Binocular Examination in Children

This chapter introduces the reader to tests commonly performed in a binocular vision examination to determine a child's binocular status. The testings introduced in this chapter are all chairside techniques that do not involve a significant amount of extra equipment or time. The binocular examination consists of determining the ocular position and then accommodation, vergence, and ocular motor statuses. The ocular position consists of determining where the eyes point in space and if they are correctly aligned. Evaluation of ocular alignment and the ability to move the eyes with coordination can be determined with various techniques, including Hirschberg, Krimsky, cover test, as well as Modified Thorington, motor testing, and vergence ranges. This chapter will familiarize the clinician with the basics of binocular vision testing and improve the reader's comfort with the various elements of the binocular vision examination.

Health-Related Motor Testing of Children in Primary School: A Systematic Review of Criterion-Referenced Standards

Being physically fit in younger years prevents several diseases in the presence as well as in the life course. Therefore, monitoring physical fitness and motor competence through motor testing is essential for determining developmental status and identifying health-related risks. The main objectives of this systematic review were (1) to identify currently available health-related criterion-referenced standards and cut-off points for physical fitness and motor competence test items, (2) to frame the methodological background on setting health-related criterion-referenced standards and (3) to give implications for a health-related evaluation system for physical fitness and motor competence tests. The electronic data base search (PubMed, Web of Science and SURF) yielded 2062 records in total and identified six empirical studies reporting cut-off points of motor test items for children (7–10 years), as well as 30 methodological papers discussing determination approaches to health-related criterion-referenced standards. Data collection, selection and analyses followed the PRISMA guidelines. Health-related motor test standards need to be gender- and age-specific but should refer to an absolute cut-off point rather than to relative performance in the reference group. Due to the lack of data on health-related criterion referenced standards, receiver-operating-characteristic (ROC) curves provide a tool for the determination of cut-off points and criterion referenced standards for physical fitness and motor competence tests. A standardized approach forms the fundamental base for a globally applicable evaluation of health-related fitness tests.

Impact of Brain Malformations on Neurodevelopmental Outcome in Children with a History of Prenatal Surgery for Open Spina Bifida

<b><i>Introduction:</i></b> This retrospective study investigates brain malformations and their impact on neurodevelopmental outcome in children after prenatal surgery for spina bifida (SB). <b><i>Methods:</i></b> Sixty-one patients were included. On neonatal MRI, SB-associated brain malformations were assessed. Ventricular size, ventriculo-peritoneal shunt (VPS), and endoscopic third ventriculostomy (ETV) were also documented. Neurodevelopment was assessed with the Bayley-III and correlated with brain malformations, ventricular size, and VPS/ETV placement. <b><i>Results:</i></b> Chiari II malformation was detected in all patients. Corpus callosum (CC) abnormality was noted in 40%, heterotopies in 35%, and cerebellar parenchymal defects in 11%. 96% had ventriculomegaly; in 46%, VPS/ETV was performed. Cognitive and language testing yielded results in the low-average range (Bayley-III: Cognitive Composite Score 93.6, Language Composite Score 89.7), motor testing was below average (Motor Composite Score 77.4). CC abnormalities, heterotopies, and cerebellar defects were not associated with poorer Bayley-III scores, whereas patients with severe ventriculomegaly performed poorer in all subtests, significantly so for the language composite score. Patients requiring intervention for hydrocephalus had significantly lower scores in motor testing. <b><i>Discussion/Conclusion:</i></b> Additional brain malformations in open SB do not seem to have an impact on cognitive function at 2 years of age. Severe ventriculomegaly is a risk factor for poorer cognitive outcome; hydrocephalus surgery adds an additional risk for delayed motor function.

Cortical proteins may provide motor resilience in older adults

Motor resilience proteins may be a high value therapeutic target that offset the negative effects of pathologies on motor function. This study sought to identify cortical proteins associated with motor decline unexplained by brain pathologies that provide motor resilience. We studied 1226 older decedents with annual motor testing, postmortem brain pathologies and quantified 226 proteotypic peptides in prefrontal cortex. Twenty peptides remained associated with motor decline in models controlling for ten brain pathologies (FDR < 0.05). Higher levels of nine peptides and lower levels of eleven peptides were related to slower decline. A higher motor resilience protein score based on averaging the levels of all 20 peptides was related to slower motor decline, less severe parkinsonism and lower odds of mobility disability before death. Cortical proteins may provide motor resilience. Targeting these proteins in further drug discovery may yield novel interventions to maintain motor function in old age.

Bench Motor Testing of Blended Fuels on their Basis

Alkaline transesterification of sunflower oil by n-butanol and ethanol on alkoxide-containing dried solutions of potassium hydroxide has been carried out. Complex character of spontaneous dividing of butanolysis products, accompanying with formation of three different species of glycerol layers, was observed. One of the later was found to be high-alkaline pure glycerol. Bench motor testing of biodiesel/diesel blends demonstrated slightly better power performance of butyl esters comparing with ethyl esters and regular decrease of harmful emissions (CO2, CO, NOx, CH) while increasing biodiesel fraction in mixture.

Comparison Of Voltage Measurements on DC Gearbox Motor and PWM Voltage Based On Arduino Uno

In this research, a DC motor tested using the L298 motor driver which is controlled by Arduino as the motor speed regulator and using the PWM method as a speed control signal generator for the DC motor. This research has several stages, namely literature study, arduino-based dc motor design, Arduino-based dc motor production, Arduino-based dc motor testing, then analysis of research results and conclusions are drawn. Testing on this Arduino-bas, ed DC motor was done with several experiments, by adjust the motor speed by setting the pwm value in the program listing section then measuring the pwm output on pin 9 of the Arduino Uno board. Then measurements were made on the right and left side of the motor. This experiment was carried out by setting the pwm value from 15 to 255 to determine the difference in the increase in the PWM output voltage and determine the voltage on the motor and determine the condition of the DC motor. The test results show that the initial motor moves when the set value of PWM = 45, PWM voltage = 0.83 V, right motor voltage = 1.53 V, and left motor = 1.75 V.

The Spine Physical Examination Using Telemedicine: Strategies and Best Practices

Study Design: Technical note. Objectives: To provide spine surgeons new to telemedicine with a structured physical examination technique based on manual motor testing principles. Methods: Expert experience describing a series of specific maneuvers for upper and lower extremity strength testing that can be performed using a telemedicine platform. In addition, we offer instruction on “setting up” for these visits and highlight special tests that can be used to diagnose specific cervical and lumbar spine conditions. Results: From our experiences in conducting telemedicine visits, we provide a means of testing and scoring upper and lower extremity strength for interpretation of weakness in the context of traditional manual motor testing. Also, we acknowledge the limitations of a remote examination and discuss maneuvers that cannot be performed remotely. Conclusions: COVID-19 has drastically altered the delivery of care for patients with spine-related complaints. The need for social distancing has led to the widespread adoption of telemedicine. This technical note provides an urgently needed framework for the standardization of the remote physical exam. Validation of the exam as a diagnostic tool will be a crucial next step in studying the impact of telemedicine.