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Purpose: Sleep is a modifiable factor affecting chronic diseases and conditions in the Active-Duty (AD) United States (US) military population. This study assesses the impact of reported sleep health behaviors and sleep profiles on reported multimorbidity in active-duty service members (ADSMs). Participants and methods: The study used a military representative sample of 17,166 active duty SMs from the 2018 Department of Defense Health Related Behaviors Survey (HRBS) to explore sleep patterns and profiles, and medical conditions. Multimorbidity was defined as the presence of two or more medical conditions which we limited to include obesity, hypertension, and hyperlipidemia. The adjusted odds ratios for six sleep-related health behaviors and their unobservable sleep profiles were calculated using a weighted multinomial logistic model. Results: Sleep-related health behaviors were associated with increased odds of obesity, hypertension, and hyperlipidemia. We found higher odds of reported multimorbidity in SMs who reported lack of energy due to poor sleep (adjusted odds ratio [aOR] = 2.35, 95% CI:1.88-2.93), sleep 6 hours or less per night (aOR = 1.95, 95% CI:1.53-2.50), trouble sleeping (aOR = 2.19, 95% CI:1.76-2.72), and use of sleep medications (aOR = 2.10, 95% CI:1.64-2.68). Latent class analysis (LCA) identified three unobservable sleep profiles in SMs: minimal or low-risk sleep patterns (37.43%), moderate-risk sleep patterns (31.11%), and high-risk sleep patterns (31.46%). SMs with high-risk sleep patterns were significantly associated with reported multimorbidity (adjusted odds ratio [aOR] = 3.54, 95% CI:2.75-4.56). Conclusion: We found a strong association between sleep-related health behaviors and their unobservable sleep profiles with multimorbidity in this AD population. Future studies should investigate whether other chronic diseases may be influenced by sleep impairment in the US military population.
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BACKGROUND: Large cerebral aneurysms are much less common in children than in adults. Thus, when present, these lesions require careful surgical evaluation and comprehensive genetic testing. RASA1-associated capillary malformation-arteriovenous malformation (RASA1-CM-AVM) syndrome is a rare disorder of angiogenic remodeling known to cause port-wine stains and arteriovenous fistulas but not previously associated with pediatric aneurysms. OBSERVATIONS: The authors report the case of a previously healthy 6-year-old boy who presented with seizure-like activity. Imaging demonstrated a lesion in the right ambient cistern with compression of the temporal lobe. Imaging characteristics were suggestive of a thrombosed aneurysm versus an epidermoid cyst. The patient underwent craniotomy, revealing a large saccular aneurysm, and clip ligation and excision were performed. Postoperative genetic analysis revealed a RASA1-CM-AVM syndrome. LESSONS: This is a rare case of a RASA1-associated pediatric cerebral aneurysm in the neurosurgical literature. This unique case highlights the need for maintaining a broad differential diagnosis as well as the utility of genetic testing for detecting underlying genetic syndromes in young children presenting with cerebral aneurysms.
