Early Intervention Research Articles

Perspectives of Teachers on Learning: A Glance on the Reading Proficiency of Kindergarten Learners

This study aimed to describe the experiences of kindergarten teachers in regards to the reading problem issue of kindergarten learners in Samal District, Island Garden City of Samal. The participants were the ten kindergarten teachers, utilizing phenomenological design to explore their challenges, perceived coping mechanisms on the issue and insights. A semi- structured interview guide was used to gather the data. Ethical considerations were observed in data collection. Thematic content analysis was used to extract the themes. The findings were: were poor background knowledge, low phonological awareness skills, local language diversity, limited exposure to reading materials, engagement and attention span struggles, and economic scarcity are the main challenges; the identified teachers’ perception on the reading situations of students in coping with the issues are use of differentiated instruction, individualized support, continuous assessment and monitoring, and collaborative efforts; and importance of early intervention, recognition of learners’ diversity, continual assessment and improvement, family and community engagement, and teacher’s professional development are the insights drawn. The recommendation included allocating resources, funding, and support services by the Department of Education specifically targeted at addressing early literacy disparities and improving outcomes for students at risk of reading difficulties.

Observation and treatment of patients with progressive metastatic differentiated thyroid cancer after establishment of radioiodine refractoriness

Differentiated thyroid cancer is one of the most common malignant diseases of the endocrine system. Usually, it responds well to the standard treatment (surgery + radioiodine therapy), especially at early stages. During both treatment and dynamic observation, distant metastases are detected in 10–15 % of patients. In these cases, the patients continue treatment with radioactive iodine. If tumor cells have insufficient ability to capture and retain 131I or completely lose this ability, the effect of radioiodine therapy becomes limited and the disease progresses during therapy which leads to 5–10 % decrease in 10-year survival. The main problem in treatment of differentiated thyroid cancer is communication between radiologists in centers performing radioiodine therapy and clinical oncologists performing surgeries and observation at patient’s place of residence. For both specialists, the main goal is to identify clinical situations where early and effective treatment intervention can be beneficial without the risk of overdiagnosis and excessive treatment.The article considers common questions arising during multidisciplinary interactions with radiologists of radioiodine centers and presents concise guidelines on the observation and treatment procedures for patients with differentiated thyroid cancer.

The Motor Optimality Score—Revised Improves Early Detection of Unilateral Cerebral Palsy in Infants with Perinatal Cerebral Stroke

Background: Neonatal cerebral stroke includes a range of focal and multifocal ischemic and hemorrhagic brain lesions, occurring in about one of 3000 live births. More than 50% of children with neonatal stroke develop adverse outcomes, mainly unilateral cerebral palsy. Asymmetries in segmental movements at three months have been proven to be an early sign of CP in infants with unilateral brain damage. Recognition of additional early signs could enhance prognostic assessment and enable an early and targeted intervention. Aim: The aim of the study was to assess early signs of CP in infants with arterial cerebral stroke through the General Movements Assessment and the Motor Optimality Score—Revised (MOS-R). Method: Twenty-four infants born at term (12 females and 12 males) diagnosed with ACS, and 24 healthy infants (16 females and 8 males) were assessed. The GMs (fidgety movements) and MOS-R were assessed from videos recorded at 11–14 weeks of post-term age. Cognitive and motor outcomes were assessed at 24 months using the Griffiths III developmental quotient and Amiel-Tison neurological examination. The gross motor function classification system expanded and revised (GMFCS-E&R) was adopted to categorize CP. Results: Among infants with ACS, 21 (87.5%) developed unilateral CP. Most of them showed non-disabling CP (14 had GMFCS-E&R grade 1 [66.6%], 6 grade 2 [28.6%], and 1 grade 5 [4.8%]). Fidgety movements (FMs) were absent in 17 (70.8%), sporadic in 4 (16.7%) infants, and normal in 3 (12.5%). Segmental movement asymmetry was found in 22/24 (91.7%). According to the MOS-R, motor items (kicking, mouth movements), postural patterns (midline centered head, finger posture variability), and movement character (monotonous and stiff) were statistically different among infants with ACS and healthy infants. The MOS-R median global score was lower in the group with ACS compared to the control group (6 vs 26; p < 0.01). FMs, segmental movement asymmetry, and MOS-R global score were significantly correlated with abnormal outcome. MOS-R global scores less than or equal to 13 had 100% specificity and sensitivity in predicting GMFCS-E&R grade ≥ 2 CP in infants with ACS. Conclusions: The rate of CP was high among infants with ACS, but in most cases it showed low GMFCS-E&R grades. The study highlighted a significant correlation between MOS-R, together with absent FMs and unilateral CP in infants with ACS. Moreover, the MOS-R showed high sensitivity and specificity in the prediction of CP. Combined assessment of FMs and MOS-R could help to better identify infants at high risk of developing UCP in a population of infants with ACS. Early identification of precocious signs of unilateral CP is fundamental to providing an early individualized intervention.

