Screen Time in First Year May Raise Autism Risk at Age 3

 

Boys exposed to at least 2 hours a day of screen time by 1 year of age were significantly more likely to have an autism spectrum disorder (ASD) diagnosis at 3 years, based on data from more than 80,000 children.

The World Health Organization and the American Academy of Pediatrics recommend against any screen time for infants up to 1 year of age and 18 months of age, respectively, wrote Megumi Kushima, MA, of the University of Yamanashi (Japan), and colleagues on behalf of the Japan Environment and Children's Study Group.

The extent to which screen time duration in infancy is associated with subsequent ASD diagnosis remains unclear, the researchers said. The ongoing COVID-19 pandemic has increased screen time among children worldwide, which makes an examination of the impact of screen time on children's health an important public health issue.

In a study published in JAMA Pediatrics, the researchers recruited pregnant women between 2011 and 2014; data were analyzed in December 2020. The final study population included 84,030 mother-child pairs. The primary exposure of screen time at 1 year of age was assessed by questionnaire, in which mothers were asked to report their number of hours they let their child watch TV or DVDs daily. Responses were none (no screen time), less than 1 hour, 1 hour or more but less than 2 hours, 2 hours or more but less than 4 hours, and 4 hours or more.

The primary outcome was ASD diagnosis at 3 years of age, and mothers were asked via questionnaire whether their 3-year-old had been diagnosed with ASD from age 2.

The study was conducted by the Japan Environment and Children's Study Group at 15 regional centers across Japan.

Overall, 330 children had received an ASD diagnosis at age 3 years, a prevalence of 0.4%. Of these, 251 (76%) were boys, and 79 (24%) were girls. Independent of ASD, the most common response for screen time was less than 1 hour, which was reported by 27,707 mothers. The proportion of children with ASD at age 3 increased as screen time at age 1 increased, the percentages were 5.8%, 22.3%, 30.2%, and 31.7% for children with no screen time, less than 1 hour, 1 to less than 2 hours, and 2 to less than 4 hours, respectively. The percentage of children with ASD diagnoses who had 4 hours or more of daily screen time was 10%.

Logistic regression analysis showed that longer screen time at age 1 year was significantly associated with higher odds of ASD at 3 years in boys, but not in girls. The researchers controlled for variables including maternal maltreatment and children's predisposition to ASD. Among boys, the adjusted odds ratios for screen times of less than 1 hour, 1 hour to less than 2 hours, 2 hours to less than 4 hours, and more than 4 hours.

 

Screen time at age 3 years was not associated with ASD diagnosis at age 3 years, potentially "because the association with environmental factors on brain development varies with age," the researchers noted.

The study findings were limited by several factors including the reliance on parental reports of screen time and potential for reporting bias, the researchers noted. Other limitations included the possible missed diagnoses of mild ASD cases at 3 years, and the inability to consider variables such as childcare environment, living conditions, diseases, genetics, and disabilities.

 

However, the results were strengthened by the large study population and examination of screen time in early childhood, they said. More research is needed to examine other factors that contribute to the association between ASD and screen time but given the rapid increase in device use in children, "it is necessary to review its health effects on infants and control excessive screen time."

Subvariant May Be More Dangerous Than Omicron

 

The Omicron subvariant, BA.2, is not only more transmissible than the original Omicron strain, BA.1, but may cause more severe disease, a lab study from Japan says.

"Our multiscale investigations suggest that the risk of BA.2 for global health is potentially higher than that of BA.1," the researchers said in the study published on the preprint server bioRxiv. The study has not been peer-reviewed yet.

The researchers infected hamsters with BA.1 and BA.2. The hamsters infected with BA.2 got sicker, with more lung damage and loss of body weight. Results were similar when mice were infected with BA.1 and BA.2.

"Infection experiments using hamsters show that BA.2 is more pathogenic than BA.1," the study said.

BA.1 and BA.2 both appear to evade immunity created by COVID-19 vaccines, the study said. But a booster shot makes illness after infection 74% less likely, CNN said.

What's more, therapeutic monoclonal antibodies used to treat people infected with COVID didn't have much effect on BA.2. 

BA.2 was "almost completely resistant" to casirivimab and imdevimab and was 35 times more resistant to sotrovimab, compared to the original B.1.1 virus, the researchers wrote. 

