RESUMEN

Group-based interventions in health care have demonstrated a positive influence on patient outcomes by strengthening patient-healthcare professional relationships and providing an avenue for patient empowerment through shared experiences and belongingness. Groups have been shown to enhance social and psychological support, improve self-management behaviors, and encourage peer-support. However group settings also present challenges, such as discomforts in sharing within a group context and managing diverse group dynamics. We outline the efficacy and dynamics of group-based activities in health care settings. This includes key behavioral components of groups, such as creating a safe, supportive, and cohesive environment in group activities where confidentiality is paramount. By recognizing principles for group and moderator behaviors, individuals are more likely to maximize the potential of these interventions.

RESUMEN

Considerable research has been conducted into the efficacy of individual probiotics in broiler production, however information on the most effective combinations of synergistic Bacillus probiotic is lacking. This study investigated the impact of different Bacillus strain combinations in broiler chickens, as well as in vitro enzyme production. In experiment one, a total of 576 Ross 308 broilers at 1 d old were grown for 21 d across 6 treatments of maize-soybean diets (n = 12 pens per treatment) to compare three different strain combinations (formulation 1 [F1]: 3 strains Bacillus amyloliquefaciens; F2: Bacillus coagulans and 2 strains B. amyloliquefaciens; F3: B. coagulans, Bacillus licheniformis and 2 strains B. amyloliquefaciens; F5: Bacillus subtilis, B. licheniformis and 2 strains B. amyloliquefaciens), positive control (PC), and a negative control antibiotic treatment group (NC). In Exp. 2, a total of 360 one-day-old ROSS308 broilers were used to test five treatments (n = 9) including PC, NC, F1 and F5 (selected from Exp. 1), and F4 (Bacillus pumilis and 2 strains B. amyloliquefaciens) in a maize-soybean diet. B. amyloliquefaciens F1 demonstrated a significant improvement in feed conversion ratio (FCR) compared to F2 at d 14 (1.49 vs 2.10; P = 0.038) and the body weight (BW) at d 21 (847.0 g vs 787.4 g) compared to other combinations (P = 0.027). The FCR at d 21 tended to be lower in birds fed F1 (1.46 vs 1.66) compared to the control (P = 0.068). Probiotic treatments had significantly improved nutrient digestibility compared to the PC and NC. Also, probiotic treatments supported the growth of Streptococcus, a common commensal genus and reduced the abundance of genera that correlated with low weight gain such as Akkermansia. Experiment two revealed that F4 improved FCR (P < 0.001) and BW at 28 d (P = 0.014). In vitro testing showed a high production of protease and amylase by Bacillus. Thus, the addition of Bacillus probiotics, particularly containing B. amyloliquefaciens strains and Bacillus pumilus, into the diet of broiler chickens improves production performance, nutrient digestibility, and allows the proliferation of beneficial gut microbiota.

RESUMEN

OBJECTIVES: Little is known about oral hygiene habits of patients suffering from chronic diseases. This study aims to describe oral hygiene behavior (OHB) in terms of tooth brushing and professional scaling frequency among patients with chronic diseases. Secondarily, it aims to assess the association between OHB and periodontitis, tooth loss, and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: This is a cross-sectional analysis of data of adult participants in the ComPaRe e-cohort. Participants were classified into having good, moderate, and poor OHB according to self-reported frequency of toothbrushing and professional tooth scaling. Periodontitis was assessed using the PEriodontal Screening Score (PESS). Weighted binary regression models were used to estimate the association between OHB and the following outcomes: (i) periodontitis; (ii) number of missing teeth; and (iii) OHRQoL based on the Oral Health Impact Profile-14. RESULTS: Overall, 8553 patients were included in the analyses (52.9% females, mean age of 56.3 ± 17 years). Of these, 2907 (34%), 3953 (46%) and 1693 (20%) were considered as having good, moderate, and poor OHB, respectively. Over half (54.1%) of the patients had a PESS ≥ 5 suggestive for severe periodontitis. Moderate OHB was associated with lower odds of PESS ≥ 5 compared to poor OHB (Adjusted Odds Ratio, OR = 0.81 [95%CI: 0.70-0.92]). Good and moderate OHB were significantly associated with lower odds of ≥ 10 missing teeth (OR = 0.26 [95%CI: 0.21-0.33] and OR = 0.47 [95%CI: 0.4-0.56], respectively) and better OHRQoL than poor OHB. CONCLUSIONS: Although, most of patients with chronic diseases reported to have good or moderate OHB, severe periodontitis is highly prevalent among this patient population in France. CLINICAL RELEVANCE: This study describes OHB in a representative sample of patients suffering from one or more chronic diseases and provides an estimate of the prevalence of self-reported severe periodontitis, missing teeth, and OHRQoL.

