Developmental Trajectories Research Articles

When thinking about pain contributes to suffering: the example of pain catastrophizing

Abstract The extensive literature on the potent role negative thoughts about pain have on the experience of pain and pain-related suffering has documented associations with important neurobiological processes involved in amplifying nociceptive signals. We focus this review on pain catastrophizing (pCAT)— appraisals of pain as threatening, overwhelming, and unmanageable— and review the evidence that these thoughts are learned in childhood through experience and observation of others, particularly caretakers and parents. For children who have learned pCAT, repeated exposures to pain over time activate pCAT and likely contribute to further amplification of pain through changes in the neurobiological pain regulatory systems, which overlap with those regulating the stress response. We propose that repeated pain and stress exposures throughout childhood, adolescence, and into adulthood alter the neurobiology of pain via a repetitive positive feedback loop that increases risk for heightened pain sensitivity over time with repeated exposures. At some point, often precipitated by an acute episode of pain and possibly influenced by allostatic load, pCAT contributes to persistence of episodic or acute pain and exacerbates pain-related suffering. This developmental trajectory is not inevitable, as the impact of pCAT on pain and pain-related suffering can be influenced by various factors. We also present future directions for work in this area.

Pain and development: interacting phenomena

Abstract For decades, clinicians and researchers have observed bidirectional relationships between child development and the pain experience in childhood. Pain in childhood is an inherently developmental phenomenon, embedded in an iterative, time-dependent process that reflects individual biological, behavioral, social, psychological, and environmental characteristics that unfold across the early life span. Childhood pain can have wide ranging effects on brain development in ways that contribute—for better and worse—to social, emotional, and cognitive well-being in childhood and on into adulthood. Atypical trajectories of development in the context of disorders such as autism, cerebral palsy, ADHD, and mood/anxiety disorders also contribute to unique childhood pain experiences. In this paper, pain will be considered as a determinant of development, and conversely development will be considered as a key determinant of a child's pain experience. We will discuss how intersectional identities (eg, gender, race, socioeconomic status) and associated social, structural, systemic, and physical environments influence the relationship between development and pain. Finally, we will identify what might be needed to think “developmentally” in ways that extend from the “bench side” in the lab to the “curb side” in the community, integrating a developmental perspective into research and clinical practice to achieve health accessibility and equity in pain care for all children across the developmental spectrum.

A Guide for Aspiring Neurology Educators.

Deans of medical schools have diverse roles and responsibilities. In this article, we use the career development trajectories of neurologists who have become education deans in student affairs and curriculum to offer advice to aspiring clinician educators of all levels and backgrounds. Although their roles differ, the advice they share is universal and essential for the career development of future clinician educators. ANN NEUROL 2024;96:823-825.

LnCeCell 2.0: an updated resource for lncRNA-associated ceRNA networks and web tools based on single-cell and spatial transcriptomics sequencing data.

We describe LnCeCell 2.0 (http://bio-bigdata.hrbmu.edu.cn/LnCeCell), an updated resource for lncRNA-associated competing endogenous RNA (ceRNA) networks and web tools based on single-cell and spatial transcriptomics sequencing(stRNA-seq)data. We have updated the LnCeCell 2.0 database with significantly expanded data and improved features, including(i) 257 single-cell RNA sequencingandstRNA-seqdatasets across 86 diseases/phenotypes and 80 human normal tissues, (ii) 836581 cell-specific and spatial spot-specific ceRNA interactions and functional networks for 1002988 cells and 367971 spatial spots, (iii) 15489 experimentally supported lncRNA biomarkers related to disease pathology, diagnosis and treatment, (iv) detailed annotation of cell type, cell state, subcellular and extracellular locations of ceRNAs through manual curationand (v) ceRNA expression profiles and follow-up clinical information of 20326 cancer patients. Further, a panel of 24 flexible tools (including 8 comprehensive and 16 mini-analysis tools) was developed to investigate ceRNA-regulated mechanisms at single-cell/spot resolution. The CeCellTraject tool, for example, illustrates the detailed ceRNA distribution of different cell populations and explores the dynamic change of the ceRNA network along the developmental trajectory. LnCeCell 2.0 will facilitate the study of fine-tuned lncRNA-ceRNA networks with single-cell and spatial spot resolution, helping us to understand the regulatory mechanisms behind complex microbial ecosystems.

