Harmonized-Multinational qEEG Norms (HarMNqEEG)

This paper extends our frequency domain quantitative electroencephalography (qEEG) methods pursuing higher sensitivity to detect Brain Developmental Disorders. Prior qEEG work lacked integration of cross-spectral information omitting important functional connectivity descriptors. Lack of geographical diversity precluded accounting for site-specific variance, increasing qEEG nuisance variance. We ameliorate these weaknesses. i) Create lifespan Hermitian Riemannian multinational qEEG norms for cross-spectral tensors. These norms result from the HarMNqEEG project fostered by the Global Brain Consortium. We calculate the norms with data from 9 countries, 12 devices, and 14 studies, including 1564 subjects. Instead of raw data, only anonymized metadata and EEG cross-spectral tensors were shared. After visual and automatic quality control developmental equations for the mean and standard deviation of qEEG traditional and Hermitian Riemannian descriptive parameters were calculated using additive mixed-effects models. We demonstrate qEEG "batch effects" and provide methods to calculate harmonized z-scores. ii) We also show that the multinational harmonized Hermitian Riemannian norms produce z-scores with increased diagnostic accuracy to predict brain dysfunction at school-age produced by malnutrition only in the first year of life. We provide data and software for constructing norms. iii) We offer open code and data to calculate different individual z-scores from the HarMNqEEG dataset. These results contribute to developing bias-free, low-cost neuroimaging technologies applicable in various health settings.

Associations of maternal plasma and infant umbilical cord blood plasma metabolomics profiles with anthropometric measures at birth: a prospective cohort study.

BackgroundThe metabolomics profiles of maternal plasma during pregnancy and cord plasma at birth might influence fetal growth and birth anthropometry. The objectives of this study are to examine how metabolites measured in maternal plasma samples collected during pregnancy and umbilical cord plasma samples collected at birth are associated with newborn anthropometric measures, a known predictor of future health outcomes.MethodsPregnant women between 24 and 28 weeks of gestation were recruited from prenatal clinics in New Hampshire as part of a prospective cohort study. Blood samples from 413 women at enrollment and 787 infant cord blood samples were analyzed using the Biocrates AbsoluteIDQ® p180 kit . Multivariable linear regression models were used to examine association of cord and maternal metabolites with infant anthropometry at birth.ResultsIn cord blood samples, several acylcarnitines, a phosphatidylcholine, and a custom metabolite indicator were negatively associated with birth weight Z-score, and lysophosphatidylcholines as well as three custom metabolite indicators were positively associated with birth weight Z-score. Acylcarnitine C5 was negatively associated with birth length Z-score, and several lysophosphatidylcholines and a custom metabolite indicator were positively associated with birth length Z-score. Maternal blood metabolites did not show significant associations with birth weight and length Z scores, however, a custom metabolite indicator, the ratio of kynurenine over tryptophan, was negatively associated with weight-for-length Z-score.ConclusionsSeveral cord blood metabolites associated with newborn weight and length Z-scores; in particular, consistent findings were observed for several acylcarnitines that play a role in utilization of energy sources, and a lysophosphatidylcholine that is part of oxidative stress and inflammatory response pathways. Fewer associations were observed with maternal metabolomic profiles.

Expressed Breast Milk Analysis: Role of Individualized Protein Fortification to Avoid Protein Deficit After Preterm Birth and Improve Infant Outcomes

Background: Expressed breast milk (EBM) protein content is highly variable between mothers and often below published values that are still used for EBM protein fortification strategies. This approach may result in significant protein deficit and suboptimal protein energy (P/E) ratio. The study aim was to determine whether individualized EBM protein analysis and fortification will reduce preterm infant protein deficits and improve growth and neurodevelopmental outcome.Study Methods: In a single-center randomized, blinded study of infants born at 24 0/7–29 6/7 weeks, mother-specific protein values measured by a milk analyzer were used to individualize infant-specific protein intake (interventional group, IG), and compared this to a standardized protein fortification scheme based on published values of EBM protein content of 1.4 g/dL (control group, CG). For IG, milk analyzer protein values of mother's EBM were used to adjust protein content of the EBM. The CG EBM protein content was adjusted using the standard published value of 1.4 g/dL and not based on milk analyzer values. EBM protein content, protein intake, protein/energy (P/E) ratio, weight (WT), head circumference (HC), length (L), growth velocity (GV) from 2 to 6 weeks of age, WT, HC and L Z-Scores at 32- and 35-weeks PMA, and lean body mass (35 weeks PMA skin fold thickness) were measured. Neurodevelopment was assessed by Bayley III at average 24 months corrected gestational age (CGA).Results: EBM protein content before fortification was significantly below published values of 1.4 g/dL at all time points in both CG and IG. CG protein deficit was significantly decreased and progressively worsened throughout the study. Individualized protein fortification in IG avoided protein deficit and optimized P/E ratio. Although no significant change in short-term GV (at 6 weeks of age) was seen between groups, IG infants born at <27 weeks had significant improvements in WT and L z-scores, and leaner body mass at 32 and 35 weeks PMA. IG exhibited significantly improved cognitive scores at 24 months CGA.Conclusions: Infant-specific protein supplementation of mother's EBM optimized P/E ratio by eliminating protein deficit and improved growth z scores at 32- and 35-weeks PMA and neurocognitive testing at 24 months.

