The Diagnostic and Statistical Manual of Mental Disorders,5th Edition(DSM-5)(American Psychiatric Association,2013)defines autism spectrum disorder(ASD)as a complex neurodevelopmental disorder that begins in early chi...The Diagnostic and Statistical Manual of Mental Disorders,5th Edition(DSM-5)(American Psychiatric Association,2013)defines autism spectrum disorder(ASD)as a complex neurodevelopmental disorder that begins in early childhood and is accompanied by social communication deficits and repetitive stereotyped behaviors.展开更多
Intelligence quotient(IQ)and adaptive behavior are the influencing factors of autism spectrum disorder(ASD)in children entering mainstream schools.This study explored the association between parental education level,I...Intelligence quotient(IQ)and adaptive behavior are the influencing factors of autism spectrum disorder(ASD)in children entering mainstream schools.This study explored the association between parental education level,IQ,and adaptive behavior in ASD groups.A total of 257 school-age ASD children were enrolled in our study from January 2017 to June 2021.Their parents completed a standard demographic form,including age at autism diagnosis,gender,school placement,and parents’educational background.The Chinese version of the Wechsler Intelligence Scale for Children,Fourth Edition(WISC-IV)was completed by a certified assessor for each enrolled child.Parents were interviewed on adaptive behavior using the Chinese version of the Adaptive Behavior Assessment System,Second Edition(ABAS-II).The average IQ of school-age ASD children was 76.88(standard deviation(SD)=22.62)and boys had higher IQ levels than girls.The IQ was positively correlated with age.The General Adaptive Composite(GAC)score was 82.47(SD=15.86)and adaptive behavior did not increase with age.ASD children who attended mainstream schools had better adaptive behavior profiles than other children.The mother’s education level showed a significant correlation with the IQ and adaptive behavior of autistic children,while the father’s education level did not.Consequently,better training and support for parents may help autistic children enter mainstream schools,with adaptive training being the most urgently required skill for parents.展开更多
To the editor:Social communication impairment(SCI)is a core symptom of autism spectrum disorder(ASD),and evidence-based interventions targeting this domain remain limited.In the past decade,repetitive transcranial mag...To the editor:Social communication impairment(SCI)is a core symptom of autism spectrum disorder(ASD),and evidence-based interventions targeting this domain remain limited.In the past decade,repetitive transcranial magnetic stimulation(rTMS),one of the most commonly applied non-invasive neurostimulation techniques,has shown efficacy in treating neuropsychiatric disorders,such as depression.展开更多
Objective To identify the target behavior in the process of behavioral intervention for children with feeding difficulty and relevant factors that may contribute to more effective intervention.Methods Children aged fr...Objective To identify the target behavior in the process of behavioral intervention for children with feeding difficulty and relevant factors that may contribute to more effective intervention.Methods Children aged from 1 to 6 years with feeding difficulty randomly received interactive behavioral intervention(245 cases)or routine primary care(217 cases).By the end of the 1,3,6,and 9 months,the rating score of feeding difficulty and the body mass index(BMI)were assessed.The target behavior was determined based on the selecting criteria that simultaneously satisfied two conditions:①it was relevant to improving children's nutritional status;②it changed fast during intervention.Moreover,the relevant factors of target behavior were analyzed by multivariate analysis(Multi-Way ANOVA).Results Among nine behaviors of feeding difficulty,"eating slowly"was identified as a target behavior because it was closely relevant to the BMI z-score increment and had the biggest score reduction at early stage during intervention.Various factors were relevant to improving the target behavior,including parents acting as caregivers,caregiver's education level equal to and above junior college,and caregiver's concern about their children's feeding difficulty.Conclusion"Eating slowly"should be selected as the target behavior for early intervention for children with feeding difficulty and some social factors should be considered for optimizing the intervention.展开更多
Background Developmental delay(DD)poses challenges to children's overall development,necessitating early detection and intervention.Existing screening tools in China focus mainly on children with developmental iss...Background Developmental delay(DD)poses challenges to children's overall development,necessitating early detection and intervention.Existing screening tools in China focus mainly on children with developmental issues in two or more domains,diagnosed as global developmental delay(GDD).However,the recent rise of early childhood development(ECD)concepts has expanded the focus to include not only those with severe brain development impairments but also children who lag in specific domains due to various social-environmental factors,with the aim of promoting positive development through active intervention.To support this approach,corresponding screening tools need to be developed.Methods The current study used a two-phase design to develop and validate the Parent-Reported Indicator of Developmental Evaluation for Chinese Children(PRIDE)tool.In Phase 1,age-specific milestone forms for PRIDE were created through a survey conducted in urban and rural primary care clinics across four economic regions in China.In Phase 2,PRIDE was validated in a community-based sample.Sensitivity and specificity of both PRIDE and Ages and Stages Questionnaires(ASQ)-3 were estimated using inverse probability weights(IPW)and multiple imputation(MI)to address planned and unplanned missing data.Results In Phase 1 involving a total of 1160 participants aged 1 to 48 months,63 items were selected from the initial item pool to create 10 age-specific PRIDE forms.Our Phase 2 study included 777 children within the same age range.PRIDE demonstrated an estimated sensitivity and specificity of 83.3%[95%confidence interval(CI):56.8%–100.0%]and 84.9%(95%CI:82.8%–86.9%)in the identification of DD.Conclusion The findings suggest that PRIDE holds promise as a sensitive tool for detecting DD in community settings.展开更多
Accurate timing of myelination is crucial for the proper functioning of the central nervous system. Here, we identified a de novo heterozygous mutation in TMEM63A (c.1894G>A;p. Ala632Thr) in a 7-year-old boy exhibi...Accurate timing of myelination is crucial for the proper functioning of the central nervous system. Here, we identified a de novo heterozygous mutation in TMEM63A (c.1894G>A;p. Ala632Thr) in a 7-year-old boy exhibiting hypomyelination. A Ca2+ influx assay suggested that this is a loss-of-function mutation. To explore how TMEM63A deficiency causes hypomyelination, we generated Tmem63a knockout mice. Genetic deletion of TMEM63A resulted in hypomyelination at postnatal day 14 (P14) arising from impaired differentiation of oligodendrocyte precursor cells (OPCs). Notably, the myelin dysplasia was transient, returning to normal levels by P28. Primary cultures of Tmem63a^(−/−) OPCs presented delayed differentiation. Lentivirus-based expression of TMEM63A but not TMEM63A_A632T rescued the differentiation of Tmem63a^(−/−) OPCs in vitro and myelination in Tmem63a^(−/−) mice. These data thus support the conclusion that the mutation in TMEM63A is the pathogenesis of the hypomyelination in the patient. Our study further demonstrated that TMEM63A-mediated Ca^(2+) influx plays critical roles in the early development of myelin and oligodendrocyte differentiation.展开更多
Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based c...Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based cross-sectional studies have been conducted in East African countries to assess the prevalence of OM;however, no similar studies have been conducted in Somalia. Therefore, we conducted a hospital-based cross-sectional study to identify the prevalence and the underlying risk factors of OM among children under the age of five in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted from July 2022 to November 2022 at three main hospitals in Mogadishu, Somalia. A total of 384 children aged less than 5 years were included. Parents of these children were interviewed with a questionnaire and a clinical examination was performed for each child. The Statistical Package for Social Sciences, SPSS (Version 22, IBM, Inc.), was used for the statistical analysis. Result: The prevalence of otitis media among the 384 children recruited was 31.25% (120/384). Otitis media was significantly associated with age less than one year (P = 0.006), malnutrition (P Conclusion: In summary, the present study found that otitis media was highly prevalent (31.25%) in Mogadishu, Somalia. The majority of the affected children were younger than one year. Age of the child, malnutrition, upper respiratory tract infections, feeding in lying position, and dripping something into a child’s ear were found to significantly increase the risk of developing otitis media in children. In contrast, breastfeeding for more than one year has been found to reduce the risk of developing otitis media in children.展开更多
Spinal muscular atrophy(SMA)is a fatal and disabling hereditary disease characterized by progressive motor dysfunction caused by survival motor neuron 1(SMN1)gene deletion or mutation[1].Childhood-onset SMA is typical...Spinal muscular atrophy(SMA)is a fatal and disabling hereditary disease characterized by progressive motor dysfunction caused by survival motor neuron 1(SMN1)gene deletion or mutation[1].Childhood-onset SMA is typically classified into types 1-3,with types 2 and 3 referred to as later-onset SMA[2].Nusinersen,the first drug approved as a disease-modifying therapy(DMT)for SMA[3],is an antisense oligonucleotide that promotes increased production of the full-length SMN protein by modifying pre-messenger RNA splicing of the SMN2 gene to improve the function of motor neurons and alleviate disease symptoms[4].展开更多
Universal newborn hearing screening(UNHS)is recognized as the most effective strategy for early detection of congenital hearing loss;however,screening coverage remains inadequate in many countries.In China,newborn hea...Universal newborn hearing screening(UNHS)is recognized as the most effective strategy for early detection of congenital hearing loss;however,screening coverage remains inadequate in many countries.In China,newborn hearing screening has been implemented for over two decades.To evaluate our policies and practices during this period and assess resource equity,health impacts,and future challenges,we conducted a nationwide survey focusing on newborn hearing screening coverage,the number of special schools for deaf-mutes,and the proportion of hearing-impaired students in mainstream education.From 2001 to 2020,China’s UNHS program coverage increased from 10.9%to 94.3%,while the proportion of hearing-impaired students in mainstream education rose from 24.8%to 57.5%.Concurrently,the number of hearing-impaired students in special schools decreased from 76,554 to 34,945,and the number of special schools for deaf-mutes declined from 639 to 389.Through the implementation of the UNHS program,China has made substantial progress in improving newborn hearing health,yielding long-term benefits for those with congenital hearing loss.However,targeted resource allocation and the establishment of a national platform remain priorities for future development.Our experience may provide valuable insights for similar settings.展开更多
Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder （ADHD） showed difficulties in neuropsychologicat function. This study aimed to assess neuropsychological function in Chin...Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder （ADHD） showed difficulties in neuropsychologicat function. This study aimed to assess neuropsychological function in Chinese preschoolers with ADHD using broad neuropsychological measures and rating scales and to test whether the pattern and severity of neuropsyehological weakness differed among ADH D presentations in preschool children. Methods： The 226 preschoolers （163 with ADHD and 63 controls） with the age of 4-5 years were included and assessed using the Behavior Rating Scale of Executive Function-Preschool Version （BRIEF-P） and a series of tests to investigate neuropsychological function. Results： Preschoolers with ADHD showed higher scorns in all domains of the BRIEF-P （inhibition： 30.64 ± 5.78 vs.20.69 ± 3.86, P 〈 0.001; shift： 13.40 ±3.03 vs. 12.41 ±2.79, P = 0.039; emotional control：15.10 ±3.53 vs.12.20 ±2.46, P 〈 0.001; working memory： 28.41± 4.99 vs.20.95± 4.60, P 〈 0.001 ; plan/organize： 17.04 ±3.30 vs. 13.29± 2.40, P 〈 0.001 ） and lower scores of Statue （23.18± 7.84 vs.28.27 ± 3.18, P = 0.001 ）, Word Generation （ 15.22 ± 6.52 vs. 19.53 ± 7.69, P = 0.025）, Comprehension of Instructions （ 14.00 ±4.44 vs. 17.02± 3.39, P = 0.016）, Visuomotor Precision （P 〈 0.050）, Toy delay （P = 0.048）, and Matrices tasks （P = 0.011）, compared with normal control. In terms of the differences among ADHD subtypes, all ADHD presentations had higher scores in several domains of the BRIEF-P （P 〈 0.001 ）, and the ADHD-combined symptoms （ADHD-C） group had the poorest ratings on inhibition and the ability to Plan/Organize. For neuropsychological measures, the results suggested that the ADHD-C group had poorer pertbrmances than the ADHD-predominantly inattentive symptoms （ADHD-I） group on Statue tasks （F = 7.34, η2= 0.12, P 〈 0.001 ）. Furthermore, the ADHD-hyperactive/impulsive symptoms group had significantly poorer perforulances compared to the ADHD-C group in the Block Construction task （F = 4.89, η2 = 0.067, P = 0.003）. However, no significant group differences were found between the ADHD-I group and normal control. Conclusion： Based on the combined evaluation of performance-based neuropsychological tests and the BRIEF-P, preschoolers with ADHD show difficulties of neuropsychological function in many aspects.展开更多
Why Was the Cohort Set Up?Autism spectrum disorder(ASD)is a child neurodevelopmental disorder,the onset of which is generally within 3 years of age,and often leads to lifelong impaired social and cognitive functions,w...Why Was the Cohort Set Up?Autism spectrum disorder(ASD)is a child neurodevelopmental disorder,the onset of which is generally within 3 years of age,and often leads to lifelong impaired social and cognitive functions,which impose significant mental pressure and economic burdens on the family and society.展开更多
