Predictive value of Bayley-III Motor Index for later motor difficulties in children born extremely preterm.

AIM: To investigate the predictive ability of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) Motor Index, in children born extremely preterm (<27 gestational weeks) without cerebral palsy. METHODS: Children from the EXPRESS study (all extremely preterm births in Sweden, 2004-2007) without neurosensory impairments assessed with Bayley-III at 2.5 years corrected age and Movement Assessment Battery for Children, Second Edition (MABC-2), at 6.5 years comprised the eligible study population (n = 282). Motor difficulty was defined as MABC-2 ≤5th percentile. RESULTS: Motor difficulties were found in 57 of 282 children (20.2%) at 6.5 years. The Bayley-III explained 18.0% of the variance in the MABC-2 (p < 0.001). The area under the receiver operating curve was 0.71 (95% confidence interval 0.64-0.79, p < 0.001). At a Bayley-III cut-off value of 85, sensitivity, specificity and positive and negative predictive values for motor difficulties were 26.3% (15.5-39.7), 92.9% (88.1-95.9), 48.4% (33.0-64.0) and 83.3% (80.9-85.4). Likelihood ratios were inconclusive. CONCLUSION: The Bayley-III at 2.5 years corrected age was a modest predictor of motor outcome in children born extremely preterm at 6.5 years, and underestimated the rate of motor difficulties. Children require follow-up beyond preschool age.

Genome-Scale Characterization of Mycobacterium abscessus Complex Isolates from Portugal.

The Mycobacterium abscessus complex (MABC) is an emerging, difficult to treat, multidrug-resistant nontuberculous mycobacteria responsible for a wide spectrum of infections and associated with an increasing number of cases worldwide. Dominant circulating clones (DCCs) of MABC have been genetically identified as groups of strains associated with higher prevalence, higher levels of antimicrobial resistance, and worse clinical outcomes. To date, little is known about the genomic characteristics of MABC species circulating in Portugal. Here, we examined the genetic diversity and antimicrobial resistance profiles of 30 MABC strains isolated between 2014 and 2022 in Portugal. The genetic diversity of circulating MABC strains was assessed through a gene-by-gene approach (wgMLST), allowing their subspecies differentiation and the classification of isolates into DCCs. Antimicrobial resistance profiles were defined using phenotypic, molecular, and genomic approaches. The majority of isolates were resistant to at least two antimicrobials, although a poor correlation between phenotype and genotype data was observed. Portuguese genomes were highly diverse, and data suggest the existence of MABC lineages with potential international circulation or cross-border transmission. This study highlights the genetic diversity and antimicrobial resistance profile of circulating MABC isolates in Portugal while representing the first step towards the implementation of a genomic-based surveillance system for MABC at the Portuguese NIH.

Cultural Adaptation of the MABC-2 Checklist as a Screening Tool for Developmental Coordination Disorder in Schools.

The purpose of this study was to adapt the MABC-2 Checklist to Czech primary schools by examining of its content validity and feasibility. The content validity achieved the satisfactory level in the second round of panels of experts on child motor development. The evidence on feasibility was obtained from classroom teachers who described this tool as clear, objective and having logical structure and its administration as comprehensible and fast. The MABC-2 Checklist is applicable instrument for the Czech school environment, but its adaptation to various countries should consider the items representing the common motor skills in local children.

Assessing Children's Fine Motor Skills With Sensor-Augmented Toys: Machine Learning Approach.

