Growth charts for weight and height of Indian children with Down syndrome.

Age and gender specific growth charts for Indian children with Down syndrome (DS) based on longitudinal data have not been published. To establish percentile growth charts for DS children inhabiting northwestern parts of India, body weight and length/height of 1125 (Male: 752, Female: 373) children with DS aged <1 month to 10 years, enrolled from the "Genetics Clinic" were measured at half yearly age intervals in the "Growth Clinic" of the Institute from August 1994 to November 2018. A total of 2089 observations were made on these children using standardized anthropometric techniques and instruments following a prospective mixed-longitudinal growth research design. Using the LMS method, age and sex-specific percentile growth charts (<1 month to 10 years) for weight, and length/ height were generated. Unpaired t-test was used to compare mean growth attainments of study children with those of DS patients representing other population groups as well as their normal Multicentre Growth Reference Study (MGRS and Indian Academy of Pediatrics (IAP) counterparts. The 50th percentile growth curves for both weight and length/height of Indian children with DS demonstrated a regular increase. As compared to their normal MGRS and Indian (IAP) counterparts, the children with DS had lower weight and height attainments. The boys and girls with Down syndrome showed short stature (height < 3rd centile) from the age of 1 year till 10 years and also became underweight beyond 5 years. As compared to their normal counterparts, children with Down syndrome exhibited compromised auxological attainments. The use of growth charts presented herein may be used to compare and monitor growth and nutritional status of Indian children with Down syndrome.

Differentiation between fetal and postnatal iron deficiency in altering brain substrates of cognitive control in pre-adolescence.

BACKGROUND: Early iron deficiency (ID) is a common risk factor for poorer neurodevelopment, limiting children's potential and contributing to global burden. However, it is unclear how early ID alters the substrate of brain functions supporting high-order cognitive abilities and whether the timing of early ID matters in terms of long-term brain development. This study aimed to examine the effects of ID during fetal or early postnatal periods on brain activities supporting proactive and reactive cognitive control in pre-adolescent children. METHODS: Participants were part of a longitudinal cohort enrolled at birth in southeastern China between December 2008 and November 2011. Between July 2019 and October 2021, 115 children aged 8-11 years were invited to participate in this neuroimaging study. Final analyses included 71 children: 20 with fetal ID, 24 with ID at 9 months (postnatal ID), and 27 iron-sufficient at birth and 9 months. Participants performed a computer-based behavioral task in a Magnetic Resonance Imaging scanner to measure proactive and reactive cognitive control. Outcome measures included accuracy, reaction times, and brain activity. Linear mixed modeling and the 3dlme command in Analysis of Functional NeuroImages (AFNI) were separately used to analyze behavioral performance and neuroimaging data. RESULTS: Faster responses in proactive vs. reactive conditions indicated that all groups could use proactive or reactive cognitive control according to contextual demands. However, the fetal ID group was lower in general accuracy than the other 2 groups. Per the demands of cues and targets, the iron-sufficient group showed greater activation of wide brain regions in proactive vs. reactive conditions. In contrast, such condition differences were reversed in the postnatal ID group. Condition differences in brain activation, shown in postnatal ID and iron-sufficient groups, were not found in the fetal ID group. This group specifically showed greater activation of brain regions in the reward pathway in proactive vs. reactive conditions. CONCLUSIONS: Early ID was associated with altered brain functions supporting proactive and reactive cognitive control in childhood. Alterations differed between fetal and postnatal ID groups. The findings imply that iron supplement alone is insufficient to prevent persisting brain alterations associated with early ID. Intervention strategies in addition to the iron supplement should consider ID timing.

Pre-adolescent children exhibit lower aerosol particle volume emissions than adults for breathing, speaking, singing and shouting.

