Association of response time and intermittent hypoxemia in extremely preterm infants.

AIM: To determine the relationship between medical staff's response time (RT) to oxygen saturation (SpO2 ) below 80% and the associated time from tactile intervention until SpO2 normalisation (CT). METHODS: Time-lapse video and continuous SpO2 were recorded for six consecutive 24 h periods. Regression analyses of RT and SpO2 in association with postmenstrual age (PMA), weight, infant sex and frequency of intermittent hypoxemia (IH). RESULTS: Five hundred and twelve hypoxemia episodes received tactile intervention in 20 extremely preterm infants (gestational age ≤28 weeks, birthweight <1500 g). Median RT was 20.5 s (IQR 16.63-25.50). RT increased with increased IH frequency (p = 0.023) independently of PMA and weight. SpO2 decreased by 3.7% with every 10 s RT (p = 0.039). Time until SpO2 normalisation was strongly associated with RT (ß = 0.58, p = 0.042). The association was amplified by lower PMA (p = 0.043). Female preterm infants experienced longer RT than males (p = 0.027). Because the total length of an IH is the sum of RT and CT, preterm infants with low PMA can reach a critical hypoxemia duration of >60 s, even with short RT. CONCLUSION: The RT is a critical factor that affects the overall time of IH treatments and the depth of desaturation. The consequences of a prolonged RT are worse for more immature preterm infants.

Cognitive and emotional regulation processes of spontaneous facial self-touch are activated in the first milliseconds of touch: Replication of previous EEG findings and further insights.

Spontaneously touching one's own face (sFST) is an everyday behavior that occurs in people of all ages, worldwide. It is-as opposed to actively touching the own face-performed without directing one's attention to the action, and it serves neither instrumental (scratching, nose picking) nor communicative purposes. These sFST have been discussed in the context of self-regulation, emotional homeostasis, working memory processes, and attention focus. Even though self-touch research dates back decades, neuroimaging studies of this spontaneous behavior are basically nonexistent. To date, there is only one electroencephalography study that analyzed spectral power changes before and after sFST in 14 participants. The present study replicates the previous study on a larger sample. Sixty participants completed a delayed memory task of complex haptic relief stimuli while distracting sounds were played. During the retention interval 44 of the participants exhibited spontaneous face touch. Spectral power analyses corroborated the results of the replicated study. Decreased power shortly before sFST and increased power right after sFST indicated an involvement of regulation of attentional, emotional, and working memory processes. Additional analyses of spectral power changes during the skin contact phase of sFST revealed that significant neurophysiological changes do not occur while skin contact is in progress but at the beginning of sFST (movement toward face and initial skin contact). The present findings clearly illustrate the complexity of sFST and that the specific trigger mechanisms and functions of this spontaneous behavior need to be further investigated in controlled, experimental studies.

[How the brain perceives the world in old age with all senses]. / Wie das Gehirn die Welt im Alter mit allen Sinnen wahrnimmt.

BACKGROUND: Aging is a multidimensional process that may lead to physical, psychological and social changes. This is predominantly due to a decline of sensory functions and their central processing. MATERIAL AND METHODS: Selective literature search in Medline and the Cochrane Library. RESULTS: In addition to specific disorders of the sensory organs, unspecific age-related degenerative processes are responsible for the high prevalence of sensory limitations in older people. This can lead to a significant reduction in the quality of life. Balance impairment, decreasing function of hearing, vision, smell and the somatosensory system are associated with an increased risk of falling and an increased mortality in older people. Furthermore, there is evidence for a link between hearing loss and cognitive decline. In addition to the functional ability of every sense on its own, the integration of multiple sensory perceptions plays an increasing role in age-related sensory limitations. CONCLUSION: Sensory impairments have to be considered when working with older people. Early detection and an interdisciplinary therapeutic approach can reduce the negative consequences. Multimodal stimulation appears to stimulate brain plasticity which helps to compensate age-related changes.

Does Studying Veterinary Medicine Improve Students' Haptic Perception Ability? A Pilot Study With Two Age-Groups.

