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The aim of this study was to explore the effects of the Israeli Lifestyle Program (ILP) on older adults' quality of life (QoL) and depressive symptoms. The study employed a non-randomized controlled pre-post intervention design, (N = 99), ages 60+ years, living independently in the community. The ILP group (n = 79) participated in 15 weekly group meetings and two individual sessions. The control group (n = 20) received an educational booklet based on the ILP content. Participants completed the (WHOQoL-BREF) and a Personal Health Questionnaire (PHQ-9) pre and post intervention. At baseline, no significant differences were found between the groups. Post-intervention, the ILP group values improved in the psychological (p <.001, η2 =.154), social relationship (p <.001, η2 =.131), and environmental (p =.002, η2 =.105) domains of the WHOQoL- BREF, whereas no change was found in these domains among the control group. Physical QoL increased beyond group (p =.020, η2 =.056), although not significantly. ILP participants showed no change in the depressive symptom report (p =.424, η2 =.007), whereas participants in the control group, reported more depressive symptoms (p =.009, η2 =.070). The ILP was found to increase participants' QoL and deemed as a promising health enhancement intervention for community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Objective: To assess the capacity of fetal pancreatic size, before standard blood glucose testing for screening and diagnosis, to predict maternal gestational diabetes mellitus (GDM). Methods: This was a retrospective cohort study of low‐risk pregnant women recruited during routine second‐trimester fetal anatomical screening at 20–25 weeks' gestation at two ultrasound units in Israel between 2017 and 2020. The predictive performance of fetal pancreatic circumference ≥ 80th and ≥ 90th centiles and glucose challenge test (GCT) was examined for the outcome of GDM. The independent‐samples t‐test was used to compare mean pancreatic circumference centile between pregnancies with GDM and those without GDM. Diagnostic performance was evaluated with 2 × 2 contingency tables and receiver‐operating‐characteristics (ROC) curves. Results: Overall, 195 women were selected for statistical analysis. Twenty‐four (12.3%) women were diagnosed subsequently with GDM. The mean ± SD fetal pancreatic circumference centile was significantly higher in the GDM group compared with the non‐GDM group (82.4 ± 14.6 vs 62.8 ± 27.6; P < 0.001). The pancreatic circumference centile was correlated positively with the estimated fetal weight centile (Pearson's coefficient, 0.243; P = 0.001). The 80th centile cut‐off for pancreatic circumference had the highest sensitivity (70.8%) and positive predictive value (23.3%) for future maternal GDM, with the best trade‐off between sensitivity and specificity achieved at the 75th centile cut‐off (sensitivity, 79%; specificity, 60%). The GCT had better specificity (90.2%) and negative predictive value (97.9%) compared with both cut‐offs in pancreatic circumference. The area under the ROC curve was higher for pancreatic circumference compared with GCT (0.71 vs 0.64) and only the former was statistically significant (P = 0.001). Conclusions: Fetal pancreatic circumference has a higher positive predictive capacity compared with GCT. Measuring pancreatic circumference can identify pregnancies at high risk for maternal GDM, thereby promoting earlier diagnosis and treatment, decreasing the time period during which the fetus is exposed to high maternal glucose levels and improving infant outcome. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: Mitochondrial complex‐I deficiency, nuclear type 16, is a rare autosomal recessive disorder caused by biallelic pathogenic variants in NDUFAF5 (C20orf7) (OMIM 618238). The aim of this study was to describe a severe early prenatal manifestation of this disorder, which was previously considered to occur only postnatally. Methods: This was a multicenter retrospective case series including five fetuses from three non‐related families, which shared common sonographic abnormalities, including brain cysts, corpus callosal malformations, non‐immune hydrops fetalis and growth restriction. Genetic evaluation included chromosomal microarray analysis and exome sequencing. Two fetuses from the same family were also available for pathology examination, including electron microscopy. Results: Chromosomal microarray analysis revealed no chromosomal abnormality in any of the tested cases. Trio exome sequencing demonstrated that three affected fetuses from three unrelated families were compound heterozygous or homozygous for likely pathogenic variants in NDUFAF5. No other causative variants were detected. The association between NDUFAF5 variants and fetal malformations was further confirmed by segregation analysis. Histological evaluation of fetal tissues and electron microscopy of the skeletal muscle, liver, proximal tubules and heart demonstrated changes that resembled postmortem findings in patients with mitochondrial depletion disorders as well as previously undescribed findings. Conclusions: Mitochondrial complex‐I deficiency and specifically biallelic mutations in NDUFAF5 have a role in abnormal fetal development, presenting with severe congenital malformations. Mitochondrial complex‐I disorders should be considered in the differential diagnosis of corpus callosal malformations and brain cysts, especially when associated with extracranial abnormalities, such as fetal growth restriction and non‐immune hydrops fetalis. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. Linked article: There is a comment on this article by Finsterer. Click here to view the Correspondence. [ABSTRACT FROM AUTHOR]

