The Performance of Infants Born Preterm and Full-term in the Mobile Paradigm: Learning and Memory

Abstract Background and Purpose. By 3 to 4 months of age, infants born full-term and without known disease display associative learning and memory abilities in the mobile paradigm, where an infant's leg is tethered to a mobile such that leg kicks result in proportional mobile movement. The first purpose of this study was to examine the learning and memory abilities of a group of infants born full-term compared with those of a comparison group. Little is known about the learning and memory abilities in infants born preterm, a group at known risk for future impairments in learning and movement. The second purpose of this study was to determine if and when an age-adjusted group of infants born prematurely display associative learning and memory abilities over a 6-week period. Subjects. Ten infants born full-term (38–42 weeks gestational age [GA]) and 10 infants born preterm (<33 weeks GA and <2,500 g) who were tethered and had control over the mobile movement were independently compared with a comparison group of 10 infants born full-term who were tethered and viewed a moving mobile but did not have control over the mobile movement. Infants in all 3 groups were seen at 3 to 4 months of age and were excluded from participation for any known visual or orthopedic diagnoses. Methods. Infants were tested using the mobile conjugate reinforcement paradigm, where one leg is tethered to an overhead mobile such that kicking with that leg results in proportional mobile movement. The kicking rates of the full-term group and the preterm group were compared with their own initial (baseline) kicking rates and with those of the comparison group. Results. After exposure to the conjugate relationship between kicking and mobile movement, the full-term group kicked more frequently compared with their own baseline levels and compared with the comparison group, fulfilling both criteria for learning and memory. In contrast, the preterm group did not increase their kicking rate according to both criteria. Discussion and Conclusion. These results suggest that infants born prematurely differ in their performance in the mobile paradigm as compared with age-matched infants born full-term. The mobile paradigm may provide clinicians with an important early assessment of infants' associative learning and memory abilities. Follow-up studies are needed, however, to further validate this paradigm as a clinical assessment tool.

Download Full-text

Risk assessment in precapillary pulmonary hypertension: a comparative analysis

Respiratory Research ◽

10.1186/s12931-021-01624-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Thomas Sonnweber ◽

Eva-Maria Schneider ◽

Manfred Nairz ◽

Igor Theurl ◽

Günter Weiss ◽

...

Keyword(s):

Risk Assessment ◽

Pulmonary Hypertension ◽

High Risk ◽

Risk Stratification ◽

Risk Prediction ◽

Mortality Risk ◽

Assessment Tool ◽

Risk Models ◽

Non Invasive

Abstract Background Risk stratification is essential to assess mortality risk and guide treatment in patients with precapillary pulmonary hypertension (PH). We herein compared the accuracy of different currently used PH risk stratification tools and evaluated the significance of particular risk parameters. Methods We conducted a retrospective longitudinal observational cohort study evaluating seven different risk assessment approaches according to the current PH guidelines. A comprehensive assessment including multi-parametric risk stratification was performed at baseline and 4 yearly follow-up time-points. Multi-step Cox hazard analysis was used to analyse and refine risk prediction. Results Various available risk models effectively predicted mortality in patients with precapillary pulmonary hypertension. Right-heart catheter parameters were not essential for risk prediction. Contrary, non-invasive follow-up re-evaluations significantly improved the accuracy of risk estimations. A lack of accuracy of various risk models was found in the intermediate- and high-risk classes. For these patients, an additional evaluation step including assessment of age and right atrium area improved risk prediction significantly. Discussion Currently used abbreviated versions of the ESC/ERS risk assessment tool, as well as the REVEAL 2.0 and REVEAL Lite 2 based risk stratification, lack accuracy to predict mortality in intermediate- and high-risk precapillary pulmonary hypertension patients. An expanded non-invasive evaluation improves mortality risk prediction in these individuals.

Download Full-text

The Long-Term Effect of Preterm Birth on Renal Function: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062951 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2951

Author(s):

Ju Sun Heo ◽

Jiwon M. Lee

Keyword(s):

