Risk For Development Research Articles

Utilization of Artificial Intelligence Coupled with a High-Throughput, High-Content Platform in the Exploration of Neurodevelopmental Toxicity of Individual and Combined PFAS

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals used in various products, such as firefighting foams and non-stick cookware, due to their resistance to heat and degradation. However, these same properties make them persistent in the environment and human body, raising public health concerns. This study selected eleven PFAS commonly found in drinking water and exposed Caenorhabditis elegans to concentrations ranging from 0.1 to 200 µM to assess neurodevelopmental toxicity using a high-throughput, high-content screening (HTS) platform coupled with artificial intelligence for image analysis. Our findings showed that PFAS such as 6:2 FTS, HFPO-DA, PFBA, PFBS, PFHxA, and PFOS inhibited dopaminergic neuron activity, with fluorescence intensity reductions observed across concentrations from 0.1 to 100 µM. PFOS and PFBS also disrupted synaptic transmission, causing reduced motility and increased paralysis in aldicarb-induced assays, with the most pronounced effects at higher concentrations. These impairments in both neuron activity and synaptic function led to behavioral deficits. Notably, PFOS was one of the most toxic PFAS, affecting multiple neurodevelopmental endpoints. These results emphasize the developmental risks of PFAS exposure, highlighting the impact of both individual compounds and mixtures on neurodevelopment. This knowledge is essential for assessing PFAS-related health risks and informing mitigation strategies.

Developmental programming: Sex-specific effects of prenatal exposure to a real-life mixture of environmental chemicals on liver function and transcriptome in sheep.

Humans are chronically exposed to a mixture of environmental chemicals (ECs), many with metabolic and endocrine disrupting potential, contributing to non-communicable disease burden. Understanding the effects of chronic exposure to low-level mixtures of ECs requires an animal model that reflects real-world conditions, lags behind studies on single ECs. Biosolids, from wastewater treatment, offers a real-life model to investigate the developmental health risks from EC mixtures. Prenatal biosolids exposure studies have documented metabolic perturbations including heavier thyroid glands in male fetuses and reduced bodyweight in prepubertal male lambs followed by catchup growth. We hypothesized that maternal preconceptional and gestational exposure of sheep to biosolids programs sex-specific transcriptional and functional changes in the offspring liver. Ewes (F0) were grazed on either inorganic fertilizer (C) or biosolids-treated pastures (BTP) preconception till parturition. All lambs (n=15/group with male n=7/group and females n=8/group) were raised on Control pastures until euthanasia at 9.5 weeks. Next generation sequencing of liver RNA and DESeq2 was used to identify exposure-specific differentially expressed genes (DEG) and sex-differentially expressed genes (SDG). Liver function was assessed with markers of oxidative stress, triglyceride and fibrosis markers. Control lambs exhibited 647 SDGs confirming the inherent sexual dimorphism in hepatic gene expression. A sex-stratified analysis identified 10 DEG, mostly affecting metabolism, in male and none in female lambs. Biosolids exposure diminished the sexual dimorphism in hepatic gene expression barring 41 genes, potentially due to the increase in androgenic steroids found in F0 maternal circulation. Additionally, BTP male lambs showed elevated plasma triglyceride and a trend towards increased liver triglyceride concentrations. The identified effects of prenatal exposure to low-dose mixture of ECs via biosolids, in a precocial species paralleling human developmental patterns holds translational importance for understanding the sexually dimorphic origin of non-communicable diseases.

Improving child and adolescent health and well-being in Europe: the imperative for a new regional strategy.

Despite significant progress during the Millennium Development Goals era, recent trends show stagnation or regression in key health indicators for children and adolescents in Europe. Obesity rates are rising, adolescent mental health is deteriorating, the digital environment poses risks, breastfeeding rates are low, many children face developmental risks, and displaced children encounter significant health challenges. To address these issues, we need a comprehensive strategy for children and adolescents in Europe, leading to increased investment, protection from commercial harm, effective governance, and accountability to improve health outcomes. The World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) have embarked jointly to lead the way.

