PeerJ Preprints: Pediatricshttps://peerj.com/preprints/index.atom?journal=peerj&subject=6200Pediatrics articles published in PeerJ PreprintsExpression pattern of Wif 1 during development of anorectum in fetal rats with anorectal malformationshttps://peerj.com/preprints/34592017-12-112017-12-11Xiao Bing TangHuan LiJin ZhangWei Lin WangZheng Wei YuanYu Zuo Bai
Purpose: This study was performed to investigate the expression pattern of Wnt inhibitory factor 1 (Wif1) during anorectal development in normal and anorectal malformation (ARM) embryos and the possible role of Wif1 in the pathogenesis of ARM. Methods: ARM was induced with ethylenethiourea on the 10th gestational day in rat embryos. Cesarean deliveries were performed to harvest the embryos. The expression pattern of Wif1 protein and mRNA was evaluated in normal rat embryos (n=288) and ARM rat embryos (n=306) from GD13 to GD16 using immunohistochemical staining, Western blot, and real time RT-PCR. Results: Immunohistochemical staining revealed that in normal embryos Wif1 was constantly expressed in the cloaca from GD13 to GD16. On GD13 and GD14, Wif1-immunopositive cells were extensively expressed in the cloaca. On GD15, the expression of Wif1 were mainly detected on the very thin anal membrane. In ARM embryos, the epithelium of the hindgut and urorectal septum demonstrated faint immunostaining for Wif1 from GD14 to GD16. Western blot and real time RT-PCR revealed that Wif1 protein and mRNA expression level was significantly decreased in the ARM groups compared with the normal group on GD14 and GD15 (p<0.05).Conclusions: This study demonstrated that the expression pattern of Wif1 was disrupted in ARM embryos during anorectal morphogenesis, which demonstrated that downregulation of Wif1 at the time of cloacal separation into the primitive rectum and urogenital septum might related to the development of ARM.
Purpose: This study was performed to investigate the expression pattern of Wnt inhibitory factor 1 (Wif1) during anorectal development in normal and anorectal malformation (ARM) embryos and the possible role of Wif1 in the pathogenesis of ARM. Methods: ARM was induced with ethylenethiourea on the 10th gestational day in rat embryos. Cesarean deliveries were performed to harvest the embryos. The expression pattern of Wif1 protein and mRNA was evaluated in normal rat embryos (n=288) and ARM rat embryos (n=306) from GD13 to GD16 using immunohistochemical staining, Western blot, and real time RT-PCR. Results: Immunohistochemical staining revealed that in normal embryos Wif1 was constantly expressed in the cloaca from GD13 to GD16. On GD13 and GD14, Wif1-immunopositive cells were extensively expressed in the cloaca. On GD15, the expression of Wif1 were mainly detected on the very thin anal membrane. In ARM embryos, the epithelium of the hindgut and urorectal septum demonstrated faint immunostaining for Wif1 from GD14 to GD16. Western blot and real time RT-PCR revealed that Wif1 protein and mRNA expression level was significantly decreased in the ARM groups compared with the normal group on GD14 and GD15 (p<0.05).Conclusions: This study demonstrated that the expression pattern of Wif1 was disrupted in ARM embryos during anorectal morphogenesis, which demonstrated thatdownregulation of Wif1 at the time of cloacal separation into the primitive rectum and urogenital septum might related to the development of ARM.The coast of giants: An anthropometric survey of high schoolers on the Adriatic coast of Croatiahttps://peerj.com/preprints/33882017-11-022017-11-02Pavel GrasgruberStipe PrceNikola StračárováEduard HrazdíraJan CacekStevo PopovićSylva HřebíčkováPredrag PotparaIvan Davidovič
The aim of this anthropometric survey was to map regional differences in height and body proportions in eight counties adjacent to the Adriatic coast of Croatia. Body height was measured in 1803 males and 782 females aged 17-20 years at 66 schools in 23 towns. When corrected for population size, average male height in the eight counties is 182.6 cm (182.8 cm in seven counties of Adriatic Croatia and 183.7 cm in four counties of Dalmatia proper). Regional variation is considerable (3.5 cm): from 180.6 cm in the county of Karlovac to 184.1 cm in the county of Split-Dalmacija. The height of females in the eight counties is 168.2 cm (168.3 cm in Adriatic Croatia and 168.5 cm in Dalmatia proper), but it is based on more limited data. The results show that young men from Dalmatia are currently the tallest in the world in the age category of 18 years, and the north-to-south gradient of increasing stature on the Adriatic coast largely mirrors that in Bosnia and Herzegovina (BiH). These parallel changes of height in Croatia and BiH can most likely be explained by unique genetic predispositions that are shared by the local populations of the Dinaric Alps.
