Reversal Training Discloses Gender Differences in a Spatial Memory Task in Humans.

Over the past few years, spatial memory has been studied using virtual-reality-based tasks. Reversal learning has been widely used in spatial orientation tasks for testing, among other things, new learning and flexibility. By means of a reversal-learning protocol, we assessed spatial memory in men and women. A total of sixty participants (half of them women) performed a task that included two phases: during the acquisition phase, participants were asked to find one or three rewarded positions in the virtual room across ten trials. During the reversal phase, the rewarded boxes were moved to a new position and maintained for four trials. The results showed that men and women differed in the reversal phase, with men outperforming women in high demanding conditions. Dissimilarities in several cognitive abilities between both genders are the base of these differences and are discussed.

Abnormal Maternal Body Mass Index and Customized Fetal Weight Charts: Improving the Identification of Small for Gestational Age Fetuses and Newborns.

BACKGROUND: Obesity and thinness are serious diseases, but cases with abnormal maternal weight have not been excluded from the calculations in the construction of customized fetal growth curves (CCs). METHOD: To determine if the new CCs, built excluding mothers with an abnormal weight, are better than standard CCs at identifying SGA. A total of 16,122 neonates were identified as SGA, LGA, or AGA, using the two models. Logistic regression and analysis of covariance were used to calculate the OR and CI for adverse outcomes by group. Gestational age was considered as a covariable. RESULTS: The SGA rates by the new CCs and by the standard CCs were 11.8% and 9.7%, respectively. The SGA rate only by the new CCs was 18% and the SGA rate only by the standard CCs was 0.01%. Compared to AGA by both models, SGA by the new CCs had increased rates of cesarean section, (OR 1.53 (95% CI 1.19, 1.96)), prematurity (OR 2.84 (95% CI 2.09, 3.85)), NICU admission (OR 5.41 (95% CI 3.47, 8.43), and adverse outcomes (OR 1.76 (95% CI 1.06, 2.60). The strength of these associations decreased with gestational age. CONCLUSION: The use of the new CCs allowed for a more accurate identification of SGA at risk of adverse perinatal outcomes as compared to the standard CCs.

Características epidemiológicas, clínicas y microbiológicas de la infección del tracto urinario neonatal en un hospital en Medellín, 2013-2017 / Epidemiologic clinical and microbiological features of neonatal urinary tract infection in a hospital in Medellín, 2013-2017

RESUMEN Objetivo: describir las características epidemiológicas, clínicas y microbiológicas de la infección del tracto urinario neonatal. Métodos: estudio descriptivo retrospectivo en neonatos con infección urinaria hospitalizados en una institución de Medellín entre enero del 2013 y diciembre del 2017. Se recolectaron datos de las historias clínicas. Las variables cualitativas se expresaron en forma de frecuencias absolutas y relativas, las cuantitativas se presentaron como promedio y desviación estándar o mediana y rangos intercuartílicos. Resultados: se incluyeron 65 pacientes. Los uropatógenos más comunes fueron Escherichia coli (52 %) y Enterococcus faecalis (20 %). Las manifestaciones clínicas más frecuentes fueron la fiebre (46 %), la ictericia (38 %) y las apneas (15 %). La proteína Creactiva elevada se presentó en el 28 % de los casos. En el uroanálisis, el hallazgo anormal predominante fueron las esterasas leucocitarias en el 65 %. Hubo 15 casos (23 %) de infecciones nosocomiales. Por ecografía renal se encontró una malformación genitourinaria en el 25 % de los pacientes. De los 35 neonatos con cistouretrografía miccional hospitalaria, el 17 % tenía reflujo vesicoureteral, el 67 % tuvo ecografía renal normal y el 83 % tuvo un aislamiento diferente a Escherichia coli. Dos pacientes presentaron bacteriemia y uno meningitis. Conclusión: la infección urinaria neonatal tuvo manifestaciones clínicas variadas, donde la fiebre y la proteína C reactiva no fueron marcadores comunes de la respuesta inflamatoria. En este estudio una ecografía renal normal no descarta la posibilidad del reflujo vesicoureteral, por ello debe tenerse en cuenta otros criterios para seleccionar los pacientes que requieren de estudio de reflujo.

