Novel rehabilitation technologies in pediatric rehabilitation: knowledge towards translation.

Knowledge translation (KT) refers to the process of applying the most promising research outcomes into practice to ensure that new discoveries and innovations improve healthcare accessibility, effectiveness, and accountability. The objective of this perspective paper is to discuss and illustrate via examples how the KT process can be implemented in an era of rapid advancement in rehabilitation technologies that have the potential to significantly impact pediatric healthcare. Using Graham et al.

Hybrid approaches to allied health services for children and young people: a scoping review.

Background: Hybrid models that integrate both in-person and remote health services are increasingly recognized as a promising approach. Nevertheless, research that defines and characterizes these models in children and young people is scarce and essential for establishing guidelines for implementation of hybrid allied health services. This scoping review evaluates four key aspects of hybrid allied health services in children and young people: 1.

Lessons learned from a pediatric powered mobility lending program.

Purpose: To evaluate children's characteristics and impact of a powered wheelchair lending program including comparisons of diagnostic sub-groups, and validation of a predictive model of powered mobility proficiency.

Methods And Materials: This retrospective study included 172 children who participated in the ALYN powered mobility lending program from 3/2009-7/2022. Demographics and functional levels were measured questionnaires; driving proficiency was evaluated when the wheelchair was returned, and parents and children were interviewed following their participation in the program.

Adaptive control of a wheelchair mounted robotic arm with neuromorphically integrated velocity readings and online-learning.

Wheelchair-mounted robotic arms support people with upper extremity disabilities with various activities of daily living (ADL). However, the associated cost and the power consumption of responsive and adaptive assistive robotic arms contribute to the fact that such systems are in limited use. Neuromorphic spiking neural networks can be used for a real-time machine learning-driven control of robots, providing an energy efficient framework for adaptive control.

Development of a new tool: progression of paediatric powered mobility- 3PM.

Purpose: To develop a tool to assess the progression of powered mobility skills for children and determine its psychometric properties.

Method: A three-phase, the mixed-method design included: I) conceptualisation based on international specialists' input through a focus group or interview to generate initial items; II) tool development using a two-round Delphi survey and III) evaluation of psychometric properties from eight video recordings of children. The Progression of Paediatric Powered Mobility (3PM) was validated Intraclass correlation coefficients (ICC) calculated from conventionally powered mobility assessments: the Powered Mobility Program, the Assessment of Learning Powered Mobility tool, and the Powered Mobility Proficiency test.

Pediatric powered mobility training: powered wheelchair versus simulator-based practice.

Method: Participants included 30 children and adolescents (23 males, 13 females) with cerebral palsy and other neuromuscular diseases, aged 6-18. Data were collected and compared at baseline and after 12 weeks of home-based practice via a powered wheelchair or a simulator. Powered mobility ability was determined by the Powered Mobility Program (PMP), the Israel Ministry of Health's Powered Mobility Proficiency Test (PM-PT) and the Assessment of Learning Powered Mobility (ALP).

Lessons Learned during a Naturalistic Study of Online Treatment for Pediatric Rehabilitation.

The COVID-19 pandemic forced many health care providers to modify their service model by adopting telehealth and tele-rehabilitation with minimal time to plan for its execution. ALYN-Pediatric Rehabilitation Hospital in Jerusalem, Israel, responded with alacrity by providing a broad range of rehabilitation services to young people via online therapy during the first 5 months of the pandemic. The objectives of this naturalistic study were: (1) to monitor usage and user experience of online rehabilitation provided to young people receiving out-patient sessions of physical therapy, occupational therapy, speech and language therapy and psychology and (2) to consider the advantages and disadvantages of retaining this model of online treatment in full or in part post-COVID-19.

Reliability and validity of pediatric powered mobility outcome measures.

Purpose: To determine the intra-rater and inter-rater reliability of the Powered Mobility Program (PMP) and the Israel Ministry of Health Powered Mobility Proficiency Test (PM-PT); to test inter-rater reliability of the Assessment of Learning Powered Mobility (ALP) tool; to determine the convergent validity of these measures for children with physical disabilities.

Materials And Methods: Participants included 30 children (mean 10 years, 6 months [SD 3 years, 7 months]; range: 6-18 years) with cerebral palsy and other neuromuscular disorders. Participants were non-proficient powered wheelchair drivers.

Comparing children's driving abilities in physical and virtual environments.

Purpose: To compare children's driving abilities in a physical and virtual environment and to validate the McGill Immersive Wheelchair Simulator (MiWe-C) for the use of children with disabilities.

Materials And Methods: Participants included 30 children (17 males, 13 females; mean age 14 y 1 mo, [SD 3 y 6 mo]; range: 5-18 y) with cerebral palsy, neuromuscular disease and spinal cord injury. All children were proficient drivers with more than 3 months' experience, who had their own powered wheelchairs.

Predictive model of proficiency in powered mobility of children and young adults with motor impairments.

Aim: To identify variables that can predict proficiency in powered mobility use for children in young adults.

Method: Participants included 80 children and young adults (42 males, 38 females; mean age 10y 2mo, [SD 5y 1mo]; range: 2-22y) with cerebral palsy, neuromuscular disease, and spinal cord injury who participated in the ALYN Hospital Powered Mobility Lending Program from 2009 to 2016. Data were collected and compared before and after participation in the program and powered mobility levels were determined by the Israeli Ministry of Health (MOH) Powered Mobility Proficiency Test.