BACKGROUND: Approximately 5%-10% of elementary school children show delayed development of fine motor skills. To address these problems, detection is required. Current assessment tools are time-consuming, require a trained supervisor, and are not motivating for children. Sensor-augmented toys and machine learning have been presented as possible solutions to address this problem. OBJECTIVE: This study examines whether sensor-augmented toys can be used to assess children's fine motor skills. The objectives were to (1) predict the outcome of the fine motor skill part of the Movement Assessment Battery for Children Second Edition (fine MABC-2) and (2) study the influence of the classification model, game, type of data, and level of difficulty of the game on the prediction. METHODS: Children in elementary school (n=95, age 7.8 [SD 0.7] years) performed the fine MABC-2 and played 2 games with a sensor-augmented toy called "Futuro Cube." The game "roadrunner" focused on speed while the game "maze" focused on precision. Each game had several levels of difficulty. While playing, both sensor and game data were collected. Four supervised machine learning classifiers were trained with these data to predict the fine MABC-2 outcome: k-nearest neighbor (KNN), logistic regression (LR), decision tree (DT), and support vector machine (SVM). First, we compared the performances of the games and classifiers. Subsequently, we compared the levels of difficulty and types of data for the classifier and game that performed best on accuracy and F1 score. For all statistical tests, we used α=.05. RESULTS: The highest achieved mean accuracy (0.76) was achieved with the DT classifier that was trained on both sensor and game data obtained from playing the easiest and the hardest level of the roadrunner game. Significant differences in performance were found in the accuracy scores between data obtained from the roadrunner and maze games (DT, P=.03; KNN, P=.01; LR, P=.02; SVM, P=.04). No significant differences in performance were found in the accuracy scores between the best performing classifier and the other 3 classifiers for both the roadrunner game (DT vs KNN, P=.42; DT vs LR, P=.35; DT vs SVM, P=.08) and the maze game (DT vs KNN, P=.15; DT vs LR, P=.62; DT vs SVM, P=.26). The accuracy of only the best performing level of difficulty (combination of the easiest and hardest level) achieved with the DT classifier trained with sensor and game data obtained from the roadrunner game was significantly better than the combination of the easiest and middle level (P=.046). CONCLUSIONS: The results of our study show that sensor-augmented toys can efficiently predict the fine MABC-2 scores for children in elementary school. Selecting the game type (focusing on speed or precision) and data type (sensor or game data) is more important for determining the performance than selecting the machine learning classifier or level of difficulty.

Motor performance and cognitive correlates in children cooled for neonatal encephalopathy without cerebral palsy at school age.

AIM: To investigate whether motor performance in school-age children without cerebral palsy (CP), cooled for neonatal encephalopathy, is associated with perinatal factors and 18-month developmental scores and to explore relationships between school-age motor and cognitive performance. METHODS: Motor and cognitive performance was assessed in 29 previously cooled children at six to eight years using the Movement Assessment Battery for Children-2 (MABC-2) and the Wechsler Intelligence Scale for Children (WISC-IV). Associations between MABC-2 scores less than/equal (≤) 15th centile and perinatal factors, social/family background, 18-month Bayley-III scores and WISC-IV scores were explored. RESULTS: Eleven of the 29 (38%) children had MABC-2 scores ≤15th centile including 7 (24%) ≤5th centile. No significant perinatal or socio-economic risk factors were identified. Motor scores <85 at 18 months failed to identify children with MABC-2 scores ≤15th centile. MABC-2 scores ≤15th centile were associated with lower Full Scale IQ (p = 0.045), Working Memory (p = 0.03) and Perceptual Reasoning (p = 0.005) scores at six to eight years and receiving greater support in school (p = 0.01). CONCLUSION: A third of cooled children without CP had MABC-2 scores indicating motor impairment at school age that was not identified at 18 months by Bayley-III. Most children with low MABC scores needed support at school. Sub-optimal MABC-2 scores indicate need for detailed school-age cognitive evaluation.

Marker-assisted introgression of resistance to fusarium wilt race 2 in Pusa 256, an elite cultivar of desi chickpea.