Haptic perception is an important tool for veterinarians. The present study analyzed the association between the haptic perception threshold of veterinary students and their palpatory experience. To approach this goal, 35 female students of veterinary medicine were divided into two groups with different levels of experience: (a) students with little practical experience, at the beginning of their studies (first year), and (b) students close to the end of their theoretical training (fourth year). To thoroughly evaluate the students' sense of touch, three different test procedures were used: the Haptic Threshold Test (HTT), the Haptic Figures Test (HFT), and tactile acuity. Contrary to our expectations, we found worse mean haptic perception thresholds (HTT) in the more experienced students than in the less experienced group. This effect was significantly correlated with age. Furthermore, we found that longer exploration times were not sufficient to compensate for shortcomings in haptic perception. We also found large interindividual differences. Future studies should investigate whether and to what extend these effects have an impact on students' palpation performance on simulators and live animals. Moreover, which beneficial effects may be achieved through an additional haptic training for students with inferior haptic thresholds should be investigated. Improving haptic perception abilities in veterinary students could be one important step toward achieving satisfactory Day One Competences in university graduates.

Refraining from spontaneous face touch is linked to personality traits, reduced memory performance and EEG changes.

Spontaneous touches of one's face (sFST) were suggested to serve cognitive-emotional regulation processes. During the pandemic, refraining from face-touching was recommended, yet, accompanying effects and the influence of personal attributes remain unclear. Ninety participants (45 female, 45 male) filled out a questionnaire concerning personality, anxiety screening and ADHD screening. Subsequently, they performed a delayed verbal memory recall task four times. After two times, sixty participants were instructed to refrain from face-touching (experimental group). Thirty participants did not receive behavioral instructions (control group). To identify face-touches and conduct further analysis, Video, EMG, and EEG data were recorded. Two samples were formed, depending on the adherence to completely refrain from face-touching (adherent, non-adherent sample) and compared to each other and the control group. EEG analyses uncovered that refraining from face-touching is accompanied by increased beta-power at sensorimotor sites and, exclusively in the non-adherent sample, at frontal sites. Decreased memory performance was found exclusively in subsamples, who non-adherently touched their face while retaining words. In terms of questionnaire results, lower Conscientiousness and higher ADHD screening scores were revealed by the non-adherent compared to the adherent sample. No differences were found among the subsamples. The presented results indicate that refraining from face-touching is related to personal attributes, accompanied by neurophysiological shifts and for a portion of humans by lower memory performance, supporting the notion that sFST serve processes beyond sensorimotor.

Observation of own exploration movements impairs haptic spatial perception.

The present study was designed to assess whether the visibility of ones' own exploratory movements impairs or enhances perceptual speed and precision of haptic stimuli with varying complexity. Previous studies have shown that noninformative vision of steady surroundings improves haptic spatial perception. However, due to the serial nature of haptic processing and limited capacity of working memory resources, we hypothesized that noninformative vision of limb movements may impair haptic perception. The study sample consisted of ninety-eight healthy adults who were randomized into two groups, matched for sex and age. Participants were required to explore two-dimensional haptic stimuli with varying complexity and to recognize them visually. The difference between the two experimental groups was a screen that would prevent the participants from viewing their hands during exploration in the nonobservation condition (NonOb). The other half of participants were able to see their hands in the manual movement observation condition (MovOb) thanks to the special design of the stimuli. As hypothesized, the persons in the MovOb condition made significantly more errors. The difference in error frequency between participants of the MovOb and NonOb condition was greater for complex stimuli than for simple ones. These results suggest that incoming visual information about own manual exploration movements increases competitive pressure for limited working memory resources, and therefore, more recognition errors are made. Covering the hands during exploration may constitute a helpful simplification of the task's demands by supporting the maintenance of information in working memory. Additionally, the relation of haptic complexity and stimulus characteristics was analyzed.

Spontaneity matters! Network alterations before and after spontaneous and active facial self-touches: An EEG functional connectivity study.

