Function Measurements Research Articles

Asymmetric right ventricular myocardial work correlates with gold standard measurements of cardiac function in pulmonary hypertension.

Right ventricular (RV) (dys)function determines outcomes in pulmonary hypertension (PH). We previously found that asymmetric RV myocardial work (MW) corresponds with inefficient RV function in experimental PH models. We therefore aimed to investigate regional distribution of RV MW and its correlation with catheter hemodynamics in children with PH. RV MW was calculated by longitudinal strain and simultaneous catheter pressure measurements in 14 patients with PH. Wasted MW was defined as the ratio of inappropriate myocardial lengthening to favorable shortening work. Segment-wise and averaged MW and wasted MW were evaluated at baseline and during pulmonary vasodilation therapy with oxygen and nitric oxide, and their relationship to hemodynamic measurements was analyzed. We found that MW was higher for the lateral wall than the septum: 1013 ± 374 mmHg · % versus 532 ± 190 mmHg · % at baseline. Wasted MW ratio did not differ significantly between wall regions. Pulmonary vasodilators slightly reduced mean pulmonary artery pressure and was accompanied by a more symmetrical MW distribution. Averaged MW correlated with the rate of RV pressure development (dP/dt maximum) and decay (dP/dt minimum) at all conditions (p 0.047). The results suggest that MW contribute to, and may be used as a marker of, systolic and diastolic efficiency in the PH RV.

Vaping causes an acute BMI-dependent change in pulmonary blood flow.

Vaping use has skyrocketed especially among young adults, however there is no consensus on how vaping impacts the lungs. We aimed to determine whether there were changes in lung function acutely after a standard vaping session or if there were differences in lung function metrics between a healthy never-vaping cohort (N = 6; 27.3 ± 3.0 years) and a young asymptomatic vaping cohort (N = 14; 26.4 ± 8.0 years) indicating chronic changes. Pulmonary function measurements and impulse oscillometry were obtained on all participants. Oxygen-enhanced and Arterial Spin Labelling MRI were used to measure specific ventilation and perfusion, respectively, before and after vaping, and in the control cohort at baseline. MRI metrics did not show any significant differences in specific ventilation or perfusion after vaping. Heart rate increased post-vaping (68.1 ± 10.5 to 71.3 ± 8.7, p = 0.020); however, this and other metrics did not show a nicotine dose-dependent effect. There was a significant negative correlation between BMI and change in mean perfusion post-vaping (p = 0.003); those with normal/low BMI showing an increase in perfusion and vice versa for high BMI. This may be due to subjects lying supine during vaping inhalation. Pulmonary function metrics indicative of airways resistance showed significant differences between the vaping and control cohorts indicating early airway changes.

Long-Term Effects of Different Number of Botulinum Toxin Injections Into the Gastrocnemius Muscle on Function and Muscle Morphology in Children With Cerebral Palsy

BackgroundBotulinum toxin (BoNT) injections are used to reduce spasticity, and sometimes repeated injections are required. The aim of this study is to investigate the effects of the number of BoNT injections into the gastrocnemius muscle on function, muscle morphology, muscle stiffness, and muscle vascularization in children with cerebral palsy (CP). MethodsThe study included 22 children with spastic-type CP aged five to 13 years who had previously received one, two, or three BoNT injections into the gastrocnemius muscle. A total of 29 gastrocnemius muscles were evaluated. Gastrocnemius muscle morphology was examined by ultrasonography, muscle stiffness by shear wave ultrasound elastography, and muscle vascularization by superb microvascular imaging. The functional status of the children was evaluated by the Gross Motor Function Measurement, the Timed-Up-and-Go Test, the Squat Test, the Vertical Jumping Test, and the Sit-and-Reach Test. ResultsIn the motor functions and muscle morphology values were similar in all three groups (P > 0.05). Muscle stiffness values were higher (P = 0.035) and vascularization values were lower (P = 0.03) in the group that received three injections compared with the groups that received one injection. There was a moderate positive correlation of the number of BoNTs with muscle stiffness (P < 0.05, r = 0.454) and a moderate negative correlation with muscle vascularization (P < 0.05, r = −0.497). ConclusionsRepeated BoNT applications have no effect on motor functions and muscle morphology in children with CP, whereas BoNT injections administered three times increase muscle stiffness and decrease vascularization.

Significance of binocular fusion in enhancing visual acuity during amblyopia treatment.

