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Craniosynostosis is defined as a premature fusion of one or more cranial sutures. Several studies have revealed cognitive deficits in some children who had undergone surgery to treat craniosynostosis. However, no general distinction has been drawn in the cognitive abilities between the various types of craniosynostosis. The purpose of the present study was to analyze if there is a difference in cognitive and motor function among the different types of non-syndromic craniosynostosis in preschool children.
Twenty-seven children with different types of non-syndromic craniosynostosis were assessed using the Wechsler Preschool and Primary Scale of Intelligence – Third Edition, as well as the Quantitative, Memory and Motor scales of McCarthy Scales of Children’s Abilities (MSCA). The children were aged between 3 and 5 years and 11 months. The various types of craniosynostosis were compared.
The unicoronal synostosis group performed significantly worse than the multisuture synostosis group on the MSCA Motor scale. No differences in cognitive functions were found between the various types of craniosynostosis.
Children with unicoronal synostosis may experience impaired motor skills and screening of their motor ability is recommended.
Previous literature supports antipsychotics’ (AP) efficacy in acute first-episode psychosis (FEP) in terms of symptomatology and functioning but also a cognitive detrimental effect. However, regarding functional recovery in stabilised patients, these effects are not clear. Therefore, the main aim of this study is to investigate dopaminergic/anticholinergic burden of (AP) on psychosocial functioning in FEP. We also examined whether cognitive impairment may mediate these effects on functioning.
A total of 157 FEP participants were assessed at study entry, and at 2 months and 2 years after remission of the acute episode. The primary outcomes were social functioning as measured by the functioning assessment short test (FAST). Cognitive domains were assessed as potential mediators. Dopaminergic and anticholinergic AP burden on 2-year psychosocial functioning [measured with chlorpromazine (CPZ) and drug burden index] were independent variables. Secondary outcomes were clinical and socio-demographic variables.
Mediation analysis found a statistical but not meaningful contribution of dopaminergic receptor blockade burden to worse functioning mediated by cognition (for every 600 CPZ equivalent points, 2-year FAST score increased 1.38 points). Regarding verbal memory and attention, there was an indirect effect of CPZ burden on FAST (b = 0.0045, 95% CI 0.0011–0.0091) and (b = 0.0026, 95% CI 0.0001–0.0006) respectively. However, only verbal memory post hoc analyses showed a significant indirect effect (b = 0.009, 95% CI 0.033–0.0151) adding premorbid IQ as covariate. We did not find significant results for anticholinergic burden.
CPZ dose effect over functioning is mediated by verbal memory but this association appears barely relevant.
The purpose of this study is to determine the decrease of neurological soft signs (NSS) during adolescence and to compare this evolutionary process in two groups of adolescents with first episode psychosis: a) schizophrenia and b) non-schizophrenia patients. The structured neurological evaluation scale (NES) was administered to 24 adolescents with first episode psychosis. The number of NSS, the total and subscales scores were correlated with age in patients and in 39 healthy controls. Adolescents with first-episode psychosis had a higher prevalence of NSS than healthy controls; the schizophrenia patients (N = 9) scored higher than non-schizophrenia patients (N = 15). The number of NSS, total score and the scores on three of the four NES subscales correlated inversely with age in the healthy control group. No correlation was found for the schizophrenia group. For the non-schizophrenia group, a significant negative correlation was found only in one subscale. The decrease of NSS during adolescence in the healthy population but not in the patient groups with psychosis may be an indicator of a disturbance of brain processes that occurs during development. We did not find a clear pattern of NSS that distinguished schizophrenia from other psychoses.
Motor abnormalities (MAs) are the primary manifestations of schizophrenia. However, the extent to which MAs are related to alterations of subcortical structures remains understudied.
We aimed to investigate the associations of MAs and basal ganglia abnormalities in first-episode psychosis (FEP) and healthy controls. Magnetic resonance imaging was performed on 48 right-handed FEP and 23 age-, gender-, handedness-, and educational attainment-matched controls, to obtain basal ganglia shape analysis, diffusion tensor imaging techniques (fractional anisotropy and mean diffusivity), and relaxometry (R2*) to estimate iron load. A comprehensive motor battery was applied including the assessment of parkinsonism, catatonic signs, and neurological soft signs (NSS). A fully automated model-based segmentation algorithm on 1.5T MRI anatomical images and accurate corregistration of diffusion and T2* volumes and R2* was used.
