Neurophysiological Development Research Articles

Offspring of women with hyperemesis gravidarum are more likely to have cardiovascular abnormalities

BackgroundHyperemesis gravidarum (HG) is a severe form of pregnancy-related nausea and vomiting affecting 0.3–2.3% of pregnancies, which can lead to fluid, electrolyte, and acid–base imbalances, nutritional deficiencies, and weight loss, and is usually severe enough to require hospitalization. Abnormally elevated urinary ketones are commonly seen in patients with HG, and ketone bodies are free to pass through the placenta, and maternal hyperketonemia, with or without acidosis, is associated with an increased rate of stillbirth, an increased incidence of congenital anomalies, and impaired neurophysiologic development of the infant. This study investigates the obstetric outcomes of patients with HG and whether HG increases the incidence of cardiovascular disease in the offspring.MethodsThis study included 1020 pregnant women who were hospitalized in our hospital for HG and ultimately delivered in our hospital as well as pregnant women without HG in early gestation and delivered in our hospital from January 2019-January 2020, and we collected and followed up the clinical information of the pregnant women and their offspring.ResultsPregnant women with HG were more likely to have severe urinary ketones, the rate of early miscarriage and mid-term miscarriage was significantly higher in women with HG compared to pregnant women without HG. Fetal and neonatal head and abdominal circumferences were smaller in HG group than in control group.Neonatal birth weight and length were also lower in the HG group and cardiovascular anomalies were more likely to occur in the offspring of women with HG when all births were followed up for 3 years.ConclusionsHG may cause poor obstetric outcomes and was associated with the development of cardiovascular disease in the offspring of women with HG.

Musical Art in Theoretical and Methodological Projections: Present-Day Music and Neuroethics

An attempt is made to comprehend the latest developments in such a field of neuroscience as neuroethics, music through the perception of the human brain. Yes, for example, the key ideas of neuroethics are generally in line with the spirit of Kantian apriorism, reinterpreted in the current terms of cognitive neuroscience. Today, more and more arguments are found that "music excites such internal physiological programs that contribute to the restoration of the homeostatic equilibrium of the organism .... This means that music plays a role in human evolution. The article proposes the concept of a musical module, which correlates with a cognitive neurostructure. The theoretical and methodological features of the formation of today's classical music are investigated. The methods of analysis, synthesis, explanatory, research and scientific methods have been applied to conduct an effective research. Priority directions of modern music development in the context of neurophysiological development have been determined. Formed the results of the study, which were the basis for determining aspects of prospective musical development. Scientific research in the field of music and the field of psychology is investigated, which is the basis for the development of neuroscience. The relevance of the article is determined by the need to adapt music to the challenges of information and communication society and to determine the prospects for further development of today's classical music.

Deficits in doors P300 amplitude during adolescence associated with preschool-onset depression.

The psychophysiological underpinnings of preschool-onset depression (PO-MDD) remain underexplored. Moreover, there is currently a limited understanding of the potential impact that PO-MDD might have on neurobiological functions later in development such as general cognitive domains and reward processing. Thus, the current study sought to examine potential neurophysiological differences, measured via electroencephalography (EEG), in adolescents with and without a history of PO-MDD. Participants and their caregivers (N = 138) from a large longitudinal study completed semi-structured clinical interviews at a baseline visit (ages 3-7) to determine PO-MDD status. At a follow-up visit approximately 11 years later, adolescents (ages 13-19) completed the doors gambling task while EEG was recorded to measure event-related potentials (ERPs) elicited by both the doors and feedback stimuli, to index cognitive and reward processing functions (i.e., doors-P300, gain/loss feedback-P300, and RewP). Adolescents with a history of PO-MDD exhibited significantly smaller doors-P300 compared with adolescents with no history of PO-MDD, whereas there were no group differences in gain/loss feedback-P300 or RewP. Additionally, reduced doors-P300 was independently associated with lower baseline income-to-needs ratio, older age, and female gender. The current study suggests that reduced doors-P300 amplitude during adolescence might reflect impaired neurophysiological development related to PO-MDD. Thus, the P300 derived from the doors stimuli might be a valuable neural measure to further our understanding of potential neurophysiological differences associated with early-onset childhood depression.

