Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities

Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.

The Effects of Noise on Cognitive Performance and Helplessness in Childhood: A Review

Environmental noise affects our daily functioning in many ways, and the cognitive, motivational, and emotional effects of noise are intertwined. Our task performance under noisy conditions depends on our ability to cope with the noise and our cognitive resources. The process of (failed) coping may wear us out cognitively, lead to learned helplessness, and, consequently, alter the motivation to persist in a task. The direct effect of irrelevant sounds on cognitive functioning in children is relatively well-established, however, the research on the framework of learned helplessness is limited when it comes to children. Learned helplessness can give more insight into effects of environmental noise on learning and child development and how the effects of short-term and long-term exposure interact. A systematic literature review is performed to assess to what extent the current evidence addresses the (interaction) effects of the sound environment on cognition and learned helplessness as measured by motivation in children and young adults up to the age of 21. The search resulted in 8 included papers that addressed both cognition and learned helplessness in their research. The included papers study children between 8-13 years old and show evidence for a relation between environmental noise, cognition, and helplessness individually, but none study a possible interaction. Based on the individual study designs, it could be hypothesized that cognitive fatigue may play a role in the interaction. Studies that conducted motivation tasks after cognitive tasks found stronger effects than those that conducted tasks in a random order. More research is needed using the same methods in different age groups to further assess the interaction between cognition and learned helplessness in relation to the sound environment.

Noise Indicators Relating to Non-Auditory Health Effects in Children-A Systematic Literature Review

A systematic literature review was conducted to investigate which objective noise indicators related to various noise sources (i.e., aircraft, road-traffic, and ambient noise) are the best predictors of non-auditory health-effects in children. These relationships are discussed via a conceptual framework, taking into account main parameters such as the type of noise source, the exposure locations and their environments, the type of noise indicators, the children's mediating factors, and the type of non-auditory health effects. In terms of the procedure, four literature databases were screened and data was extracted on study design, types of noise sources, assessment method, health-based outcomes and confounders, as well as their associations. The quality of the studies was also assessed. The inclusion criteria focused on both indoor and outdoor environments in educational buildings and dwellings, considering that children spend most of their time there. From the 3337 uniquely collected articles, 36 articles were included in this review based on the defined inclusion and exclusion criteria. From the included literature, it was seen that noise exposure, assessed by energetic indicators, has significant associations with non-auditory health effects: psychophysiological, cognitive development, mental health and sleep effects. Percentile and event-based indicators provided significant associations to cognitive performance tasks and well-being dimension aspects.

Evolution of muscle strength and physical activity 1 year after heart transplantation: a prospective observational study

Funding Acknowledgements

Type of funding sources: None.

Background

Heart transplantation (HTX) is a therapeutic option in a selected group of patients with end-stage heart failure. Although cardiac function normalizes after surgery, maximal exercise capacity of HTX-patients after 1 year is only half that of age- and gender matched healthy subjects. Data on the evolution of muscle strength and physical activity after HTX are scant. Having this knowledge might help to optimize rehabilitation programs.

Purpose

To describe changes in muscle strength and physical activity following HTX.

Methods

58 HTX-patients were addressed, of whom 52 (90%) patients participated in the study. Study visits were planned every 3 months from hospital discharge until 1 year of follow-up. 43 HTX-patients (67% male; age: 48 ± 14 years; BMI: 24 ± 4 kg/m²) fulfilled the study protocol. Outcome measures included functional exercise capacity (6MWD), peripheral strength (QF), respiratory muscle strength (MIP) and objectively measured physical activity (PAwalk, walking intensity (WI), PAsteps). All patients received physiotherapy at home during the first 6 weeks, as standard of care after thoracic surgery. After that, cardiac rehabilitation in a specialized center was started. Data were analyzed using repeated measures ANOVA, with Bonferroni test as post-hoc test.