HRP-OG: Online Learning with Generative Feature Replay for Hypertension Risk Prediction in a Nonstationary Environment

Hypertension is a major risk factor for many serious diseases. With the aging population and lifestyle changes, the incidence of hypertension continues to rise, imposing a significant medical cost burden on patients and severely affecting their quality of life. Early intervention can greatly reduce the prevalence of hypertension. Research on hypertension early warning models based on electronic health records (EHRs) is an important and effective method for achieving early hypertension warning. However, limited by the scarcity and imbalance of multivisit records, and the nonstationary characteristics of hypertension features, it is difficult to predict the probability of hypertension prevalence in a patient effectively. Therefore, this study proposes an online hypertension monitoring model (HRP-OG) based on reinforcement learning and generative feature replay. It transforms the hypertension prediction problem into a sequential decision problem, achieving risk prediction of hypertension for patients using multivisit records. Sensors embedded in medical devices and wearables continuously capture real-time physiological data such as blood pressure, heart rate, and activity levels, which are integrated into the EHR. The fit between the samples generated by the generator and the real visit data is evaluated using maximum likelihood estimation, which can reduce the adversarial discrepancy between the feature space of hypertension and incoming incremental data, and the model is updated online based on real-time data using generative feature replay. The incorporation of sensor data ensures that the model adapts dynamically to changes in the condition of patients, facilitating timely interventions. In this study, the publicly available MIMIC-III data are used for validation, and the experimental results demonstrate that compared to existing advanced methods, HRP-OG can effectively improve the accuracy of hypertension risk prediction for few-shot multivisit record in nonstationary environments.

Development of a non-invasive diagnostic model for high-risk esophageal varices based on radiomics of spleen CT.

To evaluate the diagnostic performance of radiomics models derived from multi-phase spleen CT for high-risk esophageal varices (HREV) in cirrhotic patients. We retrospectively selected cirrhotic patients with esophageal varices from two hospitals from September 2019 to September 2023. Patients underwent non-contrast and contrast-enhanced CT scans and were categorized into HREV and non-HREV groups based on endoscopic evaluations. Radiomics features were extracted from spleen CT images in non-contrast, arterial, and portal venous phases, with feature selection via lasso regression and Pearson's correlation. Ten machine learning models were developed to diagnose HREV, evaluated by area under the curve (AUC). The AUC values of the three groups of models were statistically compared by the Kruskal-Wallis H test and Bonferroni-corrected Mann-Whitney U test. A p-value less than 0.05 was considered statistically significant. Among 233 patients, 11, 6, and 11 features were selected from non-contrast, arterial, and portal venous phases, respectively. Significant differences in AUC values were observed across phases (p < 0.05), and the arterial phase models showed the highest AUC values. The best model in arterial phase was the logical regression model, whose AUC value was 0.85, sensitivity was 83.3%, specificity was 80% and F1 score was 0.81. Radiomics models based on spleen CT, especially the arterial phase models, demonstrate high diagnostic accuracy for HREV, offering the potential for early detection and intervention.