SUMMARY Objective: To describe de epidemiological, clinical, and microbiological features of neonatal urinary tract infection. Methods: A descriptive retrospective study of neonates with urinary tract infection admitted to Clinica Universitaria Bolivariana (Medellín, Colombia) between January 2013 and December 2017. Data about urinary tract infection features were collected from the clinical records of the hospital. For data analysis, qualitative variables were presented as absolute and relative frequencies, and quantitative variables were presented as mean and standard deviation or median and interquartile ranges. Results: Sixty-five patients were included. The most common uropathogens were Escherichia coli (52%) and Enterococcus faecalis (20%). The most frequent clinical features were fever (46%), jaundice (38%) and apneas (15%). Of 21 patients, 28% had C reactive protein raised. Urine dipstick test was positive for leukocyte esterase in 65%. There were 15 nosocomial infections (23%). Renal ultrasound was performed in all patients, of which 25% had congenital anomalies of the kidney and urinary tract. Voiding cystourethrogram was performed in 35 patients, of which 17% had vesicoureteral reflux; 67% of them had a normal renal ultrasound and 83% of them had a non-Escherichia coli bacteria isolation. Two patients had bacteremia and one patient had meningitis. Conclusions: neonatal urinary tract infection is a disease with multiple clinical manifestations, where fever and C-reactive protein weren't common marker of inflammatory response. In this study, having a normal renal ultrasound doesn't discard the possibility of having vesicoureteral reflux, and other criteria should be considered to select which patients need studies for vesicoureteral reflux.

Sex Differences in Spatial Memory: Comparison of Three Tasks Using the Same Virtual Context.

Spatial memory has been studied through different instruments and tools with different modalities of administration. The cognitive load varies depending on the measure used and it should be taken into account to correctly interpret results. The aim of this research was to analyze how men and women perform three different spatial memory tasks with the same spatial context but with different cognitive demands. A total of 287 undergraduate students from the University of Almeria (Spain) and the University of L'Aquila (Italy) participated in the study. They were divided into three groups balanced by sex according to the spatial memory test they performed: the Walking Space Boxes Room Task (WSBRT), the Almeria Spatial Memory Recognition Test (ASMRT) and the Non-Walking Space Boxes Room Task (NWSBRT). Time spent and number of errors/correct answers were registered for analysis. In relation to the WSBRT and the ASMRT, men were faster and reached the optimal level of performance before women. In the three tests, familiarity with the spatial context helped to reduce the number of errors, regardless of the level of difficulty. In conclusion, sex differences were determined by the familiarity with the spatial context, the difficulty level of the task, the active or passive role of the participant and the amount of visual information provided in each screen shot.

The Role of Gender and Familiarity in a Modified Version of the Almeria Boxes Room Spatial Task.

Individual factors like gender and familiarity can affect the kind of environmental representation that a person acquires during spatial navigation. Men seem to prefer relying on map-like survey representations, while women prefer using sequential route representations. Moreover, a good familiarity with the environment allows more complete environmental representations. This study was aimed at investigating gender differences in two different object-position learning tasks (i.e., Almeria Boxes Tasks) assuming a route or a survey perspective also considering the role of environmental familiarity. Two groups of participants had to learn the position of boxes placed in a virtual room. Participants had several trials, so that familiarity with the environment could increase. In both tasks, the effects of gender and familiarity were found, and only in the route perspective did an interaction effect emerge. This suggests that gender differences can be found regardless of the perspective taken, with men outperforming women in navigational tasks. However, in the route task, gender differences appeared only at the initial phase of learning, when the environment was unexplored, and disappeared when familiarity with the environment increased. This is consistent with studies showing that familiarity can mitigate gender differences in spatial tasks, especially in more complex ones.

