Growth patterns and ratios of posterior cranial fossa structures in the Japanese pediatric population: a study utilizing CT scans.

PURPOSE: The changes in the proportion of posterior cranial fossa structures during pediatric development remain unclear. This retrospective study aimed to investigate the growth patterns and ratios of these structures using CT scans. METHODS: Head CT scans of pediatric patients with minor head trauma from Osaka Women's and Children's Hospital between March 2006 and May 2023 were analyzed. The study segmented the intracranial volume (ICV), posterior cranial fossa volume (PCFV), cerebellum volume (CBMV), and brainstem volume (BSV). Correlation coefficients were calculated among the parameters. Patients aged 0 to 10 years were divided into 15 age-related clusters, and mean and standard deviation values were measured. Growth curves were created by plotting mean values sequentially. Ratios such as PCFV/ICV and (CBMV + BSV)/PCFV were examined. Statistical analyses, including unpaired t tests and logarithmic curve fitting, were performed. RESULTS: A total of 234 CT scans (97 from females, 115 from infants under 1 year of age) were analyzed. Positive correlations were observed among the parameters, with the strongest between PCFV and CBMV. The growth curves for ICV, PCFV, CBMV, and BSV exhibited a two-phase process, with rapid growth until approximately 4 years of age, followed by stabilization. The ratios PCFV/ICV and (CBMV + BSV)/PCFV showed increasing trends from birth onwards, stabilizing by 4 and 1 years of age, respectively. CONCLUSION: This study provides insights into the growth patterns and ratios of posterior cranial fossa structures in the pediatric population. The findings demonstrate a two-phase growth process and increasing trends in the examined ratios.

Can growth in dichorionic twins be monitored with individualized growth assessment?

OBJECTIVE: To characterize fetal growth in dichorionic twins using individualized growth assessment (IGA), a method based on individual growth potential estimates. METHODS: This secondary analysis included 286 fetuses/neonates from 143 dichorionic twin pregnancies that were part of the ESPRiT (Evaluation of Sonographic Predictors of Restricted Growth in Twins) study. The sample was subcategorized according to birth weight into appropriate-for-gestational-age (AGA) (n = 243) and small-for-gestational-age (SGA) (n = 43) cohorts. Serial biometric scans evaluating biparietal diameter, head circumference (HC), abdominal circumference, femur diaphysis length and estimated weight at 2-week intervals were used to evaluate fetal growth, while measurements of birth weight, crown-heel length and HC determined neonatal growth outcome. Six abnormalities (hypoxic ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, respiratory distress, sepsis and death) constituted the evaluated adverse neonatal outcomes (ANO). IGA was used to: evaluate differences in second-trimester growth velocities between singletons (from a published dataset) and dichorionic twins (138 AGA twins with normal third-trimester growth); describe the degree to which actual third-trimester growth in twins followed expected growth (111 AGA twins, normal fetal growth and neonatal growth outcomes); determine if the fetal growth pathology score 1 (-FGPS1) could detect, quantify and classify twin growth pathology (224 AGA, 42 SGA); and assess the relationship between -FGPS1 and ANO (24 SGA twins with progressive growth restriction confirmed by abnormal neonatal growth outcome). RESULTS: The differences in second-trimester growth velocity between singletons and twins (means and variances) were small and not statistically significant. Percent deviations from the expected third-trimester size trajectories were within the 95% reference ranges derived from singletons at 95.7% (1677/1752) of timepoints studied. Abnormal growth was detected in 37.9% of AGA twins and 85.7% of SGA twins. Growth restriction was more heterogeneous in AGA twins, while in SGA twins progressive growth restriction was the principal type (66.7%). -FGPS1 patterns previously defined in singletons classified 97.5% of pathological twin cases. In our most severe form of growth restriction (progressive), there were only three (12.5%) ANOs related to growth abnormalities, all in cases with -FGPS1 values more negative than -2.0%. Using these criteria, the frequency of ANO was 33%. CONCLUSIONS: With respect to growth, dichorionic twins can be considered as two singletons in the same uterus. Normally growing dichorionic twins have the same growth potential as singletons with normal growth outcome. These twins also follow expected third-trimester growth trajectories with the same precision as do singletons. Third-trimester growth pathology can be detected, quantified and classified using -FGPS1 as in singletons. Limited evidence of a relationship between fetal growth abnormalities and adverse neonatal outcome was found. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Stress and Growth in Children and Adolescents.

