A study on the neurodevelopment outcomes of late preterm infants.

BACKGROUND: The study is intended to fill the knowledge gap about the neuropsychology and neuromotor developmental outcomes, and identify the perinatal risk factors for late preterm infants (LPIs 34~36 weeks GA) born with uncomplicated vaginal birth at the age of 24 to 30 months. METHODS: The parents/guardians of 102 late preterm infants and 153 term infants, from 14 community health centers participated in this study. The Modified Checklist for Autism in Toddlers (M-CHAT) questionnaire, the Chinese version of Gesell Development Diagnosis Scale (GDDS), and the Sensory Integration Schedule (SIS), a neurological examination for motor disorders (MD) were carried out. Infants screening positive to the M-CHAT were referred to specialist autism clinics. RESULTS: Forty-six LPIs (45.1%) scored low in GDDS. Nine LPIs (8.8%) scored positive on M-Chat. 8.8% of LPIs (9 out of 102) were diagnosed MD (p <  0.05). Compared with their full-term peers, LPIs had statistically lower scores in GDDS and the Child Sensory Integration Checklist. LPIs who had positive results on M-CHAT showed unbalanced abilities in every part of GDDS. Risk factors of twin pregnancies, pregnancy induced hypertension and premature rupture of membranes had negative correlation with GDDS (all p <  0.05). Birth weight and gestational age were positively correlated with GDDS. CONCLUSIONS: LPIs shall be given special attention as compared to normal deliveries, as they are at increased risk of neurodevelopment impairment, despite being born with no major problems. Some perinatal factors such as twin pregnancies, and pregnancy induced hypertension etc. have negative effects on their neurodevelopment. Regular neurodevelopmental follow- up and early intervention can benefit their long term outcomes.

Enhanced production of 2,3-butanediol by overexpressing acetolactate synthase and acetoin reductase in Klebsiella pneumoniae.

Mutants with overexpression of α-acetolactate synthase (ALS), α-acetolactate decarboxylase, and acetoin reductase (AR), either individually or in combination, were constructed to improve 2,3-butanediol (2,3-BD) production in Klebsiella pneumoniae. The recombinant strains were characterized in terms of the enzyme activity, 2,3-BD yield, and expression levels. The recombinant K. pneumoniae strain (KG-rs) that overexpressed both ALS and AR showed an improved 2,3-BD yield. When cultured in the media with five different carbon sources (glucose, galactose, fructose, sucrose, and lactose), the mutant exhibited higher 2,3-BD productivity and production than the parental strain in all the tested carbon sources except for lactose. The 2,3-BD production of KG-rs in a batch fermentation with glucose as the carbon source was 12% higher than that of the parental strain.

[Development of national neglect norm for urban primary school students of China].

OBJECTIVE: To develop the national neglect norms for urban primary school students in China. METHODS: According to multi-stage stratified cluster sampling principle, 24 cities of 13 provinces (municipalities) in China were selected during December 1 to 31, 2008. A total of 1491 students in grade 1 - 3 and 2236 students in grade 4 - 6 were selected. Questionnaire was designed by authors and the final norms were determined through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norms. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm was completed. RESULTS: The two questionnaires of grade 1 - 3 and grade 4 - 6 students consisted of 55 and 57 items, respectively, whose item loadings were ranged from 0.301 to 0.687 and 0.321 to 0.730, which met the statistical requirements. For grade 1 - 3 students, the scale's total Cronbach α coefficients was 0.914, the total split-half reliability coefficients was 0.896, the Cronbach α coefficients of four level was above 0.737 except medical and social neglect, split-half reliability was ranged from 0.461 to 0.757; for grade 4-6 students, the scale's total Cronbach α coefficients was 0.916, split-half reliability was 0.883, except social neglect, the Cronbach α coefficients of other level was ranged 0.457 to 0.856, split-half reliability was ranged from 0.500 to 0.798. The total neglect cut-off score of the two scales grade 1-3 and 4-6 were 125 and 155, respectively. CONCLUSION: The structure of two norms was reasonable. The scales have good stability and reliability.