From circuits to lifespan: translating mouse and human timelines with neuroimaging based tractography.

Animal models are commonly used to investigate developmental processes and disease risk, but humans and model systems (e.g., mice) differ substantially in the pace of development and aging. The timeline of human developmental circuits is well known, butit is unclear how such timelines compare to those in mice. We lack age alignments across the lifespan of mice and humans. Here, we build upon our Translating Time resource, which is a tool that equates corresponding ages during development. We collected 1,125 observations from age-related changes in body, bone, dental, and brain processes to equate corresponding ages across humans, mice, and rats to boost power for comparison across humans and mice. We acquired high-resolution diffusion MR scans of mouse brains (n=16) of either sex at sequential stages of postnatal development (postnatal day 3, 4, 12, 21, 60) to track brain circuit maturation (e.g., olfactory association, transcallosal pathways). We found heterogeneity in white matter pathway growth. Corpus callosum growth largely ceases days after birth while the olfactory association pathway grows through P60. We found that a P3-4 mouse equates to a human at roughly GW24, and a P60 mouse equates to a human in teenage years. Therefore, white matter pathway maturation is extended in mice as it is in humans, but there are species-specific adaptations. For example, olfactory-related wiring is protracted in mice, which is linked to their reliance on olfaction. Our findings underscore the importance of translational tools to map common and species-specific biological processes from model systems to humans.Significance statement Mice are essential models of human brain development, but we currently lack precise age alignments across their lifespan. Here, we equate corresponding ages across mice and humans. We utilize high-resolution diffusion mouse brain scans to track the growth of brain white matter pathways, and we use our cross-species age alignments to map the timeline of these growth patterns from mouse to humans. In mice, olfactory association pathway growth continues well into the equivalent of human teenage years. The protracted development of olfactory association pathways in mice aligns with their specialized sense of smell. The generation of translational tools bridges the gap between animal models and human biology while enhancing our understanding of developmental processes generating variation across species.

The place of school-based strategies for universal, selective, and indicated prevention for depression

Abstract In response to the question ‘what is the place of universal, selective and indicated prevention strategies for depression and other mood disorders’ posed by Hickie et al. (2024) we examine the role of school-based strategies for universal and targeted (including selective and indicated) prevention of depression. Schools represent a unique opportunity for systematic evidence-based depression prevention, targeting key developmental risk periods before peak depression onset. However, the realisation of this potential has been challenging particularly for universal approaches. We summarise the evidence for each of these tiers of prevention, including recent large-scale trials of universal prevention in high-income countries. Targeted approaches show more consistent preventive effects on depression however hold significant implementation challenges in the school context. We provide recommendations about next steps for the field including a continuum of support across all levels of prevention outlined above and broadening current strategies to focus on the school contexts and structural factors in which prevention programs are delivered, as well as teacher mental health.

Multi-scale social-economic-environmental inequities lead to heterogeneity of Developmental Coordination Disorder risk across China

Multi-scale social-economic-environmental inequities lead to heterogeneity of Developmental Coordination Disorder risk across China