Maternal perception of child weight and concern about child overweight mediates the relationship between child weight and feeding practices

Objective: To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices. Setting: Pudong District, Shanghai, China. Participants: A convenience sample of 1164 mothers who were primary caregivers of preschool children. Results: Sixty percent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0.212, P < 0.001). Structural equation modeling (SEM) indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0.035, P < 0.001), restriction (β = 0.022, P < 0.001), and food as a reward (β = -0.017, P < 0.05). Conclusion: Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.

Exercise and Carotid Properties in the Young–The KiGGS-2 Study

Background: Carotid intima-media thickness (cIMT) and stiffness (cS) are predictive markers of early vascular aging and atherosclerotic risk. This study assessed, whether exercise has protective effects on carotid structure and function or on vascular risk in the young.Methods: Volume and change of exercise (recreational and organized sports participation) of German adolescents and young adults was assessed within the prospective population-study KiGGS at KiGGS-Wave-1 (2009–2012) and KiGGS-Wave-2 (2014–2017) using standardized self-reporting questionnaires. CIMT and cS were measured by real-time B-mode ultrasound sequences with semi-automated edge-detection and automatic electrocardiogram-gated quality control in 2,893 participants (14–28 years, 49.6% female). A cumulative index for atherosclerotic risk (CV-R) included z-scores of mean arterial pressure, triglycerides, total/HDL-cholesterol-ratio, body mass index, and HbA1c.Results: At KiGGS-Wave-2 cross-sectional CV-R but not cS and cIMT was lower in all exercise-groups compared to “no exercise” (B = −0.73, 95%-CI = −1.26 to 0.19, p = 0.008). Longitudinal volume of exercise was negatively associated with CV-R (B = −0.37, 95%-CI = −0.74 to 0.00, p = 0.048) but not with cS and cIMT. Cross-sectional relative risk of elevated CV-R but not cS and cIMT was lower in all exercise-groups compared to “no exercise” (RR = 0.80, 95%-CI = 0.66 to 0.98, p = 0.033). High exercise volumes were associated with lower relative risk of elevated CV-R (RR = 0.80, 95%-CI = 0.65–0.97, p = 0.021) and cS in tendency but not with cIMT.Conclusions: Increased levels of exercise are associated with a better cardiovascular risk profile in young individuals, but not with cS and cIMT. Our study confirms previous recommendations on exercise in this age group without demonstrating a clear benefit on surrogate markers of vascular health.

Sex Differences in the Association Between Midlife Cardiovascular Conditions or Risk Factors With Midlife Cognitive Decline

Background and Objectives:The prevalence of mid-life cardiovascular conditions and risk factors are higher in men than women. Associations between mid-life cardiovascular conditions or risk factors and mid-life cognitive decline has been reported, but few studies have assessed sex differences in these associations.Methods:We included 1,857 participants enrolled in the population-based Mayo Clinic Study of Aging who were aged 50-69 years at baseline. Participants were evaluated every 15 months by a coordinator, neurologic evaluation, and neuropsychological testing. The neuropsychological testing used nine tests to calculate global cognitive and domain-specific (memory, language, executive function, and visuospatial skills) z-scores. Nurse abstractors reviewed participant medical records to determine the presence of cardiovascular conditions (coronary heart disease, arrhythmias, congestive heart failure) and risk factors (hypertension, diabetes, dyslipidemia, obesity, ever smoking). Linear mixed-effect models evaluated the association between baseline cardiovascular conditions or risk factors and global and domain-specific cognitive decline. Multivariable models adjusted for demographics, APOE genotype, depression, and other medical conditions. Interactions between sex and each cardiovascular condition or risk factor were examined, and results were stratified by sex.Results:Overall, 1,465 (70.3%) participants had at least one cardiovascular condition or risk factor; the proportion of men was higher than women (767 (83.4%) vs 698 (74.5%), p<0.0001). Cross-sectionally, coronary heart disease and ever smoking were associated with a lower visuospatial z-score in multivariable models. Longitudinally, several cardiovascular conditions and risk factors were associated with declines in global and/or domain-specific z scores, but not visuospatial z-scores. Most cardiovascular conditions were more strongly associated with cognition among women: coronary heart disease, and other cardiovascular conditions were associated with global cognition decline only in women (all p<0.05). Additionally, diabetes, dyslipidemia, and coronary heart disease were associated with language z-score decline only in women (all p<0.05). However, congestive heart failure was associated with language z-score decline only in men (all p<0.05).Conclusions:Mid-life cardiovascular conditions and risk factors are associated with mid-life cognitive decline. Moreover, specific cardiovascular conditions and risk factors have stronger associations with cognition decline in mid-life for women than men despite the higher prevalence of those conditions in men.

