Until recently, pediatric body composition reference data were very limited, hindering interpretation of measurements. In the last decade, such data emerged for several techniques for children ≥ 5 ...years, but equivalent data for younger age groups remain lacking, due to their poor compliance with most techniques.
To provide reference data for use in clinical practice and research from 6 weeks to 5 years, that are based on measurements of total body water (TBW) by isotope dilution.
The data on anthropometry and TBW were available from studies of 463 infants and children aged 6 weeks to 7 years, conducted between 1988 and 2010. Both breast-fed and formula-fed infants were included. TBW was measured by
H- or
O-labeled water, and converted to fat-free mass (FFM) using published hydration coefficients. Reference charts and SD scores (SDS) were constructed for FFM, fat mass (FM), FFM index and FM index for each sex, using the lambda-mu-sigma method.
Both sexes were significantly heavier and longer than UK 1990 reference data (p < 0.01), but did not differ in body mass index SDS. Breast-fed infants were longer than formula-fed infants but did not differ in body composition.
These reference data will enhance the ability of clinicians to assess and monitor body composition and FFM/FM accretion in clinical practice in younger age groups. Total body water can be measured in most patients, though abnormalities of hydration must be addressed. However, the centiles do not overlap exactly with those published for older age groups, limiting comparability between younger and older children.
Manipulation of the gut microbiome offers a promising treatment option for children with autism spectrum disorder (ASD) for whom functional gastrointestinal disorders (FGIDs) are a common ...comorbidity. Both ASD and FGIDs have been linked to dysfunction of the microbiome-gut-brain (MGB) axis. Dysfunction of this bidirectional network has the ability to impact multiple host processes including gastrointestinal (GI) function, mood and behaviour. Prebiotic and probiotic supplementation aims to produce beneficial shifts within the gut environment, resulting in favourable changes to microbial metabolite production and gastrointestinal function. The aim of this review is to investigate the gut microbiome as a therapeutic target for children with ASD. Evidence for the utility of prebiotics, probiotics or synbiotics (i.e., prebiotic + probiotic) among this cohort is examined. Electronic databases (PubMed, Web of Science, Medline and clinicaltrials.gov) were searched using keywords or phrases to review the literature from 1 January 2010 to 30 October 2020. Findings suggest limited, but preliminary evidence of efficacy in relieving GI distress, improving ASD-associated behaviours, altering microbiota composition, and reducing inflammatory potential.
To determine the prevalence of oropharyngeal dysphagia (OPD) and its subtypes (oral phase, pharyngeal phase, saliva control), and their relationship to gross motor functional skills in preschool ...children with cerebral palsy (CP). It was hypothesized that OPD would be present across all gross motor severity levels, and children with more severe gross motor function would have increased prevalence and severity of OPD.
Children with a confirmed diagnosis of CP, 18 to 36 months corrected age, born in Queensland between 2006 and 2009, participated. Children with neurodegenerative conditions were excluded. This was a cross-sectional population-based study. Children were assessed by using 2 direct OPD measures (Schedule for Oral Motor Assessment; Dysphagia Disorders Survey), and observations of signs suggestive of pharyngeal phase impairment and impaired saliva control. Gross motor skills were described by using the Gross Motor Function Measure, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, and motor type/ distribution.
OPD was prevalent in 85% of children with CP, and there was a stepwise relationship between OPD and GMFCS level. There was a significant increase in odds of having OPD, or a subtype, for children who were nonambulant (GMFCS V) compared with those who were ambulant (GMFCS I) (odds ratio = 17.9, P = .036).
OPD was present across all levels of gross motor severity using direct assessments. This highlights the need for proactive screening of all young children with CP, even those with mild impairments, to improve growth and nutritional outcomes and respiratory health.