Speaking and singing are activities linked to increased aerosol particle emissions from the respiratory system, dependent on the utilized vocal intensity. As a result, these activities have experienced considerable restrictions in enclosed spaces since the onset of the COVID-19 pandemic due to the risk of infection from the SARS-CoV-2 virus, transmitted by virus-carrying aerosols. These constraints have affected public education and extracurricular activities for children as well, from in-person music instruction to children's choirs. However, existing risk assessments for children have been based on emission measurements of adults. To address this, we measured the particle emission rates of 15 pre-adolescent children, all eight to ten years old, with a laser particle counter for the test conditions: breathing at rest, speaking, singing and shouting. Compared with values taken from 15 adults, emission rates for breathing, speaking and singing were significantly lower for children. Particle emission rates were reduced by a factor of 4.3 across all conditions, whereas emitted particle volume rates were reduced by a factor of 4.8. These data can supplement SARS-CoV-2 risk management scenarios for various school and extracurricular settings.

[Gut microbiome composition in pre-adolescent children with different meat consumption patterns].

OBJECTIVE: To compare the composition of gut microbiome in pre-adolescent children with different meat consumption patterns. METHODS: This study was conducted among 44 healthy school-age children (age range 8-10 years) in Shenzhen. According to the monthly intake frequency ratio of white meat and red meat, the children were divided into red-meat group (n=15), balanced group (n=16) and white-meat group (n=13). The Food Frequency Questionnaire (FFQ) was used to investigate the children's diet, and samples of morning feces were collected to study the gut microbiome. The fecal DNA was extracted and amplified, and the composition of the intestinal microbiome of the children was analyzed using Illumina Miseq high-throughput sequencing. RESULTS: The children in red meat and white meat groups showed significantly lower abundance and diversity of gut microbiota than those with a balanced diet (P < 0.05). LEfSe analysis of the genus in the fecal samples showed that Escherichia-Shigella, Coprobacillus and Peptoniphilus were enriched in red-meat group and Holdemanella was enriched in the white-meat group as compared with the balanced group. In the samples of the balanced group, 31 and 25 genus (such as Laurespirillum and Rumenococcus) were significantly enriched as compared with the samples of the red-meat group and the white-meat group, respectively. Prediction of the gut microbiota KEGG pathway using PICRUSt2 suggested that compared with that in the balanced group, the gut microbiota in red-meat group had significant activation of the pathways involving lipopolysaccharide biosynthesis (P < 0.01), arachidonic acid metabolism (P < 0.01), thyroid hormone synthesis (P < 0.001), and carbohydrate digestion and absorption (P < 0.05). But compared with the white-meat group, the red-meat group showed only significant activation of the pathways of arachidonic acid metabolism (P < 0.05) and thyroid hormone synthesis (P < 0.05). CONCLUSION: The preference of red meat and white meat consumption may significantly reduce the abundance and diversity of gut microbiota in pre-adolescent children. A red meat-rich diet may cause enrichment of Escherichia-Shigella and significant activation of lipopolysaccharide biosynthesis pathway, suggesting the potential benefit of a balanced diet for pre-adolescent children.

Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia.

Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC-MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.

Design and strategies used for recruitment and retention in a double blind randomized controlled trial investigating the effects of soluble corn fiber on bone indices in pre-adolescent children (PREBONE-Kids study) in Malaysia.

BACKGROUND: Recruitment and retention in longitudinal nutrition intervention studies among children is challenging and scarcely reported. This paper describes the strategies and lessons learned from a 1-year randomized double-blind placebo-controlled trial among pre-adolescent children on the effects of soluble corn fiber (SCF) on bone indices (PREBONE-Kids). METHODS: Participants (9-11 years old) were recruited and randomized into 4 treatment groups (600 mg calcium, 12 g SCF, 12 g SCF plus 600 mg calcium and placebo). Interventions were consumed as a fruit-flavored powdered drink for 1-year. School-based recruitment was effective due to support on study benefits from parents and teachers, peer influence and a 2-weeks study run-in for participants to assess their readiness to commit to the study protocol. Retention strategies focused on building rapport through school-based fun activities, WhatsApp messaging, providing health screening and travel reimbursements for study measurements. Compliance was enhanced by providing direct on-site school feeding and monthly non-cash rewards. Choice of 2 flavors for the intervention drinks were provided to overcome taste fatigue. Satisfaction level on the manner in which the study was conducted was obtained from a voluntary sub-set of participants. RESULTS: The study successfully enrolled 243 participants within 6 months and retained 82.7% of the participants at the end of 1 year, yielding a drop-out rate of 17.3%. Compliance to the intervention drink was 85% at the start and remained at 78.7% at the end of 1 year. More than 95% of the participants provided good feedback on intervention drinks, rapport building activities, communication and overall study conduct. CONCLUSION: Successful strategies focused on study benefits, rapport building, frequent communication using social media and non-cash incentives helped improved compliance and retention rate. The lessons learned to maintain a high retention and compliance rate in this study provide valuable insights for future studies in a similar population.

