Griffiths Scales Research Articles

Efficacy and safety of Nyumi beauty sleep gummies for the management of sleep deprivation and skin condition: A single-arm clinical study

Objectives: Sleep plays a critical role in optimizing physical and mental health. The aim of this clinical study was to evaluate the efficacy and safety of Nyumi beauty sleep gummies for improvement in sleep quality in healthy adult subjects with sleep deprivation. Materials and Methods: A single-arm, clinical study was conducted. Sleep quality was assessed by the Sleep Quality Scale (SQS), Insomnia Severity Index, Perceived Stress Scale (PSS), and Daytime fatigue using Fatigue Severity Scale (FSS), along with improvement in sleep and skin quality using a subjective assessment questionnaire. In addition, skin radiance using the Modified Griffiths scale by Dermatologist and Skin Glow by Skin Glossymeter GL 200 instrument was assessed. Changes in serum cortisol levels were also recorded. Results: After consuming Nyumi beauty sleep gummies for 15 days and 25 days, a statistically significant reduction was observed in the SQS score by 35.2% and 60.8%, Insomnia Severity Index score by 52.7% and 100.0%, PSS score by 44.6% and 93.4%, and in FSS score by 33.9% and 81.0% (all P < 0.0001), respectively, implying an improvement in sleep quality. Significant improvement by 25.2% on day 15 and 53.7% on Day 25 for dermatological assessment of skin radiance by Modified Griffiths Scale and 1.16-folds on day 15 and 2.11-folds on day 25 (all P < 0.0001) for skin glow by Skin Glossymeter GL200 instrument was also recorded. Improvement in sleep quality and skin glow was recorded by subjective assessment from baseline to the end of the study. Furthermore, no adverse event was recorded during the study conduction. Conclusion: Nyumi beauty sleep gummies significantly improved the sleep quality (in terms of total sleep time, sleep latency, sleep efficiency, time to sleep onset, number of awakenings, wake time after sleep onset, and sleep efficiency), daytime mood, ability to function at work, concentration, memory; reduced perceived stress, fatigue severity, and insomnia severity score. It also helped in improving skin glow and skin radiance.

Autism, intelligence, language, and adaptive behavior, disentangling a complex relationship.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by a range of intellectual and language abilities. Its heterogeneity is acknowledged in modern diagnostics, complicating research and necessitating precision medicine and a multidimensional approach for individualized treatment and accurate assessment. Intellectual and language functioning influence adaptive skills and symptomatology. Thus, assessing adaptive functioning in a multidimensional and multi-informant manner is crucial, highlighting the importance of comprehensive evaluations. This study explores the interplay between autistic traits, demographic variables, IQ, adaptive functioning, and the applicability of ICD-11 classifications. We analyzed data from the initial global evaluation of 60 diverse autistic children (aged 35 to 120 months; IQ range 16 to 118). Parent-reports using the Vineland Adaptive Behavior Scale (VABS-II) were compared with standardized assessments from the PsychoEducational Profile (PEP-3). Children's intellectual levels were assessed using Griffiths Scales of Child Development (Griffiths III) and the Autism Diagnostic Observation Schedule (ADOS-2) was used for autistic traits. They were further classified according to the ICD-11 diagnostic system, functional language, and intellectual functioning levels. Correlations among variables, group comparisons, and multivariate analyses were performed. The analysis indicates a linear effect of IQ on all adaptive scales and the impact of autistic traits on directly measured adaptive functioning. A factorial effect was observed due to changes concerning specific age, intellectual, and linguistic levels, which do not completely align with ICD-11 categorization. Additionally, a negative correlation between intelligence and measured autistic traits was found. Parental age, education level, and age at childbirth were also found to affect various adaptive scales. The study questions the ICD-11's proposed distinctions in IQ and language functioning for ASD, advocating for more refined categorization and developmental considerations. It underscores the intricate relationship between autistic traits, IQ, and communication skills, casting doubt on the precision of diagnostic tools across the spectrum. Parental reports and direct assessments are essential for comprehensive evaluation, with parental education and age influencing children's behaviors and skills. The study calls for a nuanced approach to ASD assessment, integrating various metrics and sources of information for a detailed phenotyping necessary for personalized interventions and biological research.

Features of Physical and Psychomotor Development in Children with Brain Ischemia.