Renal Function ◽

Preterm Birth ◽

Glomerular Filtration ◽

Renal Plasma Flow ◽

Meta Analysis ◽

Full Term ◽

Significant Difference ◽

Preterm Group ◽

Preterm Born

The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function in preterm-born survivors and full-term-born controls, published until 2 February 2019. A random effects model with standardized mean difference (SMD) was used for meta-analyses. Heterogeneity of the studies was evaluated using Higgin’s I2 statistics. Risk of bias was assessed using the Newcastle–Ottawa quality assessment scale. Of a total of 24,388 articles screened, 27 articles were finally included. Compared to full-term-born controls, glomerular filtration rate and effective renal plasma flow were significantly decreased in preterm survivors (SMD −0.54, 95% confidence interval (CI), −0.85 to −0.22, p = 0.0008; SMD −0.39, 95% CI, −0.74 to −0.04, p = 0.03, respectively). Length and volume of the kidneys were significantly decreased in the preterm group compared to the full-term controls (SMD −0.73, 95% CI, −1.04 to −0.41, p < 0.001; SMD −0.82, 95% CI, −1.05 to −0.60, p < 0.001, respectively). However, serum levels of blood urea nitrogen, creatinine, and cystatin C showed no significant difference. The urine microalbumin to creatinine ratio was significantly increased in the preterm group. Both systolic and diastolic blood pressures were also significantly elevated in the preterm group, although the plasma renin level did not differ. This meta-analysis demonstrates that preterm-born survivors may be subject to decreased glomerular filtration, increased albuminuria, decreased kidney size and volume, and hypertension even though their laboratory results may not yet deteriorate.

Download Full-text

Quantitative and qualitative aspects of learning and memory in common whiplash patients: A 6-month follow-up study**

Archives of Clinical Neuropsychology ◽

10.1016/s0887-6177(96)80003-5 ◽

1996 ◽

Vol 11 (8) ◽

pp. 661-676 ◽

Cited By ~ 3

Author(s):

G DISTEFANO ◽

B RADANOV

Keyword(s):

Learning And Memory ◽

Follow Up Study

Download Full-text

Longitudinal Changes in Obesity and Body Mass Index Among Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study

Journal of Clinical Oncology ◽

10.1200/jco.2008.16.3527 ◽

2008 ◽

Vol 26 (28) ◽

pp. 4639-4645 ◽

Cited By ~ 160

Author(s):

Edward G. Garmey ◽

Qi Liu ◽

Charles A. Sklar ◽

Lillian R. Meacham ◽

Ann C. Mertens ◽

...

Keyword(s):

Body Mass Index ◽

Acute Lymphoblastic Leukemia ◽

Childhood Cancer ◽

Body Mass ◽

Cancer Survivor ◽

Comparison Group ◽

Lymphoblastic Leukemia ◽

Childhood Cancer Survivor ◽

Childhood Cancer Survivor Study

Purpose We examined the rate of increase in the body mass index (BMI; kg/m2) after final height attainment in survivors of acute lymphoblastic leukemia (ALL) and a noncancer comparison group. Methods Childhood Cancer Survivor Study (CCSS) is a retrospectively ascertained cohort study that prospectively tracks the health status of adults who were diagnosed with childhood cancer between 1970 and 1986 and a comparison group of siblings. Changes in BMI from baseline enrollment to time of completion of follow-up (mean interval, 7.8 years) were calculated for 1,451 ALL survivors (mean age, 32.3 years at follow-up) and 2,167 siblings of childhood cancer survivors (mean age, 35.9 years). Results The mean BMI of the CCSS sibling comparison group increased with age (women, 0.25 units/yr, 95% CI, 0.22 to 0.28 units; men, 0.23 units/yr, 95% CI, 0.20 to 0.25 units). Compared with CCSS siblings, ALL survivors who were treated with cranial radiation therapy (CRT) had a significantly greater increase in BMI (women, 0.41 units/yr, 95% CI, 0.37 to 0.45 units; men, 0.29 units/yr; 95% CI, 0.26 to 0.32 units). The rate of BMI increase was not significantly increased for ALL survivors who were treated with chemotherapy alone. Younger age at CRT exposure significantly modified risk. Conclusion CRT used in the treatment of childhood ALL is associated with a greater rate of increasing BMI, particularly among women treated with CRT during the first decade of life. Health care professionals should be aware of this risk and interventions to reduce or manage weight gain are essential in this high-risk population.

Download Full-text

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211015582 ◽

2021 ◽

pp. 000348942110155

Author(s):

Leonard Haller ◽

Khush Mehul Kharidia ◽

Caitlin Bertelsen ◽

Jeffrey Wang ◽

Karla O’Dell

Keyword(s):

Risk Factors ◽

Medical Records ◽

Assessment Tool ◽

Demographic Data ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

Download Full-text

TELEMEDICINE IN IBD: GOOD TRUST FROM OUTPATIENTS DURING THE COVID-19 PANDEMIC IN MILAN (LOMBARDY)

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.122 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S51-S51

Author(s):

Andrea Costantino ◽

Daniele Noviello ◽

Stefano Mazza ◽

Roberto Berté ◽

Maurizio Vecchi ◽

...