Currently, the exploration of amblyopia treatment methods is gradually shifting to the restoration of binocular visual perceptual function. Binocular fusion function, as an important component of binocular visual function, mainly reflects the patient's ability to integrate the signals received from both eyes. In this study, we investigated the relationship between binocular fusion function and improvement in visual acuity during amblyopia treatment. A retrospective analysis was conducted on a cohort of patients with amblyopia, aged 3-14 years old, who visited an outpatient clinic in Shenzhen Eye Hospital between May 2021 and January 2023. The investigation included 105 patients (210 eyes) with isometropic or anisometropic amblyopia. All participants underwent cycloplegic refraction examination and binocular fusion function measurement. All patients underwent standard amblyopia treatment, and those with the best-corrected visual acuity (BCVA) of 0.6 or higher in the amblyopic eye of both eyes received binocular fusion training using a computer platform. A statistically significant negative correlation (-0.263, P=0.007) was observed between the absolute difference in binocular BCVA and binocular fusion function at the start of treatment (baseline). Linear regression analysis revealed that the improvement in BCVA in the amblyopic eye exhibited correlations with several factors, including the baseline binocular BCVA difference, baseline BCVA of the amblyopic eye, improvement in binocular fusion function, and the number of fusion training sessions (regression coefficients: -0.463, -0.771, 0.007, and 0.063, respectively; all P<0.05). Two patterns of binocular fusion function development during treatment were identified using group-based trajectory modeling (GBTM): the slow growth pattern and the rapid growth pattern. The results of a multivariate logistic regression model indicated a statistically significant link between fusion training and the development pattern of binocular fusion function [odds ratio (OR): 5.219, 95% confidence interval (CI): 2.045-13.323]. Enhancing binocular fusion function may result in an improvement of BCVA in the amblyopic eye of patients with amblyopia. The frequency of binocular fusion training is crucial for rapid improvement in binocular fusion function.

Integration of lung function data: turning snapshots into stories.

Missing or inaccessible lung function measurements, gathered over time, have the potential to stagnate or impair clinical care decisions being made. This jeopardises patient safety and often contributes to excessive resource utilisation. Data integration is fundamental to clinical decision-making and entails amalgamating lung function data from multiple sources in a user-friendly format. Despite this, current systems for recording lung function data are suboptimal, with copious gaps in the clinical picture arising from missing or inaccessible lung function measurements. This article discusses the importance of data integration for lung function, with a call to action for key stakeholders involved in the performance, management and interpretation of such tests.

Two-dimensional echocardiographic right heart ratios for assessment of right heart size in dogs: Reference intervals and reproducibility.

Reference intervals for simple body weight-independent measurements of right heart size and function are limited. Generate reference intervals for measurements of right heart size indexed to the long-axis aortic valve diameter (AoD) or corresponding left heart structure (right heart ratios) and describe the reproducibility of these indices. Ninety healthy adult dogs of variable body weight. Prospective study. All dogs underwent an echocardiogram performed by the same operator. Numerous linear 2-dimensional measurements of right heart size and function from different imaging planes were performed. Eight dogs underwent repeated echocardiograms by the same operator on 3 different days, and 3 different operators performed repeated echocardiograms on the same day. Reference intervals were generated using the Clinical Laboratory Standards Institute method. Reproducibility was quantitated using coefficients of variation (CVs) and reproducibility coefficients. Reference intervals for right heart ratios were generated and allow simple assessments of right heart size and function that do not require a scaling exponent or body weight table. Right heart ratios did not show clinically relevant associations with body weight. All CVs were <22.6%. In general, CVs for right heart measurements indexed to AoD were lower compared with right heart measurements indexed to the corresponding left heart structure. Reference intervals for simple body weight-independent right heart ratios are available to help detect abnormalities of right heart size and function. Reproducibility coefficients might be useful to help identify meaningful changes in right heart size during serial evaluations.

