General movement assessment efficacy for assessment of nervous system integrity in children after hypoxic-ischemic encephalopathy in middle income countries

General Movements in Infants with Neurological Risk: Associations with Motor Development and Referral Patterns for Brain Magnetic Resonance Imaging

The main goal of this study was to determine the associations between the quality of presentation of GM, motor development, and brain integrity as seen through magnetic resonance imaging.

METHODS

This is an observational, descriptive, and association study; information derived from it was used to analyze associations between the following variables: Writhing Movements, Fidgety Movements, motor development, and brain integrity. With a confidence level of 95% and an estimation error of 5%, the sample was comprised of 60 children under 5 months old with any neurological risk criteria; these children were either hospitalized in the Neonatal Intensive Care Unit (NICU) or attending the Kangaroo Mother Care Program (KMCP) at the University Hospital of La Samaritana (UHS), Colombia. The data were analyzed using Fisher's exact test.

RESULTS

Over 90% of children with Absent or Sporadic Fidgety Movements had either abnormal or suspicious motor development. We observed a trend of association between the absence of Fidget Movements and alterations in White Matter.

CONCLUSIONS

Quality of presentation of General Movements is associated with motor development and alterations of brain tissue at an early age, primarily in the White Matter; it is important for early prediction of neurological risk in infants.

Prediction of cerebral palsy and cognitive delay among high-risk children in a developing nation: A successful early detection programme

AIM

To determine the feasibility of combining the Hammersmith Infant Neurological Examination (HINE) and General Movements Assessment (GMA) within a standard follow-up schedule to predict developmental outcomes in infants at risk in low- and middle-income countries (LMICs).

METHOD

A total of 201 Sri Lankan infants (128 male, 73 female) were prospectively assessed with the GMA before 44 weeks (writhing movements) and at 3 to 4 months (fidgeting movements), followed by the HINE at 5 to 6 months. Developmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, Fourth Edition and clinical assessment after 24 months.

RESULTS

The sensitivity of predicting cerebral palsy (CP) was lower with a single GMA assessment (writhing 89.5%, fidgeting 94.7%) or HINE (89.5%) compared to all three assessments combined (sensitivity 100%, 95% confidence interval [CI] = 82.4-100.0). The GMA and HINE were less predictive of non-CP-related developmental delays, particularly when single assessments were used (< 65% for all domains) compared to all three assessments combined (motor sensitivity > 86.9%, 95% CI = 66.4-97.2; cognitive sensitivity > 86.7%, 95% CI = 69.3-96.2; social-emotional sensitivity > 83.3%, 95% CI = 65.3-94.4). Specificity was lower for the prediction of CP-related (40.1%) and non-CP-related developmental delays (< 46.0% for all).

INTERPRETATION

In an LMIC such as Sri Lanka, with limited access to specialist care and neuroimaging, combining two GMA measures and the HINE identified most infants with CP-related and non-CP-related developmental delay, thereby allowing targeted early intervention therapies.

Global trends and collaborative networks in gut microbiota-insulin resistance research: a comprehensive bibliometric analysis (2000-2024)

Background

The human gut microbiota plays a crucial role in maintaining metabolic health, with substantial evidence linking its composition to insulin resistance. This study aims to analyze the global scholarly contributions on the relationship between intestinal microbiota and insulin resistance from 2000 to 2024.

Methods

A bibliometric analysis was conducted using data from Scopus and Web of Science Core Collection. The search strategy included terms related to "Gastrointestinal Microbiome" and "Insulin Resistance" in the title or abstract.

Results

The analysis of 1,884 relevant studies from 510 sources was conducted, revealing a mean citation of 51.36 per manuscript and a remarkable annual growth rate of 22.08%. The findings highlight the significant role of gut microbiota in insulin resistance, corroborating prior studies that emphasize its influence on metabolic disorders. The literature review of the current study showed key mechanisms include the regulation of short-chain fatty acids (SCFAs) and gut hormones, which are critical for glucose metabolism and inflammation regulation. The analysis also identifies "Food and Function" as the most productive journal and Nieuwdorp M. as a leading author, underscoring the collaborative nature of this research area.

Conclusion

The consistent increase in publications in the field of gut microbiota and insulin resistance indicates growing recognition of the gut microbiota's therapeutic potential in treating insulin resistance and related metabolic disorders. Future research should focus on standardizing methodologies and conducting large-scale clinical trials to fully realize these therapeutic possibilities.