Fusarium wilt caused by F. oxysporum f. sp. ciceris causes extensive damage to chickpea (Cicer arietinum L.) in many parts of the world. In the central part of India, pathogen race 2 (Foc 2) causes severe yield losses. We initiated molecular marker-assisted backcrossing (MABC) using desi cultivar, Vijay, as a donor to introgress resistance to this race (Foc2) in Pusa 256, another elite desi cultivar of chickpea. To confirm introgression of resistance for this race, foreground selection was undertaken using two SSR markers (TA 37 and TA110), with background selection to observe the recovery of recurrent parent genome using 45 SSRs accommodated in 8 multiplexes. F1 plants were confirmed with molecular markers and backcrossed with Pusa 256, followed by cycles of foreground and background selection at each stage to generate 161 plants in BC3F2 during the period 2009-2013. Similarly, 46 BC3F1 plants were also generated in another set during the same period. On the basis of foreground selection, 46 plants were found homozygotes in BC3F2. Among them, 17 plants recorded >91% background recovery with the highest recovery percentage of 96%. In BC3F1 also, 14 hybrid plants recorded a background recovery of >85% with the highest background recovery percentage of >94%. The identified plants were selfed to obtain 1341 BC3F3 and 2198 BC3F2 seeds which were screened phenotypically for resistance to fusarium wilt (race 2) besides doing marker analysis. Finally, 17 BC3F4 and 11 BC3F3 lines were obtained which led to identification of 5 highly resistant lines of Pusa 256 with Foc 2 gene introgressed in them. Development of these lines will help in horizontal as well as vertical expansion of chickpea in central part of India.

Developmental co-ordination disorder in socially disadvantaged Brazilian children.

BACKGROUND: The consequences of developmental co-ordination disorder (DCD) indicate a need for identification in order to provide adequate intervention. The goals of the study were to investigate DCD prevalence across age bands, gender, race and school performance; the motor difficulties of children with DCD, at-risk and typically developing children in the Movement Assessment Battery for Children (MABC) sub-tests across age bands and gender; and the relationship between motor outcomes, age, gender and socio-economic status (SES) in socially disadvantaged Brazilian children. METHODS: The MABC was administered to 1056 Brazilian children from 4 to 10 years old. RESULTS: Eighteen per cent of the children were screened as probable DCD (≤5th percentile) and a further 15% as at risk for DCD (>5th and ≤15th percentile). Significantly more children were screened with probable DCD at age 9-10 years (AB3: P = 0.00), whereas at risk classification was equally distributed across age bands (P = 0.12). Boys showed lower prevalence than girls of probable DCD and at risk for DCD (P = 0.04). Children (9-10 years) showed higher motor impairment in the manual dexterity test results. Children with probable DCD and at risk of DCD showed, in general, poor performance in balance and manual dexterity tasks. SES was the strongest predictor of motor outcomes, accounting for 21% of the variance in the MABC percentile scores. CONCLUSIONS: The prevalence of probable and at-risk DCD cases as well as the percentage of female were higher than those found in the previous studies, and low SES enhances the risk of poor motor development.

Handedness and developmental coordination disorder in Portuguese children: study with the M-ABC test.

This study aimed to examine the probable developmental coordination disorder (DCD) and to identify differences in motor performance according to handedness, sex and age in typically developing Portuguese children not engaged in out-of-school sports. The Movement Assessment Battery for Children (M-ABC) was applied to a convenience sample of 154 right-handed and 119 left-handed children (n=273), aged 4-12 (mean age=7.96 years, SD=2.38). The results suggest that the occurrence rate of probable DCD was 25.3% for right-handers and 36.1% for left-handers. This study showed a significant effect of handedness in age band 2, left-handers exhibited a higher prevalence of probable DCD than right-handers. Sex produced a significant effect, with girls performing better in manual dexterity in age band 1 and boys performing better in ball skills in age bands 2 and 3. The lower motor performances were observed in older children. These findings reinforce for Portuguese children and particularly for left-handers, the need for further investigation involving longitudinal studies and children of different handedness in the motor coordination domain. Moreover, we highlight the importance of developing physical education programmes that emphasize motor coordination parameters, especially in left-handed children.

The Medial Antebrachial Cutaneous Nerve Is a Low-Morbidity Alternative to the Standard Sural Nerve Autograft.