Balance Tests in Pre-Adolescent Children: Retest Reliability, Construct Validity, and Relative Ability.

Balance is an essential prerequisite for the normal physical development of a child. It consists of the ability to maintain the body's centre of mass over its base of support, which is enabled by automatic postural adjustments, and maintain posture and stability in various conditions and activities. The present study aimed to determine the measurement characteristics (reliability and concurrent validity) and the relative ability of balance tests and different motor tests in healthy 11-year-olds. We also evaluated the impact of vision on balance ability. Our results showed high interrater reliability (from 0.810 to 0.910) and confirmed the construct validity of the included balance tests. Girls performed significantly better than boys in laboratory tandem stance in following balance components: total sway path with eyes open (BSEO) (t = 2.68, p = 0.01, effect size (ES) = 0.81), total body sway with eyes closed of centre of pressure (CoP) displacement in the a-p direction (BSEC) (t = 1.86, p = 0.07, ES = 0.57), mean velocity of CoP displacements (VEO) (t = 2.67, p = 0.01, ES = 0.83), mean amplitude of CoP displacements in the a-p direction (AapEO) (t = 3.38. p = 0.00, ES = 1.01) and in mean amplitude of CoP displacements in the m-l direction (AmlEO) (t = 3.68, p = 0.00, ES = 1.19). With eyes closed, girls performed significantly better (t = 2.28, p = 0.03, ES = 0.70) than boys did in the mean amplitude of COP displacements in the a-p direction (AapEO) and significantly better (t = 2.37, p = 0.03, ES = 0.71) in the mean amplitude of COP displacements in the m-l direction (AmlEC). Insignificant correlations between different balance tests, except for a correlation between the flamingo test and one-leg stance on a low beam (r = 0.558, p < 0.01), show that each test assesses different aspects of balance ability; therefore, balance cannot be assessed with a single test.

Validity of automated FreeSurfer segmentation compared to manual tracing in detecting prenatal alcohol exposure-related subcortical and corpus callosal alterations in 9- to 11-year-old children.