This article, published in the journal "Ultrasound in Obstetrics & Gynecology," discusses the use of ultrasound in diagnosing ovarian torsion, a gynecologic emergency. The study aimed to identify sonographic predictors for the severity of ischemia (lack of blood flow) in the ovary during torsion. The researchers conducted a retrospective study and found that certain sonographic characteristics, such as edema, abnormal flow on Doppler, and free fluid in the Douglas pouch, were associated with ischemic ovaries. They developed a scoring method based on these markers to predict ovarian ischemia, which could potentially aid in early identification and prompt surgical intervention. However, further validation and research are needed to optimize the clinical utility of this scoring method. [Extracted from the article]

This article, titled "EP19.19: Angle of progression for predicting second-stage Caesarean delivery complications," explores the correlation between the angle of progression (AOP) and maternal surgical complications following a second-stage Caesarean delivery (CD). The study retrospectively evaluated women who underwent CD for arrest of descent at the second stage of labor and found that there was a significant correlation between measured AOP and composite maternal outcome. The authors suggest that assessing AOP before surgery may help identify susceptible cases and allow for appropriate preparation. [Extracted from the article]

This article discusses the role of Tricuspid Annular Plane Systolic Excursion (TAPSE) in monitoring cardiac function in fetuses diagnosed with fetal intra-abdominal umbilical vein varix (FIUVV). The study reviewed cases of FIUVV diagnosed between 2018 and 2023 and collected data on varix diameter, associated anomalies, and pregnancy outcomes. The findings suggest that fetuses with FIUVV have a hyperdynamic cardiac state, and TAPSE may be a useful tool in monitoring these fetuses and identifying cardiac decompensation. No cases of thrombosis or fetal demise were reported in the study group. [Extracted from the article]

This article, titled "Diagnostic insights and clinical outcomes of fetal urinary extravasation," presents a retrospective cohort study on cases of prenatal-diagnosed fetal urinary extravasation. The study identified seven cases out of approximately 1750 targeted scans for kidney and urinary tract anomalies, with a gender split of three males and four females. The cases had diverse pre- and postnatal clinical manifestations and outcomes, with some requiring surgical interventions and others being effectively managed conservatively. The article emphasizes the importance of prenatal diagnosis in revealing the underlying etiology and improving parental counseling regarding postnatal surgical intervention and renal outcome. [Extracted from the article]

Importance: The Adult Executive Functioning Inventory (ADEXI)-a short, practical, self-report questionnaire accessible across diverse adult populations and languages-was used to assess executive functions (EFs), primarily inhibition and working memory., Objective: To examine the construct validity of the ADEXI Hebrew version through exploratory factor analysis (EFA) and convergent validity by correlating scores with similar measures of EF., Design and Setting: Cross-sectional study using online anonymous surveys., Participants: Nonclinical sample of 239 adults, 74.1% women, ages 18 to 80 yr (Mage = 44.19 yr, SD = 12.89)., Outcomes and Measures: The Hebrew version of the 14-item ADEXI, a demographic questionnaire, and the Dysexecutive Questionnaire (DEX)., Results: Descriptive statistics, Cronbach's α EFA using varimax rotation, and Pearson's correlations were used. Total internal consistency was good (α = .86). Unlike the two factors in the original English version, our construct validity through EFA revealed three factors-inhibition, working memory, and, uniquely, flexibility-that accounted for 55.71% of the variance. Convergent validity was supported by medium to large significant correlations (r =.29-.76) between the ADEXI and the DEX subscales and total scores., Conclusions and Relevance: Our findings offer psychometric evidence to support using the Hebrew version of the ADEXI for EF assessments in adult Hebrew-speaking populations. Plain-Language Summary: The Adult Executive Functioning Inventory (ADEXI) assesses three key components: inhibition, working memory, and cognitive flexibility. In this study, we examined the construct validity of the Hebrew version of the ADEXI to assess executive functions. Our findings support using the ADEXI in Hebrew-speaking populations. The ADEXI offers occupational therapy practitioners serving Hebrew-speaking populations in their practice a validated tool for assessing executive functions., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

Objective: To investigate the association of agenesis of the ductus venosus (ADV) with genetic abnormalities using genetic studies-Chromosomal Microarray Analysis (CMA) and Exome Sequencing (ES)., Design: Retrospective study of all fetuses diagnosed with ADV between January 2013 and December 2022 in a tertiary center., Results: ADV was diagnosed in 33 fetuses. The diagnosis was made at a mean gestational age of 21.2 ± 8.4 weeks. Conventional karyotype was applied in a single fetus (3.0%), CMA was applied in 21 fetuses (66.7%), and five fetuses (22.8%) were additionally tested with ES. ADV was isolated in eight fetuses (24%), whereas in 25 (76%) it was associated with abnormal ultrasound findings, including increased nuchal translucency (NT), intrauterine growth restriction (IUGR) and variable structural malformations, mostly cardiac (42%) followed by central nervous system (CNS) and skeletal malformations (24%). Genetic abnormalities were found in six fetuses out of 22 investigated (27%), of which 3 were detected by ES, 3 by CMA and 1 by conventional karyotype. A higher incidence of genetic aberrations was evident among ADVs associated with abnormal ultrasound findings. Genetic abnormalities were indicative of Prader Willi/Angelman syndrome, Noonan syndrome, CASK related disorder, 16q24.3 microdeletion syndrome and Trisomy 21., Conclusion: ADV associated with abnormal ultrasound findings is commonly correlated with genetic abnormalities and consequently unfavorable pregnancy outcomes. Our study emphasizes the value of genetic studies chiefly among cases associated with abnormal ultrasound findings, enabling early diagnosis of fetal pathologies associated with ADV, and providing better parental counseling., (© 2024 The Author(s). Prenatal Diagnosis published by John Wiley & Sons Ltd.)

