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Variation in early-life conditions can trigger developmental switches that lead to predictable individual differences in adult behaviour and physiology. Despite evidence for such early-life effects being widespread both in humans and throughout the animal kingdom, the evolutionary causes and consequences of this developmental plasticity remain unclear. The current issue aims to bring together studies of early-life effects from the fields of both evolutionary ecology and biomedicine to synthesise and advance current knowledge of how information is used during development, the mechanisms involved, and how early-life effects evolved. We hope this will stimulate further research into early-life effects, improving our understanding of why individuals differ and how this might influence their susceptibility to disease. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.

Background: When teeth are not positioned correctly, it is referred to as malocclusion, and it frequently happens in the general population. One of the traits of malocclusion that is frequently observed in children beginning in the early mixed dentition phase is crowded teeth. This disorder will become more serious and cause speech, masticatory, and cosmetic issues if therapy is not started right away. Environmental and genetic factors have a significant impact on malocclusion. Therefore, a child's nutrition, bad habits, trauma to the main teeth, and the pattern acquired from both parents will all affect the malocclusion's characteristics. Purpose: Enhance instruction in identifying malocclusion and the stages of permanent and changing tooth growth. Methods: Forty-six students from Madrasah Tsanawiyah's classes 7A and 7B participated. Intraoral examinations and the completion of pretest and posttest questionnaires were used to collect data. Next, Stastical Package Social Science (SPSS) version 23 was used to analyze the frequency distribution data. Results: Male students had more crowded teeth (20) and less crowded teeth (2) than female students (18) and less crowded teeth (6). Class I malocclusion (41), class II malocclusion (3), and class III malocclusion (2) are the highest. Conclusion: Malocclusion class I is characterized by the greatest number of crowded teeth in males aged 8 to 10 years.

Objective To determine the normative values of the Korean version of the Modified Barthel Index (K-MBI) score for typically developing children in Korea and assess its suitability for use in children. Methods Rehabilitation physicians and occupational therapists with children were invited through an online platform to participate in a survey assessing their children’s performance of activity of daily living (ADL) using the K-MBI. The questionnaire encompassed queries on sociodemographic information of children and the assessment criteria outlined in the K-MBI. The standardized K-MBI scores by age were estimated using the nonlinear least squares method. Results The analysis incorporated responses from a total of 206 individuals. K-MBI total scores showed a rapid increase over the first 8 years of life, with 99% of children achieving a score of 90 or higher by age 8. Mobility scores exhibited a swift increase during early childhood, surpassing 90% of the maximum score at 3 years of age and nearing 100% at 7 years of age. In contrast, self-care scores demonstrated a more gradual advancement, achieving approximately 100% of the maximum score by the age of 10 years. Conclusion Age-specific normative values for K-MBI scores of typically developing children were established, which can be used as a reference in clinical care. While the K-MBI captured the overall trajectory of children’s ADL development, it did not discern subtle differences across various developmental stages. There is a need for the development of more refined assessment tools tailored specifically to children.

The temporomandibular joint is the only joint structure within the craniofacial skeletal system, responsible for performing functions related to opening and closing mouth movements, such as chewing, speaking, and facial expression in daily life. The condyle of the mandible, as a vital component of the temporomandibular joint, originates from the mandibular process formed by the first gill arch and is the key growth center at the end of the mandibular ramus. Condyle is composed of a layer of cartilage as its surface and subchondral bone below, exhibiting unique biological processes during its growth and development. In the articular fossa, the functional movement of the condyle depends on its normal physiological and anatomical structure, which plays a crucial role in establishing occlusion and shaping facial features. Abnormal growth and development can lead to the occurrence of condylar deformities, which affect the vertical height of the patient's maxillofacial region and ultimately lead to secondary skeletal class Ⅱ or Ⅲ craniofacial deformities. During the process of growth and development, the condyle is subject to complex signal regulation. In recent years, with in-depth research on the temporomandibular joint, researchers have begun to discuss the regulatory mechanisms of condyle growth and development from the perspectives of gene expression and molecular level, in order to explain the causes of temporomandibular joint diseases and condylar deformities. This article provides a review on the growth process and structure of condyle, classification and pathological manifestations of condylar deformities, and related regulatory mechanisms of the growth and development of condyle, as well as pathogenesis of condylar deformities. The aim of this article is to provide research ideas for temporomandibular joint diseases and craniofacial malformations caused by abnormal development of the mandibular condyle in clinical practice.

Objective·To analyze the anatomical and macroscopic characteristics of the pterygopalatine suture (PPS) in Chinese population using cone-beam computed tomography (CBCT) technology, and to preliminarily investigate its developmental pattern and its association with the correction of maxillary underdevelopment.Methods·A total of 134 CBCT images, taken from July to August 2023 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, were categorized into six age groups. The PPS landmarks were utilized to determine the overall transverse position (XPPS), sagittal position (YPPS), insertion angle (IAP), insertion width of the pyramidal process (IWP), and insertion depth of the pyramidal process (IDP). The pterygomaxillary junction was identified through multiplanar observations. Regression analysis was performed to assess the correlation of these parameters with age and gender, and pairwise comparisons were made to determine the stable age range for parameter changes. Paired t-tests and paired chi-squared tests were conducted to analyze the bilateral parameter differences.Results·Results showed that YPPS and IDP did not exhibit significant correlation with age, whereas XPPS, IAP, IWP, and the incidence of pterygomaxillary fusion were significantly positively correlated with age (P

Introduction: Lead is a well-documented potent environmental toxin that has various harmful effects on the body, growth, and development noticed since, birth. Despite notable advancements in the decrease of lead exposure, researchers found environmental, socioeconomic, and demographic factors associated with elevated blood lead levels in children in Chennai, India, aged 1-5 years. This underscores the necessity for additional research on correlated risk factors. Aim: To assess the prevalence of elevated blood lead levels in children and estimate its values while identifying potential sources of lead exposure to the children. Materials and Methods: The cross-sectional analytical research was conducted at SRM Medical College, Hospital, and Research Centre, Kattankulathur, Tamil Nadu, India from July 2019 to July 2022. A total of 92 children aged 1-5 years attending the Paediatric Outpatient Department (OPD) and inpatients at the same hospital were included in the study. This study was conducted to examine the impact of lead exposure on children aged one to five years by using a lead exposure risk assessment questionnaire by World Health Organisation (WHO). Blood lead levels were measured using Lead Care II analyser equipment and lead care blood lead testing kits. Chi-square test and Fisher’s exact test were applied to statistically analyse the data. Results: The majority, 48 (52.17%), were boys, while 44 (47.83%) were girls. The study found that 8 (8.7%) out of all the children had lead toxicity. Thumb sucking was associated with higher lead toxicity, while frequent waste material combustion was linked to higher lead toxicity. Other risk factors like age, gender, residence conditions, recent renovations, and exposure to smoke or dust were not significantly associated with increased blood lead levels. Food prepared in metal vessels, water sources, canned food, traffic near home, imported food, cosmetics, home remedies usage, and parental education status were not significantly associated with increased blood lead levels. Conclusion: Among the study population of 92 children, the prevalence of lead toxicity (>5 μg/dL) was found in 8 (8.7%) children. The results of present study point towards a significant association of lead toxicity in children with thumb sucking and combustion of waste material in surroundings. To fully understand lead exposure in primary and secondary care settings, greater sample sizes and additional research on confounding factors are required.