A decade of research of methicillin-resistant S. aureus (MRSA) in pigs shows that the prevalence and predominant genotypes (i.e., ST398, ST9, ST5) of MRSA vary widely geographically, yet knowledge of ...the epidemiology of S. aureus generally in swine remains rudimentary. To characterize S. aureus, including MRSA, in the US swine industry, we sampled 38 swine herds in 11 states in major swine producing regions. The herds sampled included pigs sourced from 9 different breeding stock companies, and the sample was likely biased towards larger herds that use regular veterinary services. Twenty nasal swabs were collected from 36 groups of growing pigs by 36 swine veterinarians, 2 more herds were sampled opportunistically, and a historically MRSA-positive herd was included as a positive control. S. aureus was detected on 37 of the 38 herds, and in 77% of pigs sampled. Other than the positive control herd, no MRSA were detected in the study sample, yielding a 95% upper confidence limit of 9.3% for MRSA herd prevalence. All but two (ST1-t127; ST2007-t8314) of 1200 isolates belonged to three MLST lineages (ST9, ST398, and ST5) that have been prominent in studies of MRSA in pigs globally. A total of 35 spa types were detected, with the most prevalent being t337 (ST9), t034 (ST398), and t002 (ST5). A purposively diverse subset of 128 isolates was uniformly negative on PCR testing for major enterotoxin genes. The findings support previous studies suggesting a relatively low herd prevalence of MRSA in the US swine industry, but confirm that methicillin susceptible variants of the most common MRSA genotypes found in swine globally are endemic in the US. The absence of enterotoxin genes suggests that the source of toxigenic S. aureus capable of causing foodborne enterotoxicosis from pork products is most likely post-harvest contamination.
This article was originally published under Nature Research’s License to Publish, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the article have been ...modified accordingly.
Parent-centred interventions for childhood obesity aim to improve parents’ skills and confidence in managing children’s dietary and activity patterns, and in promoting a healthy lifestyle in their ...family. However, few studies assess changes in parenting over the course of treatment. This study describes the evaluation of a lifestyle-specific parenting program (Group Lifestyle Triple P) on multiple child and parent outcomes. One-hundred-and-one families with overweight and obese 4- to 11-year-old children participated in an intervention or waitlist control condition. The 12-week intervention was associated with significant reductions in child BMI
z score and weight-related problem behaviour. At the end of the intervention, parents reported increased confidence in managing children’s weight-related behaviour, and less frequent use of inconsistent or coercive parenting practices. All short-term intervention effects were maintained at one-year follow-up assessment, with additional improvements in child body size. The results support the efficacy of Group Lifestyle Triple P and suggest that parenting influences treatment outcomes. Further research is needed to evaluate the long-term effectiveness of the intervention and to elucidate the mechanisms of change.
To compare the incidence of anterior capsular tears after femtosecond laser-assisted cataract surgery (FLACS) versus phacoemulsification cataract surgery (PCS) and to assess the ultrastructural ...features of anterior capsulotomy specimens (FLACS and PCS) using electron microscopy.
Prospective, multicenter, comparative cohort case series.
Consecutive patients undergoing FLACS or PCS.
A prospective cohort study of all patients (n = 1626) undergoing FLACS or PCS by 2 surgeons from centers A and B was undertaken to compare the incidence of anterior capsule tears. Anterior lens capsules were collected by 4 surgeons from centers A, B, C, and D using 3 different commercially available femtosecond platforms, each with latest version upgrades. Lens capsule tissue was prepared for scanning electron microscopy (SEM) using a total of 10 samples for patients undergoing PCS, and 40 samples for patients undergoing FLACS.
Incidence of anterior capsule tear and comparative ultrastructural features of capsular samples from both PCS and FLACS cases.
There was a significantly increased rate of anterior capsule tears in the FLACS group (15/804 1.87%) when compared with the PCS group (1/822 0.12%; P = 0.0002, Fisher exact test). In 7 cases, the anterior capsule tear extended to the posterior capsule. Because all cases had occurred in complete capsulotomy, the integrity of the anterior capsule was questioned in the FLACS group. Subsequent SEM sampling showed irregularity at the capsule margin, as well as multiple apparently misplaced laser pits in normal parts of the tissue. Aberrant pits were approximately 2 to 4 μm apart and occurred at a range of 10 to 100 μm radially from the capsule edge.
Laser anterior capsulotomy integrity seems to be compromised by postage-stamp perforations and additional aberrant pulses, possibly because of fixational eye movements. This can lead to an increased rate of anterior capsule tears, and extra care should be taken during surgery after femtosecond laser pretreatment has been performed. A learning curve may account for some of the increased complication rate with FLACS. However, the SEM features raise safety concerns for capsular integrity after FLACS and warrant further investigation.
