Sleep and daytime sleepiness in methylphenidate medicated and un-medicated children with attention-deficit/hyperactivity disorder (ADHD)

Objective: Excessive daytime sleepiness due to any cause can result in various symptoms similar to those used for the diagnosis of attention deficit/hyperactivity disorder (ADHD). A common treatment for children diagnosed with ADHD is methylphenidate which is also used to treat excessive daytime sleepiness. This paper reports on a study which compared the perceived levels of daytime sleepiness and prevalence of sleep disorders in medicated and un-medicated children with ADHD. Method: The sample consisted of two matched groups of children who had been formally diagnosed with ADHD. One group (n=12) was taking immediate release methylphenidate twice daily, while the other group (n=11) had never, and were not currently, taking any medication. The two groups, as well as their parents, rated their levels of daytime sleepiness at three points in a single day. Results: Significantly higher levels of daytime sleepiness were reported by the parents of the un-medicated children between the hours of 13:00 and 15:00, compared to the medicated children. The medicated children became increasingly sleepier from the first to the second measurement in both the morning and afternoon. There was no significant difference in the number of sleep disorders/disruptions reported by the parents of either group. Conclusion: In a group of children with ADHD taking methylphenidate, there was a significant increase in  sleepiness a few hours after taking the medication, which may then have a significant impact on their learning. The data also imply that part of the mechanism of action of methylphenidate effects in these children may be by reduction of daytime sleepiness.Keywords: Attention Deficit Disorder with hyperactivity; Methylphenidate; Disorders of excessive somnolenc

Low phase noise frequency synthesis for ultrastable X-band oscillators

In this letter, the design of a low phase noise frequency synthesizer is presented. The synthesizer was designed to produce four frequencies: 10 MHz, 100 MHz, 1 GHz and 10 GHz. The 1-GHz signal is produced by frequency division whereas the 100-MHz output is generated by phase-locking a low phase noise oscillator to the 1-GHz signal, hence significantly reducing its phase noise. Both residual and total phase noise measurements are presented.Waddah A. Al-Ashwal, Ashby Hilton, Andre N. Luiten, and John G. Hartnet

Role of Four-Chamber Heart Ultrasound Images in Automatic Assessment of Fetal Heart: A Systematic Understanding

The fetal echocardiogram is useful for monitoring and diagnosing cardiovascular diseases in the fetus in utero. Importantly, it can be used for assessing prenatal congenital heart disease, for which timely intervention can improve the unborn child's outcomes. In this regard, artificial intelligence (AI) can be used for the automatic analysis of fetal heart ultrasound images. This study reviews nondeep and deep learning approaches for assessing the fetal heart using standard four-chamber ultrasound images. The state-of-the-art techniques in the field are described and discussed. The compendium demonstrates the capability of automatic assessment of the fetal heart using AI technology. This work can serve as a resource for research in the field

Recent Trends in Artificial Intelligence-Assisted Coronary Atherosclerotic Plaque Characterization

Coronary artery disease is a major cause of morbidity and mortality worldwide. Its underlying histopathology is the atherosclerotic plaque, which comprises lipid, fibrous and—when chronic—calcium components. Intravascular ultrasound (IVUS) and intravascular optical coherence tomography (IVOCT) performed during invasive coronary angiography are reference standards for characterizing the atherosclerotic plaque. Fine image spatial resolution attainable with contemporary coronary computed tomographic angiography (CCTA) has enabled noninvasive plaque assessment, including identifying features associated with vulnerable plaques known to presage acute coronary events. Manual interpretation of IVUS, IVOCT and CCTA images demands scarce physician expertise and high time cost. This has motivated recent research into and development of artificial intelligence (AI)-assisted methods for image processing, feature extraction, plaque identification and characterization. We performed parallel searches of the medical and technical literature from 1995 to 2021 focusing respectively on human plaque characterization using various imaging modalities and the use of AI-assisted computer aided diagnosis (CAD) to detect and classify atherosclerotic plaques, including their composition and the presence of high-risk features denoting vulnerable plaques. A total of 122 publications were selected for evaluation and the analysis was summarized in terms of data sources, methods—machine versus deep learning—and performance metrics. Trends in AI-assisted plaque characterization are detailed and prospective research challenges discussed. Future directions for the development of accurate and efficient CAD systems to characterize plaque noninvasively using CCTA are proposed.</jats:p