Trehalases (TREs), serving as crucial enzymes regulating trehalose and chitin metabolism in insects, represent prime targets for pest control strategies. We investigated the impact of three thioxothiazolidin compounds (1G, 2G, and 11G) on TRE activity and summarized their effects on the growth and development of Spodoptera frugiperda (Lepidoptera, Noctuidae). The experimental larvae of S. frugiperda were injected with the three thioxothiazolidin compounds (1G, 2G, and 11G), while the control group received an equivalent volume of 2% DMSO as a control. All three compounds had a strong effect on inhibiting TRE activity, significantly prolonging the pre-pupal development stage. However, compared with the 11G-treated group, the survival rate of larvae treated with 1G and 2G was significantly reduced by 31.11% and 27.78% respectively, while the occurrence of phenotypic abnormalities related to growth and development was higher. These results manifest that only the TRE inhibitors, 1G and 2G, modulate trehalose and chitin metabolism pathways of larvae, ultimately resulting in the failure molting and reduction of survival rates. Consequently, the thioxothiazolidin compounds, 1G and 2G, hold potential as environmentally friendly insecticides.

ObjectivePreliminary exploration of using ultrasound to quantitatively evaluate the development of epiphyseal cartilage and analyze its correlation with bone age, based on the ultrasound findings of the long bone joint end.MethodsA study was conducted on adolescents studying at a sports school in Jining from March to June 2023. Age, height and other information were recorded. Bone age assessment by X ray were performed within 1 week with an endocrinologist interpreted the bone age using the Greulich-Pyle atlas. Two sonographers scanned a total of 7 sites in the hand, wrist and knee joint of the non-dominant side (including the dorsal side of the third metacarpal head, the ulnar styloid process, the radial styloid process, the medial and the lateral femoral epicondyle, dorsal tibia, and medial tibial condyle). The ultrasonic epiphyseal cartilage thickness (UECT) was measured and its correlation with bone age was analyzed. Intraclass correlation coefficient (ICC) was used to evaluate the reliability and repeatability of UECT measurement.ResultsA total of 141 adolescents were included, with 80 males and 61 females. The average age was 13 (12-14) years old. The average bone age was 15(13-17) years in males and 16 (14-17) years in females. The proportion of the males and females whose bone age was 1 year older than chronological age was 60% and 67%, respectively, and the height of the males was significantly higher than that of the females(P < 0.001). The UECT of 7 sites in the males and females decreased with the increase of bone age, and there was a significant negative correlation between UECT and bone age. In males, UECT was highly and negatively correlated with bone age (|r|≥0.80), while in females, it was moderately and negatively correlated (0.65≤|r|≤0.75). The correlation between the sum of UECT at seven sites and bone age reached high levels in both sexes(|r|=0.93, |r|=0.80).When 3 sites of hand and wrist or 4 sites of knee joint were selected separately, the UECT of the females was highly negatively correlated with bone age (|r| ≥0.76), while that of the males showed a very high correlation (|r| ≥0.90). The measurement consistency of UECT in all seven sites was good (ICC≥0.75).ConclusionUltrasound can observe and describe the developmental change of long bone, and UECT has potential value in quantitative evaluation of bone maturity.

The sugars will eventually be exported transporter (SWEET) family is a novel class of sugar transporters that play a crucial role in plant growth, development, and responses to stress. Cranberry (Vaccinium macrocarpon Ait.) is a nutritious berry with economic importance, but little is known about SWEET gene family functions in this small fruit. In this research, 13 VmSWEET genes belonging to four clades were identified in the cranberry genome for the first time. In the conserved domains, we observed seven phosphorylation sites and four amino acid residues that might be crucial for the binding function. The majority of VmSWEET genes in each clade shared similar gene structures and conserved motifs, showing that the VmSWEET genes were highly conserved during evolution. Chromosomal localization and duplication analyses showed that VmSWEET genes were unevenly distributed in eight chromosomes and two pairs of them displayed synteny. A total of 79 cis-acting elements were predicted in the promoter regions of VmSWEETs including elements responsive to plant hormones, light, growth and development and stress responses. qRT-PCR analysis showed that VmSWEET10.1 was highly expressed in flowers, VmSWEET16 was highly expressed in upright and runner stems, and VmSWEET3 was highly expressed in the leaves of both types of stems. In fruit, the expression of VmSWEET14 and VmSWEET16 was highest of all members during the young fruit stage and were downregulated as fruit matured. The expression of VmSWEET4 was higher during later developmental stages than earlier developmental stages. Furthermore, qRT-PCR results revealed a significant up-regulation of VmSWEET10.2, under osmotic, saline, salt-alkali, and aluminum stress conditions, suggesting it has a crucial role in mediating plant responses to various environmental stresses. Overall, these results provide new insights into the characteristics and evolution of VmSWEET genes. Moreover, the candidate VmSWEET genes involved in the growth, development and abiotic stress responses can be used for molecular breeding to improve cranberry fruit quality and abiotic stress resistance.

Introduction: There is a continuous search for an effective intervention to help preterm low birth weight neonates overcome their poor growth and developmental outcomes. Most researchers have examined the effect of Oromotor Stimulation (OMS) on feeding performance. Studies exploring Multimodal Sensory Stimulation (MSS) on various outcome parameters are sparse and reveal inconsistent results. Aim: To analyse the effectiveness of MSS in improving weight gain, length of hospitalisation, and feeding performance in preterm Very Low Birth Weight (VLBW) neonates. Materials and Methods: This quasi-experimental study was conducted between June 2021 and December 2022 in the Paediatrics Department of Agartala Government Medical College, Agartala, Tripura, India. A total of 104 hospitalised neonates with gestational age from 28 to less than 37 weeks and birth weight from 1000 to less than 1500 grams (VLBW) were included in the study. All neonates received standard care and Kangaroo Mother Care (KMC). On the advice of some faculties, several of them also received MSS. All neonates were divided into two groups: those who received MSS and those who did not, and they were monitored until discharge. Mean hospitalisation length, weight gain, and transition time were derived and statistically analysed using Chi-square and Mann-Whitney U tests. R esults: In the present study, the mean gestational age was 32.04±1.75 and 32.679±1.19 weeks, and the M:F ratio was 1.43:1 and 1.30:1 in the MSS-given and MSS-not given groups, respectively. Mean weight gain was significantly higher in the MSS-given group (97.00±123.09 g versus- 23.42±43.96 g). Mean hospitalisation length was longer in the MSS-given group, but transition time did not differ significantly across the groups. C onclusion: Multimodal sensory stimulation is effective in promoting weight gain in preterm VLBW neonates.