Asunto(s)

RESUMEN

BACKGROUND: Smoking cessation interventions requires attending to the circumstances and needs of individual patients. We aimed at highlighting the discordances between patients' and physicians' perspectives on contextual factors that should be considered during smoking cessation. METHODS: We identified 36 contextual factors identified that should be considered during smoking cessation using PubMed and interviewing general practitioners. Physicians recruited through social networks campaigns and smoker or former smoker patients from the ComPaRe cohort selected the factors they considered most relevant in two online paired comparison experiment. Bradley Terry Luce models estimated the ability of each factor (i.e. the probability to be preferred). We calculated the Pearson's correlation and the intraclass correlation coefficients for the contextual factor from each perspective and compared the ranking of the 10 contextual factors with the highest abilities. RESULTS: Seven hundred and ninety-three patients' and 795 physicians' perspectives estimated the ability (i.e., importance) of the contextual factors in 11 963 paired comparisons. We found a high correlation between physicians' and patients' perspectives of the contextual factors to be considered for smoking cessation (r = 0.76, P < 0.0001). However, the agreement between the abilities of contextual factors was poor (ICC = 0.42 [-0.10; 0.75]; P = 0.09). Fine-grain analysis of participants' answers revealed many discrepancies. For example, 40% factors ranked in the top 10 most important for physicians were not in patients' top 10 ranking. CONCLUSION: Our results highlight the importance of patient-centered care, the need to engage discussions about patients' values, beyond what is thought to be important, to avoid overlooking their real context.

RESUMEN

Genome analysis of individuals affected by retinitis pigmentosa (RP) identified two rare nucleotide substitutions at the same genomic location on chromosome 11 (g.61392563 [GRCh38]), 69 base pairs upstream of the start codon of the ciliopathy gene TMEM216 (c.-69G>A, c.-69G>T [GenBank: NM_001173991.3]), in individuals of South Asian and African ancestry, respectively. Genotypes included 71 homozygotes and 3 mixed heterozygotes in trans with a predicted loss-of-function allele. Haplotype analysis showed single-nucleotide variants (SNVs) common across families, suggesting ancestral alleles within the two distinct ethnic populations. Clinical phenotype analysis of 62 available individuals from 49 families indicated a similar clinical presentation with night blindness in the first decade and progressive peripheral field loss thereafter. No evident systemic ciliopathy features were noted. Functional characterization of these variants by luciferase reporter gene assay showed reduced promotor activity. Nanopore sequencing confirmed the lower transcription of the TMEM216 c.-69G>T allele in blood-derived RNA from a heterozygous carrier, and reduced expression was further recapitulated by qPCR, using both leukocytes-derived RNA of c.-69G>T homozygotes and total RNA from genome-edited hTERT-RPE1 cells carrying homozygous TMEM216 c.-69G>A. In conclusion, these variants explain a significant proportion of unsolved cases, specifically in individuals of African ancestry, suggesting that reduced TMEM216 expression might lead to abnormal ciliogenesis and photoreceptor degeneration.

Asunto(s)

RESUMEN

This paper introduces the design of a circularly polarized metasurface-based antenna array for C-band satellite applications that owns broadband operation and high gain characteristics. The single radiating element comprises a Y-shape patch and an above-placed 2 × 2 unit-cell metasurface. Further improvement in operating bandwidth and broadside gain is achieved by arranging four single elements in a 2 × 2 configuration and a sequential-phase feed network. A prototype has been fabricated and measured to validate the feasibility of the proposed antenna array. The measured operating bandwidth is 20% (4.50-5.50 GHz), which is an overlap between a -10 dB impedance bandwidth of 29.8% (4.50-5.99 GHz) and a 3 dB axial ratio bandwidth of 20% (4.50-5.50 GHz). Across this operating band, the peak broadside gain is 10.5 dBi. Compared with the recently published studies, the proposed array is a prominent design for producing a wide operating bandwidth and relatively high gains while maintaining the overall compact dimensions.