Brain ischemia is one of the leading causes of morbidity and mortality in infants. Currently, many factors influence the degree of development of ischemia and the consequences affecting the child's body. The purpose of this study was to find the characteristics of the physical and psychomotor development of children with brain ischemia. Based on empirical data, physical (centile tables were used) and psychomotor development (Griffiths scale was used) were studied in 246 full-term children who suffered mild and moderate brain ischemia (ICD-10 codes: 91.1-91.4). There was a frequency of physical disharmony and psychomotor dysfunction, association with each other and the modeling of prognostic characteristics. The following methods were used for the analysis: Pearson chi-square calculation, Kaplan-Meier method and logistic regression. The prevalence of physical disharmony in the studied population of children who had cerebral ischemia is 19.5%, and that of psychomotor dysfunction is 35.0%. The results of the analysis indicate the presence of an association between physical development and psychomotor development of children with cerebral ischemia (P ≤ 0.001; %95 CI OR 1.961-7.270). The disharmony of physical development in children with cerebral ischemia is higher in female children (OR = 2.061, CI = 1.002-4.236), and it grows with an increase in the childbearing age of the mother (OR = 1.090, 95% CI = 1.018-4.236) and decreases with a decrease in the birth weight of the child (OR = 0.189, 95% CI = 0.104-0.345). The probability of occurrence of psychomotor dysfunction is higher in children whose mothers had a complicated birth (OR = 2.065, 95% CI = 1.209-3.527). In children who have suffered brain ischemia, 1/5 of cases develop physical disharmony, and 1/3 of cases develop psychomotor dysfunction. These long-term consequences studied are interrelated with such prognostic characteristics as childbearing age and complicated childbirth in the mother, as well as the sex and weight of the child. The incidence of a combination of physical disharmony and psychomotor dysfunction in children who have suffered cerebral ischemia is 11.8%.

Early detection and treatment of obstructive sleep apnoea in infants with Down syndrome: a prospective, non-randomised, controlled, interventional study

Infants with Down syndrome (DS) are at high risk of obstructive sleep apnoea (OSA) which is associated with neurocognitive dysfunction and behaviour problems. The aim of our study was to evaluate the effect of early OSA treatment in infants with DS on neurocognitive development and behaviour. In this prospective, interventional, non-randomised study, 40 infants with DS underwent polysomnography (PSG) every 6 months in room air between 6 and 36 months of age (Screened Group) and were compared to a control group of 40 infants with DS receiving standard of care and a single, systematic PSG in room air at 36 months of age (Standard Care Group). When present, OSA was treated. The primary endpoint was the total score of the Griffiths Scales of Child Development, Third Edition (Griffiths III) and its subscores at 36 months. Secondary endpoints included a battery of neurocognitive and behaviour questionnaires, and PSG outcomes. On the Griffiths III, the total score was significantly higher in the Screened Group compared to the Standard Care Group (difference: 4.1; 95%CI: 1.3; 7.6; p=0.009). Results in Griffiths III subscores and secondary endpoints were in support of better neurocognitive outcomes in the Screened Group compared with the Standard Care Group. At 36 months, median (Q1; Q3) apnoea-hypopnea index was higher in the Standard Care Group (4.0 [1.5; 9.0] events/hour) compared to the Screened Group (1.0 [1.0; 3.0] events/hour, p=0.006). Moderate and severe OSA were more frequent in the Standard Care Group as compared to the Screened Group (18.9% versus 3.7% for moderate OSA and 27.0% versus 7.4% for severe OSA). Early diagnosis and treatment of OSA in infants with DS may contribute to a significantly better neurocognitive outcome and behaviour at the age of 36 months. The study was funded by the Jérôme Lejeune Foundation.

Epilepsies with onset during the first year of life: A prospective study on syndromes, etiologies, and outcomes.