Background. To evaluate effectiveness of The Greenhouse for autonomy and independence to prepare adults with severe cerebral palsy (CP) for the transition from assisted to independent living. The intervention combines weekly individual sessions using Pathways and Resources for Engagement and Participation together with weekly group sessions. Method. Seven adults with severe CP ages 23-45 years (M = 35; SD = 10) participated in the 20-week program. An Interrupted Time Series quasi-experimental design was used, assessing the intervention effect over time. The Canadian Occupational Performance Measure was administered bi-weekly from baseline to post-intervention to assess activity performance. Functional Independence Measure (FIM), Wheelchair use Confidence scale (WheelCon) and Impact on Participation and Autonomy (IPA) were administered baseline (4 weeks pre-intervention), mid and post-intervention, using Freidman test. Interviews were conducted four weeks after intervention. Findings. All participants' activity performance improved over time with significant clinical improvement in 95% of COPM goals. Significant improvement was seen in FIM (χ 2  = 8.07, p = .018) and WheelCon (χ 2  = 7.18, p = .028) though not in IPA. Participants described being better prepared, however more aware of challenges. Conclusion. The findings suggest the program may be effective to help adults with severe CP attain goals related to independent living and enhance function.

Background: Analysis of parent-provided home videos is a mode of technology that can facilitate a telehealth assessment, allowing observation of function in the child's natural home environment. This scoping review investigated areas of use of home videos for functional assessment by health professionals with a pediatric population with disabilities. Methods: Four databases were searched for articles in which parent-provided home videos were employed by health professionals for functional assessment in children with disabilities. Articles published from 2013 to 2023 were included in the review if they met the inclusion criteria, and the data were extracted into an Excel file. Results: After screening 3,019 articles, 30 articles were included in the data extraction. The majority of studies utilized home videos for diagnosis of autism, followed by assessment of motor development in infants. Studies found that using home videos for assessment is feasible and empowers parents. The validity and reliability of various home video platforms were demonstrated. Conclusions: Analysis of home videos can aid in making a timely diagnosis for prompt intervention, and can be used to assess various body functions, interchangeable with a live clinic assessment. It is important to provide parents with clear instructions when using this method. Future studies are necessary to determine whether parent-provided home videos can be utilized by a multidisciplinary team to assess diverse factors, including activity, participation, and the environment, in a variety of populations of children with disabilities, thus extending services beyond the physical borders of the clinic.

This study investigated degradation kinetics of five selected organic micropollutants (OMPs) present in poultry litter (namely: sulfadiazine, tetracycline, and doxycycline hyclate (antibiotics); estrone and 17-β-estradiol (hormones)) during hydrothermal carbonization (HTC) treatment as the temperature stepwise increased to 250 °C. All five pure OMPs were completely degraded before 250 °C was reached during the HTC process. Nevertheless, presence of poultry litter slowed down the degradation of OMPs. Through elemental mass balance calculation, it is noted that after 15 min (temperature less than 137 °C), 69-82% of organic carbon and 50-66% of organic nitrogen initially consisting part of the target antibiotics were fully mineralized. Both HTC filtrates and hydrochars obtained from poultry litter inhibited Escherichia coli and Bacillus subtilis growth. A combination of high salinity, high nutrients, dissolved organic carbon, and other ions in the filtrate as well as the adsorption of OMPs on hydrochars were probably the reason for the high toxicity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: This study aimed to determine the effect of nonreassuring fetal heart rate (NRFHR) patterns in labor on the postnatal renal function of neonates with a prenatal diagnosis of congenital anomalies of the kidney and urinary tract (CAKUT)., Study Design: A retrospective cohort study was conducted in a single tertiary referral center between 2012 and 2020. All cases with a prenatal diagnosis of CAKUT were extracted, and their fetal, maternal, obstetrical, and neonatal characteristics were analyzed. Cases of multiple gestations, preterm delivery, small for gestational age, major associated malformations or genetic aberrations, and prelabor acute obstetrical events were excluded from the analysis. The study group was comprised of patients who experienced NRFHR during labor. The control groups included (1) patients who had a trial of labor with a normal fetal heart rate pattern and (2) patients who delivered by elective cesarean section (CS). The primary outcome was abnormal serum creatinine levels in the perinatal period. For statistical purposes, the CAKUT cases were classified into a low and high estimated risk for an abnormal postnatal renal outcome. A subgroup analysis of the results was performed accordingly., Results: Two hundred and fifty-six fetuses diagnosed prenatally with CAKUT comprised the study group. Among these, 214 women (83%) opted for a labor trial, while 42 (17%) chose elective CS. Within the labor trial group, 21/214 patients (9.8%) experienced NRFHR during labor. Analysis of maternal and fetal characteristics revealed no statistically significant disparities between the groups. NRFHR patterns were not associated with a deterioration in neonatal serum creatinine compared with those with normal fetal monitoring or those born by an elective CS., Conclusion: NRFHR patterns during labor and delivery did not impair neonatal renal function status in fetuses diagnosed prenatally with low- and high-risk CAKUT. Delivery can be managed according to standard obstetrical guidelines., Key Points: · Kidneys affected by CAKUT commonly display renal dysplasia and a reduction in nephron mass.. · Low Apgar scores and asphyxia are recognized as risk factors for perinatal acute kidney injury.. · Lack of research on NRFHR impact on perinatal renal function in prenatally diagnosed CAKUT.. · NRFHR patterns during labor did not impair neonatal renal function status in prediagnosed fetuses.., Competing Interests: None declared., (Thieme. All rights reserved.)

