Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders (NDDs) and is frequently associated with psychiatric and somatic comorbidities. As a result, individuals with ASD use emergency departments more frequently than the general population. However, the core features of ASD pose specific challenges in emergency department care, particularly for adult patients and emergency staff frequently report limited training in this area. While paediatric presentations of ASD in the emergency department are well documented, the international literature on adults remains limited.

we conducted a single-centre retrospective study including all patients aged 15 years and older with a diagnosis of ASD who attended the Centre Psychiatrique d'Orientation et d'Accueil (CPOA), GHU Paris (Groupe Hospitalo-Universitaire) between 12 January 2016 and 31 December 2023. The objectives were to estimate the prevalence of ASD in this psychiatric emergency setting and to describe the patients’ socio-demographic and clinical characteristics, mode of arrival, reasons for consultation and referral following the emergency visit.

Among 69 447 patients who attended the CPOA during this period, 484 (0.7%) had a diagnosis of ASD. This population was predominantly male (71.9%), with a mean age of 25.1 years. The most frequent reasons for consultation were hetero-aggressive behaviour (37.0%) and anxiety (31.0%). Overall, 39.2% of patients were hospitalised, including 17.3% involuntarily, and 6.2% required physical restraint. The number of consultations involving patients with ASD increased significantly between 2016–2023.

This study provides a clearer understanding of the clinical and organisational challenges associated with the management of adult patients with ASD in psychiatric emergency departments. Although this study was descriptive and did not assess specific interventions, the observed patterns, in line with previous literature, suggest that adopted care strategies may help better address the needs of this population.

This study examined the effects of food accessibility on eating habits, home eating environment and anthropometrics among rural parent-child dyads.

This secondary data analysis utilised baseline and post-intervention data from a mindful eating intervention trial. Parents completed an online survey assessing their sociodemographics, height, weight, eating habits, food resource management behaviours, child feeding attitudes and practices, home eating environment and household food insecurity. Trained data collectors measured children’s height, weight, percent body fat and skin carotenoids at childcare centres. Using Geographic Information System tools, food accessibility was estimated by linking participants’ zip codes to Zip Code Tabulation Areas.

A total of 154 rural parent-child dyads from low-income households were successfully recruited from 26 Head Start childcare centres in the USA. The children’s mean age was 47.16 months (SD=6.56) while parents averaged 32.68 years old (SD=8.00). About one-third of the parents were single and nearly a third had an annual family income below US$20 000. Additionally, 44.2% of parents were unemployed and over half only had an education level of high school or below. Mixed-effect models revealed that at baseline, limited access to full-service restaurants and greater access to limited-service restaurants were related to higher BMI z-scores (p=0.021, 0.040) and percent body fat (p=0.020, 0.032) in children. Longitudinal analyses using pre-post intervention data indicated that parents’ increases in fibre intake from baseline to post-intervention were correlated with less access to limited-service restaurants (p=0.034), while their improved food resource management behaviours over time were associated with greater access to grocery stores/supermarkets (p=0.043) after accounting for other types of food access. Additionally, more access to convenience stores was associated with increases in perceived parental weight (p=0.027) over time.

These findings suggest that food accessibility influences both dietary behaviours and health outcomes, with grocery stores and full-service restaurants having positive impacts, while limited-service restaurants and convenience stores have detrimental effects.

The clinical trial associated with the study’s data is registered at ClinicalTrials.gov under the identifier NCT05780008 on 27 February 2023.

Intraoperative anaesthesia handoffs represent a risk point in the care of surgical patients. Although often necessary to prevent fatigue, improve vigilance and optimise operational efficiency, critical information can be lost, potentially leading to postoperative complications. Structured handoffs can increase the transfer of knowledge during intraoperative anaesthesia handoffs, improving their quality. We therefore propose to test the primary hypothesis that a semi-structured intraoperative anaesthesia handoff cognitive aid reduces the number of serious 30-day complications in surgical patients.

We will enrol adults having non-cardiac surgery who are scheduled to have an intraoperative anaesthesia handoff for operational reasons. We plan a cluster randomised trial (enrolling over 18 months, anticipated sample size approximately 4500 patients) that will compare the Epic Electronic Health Record intraoperative anaesthesia handoff cognitive aid to routine handoffs. Our primary outcome will be the number of serious postoperative complications within 30 days. Our secondary outcomes will be: (1) the number of minor complications; and (2) the duration of postoperative hospitalisation. Bayesian analysis with generalised linear multilevel modelling will be used to estimate the effect of structured handoffs on the primary and secondary outcomes.

This study has been approved by the local institutional review board with a waiver of informed consent. Results will be disseminated in the medical literature with de-identified data available on request.

NCT06533111.

Temperature control is a fundamental intervention for neuroprotection following resuscitation from cardiac arrest. However, evidence regarding the efficacy of hypothermia in post-cardiac arrest syndrome (PCAS) remains unclear. Retrospective studies suggest that the clinical effectiveness of hypothermia may depend on the severity of PCAS. The R-CAST OHCA trial aims to compare the efficacy of hypothermia versus normothermia in improving 30-day neurological outcomes in patients with moderately severe PCAS following out-of-hospital cardiac arrest.

The multicentre, single-blind, parallel-group, superiority, randomised controlled trial (RCT) is conducted with the participation of 35 emergency and critical care centres and/or intensive care units at academic and non-academic hospitals. The study enrols moderately severe PCAS patients, defined as those with a revised post-Cardiac Arrest Syndrome for induced Therapeutic Hypothermia score of 5.5–15.5. A target number of 380 participants will be enrolled. Participants are randomised to undergo either hypothermia or normothermia within 3 hours after return of spontaneous circulation. Patients in the hypothermia group are cooled and maintained at 34°C until 28 hours post-randomisation, followed by rewarming to 37°C at a rate of 0.25°C/hour. Patients in the normothermia group are maintained at normothermia (36.5°C–37.7°C). Total periods of intervention, including the cooling, maintenance and rewarming phases, will occur 40 hours after randomisation. Other treatments for PCAS can be determined by the treating physicians. The primary outcome is a favourable neurological outcome, defined as Cerebral Performance Category 1 or 2 at 30 days after randomisation and compared using an intention-to-treat analysis.

This study has been approved by the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Ethics Committee (approval number: R2201-001). Written informed consent is obtained from all participants or their authorised surrogates. Results will be disseminated via publications and presentations.

jRCT1062220035.