Background Sleep problems in children have been increasingly recognized as a major public health issue.Previous research has extensively studied and presented many risk factors and potential mechanisms for children’s...Background Sleep problems in children have been increasingly recognized as a major public health issue.Previous research has extensively studied and presented many risk factors and potential mechanisms for children’s sleep problems.In this paper,we aimed to identify and summarize the consequences and implications of child sleep problems.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info published in the past two decades.Both relevant data-based articles and systematic reviews are included.Results Many adverse consequences are associated with child sleep deficiency and other sleep problems,including physical outcomes(e.g.,obesity),neurocognitive outcomes(e.g.,memory and attention,intelligence,academic performance),and emotional and behavioral outcomes(e.g.,internalizing/externalizing behaviors,behavioral disorders).Current prevention and intervention approaches to address childhood sleep problems include nutrition,exercise,cognitive–behavioral therapy for insomnia,aromatherapy,acupressure,and mindfulness.These interventions may be particularly important in the context of coronavirus disease 2019.Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments.Conclusions Given the increasing prevalence of child sleep problems,which have been shown to affect children’s physical and neurobehavioral wellbeing,understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention,thus improving sleep-related child development and health.展开更多
It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organizat...It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organization(WHO),there were over 656 million confirmed cases of COVID-19 in the world as of January 1,2023,including over 6.6 million deaths[1].展开更多
Objective:To compare the immediate effects of electroacupuncture(EA)and body acupuncture(BA)on gastrocnemius muscle tone in children with spastic cerebral palsy(CP).Methods:Children with spastic CP,age from 24 to 60 m...Objective:To compare the immediate effects of electroacupuncture(EA)and body acupuncture(BA)on gastrocnemius muscle tone in children with spastic cerebral palsy(CP).Methods:Children with spastic CP,age from 24 to 60 months,who all received rehabilitation treatment in the Department of Developmental and Behavioral Pediatrics,the First Hospital of Jilin University from April 2016 to May 2017 were enrolled in this trial and assigned to EA group and BA group through a random number table.Both EA and BA therapies were performed on acupoints of Zusanli(ST 36),Shangjuxu(ST 37),Sanyinjiao(SP 6),and Xuanzhong(GB 39)for 30 min once.The root mean square(RMS),integrated electromyogram(iEMG)of the gastrocnemius of surface electromyography(sEMG),and Modified Tardieu Scale(MTS)of the two groups were evaluated before and after treatment.All adverse events were accurately recorded.Results:Thirty-six children with spastic CP completed the study(18 cases and 32 legs in the EA group;18 cases and 31 legs in the BA group).There was no significant difference in RMS,iEMG and MTS between the two groups before treatment(P>0.05).After treatment,compared with before treatment,RMS and iEMG significantly reduced and MTS(R2–R1)significantly increased in both EA and BA groups(P<0.05),and EA was more effective than BA in RMS and MTS(P<0.05).However,the iEMG between the two groups were not statistically significant after treatment(P>0.05).There was no serious adverse event during this clinical trial.Conclusion:Both EA and BA could significantly relieve the gastrocnemius muscle tone in spastic CP,and EA was more effective than BA.展开更多
Autism spectrum disorders (ASDs) are a group of neurodevelopmentaldisorders featured by social communicationand interaction deficits, and with limited interests andrepetitive behaviors. In China, ASDs was first report...Autism spectrum disorders (ASDs) are a group of neurodevelopmentaldisorders featured by social communicationand interaction deficits, and with limited interests andrepetitive behaviors. In China, ASDs was first reported byTao from Nanjing Brain Hospital in the early 1980s [ 1 , 2 ].Since then, more children with autism have been diagnosed.While the past more than 30 years have witnessed steadygrowth in ASD research and clinical diagnosis and interventionin China, there are still many challenges to overcome.In this article, we will present the current status of prevalence,screening and diagnosis of ASD in China and proposefurther eff orts for practitioners and policy-makers to secureoptimal outcomes for children with ASD.展开更多
Background This study aimed to explore the relationship of 25-hydroxyvitamin D[25(OH)D]in three trimesters and at birth with neurodevelopment at 24 months of age.Methods From 2013 to 2016,pregnant women from the Shang...Background This study aimed to explore the relationship of 25-hydroxyvitamin D[25(OH)D]in three trimesters and at birth with neurodevelopment at 24 months of age.Methods From 2013 to 2016,pregnant women from the Shanghai Birth Cohort in China were recruited for the study.Altogether,649 mother-infant pairs were included.Serum 25(OH)D was measured with mass spectrometry in three trimesters,and cord blood was divided into deficiency(<20 and<12 ng/mL,respectively),insufficiency(20–30 and 12–20 ng/mL,respectively),and sufficiency(≥30 and≥20 ng/mL,respectively).Bayley-III scale was used to assess cognitive,language,motor,social-emotional,and adaptive behavior development at 24 months of age.The Bayley-III scores were grouped into quartiles,and scores within the lowest quartile were defined as suboptimal development.Results After adjusting for confounding factors,cord blood 25(OH)D in the sufficient group was positively correlated with cognitive[β=11.43,95%confidence interval(CI)=5.65–17.22],language(β=6.01,95%CI=1.67–10.3),and motor scores(β=6.43,95%CI=1.73–11.1);cord blood 25(OH)D in the insufficient group was also positively correlated with cognitive scores(β=9.42,95%CI=3.74–15.11).Additionally,sufficient vitamin D status in the four periods and persistent 25(OH)D≥30 ng/mL throughout pregnancy were associated with a lower risk of suboptimal cognitive development in adjusted models,although the effects were attenuated after applying the false discovery rate adjustment.Conclusions Cord blood 25(OH)D≥12 ng/mL has a significant positive association with cognitive,language,and motor development at 24 months of age.Sufficient vitamin D status in pregnancy might be a protective factor for suboptimal neurocognition development at 24 months of age.展开更多
Background:Despite the current obesity pandemic,childhood malnutrition remains an urgent,public health concern.Similar to the obesity pandemic,childhood malnutrition is influenced by genetic and a number of social,env...Background:Despite the current obesity pandemic,childhood malnutrition remains an urgent,public health concern.Similar to the obesity pandemic,childhood malnutrition is influenced by genetic and a number of social,environmental and biological factors.In this study,we investigated the association between sleep duration and somatic growth in lean children.Methods:A stratified,randomly clustered sampling design was used to select fifth grade students from 10 primary schools in Shanghai.Based on a body mass index below the 15th percentile a subsample of 143 lean children aged 10-11 years old was defi ned.Sleep duration and other potential confounders were surveyed through parental or self-report questionnaires.Body measurements were collected and used to calculate the Z score of weight,height,body mass index as well as body fat percentage.Results:Compared with children who slept<9 hours,those who slept for≥10 hours grew taller and gained more weight after adjusting for confounding factors.When children slept 9-10 hours,they had signifi cantly higher Z score of weight and body mass index.Conclusions:Prolonged sleep not only benefi ts weight gain but also improves height in lean children.Our findings might provide important public health advice such that prolonged sleep may be an effective modifi er of nutritional problems in childhood.展开更多
Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sam...Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sample of preschool children was included in this study.The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma.Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma.Results Of 6389 preschool children who were invited to take part in this study,6163(response rate:96.5%)completed the questionnaire and were included in the analysis.The overall prevalence of asthma was 14.6%which increased more than six folds from 2.1%in 1990.Being male,younger age,preterm delivery,being born in spring or autumn,being delivered by elective cesarean section without indication,miscarriage,high socioeconomic status,having allergy history,and exposure to passive smoking,latex paint,and dust were potential risk factors for childhood asthma.Spending more time outdoors(>30 min/day),having indoor plants,and cleaning rooms more frequently were potential protective factors.Conclusions The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades.The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities.展开更多
Monkeypox is a zoonotic disease.Since the first human monkeypox case was detected in 1970,it has been prevalent in some countries in central and western Africa.Since May 2022,monkeypox cases have been reported in more...Monkeypox is a zoonotic disease.Since the first human monkeypox case was detected in 1970,it has been prevalent in some countries in central and western Africa.Since May 2022,monkeypox cases have been reported in more than 96 non-endemic countries and regions worldwide.As of September 14,2022,there have been more than 58,200 human monkeypox cases,and there is community transmission.The cessation of smallpox vaccination in 1980,which had some cross-protection with monkeypox,resulted in a general lack of immunity to monkeypox,which caused global concern and vigilance.As of Sep-tember 14,2022,there are four monkeypox cases in China,including three in Taiwan province and one in Hong Kong city.Previous foreign studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians'understanding of monkeypox and achieve early detection,early diagno-sis,early treatment,and early disposal,we have organized national authoritative experts in pediatric infection,respiratory,dermatology,critical care medicine,infectious diseases,and public health and others to formulate this expert consensus,on the basis of the latest"Clinical management and infection prevention and control for monkeypox"released by The World Health Organization,the"guidelines for diagnosis and treatment of monkeypox(version 2022)"issued by National Health Commission of the People's Republic of China and other relevant documents.During the development of this consensus,multidisciplinary experts have repeatedly demonstrated the etiology,epidemiology,transmission,clinical manifestations,laboratory examinations,diagnosis,differential diagnosis,treatment,discharge criteria,prevention,disposal process,and key points of prevention and control of suspected and confirmed cases.展开更多
Background Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia.We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in l...Background Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia.We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in long-term child health.Methods Data from the Collaborative Perinatal Project,a longitudinal birth cohort with 54,371 singleton births,were used.401 recurrent macrosomic infants (macro-macro) and 1327 normal weight babies with a macrosomia in the last pregnancy (macro-normal) were selected to explore risk factors for recurrent macrosomia.Furthermore,768 newly onset macrosomia with normal birthweight infant in previous pregnancies (normal-macro) were identified to examine long-term health effects of recurrent macrosomia.Results The recurrent rate of macrosomia was 23.2% [95% confidence interval (CI) 21.2%,25.2%].White race,higher pre-pregnant body mass index (BMI),more gestational weight gain,male infant and more prior macrosomic infants were significant risk factors for recurrent macrosomia.At 4 years of age,recurrent macrosomic infants had a higher BMI (16.7 vs.16.1 kg/m2,adjusted fβ:0.36,95% CI:0.12,0.60) and a higher risk of overweight and obesity (adjusted OR:1.56,95% CI:1.10,2.23) than infants with normal birthweight after a previous macrosomic sibling.There was no significant difference between recurrent macrosomia and newly onset macrosomia in child outcomes after adjustment for covariates.Conclusions Fetal macrosomia has a high recurrence rate in the following pregnancy.Higher maternal pre-pregnant BMI and gestational weight gain are still important risk factors for recurrence of macrosomia,which in turn increases the risk for childhood obesity.展开更多
基金supported by the Zhejiang Provincial Natural Science Foundation of China(No.LTGY24H090005)the Autism Research Special Fund of Zhejiang Foundation for Disabled Persons(No.2023006)。
文摘The Diagnostic and Statistical Manual of Mental Disorders,5th Edition(DSM-5)(American Psychiatric Association,2013)defines autism spectrum disorder(ASD)as a complex neurodevelopmental disorder that begins in early childhood and is accompanied by social communication deficits and repetitive stereotyped behaviors.
基金supported by the Zhejiang Provincial Natural Science Foundation of China(No.LGF20H090015)。
文摘Intelligence quotient(IQ)and adaptive behavior are the influencing factors of autism spectrum disorder(ASD)in children entering mainstream schools.This study explored the association between parental education level,IQ,and adaptive behavior in ASD groups.A total of 257 school-age ASD children were enrolled in our study from January 2017 to June 2021.Their parents completed a standard demographic form,including age at autism diagnosis,gender,school placement,and parents’educational background.The Chinese version of the Wechsler Intelligence Scale for Children,Fourth Edition(WISC-IV)was completed by a certified assessor for each enrolled child.Parents were interviewed on adaptive behavior using the Chinese version of the Adaptive Behavior Assessment System,Second Edition(ABAS-II).The average IQ of school-age ASD children was 76.88(standard deviation(SD)=22.62)and boys had higher IQ levels than girls.The IQ was positively correlated with age.The General Adaptive Composite(GAC)score was 82.47(SD=15.86)and adaptive behavior did not increase with age.ASD children who attended mainstream schools had better adaptive behavior profiles than other children.The mother’s education level showed a significant correlation with the IQ and adaptive behavior of autistic children,while the father’s education level did not.Consequently,better training and support for parents may help autistic children enter mainstream schools,with adaptive training being the most urgently required skill for parents.
