Developmental Milestones Research Articles

Clinicoaetiological Profile of Infantile Tremor Syndrome in a Tertiary Care Hospital, Punjab, India: An Observational Study

Introduction: Infantile Tremor Syndrome (ITS) is a condition that mainly affects infants aged 6-24 months. Although predominantly considered a disorder of vitamin B12 deficiency, there have been some reports of an association of other micronutrient deficiencies in ITS babies. Aim: To assess the clinicoaetiological profile of cases of ITS admitted to the tertiary care centre. Materials and Methods: This was a retrospective observational study conducted at Punjab Institute of Medical Sciences, Jalandhar, Punjab, India. All cases of ITS admitted to the Paediatric ward from April 2022 to March 2023 were enrolled. Their case records were studied for clinical signs and symptoms like presenting complaints, demographic profile, feeding history, history of tremors, and developmental milestones. Examination findings were studied for the degree of malnutrition, presence of anaemia, knuckle hyperpigmentation, sparse hypopigmented hair, other evidence of micronutrient deficiency, hepatosplenomegaly, and any focal neurological deficit. Laboratory parameters, mainly blood counts, haemoglobin, Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin Concentration (MCHC), peripheral smear findings, vitamin D and B12 levels, and serum albumin, were analysed to ascertain the clinicoaetiological profile of ITS. Results: A total of 19 cases were included in the study. All of them had sparse hypopigmented hair and anaemia. Thirteen (68.4%) had knuckle hyperpigmentation, 11 (58%) had tremors, and 16 (84.2%) had developmental delay/regression without any other underlying cause. Only 9 (47.4%) had laboratory evidence of vitamin B12 deficiency, while 14 (73.7%) had vitamin D deficiency. All the babies were discharged home, and tremors resolved in all of them after vitamin D, B12, and zinc therapy. Conclusion: In addition to vitamin B12, Vitamin D deficiency was seen in most cases of ITS. Hence, all patients with ITS need to be evaluated and treated for vitamin B12 as well as vitamin D deficiency for optimal treatment of this disorder.

ВЛИЯНИЕ ЧЕЛОВЕЧЕСКОГО КАПИТАЛА НА РАЗВИТИЕ НАЦИОНАЛЬНЫХ СОЦИАЛЬНО-ЭКОНОМИЧЕСКИХ СИСТЕМ

In the course of our research we have revealed the essence of the phenomenon of our study - human capital, the development of which determines the prosperity of the countries of the world. In the process of studying the topic of the scientific article, we determined the economic interpretation of this term, and also identified its main types and features. As is known, human capital is classified to intensive factors of production. After all, thanks to the object of our study, the formation and development of innovative technologies, as well as knowledge, skills and abilities on the highest stage of development of society and economy is carried out. In addition, we also resorted to the analysis of the list of countries according to the human development index, which is identified as a tool that contributes to the competent redistribution of countries into three key categories: developed, developing and third world countries. It should be added that this index was formed in 1990 by Pakistani and Indian economists - Mahbub ul Haq and Amartya Sen, respectively. Thus, the task of each state is the formation of high indicators of human capital, because its development will depend on the general state of the entire economic system of the country. After all, at the present stage of human development it is human capital that is more responsible for the rate of economic growth, and ensures the development of scientific and technological progress in the life of society and the entire economic system. This, in turn, again increases the im-portance and relevance of the research topic under consideration in the conditions of the modern twenty-first century.

Conscious Bias: Regulating iBlastoids

Research into the early stages of human development has remained difficult due to ethical concerns around the use of human embryonic material. The creation of iBlastoids, which are simulations of human blastocysts created from human skin cells, offers a path that provides clearer avenues for research with the potential to sidestep ethical dilemmas. However, scientific and regulatory communities are yet to decide how to regulate these structures, and a new framework around which to judge moral worth is required. One possible avenue is to consider an organism’s consciousness.

Generation of Skeletal Muscle Organoids from Human Pluripotent Stem Cells.