THE ROLE OF MONOCLONAL B-CELL LYMPHOCYTOSIS IN PREDICTING LYMPHOPROLIFERATIVE DISEASES: A LITERATURE REVIEW

Relevance: Monoclonal B-cell lymphocytosis (MBL), introduced by the World Health Organization in 2017 to classify certain types of blood diseases, opens up new perspectives in classification but also raises issues that require further study. MBCL studies are important for improving diagnosis and monitoring, which can contribute to the early detection and prevention of chronic lymphocytic leukemia (CLL). The study aimed to evaluate the immunophenotypic aspects of monoclonal B-cell lymphocytosis and the risk of progression to chronic lymphocytic leukemia. Methods: A review of scientific publications examined the causes of MBL and its association with CLL, emphasizing immunophenotypic aspects of these conditions. The literature survey provided information on factors associated with the progression of MBL to CLL, including biomarkers and clinical characteristics, allowing a more comprehensive assessment of the risk of leukemia in patients with MBL. Results: Numerous studies regarding the association between MBL and CLL were analyzed. The analysis showed that MBL often precedes the development of CLL, with MBL clones being detectable years before clinical diagnosis. This supports the hypothesis that MBL may be an early biomarker for detecting developmental risk. Various studies emphasize significant ethnic and geographic differences in the prevalence and progression of MBL and CLL. These differences may be related to epigenetic factors, immunoglobulin rearrangements, and other genetic features. Understanding these differences is important for more accurate diagnostic and prognostic approaches considering individual and patient population characteristics. ОБЗОРЫ ЛИТЕРАТУРЫ Онкология и Радиология Казахстана, №4 (74) 2024 73 Conclusion: The analysis shows that further investigation of the association between MBL and CLL and the introduction of screening programs for early detection of MBL can significantly improve the prognosis and health of patients in Kazakhstan. The review results emphasize the importance of early diagnosis and an individualized approach to treatment. This will help prevent MBL progression to CLL and improve the quality of medical care in our country.

Az óvodáskorú gyermekek ellenálló képességének előmozdítása: egy akciókutatási program eredményei

The negative impact of developmental risk often manifests itself as early as the formative years. Counteracting these risks and mitigating or modifying the factors that threaten optimal development seem feasible through pedagogical means. This study presents the initial results of a program whose primary goal is to support resilient functioning in preschool-aged children who exhibit at least four concurrent risk factors. Methods: The applied methods focused on assessing cognitive abilities, the frequency and severity of behavioral problems, and the perceived resilience as reported by the educators and parents. Children enrolled in the program participated in regular sessions, and the effectiveness of these interventions was evaluated through follow-up assessments at the end of the school year. Results: The findings indicated a slight but statistically significant improvement in cognitive abilities among the selected population. There was also a notable reduction in the risk of learning disabilities. Behavioral problems showed a significant decrease. According to both parents and educators, resilient functioning was significantly higher in the follow-up assessments compared to the initial evaluations. Conclusions: Overall, the program's impact can be considered positive. Although the sample size was not large and other factors beyond the sessions might have influenced the participants' outcomes, positive progress was achieved across all indicators. The program employs a complex methodological repertoire that extends beyond conventional pedagogical support services, which, based on the initial results, appears suitable for counteracting risk factors in preschool-aged children.

Are Nutrition Literacy and Sustainable Dietary Habits Associated with Cardiovascular Disease and Diabetes Developmental Risks?

Objective This study aimed to examine the association of nutritional literacy levels and sustainable nutritional behaviors with the risk of developing cardiovascular diseases and diabetes in the Turkish adult population. Methods Sociodemographic information, disease history, nutritional habits, and physical activity levels of 3146 volunteer individuals (male = 1590, female = 1556) between the ages of 40–75 were collected using a questionnaire form and face-to-face interviews. The sustainable nutritional behaviors of the participants were evaluated using Turkish validated scales for Sustainable and Healthy Eating Behavior (SHE) and nutritional literacy levels with the Evaluation Instrument of Nutrition Literacy on Adults (EINLA). Cardiovascular disease risks of the participants were assessed with the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator program and the Heart Score (SCORE) scale and type-2 diabetes risk with the Finnish Diabetes Risk Score (FINDRISC). Each participant’s 24-h food consumption record was obtained using the retrospective recall method. Results It was determined that ASCVD and SCORE levels were significantly higher in males compared to females. It was observed that individuals with lower cardiovascular and diabetes risk scores had higher educational levels, and the risks increased significantly with age (p < 0.05). Anthropometric measurements such as body mass index, and waist hip circumference were significantly higher in those with higher cardiovascular and diabetes risk scores. Furthermore, in individuals with higher SCORE and FINDRISC levels, SHE and EINLA scores were significantly lower (p < 0.05). It was also observed that SCORE and diabetes risk scores increased with higher energy and macronutrient intakes. Conclusion The risk of developing cardiovascular disease and diabetes was associated with sustainable nutritional behaviors and nutritional literacy. It may be suggested that increasing nutritional literacy and encouraging sustainable nutritional behaviors may be effective strategies in the management and reduction of the prevalence of certain chronic diseases. KEY TEACHING POINTS Cardiovascular diseases and diabetes are two major chronic conditions that can be managed and treated through proper nutrition. Increased nutritional literacy levels and sustainable dietary habits may result in reduced risk of cardiovascular diseases and diabetes. Nutritionists should assess the patients’ nutrition literacy levels and implement sustainable, health-focused nutrition education programs to enhance their understanding of nutrition.