Talking about practice: agency and its structural context in regional healthcare practice change

ABSTRACT Ageing societies and rising instances of non-communicable diseases require changes in public healthcare service provision. Despite a plethora of propositions, most innovations never become practically applied. In understanding innovation as a place- and path-dependent change process which depends on actors’ agency to reconfigure routinised practices and their structural context, we show how actors create, perceive and act upon opportunities for change while tracing the development trajectories of two networks in the regions of Murcia (Spain) and Örebro (Sweden), respectively. The cases illustrate the role intermediary actors play in creating opportunities and shaping organisational and institutional context.

Persistent organic pollutants and developmental trajectories of ADHD symptoms: The Rhea cohort study

Abstract Background Prenatal exposure to persistent organic pollutants (POPs) has been linked to elevated symptoms related to attention deficit hyperactivity disorder (ADHD) in a few studies, but findings remain inconclusive. We aimed to explore how prenatal exposure to POPs affects the developmental course of ADHD symptoms from early childhood to adolescence in the Rhea cohort in Crete, Greece. Methods We determined concentrations of HCB, DDE, and PCBs in first-trimester maternal serum. Child ADHD symptoms were reported by mothers using the ADHD Test at 4 years and the Conners’ Parent Rating Scale at 6, 11 and 15 years. Group-Based Trajectory Modeling was used to classify 551 participants into 4 distinct groups: Stable low (60.1%), Stable high (9.6%), Low-increasing (14.6%), and High-decreasing (15.7%) symptoms. Adjusted multinomial regression models were applied to assess the risk of being grouped into an adverse developmental trajectory as compared to the reference group (stable low), in relation to prenatal POP exposure in 465 children. The analyses were performed in sex-specific manner. Results Prenatal HCB exposure was associated with elevated risk of being grouped in the stable high ADHD symptoms trajectory only in girls (RRR [95%CI]: 2.0 [1.04, 3.82]). Overall, exposure to DDE and sum of PCBs was linked to decreased risk of membership in an adverse ADHD symptoms trajectory. More specifically, in utero exposure to DDE and sum of PCBs was associated with lower risk of being grouped in the low-increasing trajectory for boys (RRR [95%CI]: 0.7 [0.54, 0.95] and 0.5 [0.32, 0.88], respectively) and in the high-decreasing symptoms group for girls (RRR [95%CI]: 0.6 [0.44, 0.84] and 0.5 [0.30, 0.93], respectively). Conclusions The findings suggest that prenatal exposure to HCB is linked to increased risk of stable high ADHD symptoms from preschool age and up to adolescence. The association was pronounced only in girls, a group for which less is understood in relation to ADHD. Key messages • Prenatal exposure to HCB increases the risk of persistently high ADHD symptoms from preschool age to adolescence. • The impact of prenatal HCB exposure on ADHD symptoms is evident in girls.

Temporal Analysis of Sanitation and Water Development Indicators in Tunisia: 2012-2023

Abstract Background Access to sanitation and water resources is a cornerstone of the ‘One Health’ approach, which encompasses the holistic integration of human, animal and environmental health considerations. We aimed to elucidate the temporal trajectory of sanitation and water resource development in Tunisia across successive years. Methods Data from the Multiple Indicator Cluster Survey in Tunisia, a UNICEF-conducted repeated cross-sectional survey, was used to compare trends in access to improved water sources, utilization of improved sanitation facilities, and handwashing practices across 2012, 2018, and 2023. Results In 2023, we observed that 20.9% of households did not have access to drinking water on site, compared with 12.7% in 2018 (p = 0.15). The availability of drinking water in sufficient quantity was 69.8% in 2023 and 80.6% in 2018 (p = 0.37). In 2023, 78.1% of the population had access to an improved water source, compared with 86.3% in 2018 and 95.7% in 2012 (p = 0.4), 80% in urban areas and 73% in rural areas (p = 0.57). In 2023, 12.5% of the population consumed water from sources contaminated with Escherichia coli, compared with 20.5% in 2018 (p = 0.16). Disparities in Escherichia coli detection were observed between rural (21%) and urban (8.3%) areas (p = 0.01). In 2023, 92.1% of households had access to handwashing facilities equipped with soap and water, compared with 89.9% in 2018 and 91.5% in 2012 (p = 0.98). The breakdown between urban and rural areas was 95.1% and 86.4% respectively (p = 0.51). Conclusions Access to improved water sources, sanitation, and handwashing practices remains high over time, but regional disparities persist. Improved water quality directly reduces the transmission of waterborne pathogens, emphasizing the need to address regional disparities and socio-economic inequalities to promote public health nationwide. Key messages • Challenges persist in tunisia regarding sanitation and access to water. • Regional disparities threaten public health.

