A pilot randomised controlled trial on the effectiveness of infant massage on the acceptance, commitment and awareness of influence in parents of babies with Down syndrome.

BACKGROUND: The emotional state of parents of babies with Down syndrome affects their babies' development and their parent-child bonding. The aim for this study was to conduct a pilot randomised controlled evaluation of the effect of infant massage on parents of babies with Down syndrome. METHODS: This pilot study compared two groups (intervention and control), each with 16 parents of babies with Down syndrome. Indices of acceptance, engagement and awareness of influence were measured at two different time points (pre-test and after 5 weeks) using the 'This Is My Baby' Interview. The allocation of families to each group was randomised. The experimental group performed infant massage, applied by the parents, for 5 weeks, every day for at least 10 min. The massage protocol was based on the methodology created by Vimala McClure. Parents in the control group received the intervention after completion of the study. RESULTS: The indices of acceptance, commitment and awareness of influence improved in the experimental group and in the control group. The 2 × 2 mixed-model analysis of variance indicates a statistically significant group-by-time interaction for all indices (P < 0.001), which was significantly higher in the experimental group than in the control group. CONCLUSIONS: The application of infant massage, by parents to their babies, improves the rates of acceptance, commitment and awareness of influence of parents of babies with Down syndrome in the short term.

Fermented dairy products, diet quality, and cardio-metabolic profile of a Mediterranean cohort at high cardiovascular risk.

BACKGROUND AND AIMS: Fermented dairy products have been associated with a better diet quality and cardio-metabolic profile. However, in Mediterranean populations, these associations have not been well characterized. The aim of this study was to assess the diet quality and the associations between the consumption of total fermented dairy products and their subtypes and the prevalence of Metabolic Syndrome (MetS) components in a Mediterranean population at high cardiovascular risk. METHODS AND RESULTS: Baseline cross-sectional analyses were conducted on 6,572 men and women (mean age: 65 years) with overweight or obesity and MetS recruited into the PREDIMED-Plus cohort. A 143-item Food Frequency Questionnaire (FFQ) was used, and anthropometrical, biochemical, and blood pressure measurements were recorded. Multivariate-adjusted Cox regressions were fitted to analyze the association between quartiles of consumption of fermented dairy products and their subtypes and MetS components to estimate the relative risk (RR) and 95% confidence intervals (95% CIs). Participants who were high consumers of fermented dairy products reported a higher consumption of fruit, vegetables, fish, nuts, and whole bread and a lower consumption of white bread, alcohol, and cookies. Participants in the higher quartile showed a lower prevalence of the low HDL-cholesterol component of the MetS (RR=0.88; 95% CI: 0.78-0.98) than those in the lowest quartile of cheese consumption. Cheese consumption was inversely associated with the prevalence of hypertriglyceridemia. Total fermented dairy products, yogurt, and its types were not associated with any of the MetS components. CONCLUSIONS: Compared to nonconsumers, participants consuming fermented dairy products reported a better diet quality and, particularly, cheese consumers presented a lower prevalence of hypertriglyceridemia and low HDL-cholesterol plasma levels, which are MetS components.

Dynamic soluble changes in sVEGFR1, HGF, and VEGF promote chemotherapy and bevacizumab resistance: A prospective translational study in the BECOX (GEMCAD 09-01) trial.