RESUMEN

INTRODUCTION: Congenital short bowel syndrome (CSBS) is a rare congenital gastrointestinal disease and defined as a shortage of consecutive small bowel length present from birth. This syndrome is often accompanied by intestinal malrotation, reduction of peristalsis, and malabsorption. CASES PRESENTATION: This article reports on siblings carrying the Filamin A (FLNA) genetic mutation with CSBS The first case involved a child admitted to the hospital due to intestinal obstruction, undergoing four surgeries due to intestinal torsion with the remaining length of the small intestine only 60 cm, ultimately resulting in the child's death. The second case is a sibling of the first case, admitted to the hospital due to recurrent abdominal pain, diarrhea, and weight loss. With our previous experience, we conducted genetic testing for the filamin A gene (FLNA), revealing that both siblings and their mothers carried a mutation in the gene. CLINICAL DISCUSSION: The diagnosis can be indirectly based on the upper gastrointestinal tract contrast study, however, most of diagnoses are confirmed by exploratory surgery. There is no consensus on nutritional treatment guidelines for infants with congenital short-bowel syndrome. Bowel lengthening procedures have not been recommended for infants with CSBS. A lot of disease-causing mutations have been recorded as CXADR-like membrane protein (CLMP) and FLNA. CONCLUSION: Congenital short bowel syndrome is a rare condition with a poor prognosis. It requires multidisciplinary coordination for effective diagnosis and treatment. Ongoing research into genetic mutations like CLMP and FLNA is vital for understanding CSBS and enhancing patient care.

RESUMEN

For the first time, ultrasonic emulsification was studied for cinnamon essential oil (CEO) Pickering emulsion, stabilized by cellulose nanocrystal (CNC) from rice straw. Sonication proved to be an effective method for emulsifying CEO, creating small emulsion droplets around 700 nm in size, with an even dispersion characterized through a low polydispersity index. The biomass-derived CNC exhibits high encapsulation efficiency (> 95 %) with varying CEO concentration (5-25 vol%), creating droplets with negative surface charge with limited aggregation of emulsions. Optimization through the Box Behnken design using response surface methodology provides a model for the interaction and effects of variables towards the formulation. Optimal condition was concluded to be at 11.47 vol% CEO, 0.84 wt/vol% CNC and at 6 sonication cycles. The optimized Pickering emulsions retain the antimicrobial properties of CEO, with a large inhibition zone and low MIC value of around 0.048 vol% CEO. DPPH inhibition assay indicates that the emulsification process enhances the antioxidation properties of cinnamon essential oil, expressed through a lower IC50 of 0.90 vol% CEO, in comparison to pure essential oil at 1.33 vol% CEO. Overall, this research proposes a novel approach towards using nanocellulose as carriers for essential oil with potential in a large variety of applications.

Asunto(s)

RESUMEN

Over 10 million ED visits occur each year across Australia and Aotearoa New Zealand. Outside basic administrative data focused on time-based targets, there is minimal information about clinical performance, quality of care, patient outcomes, or equity in emergency care. The lack of a timely, accurate or clinically useful data collection represents a missed opportunity to improve the care we deliver each day. The present paper outlines a proposal for a National Acute Care Secure Health Data Environment, including design, possible applications, and the steps taken to date by the Australasian College for Emergency Medicine ED Epidemiology Network in collaboration with the College of Emergency Nursing Australasia. Optimal use of the existing information collected routinely during clinical care of emergency patients has the potential to enable data-driven quality improvement and research, leading to better care and better outcomes for millions of patients and families each year.

RESUMEN

This paper proposes a compact design of dual-sense circularly polarized (CP) antenna for simultaneous transmit (Tx) and receive (Rx) communication systems. The primary radiating aperture of the proposed antenna is a 2 × 2 unit-cell metasurface (MS). The MS is excited by the asymmetric patch in the center, which acts as the CP source of the whole antenna structure. By properly tuning the feeding positions, dual-sense CP with high isolation can be achieved. For verification, an antenna prototype with compact dimensions of 0.36λ × 0.36λ × 0.02λ (λ is the free-space wavelength at the center operating frequency) is fabricated and measured. The measured operating bandwidth is 1.6% (2.45-2.49 GHz), in which the reflection and transmission coefficients are less than-10 dB and the axial ratio is lower than 3 dB. Within this band, the maximum isolation value is 39 dB, and the peak gain is 5.7 dBi.