The implementation of EMI-Heart, a family-tailored early motor intervention in infants with complex congenital heart disease, in practice: a feasibility RCT

BackgroundChildren with congenital heart disease (CHD) who undergo open-heart surgery are at risk of developmental impairment, including motor delay, which contributes to parental concerns. Additionally, parents experience prolonged stress associated with their child’s disease. There is a lack of early motor interventions in infants with CHD accounting for parental burdens. We developed a family-tailored early motor intervention (EMI-Heart), aiming to promote motor development in infants with CHD and family well-being. The primary aim was to evaluate the feasibility of the study design and the intervention. The secondary aim was to evaluate differences between the intervention and the control group in motor outcomes and family well-being at baseline (3–5 months), post-treatment (6–8 months), and at follow-up (12 months).MethodIn this single-centre feasibility randomized control trial (RCT), infants with CHD after open-heart surgery without genetic or major neurological comorbidities were randomly allocated to EMI-Heart or the control group (standard of care). EMI-Heart’s key elements promote postural functional activities and encourage parental sensitivity to infants’ motor and behaviour cues. Infants assigned to EMI-Heart received nine sessions of early motor intervention at home, in the hospital, and online for a duration of 3 months by a paediatric physiotherapist. We performed descriptive statistics for feasibility and secondary outcomes.ResultsThe recruitment rate was 59% (10/17), all participating families completed the study (10/10), and the intervention duration was 3.9 months (± 0.54), including nine intervention sessions per family. Median acceptability to parents was 3.9 (1 = not agree–4 = totally agree, Likert scale). The paediatric physiotherapist considered the intervention as feasible. The comparison of motor outcomes did not show differences between groups. However, we detected improved reliable change scores in family well-being outcomes for families of the intervention group compared to the controls.ConclusionsOur research indicates that EMI-Heart is a feasible intervention for infants with CHD after open-heart surgery. The intervention was highly acceptable both to parents and to the paediatric physiotherapist. Online treatment sessions offer a valuable alternative to home and hospital visits. This feasibility RCT provides a foundation for a future full trial.Trial registrationClinicalTrials.gov, NCTT04666857. Registered 23.11.2020.

Time to treatment of first-episode psychosis: the role of early intervention teams

Background/Aims Psychosis can affect a person's functioning, quality of life and physical health. Early intervention for service users presenting with psychosis has been implemented via early intervention teams, but there are inconsistencies in assessment and treatment. The aim of this study was to examine time to treatment (defined as the commencement of antipsychotic medication) for service users experiencing first-episode psychosis, the impact of this and engagement with teams. The authors explored the effect of patient characteristics (eg gender, deprivation, ethnicity, age) and early intervention teams on time to treatment for psychosis. Methods A retrospective cohort study was undertaken using routine data of service users accessing three early intervention teams from 2018–19. The care records of 457 service users were examined, including patient characteristics, assessments, time to first contact, treatment and time to discharge. Data were analysed using the Statistical Package for Social Sciences. Results Use of the Positive and Negative Syndrome Scale assessment tool differed across the three early intervention teams. Engagement with all teams varied by gender. Men were particularly slow to access treatment in one team (118 of 163 service users, 72.4%). Conclusions Increased emphasis on engaging male patients may improve service delivery. Improved communication between early intervention teams could increase standardisation of assessment and treatment.

Interval Changes in 4D Flow-Derived in vivo Hemodynamics Stratify Aortic Growth in Type B Aortic Dissection Patients