Despite initial responsiveness, acquired resistance to both bevacizumab and chemotherapy in metastatic colorectal cancer is universal. We have recently published that in vitro, chronically oxaliplatin resistance upregulates soluble vascular endothelial growth factor receptor 1, downregulates vascular endothelial growth factor, and also promotes c-MET, b-catenin/transcription factor 4, and AKT activation. We tested whether variation in three serum biomarkers such as the natural c-MET ligand (hepatocyte growth factor), soluble vascular endothelial growth factor receptor 1, and vascular endothelial growth factor-A was associated with efficacy in metastatic colorectal cancer patients treated in the prospective BECOX study. Serum levels of vascular endothelial growth factor-A165, soluble vascular endothelial growth factor receptor 1, and hepatocyte growth factor were assessed by enzyme-linked immunosorbent assay method basally and every 3 cycles (at the time of computed tomography evaluation) in a preplanned translational study in the first-line BECOX trial in metastatic colorectal cancer patients treated with CAPOX plus bevacizumab. Response was evaluated by routine contrast-enhanced computed tomography by RECIST 1.1 by investigator assessment and by three blinded independent radiologists. Ratios between soluble vascular endothelial growth factor receptor 1/vascular endothelial growth factor-A and hepatocyte growth factor/vascular endothelial growth factor-A were established and variations through time were related to RECIST 1.1 by investigator assessment and independent radiologist. The BECOX trial included 68 patients, and 27 patients were analyzed in the translational trial. A total of 80 RECIST 1.1 evaluations were done by investigator assessment and 56 by independent radiologist. We found that a 3.22-fold increase in soluble vascular endothelial growth factor receptor 1/vascular endothelial growth factor-A by investigator assessment and a 3.06-fold increase in soluble vascular endothelial growth factor receptor 1/vascular endothelial growth factor-A by independent radiologist from previous determination were associated with responses compared with 1.38-fold increase by investigator assessment and 1.59 by independent radiologist in non-responders (p = 0.0009 and p = 0.03, respectively). Responders had a 3.36-fold increase in hepatocyte growth factor/vascular endothelial growth factor-A from previous determination by investigator assessment and 3.66-fold increase in hepatocyte growth factor/vascular endothelial growth factor-A by independent radiologist compared with 1.43-fold increase by investigator assessment and 1.53 by independent radiologist for non-responders (p = 0.002 and 0.003, respectively). In conclusion, a decrease in vascular endothelial growth factor-A and an increase in soluble vascular endothelial growth factor receptor 1 during chemotherapy and bevacizumab exposure can contribute to both chemotherapy (due to c-MET/b-catenin activation) and bevacizumab (due to low vascular endothelial growth factor requirements) resistance. Because hepatocyte growth factor levels decrease also during acquired resistance, alternative strategies to hepatocyte growth factor-ligand inhibition should be investigated.

From neurological soft signs to functional outcome in young individuals in treatment with secondary services for non-psychotic disorders: a path analysis.

BACKGROUND: Functional decline among patients with mental illness is not unique to individuals with psychotic disorders. Despite this, research on early predictors of functional outcome mainly focused on individuals thought to have an 'at risk mental state' (ARMS) for psychosis. There is evidence suggesting that certain early vulnerability markers, such as neurological soft signs (NSS), may explain variability in functional outcomes independent of the level of psychosis risk and the traditional diagnostic classification. METHOD: Structural equation modeling was applied to baseline data from a prospective longitudinal study of 138 young individuals in treatment with secondary services for non-psychotic disorders. We evaluated theoretically based models of pathways to functional outcome starting from NSS. The intervening variables were established according to previous evidence and drawn from two general categories: cognition (neuro- and social-) and negative symptoms (expressive and experiential). RESULTS: A final trimmed model was a single path running from NSS to neurocognition to experiential negative symptoms to outcome. It could not be improved by adding or dropping connections that would change the single path to multiple paths. The indirect effect from NSS to outcome was significant. The validity of the model was independent of the ARMS status and the psychiatric diagnosis. CONCLUSIONS: Our results provide evidence for a single pathway model in which the starting and intervening variables represent modifiable trans-diagnostic therapeutic targets to improve functional trajectories in young individuals with a recent-onset psychiatric diagnosis and different levels of psychosis risk.

The impact of psychosis on the course of cognition: a prospective, nested case-control study in individuals at clinical high-risk for psychosis.

BACKGROUND: Although cognitive deficits in patients with schizophrenia are rooted early in development, the impact of psychosis on the course of cognitive functioning remains unclear. In this study a nested case-control design was used to examine the relationship between emerging psychosis and the course of cognition in individuals ascertained as clinical high-risk (CHR) who developed psychosis during the study (CHR + T). METHOD: Fifteen CHR + T subjects were administered a neurocognitive battery at baseline and post-psychosis onset (8.04 months, s.d. = 10.26). CHR + T subjects were matched on a case-by-case basis on age, gender, and time to retest with a group of healthy comparison subjects (CNTL, n = 15) and two groups of CHR subjects that did not transition: (1) subjects matched on medication treatment (i.e. antipsychotics and antidepressants) at both baseline and retesting (Meds-matched CHR + NT, n = 15); (2) subjects unmedicated at both assessments (Meds-free CHR + NT, n = 15). RESULTS: At baseline, CHR + T subjects showed large global neurocognitive and intellectual impairments, along with specific impairments in processing speed, verbal memory, sustained attention, and executive function. These impairments persisted after psychosis onset and did not further deteriorate. In contrast, CHR + NT subjects demonstrated stable mild to no impairments in neurocognitive and intellectual performance, independent of medication treatment. CONCLUSIONS: Cognition appears to be impaired prior to the emergence of psychotic symptoms, with no further deterioration associated with the onset of psychosis. Cognitive deficits represent trait risk markers, as opposed to state markers of disease status and may therefore serve as possible predictors of schizophrenia prior to the onset of the full illness.