Adherence to a healthy dietary pattern is associated with greater anti-oxidant capacity and improved glycemic control in Iraqi patients with Type 2 Diabetes

BACKGROUND: Healthy dietary patterns are typically associated with improved metabolic and cardiovascular health in population-based cohorts. This study aims to investigate whether a healthy dietary score, derived from UK Diabetes and Diet Questionnaire (UKDDQ), is significantly associated with measures of metabolic health and nutritional status in patients with T2DM. METHODS: This cross-sectional study included 85 patients with T2DM (age: 51.7±9.4, BMI: 30.6±5.3) and 20 healthy volunteers (age: 48.4±8.6, BMI: 29.5±5) recruited from the Al-Hassan Diabetes and Endocrinology Specialized Center, Karbala, Iraq. Body weight, height and body mass index (BMI) and resting clinic blood pressure were measured. All participants completed the UKDDQ to assess the quality of the diet. Metabolic and nutritional biomarkers were measured in fasting blood samples. A composite nutritional heathy index score (CNHI-score) based on the sum of z-scores for plasma vitamin A, C and E concentrations was derived. RESULTS: In patients with T2DM the UKDDQ score was associated with lower fasting blood glucose (FBG) (r = –0.33; P < 0.01), hemoglobin A1C (r = –0.49; P < 0.001), total cholesterol (TC) (r = –0.26; P = 0.02) concentrations. In patients with T2DM, the CNHI-score significantly associated with UKDDQ (r = 0.43; P < 0.001). In addition, a higher CNHI-score was associated with FBG (r = –0.61; P < 0.001), HbA1C (r = –0.83; P < 0.001), TC (r = –0.30; P < 0.01) and triglyceride (r = –0.30; P < 0.01) concentrations. CONCLUSIONS: A healthy diet is associated with a higher concentration of anti-oxidant vitamins and better glycemic and lipid profile in healthy subjects and in patients with T2DM.

Remote Neuropsychological Intervention for Developmental Dyslexia with the Tachidino Platform: No Reduction in Effectiveness for Older Nor for More Severely Impaired Children

Tachidino is a web-platform for remote treatment of reading and writing disorders. A total of 91 children with developmental dyslexia and/or dysorthographia participated in the present study and received Tachidino treatment. The purpose of the study was to compare results obtained after four weeks treatment and a six-month follow-up in older versus younger children and in more versus less severely impaired children (separately subdividing them according to reading speed, reading accuracy, and writing accuracy). The results showed no difference in improvement for reading accuracy and speed in the three age groups, but children below 9 years improved more than older children in writing accuracy. Regarding severity groups, children with more severe initial impairments improved more than children with less severe impairments. Additionally, the results were confirmed after controlling for spurious effects due to use of Z-scores and regression to the mean. The findings are discussed in terms of their theoretical and practical implications.

Larger Physique as a Risk Factor for Infantile Appendicitis: A Retrospective Study

The clinical features and risk factors of acute appendicitis in infants are unclear. Our aim was to evaluate the association between anthropometrics and the occurrence of infantile appendicitis. This was a retrospective study of infants (<6 years of age) and school-age children (6–10 years of age) of Asian ethnicity who required hospitalization for appendicitis at our two participating institutions between 2004 and 2018. The Z-score for height, body weight, and body mass index (BMI) was compared between the two groups, as well as between patients presenting with perforated and non-perforated appendicitis. The analysis included data from 73 infants and 362 school-age children. Z-scores were greater in infants than in school-age children for height (0.37 versus −0.03, p = 0.003) and body weight (0.12 versus −0.36, p = 0.023), with no between-group difference for the Z-score of BMI. There was no difference in Z-scores for height, weight, and BMI between the perforated and non-perforated appendicitis infant groups. Infants presenting with acute appendicitis were characterized by a larger physique but with normal proportion. This trend was not observed in school-age children. Therefore, larger infants presenting with abdominal pain should be screened for appendicitis.

A Compound Hop Index for Assessing Soccer Players’ Performance

Athletes regularly have to pass a series of tests, among which one of the most frequently used functional performance measures are single-leg hop tests. As the collected individual results of tests constitute a large amount of data, strategies to decrease the amount of data without reducing the number of performed tests are being searched for. Therefore, the study aimed to present an effective method to reduce the hop-test battery data to a single score, namely, the Compound Hop Index (CHI) in the example of a soccer team. A male, first-league soccer team performed a battery of commonly used single-leg hop tests, including single hop and triple hop for distance tests and the six-meter timed hop test. Gathered data, including Limb Symmetry Indexes of the three tests, normalized to body height for the single- and triple-hop-tests distance separately for right and left legs, and the time of the six-meter timed hop test separately for right and left legs were standardized to z-scores. Consecutively, the z-scores were averaged and formed CHI. The developed CHI represents a novel score derived from the average of z-scores that significantly reduces, clarifies, and organizes the hop performance-measures data.