BACKGROUND: Nerve interposition grafting is an important technique in nerve reconstructive surgery that is used when a primary repair is not feasible without significant tension. This study sought to evaluate the long-term morbidity of the medial antebrachial cutaneous (MABC) nerve as an alternative donor nerve in comparison with sural nerve harvest. METHODS: A single surgeon and institution retrospective chart review was performed to identify all patients who underwent nerve autografting using the sural and MABC as donor nerves between January 1, 2000 and December 31, 2019. Surveys assessed overall patient satisfaction with surgery, as well as donor and recipient site morbidity, satisfaction, pain, numbness, and cold sensitivity. RESULTS: Of the 73 patients contacted, 54 agreed to participate, and 43 of 73 (58.9%) ultimately completed the survey: 28 MABC (65.1%) and 15 sural (34.9%). There were no significant differences between the sural and MABC groups in overall satisfaction with surgery, donor and recipient site satisfaction, pain, cold sensitivity, and effect on quality of life. Even though 66.7% of sural donor sites and 75% of MABC donor sites had residual numbness, the effect this had on quality of life was very low (2 and 3, respectively). CONCLUSION: The MABC is a safe alternative to the traditional sural nerve autograft. A small subset of patients undergoing nerve autograft harvest will experience long-term morbidity in the form of pain. Conversely, the more common presence of numbness is not reported as bothersome.

The Movement Assessment Battery for Children Second Edition in Ages 3 to 6 Years: A Cross-Cultural Comparison for Children in Taiwan.

OBJECTIVE: The Movement Assessment Battery for Children-2 (MABC-2) is a popular assessment of children's motor skills in both Western and Eastern countries. Since children's motor skills are strongly influenced by the sociocultural context, it is essential to specifically examine the applicability of the MABC-2 in different cultures. The performance on the MABC-2 age band 1 of children in Taiwan was compared with the standardized sample from the United Kingdom. The sex differences in the performance on the MABC-2 were also investigated. METHODS: Children aged 3 to 6 years were recruited and categorized into 4 age groups. The researchers assessed the children with the MABC-2 age band 1, containing 8 tasks categorized into 3 components: manual dexterity, aiming and catching, and balance. Z tests and effect sizes were used to examine the cultural differences in the 3 components and in the total scale of the MABC-2. Independent t tests were used to check for sex differences in the MABC-2. RESULTS: Data on 615 children with a mean age of 4.95 years (SD = 0.97) were collected. Clinically significant differences (effect size > 0.5) were found in 2 components and the total scale of the MABC-2 across most age groups. Children in Taiwan performed better on manual dexterity, balance, and the total scale. Marginally clinically significant differences (absolute effect size > 0.4) were found in the aiming and catching component for the children aged 3 and 6 years old; children in Taiwan scored lower on aiming and catching than did children in the United Kingdom. Girls had significantly higher scores on manual dexterity, balance, and the total scale, while boys had significantly higher scores on aiming and catching. CONCLUSIONS: Cultural and sex differences exist in the MABC-2. Constructing a norm for children in Taiwan of different sex and modification of the items are suggested for application of the MABC-2 in Taiwan.

Microbiological persistence in patients with Mycobacterium abscessus complex lung disease: The prevalence, predictors, and the impact on progression.

OBJECTIVES: Persistent growth of Mycobacterium abscessus complex (MABC) in the respiratory system is not uncommon and may indicate continuous infection of MABC lung disease (MABC-LD), but its prevalence, risk factors, and clinical impact have not been investigated. METHODS: The present study was conducted in two medical centers in northern Taiwan. We enrolled patients with MABC-LD and investigated the prevalence and predictors of persistent culture positivity (MABC-PP). Furthermore, we analyzed the association between MABC-PP and radiographic or clinical progression. RESULTS: Among 189 patients with MABC-LD, 58 were in the MABC-PP group. Independent predictors for MABC-PP included an increasing radiographic score and highest acid-fast stain (AFS) of strong positivity (3-4+) at initial diagnosis (compared with negative AFS). MABC-PP and highest AFS were independently associated with MABC-LD progression by the multivariable analysis model. The adjusted hazard ratio increased to 3.56 when the two independent factors existed. CONCLUSIONS: MABC-PP accounted for 30.7% and was predicted by initial AFS grade and radiographic score. Patients with MABC-PP, and highest AFS grade might have disease progression.

