Crecimiento y desarrollo puberal en niñas adoptadas de Rusia: seguimiento de 12 años / Growth and pubertal development in girls adopted from Russia: 12-year follow-up

Introducción: los objetivos fueron aportar datos de la evolución longitudinal del crecimiento y determinar la edad de la telarquia y menarquia en niñas adoptadas de Rusia. Material y métodos: estudio de cohorte prospectivo sobre 24 niñas rusas adoptadas en España entre 2002-2010 controladas durante doce años. Se recopilaron antecedentes adversos revisando los informes médicos preadoptivos. Se registraron estandarizadamente: peso, talla, perímetro cefálico y edad de la telarquia y menarquia. Los valores medios se compararon con estándares de referencia. Resultados: antecedentes principales: pretérmino (33,3%), bajo peso al nacer (41,7%), exposición prenatal al alcohol (45,8%), abuso/negligencia (54,2%). Evaluación inicial: edad media (DE), 3 (1,6) años; puntuación Z (pZ) peso, -1,35; pZ talla, -2,42; pZ perímetro cefálico, -1,77. Tras 1 año de la adopción, se observó crecimiento recuperador significativo del peso (pZ +0,68), talla (pZ +0,98) y perímetro cefálico (pZ +0,76). Tendencias temporales del crecimiento: no se observó retraso del peso desde los 7 años; la talla mantuvo recuperación hasta los 10 años (pZ -0,40) y se mantuvo estable hasta los 15 años (pZ -0,46); el grado de retraso de la talla siempre fue superior al del peso. Aparición de la telarquia: edad media (DE), 9,9 (0,8) años; talla 135,4 cm (pZ -0,43). Presentación de la menarquia: edad media (DE), 11,9 (0,7) años; talla 147,6 cm (pZ -0,44). Conclusiones: el patrón de crecimiento y desarrollo se caracterizó por un retraso severo de la talla y moderado del peso y perímetro cefálico en el momento de la adopción, un rápido, significativo y prolongado crecimiento recuperador, una aceleración del desarrollo puberal con telarquia y menarquia tempranas, y una incompleta recuperación de la talla. (AU)

Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth. (AU)

Fallo de medro en Pediatría de Atención Primaria: recomendaciones para su abordaje y seguimiento / Failure to Thrive in Primary Care pediatrics: recommendations for its approach and follow-up

El fallo de medro representa la dificultad para mantener un ritmo de crecimiento adecuado, tanto en peso como en talla, en menores de tres años. Se trata de una entidad actualmente infradiagnosticada que puede repercutir en el desarrollo físico, intelectual, emocional y social de los niños. El pediatra de Atención Primaria es clave en la identificación precoz y en la prevención de su morbilidad. Este documento representa una herramienta útil para el desarrollo de la labor conjunta del pediatra y la enfermería pediátrica, realizando una intervención precoz, individualizada y eficiente en estos niños. (AU)

Failure to thrive is poor physical growth, both in weight and height, in children under three years of age. This underdiagnosed entity can affect children’s physical, intellectual, emotional and social development. Paediatric Primary Care is crucial in early diagnosis and prevention of their morbidity. This document represents a useful tool for the teamwork between paediatricians and paediatric nursing. Its objective is to carry out an early, individualized and efficient approach in these children. (AU)

Efectos de la edad relativa en selecciones femeninas de Colombia: caso juegos bolivarianos 2022 / Relative age effects in Colombian women's teams: 2022 bolivarian games case / Efeitos da idade relativa nas equipes femininas colombianas: caso dos jogos bolivarianos 2022

Los efectos relativos de la edad (RAE) se refieren a aquellas (des)ventajas y resultados que proceden fundamentalmente de una interacción entre la fecha de nacimiento y las fechas utilizadas para organizar logísticamente a los participantes. Los RAE prevalecen constantemente en contextos deportivos femeninos, con un 25 % más de participantes relativamente mayores (Q1) que participantes relativamente más jóvenes (Q4). Nuestro objetivo fue identificar los RAE en las selecciones Colombia femeninas participantes en los últimos juegos Bolivarianos [JB] (Organización Deportiva Bolivariana [ODEBO], 2022). Se analizaron un total n = 87 fechas de nacimiento, utilizando la prueba estadística de chi-cuadrada. El análisis nos permitió establecer que no existen los RAE en las selecciones femeninas participantes en los JB (X2 = 12,2; p = 0,836). Estos hallazgos son importantes para el contexto del deporte femenino colombiano y pueden ser tenidos en cuenta por organizaciones, clubes deportivos, así como en lineamientos para la identificación y selección de talentos deportivos.

Relative Age Effects (RAE) refer to those (dis)advantages and outcomes that stem primarily from an interaction between the date of birth and the dates used to logistically organize the participants. RAE is consistently prevalent in female sports contexts, with 25% more relatively older participants (Q1) than relatively younger participants (Q4). Our objective was to identify the RAE in the Colombian women's teams participating in the last Bolivarian Games (JB) (ODEBO, 2022). A total of n = 87 dates of birth were analyzed using the chi-square statistical test. The analysis allowed us to establish that there are no RAE in the female teams participating in JB (X2 = 12,2; p = 0,836). These findings are important in the context of Colombian women's sports and can be considered by organizations, and sports clubs, as well as in guidelines for the identification and Selection of sports talents.