"In summary, our data suggest the possibility that BA.2 would be the most concerned variant to global health," the researchers wrote. "Currently, both BA.2 and BA.1 are recognised together as Omicron and these are almost undistinguishable. Based on our findings, we propose that BA.2 should be recognised as a unique variant of concern, and this SARS-CoV-2 variant should be monitored in depth."

If the World Health Organization recognized BA.2 as a "unique variant of concern," it would be given its own Greek letter.

But some scientists noted that findings in the lab don't always reflect what's happening in the real world of people.

"I think it's always hard to translate differences in animal and cell culture models to what's going on with regards to human disease," Jeremy Kamil, PhD, an associate professor of microbiology and immunology at Louisiana State University Health Shreveport, told Newsweek. "That said, the differences do look real."

"It might be, from a human's perspective, a worse virus than BA.1 and might be able to transmit better and cause worse disease," Daniel Rhoads, MD, section head of microbiology at the Cleveland Clinic in Ohio, told CNN. He reviewed the Japanese study but was not involved in it.

Another scientist who reviewed the study but was not involved in the research noted that human immune systems are evolving along with the COVID variants. 

"One of the caveats that we have to think about, as we get new variants that might seem more dangerous, is the fact that there's two sides to the story," Deborah Fuller, PhD, a virologist at the University of Washington School of Medicine, told CNN. "Our immune system is evolving as well. And so that's pushing back on things."

Scientists have already established that BA.2 is more transmissible than BA.1. The Omicron subvariant has been detected in 74 countries and 47 U.S. states, according to CNN. About 4% of Americans with COVID were infected with BA.2, the outlet reported, citing the CDC, but it's now the dominant strain in other nations.

It's not clear yet if BA.2 causes more severe illness in people. While BA.2 spreads faster than BA.1, there's no evidence the subvariant makes people any sicker, an official with the World Health Organization said, according to CNBC

Ischaemic Colitis - Symptoms & Treatments

A former physician of the National University Hospital in Singapore, Chua Tee Lian is the director and clinic manager of C & K Family Clinic. Chua Tee Lian also provided family medicine services at the Frankel Clinic and the Liang Clinic. Additionally, he conducted academic research on ischaemic colitis.

Ischaemic colitis represents an inflammation of the large intestine. Ischaemic colitis happens if the arteries are blocked and cannot distribute blood to the colon. The arteries can be blocked for various reasons. For example, the fat buildup can deposit on the artery and reduce blood flow or because of high blood pressure and other heart diseases. A couple of medicines can lead to ischaemic colitis if used in excess, such as opioids or hormone medications.

Ischaemic colitis typically affects people over 60 years old and can be diagnosed through CT scans, angiograms, or colonoscopies. Common symptoms include diarrhea, bloody poop, and maroon blood. Ischaemic colitis can be treated with antibiotics, as they can stop inflammation and relieve the symptoms. Doctors can also suggest intravenous fluids to keep a patient hydrated or treatments for heart conditions so that the arteries can function properly.

The Path to Becoming a Doctor in Singapore

A veteran medical professional with over 30 years of experience, Singapore-based Dr. Chua Tee Lian works as a family physician, previously serving with the Frankel Clinic and the Liang Clinic. Dr. Chua Tee Lian is now the director and clinic manager of C & K Family Clinic in Singapore. Before he could care for patients, he had to go through a rigorous process to become a medical doctor in his country.

Ranking among the elite when it comes to quality of life, it is no wonder Singapore has such a difficult journey to becoming a medical doctor. The country takes the healthcare of its citizens very seriously, and ensures that medical doctors are fully equipped to do their jobs.

In Singapore, there are a number of requirements along the road to becoming a doctor. Fluency in both English and Malay is needed, and certification will be required. It is recommended that the student choose to attend medical school in Singapore itself, and there are three different options.

Two of the medical schools in Singapore, Yong Loo Lin School of Medicine at the National University of Singapore, and Lee Kong Chian School of Medicine at Nanyang Technological University, only require a high school transcript with certain courses completed. The program is five years in length and includes both a bachelor’s of medicine and science.

For students interested in the Duke-NUS Medical School, the entrance requirements are very different. Applicants must already have a bachelor’s degree and have passed the MCATs. This program is internationally recognized, and takes only three years compared to five.

Once a student has completed their MD training, they must apply with the Singapore Medical Council, complete a housemanship (residency), and submit all of their official credentials. Once approved by the council, they can then start applying for work as a medical doctor in Singapore.