Impact of Adverse Childhood Experiences on Child Development in South America: A Systematic Review

Abstract Background Adverse Childhood Experiences (ACEs) have garnered attention globally for their detrimental effects on children’s development, such as lower communication, gross and fine motor, and personal-social domains. While extensively studied in high-income countries, there remains a gap in understanding their prevalence and impact in low- and middle-income countries (LMICs). This review aimed to identify, evaluate, and summarize the findings of an association between ACEs and children’s developmental and mental health outcomes in South America Methods A systematic review was conducted to investigate the association between ACEs and childhood development in South America. Databases MEDLINE, PsycINFO, Web of Science, Applied Social Sciences Index and Abstracts, Literatura Latino Americana em Ciências da Saúde, IBECS and CINAHL were searched. Selection criteria encompassed studies from Brazil, Colombia, Argentina, Peru, Venezuela, Chile, Ecuador, Bolivia, Paraguay, Uruguay, Guyana and Suriname examining the effects of ACEs on developmental outcomes and mental health disorders in children under 18 years old. Quality assessment aligned with World Health Organization standards was employed. Results Twenty-four studies met the inclusion criteria, with most categorized as low or very low quality. While the majority demonstrated a significant association between ACEs and developmental or mental health outcomes, a few studies reported null findings. Challenges in study quality, such as small sample sizes and selection bias, were identified. Conclusions Despite limitations in study quality, findings underscore the impact of ACEs on child development and mental health in South America. Because of the low quality of the existent studies the next steps should be to grasp a greater understanding of the issue. This review also highlights the urgency for further research and targeted interventions to mitigate the long-term consequences of ACEs in this region. Key messages • ACEs profoundly affect child development and mental health in South America, necessitating urgent attention and intervention. • Addressing the impact of ACEs in South America is critical for fostering healthier developmental trajectories and enhancing public health outcomes.

Child maltreatment and executive function development throughout adolescence and into young adulthood.

Child maltreatment impacts approximately one in seven children in the United States, leading to adverse outcomes throughout life. Adolescence is a time period critical for the development of executive function, but there is little research examining how abuse and neglect may differently affect the developmental trajectories of executive function throughout adolescence and into young adulthood. In the current study, 167 adolescents participated at six time points from ages 14 to 20. At each time point, adolescents completed behavioral tasks measuring the three dimensions of executive function (working memory, inhibitory control, and cognitive flexibility). Neglect and abuse in early life (ages 1-13) were reported at ages 18-19. Unconditional growth curve models revealed age-related improvement in all three executive function dimensions. Conditional growth curve models tested the prospective effects of recalled neglect and abuse on the developmental trajectories of executive function. The results revealed that neglect was associated with developmental changes in working memory abilities, such that greater levels of neglect during ages 1-13 were associated with slower increases in working memory abilities across ages 14-20. These findings highlight the adverse consequences of early neglect experiences shown by delayed working memory development during adolescence into young adulthood.

Supplemental Material for Joint Developmental Trajectories of Anxious Solitude and Peer Adversities From Early Childhood Through Adolescence: Characteristics and Associations With Indices of Internalizing Problems

Supplemental Material for Joint Developmental Trajectories of Anxious Solitude and Peer Adversities From Early Childhood Through Adolescence: Characteristics and Associations With Indices of Internalizing Problems

Follow-up of expressive language and general development at 12, 18 and 36 months for children with no canonical babbling at 10 months

ABSTRACT Little is known about the developmental trajectories in children who do not use canonical babbling (CB) at 10 months. The aim was to examine how speech, language, cognitive and motor abilities developed in children without CB. For 15 children identified as not having CB, consonant production, expressive vocabulary and general development were assessed at 12, 18 and 36 months from audio–video recordings. Twelve (79%) children still lacked CB at 12 months. At 18 months, six (40%) had parent-reported expressive vocabulary results below the 10th percentile, and two (14%) did not use dental/alveolar stops. The percentage of consonants correct for the group was at the level of peers at 36 months (89%, SD 0.17), but the group had fewer established target consonants than age norms. Most children had a small expressive vocabulary in comparison with Swedish age norms for younger children as well as with age-matched norms for other Nordic languages. The general development (Bayley-III) for three children (21%) who did not use speech was 1–2 SD below the average range in at least one domain (cognitive, language or motor), but the results for the whole group were within the average range. In conclusion, the heterogeneity in early consonant development in the study group resembles that of children in clinical groups with known risk for speech and language difficulties and the expressive vocabulary resembles that of children with delayed expressive vocabulary. For about one-fifth of the children, the absence of canonical babbling at age 10 months could be seen as an early sign of a more comprehensive developmental disability.