Os Efeitos da Idade Relativa (RAE) referem-se àquelas (des)vantagens e resultados que decorrem principalmente de uma interação entre a data de nascimento e as datas utilizadas para organizar logisticamente os participantes. O EIR é consistentemente prevalente em contextos esportivos femininos, com 25% mais participantes relativamente mais velhos (Q1) do que participantes relativamente mais jovens (Q4). Nosso objetivo foi identificar o RAE nas equipes femininas colombianas participantes dos últimos Jogos Bolivarianos (JB) (ODEBO, 2022). Um total de n = 87 datas de nascimento foram analisadas pelo teste estatístico do qui-quadrado. A análise permitiu estabelecer que não há EIR nas equipes femininas participantes do JB (X2 = 12,2; p = 0,836). Esses achados são importantes para o contexto do esporte feminino colombiano e podem ser levados em consideração pelas organizações e clubes esportivos, bem como nas diretrizes para a identificação e seleção de talentos esportivos.

Avaliação do crescimento e desenvolvimento infantil e fatores de risco de um município que integra uma universidade brasileira de cunho internacional / Evaluation of childhood growth and development and risk factors of a municipality that is part of an international brazilian university / Evaluación de los factores de crecimiento y desarrollo infantil y de riesgo de un municipio que forma parte de una universidad brasileña internacional

Fatores de risco, incluindo os de cunho materno, interferem no crescimento e desenvolvimento infantil. Nesse sentido, o conhecimento desses fatores e avaliação ade- quada desses processos são necessários para articulação de estratégias preventivas de transtornos futuros. Assim, o estudo visou investigar o crescimento e desenvolvimento de crianças atendidas em consulta de puericultura em unidades básicas de saúde de um mu- nicípio cearense, que integra uma universidade brasileira de cunho internacional, e seus fatores de risco. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães no Centro de Saúde de Acarape e Posto de Saúde São Benedito (Acarape ­ CE), no período de fevereiro a julho de 2021. Após consentimento, as mães preencheram um questionário, seguido de avaliação do cresci- mento e desenvolvimento das crianças. Os dados obtidos foram analisados. Das 70 crian- ças, 50,00% (n = 17) e 51,43% (n = 18) dos meninos e meninas tinham baixa estatura para idade, respectivamente. Para o desenvolvimento psicossocial, dos 284 testes condu- zidos, 86,27% (n = 245) foram realizados em plenitude pelas crianças. Observou-se as- sociação significativa entre a gestante ter concebido o filho com, no mínimo, 9 meses de período gestacional e esse apresentar relação Peso/Idade adequada e Estatura/Idade ina- dequada. Houve associação significativa entre a criança não ingerir refresco em pó e apre- sentar relação Peso/Idade adequada. Conclui-se que as crianças tinham idade gestacional adequada e apresentavam estado nutricional apropriado, apesar da baixa estatura para idade. Manifestavam desenvolvimento psicossocial, de linguagem e físico normais. Sobre os fatores de risco, esses envolveram os de cunho materno e o consumo de alimentos cariogênicos.

Risk factors, including maternal ones, interfere with child growth and de- velopment. In this sense, knowledge of these factors and adequate evaluation of these processes are necessary to articulate preventive strategies for future disorders. Thus, the study aimed to investigate the growth and development of children seen in childcare con- sultations in primary health units in Ceará, part of a Brazilian university of international character, and their risk factors. This is an observational, analytical, cross-sectional study with a quantitative approach, conducted with children and their mothers at the Acarape Health Center and São Benedito Health Center (Acarape ­ CE), from February to July 2021. After consent, the mothers completed a questionnaire, followed by an assessment of the children's growth and development. The data obtained were analyzed. Of the 70 children, 50.00% (n = 17) and 51.43% (n = 18) of the boys and girls were short for their age, respectively. Of the 284 tests conducted for psychosocial development, 86.27% (n = 245) were entirely performed by the children. A significant association was observed between the pregnant woman having conceived her child at least nine months of gestation and having an adequate Weight/Age and Height/Age ratio. There was a significant asso- ciation between the child not ingesting powdered soft drinks and having an appropriate Weight/Age ratio. It was concluded that the children had an adequate gestational age and had an appropriate nutritional status, despite their low height for their age. They showed normal psychosocial, language, and physical development. The risk factors involved those of mother nature and the consumption of cariogenic foods.

Los factores de riesgo, incluidos los maternos, interfieren en el crecimiento y desarrollo infantil. En este sentido, el conocimiento de estos factores y la evaluación adecuada de estos procesos son necesarios para articular estrategias preventivas de futu- ros trastornos. Así, el estudio tuvo como objetivo investigar el crecimiento y desarrollo de niños atendidos en consultas de puericultura en unidades básicas de salud de un muni- cipio de Ceará, que forma parte de una universidad brasileña de carácter internacional, y sus factores de riesgo. Se trata de un estudio observacional, analítico, transversal, con enfoque cuantitativo, realizado con niños y sus madres en el Centro de Salud de Acarape y el Centro de Salud São Benedito (Acarape ­ CE), de febrero a julio de 2021. Después del consentimiento, las madres completaron un cuestionario, seguido de una evaluación del crecimiento y desarrollo de los niños. Los datos obtenidos fueron analizados. De los 70 niños, el 50,00% (n = 17) y el 51,43% (n = 18) de los niños y niñas eran bajos para su edad, respectivamente. Para el desarrollo psicosocial, de las 284 pruebas realizadas, el 86,27% (n = 245) fueron realizadas íntegramente por los niños. Se observó una asociación significativa entre la gestante haber concebido a su hijo con al menos 9 meses de gesta- ción y tener una adecuada relación Peso/Edad y Talla/Edad. Hubo asociación significativa entre el niño que no ingiere gaseosas en polvo y presentar una adecuada relación Peso/Edad. Se concluyó que los niños tenían una edad gestacional adecuada y un estado nutricional adecuado, a pesar de su baja talla para su edad. Presentaron un desarrollo psi- cosocial, lingüístico y físico normal. En cuanto a los factores de riesgo, estos involucraron los de naturaleza materna y el consumo de alimentos cariogénicos.