FEP patients showed significant local atrophic changes in left globus pallidus nucleus regarding controls. Hypertrophic changes in left-side caudate were associated with higher scores in sensory integration, and in right accumbens with tremor subscale. FEP patients showed lower fractional anisotropy measures than controls but no significant differences regarding mean diffusivity and iron load of basal ganglia. However, iron load in left basal ganglia and right accumbens correlated significantly with higher extrapyramidal and motor coordination signs in FEP patients.
Taken together, iron load in left basal ganglia may have a role in the emergence of extrapyramidal signs and NSS of FEP patients and in consequence in the pathophysiology of psychosis.
The increasing prevalence of overweight and obesity has developed into an epidemic public health problem worldwide. In this regard, in the last years several investigations have suggested that water intake and water balance could have important implications for both weight management and body composition. The aim of this study was to analyse the association between fluid intake, water balance and body composition in a sample of healthy young adults from Spain.
Material and methods
A total of 358 healthy subjects (121 males; 237 females) aged 18–39 years participated in the current study. The validated questionnaire entitled “The hydration status questionnaire” was used to assess fluid intake, elimination, and water balance. Anthropometric measurements (height, weight and waist circumference) were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK). The estimates of total body water (TBW), fat mass (FM) and fat free mass (FFM) were acquired by bioelectrical bioimpedance analysis. Physical activity was estimated through the Short form of the International Physical Activity Questionnaire (IPAQ-SF). Differences in anthropometric and body composition variables were assessed through the ANOVA test and considered significant at p < 0.05.
Fluid intake was correlated with body water content in females (r = 0.180, p = 0.006) and males (r = 0.266, p = 0.003). An inverse association between water consumption per weight (ml/kg) with body weight (females (f): r = -0.318, p = 0.000; males (m): r = -0.220, p = 0.015), body fat mass (f: r = -0.320, p = 0.000; m: r = -0.200, p = 0.028), and waist circumference (f: r = -0.237, p = 0.000; m: r = -0.215, p = 0.018) was found. Finally, significant differences in body water content in females according to water balance were observed (p = 0.04).
Higher fluid intake seems to be related with a better body composition, therefore the improvement of water intake and water balance could be useful in weight management and in the prevention of overweight and obesity in healthy young adults.
Age-related hearing loss (ARHL) is a sensory impairment, with a dramatic increase in its incidence, which is caused by genetic and environmental factors such as noise and ototoxic drugs. Recent studies correlated ARHL to elevated plasma homocysteine (Hcy) by folate deficiency, suggesting that reduction of Hcy levels by folate supplementation could potentially ameliorate ARHL.
Hyperhomocysteinemia (HHcy), a status that contributes to ARHL, may also arise from malfunction of Hcy remethylation by betaine homocysteine S-methyltransferases (BHMTs) and methionine synthase in the methionine cycle. The expression and/or activity of these enzymes may be altered by ototoxic drugs, including paracetamol (APAP).
To determine the effect of APAP in cochlear morphology and function of control and Bhmt-/- mice, and to analyze putative preventive effects of folic acid (FA) supplementation.
Materials and Methods
Two-month-old Bhmt-/- mice (n = 47), with greater dependence on folate metabolism for Hcy remethylation, and Bhmt + / + mice (n = 42) were fed control or FA supplemented diets for 30 days. The last day APAP (250 mg/kg) or placebo were injected intraperitoneally.
Hearing was evaluated by recording auditory brainstem responses (ABR) at the beginning of the experiment and after treatments. Picrosirius red staining was used for evaluation of the cochlear lateral wall cytoarchitecture. Plasma and hepatic metabolite levels were determined by HPLC or on Spinlab 100® autoanalyzer.
Loss of Bhmt expression induced HHcy, but an impact on hearing acuity was not observed. Acute APAP administration did not induce ABR threshold shifts. However, following ototoxic treatment, changes of 5–17% in the areas of the stria vascularis and spiral ligament were detected between Bhmt-/- mice under different dietary treatments; cochlear structures of Bhmt-/- mice receiving APAP plus FA supplementation resemble those of the control group. APAP increases susceptibility to ototoxic damage in the presence of HHcy.