In recent years a number of semi-automated and automated segmentation tools and brain atlases have been developed to facilitate morphometric analyses of large MRI datasets. These tools are much faster than manual tracing and demonstrate excellent test-retest reliabilities. Reliabilities of automated segmentations relative to "gold standard" manual tracings have, however, been shown to vary by brain region and in different cohorts. It remains uncertain to what extent smaller brain volumes and potential changes in grey/white matter contrasts in paediatric brains impact on the performance of automated methods, and how pathology may influence performance. This study examined whether using data from automated FreeSurfer segmentation would alter our ability, compared to manual segmentation, to detect prenatal alcohol exposure (PAE)-related volume changes in subcortical regions and the corpus callosum (CC) in pre-adolescent children. High-resolution T1-weighted images were acquired, using a sequence optimized for morphometric neuroanatomical analysis, on a Siemens 3T Allegra MRI scanner in 71 right-handed, 9- to 11-year-old children (27 fetal alcohol syndrome (FAS) and partial FAS (PFAS), 25 non-syndromal heavily exposed (HE) and 19 non-exposed controls) from a high-risk community in Cape Town, South Africa. Data from timeline follow-back interviews administered to the mothers prospectively during pregnancy were used to quantify the amount of alcohol (in ounces absolute alcohol per day, AA/day) that the children had been exposed to prenatally. Volumes of corpus callosum (CC) and bilateral caudate nuclei, hippocampi and nucleus accumbens (NA) were obtained by manual tracing and automated segmentation using both FreeSurfer versions 5.1 and 6.0. Reliability across methods was assessed using intraclass correlation (ICC) estimates for consistency and absolute agreement, and Cronbach's α. Ability to detect regions showing PAE effects was assessed separately for each segmentation method using ANOVA and linear regression of regional volumes with AA/day. Our results support findings from other studies showing excellent reliability across methods for easy-to-segment structures, such as the CC and caudate nucleus. Volumes from FreeSurfer 6.0 were smaller than those from version 5.1 in all regions except the right caudate, for which they were similar, and right hippocampus and CC, for which they were larger. Despite poor absolute agreement between methods in the NA and hippocampus, all three segmentation methods detected dose-dependent volume reductions in regions for which reliabilities on ICC consistency across methods reached at least 0.70, namely the CC, and bilateral caudate nuclei and hippocampi. PAE-related changes in the NA for which ICC consistency did not reach this minimum were inconsistent across methods and should be interpreted with caution. This is the first study to demonstrate in a pre-adolescent cohort the ability of automated segmentation with FreeSurfer to detect regional volume changes associated with pathology similar to those found using manual tracing.

Neurophysiological evidences of the transient effects of mindfulness induction on emotional processing in children: An ERP study.

Mindfulness has been shown to improve mental health through adaptive responses during emotional processing. Although the benefits of mindfulness and the corresponding neural correlates have been demonstrated in adults, little is known about the impact of mindfulness on pre-adolescent children. The present study examined the influence of mindfulness induction on electrocortical responses during emotional processing in pre-adolescent children. Electroencephalograms were recorded from 35 pre-adolescent children; 18 children (Mage = 10.44 years) were randomly assigned to a mindfulness induction group and 17 children were randomly assigned to a control group (Mage = 9.88 years). Group differences in event-related brain potentials (ERPs) associated with the processing of positive, negative and neutral stimuli were analysed. The P1, N2 and late positive potentials (LPPs) were compared between the mindfulness induction group and the control group. The amplitude of the P1 was smaller in the mindfulness induction group compared to the control group under both the negative and neutral conditions. For both groups, the amplitude of the N2 was larger during the presentation of negative stimuli compared to both positive and neutral stimuli. Additionally, the LPP 600-1000 and LPP 1000-1500 were smaller in the mindfulness induction group than in the control group. The presented findings suggest that the impacts of mindfulness during emotional processing are reflected by both bottom-up (evidenced by the early ERP components) and top-down (evidenced by the later ERP components) processes. These results indicate that mindfulness modulates emotional responses in pre-adolescent children and thus has important implications in training and clinical practices.

Relação entre o autoconceito de pré-adolescentes e resolução de conflitos interpessoais / The relationship between pre-adolescent children's self-concept and interpersonal conflict resolution / Relations entre le concept de soi des preadolescents et la résolution des conflicts / Relación entre el autoconcepto en preadolescentes y la resolución de conflictos interpersonales

Resumo: Pesquisas têm evidenciado relações entre estratégias de resolução de conflitos e variáveis como idade, sexo, nível socioeconômico e cultura. Porém, a relação das estratégias com aspectos do funcionamento psicológico como o autoconceito tem sido pouco investigada, especialmente na pré-adolescência. Esta pesquisa tem como objetivo verificar a existência de relações entre as estratégias de resolução de conflitos de pré-adolescentes e o seu autoconceito. Estas foram analisadas por meio das respostas dos participantes sobre o que fariam em situações de conflito descritas no Children's Action Tendency Scale (CATS). O questionário contém dez situações de conflito, ao final dos quais se pede que seja descrita a reação a cada uma. O autoconceito foi avaliado por meio das respostas dos participantes às vinte afirmações da Escala Multidimensional de Autoconceito para pré-adolescentes (AF5) sobre autoconceito e relações interpessoais. Os dados obtidos passaram por testes de correlação, verificando-se a associação entre estratégias como a assertiva e dimensões do autoconceito.