Alcohol confounds relationship between cannabis misuse and psychosis conversion in a high-risk sample.

OBJECTIVE: Cannabis use has been examined as a predictor of psychosis in clinical high-risk (CHR) samples, but little is known about the impact of other substances on this relationship. METHOD: Substance use was assessed in a large sample of CHR participants (N = 370, mean age = 18.3) enrolled in the multisite North American Prodrome Longitudinal Study Phase 1 project. Three hundred and forty-one participants with cannabis use data were divided into groups: No Use (NU, N = 211); Cannabis Use without impairment (CU, N = 63); Cannabis Abuse/Dependence (CA/CD, N = 67). Participants (N = 283) were followed for ≥2 years to determine psychosis conversion. RESULTS: Alcohol (45.3%) and cannabis (38.1%) were the most common substances. Cannabis use groups did not differ on baseline attenuated positive symptoms. Seventy-nine of 283 participants with cannabis and follow-up data converted to psychosis. Survival analysis revealed significant differences between conversion rates in the CA/CD group compared with the No Use (P = 0.031) and CU group (P = 0.027). CA/CD also significantly predicted psychosis in a regression analysis, but adjusting for alcohol use weakened this relationship. CONCLUSION: The cannabis misuse and psychosis association was confounded by alcohol use. Non-impairing cannabis use was not related to psychosis. Results highlight the need to control for other substance use, so as to not overstate the cannabis/psychosis connection.

First-line bevacizumab and capecitabine-oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study.

BACKGROUND: Subgroup analyses of clinical studies suggest that bevacizumab plus XELOX is effective and tolerable in elderly patients with metastatic colorectal cancer (mCRC). The prospective BECOX study examined the efficacy and safety of bevacizumab plus XELOX, followed by bevacizumab plus capecitabine in elderly patients with mCRC. METHODS: Patients aged ⩾70 years with Eastern Cooperative Oncology Group performance status 0 out of 1 and confirmed mCRC were included. Patients received bevacizumab 7.5 mg kg(-1) and oxaliplatin 130 mg m(-2) on day 1, plus capecitabine 1000 mg m(-2) bid orally on days 1-14 every 21 days; oxaliplatin was discontinued after 6 cycles. The primary end point was time to progression (TTP). RESULTS: The intent-to-treat population comprised 68 patients (65% male, median age 76 years). Median TTP was 11.1 months; median overall survival was 20.4 months; overall response rate was 46%. Grade 3 or 4 adverse events included diarrhoea (18%) and asthenia (16%). Grade 3 or 4 adverse events of special interest for bevacizumab included deep-vein thrombosis (6%) and pulmonary embolism (4%). CONCLUSIONS: Bevacizumab plus XELOX was effective and well tolerated in elderly patients in the BECOX study. The adverse-event profile was similar to previous reports; no new safety concerns were identified. Fit elderly patients with mCRC should be considered for treatment with bevacizumab plus XELOX.

Occasional cannabis use is associated with higher premorbid functioning and IQ in youth at clinical high-risk (CHR) for psychosis: Parallel findings to psychosis cohorts.