The aim of this anthropometric survey was to map regional differences in height and body proportions in eight counties adjacent to the Adriatic coast of Croatia. Body height was measured in 1803 males and 782 females aged 17-20 years at 66 schools in 23 towns. When corrected for population size, average male height in the eight counties is 182.6 cm (182.8 cm in seven counties of Adriatic Croatia and 183.7 cm in four counties of Dalmatia proper). Regional variation is considerable (3.5 cm): from 180.6 cm in the county of Karlovac to 184.1 cm in the county of Split-Dalmacija. The height of females in the eight counties is 168.2 cm (168.3 cm in Adriatic Croatia and 168.5 cm in Dalmatia proper), but it is based on more limited data. The results show that young men from Dalmatia are currently the tallest in the world in the age category of 18 years, and the north-to-south gradient of increasing stature on the Adriatic coast largely mirrors that in Bosnia and Herzegovina (BiH). These parallel changes of height in Croatia and BiH can most likely be explained by unique genetic predispositions that are shared by the local populations of the Dinaric Alps.Geographical differences in the effects of age and height at peak height velocity on final body height: An analysis of a population-based cross-sectional growth curve in Japanhttps://peerj.com/preprints/33812017-10-312017-10-31Masana Yokoya
Background. The aim of this study was to elucidate the effect of geographical differences in the age at peak height velocity (APHV) and height at peak height velocity (HPHV) on final height, at a prefectural level, and to evaluate the current average height status of 47 prefectures in Japan.
Methods. We elucidated the association between the geographical differences in a prefectural-level cross-sectional population-based infancy-childhood-puberty (ICP) growth curve, derived from prefectural mean height data (age: 5-17 years, 2006-2013), APHV and HPHV, for final height.
Results. The correlation between the APHV and final height was very weak; however, the results of a multiple regression analysis showed that the final height of each prefecture can be accurately predicted based on the APHV and HPHV. This result showed that the earlier the APHV and higher the HPHV, the higher the final height. An earlier APHV reduced the height gain in the puberty component; however, this did not reduce the final height.
Discussion. From the perspective of the average value of each prefecture, in the present situation, the effect of an earlier APHV in increasing the amount of growth of the childhood component exceeded its effect in reducing the growth of the puberty component. In short, the final height of the prefectures depends on how large the height growth is in the early stages of childhood. However, the HPHV tended to be region-specific, and it is unlikely that it can increase the average height in this population in the future.
Background. The aim of this study was to elucidate the effect of geographical differences in the age at peak height velocity (APHV) and height at peak height velocity (HPHV) on final height, at a prefectural level, and to evaluate the current average height status of 47 prefectures in Japan.Methods. We elucidated the association between the geographical differences in a prefectural-level cross-sectional population-based infancy-childhood-puberty (ICP) growth curve, derived from prefectural mean height data (age: 5-17 years, 2006-2013), APHV and HPHV, for final height.Results. The correlation between the APHV and final height was very weak; however, the results of a multiple regression analysis showed that the final height of each prefecture can be accurately predicted based on the APHV and HPHV. This result showed that the earlier the APHV and higher the HPHV, the higher the final height. An earlier APHV reduced the height gain in the puberty component; however, this did not reduce the final height.Discussion. From the perspective of the average value of each prefecture, in the present situation, the effect of an earlier APHV in increasing the amount of growth of the childhood component exceeded its effect in reducing the growth of the puberty component. In short, the final height of the prefectures depends on how large the height growth is in the early stages of childhood. However, the HPHV tended to be region-specific, and it is unlikely that it can increase the average height in this population in the future.Reference standards to assess physical fitness of children and adolescents of Brazil: an approach to the students of the lake Itaipú region - Brazilhttps://peerj.com/preprints/32912017-09-272017-09-27Edilson HoboldVitor Pires-LopesRossana Gomez-CamposMiguel ArrudaCynthia Lee AndruskeJaime Pacheco-CarrilloMarco Antonio Cossio-Bolaños
Background.The importance of assessing body fat variables and physical fitness tests play an important role in monitoring the level of activity and physical fitness of the general population. The objective of this study was to develop reference norms to evaluate the physical fitness aptitudes of children and adolescents based on age and sex from the lake region of Itaipú, Brazil. Methods.A descriptive cross-sectional study was carried out with 5,962 students (2938 males and 3,024 females) with an age range of 6.0 and 17.9 years. Weight (kg), height (cm), and triceps (mm), and sub-scapular skinfolds (mm) were measured. Body Mass Index (BMI kg/m2) was calculated. To evaluate the 4 physical fitness aptitude dimensions (morphological, muscular strength, flexibility, and cardio-respiratory), the following physical education tests were given to the students: sit-and-reach (cm), push-ups (rep), standing long jump (cm), and 20-m shuttle run (m). Results and Discussion.Females showed greater flexibility in the sit-and-reach test and greater body fat than the males. No differences were found in BMI. Percentiles were created for the 4 components for the physical fitness aptitudes, BMI, and skinfolds by using the LMS method based on age and sex. The proposed reference values may be used for detecting talents and promoting health in children and adolescents.