High-Risk Infant Developmental Outcome Is Associated with Medical Complexity and Neighborhood Opportunity.

To assess how medical complexity and neighborhood opportunity jointly affect cognitive, motor, and language Bayley's Scales of Infant Development. Secondary objectives involved identifying the factors contributing to developmental disparities across diverse racial and ethnic groups. Electronic health records from a Southern California high-risk infant follow-up clinic were analyzed for 440 infants from 2014 through 2023 who had either had neonatal intensive care unit stays, prematurity, very low birthweight, or developmental delay risk. Medical complexity was categorized using the Pediatric Medical Complexity Algorithm (PMCA) into complex chronic (CC), noncomplex chronic (NCC), or non-chronic (NC). Neighborhood opportunity was assessed using the Child Opportunity Index 2.0 (COI). Developmental progress was tracked from ages 4 to 35.6 months. Of the cohort, 56% were male, and 67% were born prematurely, with 143 NC, 115 NCC, and 182 CC cases. Developmental scores showed a progressive decline with increased medical complexity. CC infants had lower cognitive (β= -15.20, p<0.001, 95% CI: -18.75, -11.7), motor (β= -20.50, p<0.001, 95% CI: -24.25, -16.8), and language scores (β=-11.88, p<0.001, 95% CI = -15.13 to -8.6) compared with NC infants. Lower COI was linked with decreased language scores (β= -0.07, p = 0.005, 95% CI: 0.01, 0.12) but not cognitive or motor scores. In high-risk infants, the adverse effects of medical complexities on developmental outcomes exceeded those of prematurity and additionally varied according to child neighborhood opportunity.

Associations of maternal peripregnancy cannabis use with behavioral and developmental outcomes in children with and without symptoms of autism spectrum disorder: Study to Explore Early Development.

Some studies report increased prevalence of autism spectrum disorder (ASD) and associated symptoms with prenatal cannabis exposure. We examined whether associations of maternal cannabis use from 3 months preconception through delivery ("peripregnancy") with behavior and development in the offspring varied with the presence of ASD symptoms. Children ages 30-68 months with ASD symptoms (i.e., met study criteria for ASD or had ASD symptoms on standardized assessments or community ASD diagnosis, N = 2734) and without ASD symptoms (other developmental delay/disorders or general population sample, N = 3454) were evaluated with the Child Behavior Checklist and Mullen Scales of Early Learning. We examined cannabis use during three time periods: peripregnancy, pregnancy, and only preconception. Peripregnancy cannabis exposure was reported for 6.0% of children with and 4.6% of children without ASD symptoms. Preconception-only cannabis use (versus no use) was associated with more aggressive behavior, emotional reactivity, and sleep problems in children with ASD symptoms, but not in children without ASD symptoms. Cannabis use during pregnancy was associated with increased attention and sleep problems in children with ASD symptoms; these associations did not differ significantly by ASD symptoms. Peripregnancy cannabis use was not associated with child developmental abilities regardless of ASD symptoms. In summary, associations of peripregnancy cannabis use with some behavioral outcomes differed in children with and without ASD symptoms. With rising cannabis use among pregnant women, future studies that examine a range of developmental risks associated with timing and patterns of cannabis use prior to conception as well as during pregnancy could inform clinical guidance.