Purpose: To understand aspects important to adults with severe cerebral palsy (CP) as they prepare to move from assisted to independent living and to create an appropriate intervention., Materials and Methods: An inclusive qualitative study was conducted together with adults with severe CP (Gross Motor Function Classification Scale 4-5) preparing to move to independent living. It included semi-structured interviews which were recorded, transcribed, and analyzed by two occupational therapists to create themes. The themes were reviewed and adjusted by the partners in a group context., Results: Seven partners aged 23-47 years (median= 35 years, standard deviation = 10; 4 female) participated. Four themes arose with sub-themes: (1) house management (finances, meals, maintenance, and housework), (2) interactions and boundaries (with a caregiver, family, friends, and romantic partners), (3) schedules (work, leisure, volunteering, education, and health management), and (4) "my way" (autonomy, independence, and self-advocacy; emotions and group power). These themes expressed the concerns of the partners and formed the basis of a group intervention before their move from assisted to independent living., Conclusions: The inclusive research revealed themes the partners raised that expressed their concerns; these became the basis for a group intervention to prepare for their move from assisted to independent living.

Advanced oxidation processes (AOPs) augment traditional water treatment methods, enhancing the removal of persistent contaminants. Efficiency of AOPs that utilize UV radiation for oxidants generation (e.g., ·OH) is reduced in water matrices that contain substants that may act as inner UV filters and/or scavengers for the generated radicals. Among such interfering compounds are major inorganic ions and dissolved organic matter that are naturally present in realistic waters. Thus, to improve AOPs efficiency it is desirable to separate the target pollutants from these natural species before treatment. Here the potential of electrodialysis as such pretreatment was investigated. The impact of this pretreatment on photo-oxidation of the pharmaceutical carbamazepine (CBZ) under VUV (λ<200 nm) irradiation, which yields ·OH generation via water homolysis, was tested in different water matrices. The obtained results indicate that in all tested solutions: Deionized water, groundwater, surface water, and treated wastewater, the addition of electrodialysis pretreatment successfully separated the target micropollutant CBZ from the major natural ions and to some extend the NOM, resulting faster degradation rates of CBZ and its transformation products in the following VUV-based AOP. Energy cost calculations indicated that addition of this pretreatment step reduces the overall energy demand of the system (i.e., energy consumption for the electrodialysis step was smaller than the energy gained by reducing the required VUV irradiation dose)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The present study aimed: 1) to simultaneously investigate the relationship between blood flow volumes of the two fetal liver afferent venous systems of normally appropriate for gestational age newborns. 2) to establish the normal reference range centiles values that will serve as a basis for future investigations., Methods: A cross-sectional, prospective study of singleton low obstetric risk pregnancies. Doppler examination included the measurement of the umbilical and the main portal vein vessels' diameters and time-averaged maximum velocity. The absolute and per kilogram of estimated fetal weight flow volumes and the ratio between the placental and portal blood volume flow were calculated from these data., Results: Three hundred and sixty-three pregnant women were included in the study. The umbilical and portal flow volumes' capacity to provide blood flow per kilogram of fetal weight, in the period of maximum fetal growth, was diverse. The placental flow decreased continuously from a mean of 121.2 mL/min/kg at the 20th week of gestation to 64.1 mL/min/kg at the 38th week of gestation. Meanwhile, the portal flow volume per kilogram of fetal weight increased from 9.6 mL/min/kg at 32 weeks of gestation to 10.3 at the 38th week of gestation. This resulted in a decrease in the umbilical to portal flow volume ratio from 13.3 to 9.6 during this period., Conclusion: Our results indicate that in the period of maximum fetal growth, the placental/portal ratio diminishes emphasizing the portal flow's predominance with low oxygen and nutrient supply to the liver., (© 2023 American Institute of Ultrasound in Medicine.)