Green path development: The agency of the City of Vaasa in establishing the battery industry

AbstractEmpirical studies on agency in green path development (GPD) have underexplored non‐firm actors' roles. Through a semi‐structured interview, this article provides insight into how the City of Vaasa exercises agency toward developing the battery industry and the concomitant effects. The findings reveal that the City of Vaasa provides place‐based leadership, for example, through a local‐based initiative, that is, the GigaVaasa, as a platform to increase participation and coordinate the actions of public and private actors. As an institutional entrepreneur, they govern the issuance of operating licenses to optimize their economic interest; as innovative entrepreneur, they strategically plan and coordinate infrastructure development to increase the region's attractiveness to external investors and talents. The City of Vaasa agency increases the chances for the region to participate in the global battery market and stimulate the region's economic development. Nonetheless, environmental sustainability concerns remain a profound unintended effect. Conceptually, the article introduces the agency cyclicality and synchronization model to enhance the understanding of the interplay and effect of agency in an emerging green industry's development trajectory.

Collapsible tree: interactive web app to present collapsible hierarchies.

A crucial component of intuitive data visualization is presenting a hierarchical tree structure with interactive functions. For example, single-cell transcriptomics studies may generate gene expression values with developmental trajectories or cell lineage structures. Two common visualization methods, t-SNE and UMAP, require two separate figures to depict the distribution of cell types and gene expression data, with low-dimension projections that may not capture the hierarchical structures among cells. Here, we present a JavaScript framework and an interactive web app named Collapsible Tree, which presents values jointly with interactive, expandable, and collapsible lineage structures. For example, the Collapsible Tree presents cellular states and gene expression from single-cell transcriptomics within a single hierarchical plot, enabling comparisons of gene expression across lineages and subtle patterns between sub-lineages. Our framework can facilitate the exploration of complicated value patterns that are not evident in UMAP or t-SNE plots. The Collapsible Tree web interface is available at https://collapsibletree.data2in.net. The JavaScript library source code is available at https://github.com/data2intelligence/collapsible_tree.

Mapping the Evolving Landscape of Library-Related Policies in China: A Topic Modeling Approach

This study aims to investigate the thematic characteristics and evolutionary patterns of library policies in China from 1949 to 2023. Employing the Latent Dirichlet Allocation (LDA) model, the research analyzed 2,703 Chinese government-issued policies related to libraries during this period, identifying key topics and tracing their developmental trajectories. The study recognized four distinct developmental phases, five major topics, and the underlying connections among feature terms within different topics. It discussed the corresponding topic strengths and evolving trends in each phase. Library policies in China are predominantly centered on five key domains: 1) spatial planning and architectural integration, 2) information management and transparency, 3) legal regulations and supervisory enforcement, 4) heritage preservation and sustainable development, and 5) community inclusion and accessibility. Notably, spatial planning and architectural integration consistently garner substantial attention, highlighting their enduring prominence, while there is relatively less emphasis on community inclusion and accessibility, as well as heritage preservation and sustainable development. The contribution of this study lies in conducting a semantic exploration of the overall transformation in library-related policies in China, validating the effectiveness of the LDA model in identifying topics within policy texts, and expanding the research perspective on library policy evolution.

Research on Digital Transformation Strategy of Multinational Company Sales Based on Big Data and AI

Abstract: In the wake of the COVID-19 pandemic, the digital transformation of industries has become paramount, with multinational corporations (MNCs) recognizing the pivotal role of sales digitization in their development trajectory. This study delves into the multifaceted impact of sales digitization on MNCs, elucidating both its benefits and the formidable challenges it presents. Notably, the integration of big data and artificial intelligence (AI) has revolutionized the collection and analysis of sales data, offering MNCs unprecedented insights into consumer behavior and market dynamics. By leveraging big data and AI technologies, MNCs can optimize their operations and substantially reduce the costs associated with data collection, particularly in diverse and segmented markets. This transformative synergy plays a pivotal role across various domains, including market analysis, predictive modeling, customer relationship management, and the formulation of agile marketing strategies. Despite these advancements, research reveals that MNCs continue to grapple with significant barriers and complexities in the process of sales digitization. This article aims to bridge this research-practice gap by offering pragmatic solutions and actionable strategies tailored to address the identified challenges. By emphasizing the importance of organizational agility, talent acquisition, and strategic partnerships, MNCs can effectively navigate the complexities of sales digitization and unlock its full potential. Ultimately, this study seeks to provide a comprehensive understanding of the evolving landscape of digital sales in MNCs, culminating in a nuanced conclusion that underscores the imperative of adaptability and innovation in an increasingly digitized global economy.

