Supporting play exploration and early developmental intervention versus usual care to enhance development outcomes during the transition from the neonatal intensive care unit to home: a pilot randomized controlled trial

Background While therapy services may start in the Neonatal Intensive Care Unit (NICU) there is often a gap in therapy after discharge. Supporting Play Exploration and Early Development Intervention (SPEEDI) supports parents, helping them build capacity to provide developmentally supportive opportunities starting in the NICU and continuing at home. The purpose of this single blinded randomized pilot clinical trial was to evaluate the initial efficacy of SPEEDI to improve early reaching and exploratory problem solving behaviors. Methods Fourteen infants born very preterm or with neonatal brain injury were randomly assigned to SPEEDI or Usual Care. The SPEEDI group participated in 5 collaborative parent, therapist, and infant interventions sessions in the NICU (Phase 1) and 5 at home (Phase 2). Parents provided daily opportunities designed to support the infants emerging motor control and exploratory behaviors. Primary outcome measures were assessed at the end of the intervention, 1 and 3 months after the intervention ended. Reaching was assessed with the infant supported in an infant chair using four 30 s trials. The Early Problem Solving Indicator was used to evaluate the frequency of behaviors during standardized play based assessment. Effect sizes are including for secondary outcomes including the Test of Infant Motor Performance and Bayley Scales of Infant and Toddler Development. Results No group differences were found in the duration of toy contact. There was a significant group effect on (F1,8 = 4.04, p = 0.08) early exploratory problem-solving behaviors with infants in the SPEEDI group demonstrating greater exploration with effect sizes of 1.3, 0.6, and 0.9 at the end of the intervention, 1 and 3 months post-intervention. Conclusions While further research is needed, this initial efficacy study showed promising results for the ability of SPEEDI to impact early problem solving behaviors at the end of intervention and at least 3 months after the intervention is over. While reaching did not show group differences, a ceiling effect may have contributed to this finding. This single blinded pilot RCT was registered prior to subject enrollment on 5/27/14 at ClinicalTrials.Gov with number NCT02153736

The Relation Between Infant Construction Strategy and Language Development in Toddlers

Infants learn from interaction with physical objects in their environments. Object construction, or merging individual objects into a single structure, has been linked previously to language. Items and toys can be structured and combined with similarity to word combinations (Greenfield, 1991). Infants initially combine 2 objects and then graduate on to combine 3 pieces or more. Words are put together in comparable ways, with each word corresponding to an object, and a sentence corresponding to a single structure. The purpose of this project is to explore how construction ability in infants affects language ability in toddlers. We hypothesize that the more advanced the infant’s construction ability at 14 months, the more advanced their language ability will be at 24 months. Methods: At 14 months of age, 47 infants were given 2 sets of nesting cups to assess construction strategy while video-recorded (Greenfield, Nelson, & Saltzman, 1972). Construction strategies coded included “nothing,” (no cup combination), “pairing,” (one cup placed on or inside another cup), and “potting,” (two or more cups placed in or stacked on a third cup). Expressive and receptive language was assessed at 2 years of age using the Preschool Language Scales, 5th edition. Data was analyzed with a regression model, using Hierarchical Linear Modeling 7 (Student version). Results: Infants who combined objects scored higher on expressive language (βs 9.52-14.3, ts(44) 2.19-2.62, ps 0.01-0.03), than infants who did not combine objects at 14 months (β00=92.82). No differences were found for construction strategy and receptive language (βs 5.49-11.79, ts(44) 1.67-0.98, ps \u3e 0.102). Conclusion: The ability to combine cups at 14 months is related to higher expressive language scores. We speculate that the ability to combine toys lays a foundation for combining words into sentences, while language comprehension may originate from other mechanisms. Further studies may assess the number of objects paired successfully and the complexity of construction with success and complexity of sentence structure at different time points throughout early childhood.https://scholarscompass.vcu.edu/uresposters/1217/thumbnail.jp

Normative EMG activation patterns of school-age children during gait

Gait analysis is widely used in clinics to study walking abnormalities for surgery planning, definition of rehabilitation protocols, and objective evaluation of clinical outcomes. Surface electromyography allows the study of muscle activity non-invasively and the evaluation of the timing of muscle activation during movement. The aim of this study was to present a normative dataset of muscle activation patterns obtained from a large number of strides in a population of 100 healthy children aged 6-11 years. The activity of Tibialis Anterior, Lateral head of Gastrocnemius, Vastus Medialis, Rectus Femoris and Lateral Hamstrings on both lower limbs was analyzed during a 2.5-min walk at free speed. More than 120 consecutive strides were analyzed for each child, resulting in approximately 28,000 strides. Onset and offset instants were reported for each observed muscle. The analysis of a high number of strides for each participant allowed us to obtain the most recurrent patterns of activation during gait, demonstrating that a subject uses a specific muscle with different activation modalities even in the same walk. The knowledge of the various activation patterns and of their statistics will be of help in clinical gait analysis and will serve as reference in the design of future gait studie

A Method for Determining the Realizability of Tropical Curves in R^3

A tropical variety is a weighted polyhedral complex whose maximal dimensional cells are pure dimensional, rational, connected, and balanced weighted around every vertex. It is known that every irreducible algebraic variety can be tropicalized, that is, there is a way one can derive a tropical variety from an algebraic one. However, there exist tropical varieties that are not the tropicalization of algebraic varieties. The goal of this work is to answer whether a given tropical curve (a 1−dimensional tropical variety) in R^3 is the tropicalization of an algebraic curve in R^3

BEYOND THE HORIZON: THE MARITIME EVOLUTION OF TRANSNATIONAL CRIME

This thesis examines how transnational criminal organizations (TCOs) leverage innovation and technological advancements within the maritime domain, blending traditional methods, such as fishing boats, pangas, go-fast boats, and container ships, with advanced technologies like narco torpedoes, semi-submersibles, low-profile vessels (LPVs), and fully submersible vessels (FSVs). Through an analysis of historical and modern strategies, this thesis demonstrates TCOs' adaptability to enforcement efforts and evolving threats. The thesis evaluates current methods used by TCOs using media reports, government reports, and case studies, ranking each method against each other. Advancements in stealth, communication, and navigation technologies enable TCOs to use any identified method effectively. Due to their superior stealth and payload capabilities, LPVs and FSVs are most effective methods used by TCOs and pose the most significant threat to U.S. maritime security. Traditional methods, while not as capable, are still used, and present ongoing challenges to law enforcement. Efforts to interdict these vessels have achieved limited success, as TCOs continuously innovate to avoid interdiction and maintain profitability. There is a pressing need for enhanced countermeasures to disrupt these illicit networks effectively, focusing on bridging gaps in technology, coordination, and enforcement to address the dynamic threat of maritime smuggling.Distribution Statement A. Approved for public release: Distribution is unlimited.Lieutenant, United States Nav