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1.
Sports Med ; 54(8): 2141-2156, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38769244

RESUMEN

BACKGROUND: Motor competence and executive functions co-develop throughout childhood and adolescence, and there is emerging evidence that improvements in motor competence may have cognitive benefits in these populations. There is a need to provide a quantitative synthesis of the cross-sectional, longitudinal and experimental studies that have examined the association between motor competence and executive functions in school-aged youth. OBJECTIVES: The primary aim of our systematic review was to synthesise evidence of the association between motor competence and executive functions in school-aged children and adolescents (5-18 years). Our secondary aim was to examine key moderators of this association. METHODS: We searched the PubMed, PsycINFO, Scopus, Ovid MEDLINE, SPORTDiscus and EMBASE databases from inception up to 27 June 2023. We included cross-sectional, longitudinal and experimental studies that assessed the association between motor competence (e.g., general motor competence, locomotor skills, object control skills and stability skills) and executive functions (e.g., general executive functions, inhibition, working memory and cognitive flexibility) in children and adolescents aged 5-18 years. RESULTS: In total, 12,117 records were screened for eligibility, and 44 studies were included. From the 44 included studies, we meta-analysed 37 studies with 251 effect sizes using a structural equation modelling approach in the statistical program R. We found a small positive association (r = 0.18, [95% confidence interval (CI) 0.13-0.22]) between motor competence and executive functions. The positive associations were observed in cross-sectional (r = 0.17, [95% CI 0.13-0.22]), longitudinal (r = 0.15, [95% CI 0.03-0.28]) and experimental studies (r = 0.25, [95% CI 0.01-0.45]). We also found that general motor competence (r = 0.25, [95% CI 0.18-0.33]), locomotor (r = 0.15, [95% CI 0.09-0.21]), object control (r = 0.14, [95% CI 0.08-0.20]) and stability (r = 0.14, [95% CI 0.08-0.20]) skills were associated with executive functions. We did not find any moderating effects for participants' age on the associations between motor competence and executive functions. CONCLUSIONS: Our findings suggest a small-to-moderate positive association between motor competence and executive functions in children and adolescents. The small number of experimental studies included in this review support the assertion that interventions targeting children's motor competence may be a promising strategy to improve their executive functions; however, more research is needed to confirm these findings. Future studies should explore the underlying mechanisms linking motor competence and executive functions as their comprehension may be used to optimise future intervention design and delivery. PROSPERO REGISTRATION: CRD42021285134.


Asunto(s)
Función Ejecutiva , Destreza Motora , Humanos , Niño , Destreza Motora/fisiología , Adolescente , Preescolar , Cognición
2.
J Sports Sci ; 42(1): 25-37, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38381852

RESUMEN

This study aimed to examine the preliminary efficacy and feasibility of implementing a tailored version of the MASTER coach education programme in Chinese primary schools to support physical education (PE) teachers' basketball lesson design and delivery. A total of 20 primary schools in Beijing, China were recruited, with one PE teacher and their class (N = 715 students aged 10-13 yrs) from each school included in the study and randomly allocated to the MASTER intervention (n = 10) or control group (n = 10). Compared to the control group, a significant difference was observed in the MASTER group for the proportion of playing-form activities delivered during PE (27.65, 95% CI [20.27, 35.03]) and for teachers' perceptions of confidence (23.92, 95% CI [15.87, 31.92]) and competence (24.12, 95% CI [10.28, 24.71]) to teach. Significant differences between groups were observed for students' perceived athletic competence (3.56%; 95% CI [3.15, 3.96]), enjoyment (11.83%; 95% CI [10.98, 12.69]), well-being (8.51%; 95% CI [7.02, 10.00]), intrinsic motivation (+0.74%; 95% CI [0.30, 1.17]), introjected motivation (-2.24%; 95% CI [-2.77, -1.70]), and external motivation (-0.49%; 95% CI [-0.90, -0.08]). The MASTER programme was effective in improving teaching practices in Chinese primary schools, and in facilitating improvements in teacher and student outcomes.