Infantile seizures cause great concern for both doctors and parents. In addition to modern neuroimaging and genetics, clinical tools helpful in predicting the course of the disease are needed. We prospectively studied the incidence, electroclinical characteristics and etiologies of epilepsy syndromes with onset before the age of 12 months and looked for prognostic determinants of outcome by age 24 months. From February 2017 through May 2019, we recruited all eligible infants diagnosed with epilepsy at our unit. Data on electroclinical studies, genetic investigations and drug response were gathered prospectively. The infants were given a structured neurological examination (Hammersmith Infantile Neurological examination [HINE] and Griffiths scales) at predetermined intervals until age 24 months at which age neurocognitive evaluation with Bayley scales was performed. Included were 60 infants (27 female). The mean onset age of epilepsy was 5.3 (±2.5 standard deviation) months. The incidence of epilepsy in the population-based cohort was 131 (95% confidence interval 99-172)/100 000. Epilepsy syndrome was identified in 80% and etiology in 58% of infants. Self-limited infantile epilepsy was the second most common syndrome (incidence 18/100 000) after infantile epileptic spasms syndrome. PRRT2 was the most common monogenic cause. At age 24 months, 37% of the infants had drug-resistant epilepsy (DRE) and half had a global developmental delay (GDD). Abnormal first HINE was the strongest predictor of GDD, followed by DRE and identified etiology. DRE was associated with structural etiology and GDD. Those with normal first HINE and good response to treatment had favorable outcomes, irrespective of the identified etiology. Our results support a high incidence of self-limited epilepsy in infancy and PRRT2 as the genetic cause in the first year of life. Notwithstanding the advances in etiological discovery, we want to highlight the importance of clinical evaluation as standardized neurological examination with HINE proved a valuable tool in prognostication. One in every 700-800 babies develop epilepsy within the first year after birth. Our study identified an epilepsy syndrome in 80% and the cause of epilepsy in 60% of the participants. By age 2 years, over one-third of the children still experienced seizures, and almost half faced significant developmental delay. Structural brain abnormalities increased the likelihood of difficult epilepsy and developmental challenges. Babies whose epilepsy was caused by a gene defect varied widely in development and response to medications. Babies with normal neurological examination at first visit, especially if their seizures stopped quickly, had favorable development.

Quantitative EEG features during the first day correlate to clinical outcome in perinatal asphyxia.

To assess whether computational electroencephalogram (EEG) measures during the first day of life correlate to clinical outcomes in infants with perinatal asphyxia with or without hypoxic-ischemic encephalopathy (HIE). We analyzed four-channel EEG monitoring data from 91 newborn infants after perinatal asphyxia. Altogether 42 automatically computed amplitude- and synchrony-related EEG features were extracted as 2-hourly average at very early (6 h) and early (24 h) postnatal age; they were correlated to the severity of HIE in all infants, and to four clinical outcomes available in a subcohort of 40 newborns: time to full oral feeding (nasogastric tube NGT), neonatal brain MRI, Hammersmith Infant Neurological Examination (HINE) at three months, and Griffiths Scales at two years. At 6 h, altogether 14 (33%) EEG features correlated significantly to the HIE grade ([r]= 0.39-0.61, p < 0.05), and one feature correlated to NGT ([r]= 0.50). At 24 h, altogether 13 (31%) EEG features correlated significantly to the HIE grade ([r]= 0.39-0.56), six features correlated to NGT ([r]= 0.36-0.49) and HINE ([r]= 0.39-0.61), while no features correlated to MRI or Griffiths Scales. Our results show that the automatically computed measures of early cortical activity may provide outcome biomarkers for clinical and research purposes. The early EEG background and its recovery after perinatal asphyxia reflect initial severity of encephalopathy and its clinical recovery, respectively. Computational EEG features from the early hours of life show robust correlations to HIE grades and to early clinical outcomes. Computational EEG features may have potential to be used as cortical activity biomarkers in early hours after perinatal asphyxia.

Neurodevelopmental Outcome at 3 Years of Age in Very Low Birth Weight Infants According to Brain Development and Lesions.

During the last decades, severe brain lesions affecting very low birth weight (<1500 gr, VLBW) infants were gradually substituted by milder lesions with debatable prognoses. The objective of this study is to define type, frequency and 3 years of neurodevelopmental outcome of prematurity-related brain lesions in a modern cohort of VLBW infants. VLBW infants admitted to our NICU in 5 years period with brain MRI at term-equivalent age were included. MRI scans were reviewed to identify and grade white matter lesions (WML), intraventricular hemorrhage (IVH), and cerebellar hemorrhage (CBH). Linear measurements of brain size, biparietal width (BPW) and trans-cerebellar diameter (TCD) were carried out. Total maturation score (TMS) was calculated. Developmental Coefficients (DQ) on Griffiths Scale at 3 years of age were compared between patients with different types and grades of lesions and patients without lesions; possible correlations between linear brain measurements, brain maturation and outcome were explored. Study included 407 patients. Of them, 187 (46%) had at least one brain lesion on MRI, while 37 (9%) had severe lesions. The most frequent lesion was IVH (28%), followed by WML (21%) and CBH (17%). Mild and severe IVH, moderate and severe WML and all grades of CBH were related to worst outcome at 3 years. In patients without lesions, small BPW and small TCD were associated with worse outcomes. No correlations were observed between TMS and outcome. We have observed that even mild brain lesions have a negative influence on neurological outcome at 3 years of age.