[Comparative study on the situation of neglected children aged 3-6 year-olds between urban and rural areas of China].

OBJECTIVE: To investigate and analyze the situation of urban and rural neglected children aged 3 - 6, in China, so as to provide basis for the analysis and comparison on relevant risk factors. METHODS: 1163 urban children aged 3 - 6 (with 49.6% males and 4.5% with minority ethnicity) were investigated from 25 cities of 14 provinces, autonomous regions and municipalities in the whole country. Multi-stage stratified cluster sampling method was used. Again, using the same sampling method, 4096 rural children (of whom 50.6% were males with 6.2% as minorities) were chosen from 26 cities of 10 provinces or municipalities. Identification of children being neglected was based on "Child Neglect Evaluation Norms of Children Aged 3 - 6 Years in Urban/Rural China". SPSS-Windows 13.0 was employed for data analysis. Scores, frequency/degrees, age, sex and types (physical, emotional, educational, safety, medical and social) of children under negligence on every group of the regions, were calculated. χ(2) test (Chi-Square) and Analysis of variance (ANOVA) were processed to determine the significance of their differences. RESULTS: The overall frequencies of negligence were 28.0% and 53.7% respectively among the urban and rural children aged 3 - 6, while the total degrees of negligence were 42.2 and 44.4 respectively. Significant difference was found between children from the urban and the rural areas (P < 0.05). Significant difference was also found between urban and rural children on every age group (P < 0.05). The frequencies of negligence among males were 32.6% and 55.9% respectively in urban and rural areas while among females, the figures appeared to be 23.7% and 51.6% respectively. The degrees of negligence were 42.7 and 44.6 among male while 41.8 and 44.3 among female children, in the urban or rural areas. Significant differences were found on male or female between urban and rural groups (P < 0.05). Frequencies of negligence in urban children aged 3 - 6 for the six types were from 5.1% to 12.9%, with the frequency in rural areas as 13.1% - 26.6%. Significant difference was found between urban and rural group for any other type (P < 0.05), in addition to the safety type. The degrees of negligence in urban children aged 3 - 6 for the different type were between 39.4 and 43.4, while in the rural areas as from 36.5 to 48.2, with significant difference for every type (P < 0.05). The degrees of negligence related to education, emotion, or physical strength were more serious on children from the urban than from the rural areas. The highest frequency of child negligence was seen in the single-parent families on both urban and rural groups (42.9% and 60.0% respectively), with no significant difference found (P > 0.05). The urban and rural children aged 3 - 6 were mainly involved in single item of negligence, with incidence rates as 16.5% and 22.7% and proportions as 58.9% and 45.1% respectively, despite the factors as age or sex. CONCLUSION: There were large differences on the situation of negligence between the urban and rural children aged 3 - 6. The frequencies and degrees of negligence in every age group and different sex for children living in the rural areas were higher than those urban children. The frequency of negligence among boys was higher than girls for both urban and rural areas. The rural children had suffered more serious negligence than the urban children at any other type, in addition to the 'safety'. Both urban and rural children had the highest frequency of negligence in single-parent family, and were mainly suffered from single item of negligence.

[The status of child neglect among rural areas children aged 0 - 6 years in China].