Age-related differences in the elderly in a spatial recognition task.

Spatial memory is a cognitive ability which declines with ageing thus showing changes in some process such as the use of allocentric strategies. These age-related changes in spatial orientation suggest that this skill could be an adequate marker of cognitive decline. Many tasks used in investigation to assess spatial memory demand a participant's active role, which involves that the navigational experience is different for everyone. In this study, the Almeria Spatial Memory Recognition Test (ASMRT), a test based on a recognition paradigm, was used to offer the same experience with the environment. The aim of this research was to determine if the ASMRT is suitable to be applied in the elderly and detect spatial memory differences as one age. The ASMRT and other neuropsychological tests were applied in a sample aged between 50and 79 years. Results revealed a decrease in the ASMRT performance by the older group. No gender differences were found. Performance in attention and visuospatial working memory tests revealed some correlations with the ASMRT performance. In conclusion, this study demonstrates that 70-79-year-old participants clearly show age-related changes in spatial memory. Thanks to its simplicity the ASMRT could be used as a screening test in medical practice.

Virtual reality assessment of walking and non-walking space in men and women with virtual reality-based tasks.

Far space and near space refer to different spatial features in which we unfold our behaviour. On the one hand, classical visuospatial neuropsychological tests assess spatial abilities in the near space; on the other, far space typically involves new spatial memory tasks in which participants display their behaviour in an environment, either interacting with objects or searching for targets. The Boxes Room Task is a virtual test that assesses spatial memory in the far space. Based upon this task, a new test was developed in which participants could not move about within the context, but they could actually perceive it from a specific viewpoint. In this work, both versions of the task were compared with one another. Furthermore, they were also compared with the results of 10/36 spatial recall test, a task assessing spatial memory in the near space. Two conditions were applied in all tasks, both in stable and rotated contexts. Our study included one hundred and twenty healthy young participants who were divided into two groups. The first group performed the Walking Space Boxes Room Task. A second group performed the Non-Walking Space Boxes Room Task as well as another traditional neuropsychological test for near space assessment, the 10/36 spatial recall test. Results proved that orientation in the non-walking space was more difficult than in the walking space. Additionally, our test also showed that men outperformed women in both virtual reality-based tasks, although they did not do it in the traditional 10/36 spatial recall test. In short, this work exposes that virtual-reality technologies provide tools to assess spatial memory, being more sensitive than traditional tests in the detection of small performance changes.

Walking and non-walking space in an equivalent virtual reality task: Sexual dimorphism and aging decline of spatial abilities.

Spatial memory enables us to locate places and objects in space, to determine our position and manage spatial relationships in our environment. Our operations are displayed in a space that sometimes is inaccessible. In this case, the impossibility of movement within the context forces individuals to rely on the information gathered from limited viewpoints. This study investigates the use of walking and non-walking spaces using two equivalent virtual reality tasks in which displacement is only permitted in one of them. One hundred and fifty participants were divided into three age groups: 50-59, 60-69 and 70-79 year-old subjects. The starting position changed pseudo-randomly and two difficulty levels were set, with one and three positions to be found. Results provided evidence for 70-79 year-old people impairment of their spatial abilities compared with 50-59 and 60-69 year-old groups. In both difficulty conditions, participants made more errors in the non-walking space than in the walking space. All participants showed an improvement in the last trials of the task. Moreover, sexual dimorphism was registered in the high level of difficulty, in which men outperformed women. This study supports the idea that aging impairs the organization of spatial representations of the environment, and that this aspect is more noticeable in conditions where displacement is limited.

Hemophagocytic Lymphohistiocytosis Associated with Salmonella typhi Infection in a Child: A Case Report with Review of Literature.

We present the case of an 8-year-old girl with hemophagocytic lymphohistiocytosis secondary to a Salmonella typhi infection. She received antibiotic treatment and intravenous immunoglobulin with complete resolution of the symptoms. We present a review of previously reported pediatric cases and propose a gradual approach to treatment.