Efficacy of Percussion Massage Therapy Applied to the Lower Extremity on Pain, Edema, and Quality of Life in Pregnant Women: Randomized Controlled Trial

Background: Pain and edema in the legs are the most common problems in pregnancy. This study examined the effect of percussion massage therapy applied to the lower extremities on pain, edema, and quality of life in pregnant women. Methods: Sixty pregnant women between 24 and 36 weeks of pregnancy were included in the study. Pregnant women were randomly divided into two groups: the percussion massage treatment (PMT) group (n = 30) and the control group (n = 30). Twelve sessions of percussive massage therapy were administered to the bilateral medial gastrocnemius, lateral gastrocnemius, peroneus longus, and tibialis anterior muscles of pregnant women included in the PMT group, three times a week for four weeks. The lower extremities of the pregnant women in the control group did not get any massage therapy. A Visual Analog Scale (VAS) was used to assess pain. A tape measure was used to measure the ankle, knee, and thigh circumference. The Fatigue Severity Scale (FSS) was used to evaluate fatigue, and the Short Form-36 (SF-36) was used to assess quality of life. Results: When comparing pre-treatment and post-treatment results within each group, statistically significant differences were found in both groups in terms of right/left ankle, knee, and thigh circumference measurements, and SF-36 physical function (PF) measurements (p &lt; 0.05). When the difference measurements between the groups were compared, a statistically significant improvement in the PMT group was detected in VAS (p = 0.000), right/left ankle (p = 0.002/p = 0.006) and right/left hip circumference measurements (p = 0.006/p = 0.008), FSS (p = 0.009), and SF-36-role emotional (RE) (p = 0.000), mental health (MH) (p = 0.005), social function (SF) (p = 0.005), and body pain (BP) (p = 0.003) measurements. Conclusions: PMT was more effective than the control group in parameters such as pain, ankle and thigh circumference measurements, fatigue, and some sub-parameters of quality of life. PMT could be preferred to enhance the quality of life of pregnant women by improving parameters like pain, edema, and fatigue. Clinical Trial Registration: The study protocol was registered at ClinicalTrials.gov https://clinicaltrials.gov/ (NCT06338254).

Recién nacida con litemia en rango tóxico. ¿Debemos retirar la lactancia materna?

Lithium is a common part of the treatment for bipolar disorder. It is excreted through breast milk, and traditionally, mothers undergoing this treatment were advised to discontinue breastfeeding due to the potential serious adverse effects of this medication on the infant. More recently, it has been demonstrated that plasma lithium levels in exposed children are generally low and well tolerated, so, in selected cases, breastfeeding can be maintained, and close clinical and analytical monitoring of the child can be conducted, including measurement of thyroid and renal function, and serial lithium levels. We present a clinical case of a full-term newborn, born to a mother with bipolar disorder receiving lithium treatment, exclusively breastfed on demand, who in the second week of life showed toxic levels of lithium in plasma with no symptoms. Careful investigation of the case revealed that the elevated lithium levels were falsely elevated due to incorrect collection of the blood sample in a container containing lithium-heparin as an anticoagulant. The circumstances of the case will be reviewed as well as current recommendations on lithium intake by mothers and breastfeeding of their children.

Higher prevalence of kidney function impairment among older people living with HIV in Uganda

BackgroundPeople living with HIV (PLWH) are at risk of kidney function impairment due to HIV-related inflammation, antiretroviral therapy (ART), diabetes mellitus, and hypertension. Older persons may experience a higher burden of chronic kidney disease (CKD) as kidney function declines with increasing age. There is a paucity of data comparing the prevalence of kidney function impairment in older PLWH to that in people without HIV in sub-Saharan Africa.MethodsWe conducted a cross-sectional study among people aged ≥ 60 years living with and without HIV in Kampala, Uganda who were matched 1:1 by community location. We collected data on sociodemographics, comorbidities, and HIV-related clinical characteristics. We defined kidney function impairment as an estimated glomerular filtration rate(eGFR) < 60mls/min/1.73m2 with or without proteinuria. We constructed multivariable logistic regression models to study associations between participant characteristics and kidney function impairment.ResultsWe enrolled 278 people (median age 66 years); 50% were PLWH, and 51.8% were female. Among PLWH, 33.1% (95% CI: 25.7-41.4%) had kidney function impairment versus 12.9% (95% CI: 8.3-19.7%) among people without HIV, (p-value < 0.01). The prevalence of proteinuria among PLWH versus people without HIV was 43.9% (95% CI:35.8-52.3%) versus 19.4% (95% CI:13.6-26.9%) p-value < 0.01. Living with HIV (OR = 3.89(95% CI: 2.04–7.41), p-value < 0.01), older age (OR = 1.13, (95% CI:1.07–1.20), p-value < 0.01), female sex (OR = 1.95, (95% CI:1.06–3.62), p-value = 0.03) and a prior diagnosis of hypertension (OR = 2.19(95% CI:1.02–4.67), p-value = 0.04) were significantly associated with kidney function impairment.ConclusionsHIV infection is strongly associated with kidney function impairment among older PLWH. Prioritizing routine measurements of kidney function and proteinuria in older PLWH will enable early detection and institution of measures to reduce the progression of kidney disease.