ObjectiveTo establish the Shanghai twin birth cohort （STBC） and analyze the effects of genetic factors， shared environment， and non-shared environment interactions on birth health and growth and development of newborns.MethodsBased on the population-wide birth cohort in Shanghai， a comprehensive survey was conducted on the families with double and multiple babies born after January 1， 2015 to collect information on birth health， growth and development， and the family environment of the babies.ResultsBy December 31， 2021， a total of 7 195 pairs （14 405 cases） of twins were successfully included in the STBC survey. The average birth length of twins was 47.2 cm and average birth weight was 2 465.3 g. Heterozygous twins accounted for 69.05% and preterm babies accounted for 57.07%. The average age of the mothers of twins was 31.82 years， and the average age of the fathers was 33.87 years， with more than 80% of the parents having a college degree or above. 44.50% of the mothers used assisted reproductive technologies， 7.40% had illnesses during pregnancy， and 15.90% were exposed to passive smoking during pregnancy. During the survey period， the average monthly increase in the length of the twin infants was 2.09 cm， and the average monthly weight gain was 0.53 kg.ConclusionThe incidence of adverse outcomes such as maternal cesarean section rate， preterm birth， and low birth weight is higher in the twin birth population. Information on birth health as well as growth and development in childhood and adolescence in the twin birth population is collected based on STBC， which can provide a solid data foundation for studying children’s chronic non-communicable diseases， psychological and behavioral disorders and other complex health problems caused by the combined effects of genetics and the environment.

Fusarium graminearum is the primary causative agent of Fusarium head blight (FHB), a devastating disease affecting cereals globally. The high-mobility group (HMG) of non-histone proteins constitutes vital architectural elements within chromatin, playing diverse roles in various biological processes in eukaryotic cells. Nonetheless, the specific functions of HMG proteins in F. graminearum have yet to be elucidated. Here, we identified 10 HMG proteins in F. graminearum and extensively characterized the biological roles of one HMGB protein, FgNhp6. We constructed the FgNhp6 deletion mutant and its complementary strains. With these strains, we confirmed the nuclear localization of FgNhp6 and discovered that the absence of FgNhp6 led to reduced radial growth accompanied by severe pigmentation defects, a significant reduction in conidial production, and a failure to produce perithecia. The ∆FgNhp6 mutant exhibited a markedly reduced pathogenicity on wheat coleoptiles and spikes, coupled with a significant increase in deoxynivalenol production. An RNA sequencing (RNA-seq) analysis indicated that FgNhp6 deletion influenced a wide array of metabolic pathways, particularly affecting several secondary metabolic pathways, such as sterol biosynthesis and aurofusarin biosynthesis. The findings of this study highlight the essential role of FgNhp6 in the regulation of the asexual and sexual reproduction, deoxynivalenol (DON) production, and pathogenicity of F. graminearum.

ABSTRACT Introduction: Legg-Calvé-Perthes disease (LCPD) is the idiopathic osteonecrosis of the capital femoral epiphysis in children. It is a self-healing condition, and the morphology of the hip may vary according to the severity of the disease, among several other factors. The treatment focuses on attempts to prevent femoral head collapse, obtain functional hip motion recovery, and reduce pain. Osteochondritis Dissecans (OCD) of the femoral head has been reported in 2% to 7% of patients diagnosed with healed LCPD. Although OCD may remain asymptomatic, the osteochondral fragment has the potential to become unstable, evolving into symptoms of pain, locking, catching, and snapping. Case report: We present a case report of a ten-year-old boy with an OCD lesion following LCPD who underwent effective osteochondral fixation through the surgical hip dislocation approach. The patient evolved to excellent functional recovery at 1 year post-operatively. Discussion: The surgical hip dislocation approach allows anatomical fixation of the OCD fragment, as well as improvement of hip biomechanics, decreasing pain, improving range of motion and joint congruency, and preserving the native articular cartilage. It also gives the surgeon the opportunity to assess hip stability, femoroacetabular impingement and labral tears, allowing a wide variety of options for the treatment of the healed LCPD. Level of Evidence IV; Type of study Case Report.

Objective To explore the influence of altitude on the bone growth and development of children and adolescents. Methods From September 2013 to December 2021, children and adolescents with normal development were included from the following regions with three different altitudes:Beijing (Peking Union Medical College Hospital) at 43.5 m above sea level, Lhasa (People's Hospital of Tibet Autonomous Region) at 3 650 m, and Nagqu (People's Hospital of Nagqu and People's Hospital of Nima County) over 4 500 m. Their demographic information and left wrist radiographs were retrospectively analyzed. Assisted by an artificial intelligence bone age (BA) software, a radiologist with 10 years of BA experience interpreted the BA using the Greulich-Pyle method. The differences between BA and chronological age (CA) in different age groups among different altitudes were calculated and statistically analyzed. Results A total of 1 013 participants (671 boys and 342 girls) consisting of 407 Han from Beijing, 456 Tibetan from Lhasa and 150 Tibetan from Nagqu were included. Generally, the BA of children and adolescents in Beijing conformed to the CA, while the average BA of Tibetan children in Lhasa and Naqu lagged behind the CA by 0.50 and 1.33 years, respectively. Compared with those in Beijing, the BA of most age groups (7-18 years old) of Tibetan boys and girls lagged further behind the CA with the increase of altitude. Conclusions The BA of Tibetan children in plateau area lags behind their CA and the gap becomes larger with the increase of altitude.

ABSTRACT Introduction: The genu recurvatum is characterized by a hyperextension deformity of the knee in the sagittal plane. Among its causes are conditions such as arthrogryposis, cerebral palsy, poliomyelitis, sequelae of tibial tuberosity fracture and some syndromes with generalized joint hypermobility. Treatment of this deformity can be challenging and, to date, aggressive methods such as femur or tibial osteotomies are the most used for its correction. Objective: This study aimed to describe a new surgical technique for correcting genu recurvatum. Methods: This is a prospective clinical study of children who underwent posterior hemiepiphysiodesis of the distal femur with transphyseal screws. Results: The approach proved to be safe and useful for genu recurvatum deformities, with femoral or articular apex. Conclusion: This approach shows great potential for correcting genu recurvatum in the developing skeleton, being an excellent alternative to the more aggressive methods currently used to treat this deformity. Level of evidence IV, Case Series.

Artificial intelligence (AI) system which can achieve stable, efficient and automatic bone age (BA) evaluation has been gradually embedded into clinical workflow. Herein, the routine BA methods were briefly reviewed and then followed by explanation of some terms commonly used in the area of AI. Then authors reviewed the research progresses of AI bone age software both in China and abroad in recent years, including the sources of training and validation dataset, the construction of algorithms and modules, and its performance in testing dataset. Finally, the challenges of applying AI in BA assessment were presented and some suggestions were given.