Various protocols have been proven effective in the directed differentiation of mouse and human pluripotent stem cells into skeletal muscles and used to study myogenesis. Current 2D myogenic differentiation protocols can mimic muscle development and its alteration under pathological conditions such as muscular dystrophies. 3D skeletal muscle differentiation approaches can, in addition, model the interaction between the various cell types within the developing organoid. Our protocol ensures the differentiation of human embryonic/induced pluripotent stem cells (hESC/hiPSC) into skeletal muscle organoids (SMO) via cells with paraxial mesoderm and neuromesodermal progenitors' identity and further production of organized structures of the neural plate margin and the dermomyotome. Continuous culturing omits neural lineage differentiation and promotes fetal myogenesis, including the maturation of fibroadipogenic progenitors and PAX7-positive myogenic progenitors. The PAX7 progenitors resemble the late fetal stages of human development and, based on single-cell transcriptomic profiling, cluster close to adult satellite cells of primary muscles. To overcome the limited availability of muscle biopsies from patients with muscular dystrophy during disease progression, we propose to use the SMO system, which delivers a stable population of skeletal muscle progenitors from patient-specific iPSCs to investigate human myogenesis in healthy and diseased conditions. Key features • Development of skeletal muscle organoid differentiation from human pluripotent stem cells, which recapitulates myogenesis. • Analysis of early embryonic and fetal myogenesis. • Provision of skeletal muscle progenitors for in vitro and in vivo analysis for up to 14 weeks of organoid culture. • In vitro myogenesis from patient-specific iPSCs allows to overcome the bottleneck of muscle biopsies of patients with pathological conditions.

ETHICAL RULES AND FEATURES OF FIRST AID PROCEDURE FOR VICTIMS BY RESCUE SERVICE FORCES AND DOCTORS IN EMERGENCY SITUATIONS

According to the United Nations, during the last 20 years, about 3 million people died in the world as a result of natural disasters, and almost 1 billion experienced the harmful effects of natural disasters. Currently, apart from natural disasters (earthquakes, floods, landslides, etc.), numerous hazards emerge from human activity, potentially triggering emergency situations. The simultaneous occurrence of mass sanitary losses in various types of disasters requires the implementation of emergency medical measures by medical professionals, while the general population should be capable of providing basic medical assistance. At a certain historical stage of human development, social upheavals such as wars and epidemics joined natural phenomena. Natural disasters, major industrial accidents, and transportation catastrophes are common and frequent occurrences. From the multitude of natural disasters and major technological catastrophes, notable events include: the Chernobyl nuclear accident (1984), the earthquake in Armenia (1988), a railway disaster with an explosion on a gas pipeline in Bashkiria (1989), an explosion in an underground passage in Moscow (2000), an explosion at Domodedovo Airport (2012), the COVID-19 pandemic (2020), an explosion at a warehouse with ammonium nitrate in the port of Beirut (2020), an earthquake in Turkey (2023), and so on. The number of disasters worldwide shows no tendency to decrease, just like the number of terrorist threats. Understanding the rules of ethics, procedures, and methods of providing first aid to the injured in extreme situations are essential for specialist physicians, rescue services, and the general civilian population.

Assessing motor development and function in mouse models of neurodevelopmental disorders.

Alterations in motor development often accompany neurodevelopmental disorders (NDD) and can have an impact on social interaction and communication. Studying motor development and function in mouse models of NDDs can offer a window to identify underlying biological mechanisms and establish preclinical outcome measures for testing therapeutics. This chapter describes tests to measure motor developmental milestones early postnatally and adult motor functions in mouse models of NDDs.