Chronic Kidney Disease Progression-A Challenge.

Chronic kidney disease (CKD) is a progressive condition characterized by a continuous decline in renal function, independent of the initial cause of damage or external factors such as infection, inflammation, or toxins. The accurate measurement of renal function, typically assessed using the glomerular filtration rate (GFR), is crucial for managing CKD. The most accepted hypothesis for CKD progression is glomerular damage caused by hyperfiltration. Various factors can accelerate CKD progression, and several biomarkers have been identified to monitor this progression. Numerous studies have explored the risk factors associated with CKD progression, and some of these factors can be modified. Additionally, several drugs are now available that can reduce CKD progression. This review summarizes recent publications and highlights potential future research directions in CKD progression. It discusses the evolution of GFR measurement methods, the mechanisms driving CKD progression, and the latest findings on biomarkers and risk factors. Furthermore, it explores therapeutic strategies, including dietary modifications and pharmacological interventions, to slow CKD progression. Understanding these mechanisms and interventions is crucial for developing effective therapeutic strategies to prevent or slow CKD progression.

Optimal spirometry thresholds for the prediction of chronic airflow obstruction: a multinational longitudinal study

IntroductionChronic airflow obstruction is key for COPD diagnosis but strategies for its early detection are limited. We aimed to define the optimal z-score thresholds for spirometry parameters to discriminate chronic airflow obstruction incidence.MethodsThe Burden of Obstructive Lung Disease study is a multinational cohort study. Information on respiratory symptoms was collected and pre- and post-bronchodilator spirometry was performed at baseline. Eighteen study sites were followed up with repeat measurements after a median of 8.4 years. We converted lung function measurements into z-scores using the Third National Health and Nutrition Survey reference equations. We used the Youden index to calculate the optimal z-score thresholds for discriminating chronic airflow obstruction incidence. We further examined differences by smoking status.ResultsWe analysed data from 3057 adults (57% females, mean age: 51 years at baseline). Spirometry parameters were good at discriminating chronic airflow obstruction incidence (AUC 0.80–0.84), while respiratory symptoms performed poorly. The optimal z-score threshold was identified for pre-bronchodilator FEV1/FVC &lt;-1.336, equivalent to the 9th percentile (sensitivity: 78%, specificity: 72%). All z-score thresholds associated with a lower post-bronchodilator FEV1/FVC and greater odds of chronic airflow obstruction at follow-up. The risk of chronic airflow obstruction was slightly greater for current smokers and, to some extent, never smokers with a pre-bronchodilator FEV1/FVC less than the 9th/10th percentiles at baseline, particularly among males.ConclusionsSpirometry is better than respiratory symptoms at predicting chronic airflow obstruction incidence. A pre-bronchodilator FEV1/FVC &lt;9th/10th percentiles, particularly among current smokers, could suggest early airflow obstruction or pre-COPD.

A side-by-side comparison of variant function measurements using deep mutational scanning and base editing.

Variant annotation is a crucial objective in mammalian functional genomics. Deep Mutational Scanning (DMS) is a well-established method for annotating human gene variants, but CRISPR base editing (BE) is emerging as an alternative. However, questions remain about how well high-throughput base editing measurements can annotate variant function and the extent of downstream experimental validation required. This study presents the first direct comparison of DMS and BE in the same lab and cell line. Results indicate that focusing on the most likely edits and highest efficiency sgRNAs enhances the agreement between a "gold standard" DMS dataset and a BE screen. A simple filter for sgRNAs making single edits in their window could sufficiently annotate a large proportion of variants directly from sgRNA sequencing of large pools. When multi-edit guides are unavoidable, directly measuring the variants created in the pool, rather than sgRNA abundance, can recover high-quality variant annotation measurements in multiplexed pools. Taken together, our data show a surprising degree of correlation between base editor data and gold standard deep mutational scanning.