Asunto(s)
Baloncesto , Humanos , Educación y Entrenamiento Físico , Proyectos Piloto , Instituciones Académicas , Estudiantes , Motivación , Maestros , Enseñanza
3.
Dalton Trans ; 52(40): 14549-14563, 2023 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-37781908

RESUMEN

Functionalising organic molecular photoswitches with metal complexes has been shown to alter and enhance their switching states. These organometallic photoswitches provide a promising basis for novel smart molecular materials and molecular electronic devices. We have detailed the synthesis and characterisation of mono- and bimetallic half-sandwich ruthenium and iron complexes functionalised with alkynyl dihydropyrenes (DHP). Their electronic and photophysical properties were determined by the use of chemical, electrochemical and spectroelectrochemical techniques. The introduction of the metal alkynyl moiety allows access to additional redox and protonation states not accessible by the DHP alone. An additional metal alkynyl moiety inhibits observable photochromic switching. Analysis of the NIR and IR bands in the mixed valence complexes suggests there is a high degree of charge delocalisation across the DHP.

4.
Scand J Med Sci Sports ; 33(11): 2369-2380, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37555440

RESUMEN

PURPOSE: Our study explored the mediating effect of sleep-related variables on older adolescents' mental health in the context of a school-based physical activity intervention. METHODS: We evaluated the Burn 2 Learn (B2L) intervention using a cluster randomized controlled trial, which included two cohorts. Participants for this sub-study were from the second cohort, which included 292 older adolescents (16.0 ± 0.5 years) from 10 secondary schools in New South Wales, Australia. Teachers at intervention schools delivered two high-intensity activity breaks (approximately 10 mins) per week to students during academic lessons. Participants completed measures of mental health (i.e., perceived stress and internalizing problems) and hypothesized mediators (i.e., sleep duration, sleep latency, awakenings, and daytime sleepiness) at baseline (February-April 2019) and post-intervention (August-September 2019). Single mediation analyses were conducted to explore the potential mediating effects of sleep variables on mental health outcomes using a product-of-coefficient test. RESULTS: We observed a small statistically significant effect for perceived stress (ß = -0.11, SE = 0.034, p = 0.002), but not for internalizing problems (ß = 0.02, SE = 0.051, p = 0.760). There were no significant intervention effects for sleep-related variables. Several sleep-related variables were associated with mental health outcomes but no mediated effects were found. CONCLUSION: The B2L intervention had a small beneficial effect on perceived stress, however our mediation analyses suggest this was not explained by changes in sleep-related variables. Markers of sleep were associated with mental health constructs, highlighting the importance of sleep for good psychological health. However, in the context of a physical activity intervention, effects on mental health may be driven by other behavioral, neurobiological, or psychosocial mechanisms.


Asunto(s)
Ejercicio Físico , Salud Mental , Humanos , Adolescente , Sueño , Aprendizaje , Australia
5.
Orphanet J Rare Dis ; 18(1): 225, 2023 08 03.
Artículo en Inglés | MEDLINE | ID: mdl-37537625

RESUMEN

BACKGROUND: Mutations in the NMDA receptor are known to disrupt glutamatergic signaling crucial for early neurodevelopment, often leading to severe global developmental delay/intellectual disability, epileptic encephalopathy, and cerebral palsy phenotypes. Both seizures and movement disorders can be highly treatment-refractory. RESULTS: We describe a targeted ABA n-of-1 treatment trial with intrathecal MgSO4, rationally designed based on the electrophysiologic properties of this gain of function mutation in the GRIN1 NMDA subunit. CONCLUSION: Although the invasive nature of the trial necessitated a short-term, non-randomized, unblinded intervention, quantitative longitudinal neurophysiologic monitoring indicated benefit, providing class II evidence in support of intrathecal MgSO4 for select forms of GRIN disorders.


