Cognitive and socioeconomic predictors of Stroop performance in children and developmental patterns according to socioeconomic status and ADHD subtype

Objectives: We conducted three empirical studies with the aim at (a) examining the cognitive predictors (i.e., working memory, inhibition, cognitive flexibility, reading, and intelligence) of each Stroop Color and Word Test (SCWT) condition (i.e., Word, Color, and Color–Word) and the convergent and divergent validity among measures, (b) examining the socioeconomic predictors of SCWT performance, further establishing normative values according to socioeconomic status (SES) and age, and (c) analyzing the distinctive patterns of performance according to SES and Attention Deficit and Hyperactivity Disorder (ADHD) subtype. Methods: A large sample of typically developing (TD) children from Middle- (n = 779) and Low- (n = 129) SES and ADHD children (n = 44), inattentive versus combined subtype, was evaluated. Multivariate analysis of variances (MANOVAs), Pearson’s correlations, and hierarchical and stepwise regressions analyses were performed. Results: Study 1 results indicated that SCWT conditions are selectively associated with reading speed and executive functions (EFs), and that the former would not depend on child’s IQ. Study 2 findings revealed distinct patterns of SCWTperformance according to SES andselective associations between socioeconomic indicators and SCWT conditions, being maternal education and housing conditions the main predictors. Finally, Study 3 results revealed distinctive patterns of SCWT performance according to ADHD subtype, with no differences on the interference measure amonggroups. Conclusions: Our findings support the validity of the SCWT as a measure of inhibition in TD children. However, when the pattern of SCWT performance is different from the typical expected one (i.e., Word score higher than Color score and this, in turn, higher than Color–Word score), the interference measure should be interpreted with caution but without disregarding the relevant and distinctive information provided by each SCWT condition.Fil: Arán Filippetti, Vanessa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; Argentina. Universidad Adventista del Plata. Secretaría de Ciencia y Técnica. Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento; Argentina. Universidad Pedagógica Nacional. Departamento de Educación y Ciencias Sociales; ArgentinaFil: Richaud, Maria Cristina. Universidad Adventista del Plata. Secretaría de Ciencia y Técnica. Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; ArgentinaFil: Krumm, Gabriela Liliana. Universidad Adventista del Plata. Secretaría de Ciencia y Técnica. Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; ArgentinaFil: Raimondi, Waldina. Universidad Adventista del Plata. Facultad de Humanidades, Educacion y Ciencias Sociales; Argentin

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

Executive Functions and its Correlates with Crystallized and Fluid Intelligence: A Study in Children and Adolescents