The Developmental Autism Early Screening (DAES): A Novel Test for Screening Autism Spectrum Disorder.

This study was undertaken to set a novel developmental screening test for autism spectrum disorder (ASD) using the Griffiths Scales of Child Development (Griffith III) (Green et al., 2016; Stroud et al., 2016), in order to intercept the early atypical developmental patterns indicating ASD risk in the first 3years of age. An observational and interactive ASD screener, the Developmental Autism Early Screening (DAES), was developed by detecting Griffiths III items differentiating toddlers with ASD risk from those with global developmental delay (DD) or neurotypical development. The DAES was validated with ASD-specific diagnostic instruments (ADOS-2) and the cut-off score based on sensitivity, specificity and positive predictive value that best differentiates between ASD and non-ASD children was identified. We enrolled a total sample of 297 subjects, including children at risk for ASD or DD and neurotypical children. At a cut-off score of 12.5, the DAES had a sensitivity of 93%, specificity of 98.4%, positive predictive value of 96.3% and negative predictive value of 96.9% for identifying children at risk for ASD from non-ASD participants (DD/neurotypical children). The DAES total score correlated significantly with the ADOS-2 calibrated severity scores (CSS) (R = 0.53, p < 0.001). Three ASD risk ranges were identified according to DAES total and ADOS-2 CSS: Little-to-no risk (CSS: 1-3, DAES: 1-7); Mild-to-moderate risk (CSS: 4-5, DAES: 8-14); Moderate-to-severe risk (CSS: 6-10, DAES ≥ 15). The DAES provides a direct approach based on developmental profiles to stratify risk for ASD in early childhood ensuring at risk children the most appropriate diagnostic procedures and targeted intervention.

Citrullinemia and What Else?

Citrullinemia type I (CTLN1) is a rare autosomal recessive metabolic disorder. Symptoms typically include vomiting, lethargy, seizures and coma. In neonatal presentation, death occurs in days if untreated. Survivors may evolve with neurocognitive dysfunction. Two 10 years old, non-identical, twin sisters (S1; S2) with CTLN1 were born after a 36W gestation: S1 by eutocic delivery and S2 by cesarean section with nuchal cord (Apgar score 5/10). On day four, S2 presented hyperammonemia with coma. S1 had no complications. Diagnosis followed that of S2. Neurocognitive development was monitored at 3 months - 4 years of age with Griffiths Scales: global development quotient kept within the average, but S2 had a deficit in language and eye and hand coordination. At 5 years, the neurocognitive abilities were evaluated using Wechsler Preschool and Primary Scale of Intelligence - Revised (WPPSI-R). S2 revealed difficulties in verbal area (vocabulary, comprehension and memorizing sentences), with a lower average verbal intelligence quotient (IQ). S1 had high average IQ. Due to learning difficulties, S2 was reassessment at 8 years old with Wechsler Intelligence Scale for Children - Third edition (WISC-III): full-scale IQ -"extremely low". These non-identical twin sisters share the same citrullinemia type 1 causing variants in the ASS1 gene. Nevertheless, their clinical presentation and neurocognitive evolution are diverse. Other factors, like the different genetic background and perinatal issues such as the type of delivery and its circumstances and the neonatal coma episode of S2 may explain the dissimilar evolution. Maximum ammonium levels (and its duration) are critical for the patients' neurodevelopment: 131 in S1 and 546 umol/l in S2.

Prospective assessment of early developmental markers and their association with neuropsychological impairment

Children who experience adversities in the pre-perinatal period are at increased risk of developing impairment later in life, despite the absence of overt brain and neurological abnormalities. However, many of these children exhibit sequelae several years after a period of normal appearance. As a result, the need for reliable developmental assessments for the early detection of infants at high risk of adverse neurodevelopmental outcomes has emerged. The Griffiths Mental Developmental Scales have a promising but poorly explored prognostic ability. This longitudinal study evaluated the predictive power of the Griffiths Mental Developmental Scales at 12 and 24 months on the cognitive and neuropsychological profile at 6 years of age in a sample of 70 children with a history of prematurity or perinatal asphyxia but without brain and neurological abnormalities. We found that the Griffiths Mental Developmental Scales at 24 months had good predictive ability on the intelligence quotient at 6 years and the capacity to predict some neuropsychological performances. On the other hand, the Griffiths Mental Developmental Scale at 12 months was not associated with the performance at 6 years or 24 months. Conclusion: Data on brain development converge to indicate that the first two years of age represent a critical stage of development, particularly for children experiencing mild pre-perinatal adversities who are thought to exhibit white matter dysmaturity. For this reason, this age is crucial for identifying which children are at major risk, leaving enough time to intervene before overt deficits become apparent. Brain development in the first 2 years could explain the limited reliability of early neurodevelopmental testing.What is Known:• Pre-perinatal adversities increase the risk of developing neurodevelopmental disorders.• The predictive ability of the Griffith scale is poorly explored in low-grade conditions.What is New:• The predictive ability of the Griffith scale has been investigated in low-risk children.• A complete neuropsychological profile could offer a more accurate prediction than the intellectual quotient.