基金supported by grants from the National Natural Science Foundation of China(82125032,81930095,82204048 and 81761128035)the Science and Technology Commission of Shanghai Municipality(19410713500 and 2018SHZDZX01)+3 种基金the Foundation of Shanghai Municipal Commission of Health and Family Planning(GWV-10.1-XK07,2020CXJQ01 and 2018YJRC03)the Shanghai Clinical Key Subject Construction Project(shslczdzk02902)the Innovative Research Team of High-Level Local Universities in Shanghai(SHSMU-ZDCX20211100)the Guangdong Key Project(2018B030335001).
文摘To the editor:Social communication impairment(SCI)is a core symptom of autism spectrum disorder(ASD),and evidence-based interventions targeting this domain remain limited.In the past decade,repetitive transcranial magnetic stimulation(rTMS),one of the most commonly applied non-invasive neurostimulation techniques,has shown efficacy in treating neuropsychiatric disorders,such as depression.
基金Science and Technology Commission of Shanghai Municipality(14411969200,10DZ2272200,09DZ2200900,10PJ1407500,10PJ1403500,10231203903,10JC1411200)Ministry of Education of China(NCET program)+4 种基金National Natural Science Foundation of China(81000592,11001084)Shanghai Municipal Education Commission(11ZZ103)Shanghai Municipal Health Bureau(2010004)Morning Star Rewarding Fund of Shanghai Jiao Tong University(Category B,2011)New Bairen Plan of Shanghai Jiao Tong University School of Medicine,and Shanghai Health Municipal Bureau Three-year Action(GWⅢ-27.3)
文摘Objective To identify the target behavior in the process of behavioral intervention for children with feeding difficulty and relevant factors that may contribute to more effective intervention.Methods Children aged from 1 to 6 years with feeding difficulty randomly received interactive behavioral intervention(245 cases)or routine primary care(217 cases).By the end of the 1,3,6,and 9 months,the rating score of feeding difficulty and the body mass index(BMI)were assessed.The target behavior was determined based on the selecting criteria that simultaneously satisfied two conditions:①it was relevant to improving children's nutritional status;②it changed fast during intervention.Moreover,the relevant factors of target behavior were analyzed by multivariate analysis(Multi-Way ANOVA).Results Among nine behaviors of feeding difficulty,"eating slowly"was identified as a target behavior because it was closely relevant to the BMI z-score increment and had the biggest score reduction at early stage during intervention.Various factors were relevant to improving the target behavior,including parents acting as caregivers,caregiver's education level equal to and above junior college,and caregiver's concern about their children's feeding difficulty.Conclusion"Eating slowly"should be selected as the target behavior for early intervention for children with feeding difficulty and some social factors should be considered for optimizing the intervention.
基金National Natural Science Foundation of China(823B2087)Shanghai Municipal Health Commission(GWVI-11.2-XD16)+1 种基金National Natural Science Foundation of China Joint Fund Project(U23A20170)Shanghai Municipal Health Commission(Child Neurological and Psychological Development Screening and Intervention Project),Shanghai Key Laboratory of Child Brain and Development(24dz2260100).
文摘Background Developmental delay(DD)poses challenges to children's overall development,necessitating early detection and intervention.Existing screening tools in China focus mainly on children with developmental issues in two or more domains,diagnosed as global developmental delay(GDD).However,the recent rise of early childhood development(ECD)concepts has expanded the focus to include not only those with severe brain development impairments but also children who lag in specific domains due to various social-environmental factors,with the aim of promoting positive development through active intervention.To support this approach,corresponding screening tools need to be developed.Methods The current study used a two-phase design to develop and validate the Parent-Reported Indicator of Developmental Evaluation for Chinese Children(PRIDE)tool.In Phase 1,age-specific milestone forms for PRIDE were created through a survey conducted in urban and rural primary care clinics across four economic regions in China.In Phase 2,PRIDE was validated in a community-based sample.Sensitivity and specificity of both PRIDE and Ages and Stages Questionnaires(ASQ)-3 were estimated using inverse probability weights(IPW)and multiple imputation(MI)to address planned and unplanned missing data.Results In Phase 1 involving a total of 1160 participants aged 1 to 48 months,63 items were selected from the initial item pool to create 10 age-specific PRIDE forms.Our Phase 2 study included 777 children within the same age range.PRIDE demonstrated an estimated sensitivity and specificity of 83.3%[95%confidence interval(CI):56.8%–100.0%]and 84.9%(95%CI:82.8%–86.9%)in the identification of DD.Conclusion The findings suggest that PRIDE holds promise as a sensitive tool for detecting DD in community settings.
基金supported by grants from the National Key R&D Program of China(2019YFA0801603)the Guangdong High Level Innovation Research Institute(2021B0909050004)+2 种基金the National Natural Science Foundation of China(32330044,32170951,82201615,and 82101393)the Natural Science Foundation of Jiangsu Province(BK20201255 and BK20210008)the Fundamental Research Funds for the Central Universities(021414380533).
文摘Accurate timing of myelination is crucial for the proper functioning of the central nervous system. Here, we identified a de novo heterozygous mutation in TMEM63A (c.1894G>A;p. Ala632Thr) in a 7-year-old boy exhibiting hypomyelination. A Ca2+ influx assay suggested that this is a loss-of-function mutation. To explore how TMEM63A deficiency causes hypomyelination, we generated Tmem63a knockout mice. Genetic deletion of TMEM63A resulted in hypomyelination at postnatal day 14 (P14) arising from impaired differentiation of oligodendrocyte precursor cells (OPCs). Notably, the myelin dysplasia was transient, returning to normal levels by P28. Primary cultures of Tmem63a^(−/−) OPCs presented delayed differentiation. Lentivirus-based expression of TMEM63A but not TMEM63A_A632T rescued the differentiation of Tmem63a^(−/−) OPCs in vitro and myelination in Tmem63a^(−/−) mice. These data thus support the conclusion that the mutation in TMEM63A is the pathogenesis of the hypomyelination in the patient. Our study further demonstrated that TMEM63A-mediated Ca^(2+) influx plays critical roles in the early development of myelin and oligodendrocyte differentiation.