BackgroundAortic diameter growth in type B aortic dissection (TBAD) is associated with progressive aortic dilation, resulting in increased mortality in patients with both de novo TBAD (dnTBAD) and residual dissection after type A dissection repair (rTAAD). Preemptive thoracic endovascular aortic repair may improve mortality in patients with TBAD, although it is unclear which patients may benefit most from early intervention. In vivo hemodynamic assessment using four-dimensional (4D) flow magnetic resonance imaging (MRI) has been used to characterize TBAD patients with growing aortas. In this longitudinal study, we investigated whether changes over time in 4D flow derived true and false lumen (TL, FL) hemodynamic parameters correlate with aortic growth rate which is a marker of increased risk. MethodsWe retrospectively identified TBAD patients with baseline and follow-up 4D flow MRI at least 120 days apart. Patients with TBAD intervention before baseline or between scans were excluded. 4D flow MRI data analysis included segmentation of the TL and FL, followed by voxel-wise calculation of TL and FL total kinetic energy (KE), maximum velocity (MV), mean forward flow (FF), and mean reverse flow (RF). Changes over time (Δ) were calculated for all hemodynamic parameters. Maximal diameter in the descending aorta was measured from MR angiogram images acquired at the time of 4D flow. Aortic growth rate was defined as the change in diameter divided by baseline diameter and standardized to scan interval. Results32 patients met inclusion criteria (age: 56.9±14.1 years, Female: 13, n=19 rTAAD, n=13 dnTBAD). Mean follow up time was 538 days (range: 135-1689). Baseline aortic diameter did not correlate with growth rate. In the entire cohort, Δ FL MV (rho=0.37, p=.04) and Δ FL RF (rho=0.45, p=0.01) correlated with growth rate. In rTAAD only, Δ FL MV (rho=0.48, p=.04) and Δ FL RF (rho=0.51, p=0.03) correlated with growth rate, while in dnTBAD only, Δ TL KE (rho=0.63, p=.02) and Δ TL MV (rho=0.69, p=.01) correlated with growth rate. Conclusions4D flow derived longitudinal hemodynamic changes correlate with aortic growth rate in TBAD and may provide additional prognostic value for risk stratification. 4D flow MRI could be integrated into existing imaging protocols to allow for identification of TBAD patients who would benefit from preemptive surgical or endovascular intervention.

A coddling of the sagittal suture: inequality in spring-assisted expansion.

We examined differences in long-term morphometric outcomes of spring-mediated cranioplasty (SMC) for various forms of isolated nonsyndromic sagittal craniosynostosis. A retrospective review was performed of children who underwent SMC from 2011 to 2020 at the Children's Hospital of Philadelphia. Cephalic indices (CI), Whitaker grades, parietal bone thickness, and degree of suture fusion were assessed. Frontal bossing and vertex-nasion-opisthocranion (VNO) angles were compared to a normal control group. Fifty-four subjects underwent surgery at age 3.6 ± 1.0 months with follow-up of 6.3 ± 1.8 years. Mean CI was 75.2 ± 4.1 at 5.9 ± 2.0 years postoperatively. Mean CI were 75.8 ± 4.1 (n = 32), 76.4 ± 4.0 (n = 22), and 77.1 ± 4.8 (n = 11) at 5, 7, and 9+ years postoperatively, respectively. Three (5.6%) required reoperation for persistent scaphocephalic cranial deformity. Fifty-one (94.4%) were Whitaker Grade I. On physical examination, 12 (22.2%) demonstrated craniofacial abnormalities. At long-term follow-up, there were no differences in frontal bossing angle (102.7 ± 5.2 degrees versus 100.7 ± 5.6 degrees, p = .052) and VNO angle (44.9 ± 3.3 degrees versus 43.9 ± 2.2 degrees, p = .063) between study and control groups. Younger age at surgery predicted a lower Whitaker grade, more normalized VNO angle, and greater change in CI during active expansion. Increased percentage fused of the posterior sagittal suture predicted a higher Whitaker grade, while decreased anterior fusion was associated with frontal bossing and temporal hollowing. Overall, children undergoing spring-mediated cranioplasty for sagittal craniosynostosis demonstrated maintenance of CI, favorable cosmetic outcomes, and a low reoperation rate at mid-term follow-up. Early intervention is associated with improved aesthetic outcomes, and regional fusion patterns may influence long-term craniofacial dysmorphology.

Clinical presentation and surgical outcomes in patients with Shone's complex: a systematic review.