Establishing reliability of dermatologist trained and validated evaluators for assessments of dermatological parameters: a comprehensive overview of concepts and techniques

Background: Multi-centered, multi-visit outpatient dermatology studies provide participant-friendly convenience, drawing diverse volunteers while avoiding extended facility stays. However, maintaining a consistent dermatologist for such studies poses challenges, possibly leading to incomplete clinical readings and delaying accurate data collection from predefined datasets. Methods: Led by a Dermatologist, the training aimed to ensure harmony in assessments among trained evaluators when utilizing digital photos to analyze dermatological parameters. It aimed to establish accord between the Dermatologist and Trained Evaluators for inter- and intra-observer evaluations. The training encompassed multiple parameters, such as Draize Scale, Fitzpatrick Skin Type, Glogau Skin Age Classification, IGA (Acne), PGA with Griffith Scale, and PGA for brittle nail signs. Results: The results of the statistical analysis for photographic evaluation inter-evaluator reliability were evaluated. Based on the data, a strong correlation was observed between the Dermatologist's dataset and the Trained Evaluator's dataset. The Pearson chi-square test yielded a p-value of &lt;0.05, indicating significant correlation among the trained evaluators' data compared to the dermatologist's data. All evaluators met the 80% acceptance criteria outlined in the training plan. Both evaluators and dermatologists were deemed suitable for dermatological assessments and photographic evaluations in relevant studies. Conclusions: Theoretical training enabled evaluators to comprehend various dermatological parameters, including Draize Scale, Fitzpatrick Skin Type, Glogau Skin Age Classification, PGA with Griffith Scale, IGA (Acne), and PGA for brittle nail signs. Trained evaluators are now qualified to independently serve as "Dermatologist Validated and Trained Evaluators" in future studies. This approach is applicable for multi-centered, multi-visit dermatological clinical studies.

Neurodevelopmental Correlates of Brain Magnetic Resonance Imaging Abnormalities in Extremely Low-birth-weight Infants

To evaluate the relationship between impaired brain growth and structural brain abnormalities at term-equivalent age (TEA) and neurodevelopment in extremely low-birth-weight (ELBW) infants over the first 2years. ELBW infants born from 2009 through 2018 and undergoing brain magnetic resonance imaging (MRI) at TEA were enrolled in this retrospective cohort study. MRI scans were reviewed using a validated quali-quantitative score, including several white and gray matter items. Neurodevelopment was assessed at 6, 12, 18, and 24months using the Griffiths scales. The independent associations between MRI subscores and the trajectories of general and specific neurodevelopmental functions were analyzed by generalized estimating equations. One hundred-nine ELBW infants were included. White matter volume reduction and delayed myelination were associated with worse general development (b = -2.33, P=.040; b = -6.88, P=.049 respectively), social skills (b = -3.13, P=.019; b = -4.79, P=.049), and eye-hand coordination (b = -3.48, P=.009; b = -7.21, P=.045). Cystic white matter lesions were associated with poorer motor outcomes (b = -4.99, P=.027), while white matter signal abnormalities and corpus callosum thinning were associated with worse nonverbal cognitive performances (b = -6.42, P=.010; b = -6.72, P=.021, respectively). Deep gray matter volume reduction correlated with worse developmental trajectories. Distinctive MRI abnormalities correlate with specific later developmental skills. This finding may suggest that TEA brain MRI may assist with neurodevelopmental prediction, counseling of families, and development of targeted supportive interventions to improve neurodevelopment in ELBW neonates.

Perinatal and postnatal exposure to phthalates and early neurodevelopment at 6 months in healthy infants born at term.

