University of Gothenburg

Autistic persons experience problems with movements and body awareness in everyday functionality, expressed in affected movement quality. Yet, there is a knowledge gap about the effects of interventions targeting these aspects in autistic persons. To evaluate effects of Basic Body Awareness Therapy (BBAT) and treatment-as-usual (TAU), compared to TAU alone on movement quality in autistic persons. In this pragmatic RCT, autistic persons with no intellectual disorder, 15-30 years old and in contact with habilitation services, were randomized to an intervention group (IG) (n=28, 22 females) or a control group (CG) (n=29, 21 females). The IG received 12 sessions of individual BBAT and TAU, the CG received TAU. Primary outcome was a person-reported measure of an individualized movement quality problem, using a numeric rating scale (NRS). Secondary outcome was Body Awareness Scale Movement Quality (BAS MQ), i.e., scored physiotherapist observations. Between- and within-group analyses, and individual one-sided t-tests were performed. Comparing the between-group changes in NRS and BAS MQ after 12 weeks, the differences were statistically significant in favor of the IG (p<0.001). Within-group analyses: the IG had statistically significant improvements on both outcomes (p<0.001), the CG had not. Individually in the IG, 54% of the participants improved significantly in NRS and 41% in BAS MQ. In the CG, the corresponding numbers were 10% and 7%, respectively. BBAT and TAU were superior to TAU alone for improving movement quality. BBAT is a relevant intervention for autistic young adults to improve everyday functionality. Clinical Trials NCT0323876.

Moritella viscosa, responsible for winter ulcer disease, is one of the major health and welfare challenges in Atlantic salmon aquaculture. This study investigated whether pre-bath exposure to commensal skin bacteria influences Atlantic salmon susceptibility to M. viscosa, compared cohabitation and bath challenge models to evaluate infection routes, and examined host and tissue responses, including the bacterial binding capacity of skin mucins. Pre-exposure to Atlantic salmon skin commensals Pseudomonas, Psychrobacter and Aliivibrio, which was expected to stimulate the immune system, did not mitigate M. viscosa-induced damage. Both bath and cohabitant challenge models resulted in low mortalities (6.3% and 2.6%, respectively), although a subset of fish in each model developed severe skin ulcers. M. viscosa remained persistent across sample types. Ulcerated individuals in the cohabitation model formed a distinct subgroup showing reduced growth, elevated acute inflammation marker expression in skin and heart, decreased serum protein and albumin levels, diminished heterologous and M. viscosa-specific antibody titers, and reduced IL-22 and IFNγ concentrations. In non-ulcerated fish, the skin barrier was impaired and showed features associated with M. viscosa pathogenesis, as indicated by a numerical decrease in transepithelial resistance, disrupted tight junctions, compromised epidermal integrity, increased keratocyte gaps, and a shift from acidic to more neutral mucus. Additionally, skin mucus bound both the investigated commensal bacteria and the pathogens M. viscosa and Aeromonas salmonicida.

Cardiac undifferentiated pleomorphic sarcoma (UPS) is a rare and highly malignant tumor, commonly arising in the left atrium. It is associated with poor prognosis, nonspecific symptoms, and difficulty in early diagnosis. Here, we report a case of a 71-year-old woman who presented with palpitations, chest pressure, and exertional dyspnea, in whom initial cardiac magnetic resonance imaging revealed only subtle atrial septal thickening, evaluated as nonspecific, whereas follow-up imaging 2 years later showed progressive growth, ultimately interpreted as a cardiac myxoma. Surgical resection was performed, and histopathologic examination revealed a high-grade UPS with immunohistochemistry and molecular profiling supporting the diagnosis, including amplification of MDM2 and PDGFRA. No metastases were detected, and after multidisciplinary discussion a decision was made to abstain from adjuvant therapy. This case highlights the diagnostic challenge posed by cardiac UPS mimicking benign tumors such as myxoma on imaging and the importance of longitudinal imaging review and a high index of suspicion in cases with atypical radiological features of myxoma. It also raises awareness of an unusually indolent behavior of an UPS that otherwise pursues an aggressive course.

Diagnostic delay is common in pediatric inflammatory bowel disease (PIBD), and fecal calprotectin (FCP) is often limited by challenges with sample collection. Therefore, we aimed to identify and validate a blood-based diagnostic protein signature of PIBD. Proteins were analyzed using proximity extension assay in plasma samples from treatment-naïve pediatric patients in a Swedish inception cohort referred for suspected inflammatory bowel disease (IBD) and validated in an independent Norwegian population-based pediatric inception cohort. Diagnostic performance was estimated by the area under the curve (AUC) with 95% confidence intervals (CIs). The discovery cohort included 58 patients with PIBD and 36 symptomatic controls without evidence of IBD, while the validation cohort consisted of 79 patients with PIBD and 37 symptomatic controls. In total, 154 proteins were examined. Univariable analyses identified 26 differentially regulated proteins for PIBD versus symptomatic controls in the discovery cohort (q < 0.05), whereas 29 proteins were differentially regulated in the validation cohort. Using regularized logistic regression, we identified a diagnostic model of 31 proteins that differentiated PIBD from symptomatic controls in the discovery cohort (AUC = 0.83; 95% CI: 0.74-0.90). The protein signature was further reduced to a clinically relevant biomarker consisting of high-sensitivity C-reactive protein (hsCRP) and seven other proteins with diagnostic capacity (AUC = 0.85, 95% CI: 0.78-0.92) outperforming hsCRP in the validation cohort (p = 0.006). We identified and validated a blood-based protein signature for PIBD with superior diagnostic performance compared to hsCRP. Given the challenges of fecal sample collection, further assay development may enable integration of these biomarkers into diagnostic pathways for PIBD. ClinicalTrials.gov identifier: NCT02727959.