The infantile, childhood, and adolescent periods of growth and development also represent times of increased vulnerability to stressors. Growth velocity in each period is dependent on the interplay of genetic, environmental, dietary, socioeconomic, developmental, behavioral, nutritional, metabolic, biochemical, and hormonal factors. A stressor may impact growth directly through modulation of the growth hormone axis or indirectly through other factors. The adaptive response to stressors culminates in behavioral, physiological, and biochemical responses which together support survival and conservation of energy. The immediate response involves activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. The time-limited stress response is at once antigrowth, antireproductive, and catabolic with no lasting adverse consequences. However, chronic activation of the stress system and hypercortisolism have consequential negative impacts on growth, thyroid function, reproduction-puberty, and metabolism. High cortisol suppresses growth hormone-insulin-like growth factor 1, hypothalamic-pituitary-gonadal, and thyroid axes and has been reported to be responsible for an increase in visceral adiposity, a decrease in lean mass, suppression of osteoblastic activity with risk of osteoporosis, and induction of insulin resistance. Early-life adversities, emotional or physical, have been associated with long-term negative physical and mental health outcomes. Existing models of chronic stress corroborate that early-life adversities can affect growth and have consequences in other aspects of well-being throughout the lifespan. Targeted interventions to reduce stress during infancy, childhood, and adolescence can have far-reaching benefits to long-term health as well as attaining adequate growth. In this review, we describe the neuroendocrinology of the stress response, the factors influencing growth, and the impact of chronic stress on growth during critical periods of infancy, childhood, and puberty with particular reference to growth, thyroid, and gonadal axis.

Dynamics of cell death across growth stages and the diel cycle in the dinoflagellate Karenia brevis.

Recent evidence suggests that programmed cell death (PCD) can play a role in stress-induced decline and termination of harmful algal blooms. However, components of the PCD cascade, i.e. reactive oxygen species (ROS) and caspase-like activity, have also been observed in the absence of exogenous stress, where their activities and functions remain unclear. Here, we characterized the variability of prevalence of cell death, ROS, and caspase-like activity at different growth phases and diel cycles in cultures of dinoflagellate Karenia brevis. Results show that ROS percentages increased with culture age and fluctuated in a phasing diel pattern, while caspase-like activity was observed throughout growth. In actively growing K. brevis cells, PCD components may be involved in key metabolic processes, while in stationary phase they may relate to stress acclimation. The circadian diel pattern of ROS may be explained by the balance between the metabolic generation of ROS and circadian rhythmicity of antioxidant enzymes. Overall, this work highlights not only the involvement of PCD components in the growth of marine phytoplankton, but the importance of understanding mechanisms controlling their accumulation, which would help to better interpret their presence in the field.

Automatic Measurement of Fetal Brain Development from Magnetic Resonance Imaging: New Reference Data.

BACKGROUND: Accurate fetal brain volume estimation is of paramount importance in evaluating fetal development. The aim of this study was to develop an automatic method for fetal brain segmentation from magnetic resonance imaging (MRI) data, and to create for the first time a normal volumetric growth chart based on a large cohort. SUBJECTS AND METHODS: A semi-automatic segmentation method based on Seeded Region Growing algorithm was developed and applied to MRI data of 199 typically developed fetuses between 18 and 37 weeks' gestation. The accuracy of the algorithm was tested against a sub-cohort of ground truth manual segmentations. A quadratic regression analysis was used to create normal growth charts. The sensitivity of the method to identify developmental disorders was demonstrated on 9 fetuses with intrauterine growth restriction (IUGR). RESULTS: The developed method showed high correlation with manual segmentation (r2 = 0.9183, p < 0.001) as well as mean volume and volume overlap differences of 4.77 and 18.13%, respectively. New reference data on 199 normal fetuses were created, and all 9 IUGR fetuses were at or below the third percentile of the normal growth chart. DISCUSSION: The proposed method is fast, accurate, reproducible, user independent, applicable with retrospective data, and is suggested for use in routine clinical practice.

The Physiology of Childhood Growth: Hormonal Regulation.

The growth patterns of a child changes from uterine life until the end of puberty. Height velocity is highest in utero and declines after birth until puberty when it rises again. Important hormonal regulators of childhood growth are growth hormone, insulin-like growth factor 1, sex steroids, and thyroid hormone. This review gives an overview of these hormonal regulators of growth and their interplay with nutrition and other key players such as inflammatory cytokines.

A minimization principle for the description of modes associated with finite-time instabilities.