Asunto(s)

RESUMEN

INTRODUCTION AND IMPORTANCE: Takotsubo syndrome (TTS) is a reversible form of acute heart failure often triggered by physical or emotional stressors. Minimally invasive mitral valve surgery (MIMVS) has become a prevalent approach for treating mitral valve pathologies, yet its association with TTS remains underexplored. CASE PRESENTATION: We present the case of a female patient undergoing MIMVS with concomitant Maze ablation, who developed TTS postoperatively. Despite a normal coronary angiogram, transient coronary spasm due to an imbalance in autonomic nervous activity was considered. The patient exhibited preoperative risk factors including sequelae of cerebral infarction. CLINICAL DISCUSSION: Female patients undergoing MIMVS with preoperative risk factors such as cerebral infarction sequelae may be at increased risk of developing TTS postoperatively. CONCLUSION: The InterTAK Diagnostic score, in conjunction with the International Expert Consensus Document on Takotsubo Syndrome, aids in promptly diagnosing TTS and differentiating it from acute coronary syndrome. Further research is warranted to elucidate the relationship between MIMVS and TTS.

RESUMEN

Background: The Primary Trauma Care (PTC) course was originally developed to instruct health care workers in the management of patients with severe injuries in low- and middle-income countries (LMICs) with limited medical resources. PTC has now been taught for more than 25 years. Many studies have demonstrated that the 2-day PTC workshop is useful and informative to frontline health staff and has helped improve knowledge and confidence in trauma management; however, there is little evidence of the effect of the course on changes in clinical practice. The Kirkpatrick model (KM) and the knowledge, attitude, and practice (KAP) model are effective methods to evaluate this question. Objective: The aim of this study was to investigate how the 2-day PTC course impacts the satisfaction, knowledge, and skills of health care workers in 2 Vietnamese hospitals using a conceptual framework incorporating the KAP model and the 4-level KM as evaluation tools. Methods: The PTC course was delivered over 2 days in the emergency departments (EDs) of Thanh Hoa and Ninh Binh hospitals in February and March 2022, respectively. This study followed a prospective pre- and postintervention design. We used validated instruments to assess the participants' satisfaction, knowledge, and skills before, immediately after, and 6 months after course delivery. The Fisher exact test and the Wilcoxon matched-pairs signed rank test were used to compare the percentages and mean scores at the pretest, posttest, and 6-month postcourse follow-up time points among course participants. Results: A total of 80 health care staff members attended the 2-day PTC course and nearly 100% of the participants were satisfied with the course. At level 2 of the KM (knowledge), the scores on multiple-choice questions and the confidence matrix improved significantly from 60% to 77% and from 59% to 71%, respectively (P<.001), and these improvements were seen in both subgroups (nurses and doctors). The focus of level 3 was on practice, demonstrating a significant incremental change, with scenarios checklist points increasing from a mean of 5.9 (SD 1.9) to 9.0 (SD 0.9) and bedside clinical checklist points increasing from a mean of 5 (SD 1.5) to 8.3 (SD 0.8) (both P<.001). At the 6-month follow-up, the scores for multiple-choice questions, the confidence matrix, and scenarios checklist all remained unchanged, except for the multiple-choice question score in the nurse subgroup (P=.005). Conclusions: The PTC course undertaken in 2 local hospitals in Vietnam was successful in demonstrating improvements at 3 levels of the KM for ED health care staff. The improvements in the confidence matrix and scenarios checklist were maintained for at least 6 months after the course. PTC courses should be effective in providing and sustaining improvement in knowledge and trauma care practice in other LMICs such as Vietnam.