Role of anganwadi workers' knowledge in the developmental milestones of children at anganwadi centers

Role of anganwadi workers' knowledge in the developmental milestones of children at anganwadi centers

Revisão narrativa sobre a relação entre estresse tóxico e desempenho ocupacional na primeira infância

Abstract Introduction Early childhood is a crucial stage for human development during which the environment significantly influences brain formation and functioning. Adverse experiences during this period can trigger toxic stress, which in turn may hinder the achievement of developmental milestones. Objective This study aims to describe the main adverse childhood experiences that lead to toxic stress in children aged 0 to 6 years, also considering their implications for mental health and occupational performance. Method A narrative review was conducted using the databases Web of Science, EBSCO, Scopus, and Psychology Database. Ten relevant articles were selected for analysis. Results The search revealed that poverty, child violence, and discrimination are the three most common adverse experiences generating toxic stress. Additionally, protective factors that can mitigate the impact of these adverse experiences, thereby strengthening childhood resilience, were identified. Among these factors, positive parenting characteristics stand out as the primary protective element. Conclusion Although a direct relationship between toxic stress and occupational performance was not found in the reviewed literature, it is concluded that the latter is indirectly affected because of its connection with mental health and child development – key aspects of participation in daily activities. This underscores the importance of expanding research in the field of occupational therapy, as it can significantly contribute to the promotion and prevention of mental health in childhood.

Regulation of Oocyte mRNA Metabolism: A Key Determinant of Oocyte Developmental Competence.

The regulation of mRNA transcription and translation is uncoupled during oogenesis. The reason for this uncoupling is two-fold. Chromatin is only accessible to the transcriptional machinery during the growth phase as it condenses prior to resumption of meiosis to ensure faithful segregation of chromosomes during meiotic maturation. Thus, transcription rates are high during this time period in order to produce all of the transcripts needed for meiosis, fertilization, and embryo cleavage until the newly formed embryonic genome becomes transcriptionally active. To ensure appropriate timing of key developmental milestones including chromatin condensation, resumption of meiosis, segregation of chromosomes, and polar body extrusion, the translation of protein from transcripts synthesized during oocyte growth must be temporally regulated. This is achieved by the regulation of mRNA interaction with RNA binding proteins and shortening and lengthening of the poly(A) tail. This chapter details the essential factors that regulate the dynamic changes in mRNA synthesis, storage, translation, and degradation during oocyte growth and maturation.

The Impact of COVID-19 on Children and Adolescents with Chronic Illness.

Children and adolescents living with chronic illness may already be at a disadvantage when compared to their healthy peers in achieving developmental milestones as they are required to manage healthcare aspects of their condition in addition to the typical transitions associated with this developmental stage. The COVID-19 pandemic has significantly impacted on the physical and mental well-being of children and adolescents including those young people living with a chronic illness. Disruptions and delays of healthcare service provision, prolonged lockdowns, strict social distancing measures, and school closures are some of the pandemic implications that have affected daily routines imposing strains on young people themselves, but also on their caregivers. This chapter presents a critical elaboration on the available evidence documenting the unique impact of the pandemic at an individual-, family-, and system-level on children and adolescents aged up to 18years old living with a non-communicable disease (e.g., cancer, diabetes, asthma).

Neuroinflammation, blood-brain barrier dysfunction, hippocampal atrophy and delayed neurodevelopment: Contributions for a rat model of congenital Zika syndrome

The congenital Zika syndrome (CZS) has been characterized as a set of several brain changes, such as reduced brain volume and subcortical calcifications, in addition to cognitive deficits. Microcephaly is one of the possible complications found in newborns exposed to Zika virus (ZIKV) during pregnancy, although it is an impacting clinical sign. This study aimed to investigate the consequences of a model of congenital ZIKV infection by evaluating the histopathology, blood-brain barrier, and neuroinflammation in pup rats 24 h after birth, and neurodevelopment of the offspring. Pregnant rats were inoculated subcutaneously with ZIKV-BR at the dose 1 × 107 plaque-forming unit (PFU mL-1) of ZIKV isolated in Brazil (ZIKV-BR) on gestational day 18 (G18). A set of pups, 24 h after birth, was euthanized. The brain was collected and later evaluated for the histopathology of brain structures through histological analysis. Additionally, analyses of the blood-brain barrier were conducted using western blotting, and neuroinflammation was assessed using ELISA. Another set of animals was evaluated on postnatal days 3, 6, 9, and 12 for neurodevelopment by observing the developmental milestones. Our results revealed hippocampal atrophy in ZIKV animals, in addition to changes in the blood-brain barrier structure and pro-inflammatory cytokines expression increase. Regarding neurodevelopment, a delay in important reflexes during the neonatal period in ZIKV animals was observed. These findings advance the understanding of the pathophysiology of CZS and contribute to enhancing the rat model of CZS.