Differences in Spatial Memory Recognition Due to Cognitive Style.

Field independence refers to the ability to perceive details from the surrounding context as a whole and to represent the environment by relying on an internal reference frame. Conversely, field dependence individuals tend to focus their attention on single environmental features analysing them individually. This cognitive style affects several visuo-spatial abilities including spatial memory. This study assesses both the effect of field independence and field dependence on performance displayed on virtual environments of different complexity. Forty young healthy individuals took part in this study. Participants performed the Embedded Figures Test for field independence or dependence assessment and a new spatial memory recognition test. The spatial memory recognition test demanded to memorize a green box location in a virtual room picture. Thereafter, during ten trials participants had to decide if a green box was located in the same position as in the sample picture. Five of the pictures were correct. The information available in the virtual room was manipulated. Hence, two different experimental conditions were tested: a virtual room containing all landmarks and a virtual room with only two cues. Accuracy and reaction time were registered. Analyses demonstrated that higher field independent individuals were related to better spatial memory performance in two landmarks condition and were faster in all landmark condition. In addition, men and women did not differ in their performance. These results suggested that cognitive style affects spatial memory performance and this phenomenon is modulated by environment complexity. This does not affect accuracy but time spent. Moreover, field dependent individuals are unable to organize the navigational field by relying on internal reference frames when few landmarks are available, and this causes them to commit more errors.

Almeria spatial memory recognition test (ASMRT): Gender differences emerged in a new passive spatial task.

Many different human spatial memory tasks were developed in the last two decades. Virtual reality based tasks make possible developing different scenarios and situations to assess spatial orientation but sometimes these tasks are complex for specific populations like children and older-adults. A new spatial task with a very limited technological requirement was developed in this study. It demanded the use of spatial memory for an accurate solution. It also proved to be sensitive to gender differences, with men outperforming women under high specific difficulty levels. Thanks to its simplicity it could be applied as a screening test and is easy to combine with EEG and fMRI studies.

Efectividad del tratamiento con Alveofact® y Curosurf® en prematuros de 32 semanas o menos con enfermedad de membrana hialina en Buga, Valle del Cauca, entre los años 2006 y 2013 / Effectiveness of treatment with Alveofact® and Curosurf® in preterm infants born at 32 weeks or less with hyaline membrane disease in Buga, Valle del Cauca between 2006 and 2013

RESUMEN Introducción: la enfermedad de membrana hialina, es una patología que afecta a prematuros, principalmente los menores de 30 semanas. Existen en el momento actual varios tipos de surfactantes para el tratamiento de esta entidad, los cuales han mostrado eficacia similar, pero algunos resultan ser más costo-efectivos que otros. Objetivo: evaluar la efectividad de Alveofact® versus Curosurf®, en neonatos prematuros ≤ 32 semanas, con enfermedad de membrana hialina, efectos colaterales de la administración, complicaciones neonatales y comparar los costos de su administración. Materiales y método: estudio de cohorte retrospectiva, en 136 neonatos prematuros, ≥ 24 semanas y ≥ 500g de peso al nacer; 64 de ellos fueron tratados con Alveofact® y 72 con Curosurf®. La exposición consistió en la administración de una dosis de Alveofact® (bovactant) 100mg/Kg y Curosurf® (poractant alfa) 200mg/Kg inicialmente, y como segunda dosis se suministró 100mg/Kg para cada uno. Posteriormente, se evaluó tiempo de ventilación mecánica, de oxigenoterapia, estancia, necesidad de segunda dosis, efectos colaterales por la administración y complicaciones; adicionalmente, mortalidad y displasia broncopulmonar. El análisis estadístico se realizó con Stata® 11.0, empleando Chi2 o Prueba exacta de Fisher, prueba t-test no pareado o Wilcoxon rank-sum. Resultados: no se hallaron diferencias significativas para tiempo de ventilación mecánica, oxigenoterapia, segunda dosis, estancia y complicaciones entre Alveofact® y Curosurf®. Adicionalmente, la displasia broncopulmonar se presentó en el 22,8% y la mortalidad en el 30,1%, sin diferencia significativa entre los dos surfactantes. Conclusiones: los resultados de esta investigación muestran que ambos surfactantes son igual de efectivos, pero el Curosurf® resulta más costoso. MÉD.UIS. 2016;29(3):13-25.

