazine articles may include a tag line giving some sense of what the article covers, but less than a formal summary. Scholarly sources have URLs that end in. Keep in mind that searching requires flexibility, both in the words you use and in the methods you try. For some topics, you might find specialized reference works such as the Film Encyclopedia or Dictionary of Philosophy, which provide in-depth information on a single field or topic and can often lead you to more specific sources.
Many reference works are also online, but some may be available only in the library. Wikipedia can often serve as a starting point for preliminary research and includes links to other sources, but since its information can be written and rewritten by anyone, make sure to consult other reference works as well. You can find bibliographies in many scholarly articles and books. Check with a reference librarian for help finding bibliographies on your research topic. Unusual responses to sensory stimuli are more common and prominent in autistic children, although there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.
Differences are greater for under-responsivity for example, walking into things than for over-responsivity for example, distress from loud noises or for seeking for example, rhythmic movements. Several studies have reported associated motor problems that include poor muscle tone, poor motor planning, and toe walking; Autism Spectrum Disorder is not associated with severe motor disturbances.
Atypical eating behavior occurs in about three-quarters of children with Autism Spectrum Disorder, to the extent that it was formerly a diagnostic indicator. Selectivity is the most common problem, although eating rituals and food refusal also occur; this does not appear to result in malnutrition.
Although some children with autism also have gastrointestinal GI symptoms, there is a lack of published rigorous data to support the theory that autistic children have more or different GI symptoms than usual; studies report conflicting results, and the relationship between GI problems and Autism Spectrum Disorder is unclear.
Sleep problems are known to be more common in children with developmental disabilities, and there is some evidence that children with Autism Spectrum Disorder are more likely to have even more sleep problems than those with other developmental disabilities; autistic children may experience problems including difficulty in falling asleep, frequent nocturnal awakenings, and early morning awakenings.
Parents of children with Autism Spectrum Disorder have higher levels of stress. Siblings of children with Autism Spectrum Disorder report greater admiration of and less conflict with the affected sibling; siblings of individuals with Autism Spectrum Disorder have greater risk of negative well-being and poorer sibling relationships as adults. While developmental disorders such as Autism, PDD-NOS and Aspergers Syndrome can have major effects on children, early diagnosis, therapy and behavioral strategies can make a significant difference in the long term.
Temple Grandin on living with autism The Feingold Diet - fact or fiction? Can MMR vaccines cause autism? Did Albert Einstein have Aspergers?
Is there an autism epidemic? Strategies for dealing with fussy eaters Let me tell you about my autism Do-it-yourself early intervention Does the gluten-free casein-free diet work? Beware the alien! Please note that copyright varies throughout the site. If you would like to reproduce information from this site, please note the copyright at the bottom of each page and check the Contact Us page for reproduction conditions.
Please note this site is intended to provide general information on autism, Aspergers syndrome and other Autism Spectrum Disorders for families, health professionals and the wider community. No guarantees can be made regarding the accuracy of information and it should not be used as a basis for any medical, behavioral or cognitive interventions. Always consult experienced qualified health professionals before commencing interventions. Visit Synapse. Could my child have autism or Asperger's syndrome?
In the majority of cases, UHS is isolated and is not part of a syndrome. The syndromic forms of UHS are caused by other genes. Inheritance Inheritance. Uncombable hair syndrome UHS is thought to be inherited in an autosomal recessive fashion; however, there are likely cases in which the condition is inherited in an autosomal dominant manner with reduced penetrance. Autosomal dominant means that having a change mutation in only one copy of the responsible gene in each cell is enough to cause features of the condition.
Reduced penetrance means that not all people with a mutation in the responsible gene will have the condition. For this reason, conditions with reduced penetrance may appear to "skip a generation" or may appear to occur for the first time or only once in a family. While people with UHS often report a negative family history , the characteristic hair shaft abnormality seen in affected people can still be seen in unaffected family members by looking at their hair under a specific type of microscope.
Diagnosis Diagnosis. A diagnosis of uncombable hair syndrome UHS is made by observing the characteristic symptoms of the condition, as well observing the hair shaft under a special microscope. The recent discovery of the genes associated with the condition may lead to genetic testing in the future. Testing Resources Orphanet lists international laboratories offering diagnostic testing for this condition.
Treatment Treatment. There is no definitive treatment for uncombable hair syndrome , but the condition usually improves or resolves on its own with the onset of puberty. Gentle hair care is generally recommended using conditioners and soft brushes, along with avoiding harsh hair treatments such as permanent waves perms ; chemical relaxants; or excessive brushing and blow drying. These strategies may improve the general manageability of the hair, although how well they work is subjective.
One case report suggested significant improvement in hair strength and combability, with an increase in rate of growth after 4 months of supplementation. Prognosis Prognosis. Uncombable hair syndrome UHS usually resolves on its own spontaneously by adolescence.
Find a Specialist Find a Specialist. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. You can also learn more about genetic consultations from MedlinePlus Genetics. Related Diseases Related Diseases. Conditions with similar signs and symptoms from Orphanet. Visit the Orphanet disease page for more information.
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