Vaccination in children with congenital heart disease: an observational study in a Beijing hospital.

INTRODUCTION: Underimmunization of CHD children is a public health concern in China. This study aimed to analyze the vaccination status of CHD children to provide additional evidence on optimal vaccination strategies and to make suggestions to promote appropriate vaccination services for these children. METHODS: This cross-sectional study evaluated 155 CHD children who received at least one vaccine at Peking University First Hospital. Vaccine-specific immunization rates were calculated. A telephone questionnaire survey was conducted that covered the following: the prognosis, reasons for delayed vaccinations and getting vaccination in the hospital. All statistical analyses were performed using the SPSS version 22 software. RESULTS: The left-to-right shunt group involved 138 children, while the other type CHD group involved 17. The vaccination rate was the highest for MPSV-AC (87.1%) and the lowest for DTaP (40.1%). The most frequent reason for vaccination in the hospital was refusal from community health centers (61.5%). No participant reported vaccine-related adverse effects. CONCLUSIONS: The age-appropriate vaccine-specific immunization rates in CHD children are low, with the lowest for DTaP. Refusal of community health centers was the primary reason. Our findings support that clinically stable CHD children may be safely vaccinated on a schedule similar to that of ordinary children in China. IMPACT: From our investigation, we found that the age-appropriate vaccine-specific immunization rates in children with CHD in China are low, with the lowest for diphtheria and tetanus toxoid and acellular pertussis. Refusal of community health centers to vaccinate was the primary reason for the low rates. We believe our study provides additional evidence on optimal vaccination strategies for children with CHD and it can be used to develop strategies to promote appropriate vaccination services for these children.

Impact of maternal neuraxial labor analgesia exposure on offspring's neurodevelopment: A longitudinal prospective cohort study with propensity score matching.

Background: Neuraxial analgesia is widely used to relieve labor pain; its effects on long-term neurodevelopment of offspring remain unclear. This study was designed to investigate the influence of maternal neuraxial labor analgesia on offspring mental development. Methods: This was a predefined secondary analysis of a 2-year prospective longitudinal study. Nulliparous women with single-term cephalic pregnancy preparing for vaginal delivery self-selected neuraxial analgesia or not during labor. Mothers and their offspring were followed up 2 years later. children's mental development was assessed with the bayley scales of infant development. A multivariable logistic model was used to identify factors associated with below-average mental development (Mental Development Index <90). Results: A Total of 508 pairs of mothers and children completed a 2-year follow-up. after propensity score matching, 387 pairs were included in the analysis. In both cohorts, the proportions with below-average mental development were slightly lower in children whose mothers received neuraxial labor analgesia, although not statistically significant [in the full cohort: 9.8 % (36/368) vs. 15.7% (22/140), P = 0.060; In the matched cohort: 8.3% (21/254) vs. 14.3% (19/133), P = 0.065]. A higher 2-year depression score (in the full cohort: Odds Ratio 1.15, 95% CI 1.08-1.22, P < 0.001; In the matched cohort: Odds Ratio 1.09, 95% CI 1.01-1.18, P = 0.037), but not neuraxial analgesia exposure, was associated with an increased risk of below-average mental development. Conclusions: Maternal depression at 2 years was associated with the risk of below-average mental development, whereas maternal exposure to neuraxial labor analgesia was not. Clinical Trial Registration: The study was registered with www.chictr.org.cn (ChiCTR-OCH-14004888) and ClinicalTrials.gov (NCT02823418).

Early grammatical marking development in Mandarin-speaking toddlers.