Results

6MWD (+178 ± 17 meter), QF (+26 ± 4 Nm) and MIP (-32 ± 3 cmH2O) significantly improved over time (p < 0.0001). Despite improvements in QF, peripheral muscle weakness was still present in 32% of patients 1 year post-HTX. A significant time effect in PA (PAwalk (+33 ± 7 minutes/day), WI (+0.036 ± 0.007 g) and PAsteps (+3711 ± 640 steps/day)) could be noticed (p < 0.0001). Sedentary time did not significantly change during follow-up (p = 0.14). (Figure 1)

Conclusion

Functional exercise capacity and muscle strength gradually improve during 1 year after HTX. A considerable number of patients still present with peripheral muscle weakness. Despite improvements in PA, results remain below recommended health levels. Enrollment in a cardiac rehabilitation program, offering a combined exercise and PA intervention seems warranted to further enhance health outcomes in this patient population.

Abstract Figure 1

An arbitrary high-order discontinuous Galerkin method with local time-stepping for linear acoustic wave propagation

This paper presents a numerical scheme of arbitrary order of accuracy in both space and time, based on the arbitrary high-order derivatives methodology, for transient acoustic simulations. The scheme combines the nodal discontinuous Galerkin method for the spatial discretization and the Taylor series integrator (TSI) for the time integration. The main idea of the TSI is a temporal Taylor series expansion of all unknown acoustic variables in which the time derivatives are replaced by spatial derivatives via the Cauchy-Kovalewski procedure. The computational cost for the time integration is linearly proportional to the order of accuracy. To increase the computational efficiency for simulations involving strongly varying mesh sizes or material properties, a local time-stepping (LTS) algorithm accompanying the arbitrary high-order derivatives discontinuous Galerkin (ADER-DG) scheme, which ensures correct communications between domains with different time step sizes, is proposed. A numerical stability analysis in terms of the maximum allowable time step sizes is performed. Based on numerical convergence analysis, we demonstrate that for nonuniform meshes, a consistent high-order accuracy in space and time is achieved using ADER-DG with LTS. An application to the sound propagation across a transmissive noise barrier validates the potential of the proposed method for practical problems demanding high accuracy.

Time-domain impedance boundary condition modeling with the discontinuous Galerkin method for room acoustics simulations

The time-domain nodal discontinuous Galerkin (TD-DG) method is emerging as a potential wave-based method for three-dimensional (3D) room acoustics modeling, where high-order accuracy in the low frequency range, geometrical flexibility, and accurate modeling of boundary conditions are of critical importance. This paper presents a formulation of broadband time-domain impedance boundary conditions (TDIBCs) of locally-reacting surfaces in the framework of the TD-DG method. The formulation is based on the approximation of the plane-wave reflection coefficient at normal incidence in the frequency domain using a sum of template rational functions, which can be directly transformed to the time-domain. The coupling of the TDIBCs with the discontinuous Galerkin discretization is achieved through the characteristic waves of the upwind flux along the boundary, where a series of first-order auxiliary differential equations is time-integrated in a high-order way. To verify the performance of the formulation, various numerical tests of single reflection scenarios are shown to demonstrate the cost efficiency and memory-efficiency of high-order basis functions, among which a 3D application to an impedance boundary of rigidly backed glass-wool baffle for room acoustic purposes is presented.

Implementation of the Nodal Discontinuous Galerkin Method for the Plate Vibration Problem using Linear Elasticity Equations

This work presents a numerical solution of the forced plate vibration problem using the nodal discontinuous Galerkin (DG) method. The plate is modelled as a three-dimensional domain, and its vibration is governed by the linear elasticity equations. The nodal DG method discretises the spatial domain and computes the spatial derivatives of the equations element-wise, while the time integration is conducted using the Runge-Kutta method. This method is in particular of interest as it is very favourable to carry out the computation by a parallel implementation. Several aspects regarding the numerical implementation such as the plate boundary conditions, the point force excitation, and the upwind numerical flux are presented. The numerical results are validated for rectangular concrete plates with different sets of boundary conditions and thicknesses, by a comparison with the exact mobilities that are derived from the classical plate theory (CPT) and the first order shear deformation theory (FSDT). The plate thickness is varied to understand its effect regarding the comparison with the CPT. An excellent agreement between the numerical solution and the FSDT was found. The agreement with the CPT occurs only at the first couple of resonance frequencies, and as the plate is getting thinner. Furthermore, the numerical example is extended to an L-shaped concrete plate. The mobility is then compared with the mobilities obtained by the CPT, FSDT, and linear elasticity equations.

