Biomechanics of foetal movement.

© 2015, AO Research Institute. All rights reserved.Foetal movements commence at seven weeks of gestation, with the foetal movement repertoire including twitches, whole body movements, stretches, isolated limb movements, breathing movements, head and neck movements, jaw movements (including yawning, sucking and swallowing) and hiccups by ten weeks of gestational age. There are two key biomechanical aspects to gross foetal movements; the first being that the foetus moves in a dynamically changing constrained physical environment in which the freedom to move becomes increasingly restricted with increasing foetal size and decreasing amniotic fluid. Therefore, the mechanical environment experienced by the foetus affects its ability to move freely. Secondly, the mechanical forces induced by foetal movements are crucial for normal skeletal development, as evidenced by a number of conditions and syndromes for which reduced or abnormal foetal movements are implicated, such as developmental dysplasia of the hip, arthrogryposis and foetal akinesia deformation sequence. This review examines both the biomechanical effects of the physical environment on foetal movements through discussion of intrauterine factors, such as space, foetal positioning and volume of amniotic fluid, and the biomechanical role of gross foetal movements in human skeletal development through investigation of the effects of abnormal movement on the bones and joints. This review also highlights computational simulations of foetal movements that attempt to determine the mechanical forces acting on the foetus as it moves. Finally, avenues for future research into foetal movement biomechanics are highlighted, which have potential impact for a diverse range of fields including foetal medicine, musculoskeletal disorders and tissue engineering

Caring for at-risk infants : the experiences of parents with infants on home apnoea monitors : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing Studies at Massey University

Home apnoea monitoring for infants considered to be at risk for sudden infant death syndrome (SIDS) has been available in New Zealand since 1978. In light of the fact that the efficacy of home monitoring is unproven (Krongrad and O'Neill. 1986; Phipps and Drotar, 1990) an understanding of the impact of monitoring on families is essential. In the present study, descriptive case studies (as described by Yin, 1984) are presented of six New Zealand families undertaking the home apnoea monitoring of their infants. Indepth interviews, conducted over a three month period, prospectively explored the experiences of one or more caregivers. Analysis of the data confirmed many of the reported findings from previous (mainly American) studies. In particular, parents perceived their infants to be "at risk" whilst monitored, and tended to become socially isolated because of their reluctance to leave their infants with other caregivers. The false alarms were a serious problem, causing negative arousal in the parents. When the alarms sounded parents found it very difficult to determine whether or not the infant was, or had been apnoeic. The monitor itself became the best indicator of the child's risk status and parents sometimes relied on the monitor to the detriment of other treatment regimes and of surveillance of the infant's condition for problems other than the risk of apnoea. The present study used a systemic family nursing perspective to frame the participants' experiences. It was thus considered essential to take into account the family context in which monitoring was undertaken. Parents in the present study who, for example, had previously lost infants to SIDS, spoke of the ongoing grieving processes underpinning their monitoring experiences of subsequent infants. When the youngest child was no longer monitored, the focus of attention shifted from the risk status of the infant to the prospect of a normal childhood. Parents increasingly made their own decisions about how and when to use the monitor, based on their perceptions of their own ability to cope without it, rather than on the medical indications for its use or discontinuance. Mothers, especially, expressed strong needs for support from knowledgeable health professionals who could provide an integrated, holistic approach to the care of their infants, for monitoring supervision and for general parenting advice and support. The concept of a community-based nurse case manager is suggested as an appropriate means to meet their needs for a co-ordinated professional support service

Preterm Infants' Pose Estimation with Spatio-Temporal Features

Objective: Preterm infants' limb monitoring in neonatal intensive care units (NICUs) is of primary importance for assessing infants' health status and motor/cognitive development. Herein, we propose a new approach to preterm infants' limb pose estimation that features spatio-temporal information to detect and track limb joints from depth videos with high reliability. Methods: Limb-pose estimation is performed using a deep-learning framework consisting of a detection and a regression convolutional neural network (CNN) for rough and precise joint localization, respectively. The CNNs are implemented to encode connectivity in the temporal direction through 3D convolution. Assessment of the proposed framework is performed through a comprehensive study with sixteen depth videos acquired in the actual clinical practice from sixteen preterm infants (the babyPose dataset). Results: When applied to pose estimation, the median root mean square distance, computed among all limbs, between the estimated and the ground-truth pose was 9.06 pixels, overcoming approaches based on spatial features only (11.27 pixels). Conclusion: Results showed that the spatio-temporal features had a significant influence on the pose-estimation performance, especially in challenging cases (e.g., homogeneous image intensity). Significance: This article significantly enhances the state of art in automatic assessment of preterm infants' health status by introducing the use of spatio-temporal features for limb detection and tracking, and by being the first study to use depth videos acquired in the actual clinical practice for limb-pose estimation. The babyPose dataset has been released as the first annotated dataset for infants' pose estimation

Neuroplasticity in Young Age: Computer-Based Early Neurodevelopment Classifier

Neurodevelopmental syndromes, a continuously growing issue, are impairments in the growth and development of the brain and CNS which are pronounced in a variety of emotional, cognitive, motor and social skills. Early assessment and detection of typical, clinically correlated early signs of developmental abnormalities is crucial for early and effective intervention, supporting initiation of early treatment and minimizing neurological and functional deficits. Successful early interventions would then direct to early time windows of higher neural plasticity. Various syndromes are reflected in early vocal and motor characteristics, making them suitable indicators of an infant’s neural development. Performance of the computerized classifiers we developed shows approximately 90% accuracy on a database of diagnosed babies. The results demonstrate the potential of vocal and motor analysis for computer-assisted early detection of neurodevelopmental insults

Spatiotemporal neurodynamics of automatic temporal expectancy in 9-month old infants

open2noAnticipating events occurrence (Temporal Expectancy) is a crucial capacity for survival. Yet, there is little evidence about the presence of cortical anticipatory activity from infancy. In this study we recorded the High-density electrophysiological activity in 9 month-old infants and adults undergoing an audio-visual S1-S2 paradigm simulating a lifelike "Peekaboo" game inducing automatic temporal expectancy of smiling faces. The results indicate in the S2-preceding Contingent Negative Variation (CNV) an early electrophysiological signature of expectancy-based anticipatory cortical activity. Moreover, the progressive CNV amplitude increasing across the task suggested that implicit temporal rule learning is at the basis of expectancy building-up over time. Cortical source reconstruction suggested a common CNV generator between adults and infants in the right prefrontal cortex. The decrease in the activity of this area across the task (time-on-task effect) further implied an early, core role of this region in implicit temporal rule learning. By contrast, a time-on-task activity boost was found in the supplementary motor area (SMA) in adults and in the temporoparietal regions in infants. Altogether, our findings suggest that the capacity of the human brain to translate temporal predictions into anticipatory neural activity emerges ontogenetically early, although the underlying spatiotemporal cortical dynamics change across development. © 2016 The Author(s).openMento, Giovanni; Valenza, EloisaMento, Giovanni; Valenza, Elois