Psychological resilience, the ability to adapt to adversity, is theorized to rely on intact inhibitory control (IC) mechanisms, which underlie one's ability to maintain goal-directed behavior by inhibiting prepotent responses. However, no study to date has explored daily fluctuations of IC performance in relation to resilience. Here, we examined the association between IC and mood measured daily in relation to psychological resilience in young adults in a stressful situation. Baseline resilience was obtained from 144 female and male soldiers during their basic combat training. Then, participants completed an ecological momentary assessment protocol, in which they reported their momentary mood and completed a short IC assessment twice/day for 2 weeks. A hierarchical linear modeling analysis revealed that psychological resilience moderated the relationship between momentary IC and momentary mood, such that better IC was associated with better mood only for those with higher, but not lower, self-reported psychological resilience at baseline. These results show that psychological resilience is manifested in the everyday association between IC and mood. Furthermore, they lend important support to cognitive models of resilience and may have significant contribution to our understanding of resilient behavior in real life.Trial Registration: MOH&#95;2018-0-13&#95;002451., (© 2023. Springer Nature Limited.)

Purpose: Powered mobility has a positive effect on social skills, self-esteem and overall development of children with motor impairments, but almost all previous studies were conducted with pre-school children. The aim of this study was to explore change beyond mobility following a therapeutic powered mobility summer camp for school-aged children and adolescents with severe cerebral palsy, as perceived by school staff., Materials and Methods: The participants in the therapeutic camp, which ran for 3 weeks, 5 days a week, three times over the summers 2018-2019, were children ages 7-19 (median age 11) with severe cerebral palsy who needed assistance in mobility and had limited hand function. Following the intervention, 19 semi-structured audio-recorded interviews were conducted with school staff, then transcribed and thematically analyzed using an inductive qualitative descriptive design with a phenomenological theoretical framework., Results: Four overarching themes were identified: (1) " Every step you take : mastering new, sometimes unexpected, skills", (2) " Break on through to the other side : changes in behaviour", (3) " Make new friends (but keep the old) : Boosting social behaviour" and (4) " I'm a believer : The journey through self-efficacy to empowerment"., Conclusions: The interviews showed the immediate positive influence of powered mobility for children who previously did not have independent mobility, following an intensive intervention. Changes in initiative, empowerment, social relationships and behaviour highlight the importance of self-generated mobility, regardless of whether independence was achieved. School-aged children with severe cerebral palsy seem to benefit from an intensive powered mobility intervention in areas other than mobility skills themselves.IMPLICATIONS FOR REHABILITATIONPowered mobility intervention seems to encourage activity and initiation among children and youth with severe CP.This research adds to the understanding of the effect powered mobility can have on social interaction and communication.Powered mobility might be a means to allow development, in addition to being an important end.

Engagement in interactive game-playing and passive TV watching has become an integral part of young children's routines. While there is a consensus regarding the harmful effect of long passive TV viewing on child development, the influence of interactive game playing is much less clear. This study seeks to specifically explore the association between passive TV watching and interactive-game playing, to executive functions (EF) in typically developing children in their natural environment. A convenience sample of 194 Israeli children (aged 5-7 years) was recruited for our cross-sectional study. Parents provided information on the average daily time their children spent watching TV and playing interactive games. In addition, parents fulfilled the Behavior Rating Inventory of Executive Function (BRIEF) to assess everyday executive skills in natural settings. Our findings revealed significant correlations between TV viewing and poor EF in five out of eight subscales of BRIEF, in addition to the indexes and the global executive composite ( p  < 0.05). However, the time spent on playing interactive games was not correlated with any of the BRIEF's subscales except one. Moreover, longer time spent watching TV was found to be a significant predictor of low EF among children (F(1,189) = 8.37; p  = .004, R 2  = 3.7%). The current study results show that passive viewing led to worse EF performance than active digital gaming. As a consequence, our study supports previous professional recommendations to limit passive TV viewing.

Background: Telehealth can assist with providing accessible pediatric occupational therapy services., Objectives: This study aimed to investigate the acceptability, inter-rater reliability, and concurrent validity of the Gilboa Functional Test (GIFT) as a video-conference-based graphomotor examination for children (GIFT-Online)., Methodology: A community-based sample of 157 children aged 3 to 7 years was screened using the GIFT-Online., Findings: Inter-rater reliability was excellent ( r = 0.97; p < .001; n = 40). In addition, significant correlations were found between the total GIFT-Online scores and the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07), the Little DCDQ (LDCDQ) ( r = 0.29, p < .001; n = 157), and the Drawing Proficiency Screening Questionnaire (DPSQ) ( r = -0.35, p < .001; n = 157); demonstrating construct and concurrent validity. The online assessment was well received by parents and children., Conclusions: The GIFT-Online was found to be an acceptable method of assessing graphomotor performance. Our results support the validity and reliability of the GIFT-Online as a screening tool administered remotely, thereby overcoming physical distancing and travel restrictions.

