RESUMO
BACKGROUND: Sensitive measures to predict neuromotor outcomes from data collected early in infancy are lacking. Measures derived from the recordings of infant movement using wearable sensors may be a useful new technique. METHODS: We collected full-day leg movement of 41 infants in rural Guatemala across 3 visits between birth and 6 months of age using wearable sensors. Average leg movement rate and fuzzy entropy, a measure to describe the complexity of signals, of the leg movements' peak acceleration time series and the time series itself were derived. We tested the three measures for the predictability of infants' developmental outcome, Bayley Scales of Infant and Toddler Development III motor, language, or cognitive composite score assessed at 12 months of age. We performed quantile regressions with clustered standard errors, accounting for the multiple visits for each infant. RESULTS: Fuzzy entropy was associated with the motor composite score at the 0.5 quantiles; this association was not found for the other two measures. Also, no leg movement characteristic was associated with language or cognitive composite scores. CONCLUSION: We propose that the entropy of leg movement associated peak accelerations calculated from the wearable sensor data collected for a full-day can be considered as one predictor for infants' motor developmental outcome assessed with Bayley Scales of Infant and Toddler Development III at 12 months of age.
Assuntos
Desenvolvimento Infantil , População Rural , Dispositivos Eletrônicos Vestíveis , Humanos , Guatemala , Lactente , Feminino , Masculino , Desenvolvimento Infantil/fisiologia , Perna (Membro)/fisiologia , Recém-Nascido , Movimento/fisiologia , Acelerometria/instrumentação , Desenvolvimento da LinguagemRESUMO
BACKGROUND: Tools to accurately assess infants' neurodevelopmental status very early in their lives are limited. Wearable sensors may provide a novel approach for very early assessment of infant neurodevelopmental status. This may be especially relevant in rural and low-resource global settings. METHODS: We conducted a longitudinal observational study and used wearable sensors to repeatedly measure the kinematic leg movement characteristics of 41 infants in rural Guatemala three times across full days between birth and 6 months of age. In addition, we collected sociodemographic data, growth data, and caregiver estimates of swaddling behaviors. We used visual analysis and multivariable linear mixed models to evaluate the associations between two leg movement kinematic variables (awake movement rate, peak acceleration per movement) and infant age, swaddling behaviors, growth, and other covariates. RESULTS: Multivariable mixed models of sensor data showed age-dependent increases in leg movement rates (2.16 [95% CI 0.80,3.52] movements/awake hour/day of life) and movement acceleration (5.04e-3 m/s2 [95% CI 3.79e-3, 6.27e-3]/day of life). Swaddling time as well as growth status, poverty status and multiple other clinical and sociodemographic variables had no impact on either movement variable. CONCLUSIONS: Collecting wearable sensor data on young infants in a rural low-resource setting is feasible and can be used to monitor age-dependent changes in movement kinematics. Future work will evaluate associations between these kinematic variables from sensors and formal developmental measures, such as the Bayley Scales of Infant and Toddler Development.
Assuntos
Aceleração , Perna (Membro) , Lactente , Humanos , Projetos Piloto , Fenômenos Biomecânicos , GuatemalaRESUMO
La presente investigación trata sobre la prevalencia de maloclusión, en un grupo de niños de 27 escuelas rurales y urbanas de los departamentos de San Salvador, San Miguel y La Libertad. El estudio se realizó en Febrero y Marzo de 2003, en niños con edades de 9 a 15 años, de ambos sexos; este grupo totalizó 4990 niños observados, del cual 53.5 % son niñas y el 46.5% restante corresponde a los niños; En el departamento de San Salvador se observaron 2155niños que equivales al 43.2%, en el departamento de San Miguel (de los municipios de San Miguel, Chapeltique y Chinameca) se observó el 41.1% representados por 2051 escolares y en el departamento de La Libertad (municipio de Comasagua)se observaron 784 niños que equivalen 15.7% de la población total. El Objetivo general de la investigación es identificar la prevalencia de la maloclusión. La maloclusión que prevalece en la población en estudio es la Clase I de Angle, presentando un 49% del total de maloclusiones; la Clase II en un 21% y la Clase III en un 15%. De igual manera los objetivos específicos se observan en porcentajes, en cuanto a la mordida cruzada representa un 13% de total observado y la mordida profunda se representa en un 17%; en cuanto a mordida abierta anterior se observó el 6%, y la mordida abierta posterior se presentó con un 4%, los incisivos borde a borde se observaron en el 14% de la población. El apiñamiento dentario estuvo representado por el 66%, los diastemas por el 35%. En cuanto a malposición dentaria, la más frecuente es la rotación en un 76%. En un 6% de la población se observó pérdida de la primera molar permanente tanto en superior como en inferior, 3.9% de la primera molar permanente inferior y el 0.5% restante corresponde a la de la primera molar permanente superior.
This research deals with the prevalence of malocclusion in a group of children from 27 rural and urban schools in the departments of San Salvador, San Miguel and La Libertad. The study was carried out in February and March 2003, in children between the ages of 9 and 15, of both sexes; This group totaled 4,990 observed children, of which 53.5% are girls and the remaining 46.5% correspond to boys; In the department of San Salvador, 2,155 children were observed, equivalent to 43.2%, in the department of San Miguel (from the municipalities of San Miguel, Chapeltique and Chinameca) 41.1% were observed, represented by 2,051 schoolchildren and in the department of La Libertad ( Municipality of Comasagua) 784 children were observed, equivalent to 15.7% of the total population. The general objective of the research is to identify the prevalence of malocclusion. The prevailing malocclusion in the study population is Angle's Class I, presenting 49% of all malocclusions; Class II by 21% and Class III by 15%. In the same way, the specific objectives are observed in percentages, as for the cross bite it represents 13% of the total observed and the deep bite is represented in 17%; Regarding the anterior open bite, 6% were observed, and the posterior open bite was presented with 4%, the incisors edge to edge were observed in 14% of the population. Dental crowding was represented by 66%, the diastemas by 35%. Regarding dental malposition, the most frequent is rotation in 76%. In 6% of the population, loss of the first permanent molar was observed in both upper and lower teeth, 3.9% of the first lower permanent molar and the remaining 0.5% corresponded to that of the first permanent upper molar.