Asunto(s)

RESUMEN

OBJECTIVES: Some therapeutic strategy questions in oncology could be answered with studies using observational data. Target trial emulation is the application of design principles from randomized controlled trials (RCTs) to the analysis of observational data, to reduce design-induced biases. Our objective was to determine which type of study physicians would preferably plan to answer a comparative effectiveness question lacking evidence in oncology. METHODS: We launched an online survey among physicians specialized in oncology. We constructed a vignette-based inquiry where vignettes described study scenarios which could be conducted to answer the predefined question. We designed six vignettes described by study design (RCT or observational study with a trial emulation framework), main study characteristics, probability of the study succeeding and anticipated delay before results availability. Participants randomly assessed five pair-wise comparisons of the vignettes and were asked which study they would preferably plan by using a Likert scale ranging from -5 to 5. The main outcome was the evaluation of clinicians' preferences for each pairwise comparison. Mean and median preference scores were calculated. RESULTS: Two hundred thirteen participants, specialized in many tumor types, assessed at least one comparison with 82% reporting France as their country of affiliation. The interquartile range was -4 to 4 across pairwise comparisons. The median preference score was in disfavor of the monocentric RCT for the five comparisons where it appeared. The median preference score was strongly in favor of the multicentric national emulated trial when compared to the monocentric emulated trial 4 [IQR 2.5-4]. The mean preference score was the highest for the large European observational study 1.14 (SD 3.33), while the mean preference score was the lowest for the monocentric RCT -1.86 (SD 2.93). CONCLUSION: No study design was strongly preferred, but the monocentric RCT was the least favored study in pair-wise comparisons. The planification of the new research is a compromise between scientific soundness, feasibility, cost, and time before obtaining results. We need to have the right answers to the right questions at the right time.

RESUMEN

Background: This study aims to present the early and mid-term outcomes of combining minimally invasive mitral valve surgery (MIMVS) with tricuspid valve repair (TVR) at the authors' centre. Methods: From January 2017 to March 2022, our centre treated a total of 67 patients with both MIMVS and TVR. Among these patients, 41 were women (61.2%), and 26 were men (38.8%). The average Euro SCORE II was 2.67±1.54%, and the patients had an average follow-up period of 25.45±16.2 months. Results: Pre-discharge echocardiography revealed no or mild TR in 82.8% of cases. The overall 30-day mortality rate was 4.5%, with 3 deaths. Five-year survival was 94.5%±3.2%. In patients with mild or moderate preoperative tricuspid regurgitation (TR), the 5-year survival rate was 95.7%±4.3%, while for those with severe TR, it was 93.7%±4.5% (P=0.947). Conclusions: The authors' 5-year experience demonstrates that the combination of MIMVS and TVR can be routinely performed with favourable perioperative and postoperative outcomes in patients undergoing non-high-risk surgery. Additionally, there is no significant difference in five-year survival between the severe TR and mild to moderate TR groups preoperatively.

RESUMEN

This paper introduces a two-element antenna array with dual-sense circular polarization, wideband operation, and high isolation characteristics. The antenna consists of two conventional truncated corner patches and an extra layer of metasurface (MS) located above the radiating patches. The overall dimensions of the proposed antenna are 0.92 λ0 × 0.73 λ0 × 0.05 λ0 and the element spacings are 0.02 λ0 and 0.39 λ0 with respect to edge-to-edge and center-to-center spacings. For validation, measurements on a fabricated antenna prototype are carried out. The measured data demonstrate that the presented MS-based antenna has a wide operating bandwidth of 14.5% with high isolation of better than 26 dB. The excellent performance could be concluded from the results of the investigation, which indicates that the proposed MS-based antenna could be a good candidate for multiple-input multiple-output (MIMO) and full-duplex applications.

Asunto(s)

RESUMEN

Thyroid storm is an endocrine emergency, and treatment must ensure primary goals, including reducing the production and release of thyroid hormones, mitigating the effects of thyroid hormones, increasing the elimination of thyroid hormones, treating systemic disturbances, and managing triggering factors. However, in a few cases where thyroid storm does not respond to initial treatment, therapeutic plasma exchange (TPE) should be considered. A 50-year-old male patient was admitted to the University Medical Center Ho Chi Minh City due to hypotonia and sensory disturbances gradually spreading from the lower extremities to the entire body. The patient was diagnosed with Guillain-Barré syndrome (GBS) and newly discovered hyperthyroidism. During the treatment course, the patient developed hospital-acquired pneumonia, acting as a trigger factor for a thyroid storm. Despite aggressive treatment for thyroid storm, the patient's condition worsened, leading to the decision to perform TPE. The replacement fluid was a combination of fresh frozen plasma (FFP) and albumin 5%. Subsequently, the patient returned to a euthyroid state and was discharged. Combining FFP and albumin 5% in TPE advantages FFP's high thyroid hormones-binding capacity and albumin's cost-effectiveness, safety, and efficiency. This reduces the drawbacks associated with high volumes of FFP and offers a balanced and effective approach to managing thyroid storms. Moreover, the concurrent presence of GBS and thyroid storm is extremely rare. Through this case, we aim to discuss the role of TPE in the treatment of thyroid storms and the effectiveness of the combination of FFP and albumin 5% as the replacement fluid.