Objective: The purpose of the current study was to examine the unique contribution of personal and medical factors, objective and subjective cognition, and self-efficacy to the explained variance of quality of life (QoL) among survivors with self-reported cancer related cognitive impairment (CRCI)., Method: Seventy-three cancer survivors (non-central nervous system) with CRCI (mean age: 50.85 ± 10.82 years old, mean years post-treatment: 3 ± 2.7) participated in this cross-sectional study. QoL was assessed using the Functional Assessment of Cancer Therapy (FACT)-GP, while the cognitive function was assessed both objectively using tests of attentional control, speed of processing and sustained attention, and subjectively using the FACT-Cognition perceived cognitive impairments (FACTcog-PCI) subscale. Self-efficacy was assessed using the New General Self-Efficacy Scale (NGSE)., Results: A hierarchical multiple linear regression analysis revealed that sustained attention, perceived cognitive impairment and self-efficacy, accounted for 54% of the variance of QoL ( R 2 = 0.543, p  < 0.000), each providing a unique contribution to the explained variance (15-20% each) after controlling for age and gender., Conclusions: Considering that these variables may be amenable to change, this model can serve as a conceptual framework for designing effective cognitive treatment options for CRCI. Clinical Trial Registration: ClinicalTrials.gov NCTImplication for rehabilitationCancer related cognitive impairment is characterized by difficulties in the speed of processing performance, severe perceived cognitive impairments, and relatively low general self-efficacy.Multi-dimensional assessments including subjective and objective cognition as well as self-efficacy should be administered to cancer survivors with cognitive complaints to understand the underlying mechanisms of their QoL.Integrative cognitive rehabilitation interventions that aim to improve QoL among people with cancer-related cognitive impairment should target sustained attention, perceived cognitive impairment, and self-efficacy.

Purpose: To examine the preliminary efficacy of Cognitive Retraining and Functional Treatment (CRAFT) combining remote computerized cognitive training (CCT) and occupation-based treatment in adults with cancer-related cognitive impairment (CRCI)., Methods: Three-armed randomized controlled trial including 74 individuals with CRCI, randomized into 12 weeks of either CRAFT, CCT alone, or treatment-as-usual. Assessments evaluating participation in daily life, perceived cognition, cognitive performance, quality-of-life, and treatment satisfaction were administered at baseline, post-intervention, and 3-month follow-up., Results: Significant time × group interactions in favor of the CRAFT and CCT groups were found for participation in daily life (F 2,34  = 5.31, p = .01, eta = .238), perceived cognition (F 2,34  = 4.897, p = .014, eta = .224), and cognitive performance on speed of processing test (F = 5.678, p = .009, eta = .289). The CRAFT group demonstrated significantly larger clinically meaningful gains on participation in daily life (chi-square = 6.91, p = .032) and significantly higher treatment satisfaction. All treatment gains were maintained at a 3-month follow-up (n = 32)., Conclusions: CCT and CRAFT were found to have a positive impact on participation and cognitive outcomes among individuals with CRCI. The CRAFT showed an additional advantage in improving self-chosen occupation-based goals suggesting that a combination of cognitive training with occupation-based intervention has a positive synergistic effect resulting in "real world" health benefits., Implications for Cancer Survivors: A combination of cognitive training with occupation-based intervention has a positive effect resulting in clinically meaningful improvements in participation in daily life, objective cognitive performance, and subjective cognitive impairment., Clinical Trial Registration: ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Local and worldwide prenatal charts for estimated fetal weight and postnatal charts for head circumference are gender specific. However, prenatal head circumference nomograms are not gender customized., Objective: This study aimed to create gender-customized curves to assess between-gender head circumference differences and to study the clinical significance of using such gender-customized curves., Study Design: A single-center retrospective study was conducted between June 2012 and December 2020. Prenatal head circumference measurements were obtained from routine estimated fetal weight ultrasound scans. Postnatal head circumference measurement at birth and gender were retrieved from computerized neonatal files. Head circumference curves were created, and the normal range was defined for the male and female subpopulations. After applying gender-specific curves, we analyzed the outcome of cases classified as microcephaly and macrocephaly according to non-gender-customized curves, which were reclassified as normal according to gender-specific curves. For these cases, clinical information and postnatal long-term outcomes were retrieved from patients' medical records., Results: The cohort included 11,404 participants (6000 males and 5404 females). The curve for male head circumference was significantly higher than the female curve for all gestational weeks ( P <.0001). Applying gender customized curves resulted in fewer cases of male fetuses defined as 2 standard deviations above the normal range and female fetuses defined as 2 standard deviations below of the normal range. Cases reclassified as normal head circumference after the application of gender-customized curves were not related to increased adverse postnatal outcomes. The rate of neurocognitive phenotypes was not higher than the expected rate in both male and female cohorts. Polyhydramnios and gestational diabetes mellitus were more common in the normalized male cohort, whereas oligohydramnios, fetal growth restriction, and cesarean delivery were more common in the normalized female cohort., Conclusion: Prenatal gender-customized curves for head circumference can reduce the overdiagnosis of microcephaly in females and macrocephaly in males. According to our results, gender-customized curves did not affect the clinical yield of prenatal measurements. Therefore, we suggest that gender-specific curves be used to avoid unnecessary workup and parental anxiety., (© 2023 The Authors.)