MicroRNAs (miRNAs) are endogenous non-coding small RNA with 19–24 nucleotides (nts) in length, which play an essential role in regulating gene expression at the post-transcriptional level. As one of the first miRNAs found in plants, miR171 is a typical class of conserved miRNAs. The miR171 sequences among different species are highly similar, and the vast majority of them have both “GAGCCG” and “CAAUAU” fragments. In addition to being involved in plant growth and development, hormone signaling and stress response, miR171 also plays multiple and important roles in plants through interactions with microbe and other small-RNAs. The miRNA functions by regulating the expression of target genes. Most of miR171’s target genes are in the GRAS gene family, but also include some NSP, miRNAs, lncRNAs, and other genes. This review is intended to summarize recent updates on miR171 regarding its function in plant life and hopefully provide new ideas for understanding miR171 function and regulatory mechanisms.

Knowing an individual's age is necessary for several situations, both in the living and the deceased. The London Atlas uses dental development and eruption to estimate age. Testing the method in different populations is necessary to assess its performance. This study aimed to assess the performance of the London Atlas method in a Russian sample using panoramic radiographs. A sample of 703 panoramic radiographs of Russian individuals (n = 405 females, 57.61% and n = 298 males, 42.39%) with ages between 8 and 23 years were analyzed. The results showed overestimation in individuals from 8 to 14 years and underestimation from 15 to 23 years. The mean difference between estimated and chronological ages did not exceed 0.7 years among individuals with ages below 19 years. The difference increased to over three years in individuals from 20 to 23 years. Statistically significant differences were found between females and males between 17 and 18 years (p

Purpose This study aimed to develop and evaluate a mobile application focusing on developmental support care for infants born prematurely. Methods An application was developed using the analysis, design, development, implementation, and evaluation model. In the analysis phase, previous research was evaluated through big data text-mining and a literature review. In the design phase, the preliminary content of the application was designed, and the content validity and comprehension were verified. A hybrid application was developed and used by eight experts and ten users, who evaluated the layout of the mobile application and their satisfaction with it. Results The content of the designed application comprised a diary, customized information, developmental play, and community. The mean scores for layout were 3.73±0.47 and 3.43±0.68 out of 4 points among the experts and users, respectively. Users’ mean satisfaction score was 3.70±0.70 out of 5 points. Conclusion The information provided by the mobile application was evaluated as consistent and systematic. The application was also found to be satisfactory by infants’ parents. The mobile application developed through this study is expected to be effective in supporting the development of children born prematurely.

Purpose This study examined the effects of an educational program for fathers on improving father-infant interactions, child-rearing knowledge, and attachment. Methods In this quasi-experimental study, the participants were recruited by convenience sampling among fathers with infants (2-6 months of age) residing in three districts of Seoul. Fifteen participants in the experimental group and 17 participants in the control group completed the follow-up investigation. A 5-week online and offline intervention program with five sessions was provided to the experimental group. The data were analyzed using generalized estimating equations (GEEs). Results There was a significant difference in the change in father-infant interaction scores of the experimental group, especially in the caregiver aspect with a significance level of .100 in time and group-to-group interactions (B=6.46, p=.051, 95% confidence interval [CI]=-0.02-12.94). The changes between the groups and times were not statistically significant when it came to infant development knowledge and father-infant attachment. Conclusion We conclude that hybrid online and offline education should be implemented as an effective method to improve fathers’ interactions with their children based on accurate knowledge about infant development.

Caring for extremely low birth weight (ELBW) infants remains a challenge in developing countries due to high morbidity and mortality rates. In Dr. Sardjito Hospital, Yogyakarta, the ELBW survival rate was 39.3%.1 Expected outcomes of these ELBW survivors are increased risk of mortality during the infant period and short term as well as long term complications.2 Osteopenia of prematurity is a comorbidity that can interfere with longterm growth and neurodevelopment.3 Osteopenia of prematurity is found in approximately 55% of babies with ELBW.4 Antenatal demineralization is aggravated by improper nutritional interventions during perinatal care and post-discharge care. This comorbidity is asymptomatic in the infant’s early life, but later contributes to linear growth failure, delayed teeth eruption, respiratory problems, and bone fractures in ELBW babies.3 Early detection and prompt management of osteopenia of prematurity are needed for all ELBW infants. Here we present a case of an ELBW infant with osteopenia of prematurity who we observed for 18 months. The child underwent multidisciplinary interventions for modifiable prognostic factors to support optimal achievement of growth and neurodevelopment.

ObjectiveTo investigate the status of maternal iodine deficiency in Lishui City of Zhejiang Province， and explore the effect of maternal iodine deficiency on the growth and development of infants.MethodsA total of 209 pregnant women living in Liandu District of Lishui City from January 2017 to December 2018 were selected by stratified sampling method. Urine iodine level in pregnant women and iodine content in edible salt at home were determined to assess the status of iodine deficiency and to analyze the influencing factors. Their babies were followed up for 1 year， and metabolic disease screening and physical examination were carried out to evaluate the growth and development.ResultsThe median of urinary iodine levels in 2017 and 2018 were 165 µg·L-1 and 192 µg·L-1， respectively. Both of the values met the standard of iodine sufficiency. The results of salt iodine content in pregnant women's homes showed that 7 cases （3.35%） were without iodized salt and 202 cases （96.65%） with iodized salt， including 186 cases （89.00%） with qualified iodized salt. Univariate analysis showed that pregnancy， education level， intake of iodized salt， cooking methods of salt， intake frequency of iodine-rich food and knowledge of iodine nutrition had significant impact on iodine deficiency in pregnant women （P

Background: The first 2 years of life are a critical period for a child's growth and development. Exclusive breastfeeding for 6 months and continued breastfeeding with safe, appropriate, and adequate feeding are recommended as a global health policy in both developing and developed countries. Objective: The objective was to study the pattern of foods given to the infants during the weaning period in an urban field practice area in Vijayapura. Materials and methods: The mothers of infants (aged 6–12 months) were interviewed by using predesigned and pretested questionnaires regarding different types of foods given to their infants and also about their immunization status, incidence of diarrhea and acute respiratory infection (ARI). Results: A total of 95 mothers with infants aged between 6 and 12 months were enrolled in the study during the period of 1 month. Majority of the infants were fed with milk (animal) as a type of complementary food. Conclusion: Poor complementary feeding practices were observed in urban areas, and urgent health education and demonstration of weaning foods in the community play a major role in preventing diseases.