Shone's complex comprises ofa combination of congenital cardiac anomalies causing obstructions in the left ventricle's inflow and outflow tracts. This systematic review aims to evaluate the clinical features and surgical outcomes of Shone's complex. An electronic literature search of PubMed and Scopus was performed to identify relevant studies related to the presentation, management, and outcomes of Shone's complex. Two reviewers independently performed selection. Data on study characteristics, participant demographics, interventions, outcomes, and follow-up durations were extracted and analyzed. A total of 691 papers were identified, with 18 studies included in the final analysis. The majority of the studies (n = 12) focused on the pediatric age group. The most common clinical presentations were coarctation of the aorta (n = 17) and mitral stenosis (n = 12). Surgical interventions often involved staged approaches, prioritizing outflow before inflow obstructions. Mitral valve repair was preferred over replacement due to better long-term outcomes (n = 8). Biventricular repair was recommended due to improved postoperative outcomes, but often needed reoperations. Reoperations were common, primarily due to recurrent coarctation (n = 10), subaortic stenosis (n = 8), and mitral valve dysfunction (n = 7). Pulmonary hypertension (n = 10) and arrhythmias (n = 11) were significant complications. Most patients were in modified Ross/NYHA functional class 1 on follow-up. Mortality rates ranged from 4 to 28%, with better outcomes associated with early and strategic surgical interventions. Early diagnosis and biventricular repair were associated with better outcomes while transplantation was often an eventuality. Standardized diagnostic criteria, long-term follow-up, and consensus guidelines are needed to improve the management of this congenital heart disease.

Effects of the Regular Use of Virtual Environments on Spatial Navigation and Memory.

Introduction: The cognitive effects of video games have garnered increasing attention due to their potential applications in cognitive rehabilitation and evaluation. However, the underlying mechanisms driving these cognitive modifications remain poorly understood. Objectives: This study investigates the fundamental mnemonic processes of spatial navigation, pattern separation, and recognition memory, closely associated with the hippocampus. Our objective is to elucidate the interaction of these cognitive processes and shed light on rehabilitation mechanisms that could inform the design of video games aimed at stimulating the hippocampus. Method: In this study, we assessed 48 young adults, including both video game players and non-players. We utilized virtual reality and cognitive tasks such as the Lobato Virtual Water Maze and the Mnemonic Similarity Task to evaluate their cognitive abilities. Results: Our key findings highlight that gamers exhibit heightened pattern separation abilities and demonstrate quicker and more accurate spatial learning, attributed to the cognitive stimulation induced by video games. Additionally, we uncovered a significant relationship between spatial memory, guided by environmental cues, and pattern separation, which serves as the foundation for more efficient spatial navigation. Conclusions: These results provide valuable insights into the cognitive impact of video games and offer potential for monitoring changes in rehabilitation processes and early signs of cognitive decline through virtual reality-based assessments. Ultimately, we propose that examining the relationships between cognitive processes represents an effective method for evaluating neurodegenerative conditions, offering new possibilities for early diagnosis and intervention.

Investigating measurement of the home learning environment in early math intervention studies

Investigating measurement of the home learning environment in early math intervention studies

Role of wearable electrochemical biosensors in monitoring renal function biomarkers in sweat: a review.

Real-time detection of renal biomarkers is crucial for immediate and continuous monitoring of kidney function, facilitating early diagnosis and intervention in kidney-related disorders. This proactive approach enables timely adjustments in treatment plans, particularly in critical situations, and enhances overall patient care. Wearable devices emerge as a promising solution, enabling non-invasive and real-time data collection. This comprehensive review investigates numerous types of wearable sensors designed to detect kidney biomarkers in body fluids such as sweat. It critically evaluates the precision, dependability, and user-friendliness of these devices, contemplating their seamless integration into daily life for continuous health tracking. The review highlights the potential influence of wearable technology on individualized renal healthcare and its role in preventative medicine while also addressing challenges and future directions. The review's goal is to provide guidance to academics, healthcare professionals, and technologists working on wearable solutions for renal biomarker detection by compiling the body of current knowledge and advancements.

Mendelian randomization supports causal effects of inflammatory biomarkers on myopic refractive errors.