Anaesthetic Management of Paediatric Patient with Klippel-Trenaunay Syndrome undergoing Excision of Scalp Cyst: A Case Report

Klippel-Trenaunay Syndrome (KTS) is a sporadic condition characterised by the clinical triad of capillary malformation, atypical varicosity, and soft-tissue and bony hypertrophy. This triad was observed in the current case. Despite being initially described over a century ago, the exact incidence of this syndrome remains unestimated. The clinical presentation of KTS is highly diverse, ranging from asymptomatic cases to severe instances involving life-threatening bleeding and embolism. The authors present a case report of a 10-year-old girl with complaints of a cystic swelling in her left temporal region. She exhibited distinct features such as facial asymmetry, a high-arched palate, a prominent mandible, a port-wine stain on her cheeks, nasal bridge depression, and right-sided body hypertrophy. The child showed delayed developmental milestones, including holding her neck at 1.5 months, a bidextrous approach at seven months, and social smiling at six months, indicating global developmental delay. The patient was scheduled for excision of the swelling. Following the successful excision of the cyst, the child was extubated. The extubation was uneventful. In the postoperative period, the patient remained haemodynamically stable. Managing such a patient for a surgical procedure requires a meticulous approach involving accurate anaesthetic preparation and the prevention of complications.

Desenvolvimento e validação de conteúdo do Instrumento de Rastreio da Comunicação - IRC-36

ABSTRACT Purpose: to develop and validate the content of the communication screening instrument for children aged 0 to 36 months. Methods: an instrument comprising nine categories organized into five domains, according to developmental milestones per age group. The research was conducted in two stages. The first included item construction and theoretical content validation by seven judges with expertise in child language. The second included the empirical validation by the target population, in which three speech-language-hearing pathologists applied the instrument to 30 parents in a school in Recife, PE, Brazil. First-stage data analysis focused primarily on verifying agreement between the judges. In the second stage, the examiners suggested adjusting some items, and the children's performances were stratified. Results: a high level of interjudge agreement was observed in the first stage (CVI > 0.90). In the second stage, the performances stratified into quartiles confirmed the instrument’s feasibility for discriminating normally developing children from those at risk of a communication disorder or needing attention. Conclusion: the process ensured the instrument's content validity, with further validation steps being recommended.

Ablation of Iron Regulatory Protein 2 produces a neurological disorder characterized by motor, somatosensory, and executive dysfunction in mice

Iron is an important cofactor for many proteins and is used to create Fe-S clusters and heme prosthetic groups that enzymes use to catalyze enzymatic reactions. Proteins involved in the import, export, and sequestration of iron are regulated by Iron Regulatory Proteins (IRPs). Recently, a patient with bi-allelic loss of function mutations in IREB2 leading to the absence of IRP2 protein was discovered. The patient failed to achieve developmental milestones and was diagnosed with dystonic cerebral palsy, epilepsy, microcytic hypochromic anemia, and frontal lobe atrophy. Several more IREB2 deficient patients subsequently identified manifested similar neurological problems. To better understand the manifestations of this novel neurological disease, we subjected an Irp2-null mouse model to extensive behavioral testing. Irp2-null mice had a significant motor deficit demonstrated by reduced performance on rotarod and hanging wire tests. Somatosensory function was also compromised in hot and cold plate assays. Their spatial search strategy was impaired in the Barnes maze and they exhibited a difficulty in flexibly adapting their response in the operant touchscreen reversal learning task. The latter is a cognitive behavior known to require an intact prefrontal cortex. These results suggest that loss of Irp2 in mice causes motor and behavioral deficits that faithfully reflect the IREB2 patient's neurodegenerative disorder.