Phthalates are non-persistent chemicals largely used as plasticizers and considered ubiquitous pollutants with endocrine disrupting activity. The exposure during sensible temporal windows as pregnancy and early childhood, may influence physiological neurodevelopment. The aim of this study is to analyze the relationship between the urinary levels of phthalate metabolites in newborn and infants and the global development measured by the Griffiths Scales of Children Development (GSCD) at six months. Longitudinal cohort study in healthy Italian term newborn and their mothers from birth to the first 6 months of life. Urine samples were collected at respectively 0 (T0), 3 (T3), 6 (T6) months, and around the delivery for mothers. Urine samples were analyzed for a total of 7 major phthalate metabolites of 5 of the most commonly used phthalates. At six months of age a global child development assessment using the third edition of the Griffith Scales of Child Development (GSCD III) was performed in 104 participants. In a total of 387 urine samples, the seven metabolites analyzed appeared widespread and were detected in most of the urine samples collected at any time of sampling (66-100%). At six months most of the Developmental Quotients (DQs) falls in average range, except for the subscale B, which presents a DQ median score of 87 (85-95). Adjusted linear regressions between DQs and urinary phthalate metabolite concentrations in mothers at T0 and in infants at T0, T3 and T6 identified several negative associations both for infants' and mothers especially for DEHP and MBzP. Moreover, once stratified by children's sex, negative associations were found in boys while positive in girls. Phthalates exposure is widespread, especially for not regulated compounds. Urinary phthalate metabolites were found to be associated to GSCD III scores, showing inverse association with higher phthalate levels related to lower development scores. Our data suggested differences related to the child's sex.

Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition.

Objectives: The Ages & Stages Questionnaires Third Version (ASQ-3) identifies the risk of developmental delay in children aged 1 to 66 months. The aim of this study was to determine a reliable and valid instrument for the Italian population to enable the screening of children's development. Methods: Data from 2278 Italian children (age range: 1-66 months) were used to evaluate item discrimination power using the corrected item-total correlation. Internal consistency was analyzed by Cronbach's alpha scores and a Confirmative Factor Analysis was conducted to test the factor structure of the test. Data were also collected to examine the ASQ-3 test-retest reliability and concurrent validity, which was investigated using the Griffiths Scales of Child Development, Third Edition, the Peabody Developmental Motor Scale, Second Edition, and the Developmental Profile, Third Edition tools. In order to evaluate discriminant validity, differences between typical development children and several clinical groups have been performed. Finally, two different cut-off scores have been proposed. Results: The results showed that the questionnaires are composed of high-quality items; the original factor structure has been confirmed and strong Pearson product-moment correlation coefficients between the overall and the total for each domain (ranging from 0.73 to 0.88). The Italian version of the ASQ-3 had adequate internal consistency and a strong agreement between observations with two weeks' intervals. Moreover, the test showed a high discriminant validity due to the possibility of fully discriminating between typical development children and several clinical groups. Finally, two different cut-off scores have been identified using ROC curves in order to have a screening and a diagnostic cut-off value. Conclusion: This study evaluated the psychometric properties of the Italian adaptation of ASQ-3 questionnaires. We demonstrated the validity of the ASQ-3 and determined new cut-off scores for Italian children. Early identification and accurate assessment are important starting points to better understand and anticipate the needs of children and their link to services.

Improvements in skin quality parameters in postmenopausal participants after use of topical growth factor serum.

Photodamage can induce skin aging processes that can be particularly concerning for postmenopausal women. Growth factors from hypoxic human fibroblast-conditioned media have demonstrated improvements in skin quality parameters. The aim of the study was to assess efficacy and tolerability of topical combination-treatment hypoxic growth factor serum (TNS A+) in postmenopausal women with moderate to severe facial photodamage. In this 12-week, open-label, single-center study, participants used TNS A+ serum twice daily. Postmenopausal women (40-65 years of age) with Fitzpatrick skin types I-VI and modified Griffiths scale scores 4-9 were eligible. Clinical and participant-reported assessments were evaluated at Weeks 6 and 12. Statistical significance was defined as p≤ 0.05. There were 17 enrolled participants. TNS A+ treatment demonstrated significant improvements from baseline in fine lines and wrinkles in periocular, forehead, and cheek areas at Week 12 and the perioral area at Weeks 6 and 12. Significant improvements from baseline in coarse lines and wrinkles were observed for the perioral area at Week 12 and periocular and cheek areas at Weeks 6 and 12. Improvements in overall photodamage, skin tone evenness, and tactile roughness were significantly greater at Weeks 6 and 12 versus baseline. Most participants reported TNS A+ made their skin look and feel smooth, soft, and rejuvenated; improved skin radiance; made lines and wrinkles less apparent; and improved skin texture. No treatment-related adverse events were reported. The TNS A+ regimen was well tolerated and provided significant improvements in skin quality in postmenopausal women with moderate to severe facial photodamage.