BACKGROUND: Neurocognitive deficits have been widely reported in clinical high-risk for psychosis (CHR) populations. Additionally, rates of cannabis use are high among CHR youth and are associated with greater symptom severity. Cannabis use has been sometimes shown to be associated with better neurocognition in more progressed psychosis cohorts, therefore in this study we aimed to determine whether a similar pattern was present in CHR. METHODS: CHR participants ages 12-30 from the North American Prodromal Longitudinal Study (NAPLS-3) (N = 698) were grouped according to: "minimal to no cannabis use" (n = 406), "occasional use" (n = 127), or "frequent use" (n = 165). At baseline, cannabis use groups were compared on neurocognitive tests, clinical, and functional measures. Follow-up analyses were used to model relationships between cannabis use frequency, neurocognition, premorbid, and social functioning. RESULTS: Occasional cannabis users performed significantly better than other use-groups on measures of IQ, with similar trend-level patterns observed across neurocognitive domains. Occasional cannabis users demonstrated better social, global, and premorbid functioning compared to the other use-groups and less severe symptoms compared to the frequent use group. Follow-up structural equation modeling/path analyses found significant positive associations between premorbid functioning, social functioning, and IQ, which in turn was associated with occasional cannabis use frequency. DISCUSSION: Better premorbid functioning positively predicts both better social functioning and higher IQ which in turn is associated with a moderate cannabis use pattern in CHR, similar to reports in first-episode and chronic psychosis samples. Better premorbid functioning likely represents a protective factor in the CHR population and predicts a better functional outcome.

[Interindividual variability in patients with visuospatial neglect: a retrospective study]. / Variabilidad interindividual en pacientes con heminegligencia visuoespacial: estudio retrospectivo.

INTRODUCTION: Patients who have suffered a stroke may present with visuospatial neglect (VSN). In clinical practice, different degrees of impairment can be observed among patients with VSN; however, there is no consensus regarding the criteria and tests used to determine them. AIM: This study aims to classify patients with VSH based on their level of impairment and to study their response to computerized cognitive training. PATIENTS AND METHODS: The sample consisted of 34 patients (19 men and 15 women) with a mean age of 47.59 ± 8.39 years. All patients underwent a neuropsychological exploration protocol composed of specific tests that assess visuospatial attention and others to evaluate multiple cognitive domains. All participants underwent computerized cognitive training consisting of 15 one-hour sessions. RESULTS: A cluster analysis was performed that divided the sample into three groups: group 1: mildly affected VSN (n = 17), group 2: moderately affected VSN (n = 11), and group 3: severely affected VSN (n = 6). Statistically significant differences were found in all tests of the visuospatial attention protocol, both in the pre-treatment and post-treatment evaluation. CONCLUSIONS: There are different levels of impairment among patients with VSN, differences that persist after applying computerized cognitive training. These results suggest that the evolution of VSN follows a homogeneous pattern linked to the initial level of impairment. These findings, although preliminary, may be relevant to neurorehabilitation professionals.

TITLE: Variabilidad interindividual en pacientes con heminegligencia visuoespacial: estudio retrospectivo.Introducción. Los pacientes que han sufrido un ictus pueden presentar heminegligencia visuoespacial (HVE). En la práctica clínica es posible observar diferentes grados de afectación entre los pacientes con HVE; sin embargo, no existe consenso respecto a los criterios y pruebas utilizadas para determinarlos. Objetivo. Este estudio tiene como objetivo clasificar a los pacientes que presentan HVE en función de su nivel de afectación y estudiar su respuesta a un entrenamiento cognitivo computarizado. Pacientes y métodos. La muestra estaba formada por 34 pacientes (19 hombres y 15 mujeres) con una edad media de 47,59 ± 8,39 años. A todos los pacientes se les administró un protocolo de exploración neuropsicológico compuesto por pruebas específicas que evalúan la atención visuoespacial y otro para evaluar múltiples dominios cognitivos. Todos los participantes realizaron un entrenamiento cognitivo computarizado consistente en 15 sesiones de una hora de duración. Resultados. Se realizó un análisis de conglomerados que dividió la muestra en tres grupos: grupo 1, HVE con afectación leve (n = 17); grupo 2, HVE con afectación moderada (n = 11); y grupo 3, HVE con afectación grave (n = 6). Se obtuvieron diferencias estadísticamente significativas en todas las pruebas del protocolo de atención visuoespacial, tanto en la evaluación pretratamiento como en la postratamiento. Conclusiones. Existen diferentes niveles de afectación entre los pacientes con HVE, diferencias que se mantienen después de aplicar un entrenamiento cognitivo computarizado. Estos resultados sugieren que la evolución de la HVE sigue un patrón homogéneo vinculado al nivel de afectación inicial. Estos hallazgos, aunque preliminares, pueden ser relevantes para los profesionales de la neurorrehabilitación.

