An Examination of Fine Motor Control In Children with ADHD

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity impulsivity, or both. Although fine motor difficulties are frequently found in children diagnosed with ADHD, often they are not identified and are undertreated. The present study examined fine motor control in children with ADHD in several ways, including through the use of digitizing technology, and compared it to that of control children. Thirty-eight children with ADHD and 28 control children in grades four through eight were administered a measure of handwriting (Test of Handwriting Skills - Revised; THS-R), a pattern completion task (Repeated Patterns Test; RPT), and a measure of fine motor skills (Bruininks Oseretsky Test of Motor Proficiency - Second Edition; BOT-2) on a digitizing tablet. Groups were compared on peak vertical velocity, variability of peak vertical velocity, normalized jerk, and mean stylus pressure. Results of the present study indicated that better quality of writing was associated with slower writing speed in children with ADHD, whereas in control children better quality writing was associated with greater stylus pressure, slower writing speed, and less variability in writing speed. No group differences were found on either a measure of fluency or stylus pressure when examining children\u27s writing between different levels of constraint. Both groups demonstrated the most fluent writing between 2 cm spaced lines, which appear to represent a level that facilitates the maximal amount of writing fluency in children in grades four through eight. Lastly, results indicated that there were no stylus pressure differences between groups for either novel or motorically complex material

Mapping MOS-HIV to HUI3 and EQ-5D-3L in Patients With HIV

Objectives: The Medical Outcomes Study HIV Health Survey (MOS-HIV) is frequently used in HIV clinical trials; however, scores generated from the MOS-HIV are not suited for cost-effectiveness analyses as they do not assign utility values to health states. Our objective was to estimate and externally validate several mapping algorithms to predict Health Utilities Index Mark 3 (HUI3) and EQ-5D-3L utility values from the MOS-HIV. Methods: We developed and validated mapping algorithms using data from two HIV clinical trials. Data from the first trial (n = 367) formed the estimation data set for the HUI3 (4,610 observations) and EQ-5D-3L (4,662 observations) mapping algorithms; data from the second trial (n = 168) formed the HUI3 (1,135 observations) and EQ-5D-3L (1,152 observations) external validation data set. We compared ordinary least squares (OLS) models of increasing complexity with the more flexible two-part, beta regression, and finite mixture models. We assessed model performance using mean absolute error (MAE) and mean squared error (MSE). Results: The OLS model that used MOS-HIV dimension scores along with squared terms gave the best HUI3 predictions (mean observed 0.84; mean predicted 0.80; MAE 0.0961); the finite mixture model gave the best EQ-5D-3L predictions (mean observed 0.90; mean predicted 0.88; MAE 0.0567). All models produced higher prediction errors at the lower end of the HUI3 and EQ-5D-3L score ranges

Multiple Sclerosis risk variants regulate gene expression in innate and adaptive immune cells

At least 200 single-nucleotide polymorphisms (SNPs) are associated with multiple sclerosis (MS) risk. A key function that could mediate SNP-encoded MS risk is their regulatory effects on gene expression. We performed microarrays using RNA extracted from purified immune cell types from 73 untreated MS cases and 97 healthy controls and then performed Cis expression quantitative trait loci mapping studies using additive linear models. We describe MS risk expression quantitative trait loci associations for 129 distinct genes. By extending these models to include an interaction term between genotype and phenotype, we identify MS risk SNPs with opposing effects on gene expression in cases compared with controls, namely, rs2256814 MYT1 in CD4 cells (q = 0.05) and rs12087340 RF00136 in monocyte cells (q = 0.04). The rs703842 SNP was also associated with a differential effect size on the expression of the METTL21B gene in CD8 cells of MS cases relative to controls (q = 0.03). Our study provides a detailed map of MS risk loci that function by regulating gene expression in cell types relevant to MS