Comparison of End-to-End Neural Network Architectures and Data Augmentation Methods for Automatic Infant Motility Assessment Using Wearable Sensors

Infant motility assessment using intelligent wearables is a promising new approach for assessment of infant neurophysiological development, and where efficient signal analysis plays a central role. This study investigates the use of different end-to-end neural network architectures for processing infant motility data from wearable sensors. We focus on the performance and computational burden of alternative sensor encoder and time series modeling modules and their combinations. In addition, we explore the benefits of data augmentation methods in ideal and nonideal recording conditions. The experiments are conducted using a dataset of multisensor movement recordings from 7-month-old infants, as captured by a recently proposed smart jumpsuit for infant motility assessment. Our results indicate that the choice of the encoder module has a major impact on classifier performance. For sensor encoders, the best performance was obtained with parallel two-dimensional convolutions for intrasensor channel fusion with shared weights for all sensors. The results also indicate that a relatively compact feature representation is obtainable for within-sensor feature extraction without a drastic loss to classifier performance. Comparison of time series models revealed that feedforward dilated convolutions with residual and skip connections outperformed all recurrent neural network (RNN)-based models in performance, training time, and training stability. The experiments also indicate that data augmentation improves model robustness in simulated packet loss or sensor dropout scenarios. In particular, signal- and sensor-dropout-based augmentation strategies provided considerable boosts to performance without negatively affecting the baseline performance. Overall, the results provide tangible suggestions on how to optimize end-to-end neural network training for multichannel movement sensor data.

Detection of Intellectual Giftedness in Children of Different Ages and Methods of its Development as an Aspect of Neurophysiological Development

In this article, the concept of giftedness in children of different ages, its types and characteristics, the basics of diagnosis and methods of development of factors contributing to intellectual abilities were studied. In this context, quite a lot of opinions and worldviews of thinkers of different historical eras, including Plato, Confucius and others, were analyzed regarding the definition of the concept of giftedness in children. The neurophysiological features of mental thinking were also investigated. It was concluded that giftedness is a unique combination of abilities that are the result of neurophysiological processes, which is a prerequisite for achieving certain successes or certain achievements in a certain activity. Thanks to such unique features, the child differs from others in a certain way. Giftedness is some unique feature of children, which is determined by the neurophysiological features of the body's development. The relevance of such topics is extremely important, because the scientific and technical development of modern society forces creative approaches in solving a number of problems. The presence of a perfect system for identifying and educating gifted and creative children is a necessary component of the successful activity of society. The purpose of the article is to clarify the necessary features and signs of giftedness in children with the aim of developing effective mechanisms for diagnosing giftedness in children of different age groups and methods of its development as an aspect of the neurophysiological approach to personality. In the research process, the method of analysis of the available theoretical information of the selected area, synthesis of all existing points of view was used. The result is the determination of the characteristics of giftedness, taking into account its types, characteristics, and the creation of methods of dealing with gifted children and developing their abilities.

The Molecular Gut-Brain Axis in Early Brain Development

Millions of nerves, immune factors, and hormones in the circulatory system connect the gut and the brain. In bidirectional communication, the gut microbiota play a crucial role in the gut-brain axis (GBA), wherein microbial metabolites of the gut microbiota regulate intestinal homeostasis, thereby influencing brain activity. Dynamic changes are observed in gut microbiota as well as during brain development. Altering the gut microbiota could serve as a therapeutic target for treating abnormalities associated with brain development. Neurophysiological development and immune regulatory disorders are affected by changes that occur in gut microbiota composition and function. The molecular aspects relevant to the GBA could help develop targeted therapies for neurodevelopmental diseases. Herein, we review the findings of recent studies on the role of the GBA in its underlying molecular mechanisms in the early stages of brain development. Furthermore, we discuss the bidirectional regulation of gut microbiota from mother to infant and the potential signaling pathways and roles of posttranscriptional modifications in brain functions. Our review summarizes the role of molecular GBA in early brain development and related disorders, providing cues for novel therapeutic targets.