BACKGROUND: Despite humans frequently performing spontaneous facial self-touches (sFST), the function of this behavior remains speculative. sFST have been discussed in the context of self-regulation, emotional homeostasis, working memory processes, and attention focus. First evidence indicates that sFST and active facial self-touches (aFST) are neurobiologically different phenomena. The aim of the present analysis was to examine EEG-based connectivity in the course of sFST and aFST to test the hypotheses that sFST affect brain network interactions relevant for other than sensorimotor processes. METHODS: To trigger spontaneous FST a previously successful setting was used: 60 healthy participants manually explored two haptic stimuli and held the shapes of the stimuli in memory for a 14 min retention interval. Afterwards the shapes were drawn on a sheet of paper. During the retention interval, artifact-free EEG-data of 97 sFST by 32 participants were recorded. At the end of the experiment, the participants performed aFST with both hands successively. For the EEG-data, connectivity was computed and compared between the phases before and after sFST and aFST and between the respective before-and the after-phases. RESULTS: For the before-after comparison, brainwide distributed significant connectivity differences (p < .00079) were observed for sFST, but not for aFST. Additionally, comparing the before- and after-phases of sFST and aFST, respectively, revealed increased similarity between the after-phases than between the before-phases. CONCLUSION: The results support the assumption that sFST and aFST are neurobiologically different phenomena. Furthermore, the aligned network properties of the after-phases compared to the before-phases indicate that sFST serve self-regulatory functions that aFST do not serve.

Incidence of Intermittent Hypoxemia Increases during Clinical Care and Parental Touch in Extremely Preterm Infants.

OBJECTIVES: An increased frequency of intermittent hypoxemia (IH) is associated with a higher risk for poor developmental outcomes, disability, or death in extremely preterm infants. The objective of the prFesent study is to quantify the effect of hands-on medical and parental interventions on the incidence of IH in extremely preterm infants. METHODS: An observational design with intraindividual comparisons was used. Blood oxygen saturation levels (SpO2) and time-lapse video were recorded. Frequency, duration, and time to occurrence of IH (SpO2 <80% for ≥10 s) were compared between nursing and medical care (NMC), health care by parents, skin-to-skin contact (SSC), touch in incubator, physiotherapy, and rest. Each infant was observed for six consecutive 24-h periods. Inclusion criteria were as follows: gestational age ≤28 weeks, birth weight <1500 g, postnatal age 0-6 weeks, gavage feeding, no severe illnesses or invasive procedures, no mechanical ventilation. RESULTS: The highest proportion of time with IH occurred during NMC (2.49%) and incubator touch (1.32%), the lowest during SSC (0.74%) and health care by parents (0.67%). IH frequency per hour was highest during NMC (2.95, IQR 1.19-4.01) and lowest during SSC (0.88, IQR 0.37-2.32, p < 0.001). While an increase in IH during NMC was expected, the high incidence during incubator touch was surprising. Parental touch in the incubator is intended to be soothing, not stressful. CONCLUSIONS: Future studies need to clarify how preterm infants process touch, which attributes of touch are fundamental trigger mechanisms of IH, and which handling strategies are most effective in lowering the incidence of IH during hands-on medical care.

The suppression of spontaneous face touch and resulting consequences on memory performance of high and low self-touching individuals.

Spontaneous touching of one's own face (sFST) is an everyday behavior that occurs primarily in cognitively and emotionally demanding situations, regardless of a persons' age or gender. Recently, sFST have sparked scientific interest since they are associated with self-inoculation and transmission of respiratory diseases. Several studies addressed the need to reduce sFST behaviors without discussing the underlying functions of this spontaneous behavior. In addition, the question of why this behavior occurs very frequently in some individuals (high self-touching individuals, HT) but less frequently in others (low self-touching individuals, LT) has not yet been addressed. For the first time, we distinguished between HT and LT and investigated the behavioral consequences of sFST suppression in these two groups. For this purpose, we examined performance outcomes of 49 participants depending on sFST behaviors during a haptic working memory task. In addition, we assessed personality traits of HT and LT using the Freiburg Personality Inventory (FPI-R). The results of our study reveal that suppressing sFST in HT is negatively related to memory performance outcomes. Moreover, HT show tendencies to differ from LT in certain personality traits. Our results highlight the relevance of distinguishing between HT and LT in future studies of sFST.

Effects, Side Effects and Contraindications of Relaxation Massage during Pregnancy: A Systematic Review of Randomized Controlled Trials.

