Early motor trajectories predict motor but not cognitive function in preterm- and term-born adults without pre-existing neurological conditions

Very preterm (VP; 0.05). Motor problems in childhood were homotypically associated with poorer motor competence in adulthood. Similarly, early cognitive problems were homotypically associated with adult cognitive outcomes. Thus, both motor and cognitive function should be assessed in routine follow-up during childhood

Effect of Accessibility Information on Restaurant Selection of Consumers with Disabilities

OBJECTIVE: The study addressed the research question, How does accessibility information about restaurants affect the diversity of restaurant choices for people with disabilities compared to others who only have general review information about restaurants? The literature describes that people with disabilities experience limited participation in community activities. One community activity is dining out at restaurants. It is hypothesized that the availability of accessibility information will diversify restaurant choices, as it would minimize the risk of encountering unforeseen barriers that enable them to prepare for ones that they anticipate. METHOD: Participants (N-14), half with disabilities and half without disabilities, selected dining experiences at 5 restaurants. They chose restaurants from a unique list of 10 restaurants composed of 5 restaurants they had visited and 5 restaurants they had not. Participants were assigned to either a group that received restaurant accessibility information through the Access Ratings for Buildings (AR-B) website (intervention) or a group that received general review information about the restaurants through Yelp.com (control). They were asked to review their respective website information as they chose 5 restaurants for dining. The number of restaurants that participants chose were compared among the 4 groups to address 3 hypotheses. Questionnaires completed by the participants provided qualitative data and informed the researchers about the participants\u27 decision making process as they were selecting restaurants. RESULTS: One of the 3 apriori hypotheses was statistically supported. On the other hand, qualitative data consistently supported the theoretical underpinnings of the study. Hypothesis 1 posed that people with a disability using the AR-B website would select more new restaurants than participants with a disability that used Yelp. The results did not reveal a significant difference. Hypothesis 2 posed that participants without a disability who used AR-B would chose a similar number of new restaurants as those without a disability who used AR-B. This was supported. Hypothesis 3 stated that participants with a disability who used Yelp would select fewer new restaurants than participants without a disability who used Yelp. This was not statistically supported. To the contrary, the overall visual analysis of the data showed consistent trends supporting the underlying theoretical constructs that AR-B information affected the restaurant choice. Additionally, qualitative analysis of questionnaire data showed that accessibility is a highly valued feature for restaurants and that the accessibility information provided through the AR-B app was beneficial to people both with and without a disability. CONCLUSION: While this small study did not find statistical significance on the effects of using the AR-B website information during dining selection, it corroborated that restaurant accessibility is a commonly valued feature for restaurant patrons and that people with disabilities find benefit from accessibility information about public buildings. People also seem to select more new restaurants when they read web-based restaurant reviews of any type during their decision-making

The Effects of Music Therapy on Stuttering

Across time and culture, music has been used to augment and treat a variety of psychological and physical diseases. The current study therefore aims to identify the effects of music on stuttering. For this study, one individual was selected to participate for a total of five weeks. The procedure included documenting the participant’s percentages of syllables stuttered in monologues and structured reading passages as well as completing pre and post mindfulness assessments during the course of the study. Results indicate that music positively affects percentages of syllables stuttered in reading passages, the types of disfluencies and overall mindfulness levels of the individual

Acute portal venous thrombosis caused by severe sepsis and not associated with liver disease