OBJECTIVE: To explore the status of child neglect among rural areas children aged 0 - 6 years in China. METHODS: A total of 7411 rural children aged 0 - 6 years old who were composed of two age groups (3315 children aged 0 - 2 years old and 4096 children aged 3 - 6 years old) were multistage stratified randomly sampled from 84 villages which were representative of 10 provinces of China, in accordance with sex and age in November 2010. To identify the child neglect based on the Neglect Norms for Children Aged 0 to 2 and 3 to 6 Years Old in Rural Areas of China, SPSS 13.0 was employed for analyzing neglect frequency and degree for every group of different age, sex and neglect type (including physical, emotional, educational, medical, safety and social neglects). χ(2) test and analysis of variance were also used. RESULTS: The degree of child neglect for the children aged 0 - 2 years old was 45.01 ± 7.56, the neglect frequency was 54.9% (1819/3315); the degree of child neglect for the children aged 3 - 6 years old was 44.42 ± 7.57, the neglect frequency was 53.8% (2203/4096). The neglect frequency of children aged 0, 1, 2 years old were 58.5% (654/1117), 52.2% (597/1144), 53.9% (568/1054) (P < 0.05). For children aged 3 - 6 years old, the degrees of emotional and safety neglect for males (44.60 ± 7.86, 36.82 ± 9.03) were higher than females (44.03 ± 7.72, 36.25 ± 9.05) (P < 0.05); and the frequencies of emotional and social neglect for males (16.8% (349/2072), 28.3% (586/2072)) were also higher than females (14.1% (286/2024), 24.8% (503/2024)) (P < 0.05). All children of two age groups suffered neglect mainly on one of the six neglect types (incidences were 20.6% (683/3315) and 22.7% (931/4096)). For 0-2 age groups, the higher neglect frequencies happened in the single-parent family and the remarried family (62.5% (15/24) and 63.2% (12/19)), but for children aged 3 - 6 years old groups, it happened in the single-parent family (60.0%, 27/45). CONCLUSION: Degree and frequency of child neglect among children aged 0 to 6 years old in the rural areas of China are high, and we should find out risk factors and provide efficient prevention measures.

[The status of child neglect for children aged 3 - 17 years in China].

OBJECTIVE: To explore the status of child neglect among urban areas children and adolescents aged 3 - 17 years in China. METHODS: Using multi-stage stratified cluster sampling method, 8001 children and adolescents were recruited from 30 cities of 14 provinces in December 2008. The investigation was carried based on The 3 - 6 years old children Neglect Norms of city in China and The 6 - 17 years old children Neglect Norms of city in China. SPSS 13.0 was employed for analyzing neglect rate and degree for group of areas, age, sex and neglect type (including neglect of physical, emotional, educational, medical, safety and social). RESULTS: The degrees of child neglect for urban children aged 3 - 6 (children aged 6 were not in school), 6 - 8 (children aged 6 were school children), 9 - 11, 12 - 14 and 15 - 17 were 42.2 ± 6.9, 42.8 ± 8.4, 42.1 ± 9.1, 46.4 ± 9.2 and 49.7 ± 8.4(P < 0.05), the neglect rates were 28.0% (326/1163), 28.8% (431/1496), 27.2% (543/1962), 22.4% (373/1664) and 32.8% (563/1716) (P < 0.05), respectively. There were differences in six neglect types for each group; the neglect degrees and rates were high in the group aged 12 - 14 and 15 - 17 (46.4 ± 9.2 and 49.1 ± 8.4, 22.4% (373/1664) and 32.8% (563/1716), respectively); for each neglect type, the neglect degree of children aged 15 - 17 were highest (52.8 ± 8.0, 47.3 ± 11.6, 49.5 ± 10.8, 42.4 ± 10.3, 52.2 ± 16.0, 56.0 ± 10.1). The degree and rate of neglect in West were highest, Middle was next, the East was lowest (the neglect degrees were 45.4 ± 9.1, 45.0 ± 9.3 and 44.0 ± 8.8, P < 0.05;the rates were 30.7% (1340/4361), 25.0% (756/3024) and 21.2% (131/616), P < 0.05). Degree and rate of child neglect for children without siblings were lower than children with siblings (the neglect degrees were 44.2 ± 9.0 and 47.6 ± 9.1, P < 0.01; the rates were 26.1% (1572/6017) and 33.0% (655/1984), P < 0.01). Neglect degree of school children aged 6 years old (43.1 ± 7.3) was higher than children not in school (40.7 ± 7.8) (P < 0.01), but neglect rate was lower (the rates were 35.4% (60/169) and 21.3% (84/394), P < 0.01). CONCLUSION: Neglect degree and rate of urban children and adolescents aged 3 - 17 years in China were both high, and neglect deserved more attentions.