Gamification and neurological motor rehabilitation in children and adolescents: a systematic review.

INTRODUCTION: Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS: We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS: From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1). CONCLUSION: The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.

Translation, cross-cultural adaptation and validation of the Rett syndrome motor evaluation scale (RESMES): Spanish version.

OBJECTIVE: To develop a Spanish version of the Rett Syndrome Motor Evaluation Scale (RESMES) for the locomotor function of Rett Syndrome (RTT) using a transcultural methodology. METHODS: The RESMES was cross-culturally adaptated and validated in the Spanish language (RESMES-sp). This study was divided into two well-differentiated phases: 1) a cross-cultural translation and adaptation; 2) psychometric characteristics analysis of the RESMES-sp (reliability, test-retest, construct validity, criteria validity, error measurements). For criteria validity, PAINAD questionnaire, the scoliosis values and PedsQL™, were used. RESULTS: A total of 63 girls and women diagnosed with RTT participated in this validation study. The total value of the RESMES-sp correlates significantly with all its dimensions, with the correlation value oscillating between 0.645 and 0.939. The correlation value with PAINAD ranges between 0.439 and 0.805; the scoliosis values ranges between 0.245 and 0.564; with PedsQOL™ questionnaire, the correlation values range between 0.273 and 0.663 for the PedsQL™ dimensions, and between 0.447 and 0.648 for the total value of PedsQOL™ questionnaire. The reliability values of Crombach's alpha ranged between 0.897 and 0.998 for the intra-observer analyses and between 0.904 and 0.998 for the inter-observer reliability. The SEM showed a value of 2,829, while the MDC90 showed a value of 6601. The Exploratory Factor Analysis showed 6 factors and values of variance of 86.163%. CONCLUSIONS: The Spanish version of the RESMES is a reliable and valid tool for the functional assessment and follow-up of patients with RTT.

Prospective study of cannabis use in adolescents at clinical high risk for psychosis: impact on conversion to psychosis and functional outcome.

BACKGROUND: Clinical and epidemiological studies suggest an association between cannabis use and psychosis but this relationship remains controversial. METHOD: Clinical high-risk (CHR) subjects (age 12-22 years) with attenuated positive symptoms of psychosis (CHR+, n=101) were compared to healthy controls (HC, n=59) on rates of substance use, including cannabis. CHR+ subjects with and without lifetime cannabis use (and abuse) were compared on prodromal symptoms and social/role functioning at baseline. Participants were followed an average of 2.97 years to determine psychosis conversion status and functional outcome. RESULTS: At baseline, CHR+ subjects had significantly higher rates of lifetime cannabis use than HC. CHR+ lifetime cannabis users (n=35) were older (p=0.015, trend), more likely to be Caucasian (p=0.002), less socially anhedonic (p<0.001) and had higher Global Functioning: Social (GF:Social) scores (p<0.001) than non-users (n=61). CHR+ cannabis users continued to have higher social functioning than non-users at follow-up (p<0.001) but showed no differences in role functioning. A small sample of CHR+ cannabis abusers (n=10) showed similar results in that abusers were older (p=0.008), less socially anhedonic (p=0.017, trend) and had higher baseline GF:Social scores (p=0.006) than non-abusers. Logistic regression analyses revealed that conversion to psychosis in CHR+ subjects (n=15) was not related to lifetime cannabis use or abuse. CONCLUSIONS: The current data do not indicate that low to moderate lifetime cannabis use is a major contributor to psychosis or poor social and role functioning in clinical high-risk youth with attenuated positive symptoms of psychosis.

Computerized social cognitive training in the subacute phase after traumatic brain injury: A quasi-randomized controlled trial.

