Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development

Introduction Neurodevelopmental delay is more common in children born with congenital heart defects (CHD), even with optimal perinatal and peri-operative care. It is hypothesized that fetuses with CHD are prone to neurological impairment in utero due to their cardiac defect, possibly leading to delayed cortical development. Methods Cerebral cortical maturation was assessed with advanced neurosonographic examinations every 4 weeks in fetuses with CHD and compared to control fetuses. Five different primary fissures and four areas were scored (ranging 0-5) by blinded examiners using a cortical maturation scheme. Results Cortical staging was assessed in 574 ultrasound examinations in 85 CHD fetuses and 61 controls. Small differences in grading were seen in Sylvian and cingulate fissures. (Sylvian fissure: -0.12 grade, 95% CI (-0.23; -0.01) p = 0.05, cingulate fissure: -0.24 grade, 95% CI (-0.38; -0.10) p = <0.001. Other cortical areas showed normal maturation as compared to control fetuses. Conclusion Small differences were seen in three of the nine analyzed cortical areas in CHD fetuses, in contrast to previous reports on progressive third-trimester delay. The clinical implications of the small differences however, remain unknown.Research into fetal development and medicin

Early detection of isolated severe congenital heart defects is associated with a lower threshold to terminate the pregnancy

Introduction: Early detection of isolated severe congenital heart defects (CHDs) allows extra time for chromosomal analysis and informed decision making, resulting in improved perinatal management and patient satisfaction. Therefore, the aim of this study was to assess the value of an additional first-trimester screening scan compared to only a second-trimester scan in fetuses diagnosed with isolated severe CHDs. Prenatal detection rate, time of prenatal diagnosis, and pregnancy outcome were evaluated in the Netherlands after implementation of a national screening program.Materials and methods: We performed a retrospective geographical cohort study and included 264 pre- and postnatally diagnosed isolated severe CHD cases between January 1, 2007, and December 31, 2015, in the Amsterdam region. Severe CHD was defined as potentially life threatening if intervention within the first year of life was required. Two groups were defined: those with a first- and second-trimester anomaly scan (group 1) and those with a second-trimester anomaly scan only (group 2). A first-trimester scan was defined as a scan between 11 + 0 and 13 + 6 weeks of gestation.Results: Overall, the prenatal detection rate for isolated severe CHDs was 65%; 63% were detected before 24 weeks of gestation (97% of all prenatally detected CHDs). Prenatal detection rate was 70.2% in the group with a first- and second-trimester scan (group 1) and 58% in the group with a second-trimester scan only (group 2) (p Conclusion: Prenatal detection rate of isolated severe CHDs and termination of pregnancy rate was higher in the group with both a first- and second-trimester scan. We found no differences between timing of terminations. The additional time after diagnosis allows for additional genetic testing and optimal counseling of expectant parents regarding prognosis and perinatal management, so that well-informed decisions can be made.</p

Designing Engaging Interactions with Digital Products

This thesis aims to investigate how the experience of engagement in interaction can be explained by examining the experiences of richness and control and how these experiences are influenced by the features of a product, the expertise of a person and the type of task. This research is carried out within the domain of digital products. From the results of these investigations a conceptual framework will be created that is intended to assist interaction designers in the creation of engaging interactions and may also be used to guide the development of user-models for product intelligence.Mechanical Maritime and Materials Engineerin

Exploring sociality and engagement in play through game-control distribution

This study explores how distributing the controls of a video game among multiple players affects the sociality and engagement experienced in game play. A video game was developed in which the distribution of game controls among the players could be varied, thereby affecting the abilities of the individual players to control the game. An experiment was set up in which eight groups of three players were asked to play the video game while the distribution of the game controls was increased in three steps. After each playing session, the players' experiences of sociality and engagement were assessed using questionnaires. The results showed that distributing game control among the players increased the level of experienced sociality and reduced the level of experienced control. The game in which the controls were partly distributed led to the highest levels of experienced engagement, because the game allowed social play while still giving the players a sense of autonomy. The implications for interaction design are discussed. © 2009 The Author(s)

Pleasantness in bodily experience: A phenomenological inquiry

This study investigated the varieties of pleasantness in bodily experience in order to advance the aesthetics of interaction paradigm. Interviews were held with twelve people varying in age and occupation. They were asked to describe pleasant experiences for Sight, Audition, Smell, Taste, Touch, Action and Thought. A phenomenological reduction performed on the interview transcripts resulted in seven pleasantness themes: sociality, aesthetics, comfort, agency, associations, vitality and progression. These pleasantness themes involved multiple bodily faculties with a prominence of two or three specific ones, which allowed a preliminary mapping of the pleasantness themes in relation to the body. The results may advance the aesthetics of interaction paradigm by explicating the varieties in pleasant experience and how the body is involved in shaping them.Industrial Design Engineerin

Sharp growth rates for semigroups using resolvent bounds

We study growth rates for strongly continuous semigroups. We prove that a growth rate for the resolvent on imaginary lines implies a corresponding growth rate for the semigroup if either the underlying space is a Hilbert space, or the semigroup is asymptotically analytic, or if the semigroup is positive and the underlying space is an (Formula presented.)-space or a space of continuous functions. We also prove variations of the main results on fractional domains; these are valid on more general Banach spaces. In the second part of the article, we apply our main theorem to prove optimality in a classical example by Renardy of a perturbed wave equation which exhibits unusual spectral behavior.Analysi