Risk factors associated with the incidence of asthma among adolescents in Ukraine

Background. Asthma is a common disease among children and adolescents. The purpose of this study was to describe the detailed characteristics of adolescents with asthma, identify risk factors associated with the development of asthma and to evaluate medical care for patients with asthma. Materials and methods. Asthma patients (n = 80) aged 12 to 18 years from the Allergology Department of the Kyiv City Children’s Clinical Hospital 2, the clinical base of the Department of Pediatrics 2 of the Bogomolets National Medical University, were included in the study. The control group consisted of 120 children without asthma. In the group of interviewed children, asthma was diagnosed based on clinical data and objective measurement of lung function. All children underwent spirometry and skin prick test with aeroallergens. During the clinical examination, weight and height were measured, and body mass index was calculated. The survey was conducted by a research doctor using a Google form. Results. Parents of 80 children with asthma were involved in our survey between September 2023 and May 2024. Asthma occurred more often in boys than in girls: odds ratio (OR) = 7.3 (95% confidence interval (CI) 3.84–14.16, P &lt; 0.0001). 31.25 % respondents reported a history of atopic dermatitis, 26.25 % had atopic dermatitis at the time of the study. Food allergy was detected in 25 % children. 48.75 % children had concomitant allergic rhinitis, of which 33.75 % had seasonal, 15 % had perennial. We found that children living in the city had asthma more often: OR = 7.3 (95% CI 3.26–16.62, P &lt; 0.0001). Having an older sibling was associated with a lower risk of asthma: OR = 3.6 (95% CI 1.86–6.92, P &lt; 0.0001). Also, we found that cat owners were significantly more likely not to have asthma: OR = 7.7 (95% CI 3.96–14.99, P &lt; 0.0001). Such data are most likely related to the refusal to own a cat due to the prevalence of cat allergy among children with asthma or at risk of cat allergy. We have not found a statistically significant difference in the group of children with asthma and in the control group in relation to the exposure to tobacco smoke in the atmosphere (passive smoking): OR = 1.4 (95% CI 0.79–2.59, P &gt; 0.05). Conclusions. Treatment of allergies and atopic conditions should be considered an important component of asthma treatment, which may affect the frequency and severity of the disease. In adolescents and adults, smoking cessation, in particular, as a factor in the impact of passive smoking on a sick child can also significantly reduce the number of hospitalizations. Confirming the diagnosis of asthma, demonstrating good inhaler technique, and emphasizing adherence to preventive therapies such as inhaled glucocorticosteroids can improve asthma control and reduce overreliance on short-acting bronchodilators.

Deprescribing of Antihypertensive Medications and Cognitive Function in Nursing Home Residents

Antihypertensive medication deprescribing is common among nursing home residents, yet its association with cognitive decline remains uncertain. To investigate the association of deprescribing antihypertensive medication with changes in cognitive function in nursing home residents. This cohort study using a target trial emulation approach included VA long-term care residents aged 65 years or older with stays of at least 12 weeks from 2006 to 2019. Residents who were not prescribed antihypertensive medication, with blood pressure greater than 160/90 mm Hg, or with heart failure were excluded. Eligible residents with stable medication use for 4 weeks were classified into deprescribing or stable user groups and followed for 2 years or until death or discharge for intention-to-treat (ITT) analysis. Participants switching treatment groups were censored in the per-protocol analysis. Cognitive function measurements during follow-up were analyzed using an ordinal generalized linear mixed model, adjusting for confounders with inverse probability of treatment weighting. Per-protocol analysis included inverse probability of censoring weighting. Data analyses were performed from May 1, 2023, and July 1, 2024. Deprescribing was defined as a reduction in the total number of antihypertensive medications or a decrease in medication dosage by 30%, sustained for a minimum of 2 weeks. Cognitive Function Scale (CFS) was classified as cognitively intact (CFS = 1), mildly impaired (CFS = 2), moderately impaired (CFS = 3), and severely impaired (CFS = 4). Of 45 183 long-term care residents, 12 644 residents (mean [SD] age 77.7 [8.3] years; 329 [2.6%] females and 12 315 [97.4%] males) and 12 053 residents (mean [SD] age 77.7 [8.3] years; 314 [2.6%] females and 11 739 [97.4%] males) met eligibility for ITT and per-protocol analyses, respectively. At the end of the follow-up, 12.0% of residents had a worsened CFS (higher score) and 7.7% had an improved CFS (lower score) with 10.8% of the deprescribing group and 12.1% of the stable user group showing a worsened CFS score. In the per-protocol analysis, the deprescribing group had a 12% reduction in the odds of progressing to a worse CFS category per 12-week period (odds ratio, 0.88; 95% CI, 0.78-0.99) compared to the stable user group. Among residents with dementia, deprescribing was associated with 16% reduced odds of cognitive decline (odds ratio, 0.84; 95% CI, 0.72-0.98). These patterns remained consistent in the ITT analysis. This cohort study indicates that deprescribing is associated with less cognitive decline in nursing home residents, particularly those with dementia. More data are needed to understand the benefits and harms of antihypertensive deprescribing to inform patient-centered medication management in nursing homes.