Hematopoietic Stem- and Progenitor-Cell Gene Therapy for Hurler Syndrome

BackgroundAllogeneic hematopoietic stem-cell transplantation is the standard of care for Hurler syndrome (mucopolysaccharidosis type I, Hurler variant [MPSIH]). However, this treatment is only partially curative and is associated with complications.MethodsWe are conducting an ongoing study involving eight children with MPSIH. At enrollment, the children lacked a suitable allogeneic donor and had a Developmental Quotient or Intelligence Quotient score above 70 (i.e., none had moderate or severe cognitive impairment). The children received autologous hematopoietic stem and progenitor cells (HSPCs) transduced ex vivo with an α-L-iduronidase (IDUA)–encoding lentiviral vector after myeloablative conditioning. Safety and correction of blood IDUA activity up to supraphysiologic levels were the primary end points. Clearance of lysosomal storage material as well as skeletal and neurophysiological development were assessed as secondary and exploratory end points. The planned duration of the study is 5 years.ResultsWe now report interim results. The children’s mean (±SD) age at the time of HSPC gene therapy was 1.9±0.5 years. At a median follow-up of 2.10 years, the procedure had a safety profile similar to that known for autologous hematopoietic stem-cell transplantation. All the patients showed prompt and sustained engraftment of gene-corrected cells and had supraphysiologic blood IDUA activity within a month, which was maintained up to the latest follow-up. Urinary glycosaminoglycan (GAG) excretion decreased steeply, reaching normal levels at 12 months in four of five patients who could be evaluated. Previously undetectable levels of IDUA activity in the cerebrospinal fluid became detectable after gene therapy and were associated with local clearance of GAGs. Patients showed stable cognitive performance, stable motor skills corresponding to continued motor development, improved or stable findings on magnetic resonance imaging of the brain and spine, reduced joint stiffness, and normal growth in line with World Health Organization growth charts.ConclusionsThe delivery of HSPC gene therapy in patients with MPSIH resulted in extensive metabolic correction in peripheral tissues and the central nervous system. (Funded by Fondazione Telethon and others; ClinicalTrials.gov number, NCT03488394; EudraCT number, 2017-002430-23.)

Long-term infant outcomes after hyperbaric oxygen treatment for acute carbon monoxide poisoning during pregnancy.

Carbon monoxide (CO) poisoning in pregnant women is linked to foetal mortality of 36-67%. This study assessed long-term fetal outcomes following hyperbaric oxygen treatment (HBOT) for acute CO poisoning in pregnant women. The effects of clinical severity parameters and pregnancy trimester were also analysed. A retrospective review of 28 pregnant patients who received HBOT for acute CO poisoning between January 2013-June 2016 was made. Adverse events, birth week, birth weight-height, birth complications, and the age of crawling, walking independently, talking (first words) of their children were recorded. Twenty-eight singleton pregnancies were included. One fetus was dead before HBOT. Three adverse events were reported: abortion, premature birth, and limb malformation. All remaining patients (n = 24) delivered healthy term infants and reported normal neurophysiological development. At final interview the median age of babies was 34 (8-44) months and none had any diagnosed disease. There was no relationship between clinical severity parameters and long-term outcomes. However, the pregnancy trimester at the time of CO poisoning had a significant relationship to birth weight (P = 0.029). Also, the week of pregnancy at the time of the incident correlated with the age of walking independently (P = 0.043, r = 0.436). This is the largest relevant series and longest follow-up to date. Adverse outcomes were likely incidental because the mothers' medical histories revealed alternative aetiologies. There was no definite evidence of fetal morbidity or mortality after HBOT in this study. HBOT may improve long-term fetal outcomes after in-utero CO poisoning without complications.

Aberrant gut-microbiota-immune-brain axis development in premature neonates with brain damage

SummaryPremature infants are at substantial risk for suffering from perinatal white matter injury. Though the gut microbiota has been implicated in early-life development, a detailed understanding of the gut-microbiota-immune-brain axis in premature neonates is lacking. Here, we profiled the gut microbiota, immunological, and neurophysiological development of 60 extremely premature infants, which received standard hospital care including antibiotics and probiotics. We found that maturation of electrocortical activity is suppressed in infants with severe brain damage. This is accompanied by elevated γδ T cell levels and increased T cell secretion of vascular endothelial growth factor and reduced secretion of neuroprotectants. Notably, Klebsiella overgrowth in the gut is highly predictive for brain damage and is associated with a pro-inflammatory immunological tone. These results suggest that aberrant development of the gut-microbiota-immune-brain axis may drive or exacerbate brain injury in extremely premature neonates and represents a promising target for novel intervention strategies.