Screening for Fragile X Syndrome Among Filipino Children with Autism Spectrum Disorder.

Individuals with autism spectrum disorder present with difficulties in social communication, restricted interests or behaviors and other co-morbidities. About 2 to 10% of cases of autism have a genetic cause, and Fragile X Syndrome (FXS) is reported in 0 to 6.5% of individuals with autism. However, the FXS and premutation prevalence among Filipino children has never been reported. The aim of the study was to establish the presence of FXS or premutation carriers among Filipino children with autism and to describe the phenotypic characteristic of cases identified. Blood was collected from 235 children aged 2-6 years old and diagnosed with autism. Samples were analyzed using PCR methods to amplify CGG repeats in the FMRI gene. The diagnosis of autism was confirmed through the Autism Diagnostic Observation Schedule-2. Additional characteristics were documented from a physical examination, Griffiths Scales of Child Development assessment and a parent-answered questionnaire using the Vineland Adaptive Behavior Scale. Fragile X testing through PCR methods in 235 children with diagnosed autism showed 220 (93.6%) were negative, no full mutations, 1 (0.436%) premutation carrier and 14 (5.95%) cases contained intermediate alleles. The FXS testing was limited to confirmed cases of autism, which is considered a high-risk group and does not provide prevalence for the general Filipino population. Subjects were self-referred or referred by clinicians, which may not represent the Filipino autism population with a bias towards those with means for clinical consultations and ability to travel to the place of testing. Samples were not measured for mosaicism, DNA methylation or AGG interspersion patterns. These may have effects on the CGG repeat expansion and overall presentation of FXS. Findings from a single premutation carrier cannot characterize features distinctly present in Filipinos with the mutation. Nevertheless, these results support the data that the prevalence of FXS in Asian populations may be lower than non-Asian populations. This can contribute to a better understanding of FXS and genetic causes of autism in the Philippines and other Asian populations.

The Kids Are Alright (?). Infants' Development and COVID-19 Pandemic: A Cross-Sectional Study.

Objectives: The study aimed to assess and compare the global development in six-month-old infants before and during the pandemic restrictive social distancing measures. Methods: This cross-sectional nested study involved infants assessed through the Griffiths Scales of Child Development (GSCD) between September 2019 and April 2021. Infants were classified in a pre-COVID or a COVID group, considering the evaluation date and the restrictive measures in place. GSCD subscales and General Development Scores (GDS) were calculated and compared. Results: One hundred and four healthy term-born infants were evaluated. GDS in the COVID group (n:70; median: 94; IQR: 90–100) appeared significantly lower than in the pre-COVID group (n:34; median: 98; IQR: 97–103; p < 0.001). Language and personal-social-emotional subareas scores appeared the most affected. A decreasing trend of GDS along with the severity of restriction was observed. Conclusion: A reduction in infant development scores was observed during pandemic social distancing. Further studies are needed to systematize these findings and to address effective public health policies for infants and families during long-term forced isolation periods.

'Low-normal' motor skills in infants at high risk for poor developmental outcomes: A prevalence and prognostic study.

To investigate the prevalence and prognostic value of 'low-normal' motor skills in infants at high-risk for poor developmental outcomes. Infants born extremely low-birthweight and extremely preterm discharged from neonatal intensive care between 2015 and 2018 completed the Alberta Infant Motor Scale (AIMS), Neuro-Sensory Motor Developmental Assessment (NSMDA) at corrected age 4, 8, and 12 months, and Griffiths Mental Development Scale at corrected age 12 months. Participating infants (n=191) with a mean gestational age (95% confidence interval [CI]) of 26.80 weeks (26.60, 27.1) and mean birthweight (95% CI) of 869 grams (843, 895) included 45 (23.80%) infants small for gestational age. AIMS rated 50.32%, 35.37%, and 14.86% of infants within the 'low-normal' motor skills range (1-2 SD below the mean for age) at 4, 8, and 12 months respectively. Of the infants within the AIMS 'low-normal' skills range, 55.70%, 88.46%, and 59.10% were classified as having impairment by NSMDA at 4, 8, and 12 months respectively. Griffiths assessment at 12 months identified only 7.33% of infants with 'low-normal' skills and 3.33% with motor disability. Minimal motor impairment rating on the NSMDA at 4 or 8 months significantly predicted general development at 12 months. High-risk infants with 'low-normal' motor skills may warrant referral to early intervention as associated impairment represents increased risk for poorer general development outcomes. High prevalence of 'low-normal' motor skill exists in high-risk infants. Clinical motor assessment validly identifies infants with motor impairment. Minimal motor impairment in high-risk infants is prognostic of general development. High-risk infants with 'low-normal' motor skills may warrant early intervention. Griffiths Scales of Child Development, Third Edition assessment at 12-months age may under-identify motor difficulties.