El presente estudio examina la relación entre las habilidades intelectuales (i.e., Gc = inteligencia cristalizada y Gf = inteligencia fluida) y las funciones ejecutivas (FE) (i.e., memoria de trabajo, inhibición, flexibilidad cognitiva, planificación y fluidez verbal y no verbal) en una muestra de 214 niños y adolescentes divididos en dos grupos según la edad: (a) 7 a 10 años y (b) 11 a 15 años. Asimismo, se analizan las diferencias de rendimiento en tareas ejecutivas según el nivel de Inteligencia General (IG) (i.e., MB: medio bajo, M: medio y MA: medio alto). En la muestra de niños, los resultados revelaron bajas correlaciones en el rango de .22 a .39, entre las habilidades intelectuales y algunas FE. En cambio, en la muestra de adolescentes, se hallaron bajas y moderadas correlaciones entre las habilidades intelectuales con todas las FE analizadas. Además, los resultados del MANOVA revelaron diferencias significativas según el nivel de IG de los adolescentes, en la mayoría de las FE analizadas. Los resultados apoyan la hipótesis que sostiene que tanto Gf como Gc se asocian a los diferentes componentes del constructo de FE, aunque selectivamente y con diferencias según la etapa del desarrollo evolutivo.O presente estudo examina a relação entre as habilidades intelectuais (i.e., Gc= inteligência cristalizada e Gf= inteligência fluída) e as funções executivas (FE) (i.e., memória de trabalho, inibição, flexibilidade cognitiva, planejamento e fluência verbal e não verbal). Com uma amostra de 214 crianças e adolescentes divididos em dois grupos etários: (a) 7 a 10 anos e (b) 11 a 15 anos. Também, foram analisadas as diferenças de rendimento entre as tarefas executivas segundo o nível de inteligência geral (IG) (i.e., MI= médio inferior, M= médio e MS= médio superior). Na amostra de crianças os resultados demonstraram baixas correlações entre as habilidades intelectuais e alguns componentes cognitivos. Já na amostra de adolescentes, foram encontrados correlações baixas e moderadas entre as habilidades intelectuais com todas as FE analisadas. Os resultados da MANOVA revelaram diferenças significativas segundo o nível de IG dos adolescentes, na maioria dos componentes FE analisados. Os resultados apoiam as hipóteses que sustentam que tanto a Gf como a Gc se associam a diferentes componentes do construto de FE, ainda que de forma seletiva e com diferenças dependendo do estágio do desenvolvimento.Cette étude examine la relation entre les compétences intellectuelles (Gc = intelligence cristallisée et Gf = intelligence fluide) et des fonctions exécutives (FE) (la mémoire, l'inhibition, la flexibilité cognitive, la planification et la fluidité verbale et non-verbale de travail) dans un échantillon de 214 enfants et adolescents répartis en deux groupes en fonction de l'âge: (a) de 7 à 10 ans, et (b) 11 à 15 ans. En outre, les différences de performance dans les fonctions exécutives sont analysés en fonction du niveau d'intelligence générale (IG) (MB: moyen à faible, M: moyen et MA: moyenne haute). Dans l'échantillon des enfants, les résultats ont révélé de faibles corrélations, à la gamme de 22-39, y compris les capacités intellectuelles et certains FE. En revanche, dans l'échantillon d'adolescents, faible à modérée des corrélations entre les capacités intellectuelles avec tous les FE analysé été trouvé. En outre, les résultats de MANOVA révélé des différences significatives selon le niveau d'adolescents de GI, la plupart des analyses FE. Les résultats soutiennent l'hypothèse que les deux Gf et Gc pour construire différents composants associés FE, bien que de manière sélective et différemment selon le stade de développement évolutif.The present study examines the relationship between intellectual abilities (i.e., Gc = crystallized intelligence and Gf = fluid intelligence) and Executive Functions (EF) (i.e., working memory, inhibition, cognitive flexibility, planning, and verbal and nonverbal fluency) in a sample of 214 children and adolescents divided into two groups according to age: (a) 7 to 10 years old and (b) 11 to 15 years old. In addition, the differences in EF task performance according to the level of General Intelligence (GI) (i.e., MB: medium low, M: medium, MA: medium high) are analyzed. In the children's sample, the results revealed low correlations in the range from .22 to .39, between intellectual skills and some EF. However, in the sample of adolescents, low to moderate correlations between intellectual abilities and all the EF analyzed were found. Likewise, MANOVA results revealed significant differences according to the GI's level of the adolescents, in most of the EF analyzed. The results support the hypothesis that sustains that both, Gf and Gc, are associated with the different components of the EF construct, although this association would be selective and with differences according to the stage of the evolutionary development.Fil: Arán Filippetti, Vanessa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones En Psicología Matemática y Experimental; ArgentinaFil: Krumm, Gabriela Liliana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones En Psicología Matemática y Experimental; ArgentinaFil: Raimondi, Waldina. Universidad Adventista del Plata. Facultad de Humanidades, Educacion y Ciencias Sociales; Argentin

Computerized versus manual versions of the Wisconsin Card Sorting Test: implications with typically developing and ADHD children

The aims of Study 1 (S1) were (a) to compare the task performance of 361 typically developing (TD) children aged 7 to 12 years, according to the mode of Wisconsin Card Sorting Test (WCST) administration (manual vs. computerized) and b) to examine the contributions of executive functions (EFs) (i.e., working memory [WM], shifting and inhibition) to each WCST version. The objectives of Study 2 (S2) were (a) to study the comparability of the results obtained from the manual version to the results from the computer version in 43 children with Attention Deficit/Hyperactivity Disorder (ADHD) and (b) to compare task performance on both versions between children with ADHD and TD children. The effect of age was only significant for the manual WCST. Regression analyses revealed that WM and shifting contributed to manual WCST performance, whereas WM and inhibition contributed to the performance on the computer version. We observed differences depending on the WCST mode of administration, as better scores for the manual version were recorded for both TD children and children with ADHD, despite similar performance on tasks involving other EFs. Additionally, children with ADHD performed worse than TD children on both versions. Our findings suggest that verbal face-to-face interactions would play a significant role in supporting children's abilities to solve novel situations characterized by uncertainty.Fil: Arán Filippetti, Vanessa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; ArgentinaFil: Krumm, Gabriela Liliana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; ArgentinaFil: Raimondi, Waldina. Universidad Adventista del Plata. Facultad de Humanidades, Educacion y Ciencias Sociales; Argentin

Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013