Early childhood growth in Daasanach pastoralists of Northern Kenya: Distinct patterns of faltering in linear growth and weight gain.

OBJECTIVES: Investigations of early childhood growth among small-scale populations are essential for understanding human life history variation and enhancing the ability to serve such communities through global public health initiatives. This study characterizes early childhood growth trajectories and identifies differences in growth patterns relative to international references among Daasanach semi-nomadic pastoralist children living in a hot, arid region of northern Kenya. METHODS: A large sample of height and weight measures were collected from children (N = 1756; total observations = 4508; age = 0-5 years) between 2018 and 2020. Daasanach growth was compared to international reference standards and Daasanach-specific centile growth curves and pseudo-velocity models were generated using generalized additive models for location scale and size. RESULTS: Compared to World Health Organization (WHO) reference, relatively few Daasanach children were stunted (14.3%), while a large proportion were underweight (38.5%) and wasted (53.6%). Additionally, Daasanach children had a distinctive pattern of growth, marked by an increase in linear growth velocity after 24 months of age and relatively high linear growth velocity throughout the rest of early childhood. CONCLUSIONS: These results identify a unique pattern of early childhood growth faltering among children in a small-scale population and may reflect a thermoregulatory adaptation to their hot, arid environment. As linear growth and weight gain remain important indicators of health, the results of this study provide insight into growth velocity variations. This study has important implications for global public health efforts to identify and address sources of early growth faltering and undernutrition in small-scale populations.

NMDA Receptor C-Terminal Domain Signalling in Development, Maturity, and Disease.

The NMDA receptor is a Ca2+-permeant glutamate receptor which plays key roles in health and disease. Canonical NMDARs contain two GluN2 subunits, of which 2A and 2B are predominant in the forebrain. Moreover, the relative contribution of 2A vs. 2B is controlled both developmentally and in an activity-dependent manner. The GluN2 subtype influences the biophysical properties of the receptor through difference in their N-terminal extracellular domain and transmembrane regions, but they also have large cytoplasmic Carboxyl (C)-terminal domains (CTDs) which have diverged substantially during evolution. While the CTD identity does not influence NMDAR subunit specific channel properties, it determines the nature of CTD-associated signalling molecules and has been implicated in mediating the control of subunit composition (2A vs. 2B) at the synapse. Historically, much of the research into the differential function of GluN2 CTDs has been conducted in vitro by over-expressing mutant subunits, but more recently, the generation of knock-in (KI) mouse models have allowed CTD function to be probed in vivo and in ex vivo systems without heterologous expression of GluN2 mutants. In some instances, findings involving KI mice have been in disagreement with models that were proposed based on earlier approaches. This review will examine the current research with the aim of addressing these controversies and how methodology may contribute to differences between studies. We will also discuss the outstanding questions regarding the role of GluN2 CTD sequences in regulating NMDAR subunit composition, as well as their relevance to neurodegenerative disease and neurodevelopmental disorders.

Addressing Pediatric Developmental and Mental Health in Primary Care Using Tele-Education.

This study evaluates the effectiveness of an early childhood tele-education program in preparing community pediatric clinicians to manage developmental and mental health disorders in young children. Community pediatric clinicians from rural, underserved, or school-based health center practices in the mid-Atlantic region participated in a weekly tele-education videoconference. There was a significant knowledge gain evidenced by the percentage of questions answered correctly from pre- to post- didactic exposure (P < .001). Participants reported an increase in knowledge from pre- (P < .001) and in confidence from pre- to post- participation (P < .001). Practice management changes demonstrated an encouraging trend toward managing patients in the Medical Home, as compared with immediately deferring to specialists following participation. This early childhood tele-education videoconferencing program is a promising response to the urgent need to confidently increase the role of pediatricians in the provision of care for childhood developmental and mental health disorders.

Early life nutrition and neuroendocrine programming.

Alterations in the nutritional environment in early life can significantly increase the risk for obesity and a range of development of metabolic disorders in offspring in later life, effects that can be passed onto future generations. This process, termed development programming, provides the framework of the developmental origins of health and disease (DOHaD) paradigm. Early life nutritional compromise including undernutrition, overnutrition or specific macro/micronutrient deficiencies, results in a range of adverse health outcomes in offspring that can be further exacerbated by a poor postnatal nutritional environment. Although the mechanisms underlying programming remain poorly defined, a common feature across the phenotypes displayed in preclinical models is that of altered wiring of neuroendocrine circuits that regulate satiety and energy balance. As such, altered maternal nutritional exposures during critical early periods of developmental plasticity can result in aberrant hardwiring of these circuits with lasting adverse consequences for the offspring. There is also increasing evidence around the role of an altered epigenome and the gut-brain axis in mediating some of the central programming effects observed. Further, although such programming was once considered to result in a permanent change in developmental trajectory, there is evidence, at least from preclinical models, that programming can be reversed via targeted nutritional manipulations during early development. Further work is required at a mechanistic level to allow for identification for early markers of later disease risk, delineation of sex-specific effects and pathways to implementation of strategies aimed at breaking the transgenerational transmission of disease.