Asunto(s)
Discapacidad Intelectual , Magnesio , Humanos , Discapacidad Intelectual/genética , Magnesio/metabolismo , Mutación/genética , Proteínas del Tejido Nervioso/genética , Receptores de N-Metil-D-Aspartato/genética , Convulsiones/genética , Estudios de Casos Únicos como Asunto
6.
ChemMedChem ; 18(19): e202300265, 2023 10 04.
Artículo en Inglés | MEDLINE | ID: mdl-37421174

RESUMEN

In an effort to further investigate previously observed activity of indolyl sulfonamides towards pancreatic cancer cell lines, a library of 44 compounds has been synthesized. The biological activity of the compounds has been determined using two different screening assay techniques against 7 pancreatic cancer cell lines and 9 non-pancreatic cancer cell lines. In the first assay, the cytotoxicity of the compounds was evaluated using a traditional (48 hour compound exposure) method. An in silico investigation was conducted to determine if the compounds might be inducing cell death by inhibiting the S100A2-p53 protein-protein interaction. In the second assay, the potential role of the compounds as metabolic inhibitors of ATP production was evaluated using a rapid screening (1-2 hour compound exposure) method. IC50 values of the hit compounds were obtained and four compounds displayed sub-micromolar potency against PANC-1 cells. The investigation has provided several compounds that display selective in vitro activity toward pancreatic cancer that warrant further development.


Asunto(s)
Antineoplásicos , Neoplasias Pancreáticas , Humanos , Estructura Molecular , Relación Estructura-Actividad , Antineoplásicos/farmacología , Sulfonamidas/farmacología , Ensayos de Selección de Medicamentos Antitumorales , Indoles/farmacología , Neoplasias Pancreáticas/tratamiento farmacológico , Proliferación Celular , Línea Celular Tumoral
7.
ChemMedChem ; 18(16): e202300134, 2023 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-37248422

RESUMEN

A library of 34 lipophilic sulfonamides based upon the memantine core has been synthesized to identify potential drug candidates to cross the blood-brain barrier and target glioblastoma. The library was screened for in vitro activity against 4 mammalian cell lines, including U-87 (glioblastoma). Additional synthetic variation of the active compounds has validated the importance of specific regions of the pharmacophore, with the sulfonamide functionality and S-aryl unit displaying the most significant impact. In silico investigations suggest the active compounds might target DDR1 or RET proteins. The investigation has resulted in several compounds that warrant further development for lead optimization.


Asunto(s)
Antineoplásicos , Glioblastoma , Animales , Humanos , Glioblastoma/tratamiento farmacológico , Memantina/farmacología , Memantina/uso terapéutico , Sulfonamidas , Barrera Hematoencefálica , Transporte Biológico , Relación Estructura-Actividad , Mamíferos
8.
PLoS One ; 18(1): e0279661, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36662842

RESUMEN

BACKGROUND: Leadership is a valuable skill that can be taught in school, and which may have benefits within and beyond the classroom. Learning to Lead (L2L) is a student-led, primary school-based leadership program whereby older 'peer leaders' deliver a fundamental movement skills (FMS) program to younger 'peers' within their own school. AIM: The aims of the study are to determine the efficacy of a peer-led FMS intervention on: (i) peer leaders' (aged 10 to 12 years) leadership effectiveness (primary outcome), leadership self-efficacy, well-being, and time on-task in the classroom; (ii) peers' (aged 8 to 10 years) physical activity levels, actual and perceived FMS competency, cardiorespiratory fitness, muscular power, and executive functioning; and (iii) teachers' (referred to as 'school champions') work-related stress and well-being. METHOD: L2L will be evaluated using a two-arm parallel group cluster randomised controlled trial. Twenty schools located within a two-hour drive of the University of Newcastle, Australia will be recruited. We will recruit 80 students (40 peer leaders and 40 peers) from each school (N = 1,600). L2L will be implemented in three phases: Phase 1 -school champions' training via a professional learning workshop; Phase 2 -school champions' delivery of leadership lessons to the peer leaders; and Phase 3 -peer leaders' delivery of the FMS program to their younger peers. The FMS program, consisting of 12 x 30-minute lessons, will be delivered over the course of one school term (10 weeks). Study outcomes will be assessed at baseline (between mid-March to June, Terms 1 and 2), intervention end (mid-August to September, Term 3), and follow-up (November to mid-December, Term 4. This trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR); registration number: ACTRN12621000376842.