Background: The first five years of a child’s life is a golden period for their growth and development, fostering their future learning skills and social and emotional abilities due to rapid gains in physical and cognitive growth and development. Objectives: The aim of this study was to examine the knowledge of mothers about the growth and development of under 5-years children in western Rajasthan. Materials and Methods: The present study was conducted with quantitative descriptive approach. The study was conducted at Prince Bijay Singh Memorial (PBM) Hospital, Bikaner, Rajasthan. The population of the current study comprised of 150 mothers, having at least an under-5 year’s child. The subjects were selected by Non-probability convenient sampling technique for this study. Self-structured questionnaire on demographic profile and knowledge about growth and development were distributed among the mothers. Results: The study revealed that half of the mothers were belongs to 26–35 years of age group. The majority of mothers (42%) were having education up to primary level. In occupational status, the most of mothers (56.66%) were house wife. Furthermore, the majority of the mothers (65.33%) had average level of knowledge followed by 28.67% of them had good level of knowledge while only 6% had poor level of knowledge regarding growth and development of under-5 year children. Likewise there was a significant association between the knowledge scores of the mothers and age (p-value- 0.031), educational status (p-value- 0.0001) and occupation (p-value- 0.0001). Whereas, variables like as: family income, type of family and Number of children in family were not significantly associated the level of knowledge. Conclusion: Findings of this research study suggested that most of the mothers having average level of knowledge towards growth and development of under-5 year children. In addition, Knowledge of the mothers was partially associated with their selected demographic variables. Furthermore, sound knowledge of mothers is vital for growth and development of under-5 year children.

Purpose The purpose of this study was to identify the gaps in research related to developmentally supportive care in the neonatal intensive care unit (NICU). The ultimate goal was to explore directions of further research on developmentally supportive care for premature patients. Methods The Arksey and O'Malley scoping review method was used. Articles on developmentally supportive care for preterm infants in the NICU, written in English or Korean, were identified through electronic search engines. A total of 279 papers were identified in the initial search, of which 22 full-text papers were included in this review. Results Several nursing studies have been published in the past 5 years. The important elements of developmentally supportive care were family-centered care and management of the NICU environment. The primary developmentally supportive care interventions were training programs to promote the care competency of NICU nurses. Conclusion It is necessary to actively develop comprehensive developmental support interventions that consider the various elements of developmentally supportive care for preterm infants. Additional studies should be done to develop programs that provide direct intervention for premature infant and their families.

At the Toddler Posyandu or Posyandu Balita, the health workers and mothers and toddlers are possible to meet, and they may communicate together to monitor toddlers growth and development. This photo essay records our health service communication in monitoring toddler growth and development in the New Normal at Posyandu Hidup Baru Desa Kaong, Kecamatan Upau, South Kalimantan, Indonesia. The activities include counseling, height and weight checking for toddles, and immunization. The visits cannot be done virtually, since we must directly provide examination of nutritional status, immunization, counseling and others monitoring to the mothers and toddlers following the standard protocols, and not all mothers of toddlers have the measuring devices. Since the checking and monitoring have been done during the Covid 19 pandemic, posyandu must apply health protocols when communicating and providing health service to the mothers and toddlers. Thus, all participants presented at the posyandu will not get infected with covid 19, and the toddler growth and development can be monitored regularly.

​​ Background and Objective: Human development is influenced by genetic, environmental, and social factors whose foundation is formed from infancy and childhood. Preterm birth and low birth weight are important issues that can affect the development and threaten the public health. The aim of this study was to investigate the effect of early exercise interventions on gross motor skills of children with preterm birth aged 3 to 6 years. Material and Methods: In this Experimental study, 30 children with average (2066 ±354g) were selected from among the preterm infants (32 to 37 weeks less than 2500 g) admitted to NICU ward. They were divided into two groups (experimental group n=15 and control group n=15 children).To evaluate the gross motor skills of children, the second version of the Peabody developmental motor scale was used. The results were analyzed by SPSS using ANCOVA test (p≤0.05). Results: The results of this study showed that early interventions can have a positive effect on the gross motor skills of these children and the participants in the experimental group were able to obtain higher scores than the control group after participating in the training program. Conclusion: The results showed that training interventions have a significant effect on both stability and locomotion skills.

Objective:To observe the effect of remote home rehabilitation mode on the development of children with cerebral palsy and their families'emotions during the quarantine for COVID-19.Methods:A total of 80 children with cerebral palsy(CP)who were treated in Children's rehabilitation department of Hebei Hospital of Traditional Chinese Medicine, the outpatient department from December 1, 2020 to January 5, 2021 were randomly divided into the control group and the observation group, with 40 cases in each group. The control group received routine home quarantine control and daily exercise training. Rehabilitation therapists used mobile phones or computer videos and other remote media platforms to carry out home isolation measures, community prevention and control measures, psychological counseling, dietary and feeding guidance and daily exercise guidance for CP children and their families. The exercise training content mainly refered to"exercise guidance and advice for children aged 0-6 years old during the epidemic of COVID-19", once a day, 30 minutes each time, five times a week, continuous intervention for one month. The observation group received remote home rehabilitation mode on the basis of prevention and control isolation at home, CP children's families trained their Children in movement, occupation, speech, cognition, massage at home under the remote guidance of rehabilitation therapists, once a day, 30 minutes a time, five times a week, continuous training for one month. Before and after intervention, Gesell scale was used to evaluate the growth and development of the children with CP; the clinical symptom score of traditional Chinese medicine(TCM)was used to evaluate clinical effect; weight scale was used to measure body mass; color doppler ultrasound was used to detecte cerebral hemodynamics indexes such as the cerebral artery mean arterial blood flow velocity(Vm)and vascular resistance index(RI); Hamilton depression scale(HAMD-17)was used to evaluate the depression of the CP children's family members.Results:Before intervention, there were no significant differences in DQ score, clinical symptom score of TCM, Vm, RI index, body mass and HAMD-17 score between two groups(P>0.05).Compare with before intervention, body weight, Vm and HAMD-17 scores of the two groups after intervention were significantly increased, DQ score of the observation group after intervention was significantly increased, the RI was significantly decreased, with statistically significant differences(PPP>0.05).Conclusion:Remote home rehabilitation mode can effectively promote the growth and development of CP children, improve the symptoms of tardiness in standing, walking, speaking, soft and hard hands and feet, and relieve the depression of CP children's family members, which is an effective rehabilitation training mode for CP children during the period of epidemic isolation.

Objective(s): Prostaglandin E2 E-prostanoid 2 receptor (PGE2 EP2), downstream of cyclooxygenase-2 (COX-2), plays an important role in inflammatory responses, but there are some reports about synaptic functions of COX-2 and PGE2 EP2 in the hippocampus.Materials and Methods: C57BL/6J mice were sacrificed at postnatal days (P) 1, 7, 14, 28, and 56 for immunohistochemical staining for EP2 and doublecortin as well as western blot for EP2. In addition, COX-2 knockout and its wild-type mice were euthanized for immunohistochemical staining for EP2.Results: EP2 immunoreactivity was observed in the majority of the cells in the dentate gyrus at P1 and P7, while at P14, it was detected in the outer granule cell layer and was confined to its subgranular zone at P28 and P56. EP2 protein levels in the hippocampal homogenates were also highest at P7 and lowest at P56. EP2 immunoreactivity was partially colocalized, with doublecortin (DCX)-immunoreactive neuroblasts appearing in the mid-zone of the granule cell layer at P14 and in the subgranular zone of the dentate gyrus at P28. Co-localization of EP2 and DCX was significantly decreased in the dentate gyrus in the P28 group compared with that in the P14 group. In COX-2 knockout mice, EP2 immunoreactivity was significantly decreased in the hippocampal CA1 region (P=0.000165) and dentate gyrus (P=0.00898). Conclusion: EP2 decreases with age, which is expressed in DCX-immunoreactive neuroblasts in the dentate gyrus. This suggests that EP2 is closely linked to structural lamination and adult neurogenesis in the dentate gyrus.