Pharmacokinetics of Maternal Drug Administration: Insights into Placental Transfer and Fetal Exposure

ABSTRACT Pregnancy profoundly influences the pharmacokinetics of maternally administered drugs, necessitating a comprehensive understanding of placental transfer and fetal exposure for safe and effective drug therapy. This review provides an updated overview of recent advancements in the field, comprising placental anatomy and physiology, pharmacokinetic changes during pregnancy, factors affecting placental transfer, techniques for studying transfer mechanisms, and clinical implications for maternal and fetal health. Recent discoveries explaining placental structure, function, and molecular transport mechanisms underscore the complexity of drug transfer across the placental barrier. Advances in pharmacokinetic research reveal dynamic alterations in drug absorption, distribution, metabolism, and excretion during pregnancy, which impact therapeutic drug levels and maternal-fetal outcomes. Factors influencing placental transfer, including drug properties, placental transporters, and maternal-fetal physiology, are increasingly recognized as critical determinants of fetal exposure. Innovative methodologies and technologies facilitate the study of placental drug transport, offering insights into drug-specific transfer kinetics and developmental risks.

Why Should Developmental Scientists Engage in Research on Adolescent Suicide? The Case for Developmentally Informed Suicidology

Adolescent suicide is a critical and prevalent issue yet is rarely studied by developmental psychologists. We assert that developmentalists’ lack of engagement has stymied progress on adolescent suicide research and practice, and we demonstrate how developmental perspectives can contribute to the next decade of research and practice in suicidology. Specifically, we (a) review theories in suicidology (that are largely a-developmental); (b) discuss how developmental phenomena may explain findings regarding the epidemiology of adolescent suicide; (c) review the evidence on the etiology of adolescent suicide, where efforts to identify risk factors have not led to strong predictions, highlighting underutilized approaches from the developmental risk and resilience literature; and (d) review strategies and developmental gaps across the suicide prevention continuum from primary prevention to postvention, recommending an adolescent developmental perspective on the development and study of school- and community-based suicide prevention and postvention. In doing so, we propose a new subfield of Developmentally Informed Suicidology.

Smartphone GPS-Based Exposure to Greenspace and Walkability and Accelerometer-Assessed Physical Activity During Pregnancy and Early Postpartum-Evidence from the MADRES Cohort.

A growing number of studies have associated walkability and greenspace exposure with greater physical activity (PA) in women during pregnancy. However, most studies have focused on examining women's residential environments and neglected exposure in locations outside the home neighborhood. Using 350 person-days (N = 55 participants) of smartphone global positioning system (GPS) location and accelerometer data collected during the first and third trimesters and 4-6months postpartum from 55 Hispanic pregnant women from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study, we examined the day-level effect of women's exposure to walkability and greenspace on their PA outcomes during pregnancy and in the early postpartum period. Moderate-to-vigorous physical activity [MVPA] minutes per day was assessed using accelerometers. Walkability and greenspace were measured using geographic information systems (GIS) within women's daily activity spaces (i.e., places visited and routes taken) recorded using a smartphone GPS and weighted by time spent. We used a generalized linear mixed-effects model to estimate the effects of daily GPS-derived environmental exposures on day-level MVPA minutes. Results showed that women engaged in 23% more MVPA minutes on days when they had some versus no exposure to parks and open spaces in activity spaces (b = 1.23; 95%CI: 1.02-1.48). In addition, protective effects of daily greenspace and walkability exposure on MVPA were stronger in the first and third trimesters, among first-time mothers, and among women who had high pre-pregnancy body mass index (BMI) and lived in least-safe neighborhoods. Our results suggest that daily greenspace and walkability exposure are important for women's PA and associated health outcomes during pregnancy and early postpartum.