ADAPTED GRIFFITHS SCALE AS A CURRENT EXPERIENCE OF EVALUATION OF PSYCHOMOTOR DEVELOPMENT OF PRESCHOOL CHILDREN

Introduction. Premature infants are a special category of children with an inherent morpho-functional immaturity and specific pathological conditions that cause significant differences in survival, morbidity and consequences of caring for these infants compared to children of other weight categories. In the structure of long-term adverse effects of premature birth remains a high frequency of neurological disorders that require further improvement of diagnostic methods and timely correction to improve the prognosis of further development. Despite the development of numerous assessment tools for prognosis of long- term adverse effects of premature infants and techniques determining the extent of violations during the last three decades, there was no study providing a comprehensive overview of those tools, as well as their strengths and weaknesses.Aim. Improve the long-term effects of preterm birth by using an adapted Griffiths scale in preschool children. Materials and methods. An assessment of the psychomotor development of 105 preschool children was estimated. Assessment of psychomotor development was performed using an adapted Griffiths scale and a traditional method. During the study, this category of children was under the supervision of follow-up doctors to systematically assess their health. Dynamic examination was performed during the first year of life every 3 months, from the second to the sixth year of life - according to the individual rehabilitation plan. Patients were divided into 3 groups depending on the severity of disabling pathology.Results. An analysis of indicators of psychomotor development (traditional methods) of preschool children born prematurely, which were divided into 3 groups according to the severity of disabling pathology: Group A Children with severe long-term consequences that led to disability - 54 (51.4 %)Group B. Children with long-term consequences that require correction - 24 (22.8 %)Group C. Children with long-term consequences that do not significantly affect the general condition - 27 (25.7 %). According to the results of the survey, it can be revealed that more than 70% of respondents had the equivalent of delayed psychomotor development of various patterns. Тhe analysis of the assessment of psychomotor development showed that the structure of the causes of delayed psychomotor development in preschool children had the same trend for different methods of examination. However, the Griffiths adapted assessment demonstrates more accurate outcomes of a certain patient, makes it possible to quickly detect long-term adverse effects of preterm birth, and gives recommendations for infants and families to develop an individual rehabilitation and habilitation program, and examinations in dynamics.Conclusions. It has been established that the adapted Griffiths psychomotor development scale is a valid diagnostic tool in the cohort of preschool children in order to determine psychomotor development indicators, calculate the child's intellectual coefficient and form an individual patient profile.

Age-related hallmarks of psychopathology in Cornelia de Lange and Rubinstein-Taybi syndromes

Background and aimThere is mounting evidence highlighting that Cornelia de Lange Syndrome (CdLS) and Rubinstein-Taybi Syndrome’s (RSTS) behavioral phenotypes are not stable over individual developmental trajectories and that several psychiatric disorders might arise with age. Our study aims to examine the specific hallmarks of psychopathology and behavioral phenotypes in four different age ranges: infancy and toddlerhood, early childhood, middle childhood, and adolescence, in both genetic syndromes. MethodThe sample included 44 patients with CdLS (48% boys, age = 6.67 ± 4.36) and 31 with RSTS (48% boys, age = 6.89 ± 4.58) recruited through follow-ups. Cognitive, behavioral, and autism assessments were carried out with Griffith's scales or the Leiter-R, the Child Behavior Checklist, and the Child Autism Rating Scales 2. Multiple ANOVA 2 × 4 were run to outline behavioral phenotypic age-related syndromic markers and ANCOVA to value the weight of IQ and ASD-related traits on the psychopathological outcome. ResultsFindings showed that anxiety is a crucial phenotypic hallmark, independent of IQ but associated with autistic traits, that increases from infancy to adolescence in both CdLS and RSTS. Conclusion and implicationsBeing aware of the developmental challenges that growing children are called to face is essential for drawing up proper standards of assessment turning into target age-related interventions, ensuring these patients personalized healthcare and improvement in life quality.