Abstract: Studies have shown relationships between conflict resolution strategies and variables including age, socioeconomic status, sex, and culture. However, the relationship between these strategies and aspects of psychological functioning such as self-concept has been little investigated, especially in pre-adolescence. This research aimed to verify the existence of relationships between the conflict resolution strategies reported by pre-adolescent children and their self-concept. The strategies were analyzed by the participants' answers about what they would do in ten conflict situations described in a questionnaire. These answers were categorized according to the type of reaction informed. Self-concept was assessed using the participants' responses to the 20 statements from the AF5 Self-Concept Questionnaire on self-concept and interpersonal relationships. The data obtained were tested for correlation, verifying the association between reported strategies such as assertiveness and self-concept dimensions.

Résumé : La recherche a montré des relations entre stratégies de résolution des conflits et des variables telles qu'âge, sexe, et culture. Cependant, la relation entre les stratégies et des aspectes du fonctionnement psychologique tels que concept de soi a été peut étudié, notamment à la préadolescence. Cette recherche visait à vérifier l'existence de relations entre les stratégies de résolution de conflits rapportées par les préadolescents et leur concept de soi. Les stratégies ont été vérifiées à travers les réponses des participants sur ce qu'ils feraient dans des situations conflictuelles décrites dans le Children's Action Tendency Scale, Le questionnaire contient dix situations conflictuelles et on leur a demandé de décrire leur réaction à chacune d'elles. Le concept de soi a été mesuré à travers de réponses des participants à l'Échelle multidimensionnelle du concept de soi pour des préadolescents sur leur autoreprésentation et leur relations interpersonnelles. Les données obtenues ont été soumis à des tests de corrélation, vérifiant la relation entre les stratégies rapportées comme la afirmation et la dimension du concept de soi.

Resumen: Estudios han demostrado las relaciones entre las estrategias de resolución de conflictos y las variables como edad, sexo, nivel socioeconómico y cultura. Sin embargo, la relación de estas estrategias con aspectos del funcionamiento psicológico como el autoconcepto ha sido poco investigada, sobre todo en cuanto a la adolescencia. Esta investigación tuvo como objetivo comprobar la existencia de relaciones entre las estrategias de resolución de conflictos de preadolescentes y su autoconcepto. Las estrategias se analizaron desde las respuestas de los participantes sobre qué harían en situaciones de conflictos descritas en Children's Action Tendency Scale . El cuestionario contiene diez situaciones de conflicto, y el participante describía su reacción ante la situación. El autoconcepto se evaluó mediante las respuestas de los participantes a veinte afirmaciones de la Escala Multidimensional de Autoconcepto para preadolescentes respecto al autoconcepto y relaciones interpersonales. Los datos obtenidos se sometieron a pruebas de correlación para comprobar si existe relación entre algunas estrategias, como la asertividad y las dimensiones del autoconcepto.

Language lateralization in pre-adolescent children: FMRI study using visual verb generation and word pair paradigms.