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Past work has demonstrated that active suppression of salient distractors is a critical part of visual selection. Evidence for goal-driven suppression includes below-baseline visual encoding at the position of salient distractors (Gaspelin and Luck, 2018) and neural signals such as the distractor positivity (Pd) that track how many distractors are presented in a given hemifield (Feldmann-Wüstefeld and Vogel, 2019). One basic question regarding distractor suppression is whether it is inherently spatial or nonspatial in character. Indeed, past work has shown that distractors evoke both spatial (Theeuwes, 1992) and nonspatial forms of interference (Folk and Remington, 1998), motivating a direct examination of whether space is integral to goal-driven distractor suppression. Here, we use behavioral and EEG data from adult humans (male and female) to provide clear evidence for a spatial gradient of suppression surrounding salient singleton distractors. Replicating past work, both reaction time and neural indices of target selection improved monotonically as the distance between target and distractor increased. Importantly, these target selection effects were paralleled by a monotonic decline in the amplitude of the Pd, an electrophysiological index of distractor suppression. Moreover, multivariate analyses revealed spatially selective activity in the θ-band that tracked the position of the target and, critically, revealed suppressed activity at spatial channels centered on distractor positions. Thus, goal-driven selection of relevant over irrelevant information benefits from a spatial gradient of suppression surrounding salient distractors.SIGNIFICANCE STATEMENT Past work has shown that distractor suppression is an important part of goal-driven attentional selection, but has not yet revealed whether suppression is spatially directed. Using behavioral data, event-related potentials (ERPs) of the EEG signal [N2pc and distractor positivity (Pd) component], as well as a multivariate model of EEG data [channel tuning functions (CTF)], we show that suppression-related neural activity increases monotonically as the distance between targets and distractors decreases, and that spatially-selective activity in the θ-band reveals depressed activity in spatial channels that index distractor positions. Thus, we provide robust evidence for spatially-guided distractor suppression, a result that has important implications for models of goal-driven attentional control.
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Atención/fisiología , Potenciales Evocados Visuales/fisiología , Estimulación Luminosa/métodos , Tiempo de Reacción/fisiología , Percepción Espacial/fisiología , Adolescente , Adulto , Electroencefalografía/métodos , Femenino , Humanos , Masculino , Percepción Visual/fisiología , Adulto JovenRESUMEN
El objetivo del presente trabajo es estudiar la asociación entre la morbilidad en neonatos nacidos con un peso menor de 1.250 gramos que requirieron cuidado intensivo neonatal y la capacidad cognitiva a la edad escolar.
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Preescolar , Servicios de Salud del Niño , MorbilidadRESUMEN
El objetivo del presente trabajo es estudiar la asociación entre la morbilidad en neonatos nacidos con un peso menor de 1,250 gramos que requirieron cuidado intensivo neonatal y la capacidad cognitiva a la edad escolar.Material y método: es un estudio prospectivo de reconstrucción de cohortes en una muestra de 18 neonatos cuyo peso al nacimiento fue menor de 1,250 gramos. Se comparan con un grupo control de niños nacidos de término y peso adecuado, apareados por medio socioeconómico. Durante la internación neonatal se registró la morbilidad y la gravedad neonatal evaluada por el SNAP y NTISS que se realizó al ingreso y semanalmente hasta el alta. Se realizaron dos evaluaciones posnatales: una en el período preescolar, entre los tres y cuatro años, y la otra en edad escolar, entre ocho y nueve años. En la primera evaluación se valoró el desarrollo con la escala de Denver y un sistema de atributos que mide el estado de salud del niño (MASH). A la edad escolar se usó la escala de WISC-III para medir la capacidad cognitiva. En ambos controles se evaluó el crecimiento a través del peso, talla y perímetro craneano. La asociación entre el número de morbilidades y la escala cognitiva se estudió usando una regresión lineal simple. Resultados: el promedio de la capacidad cognitiva (CIG) fue de 87,5±14,3 en el grupo de pretérmino y de 104,3±12,18 para el grupo control. Esta diferencia fue significativa (p<0,003). La morbilidad más frecuente fue la sepsis (47,8%). Se encontró que cada morbilidad disminuye el puntaje cognitivo en 10 puntos (IC entre 5 y 14),con un coeficiente de determinación r2 = 0,60 (p<0,05). Los niños que tuvieron tres o más morbilidades presentaron retardo severo. La gravedad de éstos fue significativamente mayor entre las tres y cuatro semanas y el crecimiento menor que los que tuvieron evolución normal...