Auditory neurophysiological development in early childhood: A growth curve modeling approach

ObjectiveDuring early childhood, the development of communication skills, such as language and speech perception, relies in part on auditory system maturation. Because auditory behavioral tests engage cognition, mapping auditory maturation in the absence of cognitive influence remains a challenge. Furthermore, longitudinal investigations that capture auditory maturation within and between individuals in this age group are scarce. The goal of this study is to longitudinally measure auditory system maturation in early childhood using an objective approach. MethodsWe collected frequency-following responses (FFR) to speech in 175 children, ages 3–8 years, annually for up to five years. The FFR is an objective measure of sound encoding that predominantly reflects auditory midbrain activity. Eliciting FFRs to speech provides rich details of various aspects of sound processing, namely, neural timing, spectral coding, and response stability. We used growth curve modeling to answer three questions: 1) does sound encoding change across childhood? 2) are there individual differences in sound encoding? and 3) are there individual differences in the development of sound encoding? ResultsSubcortical auditory maturation develops linearly from 3-8 years. With age, FFRs became faster, more robust, and more consistent. Individual differences were evident in each aspect of sound processing, while individual differences in rates of change were observed for spectral coding alone. ConclusionsBy using an objective measure and a longitudinal approach, these results suggest subcortical auditory development continues throughout childhood, and that different facets of auditory processing follow distinct developmental trajectories. SignificanceThe present findings improve our understanding of auditory system development in typically-developing children, opening the door for future investigations of disordered sound processing in clinical populations.

Meeting Nutrition and Physical Activity Guidelines at 24-Months-of-Age Is Associated With Executive Function

ObjectivesExecutive function (EF) and its constructs, cognitive flexibility (F), inhibitory self-control (ISC), emergent metacognition (EM), have been linked to overweight in older children. However, few studies have investigated toddler-aged children, when rapid neurophysiological development occurs. We hypothesized that the American Academy of Pediatrics (AAP) obesity prevention guidelines for toddlers would provide a useful framework for optimizing EF. Herein, the relationships between weight status, adherence to AAP guidelines and EF at 24 mo was examined. MethodsParents and 24-mo-old children (N = 246) were recruited from the STRONG Kids 2 cohort study. Weight-for-length z-scores (WFLz) were computed and weight status classified per WHO standards. Parents completed the Behavioral Rating Inventory of Executive Function for Preschoolers (BRIEF-P) to assess EF and reported physical activities per week (Sports, Play, and Active Recretion for Kids Survey), dietary intake (Block Food Frequency Questionnaires), and screen timeCommon Sense Media Survey). Toddlers met AAP recommendations if they consumed at least 5 servings of fruits and vegetables (FV), were physically active (PA), refrained from sugar-sweetened beverages (SSB) and limited screen time (ST) to less than 60 min per day. ResultsUsing age- and sex-standardized scores, toddlers ranged between the 43rd and 46th percentile of EF, ISC, F and EM. 43% of toddlers were at risk of overweight or overweight/obese. Most toddlers met recommendations for PA (66%), ST (50%) and SSB(62%), but only 4% met FV recommendations. There was no significant difference in BRIEF-P based on weight status or FV recommendation adherence. Toddlers that met guidelines for limiting SSB had higher EF (mean difference = –0.329, p = 0.013), ISC (–0.206, p = 0.015) and EM (–0.406, p = 0.018) than those not meeting the guidelines. Toddlers who were physically active had higher EM (–0.235, p = 0.027) than those who were not physically active every day of the week. ConclusionsBeing physically active every day and abstaining from SSB may be of significance for improving EF in toddlers. Funding SourcesSupported by the NIH, the National Dairy Council and a USDA National Needs fellowship (AM).