Healthcare professionals and expecting mothers frequently voice concerns that massages during pregnancy might cause complications or premature labor. This PRISMA review outlines current results on effects, side effects and contraindications of relaxation massage during pregnancy. Inclusion criteria: all randomized controlled trials (RCT) comparing relaxation massage during pregnancy with standard care or standard care plus another intervention (i.e., progressive muscle relaxation). Restrictions were full text availability and English language. Results: 12 RCT were included. Trials had good methodological quality but unknown risk of bias. All women were at least 12 weeks gestation at the start of the study. The main benefits of massage during pregnancy were: reduced stress, back and leg pain, depression and anxiety; increased immune response; increased serotonin and dopamine levels; higher fetal birth weight and reduced risk of preterm delivery. Only 2 RCT reported potential side effects of massage, which were minor and transient. Seven RCT excluded women with difficult pregnancies or preexisting complications, five studies did not report preexisting conditions. Those obstetric or postnatal complications that occurred were most likely unrelated to massage treatments. In healthy pregnant women without complications, relaxation massage has positive effects throughout pregnancy. Precautions for massage during pregnancy (i.e., to prevent pulmonary embolism) are discussed.

Stop touching your face! A systematic review of triggers, characteristics, regulatory functions and neuro-physiology of facial self touch.

Spontaneous face touching (sFST) is an ubiquitous behavior that occurs in people of all ages and all sexes, up to 800 times a day. Despite their high frequency, they have rarely been considered as an independent phenomenon. Recently, sFST have sparked scientific interest since they contribute to self-infection with pathogens. This raises questions about trigger mechanisms and functions of sFST and whether they can be prevented. This systematic comprehensive review compiles relevant evidence on these issues. Facial self-touches seem to increase in frequency and duration in socially, emotionally as well as cognitively challenging situations. They have been associated with attention focus, working memory processes and emotion regulating functions as well as the development and maintenance of a sense of self and body. The dominance of face touch over other body parts is discussed in light of the proximity of hand-face cortical representations and the peculiarities of facial innervations. The results show that underlying psychological and neuro-physiological mechanisms of sFST are still poorly understood and that various basic questions remain unanswered.

Sensory Dysfunction in Old Age.

BACKGROUND: The senses serve as the crucial interface between the individual and the environment. They are subject to aging and disease processes. METHODS: This review is based on pertinent publications retrieved by a selective search in the Medline and Cochrane Library databases. RESULTS: Approximately 40% of persons aged 70 to 79 manifest dysfunction in at least one, and more than 25% in multiple senses. Sensory changes are accompanied by diverse comorbidities which depend on the particular sense(s) affected. The presence of sensory deficits is associated with an increased risk of developing dementia (OR: 1.49 [95% confidence interval: 1.12; 1.98] for dysfunction in a single sensory modality, 2.85 [1.88; 4.30] for dysfunction in three or more sensory modalities). The risk of developing depressive symptoms is elevated as well (OR 3.36 [2.28; 4.96]). The individual's ability to cope with the demands of everyday life is largely determined by the ability to carry out multisensory integration, in which the perceptions of the different senses are bound together. This function itself is subject to age-related changes that can be either adaptive or maladaptive; it can, therefore, serve as an indicator for pathological aging processes. CONCLUSION: Sensory dysfunction in old age should be detected as early as possible. This implies the need for close collaboration of all of the involved disciplines. It would be desirable to develop sensory screening tests as well as a procedure for testing multisensory integration in routine clinical practice.

Light or Deep Pressure: Medical Staff Members Differ Extensively in Their Tactile Stimulation During Preterm Apnea.

