Early experience unpredictability in child development as a model for understanding the impact of the COVID-19 pandemic: A translational neuroscience perspective

Extensive evidence links adverse experiences during childhood to a wide range of negative consequences in biological, socioemotional, and cognitive development. Unpredictability is a core element underlying most forms of early adversity; it has been a focus of developmental research for many years and has been receiving increasing attention recently. In this article, we propose a conceptual model to describe how unpredictable and adverse early experiences affect children’s neurobiological, behavioral, and psychological development in the context of the COVID-19 pandemic. We first highlight the critical role of unpredictability in child development by reviewing existing conceptual models of early adversity as they relate to subsequent development across the lifespan. Then, we employ a translational neuroscience framework to summarize the current animal- and human-based evidence on the neurobiological alterations induced by early experience unpredictability. We further argue that the COVID-19 pandemic serves as a global “natural experiment” that provides rare insight to the investigation of the negative developmental consequences of widespread, clustered, and unpredictable adverse events among children. We discuss how the pandemic helps advance the science of unpredictable early adverse experiences. As unpredictability research continues to grow, we highlight several directions for future studies and implications for policymaking and intervention practices.     

Postural instability precedes motion sickness

We evaluated the hypothesis that postural instability precedes the onset of motion sickness. Subjects standing in a "moving room" were exposed to nearly global oscillating optical flow. In the experimental condition, the optical oscillations were a complex sum-of-sines between 0.1 and 0.3 Hz, with an excursion of 1.8 cm. This optical motion was of such low frequency and magnitude that it was sometimes not noticed by subjects. However, in two experiments, exposure to the moving room produced significant increases in scores on a standard motion sickness questionnaire. In addition, approximately half of subjects reported motion sickness. Analysis of postural motion during exposure to the moving room revealed increases in postural sway before the onset of subjective motion sickness symptoms. This confirms a key prediction of the postural instability theory of motion sickness.     

微创经皮骨盆前环内固定术治疗不稳定性骨盆前环损伤患者的效果

目的:观察微创经皮骨盆前环内固定术治疗不稳定性骨盆前环损伤患者的效果。方法:选取77例不稳定性骨盆前环损伤患者作为研究对象,按随机数字表法将其分为对照组38例与观察组39例。对照组采用开放性骨盆前环外固定术治疗,观察组采用微创经皮骨盆前环内固定术治疗,比较两组疾病相关指标水平、并发症发生率和治疗效果。结果:观察组手术时间长于对照组,骨痂形成时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);观察组优良率为97.44%(38/39),明显高于对照组的84.21%(32/39),差异有统计学意义(P<0.05)。结论:微创经皮骨盆前环内固定术治疗不稳定性骨盆前环损伤患者可提高优良率,缩短骨痂形成时间,以及减少术中出血量的效果优于开放性骨盆前环外固定术治疗,但手术时间会延长。     

腰椎间盘突出症再手术原因分析与手术方式选择

目的 分析腰椎间盘突出症再手术的原因,并探讨其诊疗策略.方法 对37例腰椎间盘突出症术后再手术患者的资料进行分析和总结,评价其再手术的疗效.结果 再手术的主要原因有:诊断及定位错误2例,术后椎间盘炎2例,复发性椎间盘突出13例,椎管内瘢痕形成和神经根粘连4例,节段性失稳5例,椎管狭窄9例,节段性失稳伴椎管狭窄2例.随访6个月～4.5年,28例患者症状明显改善,8例症状部分改善,1例无改善,临床疗效优良率为75,7％(28/37).再手术前JOA评分为(12.5±2.7)分;再手术后末次随访时为(24.3±4.9)分,两者比较,差异有统计学意义(P＜0.05),再手术后恢复率为71.5％.结论 腰椎间盘突出症再手术的原因较多,正确分析再手术原因,严格把握手术指征,针对不同病因选择合理的手术方式,仍可获得较为满意的疗效.     

Recurrent post-traumatic anterior shoulder dislocation – open versus arthroscopic repair

A total of 41 consecutive patients (11 women and 30 men, median age 29 (18–51) years) with unilateral, isolated, posttraumatic, recurrent anterior shoulder dislocation and a Bankart lesion were operatively repaired, either by an arthroscopic technique including a capsular plication, or by an open procedure with Mitec anchors. All the patients were followed prospectively and evaluated after a median of 36 (30–52) months follow-up by a “blind” observer. Nineteen patients in each group had excellent or good results, and one in each group was graded as fair. One patient in the arthroscopic group had a traumatic dislocation 5 months after the operation and was graded as poor. Three patients experienced subluxations postoperatively, one in the arthroscopic and two in the open group. There was no significant difference in anterior-posterior shoulder laxity measured objectively with Donjoy. The open Bankart repair group had a statistically significantly longer hospitalization (P = 0.001), a slight decrease in external range of motion, and more frequent cosmetic complaints. Apart from this, the results revealed no major differences between the two methods after a median of 36 months in this selected group of patients with longstanding problems. Received: 27 April 1998 Accepted: 1 October 1998     

Operative treatment of unstable injuries of the cervicothoracic junction

The authors present their experience in the operative treatment of unstable lesions at the cervicothoracic junction. Ten patients, six men and four women, underwent operative procedures at the cervicothoracic junction (C7-T1) between 1990 and 1997. Six patients had sustained fracture-dislocations, three patients had metastases and one patient had a primary malignant lesion. All the patients had significant cervical pain and neurologic deficit. The spinal cord and nerves were decompressed in all cases. Posterior stabilization was accomplished using various types of implants including hooks, wires and rods. Anteriorly, the spine was stabilized with plates and screws. Partial or complete vertebrectomy was performed in five cases and a titanium cylinder or an iliac autograft replaced the vertebral body. Five patients were submitted to a posterior operation only, and the other five to bilateral procedures. In four of these a one-stage operation was performed and in the last case a two-stage procedure. The anatomic and biomechanical characteristics of the cervicothoracic junction require a precise pre-operative analysis of the local anatomy and the selection of the proper implants for anterior and posterior stabilization. Received: 6 December 1997 Revised: 12 February 1999 Accepted: 2 March 1999