Keyword(s):

Primary Endpoint ◽

Assessment Tool ◽

Healthcare Providers ◽

Telemedicine Service ◽

Moderate Disease ◽

Video Consultation ◽

K Current ◽

Remote Assistance ◽

Video Calling

Abstract Background and Aim During the recent COVID-19 pandemic, telemedicine has enabled many IBD patients worldwide to get access to remote assistance. Some positive reports on the use of telemedicine among patients and healthcare providers have been published1-4, but a patient’s trust perspective is not available yet. The aim of our study was to verify IBD patients’ trust in telemedicine. This study was approved by our local Ethics Committee. Material and Methods At our Gastroenterology Unit in Milan (Italy), 123 video-consultations were delivered to IBD patients with mild or moderate disease, in place of follow-up visits scheduled but not provided during the general lockdown (March-April 2020). Video-calling solutions from Google (Hangouts or Meet) or Microsoft Teams were used according to the patient’s preference. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire.5 The primary endpoint was expressed as a >75% percentage of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements: “I can trust video-consultation”, “I can trust that possible problems with the telemedicine service will be solved properly” and “I feel at ease when working with this website”. The questionnaire was formulated through the EUSurvey platform, widely used for clinical research questionnaires in Europe. Results One-hundred-fifteen (93.4%) video-consultations were performed out of the 123 scheduled. Among the 115 consultations, 100 questionnaires were completed (86.9%). The primary endpoint of trust in the telemedicine service was achieved in 95%, 90% and 84% of patients for the three selected key statements about the trust in the telemedicine service, its capability to solve clinical problems and its ease to use. While clinical outcomes were beyond our intentions, we reported no drugs withdrawal in this cohort nor major events. Conclusion Our results showed that during the COVID-19 pandemic most of our IBD patients accepted to receive a video-consultation in spite of the traditional in-person visit and trusted the video-consultation. References: 1. Bezzio C. et al. Gut 2020;69:1213–1217 2. George L.A., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3. Lees C. W. et al. Gastroenterology 2020; 2020 May 28 4. Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883 5. Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58.

Download Full-text

Exploring the Perth Hamstring Assessment Tool and Lower Extremity Functional Scale in a Proximal Hamstring Avulsion Cohort: A Cross-sectional Study

The American Journal of Sports Medicine ◽

10.1177/03635465211008568 ◽

2021 ◽

pp. 036354652110085

Author(s):

Elsa Pihl ◽

Kenneth B. Jonsson ◽

Mida Berglöf ◽

Nina Brodin ◽

Olof Sköldenberg ◽

...

Keyword(s):

Lower Extremity ◽

Assessment Tool ◽

Patient Specific ◽

Activity Limitations ◽

Functional Tests ◽

Functional Scale ◽

Proximal Hamstring Avulsion ◽

Proximal Hamstring ◽

Lower Extremity Functional Scale

Background: The goal of treatment for a proximal hamstring avulsion (PHA) is an objectively restored muscle and a subjectively satisfied, pain-free patient at follow-up. Different self-reported and performance-based outcome measures have been used to evaluate recovery, but their validity is poorly investigated. Purpose: To investigate 1) the correlation between the commonly used self-reported outcome measurements, the Perth Hamstring Assessment Tool (PHAT) and the Lower Extremity Functional Scale (LEFS); 2) to what extent these scores can be explained by physical dysfunction as measured by performance-based tests; 3) whether performance-based tests can discriminate between the injured and uninjured extremity; and 4) which activity limitations are perceived by patients several years after the injury. Study design: Cohort study (Diagnosis); Level of evidence, 3. Methods: We included a consecutive series of patients treated for or diagnosed with PHA in our department between 2007 and 2016 having at least 2 tendons avulsed from the ischial tuberosity. Participants attended 2 study visits, answered questionnaires (PHAT, LEFS, and Patient-Specific Functional Scale [PSFS]), and performed physical performance–based tests (single-leg hop tests, single–step down test, and isometric and isokinetic strength tests). Results: A total of 50 patients were included (26 men [52%], 24 women [48%]; mean age, 50.9 years [SD, 9.8 years]). The mean follow-up time was 5.5 years (SD, 2.7 years), and 74% had been surgically treated. The correlation between PHAT and LEFS was strong ( r = 0.832) and statistically significant ( P < .001). Seven of the performance-based tests exhibited a statistically significant but weak correlation with LEFS (0.340-0.488) and 3 of the tests to PHAT (–0.304 to 0.406). However, only peak torque could significantly discriminate between the extremities. The activity limitation most commonly mentioned in PSFS was running (16 patients [32%]). Conclusion: Although PHAT and LEFS correlated strongly, the correlations between functional tests and the patient-reported outcome scores were weak, and most functional tests failed to discriminate between the injured and uninjured lower extremity in patients with PHA 5 years after injury. In general, patients alleged few activity limitations, but running difficulty was a common sequela after PHA.

Download Full-text