To determine whether inflammatory biomarkers are causal risk factors for more myopic refractive errors. Northern Sweden Population Health Study (NSPHS), providing inflammatory biomarkers data; UK Biobank, providing refractive errors data. 95,619 European men and women aged 40 to 69 years with available information of refractive errors and inflammatory biomakers. Inflammatory biomarkers including ADA, CCL23, CCL25, CD6, CD40, CDCP-1, CST5, CXCL-5, CXCL-6, CXCL-10, IL-10RB, IL-12B, IL-15RA, IL-18R1, MCP-2, MMP-1, TGF-β1, TNF-β, TWEAK and VEGF-A were exposures, and spherical equivalent (SE) using the formula SE = sphere + (cylinder/2) was outcome. Mendelian randomization analyses showed that each unit increase in VEGF-A, CD6, MCP-2 were causally related to a more myopic refractive errors of 0.040 D/pg.mL-1 (95% confidence interval 0.019 to 0.062; P = 2.031 × 10-4), 0.042 D/pg.mL-1 (0.027 to 0.057; P = 7.361 × 10-8) and 0.016 D/pg.mL-1 (0.004 to 0.028; P = 0.009), and each unit increase in TWEAK was causally related to a less myopic refractive errors of 0.104 D/pg.mL-1 (-0.152 to -0.055; P = 2.878 × 10-5). Tested by the MR-Egger, weighted median, MR-PRESSO, Leave-one-out methods, our results were robust to horizontal pleiotropy and heterogeneity in VEGF-A, MCP-2, CD6, but not in TWEAK. Our Mendelian Randomization analysis supported the causal effects of VEGF-A, MCP-2, CD6 and TWEAK on myopic refractive errors. These findings are important for providing new indicators for early intervention of myopia to make myopic eyesight threatening consequences less inevitable.

Development and Overview of a Hospital-Based PTSD Screening and Early Intervention Program for Gunshot Injury Survivors: The RISE Program

Development and Overview of a Hospital-Based PTSD Screening and Early Intervention Program for Gunshot Injury Survivors: The RISE Program

Risk stratification of new-onset psychiatric disorders using clinically distinct traumatic brain injury phenotypes

BackgroundPatients with traumatic brain injury (TBI) constitute a highly heterogeneous population, with varying risks for New-onset Psychiatric Disorders (NPDs). The objectives of this study were to identify TBI phenotypes and determine how NPDs differ among these phenotypes.MethodsHospitalized TBI patients from 2003 to 2019 were obtained from the provincial trauma registry. Propensity score matching was conducted to balance covariates among patients with TBI and controls. To uncover heterogeneity in TBI, latent class analysis (LCA)-based clustering was applied. LCA was conducted separately for two TBI cohorts: those with and without pre-injury psychiatric conditions The effect of classes on NPDs was assessed using log binomial regression models.ResultsA total of 3,453 patients with TBI and 13,112 controls were included in the analysis. In a conditional regression involving propensity matched patients with TBI and controls, TBI was significantly associated with the development of NPD-A (OR: 2.78; 95% CI: 2.49–3.09), as well as NPD-P (OR: 2.36; 95% CI: 2.07–2.70). Eight distinct latent classes were identified which differed in the incidence of NPDs. Four classes displayed a 53% (RR:1.53; 95% CI: 1.31–1.78), 48% (RR:1.48; 95% CI: 1.26–1.74), 28% (RR:1.28; 95% CI: 1.08–1.54), and 20% (RR: 1.20, 95%CI: 1.03–1.39), increased NPD risk.ConclusionTBI is a significant predictor of NPDs. There are clinically distinguishable phenotypes with different patterns of NPD risk among patients with TBI. Identifying individuals with respect to their phenotype may improve risk stratification of patients with TBI and promote early intervention for psychiatric care in this vulnerable population.

Machine Learning-Driven Prediction of Comorbidities and Mortality in Adults With Type 1 Diabetes.

Comorbidities such as cardiovascular disease (CVD) and diabetic kidney disease (DKD) are major burdens of type 1 diabetes (T1D). Predicting people at high risk of developing comorbidities would enable early intervention. This study aimed to develop models incorporating socioeconomic status (SES) to predict CVD, DKD, and mortality in adults with T1D to improve early identification of comorbidities. Nationwide Danish registry data were used. Logistic regression models were developed to predict the development of CVD, DKD, and mortality within five years of T1D diagnosis. Features included age, sex, personal income, and education. Performance was evaluated by five-fold cross-validation with area under the receiver operating characteristic curve (AUROC) and the precision-recall area under the curve (PR-AUC). The importance of SES was assessed from feature importance plots. Of the 6572 included adults (≥21 years) with T1D, 379 (6%) developed CVD, 668 (10%) developed DKD, and 921 (14%) died within the five-year follow-up. The AUROC (±SD) was 0.79 (±0.03) for CVD, 0.61 (±0.03) for DKD, and 0.87 (±0.01) for mortality. The PR-AUC was 0.18 (±0.01), 0.15 (±0.03), and 0.49 (±0.02), respectively. Based on feature importance plots, SES was the most important feature in the DKD model but had minimal impact on models for CVD and mortality. The developed models showed good performance for predicting CVD and mortality, suggesting they could help in the early identification of these outcomes in individuals with T1D. The importance of SES in individual prediction within diabetes remains uncertain.