The current study examined early grammatical marking in a relatively understudied language, Mandarin, by using the Mandarin version of MacArthur-Bates Communicative Development Inventory. Two waves of data collection included 338 monolingual children (17-36 months; 143 female) at Time 1 and 308 children (32-55 months; 139 female) at Time 2 and their caregivers, whose education ranged from third grade (elementary school) or below to postgraduate with a median of high school. Our data showed a clear order of grammatical marking acquisition among these children and supported findings on the linguistic specificity of morphological development such that early- and late-acquired markers in Mandarin are not acquired in the same order as English or other languages. Negative "mei2," "bu4," possessive "-de," classifiers, and the aspect marker "le" were the earliest-acquired markers, followed by modals, negative "bie2," adverbs, sentence final particles, resultative verb compounds, and aspect markers "guo4" and "yao4." Complex clauses and the aspect marker "zheng4" were acquired the latest. Furthermore, consistent with previous cross-linguistic studies, the development patterns of a wide range of Mandarin grammatical markers indicate that markers that are more perceptually salient and obligatory, have clear form-meaning mappings, and often appear in isolation or utterance-final position were acquired earlier than others. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Corrigendum: Prevalence of Anemia and Its Associated Risk Factors Among 6-Months-Old Infants in Beijing.

[This corrects the article DOI: 10.3389/fped.2019.00286.].

Prevalence of Anemia and Its Associated Risk Factors Among 6-Months-Old Infants in Beijing.

Objective: The worldwide prevalence of anemia is ~24.8%. Iron deficiency anemia is common in children and women and associated with sensory, motor, cognitive, language, and socioemotional deficits. Therefore, detection and early intervention strategies for anemia in infants are urgently needed. To prevent the occurrence of iron deficiency anemia, we aimed to identify risk factors associated with anemia in infants. Methods: This investigation involved a cross-sectional study of 6-months-old infants discharged between April 2014 and September 2017 from Peking University First Hospital. We assessed birth information, maternal age, and maternal educational level as well as data on feeding style, complementary foods and primary caregivers. The infants were assessed with the Denver Developmental Screening Test (DDST). Results: A total of 1,127 6-months-old infants were enrolled at the hospital. We found that the prevalence of anemia among infants in Beijing was ~11.8%. Premature infants had a higher rate of anemia than full-term infants (χ2 = 40.103, P < 0.001). Infants born in autumn or winter were at an elevated risk of developing anemia (χ2 = 22.949, P < 0.001). Birth weight had no effect on the rate of anemia in infants (χ2 = 0.023, P = 0.568). Infants who were exclusively breastfeeding had higher anemia rates than those who were fed formula (χ2 = 38.466, P < 0.001). Infants whose caregivers added no complementary foods had higher anemia rates (24.7%) than those whose caregivers added more than two kinds of complementary food (8.2%). The type of caregiver had no effect on the anemia rate in infants (χ2 = 0.031, P = 1.000). Conclusions: The following factors resulted in a higher prevalence of anemia in our study a gestational age at birth of <37 weeks, exclusive breastfeeding, a lack of supplementation with complementary foods and a spring birth date. No significant differences in DDST pass rates were evident between infants with and without anemia.

The Influence of Different Caregivers on Infant Growth and Development in China.

OBJECTIVE: An increasing number of parents in China ask grandparents or babysitters to care for their children. Modern parents are often the only child in their family because of China's One-Child Policy and thus may lack interaction with siblings. Accordingly, the present study aimed to explore whether different caregivers affect the physical and development of infants in China. METHODS: In total, 2,514 infants were enrolled in our study. We assessed their weight-for-age, supine length-for-age, weight-for-length, occipital-frontal circumference, and Denver Developmental Screening Test (DDST) results and recorded their general parental information and their primary caregivers. RESULTS: The weights and lengths of 12-month-old infants under the care of babysitters were significantly lower than those of infants under the care of parents or grandparents (P < 0.05). Additionally, 12-month-old infants under the care of babysitters had the lowest DDST pass rate (75%) among the three groups (χ2 = 11.819, P = 0.012), especially for the fine motor-adaptive and language domains. Compared to 12-month-old infants under the care of parents and babysitters, infants under the care of grandparents were more likely to be overweight or obese (P < 0.001). CONCLUSION: The study showed that caregivers had a dominant role in the physical and cognitive development of the infants. Specifically, compared with infants raised by grandparents and parents, 12-month-old infants under the care of babysitters had partially suppressed lengths and weights and lagged cognitively. The 12-month-old infants under the care of grandparents were more overweight than those cared for by parents and babysitters.

Tracing children's vocabulary development from preschool through the school-age years: an 8-year longitudinal study.