Background: Even though tactile stimulation is common practice to terminate preterm apnea, the style and intensity of these interventions is not specified during theoretical or practical training and has never been clinically evaluated. Objective: The present study was designed to analyze the various modes of tactile stimulation used to terminate preterm apnea and measure the pressure intensity and frequency of these stimulations. Methods: A model with the size and weight of an actual preterm infant was equipped with sensor technology to measure stimulation pressure and frequency of tactile stimulation. Additionally a camera system was used to record hand positions and stimulation modes. Seventy medical staff members took part in the experiment. Results: We found extreme between subjects differences in stimulation pressure that could not be explained by professional experience but, to a degree, depended on apnea intensity. Pressures ranged from 11.11 to 226.87 mbar during low intensity apnea and from 9.89 to 428.15 mbar during high intensity apnea. The majority of participants used rhythmic stimulation movements with a mean frequency of ~1 Hz. Different modes (rubbing, squeezing, tickling, and tapping) and finger positions were used. Conclusion: Medical staff members intuitively adjust their tactile stimulation pressure depending on the premature infants' apnea intensity. However, mean pressure values varied greatly between subjects, with similar pressure ranges for low and high intensity apnea. The question remains which pressure intensities are necessary or sufficient for the task. It is reasonable to assume that some stimulation types may be more effective in rapidly terminating an apneic event.

A comparison of different survey periods in online surveys of persons with eating disorders and their relatives.

Evaluations of Internet-based interventions offered to patients with mental or psychosomatic illnesses are mostly carried out in the form of online surveys. This study tested whether modifying this time interval brings about changes in the respondents' response behavior and the make-up of the sample. Two survey strategies were compared: a postblock survey (with a variable time interval between the Internet-based intervention and the online survey) and a postspot survey (time interval standardized to 90 days). In the postspot survey, it was possible to prove a higher response rate (39.9%) than in the postblock survey (28.0%) as well as a higher number of questionnaires completed correctly and in full. No differences were identified in the basic characteristics of the random samples. It was possible to demonstrate that the quality of the online survey could be improved by standardizing the length of time. Standardization of the time difference implies a controllable degree of influence on the quality of the evaluations.

A comparison of different survey periods in online surveys of persons with eating disorders and their relatives.

Evaluations of Internet-based interventions offered to patients with mental or psychosomatic illnesses are mostly carried out in the form of online surveys. Up until now, the methods used in carrying out these evaluations have seldom been systematically investigated. This study tested whether modifying this time interval brings about changes in the respondents' response behavior and the make-up of the sample. Two survey strategies were compared: a post-block survey (with a variable time interval between the Internet-based intervention and the online survey) and a post-spot survey (time interval standardised to 90 days). In the post-spot survey it was possible to prove a higher response rate (39.9%) than in the post-block survey (28.0%) as well as a higher number of questionnaires completed correctly and in full. No differences were identified in the basic characteristics of the random samples. It was possible to demonstrate that the quality of the online survey could be improved by standardising the length of time. Standardisation of the time difference implies a controllable degree of influence on the quality of the evaluations.

Self-touch: Contact durations and point of touch of spontaneous facial self-touches differ depending on cognitive and emotional load.

Every human being spontaneously touches its eyes, cheeks, chin and mouth manifold every day. These spontaneous facial self-touches (sFST) are elicited with little or no awareness and are distinct from gestures and instrumental acts. Self-touch frequency has been shown to be influenced by negative affect and attention distraction and may be involved in regulating emotion and working memory functions. Yet, even though self-touch research dates back several decades fundamental aspects, like the temporal progression of sFST or the effects of executing hand and touched face area, have not yet been analyzed. For the first time, the present study measured sFST temporal aspects to the millisecond using accelerometers and EMG. Spontaneous self-touch was triggered in sixty participants who completed a delayed memory task of complex haptic relief stimuli while listening to distracting aversive sounds. We found that while both hands were used equally often and with the same overall movement times and contact durations, significant effects occurred for face area in both frequency and contact durations. Ergo the point of touch seems to have some relevance of its own, independently of which hand is used to perform it. The results show that not only frequency but also the point of touch and contact durations are influenced by cognitive and emotional demands. We argue that investigating the fundamental characteristics of sFST will further the understanding of cognitive focusing and attentional mechanisms.

Online discussion groups for bulimia nervosa: an inductive approach to Internet-based communication between patients.