Lead contamination in human milk affects infants' language trajectory: results from a prospective cohort study.

Infants growing up in low- and middle-income countries are at increased risk of suffering adverse childhood experiences, including exposure to environmental pollution and lack of cognitive stimulation. In this study, we aimed to examine the levels of metals in the human milk of women living in São Paulo City, Brazil, and determine the effects on infants' neurodevelopment. For such, a total of 185 human milk samples were analyzed for arsenic (As), lead (Pb), mercury (Hg), and cadmium (Cd) using inductively coupled plasma mass spectrometry (ICP-MS). We applied the Bayley scales of infant and toddler development Third Edition (Bayley-III) to assess developmental milestones. In our analysis, we found a mean (standard deviation) concentration of As in human milk equal to 2.76 (4.09) μg L-1, followed by Pb 2.09 (5.36) and Hg 1.96 (6.68). Cd was not detected. We observed that infants exposed to Pb presented language trajectories lower than non-exposed infants (β = -0.413; 95% CI -0.653, -0.173) after adjustment for infant age, maternal education, socioeconomic status, infant sex, and sample weights. Our results report As, Pb, and Hg contamination in human milk, and that infant exposure to Pb decreased infants' language development. These results evidence maternal-child environmental exposure and its detrimental impact on infants' health.

E-BabyNet: Enhanced Action Recognition of Infant Reaching in Unconstrained Environments.

Machine vision and artificial intelligence hold promise across healthcare applications. In this paper, we focus on the emerging research direction of infant action recognition, and we specifically consider the task of reaching which is an important developmental milestone. We develop E-babyNet, a lightweight yet effective neural-network-based framework for infant action recognition that leverages the spatial and temporal correlation of bounding boxes of infants' hands and objects to reach for to determine the onset and offset of the reaching action. E-babyNet consists of two main layers based on two LSTM and a Bidirectional LSTM (BiLSTM) model, respectively. The first layer provides a pre-evaluation of the reaching action for each hand by providing onset and offset keyframes. Then, the biLSTM model merges the previous outputs to deliver an outcome of the reaching actions detection for each frame including the reaching hand. We evaluated our approach against four other lightweight structures using a dataset comprising 5,865 annotated images resulting in 16,337 bounding boxes from 375 distinctive infant reaching actions performed while sitting by different subjects in unconstrained (home/clinic) environments. Results illustrate the effectiveness of our approach and ability to provide reliable reaching action detection and offer onset and offset keyframes with a precision of one frame. Moreover, the biLSTM layer can handle the transition between reaching actions and help reduce false detections.

Wu Type GRIA3 Mutation Associated X-Linked Syndromic Intellectual Developmental Disorder: A Case Report

Background: A Wu type X-linked syndromic intellectual developmental disorder is caused by mutations in the GRIA3 gene This disorder is characterised by autistic features, hyporeflexia, intellectual disability and facial dysmorphism. Case report: The patient, a 4 year old male child, came with chief complaints of runny nose and tooth ache for 5 days. There was a past history of frequent falls, myoclonic jerks, tongue fibrillation, shudder attacks and delayed developmental milestones. The child at presention did not have myoclonic jerks or frequent falls. Family history is significant for maternal aunt presenting with similar complaints. On examination, protruding tongue, depressed nasal bridge, high arched palate, short fingers, right eye divergent squint, cafe-au-lait spot on the right knee, deep tendon reflexes- sluggish on both upper and lower limbs, power of 3/5 and hypotonia was observed in all four limbs with plantar- extensor bilaterally. Conclusion: On DNA testing, a missense mutation of GRIA 3 gene was noted. He was treated on a multidisciplinary approach and was admitted in a special school where occupational therapy, speech therapy, behavioural therapy and physiotherapy was given.