Background: Portal venous thrombosis (PVT) can be generally classified into three categories- acute non cirrhotic PVT, chronic PVT (also called extrahepatic portal venous occlusion), and PVT in cirrhosis. PVT is usually seen in those with liver disease and it is rare in patients without. Management is usually with anticoagulation and finding and treating the etiology of the PVT. If untreated, patients can develop portal hypertension. This patient presented a unique diagnostic challenge as she had risk factors for numerous etiologies of PVT. Case description: A 64 year old female with a history of hypertension, hyperlipidemia, and a lung nodule presented to the emergency department with fatigue, fever, nausea, and vomiting. She sought medical care upon returning home from a cruise in Mexico. She was febrile and tachycardic and, though she did not have any abdominal tenderness, stated that a few days prior she did have right upper quadrant abdominal pain. CT scan with IV contrast was ordered and showed a masslike area in the anterior left hepatic lobe, acute left PVT, and enlarged porta hepatis lymph nodes. Subsequently, an MRCP was ordered as there was concern for malignancy given the CT findings which redemonstrated the left portal venous thrombosis and the mass described on the CT was further determined to be hepatic periportal edema. Shortly after presentation she was started on broad spectrum antibiotics given concern for sepsis as well as anticoagulation for the PVT. Blood cultures grew streptococcus intermedius, strepconstellatus, and eikenella corrodens. Given a dental procedure two months prior, a TEE was performed which did not show vegetation and endocarditis was ruled out. Given a family history of colon cancer she had a colonoscopy which showed diverticulosis with friable mucosa. That was ultimately thought to the be etiology of her bacteremia. Discussion: This case was interesting in that the patient had risk factors for multiple etiologies of her sepsis and PVT. She had recent dental work, recent travel on the cruise, a history of a lung nodule, family history of colon cancer, initial CT scan with concern for liver mass and possible metastatic disease. She had a thorough work up that ultimately led to the thought that her bacteremia was due to diverticular disease and her sepsis was likely the etiology of her PVT. She was placed on antibiotics for 4 weeks outpatient as well as started on oral anticoagulation with a plan for repeat imaging of the PVT at the three month mark to determine length of anticoagulation.https://scholarlycommons.henryford.com/merf2019caserpt/1095/thumbnail.jp

General cognitive but not mathematic abilities predict very preterm and healthy term born adults’ wealth

Objective Very preterm (<32 weeks gestation; VP) and/or very low birth weight (<1500g; VLBW) children often have cognitive and mathematic difficulties. It is unknown whether VP/VLBW children’s frequent mathematic problems significantly add to the burden of negative life-course consequences over and above effects of more general cognitive deficits. Our aim was to determine whether negative consequences of VP/VLBW versus healthy term birth on adult wealth are mediated by mathematic abilities in childhood, or rather explained by more general cognitive abilities. Methods 193 VP/VLBW and 217 healthy term comparison participants were studied prospectively from birth to adulthood as part of a geographically defined study in Bavaria (South Germany). Mathematic and general cognitive abilities were assessed at 8 years with standardized tests; wealth information was assessed at 26 years with a structured interview and summarized into a comprehensive index score. All scores were z-standardized. Results At 8 years, VP/VLBW (n = 193, 52.3% male) had lower mathematic and general cognitive abilities than healthy term comparison children (n = 217, 47.0% male). At 26 years, VP/VLBW had accumulated significantly lower overall wealth than term born comparison adults (-0.57 (1.08) versus -0.01 (1.00), mean difference 0.56 [0.36–0.77], p < .001). Structural equation modeling confirmed that VP/VLBW birth (β = -.13, p = .022) and childhood IQ (β = .24, p < .001) both directly predicted adult wealth, but math did not (β = .05, p = .413). Analyses were controlled for small-for-gestational-age (SGA) birth, child sex, and family socioeconomic status. Conclusion This longitudinal study from birth to adulthood shows that VP/VLBW survivors’ general cognitive rather than specific mathematic problems explain their diminished life-course success. These findings are important in order to design effective interventions at school age that reduce the burden of prematurity for those individuals who were born at highest neonatal risk

Assessment of genomic instability in Chinese Hamster ovary (CHO) cells

CHO cells are the number one production system for therapeutic proteins due to their ease of handling, their fast growth in suspension culture and their capability to perform complex protein folding and human-like post-translational modifications. This flexibility is in part due to, but at the same time set off by the frequent occurrence of chromosomal rearrangements and other genomic variants, which influences individual cell line performance and the stability of industrial producer cell lines, resulting in prolonged screening phases in order to isolate cells with sufficiently stable properties. Furthermore producer cell properties are also frequently lost again over time and properties within clones derived of the same cell population may vary significantly. The present work focuses on methods for quantification of the rate of chromosomal rearrangements in a given cell line over time in culture. The methods tested include Amplified Fragment Length Polymorphism (AFLP), Chromosome Painting and Chromosome Counting. The principle of AFLP is a restriction enzyme digest of genomic DNA, followed by ligation of the fragments to adapters with a predefined sequence. DNA amplification of restriction fragments is performed using selective AFLP primers complementary to the annealed adapter sequence, but containing extra nucleotides. An initial pattern of bands of digested genomic DNA is defined which allows quantification of chromosomal changes over time using sophisticated statistical techniques. The second technique used is Chromosome Counting of metaphase spreads from a statistically significant number of cells (50-100) in a CHO cell population, with a focus on the spread of counts and ploidy and on how that changes over time. Finally, using chromosome painting, translocations within and across chromosomes and the variation in individual cells within a population can be observed in fine detail. A variety of CHO host cell lines, both pools and subclones were analyzed over a period of six-months in culture. With AFLP we could identify genomic rearrangements for each cell line over time revealing different rates of genomic changes in the analyzed cell lines as well as degrees of relationship between the cell lines and clones at the starting point. Chromosome Counting indicated that the chromosome number and its variation in a CHO cell population differs not only within a population over time, but also between different CHO cell lines. Furthermore the chromosome number of a CHO cell culture changes over time. The older a culture, the more variation and diversity within the population is observed, frequently with a clear tetraploid sub-population appearing after several months in culture. Chromosome painting reveals appearance of new chromosome variants over time, but typically not within the entire population. Overall we can conclude that CHO cells are highly rearranged and that the genomic stability over a production process cannot be guaranteed