Motor competence is related to acquisition of error-based but not reinforcement learning in children ages 6 to 12.

Background: An essential component of childhood development is increasing motor competence. Poor motor learning is often thought to underlie impaired motor competence, but this link is unclear in previous studies. Aims: Our aim was to test the relationship between motor competence and motor learning in the acquisition phase. Both reinforcement learning (RL) and error-based learning (EBL) were tested. We hypothesized that slower RL and slower EBL acquisition rates would relate to lower motor competence. Methods and procedures: Eighty-six participants ages 6-12 performed a target throwing task under RL and EBL conditions. The Movement Assessment Battery for Children - 2nd edition (MABC-2) provided a measure of motor competence. We assessed EBL and RL acquisition rates, baseline variability, and baseline bias from the throwing task. Outcomes and results: In a multiple linear regression model, baseline variability (ß = -0.49, p = <0.001) and the EBL acquisition rate (ß = -0.24, p = 0.018) significantly explained the MABC-2 score. Participants with higher baseline variability and slower EBL acquisition had lower motor competence scores. The RL acquisition rate was independent of MABC-2 score suggesting that RL may be less of a contributor to poor motor competence. Conclusions and implications: Children with slower EBL acquisition had lower motor competence scores but RL acquisition was unrelated to the level of motor competence. Emphasizing the unrelated reinforcement mechanisms over error-based mechanisms during motor skill interventions may help children with poor motor competence better acquire new motor skills.

Do Gender and BMI Affect the Motor Skills of Five-Year-Old Preschoolers Differently?

BACKGROUND/OBJECTIVE: Weight gain is associated with numerous health complications and constitutes a serious public health problem. Motor competence (MC) can be a protective factor since children's participation and practice in physical activities can improve their health. The objective of this study was to investigate the impact of gender and BMI on MC [i.e., manual dexterity (MD), aiming and catching (A&C), balance (Bal), and total MC percentile (TP)] depending on gender (boy/girl) and BMI (normal weight, overweight or obesity). METHODS: The MABC-2 battery was applied in a sample of 368 preschool children (5.69 ± 0.28 years of age; 54.9% girls). RESULTS: Boys and girls showed statistically significant differences in MC components: boys had higher scores in A&C (p = 0.002), while girls excelled in MD (p < 0.001), Bal (p = 0.035); TP (p < 0.001), and BMI [Bal (p = 0.009); TP (p = 0.050)], with a higher percentile in those children with overweight in both cases. Statistically significant differences were also found in the interactions between gender*BMI [MD (p < 0.001) and TP (p < 0.001)]. CONCLUSIONS: The findings showed that there were notable variations in total percentile, balance, and manual dexterity between boys and girls. In addition, girls outperformed boys in all categories save aiming and catching. However, males who were overweight or obese earned greater percentiles in both balance and the MABC-2 battery's total percentile.

A comparative study on fundamental movement skills among children with autism spectrum disorder and typically developing children aged 7-10.

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with unique differences in social interaction, communication, and a spectrum of behavioral characteristics. In the past, motor disturbance in individuals with ASD has not been considered a significant core deficit due to the predominant focus on sociability and communication issues. However, recent studies indicate that motor deficits are indeed associated with the fundamental symptoms of ASD. As there is limited research on the motor behavior of children with ASD, particularly in China, the objective of this study is to investigate the development of fundamental movement skills (FMS) in children with ASD and compare them to typically developing children. Method: The study recruited 108 children with ASD (87 boys, 21 girls) aged 7-10 years from two special education rehabilitation centers in Wuhan, China. For comparison, a control group of 108 typically developing children, matched by age and gender, was randomly selected from three local primary schools. FMS were assessed using the Movement Assessment Battery for Children - Second Edition (MABC-2), which evaluates manual dexterity, aiming and catching, as well as static and dynamic balance. Group differences on MABC-2 percentile scores were analyzed using descriptive statistics and Mann-Whitney U test. Effect sizes were also calculated for practical significance. Results: Findings from the study showed that a significant majority, around 80%, of children with ASD either displayed motor challenges or were at risk of developing such delays. When comparing to their typically developing peers, children with ASD scored notably lower in areas of manual dexterity, ball skills, and both static and dynamic balance (with all these findings being statistically significant at p < 0.001). Interestingly, gender did not show a significant influence on these results (p > 0.05). Conclusion: In addition to addressing the other skill development areas outlined in the diagnostic manual for ASD, clinicians diagnosing and treating children with ASD should also assess the presence of motor skill development. For individuals with ASD who have co-existing motor difficulties, it is essential to offer evidence-based interventions tailored to their specific needs.