Novel expression vectors enabling induction of gene expression by small-interfering RNAs and microRNAs.

Small-interfering RNAs and microRNAs are small ∼21-22 nucleotide long RNAs capable of posttranscriptional suppression of gene expression. The synthetic siRNAs are especially designed to target pre-specified genes and are common molecular biology tools. The miRNAs are endogenous regulators of gene expression found in a wide variety of eukaryotes.

MiR-125 in normal and malignant hematopoiesis.

MiR-125 is a highly conserved microRNA throughout many different species from nematode to humans. In humans, there are three homologs (hsa-miR-125b-1, hsa-miR-125b-2 and hsa-miR-125a). Here we review a recent research on the role of miR-125 in normal and malignant hematopoietic cells.

Regulation of cancer aggressive features in melanoma cells by microRNAs.

MicroRNAs (miRNAs) are small non-coding RNAs with regulatory roles, which are involved in a broad spectrum of physiological and pathological processes, including cancer. A common strategy for identification of miRNAs involved in cell transformation is to compare malignant cells to normal cells. Here we focus on identification of miRNAs that regulate the aggressive phenotype of melanoma cells.

Acquired resistance to 6-thioguanine in melanoma cells involves the repair enzyme O6-methylguanine-DNA methyltransferase (MGMT).

O(6)-methylguanine-DNA methyltransferase (MGMT), is a DNA repair enzyme that recognizes O(6)-alkylated guanine, a base analog resulting from treatment with alkylating agents. O(6)-6-thioguanine (6-TG) is used clinically to treat malignant as well as inflammatory diseases. Although MGMT participates in resistance to alkylating agents, it has not been shown to be involved in resistance of tumors to 6-TG.

Hsa-mir-125b-2 is highly expressed in childhood ETV6/RUNX1 (TEL/AML1) leukemias and confers survival advantage to growth inhibitory signals independent of p53.

MicroRNAs (miRNAs) regulate the expression of multiple proteins in a dose-dependent manner. We hypothesized that increased expression of miRNAs encoded on chromosome 21 (chr 21) contribute to the leukemogenic function of trisomy 21. The levels of chr 21 miRNAs were quantified by qRT-PCR in four types of childhood acute lymphoblastic leukemia (ALL) characterized by either numerical (trisomy or tetrasomy) or structural abnormalities of chr 21.

Diagnostic assay based on hsa-miR-205 expression distinguishes squamous from nonsquamous non-small-cell lung carcinoma.

Purpose: Recent advances in treatment of lung cancer require greater accuracy in the subclassification of non-small-cell lung cancer (NSCLC). Targeted therapies which inhibit tumor angiogenesis pose higher risk for adverse response in cases of squamous cell carcinoma. Interobserver variability and the lack of specific, standardized assays limit the current abilities to adequately stratify patients for such treatments.

Right atrial effects on right ventricular ejection fraction derived from thermodilution measurements.

Objective: The thermodilution technique provides a convenient means to monitor cardiac output, right ventricular (RV) ejection fraction (EF), and volumes at the bedside. To calculate RVEF from the pulmonary artery temperature curve, the bolus thermodilution technique assumes that right atrial (RA) temperature returns to baseline value within 1 beat following the cold saline injection. The authors hypothesized that this assumption is the reason why the thermodilution technique consistently underestimates RVEF.

A new locus for autosomal dominant posterior polar cataract in Moroccan Jews maps to chromosome 14q22-23.

Background: Posterior polar cataract is a clinically distinctive opacity located at the back of the lens. It is commonly acquired in age related cataract, and may infrequently occur in pedigrees with congenital cataract. To date, five loci for autosomal dominant congenital posterior polar cataract have been identified.

Identification of differentially expressed mRNA transcripts in drug-resistant versus parental human melanoma cell lines.

Background: Malignant melanoma resistance to chemotherapy remains a major limitation to treatment. Our aim was to identify genes associated with drug resistance, in order to better understand the molecular events underlying the drug-resistant phenotype.

Materials And Methods: A human melanoma cell line and its drug-resistant variants obtained by selection with MNNG or 6-thioguanine were used.

In vivo muscle stiffening under bone compression promotes deep pressure sores.

Pressure sores (PS) in deep muscles are potentially fatal and are considered one of the most costly complications in spinal cord injury patients. We hypothesize that continuous compression of the longissimus and gluteus muscles by the sacral and ischial bones during wheelchair sitting increases muscle stiffness around the bone-muscle interface over time, thereby causing muscles to bear intensified stresses in relentlessly widening regions, in a positive-feedback injury spiral. In this study, we measured long-term shear moduli of muscle tissue in vivo in rats after applying compression (35 KPa or 70 KPa for 1/4-2 h, N = 32), and evaluated tissue viability in matched groups (using phosphotungstic acid hematoxylin histology, N = 10).

Age-dependent changes in material properties of the brain and braincase of the rat.

Clinical and biomechanical evidence indicates that mechanisms and pathology of head injury in infants and young children may be different from those in adults. Biomechanical computer-based modeling, which can be used to provide insight into the thresholds for traumatic tissue injury, requires data on material properties of the brain, skull, and sutures that are specific for the pediatric population. In this study, brain material properties were determined for rats at postnatal days (PND) 13, 17, 43, and 90, and skull/suture composite (braincase) properties were determined at PND 13, 17, and 43.