Quantifying age-related differences in selective voluntary motor control in children and adolescents with three assessments.

Neurophysiological development of selective voluntary motor control (SVMC) is assumed but has not been quantified objectively. We assessed SVMC with (i) clinical assessments, (ii) a combination of these assessments with surface electromyography (sEMG) and, (iii) a playful computer game. The aim of this study was to describe and compare age-related differences in SVMC, quantified with these tools, in neurologically intact children, adolescents, and adults. We measured upper and lower extremity SVMC with three assessments in 31 children and adolescents. A sample of 33 and 31 adults provided reference values for the upper and lower extremity assessments, respectively. The Selective Control of the Upper Extremity Scale (SCUES) or the Selective Control Assessment of the Lower Extremity (SCALE) were combined with simultaneous sEMG recordings. We quantified SVMC by a similarity index that compared an individual's muscle activation pattern with those of an adult reference group. The SVMC Assessgame required isolated joint movements to steer an avatar and quantified the accuracy of the selective movement and the extent of involuntary movements occurring in not involved joints. Results from the conventional clinical assessments correlated low to moderately with age (SCUES: r=0.55, p=0.013; SCALE: r=0.44, p=0.001), while the correlation between the sEMG based similarity index and age was negligible (r≤0.25). The outcomes of the Assessgame correlated highly with age (r≥0.80, p≤0.001). Older children and adolescents performed movements more accurately and with fewer involuntary movements compared to younger participants. The tools assess and quantify SVMC differently, affecting the way they capture age-related differences in SVMC. Some assessments require reference values from neurologically intact children and adolescents to correctly classify impairments of SVMC in patients with neuromotor disorders.

Population genetic variation of SLC6A4 gene, associated with neurophysiological development

The serotonin transporter 5-HTT is encoded by a single gene SLC6A4. Polymorphisms in SLC6A4 has been associated with a wide variety of neurological and psychiatric disorders including increased risk of posttraumatic stress disorder, higher likelihood for depression, obsessive-compulsive disorder (OCD), increased hostility and criminal behaviour. Genes associated with complex diseases often exhibit strong signatures of purifying selection compared to others. Further, discernible population specific variation in the signature of natural selection have been observed for several complex disease-related genes. In this project we aimed to investigate the population genetic variation of the serotonin transporter gene (SLC6A4), focussing on the single nucleotide polymorphisms (SNPs). To this end, we employed 2504 individuals around the globe available in 1000 Genome project Phase III data and classified them into five ethnic groups: Americans (AMR), Europeans (EUR), Africans (AFR), East Asians (EAS) and South Asians (SAS). Principal component analysis (PCA) performed on all annotated SNPs of SLC6A4 depicted clear clustering between Africans and the rest of the world along PC1, and East Asians and other non-African populations along PC2. Further, these SNPs were found to be under strong selection pressure especially among East Asian populations with significantly high positive cross-population extended haplotype homozygosity scores compared to Africans, indicating that SLC6A4 has likely undergone a strong selective sweep among the East Asians in the recent past. Our study can potentially explain the association between polymorphisms in SLC6A4, and major depression and suicidal tendencies among people of East Asian ancestry and the absence of such associations among people of European ancestry.

The Brain Emotional Systems in Addictions: From Attachment to Dominance/Submission Systems.

Human development has become particularly complex during the evolution. In this complexity, adolescence is an extremely important developmental stage. Adolescence is characterized by biological and social changes that create the prerequisites to psychopathological problems, including both substance and non-substance addictive behaviors. Central to the dynamics of the biological changes during adolescence are the synergy between sexual and neurophysiological development, which activates the motivational/emotional systems of Dominance/Submission. The latter are characterized by the interaction between the sexual hormones, the dopaminergic system and the stress axis (HPA). The maturation of these motivational/emotional systems requires the integration with the phylogenetically more recent Attachment/CARE Systems, which primarily have governed the subject’s relationships until puberty. The integration of these systems is particularly complex in the human species, due to the evolution of the process of competition related to sexual selection: from a simple fight between two individuals (of the same genus and species) to a struggle for the acquisition of a position in rank and the competition between groups. The latter is an important evolutionary acquisition and believed to be the variable that has most contributed to enhancing the capacity for cooperation in the human species. The interaction between competition and cooperation, and between competition and attachment, characterizes the entire human relational and emotional structure and the unending work of integration to which the BrainMind is involved. The beginning of the integration of the aforementioned motivational/emotional systems is currently identified in the prepubertal period, during the juvenile stage, with the development of the Adrenarche—the so-called Adrenal Puberty. This latter stage is characterized by a low rate of release of androgens, the hormones released by the adrenal cortex, which activate the same behaviors as those observed in the PLAY system. The Adrenarche and the PLAY system are biological and functional prerequisites of adolescence, a period devoted to learning the difficult task of integrating the phylogenetically ancient Dominance/Submission Systems with the newer Attachment/CARE Systems. These systems accompany very different adaptive goals which can easily give rise to mutual conflict and can in turn make the balance of the BrainMind precarious and vulnerable to mental suffering.