Alterations of DNA methylation were associated with the rapid growth of cortisol-producing adrenocortical adenoma during pregnancy.

BACKGROUND: Cortisol-producing adrenocortical adenoma (CPA) during pregnancy rarely occurs in clinic. Growing evidence suggests that DNA methylation plays a key role in adrenocortical adenomas. The present study aims to examine the genome-wide DNA methylation profiles and identify the differences in DNA methylation signatures of non-pregnant and pregnant patients with CPA. RESULTS: Four pregnant and twelve non-pregnant patients with CPA were enrolled. The pregnant patients with CPA had higher serum cortisol, Estradiol, Progesterone, and human chorionic gonadotropin concentration, while having lower serum FSH (follicle-stimulating hormone) and luteinizing hormone concentrations (P < 0.01). Compared with the non-pregnant patients, the duration is shorter, and the growth rate of the tumor is faster in pregnant patients with CPA (P < 0.05). Morphology and cell proliferation assay showed that the percentage of Ki-67 positive cells in CPA were higher in pregnant group than non-pregnant group (8.0% vs 5.5%, P < 0.05). The DNA methylation analysis showed that Genome-wide DNA methylation signature difference between pregnant and non-pregnant with CPA, that the pregnant group had more hypermethylated DMPs (67.94% vs 22.16%) and less hypomethylated DMPs (32.93% vs 77.84%). The proportion of hypermethylated DMPs was relatively high on chromosomes 1 (9.68% vs 8.67%) and X (4.99% vs 3.35%) but lower on chromosome 2(7.98% vs 12.92%). In pregnant patients with CPA, 576 hypomethylated DMPs and 1109 hypermethylated DMPs were identified in the DNA promoter region. Bioinformatics analysis indicated that the Wnt/ß-Catenin pathway, Ras/MAPK Pathway and PI3K-AKT Pathway were associated with the development of CPA during pregnancy. CONCLUSIONS: Genome-wide DNA methylation profiling of CPA in non-pregnant and pregnant patients was identified in the present study. Alterations of DNA methylation were associated with the pathogenesis and exacerbation of CPA during pregnancy.

Physical growth of children and adolescents living at a moderate altitude: proposed percentiles based on age and sex / Crecimiento físico de los niños y adolescentes que viven a una altitud moderada: percentiles propuestos en función de la edad y el sexo

Introduction: physical growth patterns and nutritional status of children and adolescents living at a moderate altitude are not applicable for clinical assessment of growth for diverse populations around the world. Objective: a) to compare weight, height and body mass index (BMI) variables with CDC-2012 references; b) to verify if BMI and/or ponderal index (PI) are applicable to children living at a moderate altitude; and c) to propose percentiles to assess physical growth by age and sex. Methods: a total of 5,377 students, ranging in age from 6.0 to 17.9 years, were evaluated. The students were from two geographic regions of moderate altitude in Peru (2,320 meters) and Colombia (2,640 meters). Weight and height were measured. BMI and PI were calculated. Weight, height and BMI were compared with CDC-2012 references. Results: males showed lower weight and height from age 11 to 17.9 years compared to CDC-2012. Females weighed less than the reference from 9.0 to 17.9 years. Female height was lower from 6.0 to 14.9 years; however, from 15.0 to 17.9 years, values were similar to the reference. As for BMI, there were differences in both sexes (in males, from 15.0 to 17.9 years, and in females, from 12.0 to 17.9 years). Age, weight and height explained BMI: between R2 = 17 and 83 % in males, and in females between R2 = 24 and 85 %. These same variables influenced PI in a lower percentage in both sexes: for males (R2 = 0.01 to 49 %) and for females (R2 = 0.01 to 18 %). (AU)

Introducción: los patrones de crecimiento físico y el estado nutricional de los niños y adolescentes que viven a una altitud moderada no son aplicables para la evaluación clínica del crecimiento de las diversas poblaciones del mundo. Objetivo: a) comparar las variables de peso, estatura e índice de masa corporal (IMC) con las referencias del CDC-2012; b) verificar si el IMC y/o el índice ponderal (IP) son aplicables a los niños que viven a una altitud moderada, y c) proponer percentiles para evaluar el crecimiento físico por edad y sexo. Métodos: se evaluaron 5377 estudiantes con edades que oscilaban entre los 6,0 y 17,9 años. Los estudiantes procedían de dos regiones geográficas de altitud moderada de Perú (2320 metros) y Colombia (2640 metros). Se midieron el peso y la estatura. Se calcularon el IMC y el IP. El peso, la estatura y el IMC se compararon con las referencias de los CDC-2012. Resultados: los varones mostraron un peso y una estatura inferiores de los 11 hasta los 17,9 años en comparación con la CDC-2012. Las mujeres pesaron menos que la referencia desde los 9,0 hasta los 17,9 años. La estatura de las mujeres fue inferior de los 6,0 a los 14,9 años; sin embargo, de los 15,0 a los 17,9 años, los valores fueron similares a los de referencia. En cuanto al IMC, se produjeron diferencias en ambos sexos (en varones, desde 15,0 hasta 17,9 años, y en mujeres, de 12,0 hasta 17,9 años). La edad, el peso y la altura explicaron el IMC: entre R2 = 17 y 83 % en los varones, y en mujeres entre R2 = 24 y 85 %. Estas mismas variables influyeron en el IP en un porcentaje menor en ambos sexos: para los varones (R2 = 0,01 a 49 %) y para las mujeres (R2 = 0,01 a 18 %). (AU)

Intermittent bolus feeding does not enhance protein synthesis, myonuclear accretion, or lean growth more than continuous feeding in a premature piglet model.