Worldwide research trends on bone metastases of lung cancer: a bibliometric analysis

BackgroundLung cancer has the highest fatality rate among all malignancies worldwide. Within this disease, bone metastasis (BM) emerges as a particularly deleterious site of metastatic dissemination, marked by a dismal prognosis. The objective of this investigation is to shed light on the current international research efforts and the development trajectory on lung cancer BM through a bibliometric analysis (performance and visualization analysis).MethodData were obtained from the Web of Science Core Collection repository on lung cancer BM from 1 January 2012 to 1 January 2022. Subsequently, the collected data underwent scrutiny using the VOSviewer software to reveal patterns of co-authorship, co-citation, and keyword analysis, while the CiteSpace software facilitated the generation of keyword cluster maps and performed burst analyses.ResultsThe study included 327 papers of 2,154 authors, 587 organizations, and 41 countries, and explored the cooperation between them and the relationships between citations. Over the past decade, published papers showed a steady growth trend. China had the highest production with 189 papers, and USA had the highest collaboration with other countries, with 43 total link strength. Lung Cancer exhibited the highest frequency of co-cited journals, with a co-citation time of 412 and an IF/JCR partition of 6.081/Q1 in 2021. The most frequently co-cited article, authored by Tsuya A and published in Lung Cancer in 2007, amassed 70 co-citations. High-frequency keywords were categorized into four clusters: pathogenesis, treatment and clinical manifestations, prognosis, and diagnosis. In recent years, there has been a significant increase in the strong citation burst strength of keywords such as “predictor,” “skeletal-related events,” “efficacy,” “migration,” “docetaxel,” and “impact.” Lung adenocarcinoma is the most common type of tumor.ConclusionThis bibliometric study provides a comprehensive analysis of lung cancer BM in the recent 10 years. The field of early diagnosis, pathogenesis, and new treatments is entering a phase of rapid development and remains valuable for future research.

Lifespan trajectories of negative and positive affect: A coordinated analysis of 14 longitudinal studies

Lifespan developmental theories suggest age-related shifts in motivation, cognition, emotion regulation, and stressor experience lead to changes in mean levels of negative and positive affect across the lifespan. The present research used coordinated data analysis to examine mean-level affective trajectories in 186,752 participants ranging from 11–104 years old across 14 longitudinal studies. Random-effects models were used to estimate meta-analytic effect sizes. On average, negative affect decreased until early older adulthood, and then remained stable throughout older adulthood. Meanwhile, positive affect remained stable across most of the younger and middle-aged adult lifespan, before starting its descent in later middle-aged adulthood and continuing to decline throughout older adulthood. Studies with older samples showed a clearer flattening effect of negative affect and steeper decline of positive affect in late-life relative to younger samples. These findings suggest that lifespan developmental affect trajectories are nuanced and not a direct inverse of each other.

Exhibiting Colonialism and Nationalism: The Case of Egyptian Museums and Its Cultural Heritage

Abstract: Egypt is one of four ancient civilizations acknowledged by the international community as having a time-honored historical legacy and a profound cultural heritage. However, from the 19th century onward, Egypt's cultural development trajectory underwent a significant shift due to the influence of Western colonial powers. Subsequently, with the uninterrupted progression of the nationalist movement, the trajectory of Egyptian history and culture, in addition to the conservation and investigation of cultural heritage, underwent yet another transformation. Museums, as crucial instruments for the conservation and exhibition of cultural heritage, have played a pivotal role in the history of Egyptian cultural research, bearing witness to the transformation in the preponderance of Egyptian historical narratives. This paper examines how historical narratives and cultural developments in Egypt were shaped under the influence of colonialism, with a particular focus on the profound impact of Orientalist theories and practices on the construction of museums about the study of historical and cultural heritage. In the post-colonial period, Egyptian museums have served as conduits for disseminating the country's rich cultural heritage and as instruments for enhancing Egyptian national identity. These institutions have played a pivotal role in the formation of national identity and the "decolonization" of the country's cultural heritage, largely due to their irreplaceable cultural space and their capacity to adapt to changing needs. As Egyptian museums have evolved, they have played a significant role in shaping national identity and contributing to the processes of decolonization and de-Westernization. Furthermore, they symbolize the prospective trajectory of Egyptian national identity within the context of globalization and the emergence of a more interconnected world.