General cognitive but not mathematic abilities predict very preterm and healthy term born adults’ wealth

Objective Very preterm (\u3c32 weeks gestation; VP) and/or very low birth weight (\u3c1500g; VLBW) children often have cognitive and mathematic difficulties. It is unknown whether VP/VLBW children’s frequent mathematic problems significantly add to the burden of negative life-course consequences over and above effects of more general cognitive deficits. Our aim was to determine whether negative consequences of VP/VLBW versus healthy term birth on adult wealth are mediated by mathematic abilities in childhood, or rather explained by more general cognitive abilities. Methods 193 VP/VLBW and 217 healthy term comparison participants were studied prospectively from birth to adulthood as part of a geographically defined study in Bavaria (South Germany). Mathematic and general cognitive abilities were assessed at 8 years with standardized tests; wealth information was assessed at 26 years with a structured interview and summarized into a comprehensive index score. All scores were z-standardized. Results At 8 years, VP/VLBW (n = 193, 52.3% male) had lower mathematic and general cognitive abilities than healthy term comparison children (n = 217, 47.0% male). At 26 years, VP/VLBW had accumulated significantly lower overall wealth than term born comparison adults (-0.57 (1.08) versus -0.01 (1.00), mean difference 0.56 [0.36–0.77], p \u3c .001). Structural equation modeling confirmed that VP/VLBW birth (β = -.13, p = .022) and childhood IQ (β = .24, p \u3c .001) both directly predicted adult wealth, but math did not (β = .05, p = .413). Analyses were controlled for small-for-gestational-age (SGA) birth, child sex, and family socioeconomic status. Conclusion This longitudinal study from birth to adulthood shows that VP/VLBW survivors’ general cognitive rather than specific mathematic problems explain their diminished life-course success. These findings are important in order to design effective interventions at school age that reduce the burden of prematurity for those individuals who were born at highest neonatal risk

Predictors of early motor trajectories from birth to 5 years in neonatal at-risk and control children

Aim To describe motor development in preschool children, to identify perinatal, neonatal and social environmental risk factors of poor motor development, and to replicate results in a second cohort. Methods Two prospective samples in Germany (Bavarian Longitudinal Study, BLS) and Finland (Arvo Ylppo Longitudinal Study, AYLS) assessed 4741 and 1423 children from birth to 56 months, respectively. Motor functioning was evaluated at birth, and 5, 20 and 56 months. Perinatal, neonatal and social environmental information was collected at birth and 5 months. Results Two distinct motor trajectories were identified: low (BLS: n = 4486 (94.6%), AYLS: n = 1391 (97.8%)) and high (BLS: n = 255 (5.4%), AYLS: n = 32 (2.2%)) degree of motor difficulties. High degree of motor difficulties was predicted by neonatal complications, abnormal neonatal neurological status, duration of hospitalisation and poor parent-infant relationships. Although neonatal complications and poor parent-infant relationships did not significantly predict high degree of motor difficulties in the AYLS, the trends identified were similar to those obtained from the BLS. Conclusion Early identification of children at-risk of motor difficulties across infancy and toddlerhood may help referring those children to interventions earlier. Modifiable risk factors, such as parent-infant relationships, may be addressed by intervention strategies to prevent children from developing motor difficulties.Peer reviewe