ABSTRACT Introduction: hyaline membrane disease, is a condition that affects preterm infants, especially those under 30 weeks. There are at present various types of surfactants for the treatment of this entity, which have shown similar efficacy, but some turn out to be more cost-effective than others. Objective: to evaluate the effectiveness of Alveofact® versus Curosurf® in preterm infants ≤32 weeks with hyaline membrane disease, side effects of administration, neonatal complications and to compare the costs of administration of the two surfactants. Materials and method: retrospective cohort study in 136 preterm infants ≥ 24 weeks and ≥ 500 g birth weight; 64 of them were treated with Alveofact ® and 72 with Curosurf ®. The exposure was the administration of a first dose of Alveofact ® (bovactant) 100mg/Kg and Curosurf ® (poractant alpha) 200mg/Kg and 100mg/Kg second dose for each group. Duration of mechanical ventilation, oxygen therapy, stay, need for second dose, side effects and complications administration were evaluated; additionally, mortality and bronchopulmonary dysplasia. Statistical analysis was performed with Stata ® 11.0 using Chi2 or Fisher exact test, t-test or unpaired Wilcoxon rank-sum. Results: no significant differences in duration of mechanical ventilation, oxygen therapy, second dose, stay and complications between Alveofact ® and Curosurf ® were found. The bronchopulmonary dysplasia occurred in 22.8% and 30.1% mortality, with no significant difference between the two surfactants. Conclusions: the results of this research show that both surfactants are equally effective, but Curosurf ® is more expensive. MÉD.UIS.2016;29(3):13-25.

Epidemiología de la prematuridad, sus determinantes y prevención del parto prematuro / Epidemiology of prematurity, its determinants and prevention of preterm birth

La prematuridad es un grave de problema de salud pública por la gran morbilidad y mortalidad que generan, además, de los elevados costos económicos y sociales que ocasiona su atención. A nivel mundial, aproximadamente uno de cada diez neonatos nacen prematuros. Sus determinantes son múltiples. En el parto prematuro están involucrados además de los determinantes biológicos, los que son responsabilidad del sector salud y los que son responsabilidad del estado, como son los determinantes políticos, ambientales, sociales y económicos. Es por ello que la prevención y el tratamiento de la prematuridad debe ser una política pública obligada para todas las naciones, e involucra a muchos actores. Las estrategias empleadas para prevenir y tratar al parto prematuro son amplias y van desde los cuidados preconcepcionales, hasta la atención del parto y del neonato en el periodo postnatal.

Prematurity is a serious public health problem by the high morbidity and mortality also generated high economic and social costs caused by its staff. Globally, about one in ten infants born prematurely. Its determinants are numerous. In preterm birth are involved in addition to biological determinants, which are the responsibility of the health sector and which are the responsibility of the state, such as political, environmental, social and economic determinants. That is why prevention and treatment of prematurity should be a public policy required for all nations, and involves many actors. The strategies used to prevent and treat premature birth are spacious and range from preconception care, to care delivery and newborn in the postnatal period.

Age and gender-related differences in a spatial memory task in humans.