Optimizing enteral nutrition for premature infants may help mitigate extrauterine growth restriction and adverse chronic health outcomes. Previously, we showed in neonatal pigs born at term that lean growth is enhanced by intermittent bolus compared with continuous feeding. The objective was to determine if prematurity impacts how body composition, muscle protein synthesis, and myonuclear accretion respond to feeding modality. Following preterm delivery, pigs were fed equivalent amounts of formula delivered either as intermittent boluses (INT; n = 30) or continuously (CONT; n = 14) for 21 days. Body composition was measured by dual-energy X-ray absorptiometry (DXA) and muscle growth was assessed by morphometry, myonuclear accretion, and satellite cell abundance. Tissue anabolic signaling and fractional protein synthesis rates were determined in INT pigs in postabsorptive (INT-PA) and postprandial (INT-PP) states and in CONT pigs. Body weight gain and composition did not differ between INT and CONT pigs. Longissimus dorsi (LD) protein synthesis was 34% greater in INT-PP than INT-PA pigs (P < 0.05) but was not different between INT-PP and CONT pigs. Phosphorylation of 4EBP1 and S6K1 and eIF4E·eIF4G abundance in LD paralleled changes in LD protein synthesis. Satellite cell abundance, myonuclear accretion, and fiber cross-sectional area in LD did not differ between groups. These results suggest that, unlike pigs born at term, intermittent bolus feeding does not enhance lean growth more than continuous feeding in pigs born preterm. Premature birth attenuates the capacity of skeletal muscle to respond to cyclical surges in insulin and amino acids with intermittent feeding in early postnatal life.NEW & NOTEWORTHY Extrauterine growth restriction often occurs in premature infants but may be mitigated by optimizing enteral feeding strategies. We show that intermittent bolus feeding does not increase skeletal muscle protein synthesis, myonuclear accretion, or lean growth more than continuous feeding in preterm pigs. This attenuated anabolic response of muscle to intermittent bolus feeding, compared with previous observations in pigs born at term, may contribute to deficits in lean mass that many premature infants exhibit into adulthood.

Propuesta de percentiles para evaluar el crecimiento físico y la adiposidad corporal en función del estado de madurez en niños y adolescentes chilenos / Proposal of percentiles to evaluate physical growth and body adiposity as a function of maturity status in Chilean children and adolescents

Introducción: durante la infancia y la adolescencia existe una gran variabilidad individual en el crecimiento y la maduración biológica, lo que resulta en diferencias en el tamaño, la forma y la composición corporal de los niños y adolescentes de edad similar. Objetivo: proponer percentiles para evaluar el crecimiento físico y la adiposidad corporal en función del estado de madurez (EM) en niños y adolescentes chilenos. Métodos: se diseñó un estudio descriptivo (transversal) en 7292 niños y adolescentes (4214 chicos y 3084 chicas) de la región del Maule (Chile). El rango de edad oscila entre 6,0 y 17,9 años. Se evaluó el peso, la estatura y la circunferencia de la cintura (CC). Se calculó el índice de masa corporal (IMC), el índice cintura-estatura (ICE) y el EM a través de una técnica antropométrica no invasiva basada en la edad cronológica y la estatura de pie. Se utilizó el método LMS para calcular los percentiles. Resultados: el EM calculado en los chicos se observó a los 13,7 ± 0,6 APVC (años de pico de velocidad de crecimiento) y en las chicas a los 12,1 ± 0,6 APVC. Se crearon percentiles para el peso, la estatura, la CC, el IMC y el ICE. Todas las variables antropométricas se incrementan conforme el EM aumenta en APVC. Conclusión: los percentiles propuestos son una alternativa para evaluar el crecimiento físico y la adiposidad corporal en función del EM en los niños y adolescentes chilenos. Los resultados sugieren que esta técnica no invasiva puede aplicarse en contextos clínicos y epidemiológicos. (AU)

Introduction: during childhood and adolescence there is great individual variability in growth and biological maturation, resulting in differences in size, shape and body composition in children and adolescents of similar age. Objective: to propose percentiles to assess physical growth and body adiposity as a function of maturity status (SM) in Chilean children and adolescents. Methods: a descriptive (cross-sectional) study was designed in 7,292 children and adolescents (4214 boys and 3084 girls) from the Maule region (Chile). The age range was 6.0 to 17.9 years. Weight, height and waist circumference (WC) were evaluated. Body mass index (BMI), waist-height index (WHtR) and SM were calculated through a non-invasive anthropometric technique based on chronological age and standing height. The LMS method was used to calculate percentiles. Results: the SM calculated in boys was observed at 13.7 ± 0.6 APHV (years of peak growth speed) and in girls at 12.1 ± 0.6 APHV. Percentiles were created for weight, height, WC, BMI, and WHtR. All anthropometric variables increase as MS increases in PHV years. Conclusion: the proposed percentiles are an alternative to evaluate physical growth and body adiposity as a function of SM in Chilean children and adolescents. The results suggest the use of this non-invasive technique to be applied in clinical and epidemiological contexts. (AU)

Physical growth of children and adolescents living at a moderate altitude: proposed percentiles based on age and sex.