The aim of the study is the relationship between the morbility of very low birthweight newborns which requiredneonatal intensive care and their cognitive abilities during school. Material and method: this is a rospective cohort reconstruction study with a sample of 18 newborns whose birthweight was lower than 1.250 g. It was compared with a control group (term newborns with adequate birthweight), paired by their socioeconomic status. During the neonatal period in the intensive care unit morbility and neonatal severity were assessed using SNAP and NTISS from the first day with weekly controls, until delivery day. Two postnatal evaluations were done: preschool assessment (between 3 and 4 years old) and at school age (between 8 and 9 years old). In the first evaluation the Denver scale was used to evaluate their neurodevelopment. A health classification system which can detect the health state of a child (MASH) was also used. During school-age the WISC-III scale which evaluates cognitive abilities was applied. In both periods weigth, height and craneal perimeter were measured. The relationship between the number of pathologies and cognitive scale was studied with a linear regression. Results: the average cognitive capacity (CIG) was 87,5±14,3 in the preterm group and 104,3±12,18 in the control group, showing a significant difference (p<0,003). The most frequent pathology was sepsis (47,8%). Pathology decreases cognitive score in 10 points (CI 95% = between 5 and 14), with a determinant coeficient: r2 = 0,60 (p<0,05). Children who had three or more diseases developed severe neurodevelopment retardation. The severity of illness was significantly higher between 3 and 4 weeks of life.Conclusions: we found a significant relationship between neonatal complications and school outcomes in very low birth weight (<1.250 g).The newborn care in the intensive care units must aim at avoiding these complications, especially infectious diseases...
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Humanos , Recién Nacido , Niño , Desarrollo Infantil , Cognición , Recién Nacido de muy Bajo Peso , Cuidado Intensivo Neonatal , MorbilidadRESUMEN
La vigilancia del crecimiento y desarrollo es una etapa necesaria en la planificación de las actividades para mejorar el cuidado de nuestros niños. Objetivo: evaluar el crecimiento y la capacidad cognitiva a la edad escolar de niños con riesgo biológico y social. Material y métodos: se estudiaron tres grupos de niños entre 8 y 9 años. Grupo I: 18 nacidos de pretérmino con un peso al nacer menor a 1.250 gramos (riesgo biológico); grupo II: 18 nacidos de término de peso adecuado, procedentes de hogares que requerían ayuda nutricional (riesgo ambiental), y grupo III: 18 nacidos de término de peso adecuado, que concurrían a la escuela pública y cuyos padres tenían trabajo estable (grupo control). El crecimiento se evaluó a través del peso, la talla y el perímetro craneano. Para medir la capacidad cognitiva se aplicó la escala de inteligencia de Weschler (WISC III). Resultados: el promedio del coeficiente de la escala completa fue de 88,6 en el grupo I (se excluyeron dos por presentar lesiones graves), 87,5 en el grupo II y 108,5 en el grupo III. Las diferencias entre el grupo I y II no fueron significativas, mientras el grupo III fue más alto que ambos (p<0,001). El menor puntaje de la capacidad cognitiva se asoció a la morbilidad neonatal en el grupo I y a la disminución de la escolaridad materna y paterna en el grupo II. El crecimiento fue más bajo (p<0,05) en el grupo de pretérmino en los tres parámetros. Conclusiones: los niños nacidos prematuros y aquellos provenientes de un bajo nivel socioeconómico presentan alta incidencia de alteraciones cognitivas en esta serie de niños estudiados.
Growth and development supervision constitute a necessary step in the development of strategies in order to improve our children's health. Objective: the evaluation of growth and cognitive capacity in children at school age who have biological and social risk. Material and methods: three groups of children between 8 and 9 years old were studied. Results: the average of global intellectual coefficient (CIG) was 88,6 in group I (two patients were excluded because they had severe lesions), 87,5 in group II and 108,5 in group III. Differences between group I and II were not significant; however both of them were significatively lower than group III (p<0,001). The low cognitive capacity was associated with newborn morbidity in group I and to a low parental scholarship in group II. Growth was affected (p<0,05) for the preterm newborns group in the three parameters evaluated. Group II and III had no differences. Conclusions: children who were preterm newborns and those from a low socioeconomic level had a higher incidence of cognitive impairment.