Cognitive skills decline with age. Our ability to keep oriented in our surrounding environment was demonstrated to be influenced by factors like age and gender. Introduction of virtual reality based tasks improved assessment of spatial memory in humans. In this study, spatial orientation was assessed in a virtual memory task in order to determine the effect of aging and gender on navigational skills. Subjects from 45 to 74 years of age were organized in three groups (45-54, 55-64, 65-74 years old). Two levels of difficulty were considered. Results showed that males outperformed females in 65-74 years-old group. In addition to this, females showed a more noticeable poor performance in spatial memory than males, since memory differences appeared between all age groups. On the other hand, 65-74 year-old males showed an impaired performance in comparison with 45-54 year-old group. These results support that spatial memory becomes less accurate as we age and gender is an important factor influencing spatial orientation skills.

Epidemiología de la prematuridad y sus determinantes, en una población de mujeres adolescentes y adultas de Colombia / Epidemiology of prematurity and its determinants in a population of adolescent and adult women in Colombia

Antecedentes: La prematuridad es considerada actualmente una prioridad en salud pública para algunos países. Objetivo: Describir la prevalencia del parto prematuro y sus determinantes, en una población de gestantes adolescentes y adultas, que tuvieron su único o último parto en la Fundación Hospital San José de Buga, Colombia, entre los años 2010 a 2015. Métodos. Estudio de casos y controles realizado con 11.881 neonatos mujeres adolescentes y adultas. Los datos fueron analizados en Stata® 11.0, empleando para variables cuantitativas, mediana o promedio y sus medidas de dispersión, comparadas mediante pruebas t, Ranksum, ANOVA o Kruskal Wallis, de acuerdo a su distribución y para variables categóricas; medidas de frecuencia absolutas y relativas, comparadas mediante Pruebas de Chi2 o exacta de Fisher. Para estimar las asociaciones empleamos Odds Ratio con sus intervalos de confianza de 95% y para el análisis multivariado la regresión logística. La significancia estadística fue definida como un valor p<0,05. Resultados. La prevalencia de prematuridad fue 11,4%. Después del análisis multivariado, los determinantes asociados a prematuridad fueron etnia indígena-afrocolombiana o mulato, número de controles prenatales igual o inferior a 6, periodo intergenésico inferior a 2 años, embarazo múltiple, preeclampsia, oligohidramnios, restricción del crecimiento intrauterino y hemorragia del tercer trimestre (incluye desprendimiento prematuro de placenta). Conclusiones. La prematuridad es el resultado de una compleja red de determinantes individuales, sociales, culturales y gestacionales que interactúan, por lo que para su prevención se debe no sólo trabajar en medidas de salud, sino en elaboración de políticas y planes de acción integral.

Background: Prematurity is currently considered a public health priority for some countries. Objective: To describe the prevalence of preterm birth and its determinants in a population of adolescent and adult mothers who had their sole or last delivery in the Fundación Hospital San José de Buga, Colombia, between 2010-2015. Methods: Case-control study conducted with 11,881 infants adolescent and adult women. The data were analyzed in Stata 11.0, using quantitative, medium or average and dispersion measures variables compared using t tests, Ranksum, ANOVA or Kruskal Wallis, according to distribution and for categorical variables, frequency measurements absolute and relative, compared with Chi2 tests or Fisher exact. To estimate associations employ odds ratio with confidence intervals of 95% and multivariate analysis logistic regression. Statistical significance was defined as p <0.05. Results: Prematurity prevalence was 11.4%. After multivariate analysis, the determinants associated with prematurity were indigenous-Afro-Colombian or mulatto ethnicity, number of prenatal visits equal to or less than 6, less than two years intergenesic period, multiple pregnancy, preeclampsia, oligohydramnios, IUGR and bleeding of the third quarter (includes abruption). Conclusions: Prematurity is the result of a complex network of individual, social, cultural and gestational determinants that interact, so that prevention is due not only work on health measures, but in developing policies and plans integral action.