BHMT plays a central role in cochlear methionine metabolism. FA supplementation modulates Hcy levels, contributing to a proper remethylation status that prevents ARHL.
Within developmental psychology, pointing gestures have received a great deal of attention, while ostensive gestures have been overlooked in terms of their emergence and intentionality. In a longitudinal and micro-genetic study with six children at 9, 11, and 13 months of age, we codified gesture production of children within second-by-second data frames. We identified 480 instances of gestures and categorised whether they were of ostensive, ostensive–indexical, or indexical nature. We specified the communicative function of each gesture by analysing the object involved and their circumstances of production. Data analysis include frequencies, binomial tests, proportion comparisons, and repeated measures ANOVA. We identified a phatic function in other-directed gestures, as well as exploratory and private functions in self-directed gestures. This has important implications for child development since ostensive gestures are easier to produce and to understand than pointing. The consideration of objects would be essential for defining the communicative function of gestures.
Current clinical practice is based on guidelines and local protocols that are informed by clinical evidence. This means that clinical variability is reduced, but can lead to inefficient clinical decision-making, and can increase medical errors, decreasing patient's safety. The aim of the EXCON project is to investigate the innovative concept of Intelligent Clinical History (ICH), and to develop functional prototypes of high added-value in healthcare services.
The innovative EXCON project will take advantage of recent advances in technologies for coding, structuring and semantizing medical information. Thanks to this new structuring, the EXCON platform will be developed. Final users will be health professionals and other decision-makers. Doctors, nurses, epidemiologists and information specialists will be involved in the development and subsequent validation of the platforms.
To develop the ICH platform clinical data on a highly prevalent symptom with high variability in clinical practice, such as non-traumatic chest pain in emergency services, has been collected from different electronic medical record databases. The extraction of clinical data to implement new techniques of artificial intelligence requires tasks that must be automated, which today is difficult and tedious (data is often not computerized). Through techniques applied in EXCON, such as natural language processing, relevant clinical data have been extracted and a Decision Support System has been developed and validated. This tool optimizes resources and improves clinical management, reducing errors and increasing patient's safety.
In coming decades, patient management will be impacted by the application of new advanced data analytics tools. This will allow for safer and more efficient clinical management, decrease variability in clinical practice, and improve equity. That is why the development and assessment of these technologies is necessary.
The Short Obsessive–Compulsive Disorder Screener (SOCS) is recommended by the National Institute for Health and Care Excellence as a suitable and validated screening tool for 11- to 15-year olds. Despite its excellent sensitivity and specificity in detecting obsessive–compulsive disorder (OCD), it has limitations.
To empirically examine whether the SOCS is suitable for assessing OCD symptoms across a wide age range of children and adolescents and to provide new data about its psychometric properties.
Participants were 94 patients (9–19 years) with OCD, and 880 healthy controls.
The results supported the SOCS' unidimensional factor structure and metric invariance across samples. It showed good reliability in terms of internal consistency and temporal stability. Furthermore, it had significantly high correlations with other OCD measures and an acceptable sensitivity and specificity for detecting OCD.
The SOCS is a brief screening tool suitable for detecting OCD in children and adolescents.
We aim to provide a conversion between Addenbrooke's Cognitive Examination III (ACE-III) and Mini-Mental State Examination (MMSE) scores, to predict the MMSE result based on ACE-III, thus avoiding the need for both tests, and improving their comparability.
Equipercentile equating method was used to elaborate a conversion table using a group of 400 participants comprising healthy controls and Alzheimer's disease (AD) patients. Then, reliability was assessed in a group of 100 healthy controls and patients with AD, 52 with primary progressive aphasia and 22 with behavioral variant frontotemporal dementia.
The conversion table between ACE-III and MMSE denoted a high reliability, with intra-class correlation coefficients of 0.940, 0.922, and 0.902 in the groups of healthy controls and AD, behavioral variant frontotemporal dementia, and primary progressive aphasia, respectively.
Our conversion table between ACE-III and MMSE suggests that MMSE may be estimated based on the ACE-III score, which could be useful for clinical and research purposes.