Room acoustics modelling in the time-domain with the nodal discontinuous Galerkin method

To solve the linear acoustic equations for room acoustic purposes, the performance of the time-domain nodal discontinuous Galerkin (DG) method is evaluated. A nodal DG method is used for the evaluation of the spatial derivatives, and for the time-integration an explicit multi-stage Runge-Kutta method is adopted. The scheme supports a high order approximation on unstructured meshes. To model frequency-independent real-valued impedance boundary conditions, a formulation based on the plane wave reflection coefficient is proposed. Semi-discrete stability of the scheme is analyzed using the energy method. The performance of the DG method is evaluated for four three-dimensional configurations. The first two cases concern sound propagations in free field and over a flat impedance ground surface. Results show that the solution converges with increasing DG polynomial order and the accuracy of the impedance boundary condition is independent on the incidence angle. The third configuration is a cuboid room with rigid boundaries, for which an analytical solution serves as the reference solution. Finally, DG results for a real room scenario are compared with experimental results. For both room scenarios, results show good agreements.

Human echolocators adjust loudness and number of clicks for detection of reflectors at various azimuth angles

In bats it has been shown that they adjust their emissions to situational demands. Here we report similar findings for human echolocation. We asked eight blind expert echolocators to detect reflectors positioned at various azimuth angles. The same 17.5 cm diameter circular reflector placed at 100 cm distance at 0°, 45° or 90° with respect to straight ahead was detected with 100% accuracy, but performance dropped to approximately 80% when it was placed at 135° (i.e. somewhat behind) and to chance levels (50%) when placed at 180° (i.e. right behind). This can be explained based on poorer target ensonification owing to the beam pattern of human mouth clicks. Importantly, analyses of sound recordings show that echolocators increased loudness and numbers of clicks for reflectors at farther angles. Echolocators were able to reliably detect reflectors when level differences between echo and emission were as low as -27 dB, which is much lower than expected based on previous work. Increasing intensity and numbers of clicks improves signal-to-noise ratio and in this way compensates for weaker target reflections. Our results are, to our knowledge, the first to show that human echolocation experts adjust their emissions to improve sensory sampling. An implication from our findings is that human echolocators accumulate information from multiple samples.

Why orchestral musicians are bound to wear earplugs: About the ineffectiveness of physical measures to reduce sound exposure

Symphony orchestra musicians are exposed to noise levels that put them at risk of developing hearing damage. This study evaluates the potential effectivity of common control measures used in orchestras on open stages with a typical symphonic setup. A validated acoustic prediction model is used that calculates binaural sound exposure levels at the ears of all musicians in the orchestra. The model calculates the equivalent sound levels for a performance of the first 2 min of the 4th movement of Mahler's 1st symphony, which can be considered representative for loud orchestral music. Calculated results indicate that risers, available space, and screens at typical positions do not significantly influence sound exposure. A hypothetical scenario with surround screens shows that, even when shielding all direct sound from others, sound exposure is reduced moderately with the largest effect on players in loud sections. In contrast, a dramatic change in room acoustic conditions only leads to considerable reductions for soft players. It can be concluded that significant reductions are only reached with extreme measures that are unrealistic. It seems impossible for the studied physical measures to be effective enough to replace hearing protection devices such as ear plugs.

Noise disturbance in open-plan study environments: a field study on noise sources, student tasks and room acoustic parameters

The aim of this study is to gain more insight in the assessment of noise in open-plan study environments and to reveal correlations between noise disturbance experienced by students and the noise sources they perceive, the tasks they perform and the acoustic parameters of the open-plan study environment they work in. Data were collected in five open-plan study environments at universities in the Netherlands. A questionnaire was used to investigate student tasks, perceived sound sources and their perceived disturbance, and sound measurements were performed to determine the room acoustic parameters. This study shows that 38% of the surveyed students are disturbed by background noise in an open-plan study environment. Students are mostly disturbed by speech when performing complex cognitive tasks like studying for an exam, reading and writing. Significant but weak correlations were found between the room acoustic parameters and noise disturbance of students. Practitioner Summary: A field study was conducted to gain more insight in the assessment of noise in open-plan study environments at universities in the Netherlands. More than one third of the students was disturbed by noise. An interaction effect was found for task type, source type and room acoustic parameters.