Background The main planting modes currently used for the production of Coptis chinensis Franch are under the shade of a manmade scaffold or a natural understory. In this study, we analysed changes in the growth, development, and alkaloids of C. chinensis when grown in a natural understory compared with under a manmade scaffold. We also clarified the differences in the rhizosphere soil microenvironment, represented by soil physicochemical factors, enzyme activity, and microbial community structure of 1- to 5-year-old C. chinensis between the different planting modes. These results will provide theoretical guidance and scientific evidence for the development, application, and extension of ecological planting technologies for C. chinensis. Results The results of this study showed that rhizome length, rhizome diameter, and rhizome weight all increased over time in both planting modes. The greatest rhizome length was reached in 4-year-old C. chinensis, while the greatest rhizome diameter and rhizome weight were obtained in 5-year-old C. chinensis. There was no significant difference in rhizome biomass between the two planting modes. The alkaloid content of the four common alkaloids in the rhizome of 5-year-old C. chinensis at the harvest stage met the standards found in the Pharmacopoeia of the People’s Republic of China; the berberine content and total alkaloids in the rhizomes were significantly higher with natural understory planting compared to planting under a manmade scaffold. A redundancy analysis revealed that the physicochemical factors and enzyme activity of rhizosphere soil were significantly correlated with variation in microbial community structure. Soil pH, available potassium, bulk density, available nitrogen, catalase, and peroxidase were all significantly correlated with bacterial and fungal community structures. Among these, soil pH was the most important factor influencing the structures of the fungal and bacterial community. In the two planting modes, the differences in soil enzyme activity and microbial community structure mainly manifested in the rhizosphere soil of C. chinensis between different growth years, as there was little difference between the rhizosphere soil of C. chinensis in a given growth year under different planting modes. The levels of nitrogen, phosphorus, potassium, and organic matter in the rhizosphere soil under either planting mode were closely associated with the type and amount of fertiliser applied to C. chinensis. Investigating the influence of different fertilisation practices on nutrient cycling in farmland and the relationship between fertilisation and the soil environment will be key to improving the yield and quality of C. chinensis medicinal materials while maintaining the health of the soil microenvironment.

Background The auxin indole-3-acetic acid (IAA) is a type of endogenous plant hormone with a low concentration in plants, but it plays an important role in their growth and development. The AUX/IAA gene family was found to be an early sensitive auxin gene with a complicated way of regulating growth and development in plants. The regulation of root growth and development by AUX/IAA family genes has been reported in Arabidopsis, rice and maize. Results In this study, subcellular localization indicated that ZmIAA1-ZmIAA6 primarily played a role in the nucleus. A thermogram analysis showed that AUX/IAA genes were highly expressed in the roots, which was also confirmed by the maize tissue expression patterns. In maize overexpressing ZmIAA5, the length of the main root, the number of lateral roots, and the stalk height at the seedling stage were significantly increased compared with those of the wild type, while the EMS mutant zmiaa5 was significantly reduced. The total number of roots and the dry weight of maize overexpressing ZmIAA5 at the mature stage were also significantly increased compared with those of the wild type, while those of the mutant zmiaa5 was significantly reduced. Yeast one-hybrid experiments showed that ZmTCP15/16/17 could specifically bind to the ZmIAA5 promoter region. Bimolecular fluorescence complementation and yeast two-hybridization indicated an interaction between ZmIAA5 and ZmARF5. Conclusions Taken together, the results of this study indicate that ZmIAA5 regulates maize root growth and development by interacting with ZmARF5 under the specific binding of ZmTCP15/16/17.

Abstract Dietary modifications in certain IEMs are highly cariogenic, subsequently posing a significant risk to dental health. Multidisciplinary input is imperative to ensure metabolic dietary needs are met, whilst complementing dental preventive regimes.

Introduction: Planning in the field of medical tourism is of particular importance. The main objective of this research was to identify and analyze the factors affecting the growth of medical tourism in Iran. It could be a small step toward promoting entrepreneurship and increasing non-oil revenues in the country. Methods: Studies published in the Persian and English language during the years 2006-2019 in Science Direct, ProQuest, Springer, Medline, Scopus, Ovid, and SID databases were reviewed, and the findings were then compared. Results: A total of 75 articles out of 2631 unique publications were included in this study. Most articles reported studies performed for all patients, including the whole country (Iran) (n=22, 30%), Shiraz only (n=11, 15%), Tehran only (n=11, 15%), Mashhad only (n=6, 8%), Isfahan only (n=5, 6%), and Ardabil only (n=4, 5%). Conclusion: Given the history of Iranian hospitals in attracting foreign patients and the analysis of their status, there are many limitations in achieving a proper standing in the medical tourism industry. Strategies offered by various managers and authorities in tourism can lead to increased attraction of medical tourists to public and private hospitals in Shiraz, relying on the capabilities and potential of Shiraz and its health sectors, including climate and nature, cultural and historical attractions, renowned practitioners, advanced equipment, facilities, and methods, and thereby generating more foreign exchange earnings and employment.

ABSTRACT BACKGROUND: Sports participation plays an important role in bone gain during childhood and adolescence. The aim here was to identify sex-related determinants of bone mineral density (BMD) differences between male and female adolescents, with emphasis on the role of sports participation. DESIGN AND SETTING: Longitudinal study conducted in a public university in Presidente Prudente, Brazil. METHODS: The sample comprised 48 adolescents aged 11-17 years, of both sexes, who were matched according to sex, age and sports participation. BMD was the main outcome, while muscle mass, sports participation, calendar age and biological maturation were treated as covariates. Participants were followed up after nine months. RESULTS: At baseline, BMD values were similar between the sexes. However, adjustment for covariates showed that BMD was higher among girls at all sites, with a contribution from lean soft tissue (LST) in the model (partial eta-squared, ES-r = 0.619 in upper limbs; 0.643 in lower limbs; 0.699 in spine; and 0.599 in whole body). Sports participation only explained the upper-limb variance (ES-r = 0.99). At the follow-up, the results resembled the baseline except in the lower limbs (P = 0.109), in which BMD was similar between the groups. BMD gain over time was similar between girls and boys in all segments, and baseline LST affected upper-limb and whole-body BMD accrual (ES-r = 0.396 and 0.107, respectively). CONCLUSION: Whole-body and specific-site BMD differed between baseline and follow-up. However,BMD accrual was similar between the sexes, given that muscle mass constituted the most relevant determinant of the difference between them.