New speleothem records from northeastern Iberian caves provide data to explore the climatic patterns during the Holocene. We present δ13C and Mg/Ca from three speleothems from two different caves located in the Iberian Range allowing replication of the climatic signal for several millennia. Through the integration of those stalagmites covering since the Holocene onset to 2 ka, the early Holocene (11.7–8.5 ka) appears as the wettest interval. A marked change towards aridity is observed during the middle Holocene (8.5–4.8 ka) and an increase of humidity afterwards (4.8–2 ka). This three-part pattern, contrasting with other Iberian sequences, seems to be associated with the different role that seasonality has played in the response of different proxies (or records) to changes in water availability. Interpreting our speleothem records as changes in winter-spring precipitation along the Holocene allows reconciling previous data on hydrological variability from the western Mediterranean borderlands.
Addenbrooke's Cognitive Examination III (ACE-III) is a screening test that was recently validated for diagnosing dementia. Since it assesses attention, language, memory, fluency, and visuospatial function separately, it may also be useful for general neuropsychological assessments. The aim of this study was to analyze the tool's ability to detect early stages of Alzheimer's disease and to examine the correlation between ACE-III scores and scores on standardized neuropsychological tests.
Our study included 200 participants categorized as follows: 25 healthy controls, 48 individuals with subjective memory complaints, 47 patients with amnestic mild cognitive impairment and 47 mild Alzheimer's disease, and 33 patients with other neurodegenerative diseases.
The ACE-III memory and language domains were highly correlated with the neuropsychological tests specific to those domains (Pearson correlation coefficient of 0.806 for total delayed recall on the Free and Cued Selective Reminding Test vs. 0.744 on the Boston Naming Test). ACE-III scores discriminated between controls and patients with amnestic mild cognitive impairment (AUC: 0.906), and between controls and patients with mild Alzheimer's disease (AUC: 0.978).
Our results suggest that ACE-III is a useful neuropsychological test for assessing the cognitive domains of attention, language, memory, and visuospatial function. It also enables detection of Alzheimer's disease in early stages.
The estimation of age and growth of cephalopod stocks is a key issue for their sustainable management. Recently, several studies have successfully validated the daily deposition of growth rings in the vestigial shell or stylets of several octopus species. Octopus vulgaris eggs were incubated at two different temperatures, 18 and 22°C, until hatching to determine stylet size at hatching and assess the effect of temperature in the stylet dimensions. The 3-day-old hatchlings were sectioned transversally and 6 μm sections were stained to enhance the stylet position and visibility. The sections were observed under transmitted light microscopy at a magnification of 1000×, and the stylets identified as blue/green structures inside the mantle–funnel retractor muscle. The transversal sections of the whole paralarvae allowed the diameter of the embryonic stylet of an octopus species to be measured for the first time. The mean stylet diameter in 3-day-old paralarvae is 3.99 μm independently of the thermal conditions. Moreover, significant differences in stylet size between captive and wild paralarvae were observed; the latter showed significantly larger stylets, an indication that they are over 3 days old. Our results also indicate that the stylet nucleus is much smaller than previously thought based on measurements in stylets of juveniles and adults.
A multidisciplinary study from a number of drilled cores in the Guadalquivir estuary has made possible to identify as many as three extreme wave events and their facies in the 4th millennium BP (A: ~ 4000 cal yr BP, B: ~ 3550 cal yr BP, and C: ~ 3150 cal yr BP). These events, which caused strong erosion in the Guadalquivir sandy barrier and in the neighboring aeolian systems of El Abalario, brought about significant paleogeographical changes that may have affected human settlements established in the area during the Neolithic and Copper Age periods and during the Middle Bronze Age. The three events can be spatially correlated and their facies differentiated from more proximal to more distal from the coastline. The most proximal facies is characterized by a massive accumulation of shells, a sandy or sandy–muddy matrix, an erosive base, a highly diverse mixture of species (marine and estuarine), and lithoclasts. The most distal facies presents a muddy–sandy matrix, dominance of estuarine fauna, shell accumulation, presence of terrestrial species, mudpebbles, pebbles in a clayey matrix, and bioturbation. The evidence presented will further advance scientific knowledge about the impact of extreme wave events on coastal areas in SW Iberia and NW Africa.