OBJECTIVES: To assess the usefulness of a computerized tasks module designed for the rehabilitation of social cognition (SC) in acquired brain injury. METHODS: Quasi-randomized controlled trial (ClinicalTrials.gov:NCT03479970) involving 45 patients with moderate-severe traumatic brain injury (TBI) in a subacute inpatient rehabilitation hospital. The experimental group (n = 28) received treatment with a computerized SC module in combination with a non-SC module. The control group (n = 26) only received a treatment with non-SC module. RESULTS: Intragroup comparisons showed that the experimental group had better results for all SC measures, except for International Affective Picture System (IAPS). The control group improved for Facial Expressions of cEmotion-Stimuli and Tests (FEEST) and Moving Shapes Paradigm (MSP), showing no changes with respect to pretreatment in IAPS, MSP and Reading the Mind in the Eyes Test (RMET). Intergroup comparisons did not present differences between the two groups for pretreatment measures. Post-treatment comparison showed that the experimental group obtained better results for RMET than the control group. CONCLUSION: The computerized SC module was useful for the rehabilitation of SC in patients with moderate-severe TBI in the subacute phase. The group that received combined rehabilitative treatment (SC + non-SC) obtained better results for SC than the group that received treatment intended only for non-SC.

Social and nonsocial cognition: Are they linked? A study on patients with moderate-to-severe traumatic brain injury.

OBJECTIVES: The first aim was to study the relationship between Social Cognition (SC) and nonsocial Cognition (n-SC) measures in a group of patients with moderate or severe traumatic brain injury (TBI) to assess the dependence or independence of both types of cognition. The second aim was to explore the relationships between SC measures and generate a model based on the results of these relationships. METHODS AND PROCEDURES: Forty-three subacute patients with TBI were included in the study. They were administered a SC battery and n-SC battery. SC battery included the following measures: International Affective Picture System (IAPS); Facial Expressions of Emotion-Stimuli Test (FEEST); Moving Shapes Paradigm (MSP); Reading the Mind in the Eyes Test- Revised Version (RMET); Social Decision Making Task (SDMT). n-SC battery included Digit Span Forwards and Backwards; Trail Making Test (Part A); Rey's Auditory Verbal Learning Test; Letter-Number Sequencing; and verbal fluency test (PMR). RESULTS: FEEST, MSP and RMET were related to n-SC measures. The exploratory factor analysis shows a two-factor SC structure: Factor 1: Emotional recognition and mentalization (FEEST, MSP and RMET) and Factor 2: Acquisition and contextualization (IAPS and SDMT). CONCLUSION: The performance of subjects with moderate-to-severe TBI in the SC measures is related, at least partially, by the performance in the n-SC measures. Our SC model shows a two-factor structure characterized by a first factor that brings together SC measures that are highly related to n-SC domains and a second factor that brings together measures whose performance is not influenced by n-SC domains.

[Mirror and action observation therapy in children with unilateral spastic cerebral palsy: a feasibility study]. / Terapia en espejo y de observación de la acción en niños con parálisis cerebral espástica unilateral: estudio de viabilidad.

INTRODUCTION: Unilateral spastic cerebral palsy affects upper extremity function. Mirror and home-based action observation therapies may be useful in its treatment. The aim has been to evaluate the feasibility of action observation therapy and mirror therapy programmes combined with home action observation in children with unilateral spastic cerebral palsy. SUBJECTS AND METHODS: The feasibility study included children (6-12 years old), randomly assigned to two groups: action observation therapy and mirror therapy and action observation. Twenty-hour home sessions were conducted, including unimanual and bimanual activities. Feasibility of interventions and procedures, and spontaneous use (Assisting Hand Assessment scale) and functionality (Jebsen Taylor Hand Function Test) of the upper extremity were assessed. RESULTS: Twenty-five families were recruited, with 17 meeting the inclusion criteria. Twelve children (8.75 ± 2.38 years) participated in the study. All families completed the interventions, with no adverse effects. The total intervention dose was above 96%. After the intervention, clinically relevant changes were found in both groups in spontaneous use of the upper extremity, as well as in functionality in the action observation therapy group. CONCLUSIONS: Action observation therapy and mirror therapy combined with action observation therapy are considered feasible to be applied at home and aimed at children with unilateral spastic cerebral palsy.