We introduce a minimization formulation for the determination of a finite-dimensional, time-dependent, orthonormal basis that captures directions of the phase space associated with transient instabilities. While these instabilities have finite lifetime, they can play a crucial role either by altering the system dynamics through the activation of other instabilities or by creating sudden nonlinear energy transfers that lead to extreme responses. However, their essentially transient character makes their description a particularly challenging task. We develop a minimization framework that focuses on the optimal approximation of the system dynamics in the neighbourhood of the system state. This minimization formulation results in differential equations that evolve a time-dependent basis so that it optimally approximates the most unstable directions. We demonstrate the capability of the method for two families of problems: (i) linear systems, including the advection-diffusion operator in a strongly non-normal regime as well as the Orr-Sommerfeld/Squire operator, and (ii) nonlinear problems, including a low-dimensional system with transient instabilities and the vertical jet in cross-flow. We demonstrate that the time-dependent subspace captures the strongly transient non-normal energy growth (in the short-time regime), while for longer times the modes capture the expected asymptotic behaviour.

Predicting intrapartum fetal compromise using the fetal cerebro-umbilical ratio.

INTRODUCTION: The aim of this study was to explore the association between the cerebro-umbilical ratio measured at 35-37 weeks and intrapartum fetal compromise. METHODS: This retrospective cross sectional study was conducted at the Mater Mothers' Hospital in Brisbane, Australia. Maternal demographics and fetal Doppler indices at 35-37 weeks gestation for 1381 women were correlated with intrapartum and neonatal outcomes. RESULTS: Babies born by caesarean section or instrumental delivery for fetal compromise had the lowest median cerebro-umbilical ratio 1.60 (IQR 1.22-2.08) compared to all other delivery groups (vaginal delivery, emergency delivery for failure to progress, emergency caesarean section for other reasons or elective caesarean section). The percentage of infants with a cerebro-umbilical ratio <10th centile that required emergency delivery (caesarean section or instrumental delivery) for fetal compromise was 22%, whereas only 7.3% of infants with a cerebro-umbilical ratio between the 10th-90th centile and 9.6% of infants with a cerebro-umbilical ratio > 90th centile required delivery for the same indication (p < 0.001). A lower cerebro-umbilical ratio was associated with an increased risk of emergency delivery for fetal compromise, OR 2.03 (95% CI 1.41-2.92), p < 0.0001. DISCUSSION: This study suggests that a low fetal cerebro-umbilical ratio measured at 35-37 weeks is associated with a greater risk of intrapartum compromise. This is a relatively simple technique which could be used to risk stratify women in diverse healthcare settings.

Autophagy fosters myofibroblast differentiation through MTORC2 activation and downstream upregulation of CTGF.

Recent evidence suggests that autophagy may favor fibrosis through enhanced differentiation of fibroblasts in myofibroblasts. Here, we sought to characterize the mediators and signaling pathways implicated in autophagy-induced myofibroblast differentiation. Fibroblasts, serum starved for up to 4 d, showed increased LC3-II/-I ratios and decreased SQSTM1/p62 levels. Autophagy was associated with acquisition of markers of myofibroblast differentiation including increased protein levels of ACTA2/αSMA (actin, α 2, smooth muscle, aorta), enhanced gene and protein levels of COL1A1 (collagen, type I, α 1) and COL3A1, and the formation of stress fibers. Inhibiting autophagy with 3 different class I phosphoinositide 3-kinase and class III phosphatidylinositol 3-kinase (PtdIns3K) inhibitors or through ATG7 silencing prevented myofibroblast differentiation. Autophagic fibroblasts showed increased expression and secretion of CTGF (connective tissue growth factor), and CTGF silencing prevented myofibroblast differentiation. Phosphorylation of the MTORC1 target RPS6KB1/p70S6K kinase was abolished in starved fibroblasts. Phosphorylation of AKT at Ser473, a MTORC2 target, was reduced after initiation of starvation but was followed by spontaneous rephosphorylation after 2 d of starvation, suggesting the reactivation of MTORC2 with sustained autophagy. Inhibiting MTORC2 activation with long-term exposure to rapamycin or by silencing RICTOR, a central component of the MTORC2 complex abolished AKT rephosphorylation. Both RICTOR silencing and rapamycin treatment prevented CTGF and ACTA2 upregulation, demonstrating the central role of MTORC2 activation in CTGF induction and myofibroblast differentiation. Finally, inhibition of autophagy with PtdIns3K inhibitors or ATG7 silencing blocked AKT rephosphorylation. Collectively, these results identify autophagy as a novel activator of MTORC2 signaling leading to CTGF induction and myofibroblast differentiation.

Comparative transcriptome profiles of the WRKY gene family under control, hormone-treated, and drought conditions in near-isogenic rice lines reveal differential, tissue specific gene activation.