Atherosclerosis initiates at predictable focal sites and develops to a spatially regional disease with limited distribution. There is compelling evidence that links haemodynamics to the localized ...origin of atherosclerotic lesions. Arterial flow in vivo is unsteady, dynamically complex, and regionally variable. Sites susceptible to atherosclerosis near arterial branches and curves are associated with regions of disturbed blood flow that contain repetitive phases of flow reversal resulting in steep multidirectional temporal and spatial gradients of wall shear stresses. Endothelium in atherosusceptible regions relative to protected sites shows activation of endoplasmic reticulum (ER) stress and the unfolded protein response (UPR), the altered expression of pro-inflammatory Nuclear Factor kappa B (NFκB) and oxidant/antioxidant pathways, and low expression of major protective factors, notably endothelial nitric oxide synthase and Kruppel-like Factors KLF2 and KLF4. At some atherosusceptible locations, reactive oxygen species levels are significantly elevated. Here we describe flow-related phenotypes identified in steady-state in vivo and outline some of the molecular mechanisms that may contribute to pre-lesional atherosusceptibility as deduced from complementary cell experiments in vitro. We conclude that disturbed flow is a significant local risk factor for atherosclerosis that induces a chronic low-level inflammatory state, an adaptive response to ensure continued function at the expense of increased susceptibility to atherogenesis. Surprisingly, when challenged by short-term hypercholesterolaemia in vivo, atherosusceptible endothelial phenotype was resistant to greater pro-inflammatory expression, suggesting that sustained hyperlipidaemia is required to overcome these protective characteristics.
Several decades back, people’s lives could become extremely limited by having Type One Diabetes, but thankfully, that is not usually the case today. However, I do feel greatly saddened that so many ...people in our world struggle to even get hold of insulin, let alone basic Diabetes equipment. Surely, that cannot be right in this day and age? I see this situation as shameful, as I firmly believe that this condition should never prevent anyone from having a really great life, where they can typically fulfil all their dreams. I certainly have, and I continue to do so. I am immensely grateful for that!
A chronic proinflammatory state precedes pathological change in arterial endothelial cells located within regions of susceptibility to atherosclerosis. The potential contributions of regulatory ...microRNAs to this disequilibrium were investigated by artery site-specific profiling in normal adult swine. Expression of endothelial microRNA10a (miR-10a) was lower in the athero-susceptible regions of the inner aortic arch and aorto-renal branches than elsewhere. Expression of Homeobox A1 (HOXA1), a known miR-10a target, was up-regulated in the same locations. Endothelial transcriptome microarray analysis of miR-10a knockdown in cultured human aortic endothelial cells (HAEC) identified IκB/NF-κB–mediated inflammation as the top category of up-regulated biological processes. Phosphorylation of IκBα, a prerequisite for IκBα proteolysis and NF-κB activation, was significantly up-regulated in miR-10a knockdown HAEC and was accompanied by increased nuclear expression of NF-κB p65. The inflammatory biomarkers monocyte chemotactic protein 1 (MCP-1), IL-6, IL-8, vascular cell adhesion molecule 1 (VCAM-1), and E-selectin were elevated following miR-10a knockdown. Conversely, knockin of miR-10a (a conservative 25-fold increase) inhibited the basal expression of VCAM-1 and E-selectin in HAEC. Two key regulators of IκBα degradation—mitogen-activated kinase kinase kinase 7 (MAP3K7; TAK1) and β-transducin repeat-containing gene (βTRC)—contain a highly conserved miR-10a binding site in the 3' UTR. Both molecules were up-regulated by miR-10a knockdown and suppressed by miR-10a knockin, and evidence of direct miR-10a binding to the 3' UTR was demonstrated by luciferase assay. Comparative expression studies of endothelium located in athero-susceptible aortic arch and athero-protected descending thoracic aorta identified significantly up-regulated MAP3K7, βTRC, phopho-IκBα, and nuclear p65 expression suggesting that the differential expression of miR-10a contributes to the regulation of proinflammatory endothelial phenotypes in athero-susceptible regions in vivo.
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