Asunto(s)
Liderazgo , Instituciones Académicas , Humanos , Australia , Estudiantes , Aprendizaje , Servicios de Salud Escolar , Ensayos Clínicos Controlados Aleatorios como Asunto
9.
Scand J Med Sci Sports ; 33(5): 737-753, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36609844

RESUMEN

INTRODUCTION: The relationship between physical activity (PA) intensity and executive functions in older adolescents remains poorly understood. This study aimed to examine the associations between PA intensity, volume, attentional control, and working memory and the moderating effects of sex in older adolescents. METHOD: We analyzed baseline data from 418 participants (211 females, Mage  = 16.5 ± 0.40 years) from the Burn 2 Learn trial. Adolescents wore GT9X Link accelerometers on a non-dominant wrist for 7 days, 24-h·d-1 . PA intensity was expressed as intensity gradient (IG) and moderate-to-vigorous PA (MVPA, Hildebrand cut-points); PA volume was expressed as average acceleration (AvACC). Attentional control was measured with a standard deviation (SDRT) and a coefficient of variation (CVRT) of the reaction time on the incongruent trials of a flanker task. Working memory was expressed as a d prime (a signal discrimination index) on the 2-back task. The moderating effects of sex on the PA-executive functions associations, adjusting for age, BMI z-score, and cardiorespiratory fitness, were tested using multilevel random intercept models. RESULTS: After controlling for AvACC, sex moderated the relationships between IG and incongruent SDRT (B = 0.53, 95% CI: 0.12, 0.94) and CVRT (B = 0.63, 95% CI: 0.22, 1.05; ps ≤ 0.002). Only girls with higher IG showed smaller incongruent SDRT and CVRT (Bs ≤ -0.26, ps ≤ 0.01). IG was not related to working memory. AvACC and MVPA were not associated with attentional control or working memory. CONCLUSION: Our findings reveal a novel association between higher-intensity PA and superior attentional control among adolescent girls.


Asunto(s)
Acelerometría , Capacidad Cardiovascular , Femenino , Humanos , Adolescente , Ejercicio Físico , Función Ejecutiva , Memoria a Corto Plazo
10.
Sci Rep ; 12(1): 21222, 2022 12 08.
Artículo en Inglés | MEDLINE | ID: mdl-36481781

RESUMEN

The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders' academic, psychosocial, behavioural, and physical outcomes. Eligible studies were those that: (i) evaluated a school-based peer-led intervention using an experimental or quasi-experimental study design, (ii) included an age-matched control or comparison group, and (iii) evaluated the impact of the intervention on one or more leader outcomes. Medline, Sportdiscus, Psychinfo, Embase, and Scopus online databases were searched on the 24th of October, 2022 which yielded 13,572 results, with 31 included in the narrative synthesis and 12 in the meta-analysis. We found large positive effects for leaders' attitudes toward bullying (d = 1.02), small-to-medium positive effects for leaders' literacy (d = 0.39), and small positive effects for leaders' self-esteem (d = 0.18). There were mixed findings for behavioural outcomes and null effects for physical outcomes. Notable limitations of this research are the inclusion of a relatively small number of studies, and high heterogeneity in those included. Our findings have the potential to inform educational practice, but also highlight the need for further research examining the mechanisms that might account for the observed effects. Our systematic review was prospectively registered with PROSPERO (CRD42021273129).


Asunto(s)
Acoso Escolar , Instituciones Académicas , Proyectos de Investigación
11.
BMJ Open ; 12(8): e065321, 2022 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-35948376