A longitudinal study on the development trajectory of auditory processing and its relationship with language development in Chinese preschool children with autism spectrum disorder: study protocol

BackgroundIt was reported that more than 96% of autism spectrum disorder (ASD) children are accompanied with different degrees of sensory processing abnormalities, and up to 50% of ASD children exhibit abnormal auditory response. Studies have confirmed that some ASD children’s abnormal auditory response may be related to their abnormal auditory processing. Prior research demonstrated that ASD children’s auditory processing has high heterogeneity, thus, ASD children’s auditory processing may have different developmental trajectories. However, no study has concentrated on the developmental trajectories of ASD children’s auditory processing. In addition, auditory processing plays a crucial role in ASD children’s language development, thus, ASD children’s different language development outcomes may be related to different auditory processing development tracks. Therefore, this study aims to explore the developmental trajectory of auditory processing in ASD children and analyze the relationship between different developmental trajectories of auditory processing and language impairment.Methods/DesignIn this study, 220 ASD children aging 3 years and 0 months to 4 years and 11 months are recruited as the research objects, and their demographic characteristics are collected. The subjects are tested for peripheral hearing, intelligence, and autism symptoms. Furthermore, ASD children’s auditory processing and language development are evaluated at baseline, 1 year, and 2 years later. In addition, ASD children’s auditory processing is evaluated by electrophysiological test and the Preschool Auditory Processing Assessment Scale. Moreover, ASD children’s language skills are assessed using the Language Development Assessment Scale for Children Aged 1–6. The various categories of the developmental trajectory of ASD children’s auditory processing are examined through the latent category growth model. Additionally, a hierarchical regression model is developed to analyze the predictive impact of different auditory processing development trajectories on language impairment in ASD children.DiscussionThis longitudinal study will explore the categories of auditory processing developmental trajectories in ASD children, and analyze the relationship between different categories of auditory processing developmental trajectories and language development, providing new ideas and targeted targets for the rehabilitation training of language impairment in ASD children, as well as promoting early and accurate interventions for ASD children.

The mechanism underlying B-cell developmental dysfunction in Kawasaki disease based on single-cell transcriptomic sequencing

BackgroundKawasaki disease (KD) is an acute systemic vasculitis that can lead to acquired heart disease in children mostly from in developed countries. The previous research showed that B cells in KD patients underwent a profound change in both the cell numbers and types after intravenous immunoglobulin (IVIG) therapy.MethodsWe performed the single-cell RNA-sequencing for the peripheral blood mononuclear cells (PBMCs) from three febrile patients and three KD patients to investigate the possible mechanism underlying B cell developmental dysfunction in KD. The pseudo-time analysis was employed to study the developmental trajectories of the PBMCs in febrile control and KD patients.ResultsOverall single-cell expression profiles show that the biological processes of immunity, B cell activation pathway and their related biological entities are repressed in KD patients before IVIG treatment compared to febrile patient and KD patients after IVIG treatment. The differentially expressed gene analyses further demonstrate that B cell signaling pathway is downregulated in B cells and plasma blast cells of KD patients before treatment while cell cycle genes and MYC gene are upregulated in dendritic cells (DCs) and hematopoietic stem and progenitor cells (HSPCs) of KD patients before treatment. The biological process of immune response is upregulated in the HSPCs of KD patients before treatment in our dataset while the biological process of inflammatory response is upregulated in the HSPCs of KD patients before treatment in GSE168732 dataset. Single-cell trajectory analyses demonstrate that KD patients before treatment have a shortened developmental path in which B cells and T cells are failed to differentiate into separate lineages. HSPD1 and HSPE1 genes show an elevated expression level in the early cell development stage of KD patients before treatment accompanied with the repression of MYC, SPI1, MT2A and UBE2C genes. Our analyses of all B cells from KD patients before treatment show most of B cells are arrested in a transitional state with an ill developmental path compared with febrile patients and KD patients after treatment.ConclusionOur results indicate that the immune premature HSPCs accompanied with the abnormal expression dynamics of cell cycle and SPI1 genes are the mechanism underlying B cell developmental dysfunction in KD patients.