Acute Neurobehavioral and Glial Responses to Explosion Gas Inhalation in Rats.

Military personnel, firefighters, and fire survivors exhibit a higher prevalence of mental health conditions such as depression and post-traumatic stress disorder (PTSD) compared to the general population. While numerous studies have examined the neurological impacts of physical trauma and psychological stress, research on acute neurobehavioral effects of gas inhalation from explosions or fires is limited. This study investigates the early-stage neurobehavioral and neuronal consequences of acute explosion gas inhalation in Sprague-Dawley rats. Rats were exposed to simulated explosive gas and subsequently assessed using behavioral tests and neurobiological analyses. The high-dose exposure group demonstrated significant depression-like behaviors, including reduced mobility and exploration. However, neuronal damage was not evident in histological analyses. Immunofluorescence revealed increased density of radial glia and oligodendrocytes in specific brain regions, suggesting hypoxia and axon damage induced by gas inhalation as a potential mechanism for the observed neurobehavioral changes. These findings underscore the acute impact of explosion gas inhalation on mental health, highlighting the habenula and dentate gyrus of hippocampus as the possible target regions. The findings are expected to support early diagnosis and treatment strategies for brain injuries caused by explosion gas, offering insights into early intervention for depression and PTSD in affected populations.

Experiences of Families Using the Coaching Model in Early Intervention

Abstract Date Presented 03/21/24 This qualitative study examined the experiences of eight families using the coaching model in early intervention (EI) through in-depth interviews in order to dispel some myths and provide strategies to best meet families’ needs in EI. Primary Author and Speaker: Beth K. Elenko Additional Authors and Speakers: Alexa Georgeton, Nicole Maguire, Kavita Gera

Construction of Risk Prediction Models for Autogenous Arteriovenous Fistula Thrombosis in Patients on Maintenance Hemodialysis.

Autogenous arteriovenous fistula (AVF) is the preferred vascular access in patients undergoing maintenance hemodialysis. However, complications such as thrombosis may occur. This study aimed to construct and validate a machine learning-based risk-prediction model for AVF thrombosis, hypothesizing that such a model can effectively predict occurrences, providing a foundation for early clinical intervention. The retrospective longitudinal study included a total of 270 patients who underwent maintenance hemodialysis (MHD) at the Hemodialysis Center of the Second Affiliated Hospital of Harbin Medical University between March 2021 and December 2022. During this study, baseline data and scale information of patients between March 2020 and December 2021 were collected. We recorded outcome indicators between March 2021 and December 2022 for subsequent analyses. Five machine learning models were developed (artificial neural network, logistic regression, ridge classification, random forest, and adaptive boosting). The sensitivity (recall), specificity, accuracy, and precision of each model were evaluated. The effect size of each variable was analyzed and ranked. Models were assessed using the area under the receiver-operating characteristic (AUROC) curve. Among the 270 included patients, 105 had AVF thrombosis (55 male and 50 female patients; age range, 29-79 years; mean age, 56.72 years; standard deviation [SD], ±13.10 years). Conversely, 165 patients did not have AVF thrombosis (99 male and 66 female patients; age range, 23-79 years; mean age, 53.58 years; SD, ±13.33 years). During the observation period, approximately 52.6% of patients with AVF experienced long-term complications. The most common complications associated with AVF were thrombosis (105; 38.9%), aneurysm formation (27; 10%), and excessively high output flow (10; 3.7%). Fifty-four (20%) patients with AVF required intervention because of complications associated with vascular access. The AUROC curve of the testing set was between 0.858 and 0.903. In this study, we developed five machine learning models to predict the risk of AVF thrombosis, providing a reference for early clinical intervention.