VEPs latencies for each visual stimulation, group and age.

<p>On both bar-charts (a and b), VEPs latencies in response to the mixed or co-activations of P and M pathways (Low95% stimulus) are shown on the left part of the histogram; to the preferential M pathway (Low10% stimulus) on the middle part of the histogram; and to the preferential P pathway (High95% stimulus), on the right part of the histogram. For each stimulation, VEP latencies from both groups (preterms and fullterms) and each age (3, 6 and 12 months) are presented separately and identified in the legend. Significant differences (p≤0.05) are identified with *, and tendencies (p>0.05) with (*). a) <b>N1 component latencies</b>. In response to the preferential M pathway stimulation, significant differences at 3 months of age are found between preterm and fullterm groups. Moreover, compared to fullterm infants, preterms from all age groups taken together had longer N1 latencies in response to the <i>Low95% stimulation</i>, which activate both M and P systems. No differences are found in response to the preferential P pathway stimulations. b) <b>P1 component latencies</b>. In response to the preferential M pathway stimulation, significant differences at 3 months of age and statistical tendencies at 6 and 12 months are found between preterm and fullterm groups. No differences are found in response to the mixed and preferential P pathway stimulations.</p

Demographic and clinical data.

<p>N  =  number of participants included in the analyses; mo  =  months; w  =  weeks; SD  =  standard deviation; g  =  grams.</p><p>Demographic and clinical data.</p

VEPs amplitudes for each visual stimulation, group and age.

<p>On both bar-charts (a: N1 component; and b: P1 component), VEPs amplitude in response to the mixed or co-activations of P and M pathways (Low95% stimulus) are shown on the left part of the histogram; to the preferential M pathway (Low10% stimulus) on the middle part of the histogram; and to the preferential P pathway (High95% stimulus), on the right part of the histogram. For each stimulation, VEP amplitudes from both groups (preterms and fullterms) and each age (3, 6 and 12 months) are presented separately and identified in the legend.</p

Source waveform intensity for the preferential M system in dorso-parietal areas.

<p>Source waveform intensity as a function of time (ms) extracted from the dorso-parietal ROI of both groups (fullterms in blue; preterms in red) for the preferential M system (Low10% visual stimulation). A statistical difference (tendency shown with (*), p = 0.063) is found between groups at 120 ms, corresponding to P1 component. Although a difference between groups is suspected upon visual inspection around 90 ms (N1 component), statistical comparison were not significant, probably because of the low amplitude of this component due to developmental stage at 12 months old. See source distribution of both groups on <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107992#pone-0107992-g004" target="_blank">Figure 4</a>.</p

Table1_The role of parenting stress in anxiety and sleep outcomes in toddlers with congenital heart disease.docx

ObjectivesThis retrospective cohort study investigates how parenting stress, measured at 4 months of age by use of a classic three-dimensional parent-reported scale (Parenting Stress Index, 4th Ed. or PSI-4), can predict anxiety symptoms and quality of sleep at 24 months in toddlers with congenital heart disease (CHD).Study DesignSixty-six toddlers with CHD followed at our cardiac neurodevelopmental follow-up clinic were included in this study. As part of their systematic developmental assessment program, parents completed questionnaires on their stress level (PSI-4) when their child was 4 months old, and on their child's anxiety symptoms and quality of sleep at 24 months. Eight multiple linear regression models were built on the two measures collected at 24 months using the PSI-4 scores collected at 4 months. For each measure, four models were built from the PSI-4 total score and its three subscales (Parental Distress, Parent-Child Dysfunctional Interaction, Difficult Child), controlling for sex and socioeconomic status.ResultsThe PSI-4 Difficult Child subscale, which focuses on parenting anxiety related to the child's behavioral problems and poor psychosocial adjustment, accounted for 17% of the child's anxiety symptoms at 24 months. The two other PSI-4 subscales (Parental Distress and Parent-Child Dysfunctional Interaction) and the PSI-4 total score did not contribute significantly to the models. None of the four regression models on perceived quality of sleep were significant. It is important to note that 33% of parents responded defensively to the PSI-4.ConclusionsParenting stress related to the child's behavioral problems and poor psychosocial adjustment, measured when the child is 4 months old, is associated with the child's ulterior anxiety symptoms. As very few standardized tools are available to assess the behavioral and psychoaffective development of infants, this study highlights the importance of early psychosocial screening in parents of infants with CHD. The high rate of significant Defensive Responding Indices reminds us to not take parent reports at face value, as their actual stress levels might be higher.</p

Grand averaged waveforms (Oz electrode) for each stimulus condition and specific age group.

<p>(a) Visual stimulations. Left column: mixed or co-activation of P and M pathways (Low95% stimulus); Middle column: preferential M pathway (Low10% stimulus); Right column: the preferential P pathway (High95% stimulus). (b) Grand-average VEP waveforms for preterm (red line) and fullterm (blue line) groups in response to each visual stimulation at 3 (top graph line), 6 (middle graph line), and 12 (bottom graph line) months of age. The same scale was used for each graph in order to appreciate the differential maturational changes in morphology, latency, and amplitude of N1 and P1 components (identify on one graph) according to visual stimulations, ages and groups.</p

Source distribution.