The OsWRKY genes play various roles in developmental processes and in stress-related responses in plants. We describe the rice OsWRKY gene expression profiles (GEPs) under control, hormone-treated, and water-deficit treatment (WDT) conditions. The preferential expression of 3 genes was observed in specific tissues, suggesting that these genes may play important roles in the root and panicle stages of growth. To investigate the GEPs in the root and panicle of 3 rice genotypes, we used 2 near-isogenic rice lines from a common genetic combination backcross developed by Aday Selection and IR64. WDTs were applied using the fraction of transpirable soil water (FTSW) for severe, mild, and control conditions. Transcriptomic analysis using a 44K oligoarray from Affymetrix and Agilent was performed on all the tissues. The majority of the OsWRKY genes that were activated were activated in the drought-tolerant IR77298-14-1-2-B-10 line but not in the drought-susceptible IR77298-14-1-2-B-13 or IR64 lines. In IR77298-14-1-2-B-10, non-redundant genes (9) were very specific in their higher expression levels. Approximately 27 and 43% more genes from group III and subgroup IV-a, respectively, were activated in the panicle during severe stress than during the control treatment. We found 5 OsWRKY genes that introgressed in the drought-tolerant IR77298-14-1-2-B-10 line. Os01g43650 was up-regulated in the root under both WDTs and in the panicle under mild stress. OsWRKY up-regulated genes with tissue-specific expression patterns that contained at least 3 cis-elements in the tolerant line. These results provide a useful reference for the cloning of candidate genes for further functional analysis.

The Effect of Obesity on Serum Growth Factors, and Insulin-like Growth Factor Binding Protein-3 Proteolysis in Children with Simple Obesity / 대한소아내분비학회지

PURPOSE: In children with simple obesity, spontaneous and stimulated growth hormone (GH) secretion are diminished, but their heights usually are normal or even taller for their age and sex. The exact mechanism to explain the discrepancy between impaired GH secretion and normal height velocity has not been elucidated. In this study, we aimed to determine the level of serum growth factors, and the degree of insulin-like growth factor binding protein (IGFBP)-3 proteolysis, and to assess the alteration of the IGF system associated with accelerated or normal growth in simple obesity. METHODS: We evaluated serum growth factors, and IGFBP-3 proteolysis in 27 obese, 25 obesity risk group, and 28 age-matched control group. We measured serum levels of insulin-like growth factor (IGF)-I, IGFBP-1, -3, and free IGF-I by immuno-radiometric assay and IGFBP-3 fragment by Western immunoblotting. RESULTS: The height was taller in obese children than in lean control group. The results showed no significant difference in the level of serum total IGF-1 and IGFBP-3 between obese and normal control group. Although there was no significant difference in other components, serum free IGF-I levels were significantly increased (P<0.05) and showed positive correlation with their height in obese children (r=0.25, P<0.05). The degree of IGFBP-3 proteolysis was increased in obesity and obesity risk group compared to control group. The densities of the IGFBP-3 proteolytic fragment approximate 18 kDa also showed positive correlation with levels of free IGF-I (r=0.23, P<0.05) and height (r=0.19, P<0.05). CONCLUSION: These findings may suggest that elevated levels of serum IGFBP-3 proteolytic fragments showing decreased affinity to IGF-I result in the increase of biologically active free IGF-I, thereby maintain normal growth in the obese children.

Effects of maxillary protraction on growth in Class III malocclusion / 대한치과교정학회지

The method of treatment in skeletal Class III malocclusion must be chosen according to an etiology and timing of the treatment. Maxillary protraction has been used as an effective treatment method in growing children with maxillary deficiency. The efficacy of maxillary protraction has been viewed as a result of downward-backward displacement of mandible and compensatory dental displacement during the treatment rather than forward-downward growth of maxilla itself. In this study, 104 subjects treated with maxillary protraction, and 19 males and 21 females with known annual growth amount have been chosen longitudinally as treated group and normal group, respectively. And changes in position of maxilla, mandible and dentition have been comparatively analyzed on the lateral cephalometric radiographs by age. The results were as follows: 1. Treated group showed more forward movement of maxilla compare to the normal group and the mandible displaced backward compare to the normal group. 2. Downward movement of maxilla in treated group was similar to that of normal group with statistical signigicance in female 12 year old group and downward movement of mandible in treated group was similar to that of normal group. 3. In treated group, maxillary central incisor moved more forward than the normal group with statistical significance in male 8, 10 year-old groups and female 8, 9, 10 year-old groups. In treated group, downward movement of maxillary central incisor was similar to that of the normal group with statistical significance in male and female 7, 8 year-old groups. Considering the above results and the duration of the treatment, the forward movement of maxilla due to maxillary protraction was effective compared to normal growth amount of the normal group.