文摘Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based cross-sectional studies have been conducted in East African countries to assess the prevalence of OM;however, no similar studies have been conducted in Somalia. Therefore, we conducted a hospital-based cross-sectional study to identify the prevalence and the underlying risk factors of OM among children under the age of five in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted from July 2022 to November 2022 at three main hospitals in Mogadishu, Somalia. A total of 384 children aged less than 5 years were included. Parents of these children were interviewed with a questionnaire and a clinical examination was performed for each child. The Statistical Package for Social Sciences, SPSS (Version 22, IBM, Inc.), was used for the statistical analysis. Result: The prevalence of otitis media among the 384 children recruited was 31.25% (120/384). Otitis media was significantly associated with age less than one year (P = 0.006), malnutrition (P Conclusion: In summary, the present study found that otitis media was highly prevalent (31.25%) in Mogadishu, Somalia. The majority of the affected children were younger than one year. Age of the child, malnutrition, upper respiratory tract infections, feeding in lying position, and dripping something into a child’s ear were found to significantly increase the risk of developing otitis media in children. In contrast, breastfeeding for more than one year has been found to reduce the risk of developing otitis media in children.
基金supported by the National Natural Science Foundation of China(grant number:82271735).
文摘Spinal muscular atrophy(SMA)is a fatal and disabling hereditary disease characterized by progressive motor dysfunction caused by survival motor neuron 1(SMN1)gene deletion or mutation[1].Childhood-onset SMA is typically classified into types 1-3,with types 2 and 3 referred to as later-onset SMA[2].Nusinersen,the first drug approved as a disease-modifying therapy(DMT)for SMA[3],is an antisense oligonucleotide that promotes increased production of the full-length SMN protein by modifying pre-messenger RNA splicing of the SMN2 gene to improve the function of motor neurons and alleviate disease symptoms[4].
基金Supported by National Natural Science Foundation of China(81730028,82371141,81800899)Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases Grant(14DZ2260300)+6 种基金Collaborative Innovation Project of Translational Medicine from Shanghai Jiao Tong University School of Medicine(TM202011)Shanghai Key Clinical Discipline(shlczdzk00802)Clinical Research Plan of SHDC(SHDC2020CR1044B)Biobank program of Shanghai ninth people’s hospital,Shanghai Jiao Tong University School of Medicine(YBKA202205)Clinical Research Program of Shanghai Municipal Health Commission Health(202240003)Shanghai Natural Science Foundation(23ZR1437100)Fundamental research program funding of Ninth People’s Hospital affiliated to Shanghai Jiao Tong university School of Medicine(JYZZ260).
文摘Universal newborn hearing screening(UNHS)is recognized as the most effective strategy for early detection of congenital hearing loss;however,screening coverage remains inadequate in many countries.In China,newborn hearing screening has been implemented for over two decades.To evaluate our policies and practices during this period and assess resource equity,health impacts,and future challenges,we conducted a nationwide survey focusing on newborn hearing screening coverage,the number of special schools for deaf-mutes,and the proportion of hearing-impaired students in mainstream education.From 2001 to 2020,China’s UNHS program coverage increased from 10.9%to 94.3%,while the proportion of hearing-impaired students in mainstream education rose from 24.8%to 57.5%.Concurrently,the number of hearing-impaired students in special schools decreased from 76,554 to 34,945,and the number of special schools for deaf-mutes declined from 639 to 389.Through the implementation of the UNHS program,China has made substantial progress in improving newborn hearing health,yielding long-term benefits for those with congenital hearing loss.However,targeted resource allocation and the establishment of a national platform remain priorities for future development.Our experience may provide valuable insights for similar settings.
文摘Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder （ADHD） showed difficulties in neuropsychologicat function. This study aimed to assess neuropsychological function in Chinese preschoolers with ADHD using broad neuropsychological measures and rating scales and to test whether the pattern and severity of neuropsyehological weakness differed among ADH D presentations in preschool children. Methods： The 226 preschoolers （163 with ADHD and 63 controls） with the age of 4-5 years were included and assessed using the Behavior Rating Scale of Executive Function-Preschool Version （BRIEF-P） and a series of tests to investigate neuropsychological function. Results： Preschoolers with ADHD showed higher scorns in all domains of the BRIEF-P （inhibition： 30.64 ± 5.78 vs.20.69 ± 3.86, P 〈 0.001; shift： 13.40 ±3.03 vs. 12.41 ±2.79, P = 0.039; emotional control：15.10 ±3.53 vs.12.20 ±2.46, P 〈 0.001; working memory： 28.41± 4.99 vs.20.95± 4.60, P 〈 0.001 ; plan/organize： 17.04 ±3.30 vs. 13.29± 2.40, P 〈 0.001 ） and lower scores of Statue （23.18± 7.84 vs.28.27 ± 3.18, P = 0.001 ）, Word Generation （ 15.22 ± 6.52 vs. 19.53 ± 7.69, P = 0.025）, Comprehension of Instructions （ 14.00 ±4.44 vs. 17.02± 3.39, P = 0.016）, Visuomotor Precision （P 〈 0.050）, Toy delay （P = 0.048）, and Matrices tasks （P = 0.011）, compared with normal control. In terms of the differences among ADHD subtypes, all ADHD presentations had higher scores in several domains of the BRIEF-P （P 〈 0.001 ）, and the ADHD-combined symptoms （ADHD-C） group had the poorest ratings on inhibition and the ability to Plan/Organize. For neuropsychological measures, the results suggested that the ADHD-C group had poorer pertbrmances than the ADHD-predominantly inattentive symptoms （ADHD-I） group on Statue tasks （F = 7.34, η2= 0.12, P 〈 0.001 ）. Furthermore, the ADHD-hyperactive/impulsive symptoms group had significantly poorer perforulances compared to the ADHD-C group in the Block Construction task （F = 4.89, η2 = 0.067, P = 0.003）. However, no significant group differences were found between the ADHD-I group and normal control. Conclusion： Based on the combined evaluation of performance-based neuropsychological tests and the BRIEF-P, preschoolers with ADHD show difficulties of neuropsychological function in many aspects.