Quantification of structural changes in the corpus callosumin children with profound hypoxic-ischaemic brain injury

Background Birth-related acute profound hypoxic–ischaemic brain injury has specific patterns of damage including the paracentral lobules. Objective To test the hypothesis that there is anatomically coherent regional volume loss of the corpus callosum as a result of this hemispheric abnormality. Materials and methods Study subjects included 13 children with proven acute profound hypoxic–ischaemic brain injury and 13 children with developmental delay but no brain abnormalities. A computerised system divided the corpus callosum into 100 segments, measuring each width. Principal component analysis grouped the widths into contiguous anatomical regions. We conducted analysis of variance of corpus callosum widths as well as support vector machine stratification into patient groups. Results There was statistically significant narrowing of the mid–posterior body and genu of the corpus callosum in children with hypoxic–ischaemic brain injury. Support vector machine analysis yielded over 95% accuracy in patient group stratification using the corpus callosum centile widths. Conclusion Focal volume loss is seen in the corpus callosum of children with hypoxic–ischaemic brain injury secondary to loss of commissural fibres arising in the paracentral lobules. Support vector machine stratification into the hypoxic–ischaemic brain injury group or the control group on the basis of corpus callosum width is highly accurate and points towards rapid clinical translation of this technique as a potential biomarker of hypoxic–ischaemic brain injur

Mortality After Pediatric Arterial Ischemic Stroke

OBJECTIVES: Cerebrovascular disease is among the top 10 causes of death in US children, but risk factors for mortality are poorly understood. Within an international registry, we identify predictors of in-hospital mortality after pediatric arterial ischemic stroke (AIS). METHODS: Neonates (0-28 days) and children (29 days- < 19 years) with AIS were enrolled from January 2003 to July 2014 in a multinational stroke registry. Death during hospitalization and cause of death were ascertained from medical records. Logistic regression was used to analyze associations between risk factors and in-hospital mortality. RESULTS: Fourteen of 915 neonates (1.5%) and 70 of 2273 children (3.1%) died during hospitalization. Of 48 cases with reported causes of death, 31 (64.6%) were strokerelated, with remaining deaths attributed to medical disease. In multivariable analysis, congenital heart disease (odds ratio [OR]: 3.88; 95% confidence interval [CI] : 1.23-12.29; P = .021), posterior plus anterior circulation stroke (OR: 5.36; 95% CI: 1.70-16.85; P = .004), and stroke presentation without seizures (OR: 3.95; 95% CI: 1.26-12.37; P = .019) were associated with in-hospital mortality for neonates. Hispanic ethnicity (OR: 3.12; 95% CI: 1.56-6.24; P = .001), congenital heart disease (OR: 3.14; 95% CI: 1.75-5.61; P < .001), and posterior plus anterior circulation stroke (OR: 2.71; 95% CI: 1.40-5.25; P = .003) were associated with in-hospital mortality for children. CONCLUSIONS: In-hospital mortality occurred in 2.6% of pediatric AIS cases. Most deaths were attributable to stroke. Risk factors for in-hospital mortality included congenital heart disease and posterior plus anterior circulation stroke. Presentation without seizures and Hispanic ethnicity were also associated with mortality for neonates and children, respectively. Awareness and study of risk factors for mortality represent opportunities to increase survival

An evaluation of the effectiveness of PROMPT therapy in improving speech production accuracy in six children with cerebral palsy