In July 2021, Sweden introduced the criminal offence 'violation of a child's integrity' (Barnfridsbrott, Swedish Penal Code, Chap. 4 § 3), making perpetrators criminally responsible for a separate offence when children, under certain circumstances, witness violence and other criminal acts committed by and against persons close to them. This archival study examined case characteristics and legal outcomes in prosecuted cases of violation of a child's integrity. The material included 200 Swedish court cases handled between 2023 and 2024 involving 321 children. Data extracted from court documents were analyzed using descriptive statistics and multilevel logistic regression models. For 73% of the children, a conviction was reached on at least one count. Challenges for the prosecution included substantiating the underlying offence and proving beyond reasonable doubt that the child had witnessed that offence. Convictions were more likely in cases when defendants admitted guilt (OR=12.09, 95% CI [0.72, 204.27], p=.009) or when technical/forensic evidence was present (OR=2.69, 95% CI [1.14, 6.39], p=.025), and less likely when the injured party to the underlying offence did not participate or retracted a statement (OR=0.37, 95% CI [0.12, 0.98], p=.046). The results reveal both strengths and limitations in the legal application of the new legislation in cases involving children who witness violence.

Antibiotic use in early childhood may alter the developing microbiome and has been proposed as a risk factor for inflammatory bowel disease (IBD). We conducted a systematic review to examine the association between childhood antibiotic use and subsequent risk of IBD. In a systematic literature search, we identified cohort and case-control studies reporting the association between antibiotic use (exposure age <1 to 17 years) and development of IBD. MEDLINE and EMBASE databases were searched from inception through December 31, 2024. Studies reporting a hazard ratio, odds ratio, or risk ratio (RR) were included. To account for heterogeneity, pooled estimates were calculated using the DerSimonian-Laird random-effects model. Estimates were adjusted for potential confounding as reported in the original studies. We identified 10 studies, of which 8 (n = 2783 cases) reported associations between childhood antibiotics and IBD risk. Additionally, 2 studies on Crohn's disease (CD) and 1 on ulcerative colitis were included in disease-specific analyses. In pooled analyses, antibiotic exposure compared with no exposure was associated with increased risk of IBD (RR, 1.42; 95% confidence interval [CI], 1.23-1.66), CD (RR, 1.59; 95% CI, 1.39-1.81), and ulcerative colitis (RR, 1.23; 95% CI, 1.08-1.40). Heterogeneity was low to moderate (I2 = 0%-35%), and funnel plots did not indicate publication bias (Egger's test, P = .12-.43). Adjustment for infections did not attenuate the association between childhood antibiotic exposure and IBD development. While causal interpretation should be cautious, childhood exposure to antibiotics was associated with an increased risk of later IBD, particularly for CD.

In 2006, the Foundation Acta Paediatrica launched the annual Young Investigator Award, which recognises the first authors of important papers who are up to 45 years of age. The winning candidates are selected by the Chairman of the Foundation and the Swedish Paediatric Society. The prize was established to honour the journal's previous long-standing Editor-in-Chief, Rolf Zetterström. We are pleased to announce that the prize for the best paper published in 2025 will be shared by two Swedish authors, Lina Broström from the Karolinska Institutet in Stockholm and Tim Malmström from Lund University and the Department of Paediatrics in Kalmar. A prospective study by Lina Broström and her co-authors compared the neonatal characteristics and outcomes of Swedish children who were born extremely preterm, with and without low-grade intra-ventricular haemorrhage (IVH) [1]. It focused on 103 children who were born in Stockholm from 2004 to 2007 at less than 27 weeks of gestation. None of them had major brain injuries. The authors reported that the children who had low-grade IVH were sicker during the neonatal period than the children in the no IVH group. They also had more complications. The children in the low-grade IVH group had been born at lower gestational ages, spent more days on mechanical ventilation, and had a higher incidence of necrotising enterocolitis. They were also more likely to undergo surgical ligation for patent ductus arteriosus than the children in the no IVH group. Despite these findings, Lina Broström and her co-authors reported that the children in the low-grade IVH group did not have a smaller brain volume of cerebrum or cerebellum at 10 years of age than the no IVH group. In addition, they did not have worse neurodevelopment outcomes than the no IVH group when they reached 12 years of age. These similar findings between the two groups are very encouraging. Urinary tract dilatation is often detected during the prenatal period and is frequently caused by ureteropelvic junction obstruction. Children need repeated examinations to detect and prevent their kidney function deteriorating. Tim Malmström and his co-authors explored whether this diagnostic burden could be reduced [2]. Children with prenatally detected unilateral ureteropelvic junction obstruction were identified from a prenatal hydronephrosis registry. The anteroposterior renal pelvic diameter was used to describe the dilatation. Cases with bilateral renal pelvis dilatation or other urinary tract malformations were excluded. Most adverse events, such as urinary tract infections, occurred during the first year of life and then the frequency reduced. An anteroposterior pelvic diameter of less than 15 mm at 12 months of age was associated with an uneventful follow up. Tim Malmström and his co-authors concluded that a stable anteroposterior renal pelvic diameter during the first year could help to identify children who need fewer follow-up visits. It also seems safe to end these visits when the children reach 2 years of age if there is no increase in the anteroposterior pelvic diameter during the first year. These visits could also cease after the first year if the child has not had any adverse events and has had a stable anteroposterior pelvic diameter of less than 15 mm during that period. Göran Wennergren: writing – original draft, writing – review and editing.