INTRODUCTION: Introduction: physical growth patterns and nutritional status of children and adolescents living at a moderate altitude are not applicable for clinical assessment of growth for diverse populations around the world. Objective: a) to compare weight, height and body mass index (BMI) variables with CDC-2012 references; b) to verify if BMI and/or ponderal index (PI) are applicable to children living at a moderate altitude; and c) to propose percentiles to assess physical growth by age and sex. Methods: a total of 5,377 students, ranging in age from 6.0 to 17.9 years, were evaluated. The students were from two geographic regions of moderate altitude in Peru (2,320 meters) and Colombia (2,640 meters). Weight and height were measured. BMI and PI were calculated. Weight, height and BMI were compared with CDC-2012 references. Results: males showed lower weight and height from age 11 to 17.9 years compared to CDC-2012. Females weighed less than the reference from 9.0 to 17.9 years. Female height was lower from 6.0 to 14.9 years; however, from 15.0 to 17.9 years, values were similar to the reference. As for BMI, there were differences in both sexes (in males, from 15.0 to 17.9 years, and in females, from 12.0 to 17.9 years). Age, weight and height explained BMI: between R2 = 17 and 83 % in males, and in females between R2 = 24 and 85 %. These same variables influenced PI in a lower percentage in both sexes: for males (R2 = 0.01 to 49 %) and for females (R2 = 0.01 to 18 %). Conclusions: children and adolescents living at a moderate altitude in Peru and Colombia diverge from the CDC-2012 physical growth patterns. In addition, PI is a new alternative for estimating weight in relation to BMI. The proposed curves for weight, height, and PI by age and sex could have greater implications in the control of child health programs and in clinical and epidemiological practices.

INTRODUCCIÓN: Introducción: los patrones de crecimiento físico y el estado nutricional de los niños y adolescentes que viven a una altitud moderada no son aplicables para la evaluación clínica del crecimiento de las diversas poblaciones del mundo. Objetivo: a) comparar las variables de peso, estatura e índice de masa corporal (IMC) con las referencias del CDC-2012; b) verificar si el IMC y/o el índice ponderal (IP) son aplicables a los niños que viven a una altitud moderada, y c) proponer percentiles para evaluar el crecimiento físico por edad y sexo. Métodos: se evaluaron 5377 estudiantes con edades que oscilaban entre los 6,0 y 17,9 años. Los estudiantes procedían de dos regiones geográficas de altitud moderada de Perú (2320 metros) y Colombia (2640 metros). Se midieron el peso y la estatura. Se calcularon el IMC y el IP. El peso, la estatura y el IMC se compararon con las referencias de los CDC-2012. Resultados: los varones mostraron un peso y una estatura inferiores de los 11 hasta los 17,9 años en comparación con la CDC-2012. Las mujeres pesaron menos que la referencia desde los 9,0 hasta los 17,9 años. La estatura de las mujeres fue inferior de los 6,0 a los 14,9 años; sin embargo, de los 15,0 a los 17,9 años, los valores fueron similares a los de referencia. En cuanto al IMC, se produjeron diferencias en ambos sexos (en varones, desde 15,0 hasta 17,9 años, y en mujeres, de 12,0 hasta 17,9 años). La edad, el peso y la altura explicaron el IMC: entre R2 = 17 y 83 % en los varones, y en mujeres entre R2 = 24 y 85 %. Estas mismas variables influyeron en el IP en un porcentaje menor en ambos sexos: para los varones (R2 = 0,01 a 49 %) y para las mujeres (R2 = 0,01 a 18 %). Conclusiones: los niños y adolescentes que viven a una altitud moderada en Perú y Colombia divergen de los patrones de crecimiento físico del CDC-2012. Además, el IP es una nueva alternativa para estimar el peso en relación al IMC. Las curvas propuestas para el peso, la talla y el IP por edad y sexo podrían tener mayores implicaciones en el control de los programas de salud infantil y en las prácticas clínicas y epidemiológicas.

Unbiased Screening Identifies Functional Differences in NK Cells After Early Life Psychosocial Stress.

Early Life Adversity (ELA) is closely associated with the risk for developing diseases later in life, such as autoimmune diseases, type-2 diabetes and cardiovascular diseases. In humans, early parental separation, physical and sexual abuse or low social-economic status during childhood are known to have great impact on brain development, in the hormonal system and immune responses. Maternal deprivation (MD) is the closest animal model available to the human situation. This paradigm induces long lasting behavioral effects, causes changes in the HPA axis and affects the immune system. However, the mechanisms underlying changes in the immune response after ELA are still not fully understood. In this study we investigated how ELA changes the immune system, through an unbiased analysis, viSNE, and addressed specially the NK immune cell population and its functionality. We have demonstrated that maternal separation, in both humans and rats, significantly affects the sensitivity of the immune system in adulthood. Particularly, NK cells' profile and response to target cell lines are significantly changed after ELA. These immune cells in rats are not only less cytotoxic towards YAC-1 cells, but also show a clear increase in the expression of maturation markers after 3h of maternal separation. Similarly, individuals who suffered from ELA display significant changes in the cytotoxic profile of NK cells together with decreased degranulation capacity. These results suggest that one of the key mechanisms by which the immune system becomes impaired after ELA might be due to a shift on the senescent state of the cells, specifically NK cells. Elucidation of such a mechanism highlights the importance of ELA prevention and how NK targeted immunotherapy might help attenuating ELA consequences.