In this 8-year longitudinal study, we traced the vocabulary growth of Chinese children, explored potential precursors of vocabulary knowledge, and investigated how vocabulary growth predicted future reading skills. Two hundred and sixty-four (264) native Chinese children from Beijing were measured on a variety of reading and language tasks over 8 years. Between the ages of 4 to 10 years, they were administered tasks of vocabulary and related cognitive skills. At age 11, comprehensive reading skills, including character recognition, reading fluency, and reading comprehension were examined. Individual differences in vocabulary developmental profiles were estimated using the intercept-slope cluster method. Vocabulary development was then examined in relation to later reading outcomes. Three subgroups of lexical growth were classified, namely high-high (with a large initial vocabulary size and a fast growth rate), low-high (with a small initial vocabulary size and a fast growth rate) and low-low (with a small initial vocabulary size and a slow growth rate) groups. Low-high and low-low groups were distinguishable mostly through phonological skills, morphological skills and other reading-related cognitive skills. Childhood vocabulary development (using intercept and slope) explained subsequent reading skills. Findings suggest that language-related and reading-related cognitive skills differ among groups with different developmental trajectories of vocabulary, and the initial size and growth rate of vocabulary may be two predictors for later reading development.

Phonological skills and vocabulary knowledge mediate socioeconomic status effects in predicting reading outcomes for Chinese children.

This study examined the relations among socioeconomic status (SES), early phonological processing, vocabulary, and reading in 262 children from diverse SES backgrounds followed from ages 4 to 9 in Beijing, China. SES contributed to variations in phonological skills and vocabulary in children's early development. Nonetheless, early phonological and vocabulary abilities exerted equally strong and independent mediation of the SES effects on children's reading achievement by the end of 3rd grade for this Chinese sample. These findings not only replicate studies in alphabetic languages but, because of their longitudinal nature, also demonstrate the potential for interventions focused on improving children's early language skills, and at which ages these factors may have the greatest impact.

Association of the DYX1C1 dyslexia susceptibility gene with orthography in the Chinese population.

Several independent studies have supported the association of DYX1C1 with dyslexia, but its role in general reading development remains unclear. Here, we investigated the contribution of this gene to reading, with a focus on orthographic skills, in a sample of 284 unrelated Chinese children aged 5 to 11 years who were participating in the Chinese Longitudinal Study of Reading Development. We tested this association using a quantitative approach for Chinese character reading, Chinese character dictation, orthographic judgment, and visual skills. Significant or marginally significant associations were observed at the marker rs11629841 with children's orthographic judgments at ages 7 and 8 years (all P values<0.020). Significant associations with Chinese character dictation (all P values<0.013) were also observed for this single-nucleotide polymorphism (SNP) at ages 9, 10, and 11 years. Further analyses revealed that the association with orthographic skills was specific to the processing of specific components of characters (P values<0.046). No association was found at either SNP of rs3743205 or rs57809907. Our findings suggest that DYX1C1 influences reading development in the general Chinese population and supports a universal effect of this gene.

Developmental trajectories of reading development and impairment from ages 3 to 8 years in Chinese children.

BACKGROUND: Early prediction of reading disabilities in Chinese is important for early remediation efforts. In this 6-year longitudinal study, we investigated the early cognitive predictors of reading skill in a statistically representative sample of Chinese children from Beijing. METHOD: Two hundred sixty-one (261) native Chinese children were administered seven language-related skills over three years between the ages of 3 and 6 years. Performances on these skills were then examined in relation to subsequent word reading accuracy and fluency. Individual differences in developmental profiles across tasks were then estimated using growth mixture modeling. RESULTS: Four developmental trajectories were classified - the typical (control), catch-up (with low initial cognitive performances but adequate subsequent reading), literacy-related-cognitive-delay (with difficulties in morphological awareness, phonological awareness, and speeded naming and subsequent word recognition), and language-delay (relatively low across all tasks) groups. CONCLUSION: Findings suggest that the combination of phonological awareness, rapid naming and morphological awareness are essential in the early prediction of later reading difficulties in Chinese children.

Early vocabulary development in Mandarin (Putonghua) and Cantonese.