Background: People with Parkinson's disease (PwP) may experience gait impairment and freezing of gait (FOG), a major cause of falls. External cueing, including visual (e.g., spaced lines on the floor) and auditory (e.g., rhythmic metronome beats) stimuli, are considered effective in alleviating mobility deficits and FOG. Currently, there is a need for a technology that delivers automatic, individually adjusted cues in the homes of PwP. The aims of this feasibility study were to describe the first step toward the development of a home-based technology that delivers external cues, test its effect on gait, and assess user experience., Methods: Iterative system development was performed by our multidisciplinary team. The system was designed to deliver visual and auditory cues: light stripes projected on the floor and metronome beats, separately. Initial testing was performed using the feedback of five healthy elderly individuals on the cues' clarity (clear visibility of the light stripes and the sound of metronome beats) and discomfort experienced. A pilot study was subsequently conducted in the homes of 15 PwP with daily FOG. We measured participants' walking under three conditions: baseline (with no cues), walking with light stripes, and walking to metronome beats. Outcome measures included step length and step time. User experience was also captured in semi-structured interviews., Results: Repeated-measures ANOVA of gait assessment in PwP revealed that light stripes significantly improved step length (p = 0.009) and step time (p = 0.019) of PwP. No significant changes were measured in the metronome condition. PwP reported that both cueing modalities improved their gait, confidence, and stability. Most PwP did not report any discomfort in either modality and expressed a desire to have such a technology in their homes. The metronome was preferred by the majority of participants., Conclusions: This feasibility study demonstrated the usability and potential effect of a novel cueing technology on gait, and represents an important first step toward the development of a technology aimed to prevent FOG by delivering individually adjusted cues automatically. A further full-scale study is needed. Trial registration This study was registered in ClinicalTrials.gov at 1/2/2022 NCT05211687., (© 2023. The Author(s).)

The current study aimed to examine the unique contribution of personal and environmental factors to explain graphomotor skills in typically developing preschoolers and first-year elementary school students. A convenience sample of 136 Israeli children aged three−seven years was recruited. Graphomotor skills were assessed using the Gilboa Functional Test (GIFT); personal and environmental factors were assessed using a demographic questionnaire and the Home Literacy Experiences Questionnaire (HLEQ). A hierarchical multiple linear regression analysis revealed that home literacy and educational approach accounted for 43.1% of the variance of graphomotor skills (R2 = 40.4, p < 0.000), each providing a unique contribution to the explained variance after controlling for age, gender, and spoken language. Generally, our results supported the bioecological model, with proximal factors (home literacy and educational approach) having a greater influence on child graphomotor skills than distal factors (parental socioeconomic and immigration status). By highlighting the role of environmental factors in graphomotor development, these results can be used as a conceptual framework for developing early intervention programs., Competing Interests: The authors declare no conflict of interest.

Importance: In-home therapy provides the opportunity for rehabilitation intervention to be completed in the context of the patient's natural environment. However, most studies have focused on the effects of physical exercise, leaving a gap in understanding the effectiveness of a more task-oriented intervention that addresses individual preferences., Objective: To assess the feasibility and preliminary efficacy of the Cognitive Orientation to daily Occupational PerformanceTM (CO-OP) approach, delivered at home with older adults after a hip fracture to improve functional outcomes., Design: Single-arm quasi-experimental design., Setting: Patients' home., Participants: Nine participants (age ≥60 yr) being discharged home from an inpatient rehabilitation ward in a geriatric hospital in a central city in Israel., Intervention: Up to 10 1-hr weekly face-to-face sessions in using the CO-OP approach., Outcomes and Measures: The Canadian Occupational Performance Measure was used to measure performance and satisfaction with the patients' level of participation in daily functioning., Results: A 30% recruitment rate, an 81% retention rate, were observed, with 88% of the participants expressing high to very high overall satisfaction with the intervention. Friedman test results indicated statistically significant improvements in occupational performance and satisfaction on trained and untrained goals (p < .01)., Conclusions and Relevance: The findings suggest that a home-based CO-OP intervention is feasible and potentially beneficial for older adults who are returning home after a hip fracture. What This Article Adds: This study shows that a task-oriented intervention can be effective in helping older adults return home successfully after a hip fracture., (Copyright © 2023 by the American Occupational Therapy Association, Inc.)