RESUMEN

INTRODUCTION: Physical activity declines during adolescence, with the lowest levels of activity observed among those with disability. Schools are ideal settings to address this issue; however, few school-based interventions have been specifically designed for older adolescents with disability. Our aim is to investigate the effects of a school-based physical activity programme, involving high-intensity interval training (HIIT), on physical, mental and cognitive health in older adolescents with disability. METHODS AND ANALYSIS: We will evaluate the Burn 2 Learn adapted (B2La) intervention using a two-arm, parallel group, cluster randomised controlled trial with allocation occurring at the school level (treatment or waitlist control). Secondary schools will be recruited in two cohorts from New South Wales, Australia. We will aim to recruit 300 older adolescents (aged 15-19 years) with disability from 30 secondary schools (10 in cohort 1 and 20 in cohort 2). Schools allocated to the intervention group will deliver two HIIT sessions per week during scheduled specialist support classes. The sessions will include foundational aerobic and muscle strengthening exercises tailored to meet student needs. We will provide teachers with training, resources, and support to facilitate the delivery of the B2La programme. Study outcomes will be assessed at baseline, 6 months (primary endpoint), and 9 months. Our primary outcome is functional capacity assessed using the 6 min walk/push test. Secondary outcomes include physical activity, muscular fitness, body composition, cognitive function, quality of life, physical literacy, and on-task behaviour in the classroom. We will also conduct economic and process evaluations to determine cost-effectiveness, programme acceptability, implementation, adaptability, and sustainability in schools. ETHICS AND DISSEMINATION: This study has received approval from the University of Newcastle (H-2021-0262) and the New South Wales Department of Education (SERAP: 2021257) human research ethics committees. Findings will be published in peer-reviewed journals, and key stakeholders will be provided with a detailed report following the study. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry Number: ACTRN12621000884808.


Asunto(s)
Ejercicio Físico , Calidad de Vida , Adolescente , Australia , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Instituciones Académicas
13.
Org Biomol Chem ; 20(33): 6680-6693, 2022 08 24.
Artículo en Inglés | MEDLINE | ID: mdl-35950721

RESUMEN

Polycyclic hydrocarbons (PH) provide intriguing potential as lipophilic scaffolds within medicinal chemistry, but are currently limited by the availability of synthetic tools for predictable modification of the PH unit. Herein we report the development of new methods for installation of a sulfonamide unit to PH cores. In the first method, a xanthate ester serves as reagent for aminosulfonation using pre-formed imidoiodinane as N-source. An investigation of the reaction mechanism was performed to implicate a process involving a N-centered radical. An additional method for sulfonamide installation is described that involves the use of commercially available reagents and operationally convenient conditions. Using the new synthetic methods, 22 compounds were prepared and screened for biological activity against 6 mammalian cell lines along with Gram-positive and Gram-negative bacterial strains. Results of the viability assays have identified compounds that exhibit higher potency than other known anticancer agents such as indisulam and ABT-751. Additionally, the physicochemical and drug-likeness properties of the synthesized compounds have been determined experimentally and using in silico predictive tools. The initial exploration into sulfonamide insertion into PH cores has resulted in a number of compounds that warrant further development to produce molecules with therapeutic value.


Asunto(s)
Antineoplásicos , Nitrógeno , Animales , Antineoplásicos/química , Bacterias Gramnegativas , Mamíferos , Sulfonamidas/química
14.
Front Neurol ; 13: 847834, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35493815

RESUMEN

In the evolving modern era of neuromodulation for movement disorders in adults and children, much progress has been made recently characterizing the human motor network (MN) with potentially important treatment implications. Herein is a focused review of relevant resting state fMRI functional and effective connectivity of the human motor network across the lifespan in health and disease. The goal is to examine how the transition from functional connectivity to dynamic effective connectivity may be especially informative of network-targeted movement disorder therapies, with hopeful implications for children.

15.
Cardiovasc Diagn Ther ; 12(1): 1-11, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35282665

RESUMEN

Background: Non-ST elevation myocardial infarction (NSTEMI) has higher post-discharge mortality than ST-elevation myocardial infarction (STEMI). Prognosis worsens in those with multivessel coronary disease (MVD). However, information about the prevalence and extent of MVD in NSTEMI is limited, in turn limiting insights into optimal treatment strategies. This study aimed to define the prevalence and extent of MVD, preferred treatment strategies and the predictors of MVD in a real-world NSTEMI population. Methods: The Coronary Angiogram Database of South Australia (CADOSA) was used to identify consecutive patients presenting to major teaching hospitals with NSTEMI between 2012 and 2016. Obtaining clinical and angiographic details, patients were stratified by the number of significantly diseased vessels (0,1,2,3-VD), defined by a stenosis of ≥70%, or ≥50% in the left main coronary artery. Data was analysed retrospectively. Results: The prevalence of MVD (2- or 3-VD) was 42% amongst 3,722 NSTEMI presentations. Multivariate logistic regression modelling showed age, male gender, diabetes, dyslipidaemia and prior myocardial infarction predicted MVD over 1-VD or 0-VD. Percutaneous coronary intervention (PCI) was performed in 42% of patients with MVD. This comprised 61% of 2-VD patients and only 22% of 3-VD patients, with 24% and 66% of each group referred for coronary bypass grafting, respectively. Among MVD patients treated with PCI, 76% had their culprit lesion treated alone in the index admission. Conclusions: In this NSTEMI cohort, over 40% had MVD. Notably, a minority of patients with MVD undergoing PCI received multivessel revascularisation. This real-world practice emphasises that further evaluation is required to determine whether complete revascularisation is beneficial in NSTEMI, as reported for STEMI.