Parent report instruments adapted from the MacArthur-Bates Communicative Development Inventories (CDI) examined vocabulary development in children aged 0 ; 8 to 2 ; 6 for two Chinese languages, Mandarin (n=1694) and Cantonese (n=1625). Parental reports suggested higher overall scores for Mandarin- than for Cantonese-speaking children from approximately 1 ; 4 onward. Factors relevant to the difference were only-child status, monolingual households and caregiver education. In addition to the comparison of vocabulary scores overall, the development of noun classifiers, grammatical function words common to the two languages, was assessed both in terms of the age and the vocabulary size at which these terms are acquired. Whereas age-based developmental trajectories again showed an advantage for Beijing children, Hong Kong children used classifiers when they had smaller vocabularies, reflecting the higher frequencies and greater precision of classifier use in adult Cantonese. The data speak to the importance of using not just age, but also vocabulary size, as a metric by which the acquisition of particular linguistic elements can be examined across languages.

Baby's first 10 words.

Although there has been much debate over the content of children's first words, few large sample studies address this question for children at the very earliest stages of word learning. The authors report data from comparable samples of 265 English-, 336 Putonghua- (Mandarin), and 369 Cantonese-speaking 8- to 16-month-old infants whose caregivers completed MacArthur-Bates Communicative Development Inventories and reported them to produce between 1 and 10 words. Analyses of individual words indicated striking commonalities in the first words that children learn. However, substantive cross-linguistic differences appeared in the relative prevalence of common nouns, people terms, and verbs as well as in the probability that children produced even one of these word types when they had a total of 1-3, 4-6, or 7-10 words in their vocabularies. These data document cross-linguistic differences in the types of words produced even at the earliest stages of vocabulary learning and underscore the importance of parental input and cross-linguistic/cross-cultural variations in children's early word-learning.

[The related factors influencing development of language understanding and expression of early-children].

OBJECTIVE: To assess the level of language understanding and expression of healthy children aged from 8 to 16 months in urban Beijing and to investigate the children's physical and psychological development conditions and social and economic status of children's family as to identifying the related factors to children's language development and providing a basis for instructing parents child-rearing and promoting early children language development. METHODS: A quantitative Cross-sectional Study was made. The parents or care givers of 636 healthy young children, randomly stratified and selected in two districts in Beijing were interviewed. T-test was used to compare the scores of language understanding and expression between boys and girls in the same age. Single and multiple factors analysis were used so as to find out the related factors. RESULTS: For boys, the average scores of language were respectively 115.0 for 8 months, 243.0 for 12 months and 410.6 for 16 months; for girls the average scores were respectively 109.9 for 8 months, 286.4 for 12 months and 456.2 for 16 months. The average score of language understanding of boys was higher than that of girls only in the 11 month group. The average scores of language expression of girls were higher than those of boys in 11, 12, 14, 15 month groups. Multiple factors analysis showed that parent-child book reading, parent-child tape listening, higher education level of grandmothers, children' extroversion personality, child being able to speak one word and children's age were positively related to the children' language score. CONCLUSION: Providing rich language environment should be helpful to early children's language development.

[Individual and family factors influencing vocabulary development in toddlers].