Association of early life exposure to PM2.5 and its components with offspring neurodevelopment: a prospective birth cohort study

Emerging data have explored early life fine particulate (PM2.5) exposure and its relationship with offspring neurodevelopment. However, the findings remain inconsistent, and the roles of specific PM2.5 components are unclear. We investigated these associations and explored the potential interactive role of children’s physical activity (PA). A total of 1547 mother-child pairs from the Shenzhen Birth Cohort were included. Neurodevelopment was assessed at seven time points (1, 3, 6, 8, 12, 18, and 24 months) using the Ages and Stages Questionnaire. An established spatiotemporal model was used to estimate early life exposure to PM2.5 and five components [sulfate (SO42), nitrate (NO3-), ammonium (NH4+), organic matter (OM), and black carbon (BC)]. Associations of individual and joint exposure to components with neurodevelopment were analyzed using generalized estimating equation and quantile-based g-computation models with a binomial distribution. Most mothers (79.1%) were under 35 at delivery, and 43.6% of the children were boys. During the early postnatal period, a 5μg/m3 increase in PM2.5 was associated with higher adjusted odds ratios (aORs) for developmental delays in gross motor (1.24, 95%CI:1.12, 1.37), fine motor (1.11, 95%CI:1.04, 1.20), and problem-solving (1.12, 95%CI:1.03, 1.22) domains. Similar associations were observed for individual PM2.5 components. Each quintile increase in early postnatal exposure to PM2.5 mixtures was correlated with higher aORs for these domains, with NO3- constituting the largest weight. No significant associations were found for the prenatal period. The children’s PA showed no interaction. These findings underscore the need to reduce PM2.5 exposure, particularly its toxic components, to minimize developmental risks.

A life course perspective on parental incarceration and other forms of childhood adversity

Prior research on childhood adversity has revealed that exposure to multiple adverse childhood experiences (ACE) is relatively common, and that failure to consider these experiences in tandem may misattribute their effects to a single adversity. Yet attempts to isolate the effects of a given ACE are quite common, particularly in the burgeoning body of research on parental incarceration. Guided by recent theorizing in the parental incarceration effects tradition, and key insights from prior work on ACEs, the current investigation situated parental incarceration within broader contexts of childhood adversity. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we drew on person-centered analyses to consider associations between different constellations of risk, well-being, and other important life course considerations. Additionally, we centered the experience of parental incarceration to explore its prevalence across the different constellations identified and to examine its independent and interactive effects on problematic behavioral outcomes and successful adult transitions. Our findings revealed that 1) ACEs tend to cluster, 2) certain constellations may pose greater developmental risks, and 3) the effect of parental incarceration may depend, in part, on the unique set of ecological risks to which children are exposed.

Adolescents’ dietary patterns, their drivers and association with double burden of malnutrition in adolescents: a cross-sectional study in Kenya’s urban slums

BackgroundThe double burden of malnutrition (DBM) during adolescence is associated with growth and developmental impairment and risk of non-communicable diseases. There is limited evidence on adolescent’s dietary patterns (DPs), and how they contribute to DBM in urban low income contexts in sub Saharan Africa. This study assessed DPs of adolescents, their drivers and association with DBM in Kenya’s urban slums.MethodsAnthropometric, socio-demographic and dietary-intake data were collected through a cross-sectional survey of 621 adolescents from three major urban slums in Nairobi, Kenya. DPs were derived using principal component analysis. Multinomial-logistic-regression was used to assess the association between the DPs, individual and environmental factors and DBM.ResultsTwo DPs were identified: traditional DP (whole grains/cereals, rice, fruits, legumes/nuts, and water) and transitioning DP (refined cereals (maize/wheat), vegetables, meat, tea/coffee, sweet ultra-processed/deep fried snacks). Adolescents from Mathare (the largest slum) were more likely to adhere to the traditional DP (RRR = 3.43; 95% CI 1.85–6.37). Cultural background (Luo) had a positive association (RRR = 4.28; 95% CI 1.97–9.32), while longer residency in the slum (> 10 years) had a negative association (RRR = 0.47; 95% CI 0.25–0.90) with transitioning DP. The transitioning DP had a positive (non-linear) association with overweight/obesity in girls (RRR = 2.79; 95% CI 1.16–6.71). The DPs were not associated with thinness or stunting.ConclusionThe DPs indicate various stages of nutrition transition of adolescent diets, which are influenced by cultural background, neighbourhood and duration of stay in the slum. Transitioning DP may expose adolescents to the risks of overweight/obesity in the long-term.