This study evaluates perceptual changes in speech production accuracy in six children (3 – 11 years) with moderate-to-severe speech impairment associated with cerebral palsy before, during, and after participation in a motor-speech intervention program (Prompts for Restructuring Oral Muscular Phonetic Targets). An A1BCA2 single subject research design was implemented. Subsequent to the baseline phase (phase A1), phase B targeted each participant’s first intervention priority on the PROMPT motor-speech hierarchy. Phase C then targeted one level higher. Weekly speech probes were administered, containing trained and untrained words at the two levels of intervention, plus an additional level that served as a control goal. The speech probes were analysed for motor-speech-movement-parameters and perceptual accuracy. Analysis of the speech probe data showed all participants recorded a statistically significant change. Between phases A1 – B and B – C 6/6 and 4/6participants, respectively, recorded a statistically significant increase in performance level on the motor speech movement patterns targeted during the training of that intervention. The preliminary data presented in this study make a contribution to providing evidence that supports the use of a treatment approach aligned with dynamic systems theory to improve the motor-speech movement patterns and speech production accuracy in children with cerebral palsy

Comparisons between Tethyan Anorthosite-bearing Ophiolites and Archean Anorthosite-bearing Layered Intrusions: Implications for Archean Geodynamic Processes

Elucidating the petrogenesis and geodynamic setting(s) of anorthosites in Archean layered intrusions and Tethyan ophiolites has significant implications for crustal evolution and growth throughout Earth history. Archean anorthosite-bearing layered intrusions occur on every continent. Tethyan ophiolites occur in Europe, Africa, and Asia. In this contribution, the field, petrographic, petrological, and geochemical characteristics of 100 Tethyan anorthosite-bearing ophiolites and 155 Archean anorthosite-bearing layered intrusions are compared. Tethyan anorthosite-bearing ophiolites range from Devonian to Paleocene in age, are variably composite, contain anorthosites with highly calcic (An44-100) plagioclase and magmatic amphibole. These ophiolites formed predominantly at convergent plate margins, with some forming in mid-ocean ridge, continental rift, and mantle plume settings. The predominantly convergent plate margin tectonic setting of Tethyan anorthosite-bearing ophiolites is indicated by negative Nb and Ti anomalies and magmatic amphibole. Archean anorthosite-bearing layered intrusions are Eoarchean to Neoarchean in age, have megacrystic anorthosites with highly calcic (An20-100) plagioclase and magmatic amphibole and are interlayered with gabbros and leucogabbros and intrude pillow basalts. These Archean layered intrusions are interpreted to have predominantly formed at convergent plate margins, with the remainder forming in mantle plume, continental rift, oceanic plateau, post-orogenic, anorogenic, mid-ocean ridge, and passive continental margin settings. These layered intrusions predominantly crystallized from hydrous Ca- and Al-rich tholeiitic magmas. The field, petrographic and geochemical similarities between Archean and Tethyan anorthosites indicate that they were produced by similar geodynamic processes mainly in suprasubduction zone settings. We suggest that Archean anorthosite-bearing layered intrusions and spatially associated greenstone belts represent dismembered subduction-related Archean ophiolites

The effect of cerebral palsy on arithmetic accuracy is mediated by working memory, intelligence, early numeracy and instruction time

Item does not contain fulltextThe development of addition and subtraction accuracy was assessed in first graders with cerebral palsy (CP) in both mainstream (16) and special education (41) and a control group of first graders in mainstream education (16). The control group out-performed the CP groups in addition and subtraction accuracy and this difference could not be fully explained by differences in intelligence. Both CP groups showed evidence of working memory deficits. The three groups exhibited different developmental patterns in the area of early numeracy skills. Children with CP in special education were found to receive less arithmetic instruction and instruction time was positively related to arithmetic accuracy. Structural equation modeling revealed that the effect of CP on arithmetic accuracy is mediated by intelligence, working memory, early numeracy, and instruction time