The Role of Affectionate Caregiver Touch in Early Neurodevelopment and Parent-Infant Interactional Synchrony.

Though rarely included in studies of parent–infant interactions, affectionate touch plays a unique and vital role in infant development. Previous studies in human and rodent models have established that early and consistent affectionate touch from a caregiver confers wide-ranging and holistic benefits for infant psychosocial and neurophysiological development. We begin with an introduction to the neurophysiological pathways for the positive effects of touch. Then, we provide a brief review of how affectionate touch tunes the development of infant somatosensory, autonomic (stress regulation), and immune systems. Affective touch also plays a foundational role in the establishment of social affiliative bonds and early psychosocial behavior. These touch-related bonding effects are known to be mediated primarily by the oxytocin system, but touch also activates mesocorticolimbic dopamine and endogenous opioid systems which aid the development of social cognitive processes such as social learning and reward processing. We conclude by proposing a unique role for affectionate touch as an essential pathway to establishing and maintaining parent-infant interactional synchrony at behavioral and neural levels. The limitations of the current understanding of affectionate touch in infant development point to fruitful avenues for future research.

Neurophysiological control of urinary bladder storage and voiding-functional changes through development and pathology.

The effective storage of urine and its expulsion relies upon the coordinated activity of parasympathetic, sympathetic, and somatic innervations to the lower urinary tract (LUT). At birth, all mammalian neonates lack the ability to voluntary regulate bladder storage or voiding. The ability to control urinary bladder activity is established as connections to the central nervous system (CNS) form through development. The neural regulation of the LUT has been predominantly investigated in adult animal models where comparatively less is known about the neonatal and postnatal neurophysiological development that facilitate urinary continence. Furthermore, congenital neurological or anatomical defects can adversely affect both storage and voiding functions through postnatal development and into adulthood, leading to secondary conditions including vesicoureteral reflux, chronic urinary tract infections, and end-stage renal disease. Therefore, the aim of the review is to provide the current knowledge available on neurophysiological regulation of the LUT through pre- to postnatal development of human and animal models and the consequences of congenital anomalies that can affect LUT neural function.

Neonatal complications and neurophysiological development in twins – a long-term follow-up study

Objectives To investigate the association between neonatal complications and neurophysiological development in twins at 18 and 48–60 months of age. Methods This was a secondary analysis of 841 Danish mono- and dichorionic diamniotic twins from a randomized controlled trial (PREDICT study), which included an assessment of the twin’s neurophysiological development using the Ages and Stages Questionnaire (ASQ) that had been filled out by the parents at 18 and 48 or 60 months. The correlation within twin pairs was accounted for by the method of generalized estimating equation. Models were adjusted for maternal educational score and gestational age at delivery. Results ASQ data were available for 823 children at 18 months and 425 children at 48 or 60 months. Low maternal educational score and preterm delivery <34 weeks were associated with a lower ASQ score at 48–60 months (−15.4 points (95%CI −26.4; −4.5) and −13.2 points (95%CI −23.8; −2.5), respectively). Neonatal sepsis and a compound of intraventricular hemorrhage, retinopathy of prematurity and necrotizing enterocolitis (IVH/ROP/NEC) were associated with lower ASQ score at 18 months (−15.3 points (95%CI −28.1; −2.5) and −30.8 points (95%CI −59.5; −2.1), respectively). Children with IVH/ROP/NEC had a lower ASQ score at 48–60 months (−34.2 points (95%CI −67.9; −0.6)). The associations were not specific to only one ASQ domain. Conclusion Several neonatal complications are associated with poorer neurophysiological development in twins during childhood, even after adjustment for gestational age at delivery.