The Effect of Rood's Ontogenic Motor Patterns on Trunk Control and Balance in Spastic Diplegic Cerebral Palsy Children

Background: Cerebral palsy (CP) is a non-progressive neuromotor disorder affecting movement, muscle tone, and posture due to brain injury during early development. Effective interventions are essential for improving functional outcomes in children with spastic diplegic CP.Objective: This study aimed to evaluate the effects of Rood's Ontogenic Motor Patterns (ROMP) on trunk control and balance in children with spastic diplegic cerebral palsy.Methods: A single-blinded randomized clinical trial was conducted with 22 children aged 3-10 years, diagnosed with spastic diplegic CP. Participants were randomly assigned to two groups: Group A received Functional Electrical Stimulation with ROMP, and Group B received conventional physical therapy. The intervention lasted five weeks, with three sessions per week. Outcomes were assessed using the Modified Ashworth Scale, Gross Motor Function Measurement Scale (GMFM-88), and Pediatric Berg Balance Scale. Data were analyzed using SPSS 27.Results: Group A showed significant improvement in balance (PBBS: pre 13.81 ± 1.64, post 24.18 ± 4.67; p=0.017) and GMFM-88 scores (pre 9.95 ± 109.50, post 15.73 ± 173.0; p&lt;0.001). Spasticity reduced significantly in the ROMP group (MAS: pre 11.50 ± 126.50, post 7.30 ± 73.00; p=0.010).Conclusion: ROMP significantly improved balance and reduced spasticity in children with spastic diplegic CP compared to conventional therapy, suggesting its potential integration into rehabilitation programs.

Does the optimal level of illumination improve both visual functions and visual comfort in schoolchildren with low vision?

Lighting modification is commonly performed by optometrists and occupational therapists to enhance visibility and visual comfort among schoolchildren with low vision. The purpose of this study is to determine the optimal illumination level for visual function and visual comfort of schoolchildren with low vision and the relationship between them. A cross-sectional study was conducted to assess five levels of illumination ranging from 125 lux to 2000 lux to determine the optimal illumination for visual functions and visual comfort in schoolchildren with low vision from a special education school for blind in Malaysia. Purposive sampling was done to recruit forty-two schoolchildren with low vision for this study. Visual functions assessed were visual acuity, measured using the Early Treatment Diabetic Retinopathy Study LogMAR chart at distance and near, contrast sensitivity (CS) measured using the Pelli-Robson chart at distance and the Mars CS chart at near. Reading speed was determined using the Universiti Kebangsaan Malaysia Malay Language Related Word Reading Text test chart. Subjects were asked to rate their visual comfort using a validated questionnaire at the end of each measurement of visual functions and reading speed for the different illumination levels. Visual acuity and contrast sensitivity at distance and near, visual comfort and reading speed improved significantly with increase in illumination levels (p&lt;0.05). However, the interaction between illumination level and level of low vision was not significant (p&gt;0.05). Visual comfort was significantly associated with visual function (p&lt;0.05), while direct association between visual comfort and illumination level was not significant (p&gt;0.05). Optimal illumination for improvement of visual function, reading speed and visual comfort range from 276.67 lux to 701.59 lux. Majority of the schoolchildren with low vision had improved visual function, reading speed and visual comfort with increased illumination. Illumination of at least 600 lux is recommended for maximum visual functioning and visual comfort of schoolchildren with low vision.