NAC (NAM, ATAF1-2, and CUC2) transcription factors (TFs) play a vital role in plant growth and development, as well as in plant response to biotic and abiotic stressors (Duan et al., 2019; Guerin et al., 2019). Chrysanthemum is a plant with strong stress resistance and adaptability; therefore, a systematic study of NAC TFs in chrysanthemum is of great significance for plant breeding. In this study, 153 putative NAC TFs were identified based on the Chrysanthemum nankingense genome. According to the NAC family in Arabidopsis and rice, a rootless phylogenetic tree was constructed, in which the 153 CnNAC TFs were divided into two groups and 19 subfamilies. Moreover, the expression levels of 12 CnNAC TFs belonging to the OsNAC7 subfamily were analyzed in C. nankingense under osmotic and salt stresses, and different tissues were tested during different growth periods. The results showed that these 12 OsNAC7 subfamily members were involved in the regulation of root and stem growth, as well as in the regulation of drought and salt stresses. Finally, we investigated the function of the CHR00069684 gene, and the results showed that CHR00069684 could confer improved salt and low temperature resistance, enhance ABA sensitivity, and lead to early flowering in tobacco. It was proved that members of the OsNAC7 subfamily have dual functions including the regulation of resistance and the mediation of plant growth and development. This study provides comprehensive information on analyzing the function of CnNAC TFs, and also reveals the important role of OsNAC7 subfamily genes in response to abiotic stress and the regulation of plant growth. These results provide new ideas for plant breeding to control stress resistance and growth simultaneously.

Background The meat quality of yellow feathered broilers is better than the quality of its production. Growth traits are important in the broiler industry. The exploration of regulation mechanisms for the skeletal muscle would help to increase the growth performance of chickens. At present, some progress has been made by researchers, but the molecular mechanisms of the skeletal muscle still remain unclear and need to be improved. Methods In this study, the breast muscles of fast- and slow-growing female Jinghai yellow chickens (F4F, F8F, F4S, F8S) and slow-growing male Jinghai yellow chickens (M4S, M8S) aged four and eight weeks were selected for transcriptome sequencing (RNA-seq). All analyses of differentially expressed genes (DEGs) and functional enrichment were performed. Finally, we selected nine DEGs to verify the accuracy of the sequencing by qPCR. Results The differential gene expression analysis resulted in 364, 219 and 111 DEGs (adjusted P-value ≤ 0.05) for the three comparison groups, F8FvsF4F, F8SvsF4S, and M8SvsM4S, respectively. Three common DEGs (ADAMTS20, ARHGAP19, and Novel00254) were found, and they were all highly expressed at four weeks of age. In addition, some other genes related to growth and development, such as ANXA1, COL1A1, MYH15, TGFB3 and ACTC1, were obtained. The most common DEGs (n = 58) were found between the two comparison groups F8FvsF4F and F8SvsF4S, and they might play important roles in the growth of female chickens. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway also showed some significant enrichment pathways, for instance, extracellular matrix (ECM)-receptor interaction, focal adhesion, cell cycle, and DNA replication. The two pathways that were significantly enriched in the F8FvsF4F group were all contained in that of F8SvsF4S. The same two pathways were ECM–receptor interaction and focal adhesion, and they had great influence on the growth of chickens. However, many differences existed between male and female chickens in regards to common DEGs and KEGG pathways. The results would help to reveal the regulation mechanism of the growth and development of chickens and serve as a guideline to propose an experimental design on gene function with the DEGs and pathways.

Introduction: For people, the difficulty in setting up emotions is a kind of incompatibility, and represents a high risk factor for mental health. The present study examined the predictive role of emotion regulation in the posttraumatic growth and development of blind veterans. Materials and Methods: In this descriptive-correlation study, participants were 110 blind veterans who were selected using convenience sampling method. Calhoun and Tedeschi emotion regulation difficulty questionnaire as well as Gratz and Roemer posttraumatic growth and development questionnaire were completed with the help of questioners. The data were analyzed using Pearson correlation and multiple linear regression tests via SPSS software. Results: There was a negative relationship between emotion regulation difficulty with posttraumatic growth and development. Moreover, as a result of regression analysis between emotion regulation difficulty with posttraumatic growth and development, F statistic value was 4.319, and the standardized regression coefficient was -0.196. Therefore emotion regulation was able to predict posttraumatic growth and development (P < 0.05). Conclusion: According to research findings, it seems that if emotional regulation is appropriately performed, it is not only possible to prevent high-risk behaviors, but also leads to individual’s growth and development.

Introduction: The nutritional status along with physical and mental development of infants is an effective factor on children’s health throughout the life. Various strategies have, so far, been used to achieve optimal infant growth. Using non-professional support is one of these methods . This study aimed to investigate the effectiveness of peer support on the growth patterns of infants aged below one year old. Materials & Methods: In this clinical trial, 240 primiparous women were randomly divided into two experimental and control groups. The control group received standard education and the experimental group was, besides receiving the same education, supported by 30 breast feeding consultants (women with successful breastfeeding records) during the 6 months of postpartum. The infants’ growth and developmental patterns were evaluated at the end of 1,2,4,6 and 12 months, respectively. This clinical trial was carried out in all the maternity hospitals and health centers of Ilam city (western Iran) during July 2010 to April 2012. Data were collected using a questionnaire and then analyzed using SPSS software version 16 and statistical tests including mean, percentage, Chi square test, Fisher test. Findings: At 1, 2, 4.6 and 12 months of our reaerch, the two groups demonstrated a significant difference in terms of accommodation with the standard curve of weight gain, (P=0.001). The mean heights in both the groups was significantly different at 2, 12 months(P=0.001). The mean of head circumferences in the groups did not show any differences significantlym, (P>0.05). Discusion & Conclusion: Our investigation came to the ocnclusion that besides encouraging mothers to continue lactation, peer support can be effective in promoting the growth and developmental patterns of children.

Purpose: This prospective study aimed to examine the development of premature infants at 12 and 24 months and to explore the factors related to their development. Methods: Of the 80 premature infants who were recruited, 52 participants at 12 months and 31 participants at 24 months were included in this study. The development of the infants was examined using the Korean Bayley scale of infant development-II. Postnatal depression, husband’s support, social support, mother-infant attachment, and the home environment were assessed using self-report questionnaires completed by the mothers and through the researcher’s observations. Results: There was significant difference between normal and delay group at psychomotor development at 12 months depending on social support at 6 months (t=2.03, p=.049). Mother-infant attachment at 6 months (r=.71, p

Introduction: The purpose of this study was to analyze secular trends in anthropometrics and physical fitness of Portuguese children. Material and Methods: A group of 1819 students (881 boys and 938 girls) between 10 and 11 years old was assessed in their 5th and 6th scholar grade throughout a 20 years’ time-frame. ANCOVA models were used to analyze variations in anthropometrics (height, weight and body mass index) and physical fitness (sit and reach, curl-up, horizontal jump and sprint time) across four quinquennials (1993 - 1998; 1998 - 2003; 2003 - 2008; 2008 - 2013). Results: Secular trends showed the presence of heavier boys and girls with higher body mass index in the 5th and 6th grade throughout the last 20 years. There was also a presence of taller girls but just until the 3rd quinquennial. Both boys and girls were able to perform better on the core strength test and sprint time but become less flexible over the years. Mean jumping performance remained unchanged for both genders. Discussion: The present study provides novel data on anthropometrics and physical fitness trends over the last two decades in young Portuguese children, consistent with the results reported in other developed countries. Conclusion: Evidence for the start of a positive secular trend in body mass index and in some physical fitness components over the last two decades among the Portuguese youth.