This case series describes our experience with a prenatal diagnosis of fetal perineal masses. We propose a clinical-sonographic approach for prenatal workup in cases presenting perineal findings based on imaging the target sign at the posterior perineal triangle, the fetal genitalia, and sacrum. Targeted, structured prenatal anatomical scan in fetuses presenting with perineal masses may aid in the prenatal differential diagnosis and enable appropriate genetic analysis, prenatal counseling, and postnatal treatment.

Objectives: The purpose of this study is to demonstrate whether diabetes during pregnancy affects the development of the fetal immune system. The background: evaluation of potential complications in diabetic pregnancy. The objective is evaluation of the significance of a new ultrasound method of thymus size in pregnancies complicated by diabetes., Material and Methods: The analysis was performed with the use of IBM SPSS Statistics 25.0 software. The Mann-Whitney U test was used for comparison of two groups, i.e., diabetic pregnancies and non-diabetic pregnancies, whereas Kruskal-Wallis H test was used to compare multiple groups. A linear regression model was used to determine the correlation between the type of diabetes and fetal thymus size as well as between maternal body mass index (BMI) and fetal thymus size. The significance level α was set at 0.05., Results: A comparison between diabetic and non-diabetic pregnancies was made with the use of Kruskal-Wallis H test. The compared groups included women without gestational diabetes, with pre-gestational diabetes, gestational diabetes managed by diet and gestational diabetes treated with insulin and diet. The analysis revealed significant differences between the compared groups, H (3) = 23.06; p < 0.001; ƞ2 = 0.04. The additional post hoc Dunn's test with Bonferroni correction of the significance level was used to explore specific differences between group means. The results of this detailed analysis indicated that foetuses of diabetic mothers treated with diet had smaller thymus than foetuses of non-diabetic mothers (p = 0.001). Linear regression analysis was used to establish whether maternal BMI (defined as the body mass divided by the square of the body height and expressed in units of kg/m²) affects fetal thymus size. The analysis found no correlation between maternal BMI divided into the following categories: 18.5-24.99 normal weight, 25-29.99 overweight, 30.00-34.99 obese class I, 35.00-39.99 obese class II and ≥ 40.00 very severely obese, and fetal thymus size, b = -1.82; SE = 2.17; t = -0.84; p = 0.405; R2 < 0.01., Conclusions: Thymus size is statistically smaller in foetuses of diabetic mothers when compared to healthy controls. Overweighted and obese pregnancy is not a factor affecting fetal thymus size.

Objective:  Congenital aortic vascular ring may present after birth with variable degrees of respiratory distress due to tracheal compression. The aim of this study was to prospectively evaluate in utero tracheal patency in correlation with postnatal outcome., Methods:  During an eight-year period, fetuses with aortic arch abnormality encircling the trachea and forming a complete ring were recruited for the study. Tracheal patency was classified as: no compression, partial compression, or complete compression. Postnatal MRI/CTangio studies were performed and outcome data was retrospectively analyzed from the medical records., Results:  Among the 46 fetuses recruited to the study, 38 had right aortic arch (RAA), and 8 presented with double aortic arch (DAA). In the RAA group 35 (92.1 %) of the fetuses presented no compression and 34 (97.1 %) of them were asymptomatic in the long-term follow-up. Three fetuses (7.9 %) in this group presented in utero compression: one was terminated at 16 weeks of gestation due to associated ominous findings, and the other two had mild respiratory symptoms around 12 months of age and underwent surgery with a good outcome. In the DAA group, all fetuses presented in utero with tracheal compression. Seven showed partial and one complete compression. Among the seven with partial compression, six were symptomatic and underwent surgery. The case with severe airway occlusion had emergency tube insertion in the delivery room and underwent surgery at 7 days but died from severe respiratory complications., Conclusion:  This is the first study to evaluate in utero tracheal patency in cases with vascular ring. It allows better prenatal and postnatal workup and follow-up including potentially life-threatening respiratory failure., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objectives: The aim of this study is to assess the procedure-to-delivery interval (PDI), the obstetric complications, and the early neonatal outcome in patients that did or did not receive glucocorticosteroids (GCSs) before third-trimester amniocentesis (TTA)., Methods: A retrospectively analysis of 445 TTA procedures divided into two groups based on the administration (study group = 220 patients) or not (control group = 225 patients) of GCSs before TTA. The PDI was calculated for all patients. Obstetric and neonatal outcomes were compared between the groups., Results: The rate of procedure-associated complications was similar between the groups. The mean PDI was 47.2 ± 16.8 days. The overall incidence of preterm birth was 11.7%; 9% delivered between 34 and 37 weeks and 2.7% between 28 and 34 weeks. Only nine patients (2%) delivered within seven days following TTA. The incidence of respiratory distress syndrome in the study and control groups was 1.8% and 1.3%, p  = .71, respectively. There were no significant differences in other neonatal outcomes in term and preterm deliveries between the study and control groups., Conclusions: In the present study, the administration of glucocorticoids prior to TTA did not reduce the rates of neonatal complications, which was similar in both groups and not higher than the general population.