基金This insight article was supported by the National Natural Science Foundation of China(82125032,81901826,81930095,81761128035,81873909,and 82001771)the Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)+6 种基金the Natural Science Foundation of Shanghai Municipality(19ZR1405600 and 20ZR1404900)the Science and Technology Commission of Shanghai Municipality(19410713500 and 2018SHZDZX01)the Shanghai Municipal Commission of Health and Family Planning(GWV-10.1-XK07,2020CXJQ01,and 2018YJRC03)the Shanghai Clinical Key Subject Construction Project(shslczdzk02902)the Guangdong Key Project(2018B030335001)the China Medical Board Open Competition Program(CMB#21-418)ZJLab,and Shanghai Center for Brain Science and Brain-inspired Technology.
文摘Why Was the Cohort Set Up?Autism spectrum disorder(ASD)is a child neurodevelopmental disorder,the onset of which is generally within 3 years of age,and often leads to lifelong impaired social and cognitive functions,which impose significant mental pressure and economic burdens on the family and society.
基金funded by the National Institute of Child Health and Development(NIH/NICHD R01-HD087485)supported by the National Natural Science Foundation of China(Nos.82073568,82071493)+2 种基金Innovative Research Team of High-level Local Universities in Shanghai(Nos.SHSMUZDCX20211100,20211900)Science and Technology Commission of Shanghai Municipality(No.2018SHZDZX05)Shanghai Municipal Health Commission(Nos.2022XD056,2020CXJQ01).
文摘Background Sleep problems in children have been increasingly recognized as a major public health issue.Previous research has extensively studied and presented many risk factors and potential mechanisms for children’s sleep problems.In this paper,we aimed to identify and summarize the consequences and implications of child sleep problems.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info published in the past two decades.Both relevant data-based articles and systematic reviews are included.Results Many adverse consequences are associated with child sleep deficiency and other sleep problems,including physical outcomes(e.g.,obesity),neurocognitive outcomes(e.g.,memory and attention,intelligence,academic performance),and emotional and behavioral outcomes(e.g.,internalizing/externalizing behaviors,behavioral disorders).Current prevention and intervention approaches to address childhood sleep problems include nutrition,exercise,cognitive–behavioral therapy for insomnia,aromatherapy,acupressure,and mindfulness.These interventions may be particularly important in the context of coronavirus disease 2019.Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments.Conclusions Given the increasing prevalence of child sleep problems,which have been shown to affect children’s physical and neurobehavioral wellbeing,understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention,thus improving sleep-related child development and health.
基金National Natural Science Foundation of China(72174138)High-level Public health Talents Training Program of Beijing Municipal Health Commission(2022-2-002).
文摘It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organization(WHO),there were over 656 million confirmed cases of COVID-19 in the world as of January 1,2023,including over 6.6 million deaths[1].
基金Supported by the National Key Research and Development Project of China(No.2016YFC1306204)
文摘Objective:To compare the immediate effects of electroacupuncture(EA)and body acupuncture(BA)on gastrocnemius muscle tone in children with spastic cerebral palsy(CP).Methods:Children with spastic CP,age from 24 to 60 months,who all received rehabilitation treatment in the Department of Developmental and Behavioral Pediatrics,the First Hospital of Jilin University from April 2016 to May 2017 were enrolled in this trial and assigned to EA group and BA group through a random number table.Both EA and BA therapies were performed on acupoints of Zusanli(ST 36),Shangjuxu(ST 37),Sanyinjiao(SP 6),and Xuanzhong(GB 39)for 30 min once.The root mean square(RMS),integrated electromyogram(iEMG)of the gastrocnemius of surface electromyography(sEMG),and Modified Tardieu Scale(MTS)of the two groups were evaluated before and after treatment.All adverse events were accurately recorded.Results:Thirty-six children with spastic CP completed the study(18 cases and 32 legs in the EA group;18 cases and 31 legs in the BA group).There was no significant difference in RMS,iEMG and MTS between the two groups before treatment(P>0.05).After treatment,compared with before treatment,RMS and iEMG significantly reduced and MTS(R2–R1)significantly increased in both EA and BA groups(P<0.05),and EA was more effective than BA in RMS and MTS(P<0.05).However,the iEMG between the two groups were not statistically significant after treatment(P>0.05).There was no serious adverse event during this clinical trial.Conclusion:Both EA and BA could significantly relieve the gastrocnemius muscle tone in spastic CP,and EA was more effective than BA.
基金National Natural Science Foundation of China(no.81373015).
文摘Autism spectrum disorders (ASDs) are a group of neurodevelopmentaldisorders featured by social communicationand interaction deficits, and with limited interests andrepetitive behaviors. In China, ASDs was first reported byTao from Nanjing Brain Hospital in the early 1980s [ 1 , 2 ].Since then, more children with autism have been diagnosed.While the past more than 30 years have witnessed steadygrowth in ASD research and clinical diagnosis and interventionin China, there are still many challenges to overcome.In this article, we will present the current status of prevalence,screening and diagnosis of ASD in China and proposefurther eff orts for practitioners and policy-makers to secureoptimal outcomes for children with ASD.
基金supported by the National Key Research and Development Program of China(No.2022YFC2705203)the National Natural Science Foundation of China(No.81773411)+4 种基金the Special Program for Women and Children Health(No.2020YJZX0212)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20152220)the Cultivation Project of Clinical Research from SCMC(No.LY-SCMC2020-06)Shanghai Children’s Health Services Capacity Program(No.GDEK201708)the Key Program for Clinical Nutrition(No.2019ZB0103)from Shanghai Municipal Health Commission.