Multi-Omics Analysis on Neurodevelopment in Preterm Neonates: A Protocol Paper.

BACKGROUND: The gut microbiome is an important determinant of health and disease in preterm infants. OBJECTIVES: The objective of this article was to share our current protocol for other neonatal intensive care units to potentially expand their existing protocols, aiming to characterize the relationship between the intestinal microbiome and health outcomes in preterm infants. METHODS: This prospective, longitudinal study planned to recruit 160 preterm infants born <32 weeks gestational age or weighing <1,500 g and admitted to one of two Level III/IV neonatal intensive care units. During the neonatal intensive care unit period, the primary measures included events of early life pain/stress, gut microbiome, host genetic variations, and neurobehavioral assessment. During follow-up visits, gut microbiome; pain sensitivity; and medical, growth, and developmental outcomes at 4, 8-12, and 18-24 months corrected age were measured. DISCUSSION: As of February 14, 2020, 214 preterm infants have been recruited. We hypothesize that infants who experience greater levels of pain/stress will have altered gut microbiome, including potential adverse outcomes such as necrotizing enterocolitis and host genetic variations, feeding intolerance, and/or neurodevelopmental impairments. These will differ from the intestinal microbiome of preterm infants who do not develop these adverse outcomes. To test this hypothesis, we will determine how alterations in the intestinal microbiome affect the risk of developing necrotizing enterocolitis, feeding intolerance, and neurodevelopmental impairments in preterm infants. In addition, we will examine the interaction between the intestinal microbiome and host genetics in the regulation of intestinal health and neurodevelopmental outcomes.

Cord blood metabolic signatures predictive of childhood overweight and rapid growth.

INTRODUCTION: Metabolomics may identify biological pathways predisposing children to the risk of overweight and obesity. In this study, we have investigated the cord blood metabolic signatures of rapid growth in infancy and overweight in early childhood in four European birth cohorts. METHODS: Untargeted liquid chromatography-mass spectrometry metabolomic profiles were measured in cord blood from 399 newborns from four European cohorts (ENVIRONAGE, Rhea, INMA and Piccolipiu). Rapid growth in the first year of life and overweight in childhood was defined with reference to WHO growth charts. Metabolome-wide association scans for rapid growth and overweight on over 4500 metabolic features were performed using multiple adjusted logistic mixed-effect models and controlling the false discovery rate (FDR) at 5%. In addition, we performed a look-up analysis of 43 pre-annotated metabolites, previously associated with birthweight or rapid growth. RESULTS: In the Metabolome-Wide Association Study analysis, we identified three and eight metabolites associated with rapid growth and overweight, respectively, after FDR correction. Higher levels of cholestenone, a cholesterol derivative produced by microbial catabolism, were predictive of rapid growth (p = 1.6 × 10-3). Lower levels of the branched-chain amino acid (BCAA) valine (p = 8.6 × 10-6) were predictive of overweight in childhood. The area under the receiver operator curve for multivariate prediction models including these metabolites and traditional risk factors was 0.77 for rapid growth and 0.82 for overweight, compared with 0.69 and 0.69, respectively, for models using traditional risk factors alone. Among the 43 pre-annotated metabolites, seven and five metabolites were nominally associated (P < 0.05) with rapid growth and overweight, respectively. The BCAA leucine, remained associated (1.6 × 10-3) with overweight after FDR correction. CONCLUSION: The metabolites identified here may assist in the identification of children at risk of developing obesity and improve understanding of mechanisms involved in postnatal growth. Cholestenone and BCAAs are suggestive of a role of the gut microbiome and nutrient signalling respectively in child growth trajectories.

Hydrostatic mechanical stress regulates growth and maturation of the atrioventricular valve.

During valvulogenesis, cytoskeletal, secretory and transcriptional events drive endocardial cushion growth and remodeling into thin fibrous leaflets. Genetic disorders play an important role in understanding valve malformations but only account for a minority of clinical cases. Mechanical forces are ever present, but how they coordinate molecular and cellular decisions remains unclear. In this study, we used osmotic pressure to interrogate how compressive and tensile stresses influence valve growth and shape maturation. We found that compressive stress drives a growth phenotype, whereas tensile stress increases compaction. We identified a mechanically activated switch between valve growth and maturation, by which compression induces cushion growth via BMP-pSMAD1/5, while tension induces maturation via pSer-19-mediated MLC2 contractility. The compressive stress acts through BMP signaling to increase cell proliferation and decrease cell contractility, and MEK-ERK is essential for both compressive stress and BMP mediation of compaction. We further showed that the effects of osmotic stress are conserved through the condensation and elongation stages of development. Together, our results demonstrate that compressive/tensile stress regulation of BMP-pSMAD1/5 and MLC2 contractility orchestrates valve growth and remodeling.