16.
Curr Top Behav Neurosci ; 53: 103-130, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34697789

RESUMEN

Over the last decade, a growing body of research has examined the link between physical activity, fitness, and cognitive function in children and adolescents. Physical activity experimental research conducted with children and adolescents has identified selectively greater effects for tasks requiring higher order executive functions. As such, the primary aim of our chapter is to provide an overview of findings from systematic reviews and meta-analyses that have examined the effects of physical activity on measures of executive function in child and adolescent populations. We begin our chapter with definitions of key concepts associated with physical activity, fitness and cognitive function. We then provide a synthesis of systematic reviews and meta-analyses that have examined the acute and chronic effect of physical activity on EFs. Following this, we discuss the quantitative (e.g., time, intensity) and qualitative (e.g., type) characteristics of physical activity that may moderate effects. The next section focuses on the neurobiological, psychosocial and behavioral mechanisms responsible for the effect of physical activity on executive functions. We conclude by highlighting the limitations of the existing evidence base and providing recommendations for future research.


Asunto(s)
Función Ejecutiva , Ejercicio Físico , Adolescente , Niño , Cognición , Humanos , Revisiones Sistemáticas como Asunto
17.
J Isl Coast Archaeol ; 16(2-4): 261-289, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34557059

RESUMEN

The colonization of the Caribbean initiated a process of entanglement of people, goods, and ideas between the "New" and "Old World," which is popularly referred to as the Columbian Exchange. This paper seeks to highlight the multiscalar and material underpinnings of this process of global importance by tracing it to its roots: the earliest encounters between the indigenous peoples of the Caribbean and European colonists. We present a database, based on key Spanish historical sources, which catalogs all references to the transaction of objects between Amerindians and Europeans from AD 1492-1497. We furthermore argue for the need of a framework that is able to connect, explore, and track the structural materiality of things in encounter events. For this we suggest a combination of entanglement theory with network and substantive analyses. This multiscalar theoretical and methodological framework shows how a diverse and contextually specific network of humans and things arose in tandem with European and Amerindian attempts to establish, manipulate, and contest ties of significant personal and historical interest.

18.
ACS Omega ; 6(28): 18333-18343, 2021 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-34308064

RESUMEN

Traditional long exposure (24-72 h) cell viability assays for identification of potential drug compounds can fail to identify compounds that are: (a) biologically active but not toxic and (b) inactive without the addition of a synergistic additive. Herein, we report the development of a rapid (1-2 h) compound screening technique using a commercially available cell viability kit (CellTiter-Glo) that has led to the detection of compounds that were not identified as active agents using traditional cytotoxicity screening methods. These compounds, in combination with metabolic inhibitor 2-deoxyglucose, display selectivity toward a pancreatic cancer cell line. An evaluation of 11 mammalian cell lines against 30 novel compounds and two metabolic inhibitors is reported. The inclusion of metabolic inhibitors during an initial screening process, and not simply during mechanistic investigations of a previously identified hit compound, provides a rapid and sensitive tool for identifying drug candidates potentially overlooked by other methods.