JAAD Game Changers: “Propranolol treatment of infantile hemangioma (IH) is not associated with developmental risk or growth impairment at age 4 years”

JAAD Game Changers: “Propranolol treatment of infantile hemangioma (IH) is not associated with developmental risk or growth impairment at age 4 years”

Net worth poverty and child Well-being: Black–White differences

Net worth poverty, defined as having wealth (assets minus debts) that is less than one-fourth the federal poverty line, can have negative associations with children’s development. Net worth poverty can reflect the lack of assets or the presence of debts, with the former posing greater developmental risks than the latter. Structural inequalities and racial discrimination have led to higher rates of asset poverty for Black than White families, suggesting that net worth poverty may pose disproportionate risks for Black children. To inform this hypothesis, this study examines how net worth poverty and its subcomponents of asset and debt poverty relate to Black and White children’s academic and behavioral outcomes. Data come from the Panel Study of Income Dynamics and its Child Development Study, which includes 3,164 Black and 3,578 White children aged 3–17 observed between 2002 and 2019. Regression models estimated the association between poverty (measured as net worth, income, assets, or debt) and four child outcomes: reading and math achievement and externalizing and internalizing behavior scores. In models that control for income poverty, among White children, net worth poverty, as well as asset and debt poverty, was associated with worse outcomes. Contrary to expectations, using the same set of covariates, net worth poverty among Black children was not a significant predictor of outcomes. For this racial group, asset poverty was negatively related to outcomes, but effects were roughly half the size as those found for White children. Additionally, debt poverty among Black children was not associated with either positive or negative effects. The small effect of asset poverty, when coupled with the lack of effects for debt poverty, mechanically explains why net poverty was not detrimental for Black children. This study underscores the importance of wealth deprivation in studies of poverty and shows that the negative effects of net worth poverty differ between White and Black children.

Developmental Patterns and Risk Factors of Scoliosis After Hemipelvectomy for the Pelvic Bone Tumor.

Postoperative scoliosis is often seen after hemipelvectomy for malignancies involving the pelvic area, but the details remain unclear. The objectives were to investigate the development patterns and risk factors of scoliosis after hemipelvectomy. We retrospectively reviewed 30 patients who underwent hemipelvectomy at our hospital between 1998 and 2020. The risk factors of scoliosis with a Cobb angle of ≥10° were investigated. The postoperative Cobb angle significantly increased in all patients compared with the preoperative one (p < 0.001), and the change ratio of the Cobb angle was significantly higher during the first postoperative year than thereafter. The external hemipelvectomy (EH) group demonstrated a larger Cobb angle and a higher change ratio than the internal hemipelvectomy group. Nine patients developed scoliosis with a final Cobb angle of ≥10°, and the risk factors were EH (p = 0.017), P1+2+3+4 resection according to the Enneking classification (p = 0.005), iliac crest resection (p = 0.004), L5/S resection (p = 0.020), and no pelvic ring reconstruction after hemipelvectomy (p = 0.004). Approximately 30% of patients who underwent hemipelvectomy developed scoliosis with a Cobb angle of ≥10°, and this angle increased rapidly during the first postoperative year. Hence, careful follow-up of scoliosis is required after hemipelvectomy.