Purpose: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. Methods: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. Results: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (≥21 days; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (≥38; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (≥35 years; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. Conclusion: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.

Background Working mothers with toddlers are often confused with the difficulties of caregiver substitutes. This leads to the con- cern about neglecting their toddlers. Day care centers are expected to respond by substituting the absent mothers, in order for the children’s needs of growth and development to become optimal. Objective To examine the profile of day care centers in correla- tion with growth and development of toddlers, and to understand the characteristics of facilities for growth and development in tod- dlers at day care centers. Method This cross-sectional study was conducted at the day care centers (DCC) of the Department of Social Affairs of the Republic of Indonesia Harapan Ibu (HI) in Salemba, Central Jakarta and Teratai in Bekasi from February 1-August 1, 2004. Results There were 106 children enrolled in this study; 47 chil- dren in DCC HI and 59 in DCC Teratai, male:female ratio was 1:1, mostly at age 3.1-5 years. Growth status was measured accord- ing to body weight/age, body height/age, height circumference/ age and found good, normal, and proper growth status in 85 chil- dren (80.2%), 48 children (45.3%), 102 children (96.2%), respec- tively. We found good nutritional status in 44 children (41.5%) and normal developmental status (Denver II) in 81 children (76.4%). Ratio of caregivers to child was 1:10. All children had complete immunization. No trauma or upper respiratory tract infection was recorded as frequent morbidity. Parents’ reasons for relying their children in DCCs were to enable their children to socialize (50 children/47.2%), and to allow them to become independent (49 children/46.2%). Conclusion DCCs can serve as a safe alternative caregiving sub- stitute based on good growth and development, good nutritional status, also good characteristics facilities

BACKGROUND AND OBJECTIVE: With the advancement of medical care procedures, survival rate of preterm neonates has increased remarkably. In Iran, few studies have assessed the extent and severity of developmental disorders in these infants. This study aimed to evaluate developmental disorders in premature neonates. METHODS: This cohort study was conducted on 270 premature infants born in Ghaem Hospital in Mashhad, Iran with mean birth weight of 1460±40 grams. Data on pregnancy, parturition and complications during hospitalization were recorded. Moreover, preterm neonates were evaluated in terms of developmental delay at 6, 12, 18 and 24 months of age based on the Ages and Stages questionnaire (ASQ). FINDINGS: In this study, symptoms of developmental delay were observed in 152 neonates (56%) at six months, 115 neonates (42.7%) at 12 months, 101 infants (37.5%) at 18 months, and 49 neonates (18%) at 24 months. In addition, abnormal development was detected in different areas, including communication (n=21, 7.8%), major movements (n=53, 19.6%), minor movements (n=74, 27.5%), social interactions (n=89, 33%), and problem solving (n=153, 57%). After a two-year follow-up, 27 infants (60%) had asphyxia, 29 (28%) had respiratory distress syndrome, and 20 infants (15%) had developmental disorders. CONCLUSION: According to the results of this study, about one-sixth of preterm neonates had developmental delay at two years of age. The highest rate of developmental disorders was observed in the area of problem solving, which should be taken into account in neonatal rehabilitation services. On the other hand, appropriate monitoring of neonatal asphyxia and jaundice is likely to reduce the risk of other complications during infancy

Background: Identifying infants with congenital infection for early intervention will likely be challenging in future Zika virus outbreaks. We investigated indicators of risk for developmental delay among children born with and without obvious manifestations of congenital Zika virus infection. Methods: We evaluated 120 children conceived during the 2015−2016 Zika virus outbreak in Paraíba, Brazil. We analyzed data from children at birth; ages 1−7 months and approximately 24 months, using medical records (i.e., anthropometric measurements diagnoses), medical evaluation (i.e., Zika/other laboratory tests, dysmorphic features), and parent report (seizures, developmental delay). We used a Bayesian modeling approach to identify predictors of developmental delay. Results: Head circumference (HC) and length at birth and rates of growth for HC and length at follow-up were consistent across domains of developmental delay; (e.g., for every 1 cm per month decrease in HC growth rate; there was a corresponding decrease in the gross motor z-score). Modeling results indicated that HC and length at birth, and follow-up HC and length rates of growth, were predictive of developmental delay. Conclusion: These findings suggest that accurate measurement and frequent monitoring of HC and length, especially in the first few months of life, may be useful for identifying children possibly congenitally exposed to Zika virus who could benefit from early intervention services.

Background: The reasonable use of amino acids (AAs) in parenteral nutrition (PN) is very critical to the growth and development of premature infants. However, the appropriate dose of AAs has not been determined. Our study was designed to investigate the clinical effect of two different doses of AAs in PN for low birth weight premature infants. Materials and Methods: This randomized controlled study included 191 preterm infants who admitted to the neonatal intensive care unit of the First Affiliated Hospital of Nanjing Medical University from June 2015 to December 2016 and they were randomly divided into Group 1 (n = 81) and Group 2 (n = 110). In Group 1, the starting dose of AAs dose was 1.0–1.5 g/kg/day, which was increased by 0.5 g/kg with the maximum dose at 3.5 g/kg/day. In Group 2, the starting dose of AAs was 1.8–2.5 g/kg/day and was increased by 1.0 g/kg with the maximum dose at 4.0–4.5 g/kg/day. We analyzed the clinical characteristics, body weight, body length, total calorie intake, nonprotein calorie intake, total protein intake, liver and kidney function, and complications of the two groups of preterm infants. Results: The start of enteral feeding and the recovery of birth weight in Group 2 were earlier than those in Group 1 (3.83 ± 3.15 day vs. 5.53 ± 5.63 day, P = 0.016 and 6.36 ± 4.88 day vs. 8.48 ± 9.27 day, P = 0.043, respectively). The duration of PN and the time before total enteral nutrition were shorter in Group 2 than in Group 1 (16.46 ± 10.33 day vs. 21.41 ± 18.00 day, P = 0.029 and 15.47 ± 10.54 day vs. 19.47 ± 14.57 day, P = 0.038; respectively). The duration of mechanical ventilation (1.12 ± 2.62 day vs. 3.31 ± 8.13 day, P = 0.028) in Group 2 was shorter than that in Group 1. Conclusion: High doses of AAs in the early PN for preterm infants facilitate the promotion of early growth and development, advance recovery of birth weight, reduce the duration of PN, and reduce respiratory support without increasing the incidence of complications.