TITLE: Terapia en espejo y de observación de la acción en niños con parálisis cerebral espástica unilateral: estudio de viabilidad.Introducción. La parálisis cerebral espástica unilateral afecta a la función de la extremidad superior. Las terapias en espejo y de observación de la acción domiciliaria pueden ser útiles en su tratamiento. El objetivo ha sido evaluar la viabilidad de programas de terapia de observación de la acción y terapia en espejo combinada con observación de la acción domiciliaria en niños con parálisis cerebral espástica unilateral. Sujetos y métodos. El estudio de viabilidad incluyó a niños (6-12 años), asignados aleatoriamente a dos grupos: terapia de observación de la acción y terapia en espejo y observación de la acción. Se realizaron 20 sesiones domiciliarias de una hora, y se incluyeron actividades unimanuales y bimanuales. Se evaluó la viabilidad de las intervenciones y procedimientos, y el uso espontáneo (escala Assisting Hand Assessment) y la funcionalidad (Jebsen Taylor Hand Function Test) de la extremidad superior. Resultados. Se reclutaron 25 familias, y 17 cumplieron los criterios de inclusión. Doce niños (8,75 ± 2,38 años) participaron en el estudio. Todas las familias completaron las intervenciones y no existieron efectos adversos. La dosis total de intervención fue superior al 96%. Tras la intervención, se hallaron cambios clínicamente relevantes en ambos grupos en el uso espontáneo de la extremidad superior, así como en la funcionalidad en el grupo de terapia de observación de la acción. Conclusiones. La terapia de observación de la acción y la terapia en espejo combinada con terapia de observación de la acción se consideran viables para aplicarse en el hogar y dirigidas a niños con parálisis cerebral espástica unilateral.

Neuropsychological rehabilitation for post-COVID-19 syndrome: results of a clinical programme and six-month follow up.

INTRODUCTION: Patients with post-COVID-19 syndrome may present cognitive and emotional symptomatology. This study aims to analyse the results of an outpatient neuropsychological intervention programme for post-COVID-19 syndrome. METHOD: In June 2020 Institut Guttmann started an outpatient post-COVID-19 neurorehabilitation programme, including respiratory therapy, physiotherapy, and neuropsychological rehabilitation. Before and after the programme, the cognitive-emotional state of all participants is assessed. Six months after treatment, a follow-up assessment is administered (which includes a collection of information on various aspects of daily life). RESULTS: The sample analysed consisted of 123 patients (mean age: 51 years, SD: 12.41). Seventy-four per cent (n = 91) had cognitive impairment and underwent cognitive treatment (experimental group); the remaining 26% (n = 32) constituted the control group. After the intervention, the experimental group improved in working memory, verbal memory (learning, recall and recognition), verbal fluency and anxious-depressive symptomatology. The control group showed changes in immediate memory, verbal memory (learning and recognition) and depressive symptomatology, although the effect size in the latter two was smaller than in the experimental group. Six months after treatment, 44.9% of the patients were unable to perform their pre-COVID-19 work activity, and 81.2% reported difficulties in their activities of daily living. CONCLUSIONS: Neuropsychological rehabilitation is an effective tool to treat the cognitive-emotional deficits present in post-COVID-19 syndrome. However, months after the end of treatment, not all patients recover their pre-COVID-19 functional level.

Divergence of duplicate POMC genes in gilthead sea bream Sparus auratus.

Proopiomelanocorticotrophin (POMC) in vertebrates is produced in the pituitary gland and undergoes post-translational processing to give rise to a range of biologically active peptides. Teleosts possess 2-3 different POMC transcripts which have been proposed to have originated from a whole or partial genome duplication. In the present study 2 transcripts of gilthead sea bream POMC (sbPOMC-α1 and α2) were cloned and characterised. sbPOMC-α1 is expressed principally in the melanotroph cells of the pars intermedia (PI) and sbPOMC-α2 is expressed in the corticotroph cells of the rostral pars distalis and probably also in the PI. The 2 sbPOMC transcripts have a differential tissue distribution in extra-pituitary sites. An appraisal of POMC evolution indicates sbPOMCs belong to one of the two main clades that exist in teleosts and that overall a non conservative process of gene loss occurred in this infraclass.

Combined study of daily growth variability and nitrogen-carbon isotopic signature analysis of schooling Sardina pilchardus larvae.