Influencia de la adolescencia y su entorno en la adherencia al control prenatal e impacto sobre la prematuridad, bajo peso al nacer y mortalidad neonatal / Influence of adolescence and its environment on adherence to prenatal care and impact on prematurity, low birth weight and neonatal mortality

ANTECEDENTES: La morbimortalidad materna y neonatal está incrementada en adolescentes y gestantes sin control prenatal o con una mala adherencia. OBJETIVO: Identificar la influencia de la adolescencia y su entorno sobre la adherencia al control prenatal y su impacto sobre la prematuridad y/o bajo peso al nacer y la mortalidad neonatal. MÉTODOS: Estudio de casos y controles, realizado con 570 adolescentes y 2093 gestantes ≥20 años de edad, cuyos neonatos fueron hospitalizados en una unidad neonatal. Las asociaciones se determinaron mediante Odds Ratio, con su intervalo de confianza de 95%, empleándose la regresión logística en el análisis multivariado. Para la construcción del Modelo con Árboles de Clasificación y Regresión se emplearon variables que en el bivariado hubieran tenido un valor p<0,05. RESULTADOS: La edad materna 13-19 años se halló asociada a mala adherencia al control prenatal, después de ajustarse por escolaridad <11 años, carencia de esposo o compañero permanente, carencia de seguridad social en salud y antecedente de gravidez ≥2 gestaciones. Esta mala adherencia al control prenatal se asoció con aumento de riesgo de prematuridad y/o bajo peso al nacer y de la mortalidad neonatal. CONCLUSIONES: La adolescencia se halló independientemente asociada a una mala adherencia al control prenatal, sin embargo, existen otros determinantes importantes de esta mala adherencia, que a su vez se halló asociada con prematuridad y/o bajo peso al nacer, y con mortalidad neonatal.

BACKGROUND: Maternal morbidity and neonatal mortality is increased in adolescents and pregnant women without prenatal care or poor adherence. OBJECTIVE: To identify the influence of adolescence and its surroundings on adherence to prenatal care and its impact on prematurity and/or low birth weight and neonatal mortality. METHODS: Case-control study, conducted with 570 pregnant adolescents and 2093 ≥20 years of age whose infants were hospitalized in a neonatal unit. Associations were determined by Odds Ratio with confidence interval of 95%, using the multivariate logistic regression analysis. To build the model with Classification and Regression Trees variables in the bivariate had had a p<0.05 was used. Results: Maternal age 13-19 was found associated with poor adherence to prenatal care, after adjusting for schooling <11 years, lack of spouse or life partner, lack of social security in health and pregnancy history of ≥2 pregnancies. This poor adherence to prenatal care was associated with increased risk of prematurity and/or low birth weight and increased neonatal mortality. CONCLUSIONS: The teen was found independently associated with poor adherence to prenatal care, but there are other important determinants of poor adherence, which in turn was found associated with prematurity and/or low birth weight, and neonatal mortality.

Developmental gender differences in children in a virtual spatial memory task.

OBJECTIVE: Behavioral achievements are the product of brain maturation. During postnatal development, the medial temporal lobe completes its maturation, and children acquire new memory abilities. In recent years, virtual reality-based tasks have been introduced in the neuropsychology field to assess different cognitive functions. In this work, desktop virtual reality tasks are combined with classic psychometric tests to assess spatial abilities in 4- to 10-year-old children. METHOD: Fifty boys and 50 girls 4-10-years of age participated in this study. Spatial reference memory and spatial working memory were assessed using a desktop virtual reality-based task. Other classic psychometric tests were also included in this work (e.g., the Corsi Block Tapping Test, digit tests, 10/36 Spatial Recall Test). RESULTS: In general terms, 4- and 5-year-old groups showed poorer performance than the older groups. However, 5-year-old children showed basic spatial navigation abilities with little difficulty. In addition, boys outperformed girls from the 6-8-year-old groups. Gender differences only emerged in the reference-memory version of the spatial task, whereas both sexes displayed similar performances in the working-memory version. CONCLUSION: There was general improvement in the performance of different tasks in children older than 5 years. However, results also suggest that brain regions involved in allocentric memory are functional even at the age of 5. In addition, the brain structures underlying reference memory mature later in girls than those required for the working memory.