A high-resolution study of a marsh sedimentary sequence from the Minho estuary provides a new palaeoenvironmental reconstruction from NW Iberian based on geological proxies supported by historical and instrumental climatic records. A low-salinity tidal flat, dominated by Trochamminita salsa, Haplophragmoides spp. and Cribrostomoides spp., prevailed from AD 140–1360 (Roman Warm Period, Dark Ages, Medieval Climatic Anomaly). This sheltered environment was affected by high hydrodynamic episodes, marked by the increase in silt/clay ratio, decrease of organic matter, and poor and weakly preserved foraminiferal assemblages, suggesting enhanced river runoff. The establishment of low marsh began at AD 1380. This low-salinity environment, marked by colder and wet conditions, persisted from AD 1410–1770 (Little Ice Age), when foraminiferal density increased significantly. Haplophragmoides manilaensis and Trochamminita salsa mark the transition from low to high marsh at AD 1730. Since AD 1780 the abundances of salt marsh species (Jadammina macrescens, Trochammina inflata) increased, accompanied by a decrease in foraminiferal density, reflecting climate instability, when droughts alternate with severe floods. SW Europe marsh foraminifera respond to the hydrological balance, controlled by climatic variability modes (e.g., NAO) and solar activity, thus contributing to the understanding of NE Atlantic climate dynamics.
A number of systems based on synthetic molecules, among them cationic liposomes and poly(ethylene imine)-based polymers, have been proposed as delivery vehicles for nucleic acids. Some of these systems have even reached the market, ensuring efficient and transient transfection levels in a variety of cell types. However, toxicity issues have limited their application in vivo. In this context, chitosan, a biocompatible and biodegradable polysaccharide, has been proposed as a promising alternative for the delivery of nucleic acid-based molecules. Here we present an overview of the state of the art of chitosan-based vectors for nucleic acid delivery and the most recent data on the in vivo testing of the proposed systems. We additionally express our view on the barriers that might be hampering the translation of this knowledge into clinical practice and the challenges that need to be fulfilled for these promising vehicles to reach patients.
This study analyzes the effect on levels of patient anxiety and depression of a
partner joining a cardiac rehabilitation program support group, also taking into
account the sex of the patient. The study was undertaken using a two-group
comparison design with pre-and post-test measures in non-equivalent groups. The
sample comprised patients in the cardiac rehabilitation program (CRP) at the
Ramón y Cajal Hospital, Madrid (Spain). Analysis of covariance
(ANCOVA) showed direct effects of sex and partner participation in support
groups on the anxiety trait. Similarly, interaction effects were observed
between the sex variable and partner participation. These results indicate the
pertinence of designing separate groups for patients and partners.
Morphometric characteristics of the periotic–timpanic bone complex in the middle ear of cetaceans, are effective characteristics in evaluating systematics. However, they have not been used for studies of geographic variation regarding dolphins of the genus Sotalia. This study aimed to compare the periotic–timpanic of Sotalia guianensis from four distinct locations, considered here as different operational taxonomic units, Amapá/Pará (AM/PA), Maranhão/Piauí (MA/PI), Ceará (CE), and Rio de Janeiro (RJ), using 21 morphometric measurements. Multivariate analysis showed significant distinction mainly between the units of northern (AM/PA and MA/PI) and south-eastern (RJ) Brazilian coast. The timpanic bone showed variation, reaching larger sizes in the Brazilian south coast unit, corroborating current molecular data on the geographic variation of S. guianensis.
Speleothem growth requires humid climates sufficiently warm to stimulate soil CO2 production by plants. We compile 283 U/Th dates on 21 stalagmites from six cave systems in the NW coast of Spain to evaluate if there are patterns in stalagmite growth that are evidence of climatic forcing. In the oldest stalagmites, from marine oxygen isotope stage (MIS) 7–5, growth persists through the glacial period. Hiatuses and major reductions in growth rate occur during extreme minima in summer insolation. Stalagmites active during the last interglaciation cease growth at the MIS 5–4 boundary (74 ka), when regional sea-surface temperature cooled significantly. During MIS 3, only two stalagmites grew; rates were highest between 50 and 60 ka during the maximum in summer insolation. One stalagmite grew briefly at 41 ka, 36.5 and 28.6 ka, all during warm phases of the Dansgaard–Oeschger cycles. A pronounced Holocene optimum in stalagmite growth occurs from 9 to 6 ka. The cessation of most growth by 4.1 ka, coincident with broad increases in aridity over the Mediterranean and areas influenced by the North African Monsoon, suggest that regions such as NW Spain, with dominant Atlantic moisture sources, also experienced increased aridity at this time.