Background.The importance of assessing body fat variables and physical fitness tests play an important role in monitoring the level of activity and physical fitness of the general population. The objective of this study was to develop reference norms to evaluate the physical fitness aptitudes of children and adolescents based on age and sex from the lake region of Itaipú, Brazil. Methods.A descriptive cross-sectional study was carried out with 5,962 students (2938 males and 3,024 females) with an age range of 6.0 and 17.9 years. Weight (kg), height (cm), and triceps (mm), and sub-scapular skinfolds (mm) were measured. Body Mass Index (BMI kg/m2) was calculated. To evaluate the 4 physical fitness aptitude dimensions (morphological, muscular strength, flexibility, and cardio-respiratory), the following physical education tests were given to the students: sit-and-reach (cm), push-ups (rep), standing long jump (cm), and 20-m shuttle run (m). Results and Discussion.Females showed greater flexibility in the sit-and-reach test and greater body fat than the males. No differences were found in BMI. Percentiles were created for the 4 components for the physical fitness aptitudes, BMI, and skinfolds by using the LMS method based on age and sex. The proposed reference values may be used for detecting talents and promoting health in children and adolescents.Assessing vision in young children: Communication skillshttps://peerj.com/preprints/30232017-06-142017-06-14Nabin Paudel
Measurement of visual functions is critical to the detection and diagnosis of eye disease, particularly in children where eliciting symptomology can be challenging. An effective practitioner-patient relationship is crucial in optometric practice and has numerous benefits such as increased satisfaction, good compliance to assessment and treatment. The aim of this work is to share my experience of assessing visual functions (visual acuity, stereopsis, and computer-based visual psychophysical testing) in infants and children. I will discuss some unique strategies in order gain attention of children ranging from infants to preschoolers. The importance of the waiting area, use of colorful toys, appropriate use of tests and language are a few among many strategies for getting through a pediatric vision assessment. Based on my 9 years experience as a pediatric optometrist and a child vision researcher, these approaches has been quite successful in conducting hundreds of pediatric vision assessments. A friendly clinician equipped with interesting age appropriate tests and colorful toys along with some essential communication skills can easily conduct a thorough and efficient pediatric vision assessment.
Measurement of visual functions is critical to the detection and diagnosis of eye disease, particularly in children where eliciting symptomology can be challenging. An effective practitioner-patient relationship is crucial in optometric practice and has numerous benefits such as increased satisfaction, good compliance to assessment and treatment. The aim of this work is to share my experience of assessing visual functions (visual acuity, stereopsis, and computer-based visual psychophysical testing) in infants and children. I will discuss some unique strategies in order gain attention of children ranging from infants to preschoolers. The importance of the waiting area, use of colorful toys, appropriate use of tests and language are a few among many strategies for getting through a pediatric vision assessment. Based on my 9 years experience as a pediatric optometrist and a child vision researcher, these approaches has been quite successful in conducting hundreds of pediatric vision assessments. A friendly clinician equipped with interesting age appropriate tests and colorful toys along with some essential communication skills can easily conduct a thorough and efficient pediatric vision assessment.Evidence based pathways to intervention for children with language disordershttps://peerj.com/preprints/29512017-04-272017-04-27Susan H EbbelsElspeth McCartneyVicky SlonimsJulie E DockrellCourtenay Norbury
Background: Paediatric SLT roles often involve planning individualised intervention for specific children (provided directly by SLTs or indirectly through non-SLTs), working collaboratively with families and education staff and providing advice and training. A tiered approach to service delivery is currently recommended, whereby services become increasingly specialised and individualised for children with greater needs.
