Musical Shoes Shine a New Light on the Clinical World

This study focused on the application of a unique technology designed originally to supply biofeedback to dancers, but in this case was used to assist a child learning to walk while battling the effects of Cerebral Palsy. The music shoes, called “Electroskip”, utilize a biofeedback system that generates different sounds/beats/songs when an individual is walking and placing pressure on their heel or toe. The study lasted six weeks with 2 sessions per week. While the Electroskip technology was worn for each session, it was only activated every other session. Data indicated that at the end of the study the child was able to walk better based on a comparison of pre and post study scores from the Test of Gross Motor Development II (TGMD-II) evaluation instrument administered by the director of the SIMs Laboratory on campus.https://digitalcommons.cortland.edu/slides/1000/thumbnail.jp

An Analysis of a New Shoe Technology in The Gait Patterns of a Child with a Neurological Disability

This study focused on the application of a unique technology originally designed to supply biofeedback to dancers, but in this case was used to assist a child learning to walk while battling the effects of Cerebral Palsy. The musical shoes, called ElectroskipTM, utilize a biofeedback system that generates variable sounds/beats/songs when an individual is walking and placing pressure on their heel or toe. The study lasted six weeks with two sessions per week. Each session started with shoes fitted with ElectroskipTM technology placed on the child’s feet. When instructed by the researcher the child would proceed to a size appropriate set of parallel bars to begin the pre-test walking trial. Gripping the parallel bars the child would attempt to complete two passes, back and forth, walking along the 2.4 meter length of the bars. ElectroskipTM and video data from each walking attempt was recorded. The child would then have a free play time followed by a post-test walking trial. While the ElectroskipTM technology was worn for each session to make sure the session routine was consistent for the child, it was only activated every other session. Following each session the number of steps taken during the pre-test and post-test trials recorded with the ElectroskipTM software was compared to the visual information found in the video record. Data indicated that at the end of the study the child was able to walk better, based on a comparison of pre and post study scores from the Test of Gross Motor Development II (TGMD-II) evaluation instrument administered by the director of the SIMs Laboratory on the SUNY Cortland campus

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

[ePost] An audit of referral timeframes for ultrasound screening of developmental hip dysplasia (DDH) in neonates with a normal clinical examination

Introduction The recent opening of Brisbane's amalgamated tertiary paediatric hospital centralised much of the ultrasound screening for DDH in South-East Queensland. Variation in referral timeframes for initial screening ultrasound in babies with a risk factor and normal clinical examination was noted. Early screening ultrasounds may result in over-diagnosis of DDH during the maturation process of the neonatal acetabulum, potentially causing anxiety and unnecessary follow-up. Method Literature review and clinical audit were undertaken. DDH ultrasounds of all babies with the following inclusion criteria were reviewed: normal clinical examination and one or more risk factors including breech position, talipes, oligohydramnios and family history of DDH. Patients with Graf IIA classification or worse were followed up via their electronic medical record. Results There were 183 eligible patients reviewed between February 2016 and June 2016. Of these, 117 (64%) had normal initial scans while 66 (36%) required a follow-up scan in a further four weeks. All 66 of these babies demonstrated normal hips at follow-up scan and none required treatment. Most of the sub-optimal results (n = 57, 86%) were scanned before four weeks, only 9 presented at five weeks after birth or later. Conclusion Our study identified a reduction in potentially unnecessary follow-up studies with delayed ultrasound, improving from four to six weeks of age, with no adverse outcomes. Take home message Timing of DDH ultrasound screening in patients with a risk factor and normal clinical examination should account for ongoing post-natal acetabular maturation and be after four or preferably six weeks of age

An audit of referral time frames for ultrasound screening of developmental hip dysplasia in neonates with a normal antenatal clinical examination

Introduction Ultrasound has an established role in the detection of developmental dysplasia of the hip (DDH). Lack of uniformity in the appropriate age to perform studies in at‐risk children with a normal clinical examination at birth exists. Opening a new tertiary paediatric hospital saw a variety of referral time frames for initial screening ultrasound for DDH. Methods Literature review and retrospective clinical audit were undertaken. DDH ultrasounds of babies with the following criteria were reviewed: normal clinical examination and one or more risk factors. Patients were followed up via their electronic medical record. Results There were 187 eligible patients: 124 (66.3%) had normal initial scans while 63 (33.7%) were recommended to have a follow‐up scan. Most subnormal results (Graf 2A or lower, laxity and/or less than 50% femoral head coverage) (n = 59, 93.7%) were scanned before 6 weeks of age, only four (6.3%) presented at 5 weeks after birth or later. Discussion This study identified a potential for reduction in follow‐up studies through delayed initial ultrasound, improving from 4 to 6 weeks of age, without adverse outcomes. Early screening ultrasounds may result in overdiagnosis of DDH during the maturation process of the neonatal acetabulum, potentially causing anxiety and unnecessary follow‐up

Ipilimumab and Stereotactic Radiosurgery with CyberKnife® System in Melanoma Brain Metastases: A Retrospective Monoinstitutional Experience

The median overall survival (OS) and local control (LC) of patients with melanoma brain metastases (MBMs) are poor even with immune checkpoint inhibitors and/or radiotherapy (RT). The aims of the study were to evaluate the association and timing of stereotactic radiotherapy (SRT)/radiosurgery (SRS) performed with the CyberKnife® System and ipilimumab (IPI). A total of 63 MBMs patients were analyzed: 53 received RT+IPI and 10 RT alone. Therefore, the patients were divided into four groups: RT PRE-PI (>4 weeks before IPI) (18), RT CONC-IPI (4 weeks before/between first and last cycle/within 3 months of last cycle of IPI) (20), RT POST-IPI (>3 months after IPI) (15), and NO-IPI (10). A total of 127 lesions were treated: 75 with SRS (one fraction) and 24 with SRT (three to five fractions). The median follow-up was 10.6 months. The median OS was 10.6 months for all patients, 10.7 months for RT+IPI, and 3.3 months for NO-IPI (p = 0.96). One-year LC was 50% for all patients, 56% for RT+IPI, and 18% for NO-IPI (p = 0.08). The 1-year intracranial control was 45% for all patients, 44% for RT+IPI, and 51% for NO-IPI (p = 0.73). IPI with SRS/SRT in MBMs treatment could improve LC. However, the impact and timing of the two modalities on patients’ outcomes are still unclear