OBJECTIVE: Online discussion forums are often used by people with eating disorders. METHOD: This study analyses 2,072 threads containing a total of 14,903 postings from an unmoderated German "prorecovery" forum for persons suffering from bulimia nervosa (www.ab-server.de) during the period from October 2004 to May 2006. The threads were inductively analyzed for underlying structural types, and the various types found were then analyzed for differences in temporal and quantitative parameters. RESULTS: Communication in the online discussion forum occurred in three types of thread: (1) problem-oriented threads (78.8% of threads), (2) communication-oriented threads (15.3% of threads), and (3) metacommunication threads (2.6% of threads). Metacommunication threads contained significantly more postings than problem-oriented and communication-oriented threads, and they were viewed significantly more often. Moreover, there are temporal differences between the structural types. CONCLUSION: Topics relating to active management of the disorder receive great attention in prorecovery forums.

Neuropsychological and Neurophysiological Indicators of General and Food-Specific Impulsivity in Children with Overweight and Obesity: A Pilot Study.

Impulsivity, particularly towards food, is a potential risk factor for increased energy intake and the development and maintenance of obesity in children. However, neuropsychological and neurophysiological indicators of general and food-specific impulsivity and their association with children's weight status are poorly understood. This pilot study examined electroencephalography (EEG) frequency band profiles during eyes-closed and eyes-open resting state in n = 12 children with overweight or obesity versus n = 22 normal-weight controls and their link to child- and parent-reported and experimentally assessed impulsivity of children (e.g., risk-taking behavior, approach-avoidance behavior towards food). The main results indicated that children with overweight/obesity versus normal weight showed significantly increased delta and decreased alpha band activity during eyes-closed resting state. Across the total sample, EEG slow-wave band activity was particularly linked to self- and parent-reported impulsivity and greater risk-taking behavior, but not to approach behavior towards food, after controlling for children's age and weight status. The identification of specific EEG patterns in children with excess weight may provide a new basis for developing neurophysiological diagnostic and treatment approaches for childhood obesity. Future studies with larger samples and longitudinal designs are needed to replicate the present findings and test their stability over time.

Does the hippocampal atrophy correlate with the cortical theta power in elderly subjects with a range of cognitive impairment?

A previous study with a small sample (N = 39) showed a significant correlation between the cortical theta activity and the hippocampal volume in different stages of cognitive impairment in aged subjects. The recent study was aimed to replicate these results in a much bigger sample. The authors examined a sample of 121 right-handed subjects. The sample consisted of 37 healthy controls, 40 patients with questionable dementia, and 44 patients with mild dementia assessed by Clinical Dementia Rating. All subjects underwent EEG and brain MRI. Mean spectral power was calculated, and volume of hippocampal segments was measured. EEG theta power of the left and right hemisphere correlated significantly with the hippocampal volume on the left and right side in different stages of cognitive impairment. An increase of theta power was associated with decreased hippocampal volume. No other significant correlations were found for alpha or beta band power. No correlation was found between cortical theta and global brain volume. There seems to be a direct relationship between neuronal loss of the hippocampus and changed cortical theta activity for different stages of cognitive impairment in aged subjects.

Special online consulting for patients with eating disorders and their relatives: analysis of user characteristics and E-mail content.

In the treatment of chronic diseases, programs that use the internet as a medium are becoming more and more important as a complement to classical intervention techniques. Since 1998, a non-profit information and online consulting service for patients with eating disorders and their friends and relatives (www.ab-server.de) has existed. This was established by members of the Deutsche Forschungsinitiative Essstörungen e.V. (DFE) [German Research Initiative for Eating Disorders] and members of the Clinic of Psychiatry, University of Leipzig, Germany. For the present study, 2,176 e-mail requests from users of the online consultation service were analyzed qualitatively and quantitatively in order to better understand the differences between different types and groups of users. The analysis was related to the social field of the person requesting the consultation, the type of disorder reported, and the content of the e-mail request. Three main user groups could be identified: people who described themselves as having an eating disorder (57.2%), people who were related socially to the affected person (32.4%), and interested persons (9.8%). The consulting service was predominantly used by persons suffering from bulimia nervosa or their families and friends (63.1%). One third (33.3%) of the posted e-mails were related to behavioral patterns in dealing with the illness and the affected person. They were followed by inquiries for information about the disease (18.7%) and by those seeking help in finding specialized clinics/therapists and places in therapies. The increasing use of the online consulting service indicates that there is a substantial need for information and help in persons with eating disorders and in their relatives, who are able to easily contact professionals using this online service. Online consulting has a high potential for complementary care of affected people.