文摘Background This study aimed to explore the relationship of 25-hydroxyvitamin D[25(OH)D]in three trimesters and at birth with neurodevelopment at 24 months of age.Methods From 2013 to 2016,pregnant women from the Shanghai Birth Cohort in China were recruited for the study.Altogether,649 mother-infant pairs were included.Serum 25(OH)D was measured with mass spectrometry in three trimesters,and cord blood was divided into deficiency(<20 and<12 ng/mL,respectively),insufficiency(20–30 and 12–20 ng/mL,respectively),and sufficiency(≥30 and≥20 ng/mL,respectively).Bayley-III scale was used to assess cognitive,language,motor,social-emotional,and adaptive behavior development at 24 months of age.The Bayley-III scores were grouped into quartiles,and scores within the lowest quartile were defined as suboptimal development.Results After adjusting for confounding factors,cord blood 25(OH)D in the sufficient group was positively correlated with cognitive[β=11.43,95%confidence interval(CI)=5.65–17.22],language(β=6.01,95%CI=1.67–10.3),and motor scores(β=6.43,95%CI=1.73–11.1);cord blood 25(OH)D in the insufficient group was also positively correlated with cognitive scores(β=9.42,95%CI=3.74–15.11).Additionally,sufficient vitamin D status in the four periods and persistent 25(OH)D≥30 ng/mL throughout pregnancy were associated with a lower risk of suboptimal cognitive development in adjusted models,although the effects were attenuated after applying the false discovery rate adjustment.Conclusions Cord blood 25(OH)D≥12 ng/mL has a significant positive association with cognitive,language,and motor development at 24 months of age.Sufficient vitamin D status in pregnancy might be a protective factor for suboptimal neurocognition development at 24 months of age.
基金supported by grants from the Chinese National Natural Science Foundation(81172685)Ministry of Science and Technology(2010CB535000)+5 种基金Ministry of Health(201002006)Shanghai Science and Technology Commission(12411950405,13QH1401800)Shanghai Municipal Committee of Education(11SG19,HJTY-2010-A09)Shanghai Key Discipline of Public HealthAFINS research project(AFINS-HOPE-2011025)MOE New Century Excellent Talents(NCET-13-0362),Shengyuan Research Project.
文摘Background:Despite the current obesity pandemic,childhood malnutrition remains an urgent,public health concern.Similar to the obesity pandemic,childhood malnutrition is influenced by genetic and a number of social,environmental and biological factors.In this study,we investigated the association between sleep duration and somatic growth in lean children.Methods:A stratified,randomly clustered sampling design was used to select fifth grade students from 10 primary schools in Shanghai.Based on a body mass index below the 15th percentile a subsample of 143 lean children aged 10-11 years old was defi ned.Sleep duration and other potential confounders were surveyed through parental or self-report questionnaires.Body measurements were collected and used to calculate the Z score of weight,height,body mass index as well as body fat percentage.Results:Compared with children who slept<9 hours,those who slept for≥10 hours grew taller and gained more weight after adjusting for confounding factors.When children slept 9-10 hours,they had signifi cantly higher Z score of weight and body mass index.Conclusions:Prolonged sleep not only benefi ts weight gain but also improves height in lean children.Our findings might provide important public health advice such that prolonged sleep may be an effective modifi er of nutritional problems in childhood.
基金The study was funded by special grant for Preschool Children’s Health Management from Shanghai Municipal Education Commission,grants from National Natural Science Foundation of China(81874266,81673183)key project from Shanghai Municipal Science and Technology Commission(18411951600).
文摘Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sample of preschool children was included in this study.The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma.Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma.Results Of 6389 preschool children who were invited to take part in this study,6163(response rate:96.5%)completed the questionnaire and were included in the analysis.The overall prevalence of asthma was 14.6%which increased more than six folds from 2.1%in 1990.Being male,younger age,preterm delivery,being born in spring or autumn,being delivered by elective cesarean section without indication,miscarriage,high socioeconomic status,having allergy history,and exposure to passive smoking,latex paint,and dust were potential risk factors for childhood asthma.Spending more time outdoors(>30 min/day),having indoor plants,and cleaning rooms more frequently were potential protective factors.Conclusions The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades.The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities.
基金National Natural Science Foundation of China(72174138)High-level Public health Talents Training Program of Beijing Municipal Health Commission(2022-2-002).
文摘Monkeypox is a zoonotic disease.Since the first human monkeypox case was detected in 1970,it has been prevalent in some countries in central and western Africa.Since May 2022,monkeypox cases have been reported in more than 96 non-endemic countries and regions worldwide.As of September 14,2022,there have been more than 58,200 human monkeypox cases,and there is community transmission.The cessation of smallpox vaccination in 1980,which had some cross-protection with monkeypox,resulted in a general lack of immunity to monkeypox,which caused global concern and vigilance.As of Sep-tember 14,2022,there are four monkeypox cases in China,including three in Taiwan province and one in Hong Kong city.Previous foreign studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians'understanding of monkeypox and achieve early detection,early diagno-sis,early treatment,and early disposal,we have organized national authoritative experts in pediatric infection,respiratory,dermatology,critical care medicine,infectious diseases,and public health and others to formulate this expert consensus,on the basis of the latest"Clinical management and infection prevention and control for monkeypox"released by The World Health Organization,the"guidelines for diagnosis and treatment of monkeypox(version 2022)"issued by National Health Commission of the People's Republic of China and other relevant documents.During the development of this consensus,multidisciplinary experts have repeatedly demonstrated the etiology,epidemiology,transmission,clinical manifestations,laboratory examinations,diagnosis,differential diagnosis,treatment,discharge criteria,prevention,disposal process,and key points of prevention and control of suspected and confirmed cases.
文摘Background Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia.We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in long-term child health.Methods Data from the Collaborative Perinatal Project,a longitudinal birth cohort with 54,371 singleton births,were used.401 recurrent macrosomic infants (macro-macro) and 1327 normal weight babies with a macrosomia in the last pregnancy (macro-normal) were selected to explore risk factors for recurrent macrosomia.Furthermore,768 newly onset macrosomia with normal birthweight infant in previous pregnancies (normal-macro) were identified to examine long-term health effects of recurrent macrosomia.Results The recurrent rate of macrosomia was 23.2% [95% confidence interval (CI) 21.2%,25.2%].White race,higher pre-pregnant body mass index (BMI),more gestational weight gain,male infant and more prior macrosomic infants were significant risk factors for recurrent macrosomia.At 4 years of age,recurrent macrosomic infants had a higher BMI (16.7 vs.16.1 kg/m2,adjusted fβ:0.36,95% CI:0.12,0.60) and a higher risk of overweight and obesity (adjusted OR:1.56,95% CI:1.10,2.23) than infants with normal birthweight after a previous macrosomic sibling.There was no significant difference between recurrent macrosomia and newly onset macrosomia in child outcomes after adjustment for covariates.Conclusions Fetal macrosomia has a high recurrence rate in the following pregnancy.Higher maternal pre-pregnant BMI and gestational weight gain are still important risk factors for recurrence of macrosomia,which in turn increases the risk for childhood obesity.