Case-control study of sudden infant death syndrome in Lithuania, 1997–2000

BACKGROUND: To identify risk factors for sudden infant death syndrome relevant in Lithuania. METHODS: A nationwide case-control study surveying parents of 35 infants who died from sudden infant death syndrome during the period of 1997–2000 and parents of 145 control infants matched with SIDS infants for date of birth and for region of birth was carried out. RESULTS: Deaths incidence was greater in the warm period (60%) vs. cold period (40%). Prone and side sleeping positions both carried no increased risk of sudden infant death syndrome compared with supine because of a rare prone sleeping (4.1% of controls vs. 0% of dead infants) and more prevalent side than supine sleeping (84.8% of controls vs. 94.3% of dead infants) in the controls as well as the cases. Bed sharing for the whole night as a risk factor for sudden infant death syndrome has not been confirmed, either, as bed sharing was common only for the controls (13.8% of controls vs. 0% of dead infants). Routine sleeping environment factors such as heavy wrapping (≥4 togs) of an infant (odds ratio 8.49; 95% confidence interval 2.38 to 30.32), sleeping in a bassinet (4.22; 1.16 to 15.38) and maternal factors such as maternal education ≤12 years (4.48; 1.34 to 14.94), unplanned pregnancy (5.22; 1.49 to 18.18) and ≥2 previous live births (3.90; 1.00 to 15.10) were significantly associated with sudden infant death syndrome on multivariate analysis. CONCLUSION: The results of this first population-based case-control study have shed some light on the epidemiology of the syndrome in Lithuania. Although the mortality of sudden infant death syndrome in Lithuania is not high, it might be lowered moreover by public informing about sudden infant death syndrome and related risk factors. Special attention must be paid to mothers with low education on potentially modifiable risk factors such as routine heavy wrapping of an infant during sleep, routine sleeping in a bassinet and unplanned pregnancy

Country, Sex, EDSS Change and Therapy Choice Independently Predict Treatment Discontinuation in Multiple Sclerosis and Clinically Isolated Syndrome

We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS). The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation. A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p = 0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p = 0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p<0.001), and intramuscular interferon-β-1a (HR 1.38, p = 0.028) and subcutaneous interferon-β-1a (HR 1.45, p = 0.012) had higher rates of discontinuation than glatiramer acetate, although this varied widely in different countries. Onset cerebral MRI features, age, time to treatment initiation or relapse on treatment were not associated with IMD cessation. In this multivariable survival analysis, female sex, country of residence, EDSS change and IMD choice independently predicted time to first IMD cessation

Myocardial infarction risk and occupational categories in Kaunas 25-64 year old men

AIMS: To investigate the risk of a first time myocardial infarction (MI) among different occupational categories in 25-64 year old men in Kaunas, Lithuania, a country in a transition market economy. METHODS: Case-control study among men aged 25-64 who were residents in Kaunas between 1997 and 2000. First time, non-fatal MI cases (n = 448) were identified from the MI hospital register (International Classification of Diseases, 10th revision, code I21). Controls (n = 1777) were selected and matched on age, gender, and city district of residence. Information was obtained on occupation, smoking, hypertension, psychosocial, and behavioural factors. The International Standard Classification of Occupations (ISCO) was used to code for occupational categories. The relation between MI and occupational categories was evaluated by logistic regression analysis, adjusting for a number of selected risk factors. RESULTS: Legislators, senior officials, and managers (1st ISCO category) had a twofold increased risk for MI compared to craft and related trades workers (7th ISCO category) after adjustment for age, district, smoking, hypertension, obesity, stress, education, and employment duration. An increased risk for professionals (2nd ISCO category) and plant and machine operators and assemblers (8th ISCO category) was also observed. Employment duration in the last occupation for 20 years and more almost doubled the risk of MI in the whole population. We also found an increased risk for other traditional IHD risk factors such as smoking and arterial hypertension. CONCLUSIONS: Differences in first time MI risk among occupational categories were found. Legislators, senior officials, and managers (1st ISCO category), professionals (2nd ISCO category), and plant and machine operators and assemblers (8th ISCO category) were at an increased risk. Differences in psychosocial factors in transition market economy countries may contribute to observed resultsAplinkotyros katedraKauno medicinos universitetasKauno medicinos universiteto Kardiologijos institutas, [email protected] Didžiojo universiteta