Aims: To examine 1) evidence of intervention effectiveness for children with language disorders at different tiers and 2) evidence regarding SLT roles; and to propose an evidence-based model of SLT service delivery.
Methods: Controlled, peer-reviewed studies, meta-analyses and systematic reviews of interventions for children with language disorders are reviewed and their outcomes discussed, alongside the differing roles SLTs play in these interventions. We indicate where gaps in the evidence base exist and present a possible model of service delivery consistent with current evidence, and a flowchart to aid clinical decision making.
Main Contribution: The service delivery model presented resembles the tiered model commonly used in education services, but divides individualised (Tier 3) services into Tier3A: indirect intervention delivered by non-SLTs, and Tier 3B: direct intervention by an SLT. We report the evidence for intervention effectiveness and which children might best be served by each tier, the role SLTs could take within each, and the evidence of effectiveness of these roles. Regarding universal interventions provided to all children (Tier 1) and those targeted at children with language weaknesses (Tier 2), there is growing evidence that approaches led by education services can be effective when staff are highly trained and well-supported. There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2. With regard to individualised intervention (Tier 3): children with complex or pervasive language disorders progress significantly following direct individualised intervention (Tier 3B), whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), provided they are well-trained, -supported and -monitored.
Conclusions: SLTs have a contribution to make at all tiers, but where prioritisation for clinical services is a necessity, we need to establish the benefits and cost-effectiveness of each contribution. Good evidence exists for SLTs delivering direct individualised intervention, and we should ensure that this is available to those children with pervasive and/or complex language impairments. In cases where service models are being provided which lack evidence, we strongly recommend that SLTs investigate the effectiveness of their approaches.
Background: Paediatric SLT roles often involve planning individualised intervention for specific children (provided directly by SLTs or indirectly through non-SLTs), working collaboratively with families and education staff and providing advice and training. A tiered approach to service delivery is currently recommended, whereby services become increasingly specialised and individualised for children with greater needs.Aims: To examine 1) evidence of intervention effectiveness for children with language disorders at different tiers and 2) evidence regarding SLT roles; and to propose an evidence-based model of SLT service delivery.Methods: Controlled, peer-reviewed studies, meta-analyses and systematic reviews of interventions for children with language disorders are reviewed and their outcomes discussed, alongside the differing roles SLTs play in these interventions. We indicate where gaps in the evidence base exist and present a possible model of service delivery consistent with current evidence, and a flowchart to aid clinical decision making.Main Contribution: The service delivery model presented resembles the tiered model commonly used in education services, but divides individualised (Tier 3) services into Tier3A: indirect intervention delivered by non-SLTs, and Tier 3B: direct intervention by an SLT. We report the evidence for intervention effectiveness and which children might best be served by each tier, the role SLTs could take within each, and the evidence of effectiveness of these roles. Regarding universal interventions provided to all children (Tier 1) and those targeted at children with language weaknesses (Tier 2), there is growing evidence that approaches led by education services can be effective when staff are highly trained and well-supported. There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2. With regard to individualised intervention (Tier 3): children with complex or pervasive language disorders progress significantly following direct individualised intervention (Tier 3B), whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), provided they are well-trained, -supported and -monitored.Conclusions: SLTs have a contribution to make at all tiers, but where prioritisation for clinical services is a necessity, we need to establish the benefits and cost-effectiveness of each contribution. Good evidence exists for SLTs delivering direct individualised intervention, and we should ensure that this is available to those children with pervasive and/or complex language impairments. In cases where service models are being provided which lack evidence, we strongly recommend that SLTs investigate the effectiveness of their approaches.CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development. Phase 2. Terminologyhttps://peerj.com/preprints/24842017-02-122017-02-12Dorothy V BishopMargaret J SnowlingPaul A ThompsonTrisha Greenhalgh
Background: Lack of agreement about criteria and terminology for children’s language difficulties affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. Methods: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 54 individuals representing a range of professions and nationalities. Results: We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. The term ‘Language Disorder’ was preferred to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (1) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (2) DLD can co-occur with other neurodevelopmental disorders (e.g., ADHD), and (3) DLD does not require a mismatch between verbal and nonverbal ability. Conclusions: This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.