Effect of body mass index on post-treatment oral function in patients with oral cancer: a cross-sectional study

This single-center cross-sectional study used sequential sampling to examine the influence of body mass index (BMI) on oral function after oral cancer treatment. Patients who completed primary oral cancer treatment between September 2019 and March 2023 (102 patients, 74 male [72.5%] and 28 female [27.5%]; mean age, 69.6 years) were analyzed. Patient background data were collected from electronic medical records. Post-treatment oral function measurements were conducted on all patients using six assessment tools. Statistical analysis was conducted using Pearson’s correlation coefficient, one-way analysis of variance, the Jonckheere–Terpstra test, and multiple linear regression. Pre-treatment BMI showed a statistically significant relationship with postoperative oral function, particularly tongue pressure (P = 0.01). While the mean values of the groups showed no significant differences, the Jonckheere–Terpstra test revealed a statistically significant trend toward a stepwise increase in tongue pressure for each BMI group (P = 0.03). Multiple linear regression analysis revealed a statistically significant correlation between tongue pressure and pre-treatment BMI (P < 0.05). Pre-treatment BMI was significantly associated with tongue pressure. Since BMI is a variable factor that can be controlled by nutritional therapy even before treatment, nutritional intervention, weight control, and treatment strategies including reconstructive interventions to maintain tongue pressure may be important in oral cancer treatment.

From task-general towards task-specific cognitive operations in a few minutes? Working memory performance as an adaptive process.

Measurement of cognitive functions is typically based on the implicit assumption that the mental architecture underlying cognitive task performance is constant throughout the task. In contrast, skill learning theory implies that cognitively demanding task performance is an adaptive process that progresses from initial heavy engagement of effortful and task-general metacognitive and executive control processes towards more automatic and task-specific performance. However, this hypothesis is rarely applied to the short time spans of traditional cognitive tasks such as working memory (WM) tasks. We utilised longitudinal structural equation models on two well-powered data sets to test the hypothesis that the initial stages of WM task performances load heavily on a task-general g-factor and then start to diverge towards factors specific to task structure. In line with the hypothesis, data from the first experiment (N = 296) were successfully fitted in a model with task-initial unity of the WM paradigm-specific latent factors, after which their intercorrelations started to diverge. The second experiment (N = 201) replicated this pattern except for one paradigm-specific latent factor. These preliminary results suggest that the processes underlying WM task performance tend to progress rapidly from more task-general towards task-specific, in line with the cognitive skill learning framework. Such task-internal dynamics has important implications for the measurement of complex cognitive functions.

Adolescent Executive Function Measurements in Indonesia : Systematic Review and Implications in Educational Settings

This study examines the landscape of executive function (EF) assessments for Indonesian adolescents, focusing on their psychometric properties. The adolescent development phase, marked by cognitive growth, presents opportunities and risks, especially in education settings where well-developed EF is beneficial. This research used a qualitative approach, with a systematic literature review method using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis), analyzing peer-reviewed empirical studies from databases such as SCOPUS and others, focusing on EF measurements for adolescents in Indonesia from 2014 to 2024. Nine studies met the inclusion criteria, highlighting tools like the Behavior Rating Inventory of Executive Function (BRIEF)-Indonesian version, Executive Skills Questionnaire-Revised (ESQ-R), Executive Function Questionnaire (EFQ), and performance-based measures like the Wisconsin Card Sorting Test and Stroop Test. Using content analysis, this study reveals that while the BRIEF is widely used in clinical studies, its applicability in educational settings requires improvement. The findings highlight the importance of adapting EF tools with cultural sensitivity and developing new comprehensive assessments with clear psychometric properties regarding all critical EF components. In recommendations, the study pinpoints a multi-method approach combining inventory-based and performance-based measures to provide a thorough understanding of EF while maintaining practicality for educational settings. The implications for advancing EF research and practice in Indonesia, particularly in education, are discussed, emphasizing the need for reliable, valid, culturally sensitive, and accessible assessment tools.

Apparent Parity Violation in the Observed Galaxy Trispectrum.

Recent measurements of the four-point correlation function in large-scale galaxy surveys have found apparent evidence of parity violation in the distribution of galaxies. This cannot happen via dynamical gravitational effects in general relativity. If such a violation arose from physics in the early Universe it could indicate important new physics beyond the standard model, and would be at odds with most models of inflation. It is therefore now timely to consider the galaxy trispectrum in more detail. While the intrinsic four-point correlation function, or equivalently the trispectrum, its Fourier counterpart, is parity invariant, the observed trispectrum must take redshift-space distortions into account. Although the standard Newtonian correction also respects parity invariance, we show that subleading relativistic corrections do not. We demonstrate that these can be significant at intermediate linear scales and are dominant over the Newtonian parity-invariant part around the equality scale and above. Therefore when observing the galaxy four-point correlation function, we should expect to detect parity violation on large scales.