BACKGROUND: FMRI is a noninvasive tool for mapping language networks, especially in children. We conducted FMRI studies in children in the age group 8- 12 years using 2 different paradigms for assessing language networks and lateralization. AIM: To map language networks in pre-adolescent children and to calculate lateralization index using two different visual paradigms. METHODS AND MATERIALS: The study was conducted in normal right handed children in the age group 8-12 years. Sixteen normal subjects underwent FMRI using 2 paradigms- visual verb generation (VVG), word pairs paradigm (WPP) to stimulate language areas. FMRI data analysis was done using SPM8 (statistical parametric Mapping) software. Total activated voxels were calculated for each hemispheres in the pre-defined ROIs for both paradigms. RESULTS: FMRI showed left language lateralization in 13 out of 16 children with both VVG and WPP and bilateral language lateralization in two subjects. With VVG there was more significant activation in the left inferior triangular gyrus (ITG) (P < 0.001), left inferior opercular gyrus (IOG) (P < 0.01), left middle frontal gyrus (MFG) (P < 0.05), left and right dorsolateral prefrontal cortex (P < 0.05). Left posterior superior temporal gyrus (STG or WA) (P < 0.001), Left AG (P < 0.03), Left SMG (P < 0.05) were significantly activated with WP paradigm. CONCLUSION: Our FMRI studies showed that VGP predominantly activated frontal language areas and WPP predominantly activated temperoparietal language areas. Several other brain regions were also involved in language processing apart from the classical language areas.

Total energy expenditure of 10- to 12-year-old Japanese children measured using the doubly labeled water method.

BACKGROUND: To establish Japanese children's estimated energy requirements, total energy expenditure (TEE) data measured using the doubly labeled water (DLW) method is needed. This study aimed to 1) obtain basic TEE data from Japanese children measured using DLW (TEEDLW), 2) compare TEEDLW with TEE estimated by various estimation formulas to calculate their accuracy, and 3) develop a new equation to estimate TEE using body composition and pedometers. METHODS: TEE was measured using DLW in 56 10- to 12-year-old Japanese children (33 boys, 23 girls). Physical activity level (PAL) was calculated by dividing TEEDLW by estimated resting energy expenditure. To assess their physical activity, participants wore pedometers during the 7-d DLW period. Total body water was calculated from 2H and 18O; fat-free mass (FFM) and fat mass (FM) were then determined. RESULTS: In boys and girls of normal weight, TEEDLW was 2067 ± 230 kcal/d and 1830 ± 262 kcal/d, respectively. Average PAL was 1.58 ± 0.17. FFM was strongly related to TEE (r = 0.702, p < 0.01). After adjusting for FFM and FM, step count was significantly associated with TEE (r = 0.707, p < 0.01). The TEE estimation formula used in the Dietary Reference Intakes (DRI) for the United States and Canada estimated TEEDLW with high accuracy (bias: 2.0%) in both sexes. We developed new equations for TEE consisting of FFM and step count, which accounted for 68% and 65% of TEE variance in boys and girls, respectively: boys, 47.1 × FFM (kg) + 0.0568 × step count (steps/d) - 122, and girls, 55.5 × FFM (kg) + 0.0315 × step count (steps/d) - 117. CONCLUSIONS: The TEE in 10- to 12-year-old Japanese children measured using DLW was approximately 7% lower for boys and 12% lower for girls compared to the current Japanese DRI. If PAL can be accurately determined, the equation in the DRI for the United States and Canada may be applicable to Japanese children. In addition, TEE could be predicted using FFM and step count.

Piloting a perfectionism intervention for pre-adolescent children.

OBJECTIVE: The aim of this pilot study was to evaluate a school-based intervention program focussing on reducing perfectionism in pre-adolescent children. METHOD: A 2-lesson intervention or the control condition was implemented across three schools (N = 125; M age = 11.60 years; 47.2% girls). Students completed assessments at baseline, post-intervention and 4-week follow-up. RESULTS: Significant between group differences for self-oriented perfectionism-striving were identified post-intervention and were maintained at 4-week follow-up (d = 0.47 and 0.40 respectively). Significant interactions between group and time favouring the intervention group were identified for the hyperactivity and emotional problems. DISCUSSION: Findings from this study provide preliminary support for the effectiveness of a perfectionism intervention at an earlier age than has been targeted to date. While these findings appear promising, the justification of such approaches with this age group will require follow-up investigations with expanded intervention content, longer follow-up assessments, larger samples, and evidence of impact on other variables such as well-being. TRIAL REGISTRATION: ACTRN12614001262695.