The effect of tub bathing and sponge bathing on neonatal comfort and physiological parameters in late preterm infants: A randomized controlled trial

BackgroundIncreasing comfort and physiological stabilization in preterm infants during neonatal care improves their neurophysiological development. Bathing procedures that support this development and will not expose the newborn to stress should be preferred. ObjectivesOur study aimed to examine the effectiveness of tub bathing and sponge bathing methods on the physiological parameters (i.e., heart rate, respiration rate, oxygen saturation, body temperature) and comfort of late preterm infants. DesignRandomized controlled trial. Study is registered at ClinicalTrials.gov NCT03796312. SettingsThe trial was conducted in a neonatal intensive care unit of a university hospital in Antalya, Turkey. MethodsLate preterm infants (gestational age between 34 0/7 weeks and 36 6/7 weeks) were randomly assigned by a computer program to either intervention (tub bath) or control group (sponge bath). The physiological parameters and comfort of preterm infants in both groups were evaluated at 10 min before the bath. Infant comfort was reevaluated 10 min after the procedure, while physiological parameters were reevaluated after 15 and 30 min. Preterm infant heart rate, oxygen saturation, respiratory rate, body temperature and comfort behaviors were assessed by two independent evaluators who were blinded to the purpose of the study at different phases across the two bathing protocols. Written consent was obtained from the university and hospital ethics committee where the research was performed, and from the families of the infants participating in the study. SPSS 20.0 and SAS 9.3 were used for data analysis. Data was analyzed by percentage distribution, mean, repeated analysis, variance analysis, Bonferroni analysis as a further analysis and t-test in dependent groups. ResultsApproximately 120 preterm infants completed the protocol (60 in each group). The two groups did not differ in gestational age, sex, weight or other demographic variables (p > 0.05). Tub bathing was more effective in reducing preterm infants’ comfort scores (9.47 ± 2.55 vs. 14.85 ± 4.77, p < 0.001) and heart rate than sponge bathing (132.88 ± 12.00 vs. 144.00 ± 17.74, p < 0.05). Preterm infants in the tub bathing group maintained their body temperature better than those in the sponge bathing group (36.75 ± 0.26 vs. 36.59 ± 0.25, p < 0.05). There was no difference in oxygen saturation (98.35 ± 0.88 vs. 97.85 ± 1.36, p = 0.291) or respiratory rate (45.57 ± 5.39 vs. 47.20 ± 5.41, p = 0.472) between the tub and sponge bathing groups. ConclusionsTub bathing is a safer, more pleasurable/comfortable bathing option and is the recommended method for bathing healthy, late preterm infants.

Impact of Chronic Exposure to Radiofrequency Electromagnetic Fields on Neurophysiological Development in the Preterm Neonate

Impact of Chronic Exposure to Radiofrequency Electromagnetic Fields on Neurophysiological Development in the Preterm Neonate

Treating Insecure Attachment in Group Therapy: Attachment Theory Meets Modern Psychoanalytic Technique

ABSTRACT Attachment theory is a comprehensive, empirically supported theory of emotional, relational, and neurophysiological development. Modern psychoanalysis is a theory of technique that addresses early psychological deficits and conflicts considered beyond the reach of traditional psychoanalysis. Both orientations have influenced the theory and practice of group psychotherapy and emphasize personality maturation as a treatment goal. This paper explores their potential synergies when treating preoedipal, insecurely attached emotional states, disrupted emotional self-regulation, and impaired mentalization. Theoretical and technical applications are suggested that may enhance the treatment of disordered attachment in group psychotherapy. By addressing insecure attachment as resistance, modern psychoanalytic techniques may engage the emotional substrates of the attachment process to facilitate the expansion of relational capacities, mentalization, self-regulation, the differentiation of self/other representations, and epistemic trust.