Craniofacial Collaboration UK: Developmental Outcomes in 5-Year-Old Children With Sagittal Synostosis.

ABSTRACT: The Craniofacial Collaboration UK (CC-UK) is a joint initiative that seeks to address some of the limitations of previous developmental research with this patient group by providing systematically collected, robust data from clinically and chronologically homogenous representative samples of children. The current paper outlines the developmental outcomes at the age of 5 for children who had previously undergone primary surgery for single-suture sagittal synostosis (SS). It shows broad consistencies with the previous CC-UK work, indicating that the majority of children with SS will perform within the average range compared to peers across a number of developmental, behavioral and emotional domains. However, the group mean for children with SS indicates significantly greater difficulties with fine motor skills and hyperactivity, relative to normative data. Unexpectedly, children with SS had significantly better problem solving skills. While it is reassuring that the majority of children are broadly developing in line with their unaffected peers, these small but significant differences may be early indicators of some of the subtle difficulties documented in older children with craniosynostosis. Longitudinal follow up is therefore important to understand the developmental trajectory for children with SS and identification of potentially 'at risk' sub groups within this diagnostic cohort.

Preliminary Analysis From the Craniofacial Collaboration United Kingdom Developmental Outcomes in Children With Sagittal Synostosis.

The Craniofacial Collaboration United Kingdom (CC-UK) was established across the 4 Highly Specialized Craniofacial Centres (HSCCs) in the UK in 2015. This is the first wave of data to be analyzed, looking at 3-year-old children with sagittal synostosis who have had primary corrective surgery. This is a comprehensive, homogenous dataset, looking at parental measures of development and behavior. The results indicate that the majority of children are rated by their parents as falling within one standard deviation of the mean for both developmental and behavioral measures. However, there was a trend across the age groups within the sample which, although not statistically significant, indicates that more developmental difficulties may become apparent as children get older. Behavior was rated as more problematic, and the areas of greatest parental concern were Conduct (challenging or confrontational behavior) and Hyperactivity domains, where 24% of children were rated as within the clinically significant range. Although the majority of children were rated as falling within the average range, the difference in the mean between the sagittal and the normative group was significant in 5 of the 6 behavioral domains. Further research is required to examine whether these findings are stable over time and to look at the mechanism which might be driving these changes. It is anticipated that future CC-UK analysis will elucidate this more clearly.

Aversive viscerally referred states and thirst accompanying the sating of hunger motivation by rapid digestion of glucosaccharides.

Associative conditioning of satiety indicates that concentrated maltodextrin (cMD) may induce a mildly aversive visceral signal within 20 min of its ingestion, as well as satiating normally. Individuals' awareness of this adverse state was tested on ratings of statistically distinct descriptions of factors liable to suppress hunger, whether distressing or comfortably satisfying. Wanted amount of a food and the pleasantness of eating it correlated highly for each of five foods, once again refuting the widespread presumption that "pleasant" refers to sensory pleasure; hence, as in previous reports, suppression of hunger was measured as a reduction of the averaged pleasantness of functionally related foods. At 20 min after the start of ingestion of a small meal on a near-empty stomach, cMD reliably reduced hunger. The greatest influence on hunger, besides normal sating, was thirst, but there were also tendencies to nausea and bloat, although all less than after a full sized meal. Visceral processes shortly after a meal can create dissociable conscious states, only one of which is satiety for food.