Asunto(s)

RESUMEN

Argyrodite-type solid electrolytes of Li6PS5Cl doped with multivalent cations (Mg2+, Ba2+, Zn2+, Al3+, Y3+) were prepared via a mechanochemical synthesis method. The lattice constant (a0), interplanar spacing (d220, d311, d222), and micro-strain (ε) showed that the doping elements were incorporated into the crystal structure of Li6PS5Cl. The lattice constant and interplanar spacing of the doped samples were smaller than those of Li6PS5Cl. The prepared samples exhibited a positive lattice strain, and the substituted samples exhibited higher strains than Li6PS5Cl. The doped samples exhibited higher ionic conductivity than Li6PS5Cl at 25 °C. Li5.94Al0.02PS5Cl exhibited the highest σDC of approximately 2.36 × 10-3 S cm-1 at 25 °C. The charge carrier movement at the grain boundary changing from long-range diffusion in Li6PS5Cl to short-range diffusion in Li5.94Al0.02PS5Cl enhanced the conductivity.

RESUMEN

INTRODUCTION: The prevalence of Barrett's esophagus (BE) in France is unknown. However, the management of dysplastic BE in expert centers is recommended and reduces the risk of developing invasive adenocarcinoma. Our aim was to determine the burden of BE patients in the Paris Region. METHODS: We performed a retrospective study using the data from electronic medical records from the data warehouse of the 39 Greater Paris public hospitals (Entrepôt de données de santé de l' Assistance Publique- Hôpitaux de Paris) for the year 2018, and used natural language processing to search for occurrences of Barrett's esophagus in endoscopy and pathology reports. RESULTS: we observed a 2.2 % prevalence of Barrett's esophagus. Patients with Barrett's esophagus were older, more frequently males, with a hiatal hernia, proton pump inhibitor users, and less frequently infected by H. Pylori. Gastro-esophageal reflux symptoms were not more frequently encountered in Barrett's patients. Eleven percent of patients with Barrett's esophagus had dysplasia or adenocarcinoma. DISCUSSION: Over 200 000 patients with Barrett's esophagus are expected in the Paris Region, of which 11 % harbor dysplasia or adenocarcinoma. This data should be taken into account to tailor healthcare offer in France.

Asunto(s)

RESUMEN

Introduction: Effects of dioxin exposure on gray matter volume have been reported in previous studies, but a few studies reported effects of dioxin exposure on white matter structure. Therefore, this study was undertaken to investigate the impact of dioxin exposure on white matter microstructure in men living in the most severely dioxin-contaminated areas in Vietnam. Methods: In 2019 brain MRI scans from 28 men living near Bien Hoa airbase were obtained at Dong Nai General Hospital, Vietnam, on a 3 T scanner using a conventional diffusion tensor imaging sequence. Two exposure markers were indicated by perinatal exposure estimated by assessment of maternal residency in a dioxin-contaminated area during pregnancy and by measurement of blood dioxin levels. A general linear model was used to compare fractional anisotropy (FA) values in 11 white matter tracts in both hemispheres between groups with and without perinatal dioxin exposure and groups with high and low blood dioxin levels after adjusting for covariates. Results: The adjusted mean FA value in the left cingulum hippocampal part (CGH) was significantly lower in the perinatal dioxin exposure group compared with the group without perinatal dioxin exposure. The high blood TCDD group showed significantly reduced FA values in the left and right CGH and right uncinate fasciculus (UNC). Moreover, the high blood TEQ-PCDDs group showed significantly lower FA values in the left and right CGH and the left UNC. There were no significant differences in FA values between the groups with high and low TEQ-PCDFs levels or between the groups with high and low TEQ-PCDD/Fs levels. Discussion: It was concluded that dioxin exposure during the perinatal period and adulthood may alter the microstructure of white matter tracts in individuals with neurodevelopmental disorders.