Nutrición de la embarazada, primer pilar de la nutrición para la vida / Nutrition of the pregnant, the first pillar of a nutrition for life

Following healthy eating patterns is important for pregnant and lactating women for a number of reasons. Increasing calories and nutrient intake is necessary to support the growth and development of the baby and maintain the health of the mother. Having access to a healthy dietary pattern before and during pregnancy will improve pregnancy outcomes. In addition, following a healthy diet plan before and during pregnancy as well as while breastfeeding has the potential to influence the health of mother and child in successive stages of life. Pregnancy and breastfeeding are special stages in a woman's life and nutrition plays a vital role before, during and after these stages in maintaining the health of the mother and her child. Consideration should be given to achieving and maintaining a healthy weight before pregnancy, gaining weight during pregnancy as recommended, and returning to a healthy weight after the postpartum period. Events that occur in the early stages of life play an important role in the development of chronic diseases. It is recognized that diet and lifestyle during pregnancy are crucial determinants for modulating the microbiota of the offspring, through a vertical transfer from the dysbiotic maternal environment. In addition, intestinal colonization is maximized in the first two years of life through the type and timing of feeding of the newborn

Seguir patrones de alimentación saludables es importante para las mujeres embarazadas y mujeres lactantes por varias razones. Aumento de calorías y la ingesta de nutrientes es necesaria para apoyar el crecimiento y desarrollo del bebé y mantener la salud de la madre. Tener acceso a un patrón dietético saludable antes y durante el embarazo mejorará. resultados del embarazo. Además, seguir un plan de dieta saludable antes y durante el embarazo, así como durante la lactancia, tiene el potencial influir en la salud de la madre y el niño en las sucesivas etapas de la vida. El embarazo y la lactancia son etapas especiales en la vida de una mujer y la nutrición juega un papel vital antes, durante y después de estas etapas en el mantenimiento de la salud de la madre y su hijo. Consideración debe darse para lograr y mantener un peso saludable antes embarazo, aumento de peso durante el embarazo según lo recomendado, y volver a un peso saludable después del período posparto. Los eventos que ocurren en las primeras etapas de la vida juegan un papel importante en el desarrollo de enfermedades crónicas. Se reconoce que la dieta y El estilo de vida durante el embarazo son determinantes cruciales para modular la microbiota de la descendencia, a través de una transferencia vertical desde el ambiente materno disbiótico. Además, la colonización intestinal se maximiza en los primeros dos años de vida a través del tipo y el momento de alimentación del recién nacido

[Proposal of percentiles to evaluate physical growth and body adiposity as a function of maturity status in Chilean children and adolescents]. / Propuesta de percentiles para evaluar el crecimiento físico y la adiposidad corporal en función del estado de madurez en niños y adolescentes chilenos.

INTRODUCTION: Introduction: during childhood and adolescence there is great individual variability in growth and biological maturation, resulting in differences in size, shape and body composition in children and adolescents of similar age. Objective: to propose percentiles to assess physical growth and body adiposity as a function of maturity status (SM) in Chilean children and adolescents. Methods: a descriptive (cross-sectional) study was designed in 7,292 children and adolescents (4214 boys and 3084 girls) from the Maule region (Chile). The age range was 6.0 to 17.9 years. Weight, height and waist circumference (WC) were evaluated. Body mass index (BMI), waist-height index (WHtR) and SM were calculated through a non-invasive anthropometric technique based on chronological age and standing height. The LMS method was used to calculate percentiles. Results: the SM calculated in boys was observed at 13.7 ± 0.6 APHV (years of peak growth speed) and in girls at 12.1 ± 0.6 APHV. Percentiles were created for weight, height, WC, BMI, and WHtR. All anthropometric variables increase as MS increases in PHV years. Conclusion: the proposed percentiles are an alternative to evaluate physical growth and body adiposity as a function of SM in Chilean children and adolescents. The results suggest the use of this non-invasive technique to be applied in clinical and epidemiological contexts.

INTRODUCCIÓN: Introducción: durante la infancia y la adolescencia existe una gran variabilidad individual en el crecimiento y la maduración biológica, lo que resulta en diferencias en el tamaño, la forma y la composición corporal de los niños y adolescentes de edad similar. Objetivo: proponer percentiles para evaluar el crecimiento físico y la adiposidad corporal en función del estado de madurez (EM) en niños y adolescentes chilenos. Métodos: se diseñó un estudio descriptivo (transversal) en 7292 niños y adolescentes (4214 chicos y 3084 chicas) de la región del Maule (Chile). El rango de edad oscila entre 6,0 y 17,9 años. Se evaluó el peso, la estatura y la circunferencia de la cintura (CC). Se calculó el índice de masa corporal (IMC), el índice cintura-estatura (ICE) y el EM a través de una técnica antropométrica no invasiva basada en la edad cronológica y la estatura de pie. Se utilizó el método LMS para calcular los percentiles. Resultados: el EM calculado en los chicos se observó a los 13,7 ± 0,6 APVC (años de pico de velocidad de crecimiento) y en las chicas a los 12,1 ± 0,6 APVC. Se crearon percentiles para el peso, la estatura, la CC, el IMC y el ICE. Todas las variables antropométricas se incrementan conforme el EM aumenta en APVC. Conclusión: los percentiles propuestos son una alternativa para evaluar el crecimiento físico y la adiposidad corporal en función del EM en los niños y adolescentes chilenos. Los resultados sugieren que esta técnica no invasiva puede aplicarse en contextos clínicos y epidemiológicos.