A combined study of Alborán Sea Sardina pilchardus larval daily growth and isotopic signature was carried out to elucidate the cause of morphometric differences observed in a single larval school whereby the standard length (L(S)) v. dry mass (M(D)) relationship differentiated a heavier-by-size larval group from a lighter larval group. The daily growth analysis revealed that this difference originated from two larval growth patterns, where a fast growing population (F) in contrast to a slow-growing larval population (S) was distinguished. The S-growing larval cohort had a significantly higher nitrogen (N) content as a result of greater somatic mass build up with time in the form of structural proteins. Alternatively, the F-growing population showed a significantly greater amount of carbon (C) content with age, indicating faster metabolic rates of C accretion compared to the S-growing group. In consequence, the C:N ratios of the F-growing larvae were significantly higher than the S-group. C:N ratios of both larval populations showed significant linear decrease with age (and size), while K showed an inverse relationship. The stable isotopes of N did not show significant differences between the S and F-growing larvae. In F-growing larvae, however, a significant linear increase in δ(15)N (by age class) was observed, indicating that as larvae undergo ontogenetic development, trophic level tends to increase. This was also made evident by the significant decrease in age of δ(15)N coefficients of variation (by age class). The higher δ(13)C values in the S-growing larvae were related to the lower growth rates observed in this group. These results suggest a broader trophic flexibility in younger larvae, but moving towards a trophic specialization and more selective diets with age. This trophic specialization shows a tendency of a greater prey size with age. These findings suggest that S-growing larvae have a more omnivorous diet than the F-growing ones.

[Influence of constraint-induced movement therapy on childhood hemiparesis with moderate manual dexterity at 16 years of age: a systematic review]. / Influencia de la terapia de movimiento inducido por restricción en hemiparesia infantil con habilidad manual moderada de 2 a 16 años: revisión sistemática.

INTRODUCTION: The deficit of use on the upper limb affects, as well as the quality of movement, influences the execution of a functional grasp (action of grasping-releasing an object) and therefore, reduces the possibilities of execution of the child's daily activities diagnosed with infantile hemiplegia. Manual ability (finger movements, global and distal grasp, handling, precise movement, fluid...) could be a factor that determines whether the execution of constraint induced movement therapy favors the increase in functionality of the upper limb affected. AIM: To study the constraint induced movement therapy influence on the functionality of the affected upper limb in infantile hemiplegia with moderate manual ability from 2 to 16 years of age. PATIENTS AND METHODS: A bibliographic search of the works published between 2014 and 2019 was performed in the PubMed, PEDro and The Cochrane Library databases. RESULTS: After applying the inclusion/exclusion criteria, seven studies were obtained from a total of 203 to be analyzed, comparing constraint induced movement therapy with other interventions. CONCLUSIONS: The results comparison is complex due to the lack of unanimity in the doses application and evaluation tools of the affected segment. The exclusive application of constraint induced movement therapy allows greater benefits in functionality, at the level of manual ability on affected upper limb in infantile hemiplegia with moderate manual ability than conventional therapy or other therapies.

TITLE: Influencia de la terapia de movimiento inducido por restricción en hemiparesia infantil con habilidad manual moderada de 2 a 16 años: revisión sistemática.Introducción. El déficit de uso de la extremidad superior afectada, así como la calidad del movimiento, influyen en la ejecución de un agarre funcional (acción de agarrar-liberar un objeto) y, por tanto, reducen las posibilidades de ejecución de las actividades cotidianas del niño diagnosticado de hemiplejía infantil. La habilidad manual (movimientos de los dedos, agarre global y distal, manipulación, movimiento preciso, fluido…) podría ser un factor que determine si la ejecución de terapia de movimiento inducido por restricción favorece el incremento de la funcionalidad de la extremidad superior afectada. Objetivo. Estudiar la influencia de la terapia de movimiento inducido por restricción en la funcionalidad de la extremidad superior afectada en hemiplejía infantil con una habilidad manual moderada de 2 a 16 años. Pacientes y métodos. Se realizó una búsqueda bibliográfica de los trabajos publicados entre 2014 y 2019 en las bases de datos PubMed, PEDro y The Cochrane Library. Resultados. Tras aplicar los criterios de inclusión y exclusión, se obtuvieron siete estudios, de un total de 203, para ser analizados, en los que se compara la terapia de movimiento inducido por restricción con otras intervenciones. Conclusiones. La comparativa de resultados resulta compleja debido a la falta de unanimidad en la aplicación de dosis y herramientas de evaluación del segmento afectado. La terapia de movimiento inducido por restricción aplicada de manera exclusiva permite mayores beneficios en la funcionalidad en cuanto a destreza manipulativa de la extremidad superior afectada en hemiplejía infantil con habilidad manual moderada que la terapia convencional u otras terapias.