OBJECTIVE: Many researchers have conducted studies on child language development and relevant risk factors, but most of these studies were about English-speaking children and few of them were on Chinese-speaking children, and less reports of studies on language development of infants or toddlers are available as compared to those on children above 3 years of age. The objective of this study was to assess the level of vocabulary development of healthy toddlers in urban Beijing and to investigate toddlers' physical and psychological development and socioeconomic status of toddlers' family so as to identify factors related to toddlers' language development and provide basis for instructing parents child-rearing. METHOD: This is a quantitative cross-sectional study. Using Chinese Communicative Development Inventory mandarin version, (CCDI) and related background questionnaire, a survey was conducted among the parents or care givers of 1056 healthy toddlers (16 approximately 30 months), randomly stratified and selected from two areas of four urban districts in Beijing. The children who were born prematurely, who had low birth weight, or who were deaf, dumb or with disability, were excluded from this study. The mothers who were deaf, dumb or having disability were not included in this study, either. Rank sum test was used to compare the vocabulary scores between boys and girls at the same age. Single and multiple factors analysis were used to find related factors. RESULTS: By 16 months of age, boys could speak about 22 words and girls 84 words on the CCDI. By 29 - 30 months of age, boys could speak about 725 words and girls 752 words on the CCDI. The level of vocabulary development of healthy toddlers in urban Beijing was higher than that reported in previous studies of English-speaking children. Girls had higher vocabulary scores than boys in a few different age groups. Single factor analysis showed that the ages of father and mother, income of father, the language used by care-givers and GDP of the families were factors related to families of toddlers and the age, gender, height, weight and the age at which the toddlers began to speak were factors related to individuals. Multiple factors analysis showed that higher education level of mothers, younger father, earlier beginning of children to speak, toddlers' amiable disposition and emotion, girls, toddlers' age and height positively correlated with toddlers' vocabulary score. CONCLUSION: The level of vocabulary development of healthy toddlers in urban Beijing is on the high side. Certain individual and familial factors may influence toddlers' language development. It is suggested that health workers should pay attention to the toddlers' language development. The toddlers' parents and caregivers should be taught how to interact with and talk to their children and how to promote children to develop healthy disposition and emotion.

Antibody-mediated CNS demyelination II. Focal spinal cord lesions induced by implantation of an IgM antisulfatide-secreting hybridoma.

We showed previously that spinal cord implants of hybridoma cells (O1) that secrete an IgM antigalactocerebroside cause focal multiple-sclerosis-like plaques of demyelination followed by remyelination to form "shadow plaques" (Rosenbluth et al., 1999). The antibody in that case was directed against a glycolipid present in mature oligodendrocytes and myelin but not in precursor cells. We now report the effects of implanting a different hybridoma (O4) that secretes IgM antibodies directed against sulfatide, a constituent not only of mature myelin and oligodendrocytes but also of late precursor cells, in order to determine whether this hybridoma too would generate focal demyelination and would, in addition, block remyelination. Our results show that focal plaques of demyelination indeed appear after O4 implantation, and that remyelination does occur, but only in cases where the hybridoma cells have degenerated, probably through host rejection. The occurrence of remyelination suggests that oligodendrocyte precursor cells are capable of migrating in rapidly from adjacent areas or that early precursors, not yet expressing sulfatide, remain undamaged within the lesions. In cases where intact hybridoma cells persist at lesion sites, remyelination does not occur. Failure of remyelination in this model thus appears to result from the continuing presence of antimyelin antibodies rather than from depletion of oligodendrocyte precursors.

Distribution and morphology of transgenic mouse oligodendroglial-lineage cells following transplantation into normal and myelin-deficient rat CNS.

Glial cells from neonatal MbetaP5 transgenic mice, which express bacterial beta-galactosidase (lacZ) under control of the myelin basic protein (MBP) promoter (Gow et al, 1992), were transplanted into the spinal cord or cerebral hemisphere of immunosuppressed normal and myelin-deficient (md) rats in order to assess the ability of the donor cells to survive, migrate, and differentiate within normal compared with myelin-deficient central nervous system (CNS). LacZ+ cells were detected as early as 6-7 days after transplantation into the low thoracic cord and by 10 days had spread rostrally to the brainstem and caudally to the sacral spinal cord. Initially, compact lacZ+ cells, lacking processes, were found associated with small blood vessels and with the glia limitans. Cells of this type persisted throughout the experiment. Later, lacZ+ cells with processes were seen along fiber tracts in the dorsal columns and, after intracerebral injection, subjacent to ventricular ependyma, as well as scattered in cerebral white and gray parenchyma. The extent of spread was comparable in md and normal rats, but in the md group, the success rate was higher, and more cells differentiated into process-bearing oligodendrocytes. Acceptance of xenografts in immunosuppressed recipients equaled that of allografts. The overall spread of grafted cells exceeded that of injected charcoal, indicating active migration. In contrast to earlier studies that identified oligodendrocytes based on morphology alone, this study has allowed us to identify and track oligodendrocytes based on myelin gene expression. We show some oligodendrocytes whose morphology is consistent with classical morphological descriptions, some that resemble astrocytes, and a class of compact perivascular oligodendrocyte-lineage cells that we suggest are migratory.