19.
Epilepsia ; 62(7): 1629-1642, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34091885

RESUMEN

OBJECTIVE: We aimed to characterize the clinical profile and outcomes of new onset refractory status epilepticus (NORSE) in children, and investigated the relationship between fever onset and status epilepticus (SE). METHODS: Patients with refractory SE (RSE) between June 1, 2011 and October 1, 2016 were prospectively enrolled in the pSERG (Pediatric Status Epilepticus Research Group) cohort. Cases meeting the definition of NORSE were classified as "NORSE of known etiology" or "NORSE of unknown etiology." Subgroup analysis of NORSE of unknown etiology was completed based on the presence and time of fever occurrence relative to RSE onset: fever at onset (≤24 h), previous fever (2 weeks-24 h), and without fever. RESULTS: Of 279 patients with RSE, 46 patients met the criteria for NORSE. The median age was 2.4 years, and 25 (54%) were female. Forty (87%) patients had NORSE of unknown etiology. Nineteen (48%) presented with fever at SE onset, 16 (40%) had a previous fever, and five (12%) had no fever. The patients with preceding fever had more prolonged SE and worse outcomes, and 25% recovered baseline neurological function. The patients with fever at onset were younger and had shorter SE episodes, and 89% recovered baseline function. SIGNIFICANCE: Among pediatric patients with RSE, 16% met diagnostic criteria for NORSE, including the subcategory of febrile infection-related epilepsy syndrome (FIRES). Pediatric NORSE cases may also overlap with refractory febrile SE (FSE). FIRES occurs more frequently in older children, the course is usually prolonged, and outcomes are worse, as compared to refractory FSE. Fever occurring more than 24 h before the onset of seizures differentiates a subgroup of NORSE patients with distinctive clinical characteristics and worse outcomes.


Asunto(s)
Epilepsia Refractaria/diagnóstico , Convulsiones Febriles/diagnóstico , Estado Epiléptico/diagnóstico , Niño , Preescolar , Estudios de Cohortes , Bases de Datos Factuales , Electroencefalografía , Femenino , Fiebre/complicaciones , Humanos , Lactante , Masculino , Estudios Prospectivos , Convulsiones Febriles/líquido cefalorraquídeo , Estado Epiléptico/líquido cefalorraquídeo , Resultado del Tratamiento
20.
Pilot Feasibility Stud ; 7(1): 120, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34088346

RESUMEN

BACKGROUND: Adolescents with disability are less active and have lower levels of physical fitness than their typically developing peers. Schools are ideal settings to address this; however, few school-based interventions have been designed and evaluated among this group. Therefore, the aim of this pilot study was to determine the feasibility of a time-efficient school-based physical activity intervention for adolescents with disability. METHODS: A non-randomized pilot trial was conducted with adolescents in the special education unit at one secondary school in New South Wales, Australia. Sixteen grade 11 and 12 students (aged 17.3 ± 0.7 years) participated in the 2-month physical activity intervention. Two classroom teachers were trained to facilitate the delivery of a high-intensity interval training (HIIT) program, known as Burn 2 Learn adapted (B2La). Teachers were asked to deliver 2-3 weekly HIIT sessions for a period of 2 months. Four domains of feasibility (acceptability, implementation, adaptability, and practicality) were assessed using quantitative measures at the student and teacher levels (e.g., observations, process evaluation questionnaires, and heart rate [HR] monitoring). Data were also collected from three learning and support teachers who assisted classroom teachers with intervention delivery. Preliminary efficacy of the intervention on measures of adolescents' functional capacity (6-min walk/run test) and muscular fitness (sit-to-stand test and modified push-up test) were analyzed using paired sample t-tests. RESULTS: Moderate-to-high levels of program satisfaction were reported by both students (80% rated "Good" or "Excellent") and teachers (100% rated "Good" or "Excellent"). Teachers reported delivering 2.5 ± 0.7 sessions per week during the study. Based on researcher session observations, the program was delivered effectively by teachers (14/20). However, HR data indicated session intensity was lower than intended. The program was considered "adaptable" by teachers, with several observed modifications to HIIT sessions to cater for the needs of adolescents with disability. No adverse events were reported. We observed improvements in preliminary efficacy measures. CONCLUSIONS: Our findings suggest it is feasible to train teachers to deliver a school-based HIIT program for adolescents with disability. Evaluation of B2La within a larger-scale effectiveness trial is warranted. TRIAL REGISTRATION: ACTRN12621000219886 .

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