Is It Possible to Improve Motor Competence through a Structured Balance Bike Program in Preschool Children Aged 3 to 6 Years?

This study aimed (1) to investigate the effect of a brief 9-week bike program on preschool motor competence levels and (2) to know the effects of the intervention program on gender. A total of 98 schoolchildren (3.86 ± 0.91 years) from La Coruña (Spain) participated. A pre-post-test quasi-experimental design was used with a control group (CG) made up of 39 students (18 boys) and an experimental group (EG) made up of 59 students (29 boys). Data were gathered using the Movement Assessment Battery for Children-2 (MABC-2). The data demonstrate that the CG and the EG differ significantly from one another before the intervention program in favour of CG in manual dexterity (MD; p < 0.001), balance (Bal; p = 0.003), total test score (TTS; p = 0.001), and total percentile score (TPS; p < 0.001), except in aiming and catching (A&C, p = 0.588). After the application of the 9-week intervention program based on the balance bike, these differences disappear (i.e., MD (p = 0.166), A&C (p = 0.372), Bal (p = 0.219), TTS (p = 0.306), and in TPS (p = 0.259)). The information gathered indicates that implementing intervention programs such as the one applied in this study could have a positive impact on improving motor competence in preschool-aged boys and girls, increasing its level.

Patient with Adult T-cell Leukemia and Lung Infection caused by Mycobacterium abscessus: Successful Treatment with Intensive Chemotherapy Followed by Haploidentical Hematopoietic Stem Cell Transplantation: A Case Report.

A 63-year-old woman with adult T-cell leukemia (ATL) lymphomatous type developed a mild dry cough. Computed tomography revealed lung lesions with a tree-in-bud appearance during intensive chemotherapy. Antibodies against Mycobacterium avium complex were positive. Bronchoalveolar lavage culture showed growth of M. abscessus complex. Finally, M. abscessus subsp. massiliense was also identified. Sequential use of antimicrobials, including macrolides, was introduced during intensive chemotherapy, and the patient successfully underwent allogeneic hematopoietic stem cell transplantation (AHSCT). This is the first case report of a patient with ATL complicated by M. massiliense lung infection, who was successfully treated with haploidentical AHSCT using various combinations of antimicrobials.

Marker-Assisted Introgression of the Salinity Tolerance Locus Saltol in Temperate Japonica Rice.