<p>Mean LORETA solutions (represented in transverse and sagittal planes) for the cerebral response induced by three visual stimulations: Mixed (Low95%), which co-activate P and M systems (top line); the preferential M system (Low10%, middle line); and the preferential P system (High95%, bottom line), of 12-month-old fullterms (left column) and preterm (right column). Source distributions at two specific time points, which correspond to time points associated with N1 and P1, are illustrated for each stimulation. (*) Differences on source localisation between fullterms and preterms are seen in response to the preferential M pathway (statistical tendency; p = 0.063). Radiological convention is here used left (L)  =  right (R) and R = L. Anterior (A); posterior (P).</p

Table_1_Impact of Early Childhood Malnutrition on Adult Brain Function: An Evoked-Related Potentials Study.DOCX

More than 200 million children under the age of 5 years are affected by malnutrition worldwide according to the World Health Organization. The Barbados Nutrition Study (BNS) is a 55-year longitudinal study on a Barbadian cohort with histories of moderate to severe protein-energy malnutrition (PEM) limited to the first year of life and a healthy comparison group. Using quantitative electroencephalography (EEG), differences in brain function during childhood (lower alpha1 activity and higher theta, alpha2 and beta activity) have previously been highlighted between participants who suffered from early PEM and controls. In order to determine whether similar differences persisted into adulthood, our current study used recordings obtained during a Go-No-Go task in a subsample of the original BNS cohort [population size (N) = 53] at ages 45–51 years. We found that previously malnourished adults [sample size (n) = 24] had a higher rate of omission errors on the task relative to controls (n = 29). Evoked-Related Potentials (ERP) were significantly different in participants with histories of early PEM, who presented with lower N2 amplitudes. These findings are typically associated with impaired conflict monitoring and/or attention deficits and may therefore be linked to the attentional and executive function deficits that have been previously reported in this cohort in childhood and again in middle adulthood.</p

Feasibility, acceptability, and clinical effectiveness of a technology-enabled cardiac rehabilitation platform (Physical Activity Toward Health-I): randomized controlled trial

BACKGROUND: Cardiac rehabilitation (CR) is highly effective as secondary prevention for cardiovascular diseases (CVDs). Uptake of CR remains suboptimal (30% of eligible patients), and long-term adherence to a physically active lifestyle is even lower. Innovative strategies are needed to counteract this phenomenon. OBJECTIVE: The Physical Activity Toward Health (PATHway) system was developed to provide a comprehensive, remotely monitored, home-based CR program for CVD patients. The PATHway-I study aimed to investigate its feasibility and clinical efficacy during phase III CR. METHODS: Participants were randomized on a 1:1 basis to the PATHway (PW) intervention group or usual care (UC) control group in a single-blind, multicenter, randomized controlled pilot trial. Outcomes were assessed at completion of phase II CR and 6-month follow-up. The primary outcome was physical activity (PA; Actigraph GT9X link). Secondary outcomes included measures of physical fitness, modifiable cardiovascular risk factors, endothelial function, intima-media thickness of the common carotid artery, and quality of life. System usability and patients' experiences were evaluated only in PW. A mixed-model analysis of variance with Bonferroni adjustment was used to analyze between-group effects over time. Missing values were handled by means of an intention-to-treat analysis. Statistical significance was set at a 2-sided alpha level of .05. Data are reported as mean (SD). RESULTS: A convenience sample of 120 CVD patients (mean 61.4 years, SD 13.5 years; 22 women) was included. The PATHway system was deployed in the homes of 60 participants. System use decreased over time and system usability was average with a score of 65.7 (SD 19.7; range 5-100). Moderate-to-vigorous intensity PA increased in PW (PW: 127 [SD 58] min to 141 [SD 69] min, UC: 146 [SD 66] min to 143 [SD 71] min; Pinteraction=.04; effect size of 0.42), while diastolic blood pressure (PW: 79 [SD 11] mmHg to 79 [SD 10] mmHg, UC: 78 [SD 9] mmHg to 83 [SD 10] mmHg; Pinteraction=.004; effect size of -0.49) and cardiovascular risk score (PW: 15.9% [SD 10.4%] to 15.5% [SD 10.5%], UC: 14.5 [SD 9.7%] to 15.7% [SD 10.9%]; Pinteraction=.004; effect size of -0.36) remained constant, but deteriorated in UC. CONCLUSIONS: This pilot study demonstrated the feasibility and acceptability of a technology-enabled, remotely monitored, home-based CR program. Although clinical effectiveness was demonstrated, several challenges were identified that could influence the adoption of PATHway. TRIAL REGISTRATION: ClinicalTrials.gov NCT02717806; https://clinicaltrials.gov/ct2/show/NCT02717806. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2017-016781

A qualitative exploration of cardiovascular disease patients’ views and experiences with an eHealth cardiac rehabilitation intervention: The PATHway project

The aim of this study is to explore participants’ views and experiences of an eHealth phase 3 cardiac rehabilitation (CR) intervention: Physical Activity Towards Health (PATHway). Sixty participants took part in the PATHway intervention. Debriefs were conducted after the six-month intervention. All interviews were audio recorded and transcribed verbatim. Transcripts were analysed with Braun and Clarke’s thematic analysis. Forty-four (71%) debriefs were conducted (n = 34 male, mean (SD) age 61 (10) years). Five key themes were identified: (1) Feedback on the components of the PATHway system, (2) Motivation, (3) Barriers to using PATHway, (4) Enablers to using PATHway, and (5) Post programme reflection. There were a number of subthemes within each theme, for example motivation explores participants motivation to take part in PATHway and participants motivation to sustain engagement with PATHway throughout the intervention period. Participant engagement with the components of the PATHway system was variable. Future research should focus on optimising participant familiarisation with eHealth systems and employ an iterative approach to development and evaluation