Incorporating directivity in the Fourier pseudospectral time-domain method using spherical harmonics

The pseudospectral time-domain method (PSTD) provides an efficient way to solve the linear acoustics equations. With regards to acoustic modeling and auralization, source directivity as well as head-related directivity have a clear influence on the perceived sound field and have to be included in computations. In this paper directive sources are implemented in the time-domain method PSTD. First, a given frequency dependent source directivity is decomposed onto spherical harmonic functions. The directive source is then implemented through spatial distributions in PSTD that relate to the spherical harmonic functions, and time-dependent functions are assigned to the spatial distributions in order to obtain the frequency content of the directivity. Since any directivity function can be expressed as a summation of series of spherical harmonics, the approach can be used to model any type of directive source. For the evaluation of the method, a directivity function was designed analytically and then modeled in PSTD. Octave band analysis was performed and results show a good agreement between the analytical and simulated directivity. A distance related error was observed. However, for distances above 17.5 grid cells from the source center the average error was small (<0.9 dB) at all octave-bands.

Application of the Fourier pseudospectral time-domain method in orthogonal curvilinear coordinates for near-rigid moderately curved surfaces

The Fourier pseudospectral time-domain method is an efficient wave-based method to model sound propagation in inhomogeneous media. One of the limitations of the method for atmospheric sound propagation purposes is its restriction to a Cartesian grid, confining it to staircase-like geometries. A transform from the physical coordinate system to the curvilinear coordinate system has been applied to solve more arbitrary geometries. For applicability of this method near the boundaries, the acoustic velocity variables are solved for their curvilinear components. The performance of the curvilinear Fourier pseudospectral method is investigated in free field and for outdoor sound propagation over an impedance strip for various types of shapes. Accuracy is shown to be related to the maximum grid stretching ratio and deformation of the boundary shape and computational efficiency is reduced relative to the smallest grid cell in the physical domain. The applicability of the curvilinear Fourier pseudospectral time-domain method is demonstrated by investigating the effect of sound propagation over a hill in a nocturnal boundary layer. With the proposed method, accurate and efficient results for sound propagation over smoothly varying ground surfaces with high impedances can be obtained.

The extended Fourier pseudospectral time-domain method for atmospheric sound propagation

An extended Fourier pseudospectral time-domain (PSTD) method is presented to model atmospheric sound propagation by solving the linearized Euler equations. In this method, evaluation of spatial derivatives is based on an eigenfunction expansion. Evaluation on a spatial grid requires only two spatial points per wavelength. Time iteration is done using a low-storage optimized six-stage Runge-Kutta method. This method is applied to two-dimensional non-moving media models, one with screens and one for an urban canyon, with generally high accuracy in both amplitude and phase. For a moving atmosphere, accurate results have been obtained in models with both a uniform and a logarithmic wind velocity profile over a rigid ground surface and in the presence of a screen. The method has also been validated for three-dimensional sound propagation over a screen. For that application, the developed method is in the order of 100 times faster than the second-order-accurate FDTD solution to the linearized Euler equations. The method is found to be well suited for atmospheric sound propagation simulations where effects of complex meteorology and straight rigid boundary surfaces are to be investigated.

The 2.5-dimensional equivalent sources method for directly exposed and shielded urban canyons

When a domain in outdoor acoustics is invariant in one direction, an inverse Fourier transform can be used to transform solutions of the two-dimensional Helmholtz equation to a solution of the three-dimensional Helmholtz equation for arbitrary source and observer positions, thereby reducing the computational costs. This previously published approach [D. Duhamel, J. Sound Vib. 197, 547-571 (1996)] is called a 2.5-dimensional method and has here been extended to the urban geometry of parallel canyons, thereby using the equivalent sources method to generate the two-dimensional solutions. No atmospheric effects are considered. To keep the error arising from the transform small, two-dimensional solutions with a very fine frequency resolution are necessary due to the multiple reflections in the canyons. Using the transform, the solution for an incoherent line source can be obtained much more efficiently than by using the three-dimensional solution. It is shown that the use of a coherent line source for shielded urban canyon observer positions leads mostly to an overprediction of levels and can yield erroneous results for noise abatement schemes. Moreover, the importance of multiple facade reflections in shielded urban areas is emphasized by vehicle pass-by calculations, where cases with absorptive and diffusive surfaces have been modeled.