Avaliação do neurodesenvolvimento em crianças com sífilis congênita através do teste de Denver II

Objective: To evaluate the performance of infants with congenital syphilis from the Denver Test II. Methods: This is an epidemiological and descriptive study. Data were collected at the Aracaju Teaching Maternity in 2022 through the Denver II Test in children aged 0 to 6 years. This is a child developmental risk screening test, which includes 125 items that assess social and personal behavior, language and motor skills advocated. Results: Among the items of the instrument, there were alterations of 4 marks in the personal-social evaluation, 3 marks in the adaptive fine motor and 1 mark in language. On the other hand, there were no relevant changes in gross motor skills. The prevalence of individuals who presented a risk test on the Denver II was 80.7%, with 54.5% being male. Regarding the nutritional factor, 29.8% of the children practice family feeding. Moreover, the mothers had a mean age of 23.5 years. Most of the interviewees (61.4%) reported not having a provider and 98.2% reported maternal education, but only 8.8% had completed higher education. In the inferential statistics it was found that when there are more children in the family context the children presented later milestones. Conclusion: When performing the inferential statistics comparing the maternal variable, number of children, with the Denver II test it was found that the more children the p-value was 0.040, therefore statistically significant for delayed developmental milestones. Therefore, the Denver II scale

유아기후변화교육에 대한 유아교사의 인식 및 요구

This study investigates early childhood teachers' perceptions and requirements concerning climate change education for young children, aiming to inform improvements and the development of early childhood climate change education programs. The research involved 356 early childhood teachers from Seoul and Gyeonggi regions, with data collected through online surveys and analyzed using SPSS 25.0. Qualitative analysis was applied to open-ended questions related to the definition of 'climate change.' Key findings include early childhood teachers demonstrating a robust awareness of climate change's gravity. However, they often perceive 'climate change' as primarily 'environmental destruction and natural disasters,' indicating a limited understanding of the concept. Despite 98.8% recognizing the need for early childhood climate change education, the implementation is challenged by high workloads and inadequate preparation time. Vital requirements for effective implementation include the development and distribution of materials suitable for young children's developmental stages and specific climate change educational resources for teachers. Teachers emphasize a proactive, practical educational approach that fosters understanding of climate change causes and impacts while promoting active responses and adaptation. Notably, even though over half of the teachers lacked prior climate change training, roughly 80% expressed intent to participate in future training. These findings lay the groundwork for discussions on early childhood climate change education and teacher training.

Phases of human development: Comparing Western and Islamic theories and the implication in Islamic education

The physical, cognitive, and socio-emotional development determine every aspect of human life, including education. Providing appropriate education for children is determined by the child's developmental stage. The current study aims to describe the stages of human development according to Western and Islamic concepts and their implications in Islamic education. To ensure a comprehensive investment in human beings, attention to religious education and introducing religious instruction from the prenatal stage is deemed necessary, as this period forms the foundation for further development. The research methodology employed in this study is a Systematic Literature Review (SLR). After reviewing various literature sources, the researchers selected several references that were relevant to the topic. The study's results indicate that the prenatal phase in Islamic psychology is more extended than Western psychology's. The tamyiz and amrad phases, viewed in Islamic psychology as preparations for entering adulthood, correspond to the Western psychological perspective of puberty. The futuh phase, or the phase of wisdom in Islamic psychology, occurs when a person ages 40, whereas Western psychology labels this as the adult phase. The phase of the Hereafter is considered crucial in Islamic psychology, while Western psychology lacks an afterlife phase. Consequently, Muslims undergo lifelong education from early birth to death. In conclusion, every phase of human life must be educated according to the level of maturity, starting from prenatal, infant, early childhood, school age, adolescent, young adult, mature adult, to late adult.