BACKGROUND: Rice is one of the most salt sensitive crops at seedling, early vegetative and reproductive stages. Varieties with salinity tolerance at seedling stage promote an efficient growth at early stages in salt affected soils, leading to healthy vegetative growth that protects crop yield. Saltol major QTL confers capacity to young rice plants growing under salt condition by maintaining a low Na+/K+ molar ratio in the shoots. RESULTS: Marker-assisted backcross (MABC) procedure was adopted to transfer Saltol locus conferring salt tolerance at seedling stage from donor indica IR64-Saltol to two temperate japonica varieties, Vialone Nano and Onice. Forward and background selections were accomplished using polymorphic KASP markers and a final evaluation of genetic background recovery of the selected lines was conducted using 15,580 SNP markers obtained from Genotyping by Sequencing. Three MABC generations followed by two selfing, allowed the identification of introgression lines achieving a recovery of the recurrent parent (RP) genome up to 100% (based on KASP markers) or 98.97% (based on GBS). Lines with highest RP genome recovery (RPGR) were evaluated for agronomical-phenological traits in field under non-salinized conditions. VN1, VN4, O1 lines were selected considering the agronomic evaluations and the RPGR% results as the most interesting for commercial exploitation. A physiological characterization was conducted by evaluating salt tolerance under hydroponic conditions. The selected lines showed lower standard evaluation system (SES) scores: 62% of VN4, and 57% of O1 plants reaching SES 3 or SES 5 respectively, while only 40% of Vialone Nano and 25% of Onice plants recorded scores from 3 to 5, respectively. VN1, VN4 and O1 showed a reduced electrolyte leakage values, and limited negative effects on relative water content and shoot/root fresh weight ratio. CONCLUSION: The Saltol locus was successfully transferred to two elite varieties by MABC in a time frame of three years. The application of background selection until BC3F3 allowed the selection of lines with a RPGR up to 98.97%. Physiological evaluations for the selected lines indicate an improved salinity tolerance at seedling stage. The results supported the effectiveness of the Saltol locus in temperate japonica and of the MABC procedure for recovering of the RP favorable traits.

Nontuberculous Mycobacterial Infection of Larynx and Cervical Trachea.

OBJECTIVES: To present a patient with the first case of NTM (nontuberculous mycobacteria) infection of the larynx extending to cervical trachea, and the first case of subglottic stenosis associated with an NTM infection. METHODS: Case report and review of the literature. RESULTS: A 68-year-old female with history of prior smoking, gastroesophageal reflux disease, asthma, bronchiectasis, and tracheobronchomalacia presented with a 3-month history of shortness of breath, exertional inspiratory stridor, and hoarseness. Flexible laryngoscopy demonstrated ulceration of medial aspect of right vocal fold and subglottic tissue abnormality with crusting and ulceration extending through the upper trachea. Microdirect laryngoscopy with tissue biopsies and carbon dioxide (CO2) laser ablation of disease completed, and intraoperative culture revealed positive Aspergillus and acid-fast bacilli with Mycobacterium abscessus (type of NTM). Patient began antimicrobial treatment of cefoxitin, imipenem, amikacin, azithromycin, clofazimine, and itraconazole. Fourteen months after initial presentation, patient developed subglottic stenosis with limited extension into the proximal trachea prompting CO2 laser incision, balloon dilation, and steroid injection of the subglottic stenosis. Patient remains disease free without further subglottic stenosis. CONCLUSION: Laryngeal NTM infections are exceedingly rare. Failure to consider NTM infection in the differential diagnosis when presented with an ulcerative, exophytic mass in patients with increased risk factors (structural lung disease, Pseudomonas colonization, chronic steroid use, prior NTM positivity) may result in insufficient tissue evaluation, delayed diagnosis, and disease progression.

Sustainability of a Given Ten-Week Motor Skills Training Program for Children with Developmental Coordination Disorder.

The aim of this research was to determine the sustainability of a given ten-week motor skills training program for children with developmental coordination disorder (DCD). Children with DCD in four kindergartens in the Khorezm region of Uzbekistan were selected to take part in the study. Participants were 24 children between 4 and 6 years old (5.25 ± 0.13 years), assigned to an intervention group (IG: 17 children; 10 boys) and a control group (CG: 7 children; 4 boys). The Movement Assessment Battery for Children (MABC-2) was used to assess motor competence pre-intervention, post-intervention, and retention test measurement after 18 months. The retention test results for the IG indicated a decline in all three motor domains of MABC-2. Despite this, the results that were acquired during the retention test came out to be better than the results that were achieved during the pre-test. At the same time, children who were allocated to the CG maintained their performance. The findings suggest that a preschool-based motor skill training program has the potential to increase motor skills in children with DCD. However, the positive benefits produced by the intervention may decrease over the course of time if the intervention is not continued.