Background: Lack of agreement about criteria and terminology for children’s language difficulties affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. Methods: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 54 individuals representing a range of professions and nationalities. Results: We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. The term ‘Language Disorder’ was preferred to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (1) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (2) DLD can co-occur with other neurodevelopmental disorders (e.g., ADHD), and (3) DLD does not require a mismatch between verbal and nonverbal ability. Conclusions: This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.A simple photographic classification of protruding earshttps://peerj.com/preprints/24262016-09-062016-09-06JA Lopes-Santos
Backgroud: Protruding ear is the most commonly found auricular populational deformity with significant social consequences. The problem is clearly perceptible in frontal facial images, but a simple photographic classification for prominence has not yet been defined. Methods: Frontal facial images of forty patients with protruding ears and 102 controls were prospectively collected. A rectangle was drawn in each ear, involving its full visible anatomy. The height of each rectangle was divided by its width in each ear. Results: Results show a trend for higher values in the protruding ears group when compared to controls for both ears. Discussion: This finding can be useful for the classification of this auricular deformity.
Backgroud: Protruding ear is the most commonly found auricular populational deformity with significant social consequences. The problem is clearly perceptible in frontal facial images, but a simple photographic classification for prominence has not yet been defined. Methods: Frontal facial images of forty patients with protruding ears and 102 controls were prospectively collected. A rectangle was drawn in each ear, involving its full visible anatomy. The height of each rectangle was divided by its width in each ear. Results: Results show a trend for higher values in the protruding ears group when compared to controls for both ears. Discussion: This finding can be useful for the classification of this auricular deformity.Augmenting caregiver in-home safety practices via mHealth: A randomized controlled trialhttps://peerj.com/preprints/23302016-08-032016-08-03Michael L. WilsonHamisi A. Kigwangalla
Unintentional injuries among under-fives represent an important cause of preventable morbidity in Dar es Salaam, Tanzania. In-home interventions targeting caregiver safety practices currently show promise in reducing household injury risks. Mobile health (mHealth) is emerging as a potentially cost effective platform for the delivery of critical health information in resource poor settings. The goal of this project is to introduce an mHealth intervention targeting risk factors for child burn injuries in Dar es Salaam.
Unintentional injuries among under-fives represent an important cause of preventable morbidity in Dar es Salaam, Tanzania. In-home interventions targeting caregiver safety practices currently show promise in reducing household injury risks. Mobile health (mHealth) is emerging as a potentially cost effective platform for the delivery of critical health information in resource poor settings. The goal of this project is to introduce an mHealth intervention targeting risk factors for child burn injuries in Dar es Salaam.Fetus-in-fetu in an 8-month-old girlhttps://peerj.com/preprints/22952016-07-182016-07-18Bei Bei ZhaoYu Zuo Bai
Fetus in fetu (FIF) is a very rare congenital malformation with an incidence of 1/500,000 live births. These children are often hospitalized because of vomiting, abdominal distension or abdominal mass found by their parents. The most common position for the parasitic fetus is the retroperitoneum but other position such as the scrotal sac, cranial cavity, sacrococcygeal region, back , oral cavity has been reported. FIF is often misdiagnosed as a mature teratoma. Ultrasound, CT, MRI are of great significance in distinguishing between FIF and teratoma. The postoperative pathological examination may reveal axial skeleton which can make a definitive diagnosis of FIF. In this report, we present a case of FIF in an 8-month-old girl.
Fetus in fetu (FIF) is a very rare congenital malformation with an incidence of 1/500,000 live births. These children are often hospitalized because of vomiting, abdominal distension or abdominal mass found by their parents. The most common position for the parasitic fetus is the retroperitoneum but other position such as the scrotal sac, cranial cavity, sacrococcygeal region, back , oral cavity has been reported. FIF is often misdiagnosed as a mature teratoma. Ultrasound, CT, MRI are of great significance in distinguishing between FIF and teratoma. The postoperative pathological examination may reveal axial skeleton which can make a definitive diagnosis of FIF. In this report, we present a case of FIF in an 8-month-old girl.