Pub Date : 2025-11-01Epub Date: 2025-08-06DOI: 10.1016/j.earlhumdev.2025.106368
Laith R Sultan, Karen I Ramirez-Suarez, Sara Rae Schenkel, Monica Miranda Schaeubinger, Carmen Cerron-Vela, Samuel W Kgole, Gosego Masasa, Boitshepo Phale, Joseph Makhema, Thuso Mokane, Elizabeth D Lowenthal, Kathleen M Powis, Hansel J Otero
Background: Over 1 million infants born annually with fetal exposure to HIV and maternal antiretroviral treatment (ART) who remain HIV-uninfected (HEU) are at higher risk of neurodevelopmental delays compared to infants HIV-unexposed (HU).
Objective: We explored the use of brain ultrasound radiomics, specifically texture analysis, as an early imaging neurodevelopmental biomarker, comparing findings by newborn in utero HIV exposure status.
Methods: Brain ultrasound was performed on full-term newborns (≥ 37 weeks gestation) enrolled in a prospective observational study in Botswana. Radiomic ultrasound features, including first-order statistics, run-length, and co-occurrence matrix parameters, were extracted from the basal ganglia and periventricular white matter. Statistical comparisons were conducted based on fetal exposure to maternal HIV. The diagnostic performance of individual features was assessed, and logistic regression was used to combine the features for overall performance evaluation.
Results: Thirty-three infants (HEU: 20, HU: 13) were included in the analysis. The basal ganglia of HEU infants exhibited significantly lower heterogeneity (176.6 ± 10.76 vs. 205.97 ± 13.26, p = 0.04) and entropy (0.37 ± 0.01 vs. 0.41 ± 0.01, p = 0.03), and marginally lower gray level non-uniformity (310.04 ± 15.32 vs. 352.37 ± 24.20, p = 0.06) compared to HU infants, suggesting reduced parenchymal complexity. These combined radiomic features yielded an AUC of 0.72 with a specificity of 0.86. Similar trends were observed in the white matter, where HEU infants demonstrated marginally lower heterogeneity (191.66 ± 14.32 vs. 231.76 ± 17.34, p = 0.06). Gray level non-uniformity and run length non-uniformity were significantly lower in the HEU group (1996.87 ± 157.06 vs. 2487.43 ± 223.67, p = 0.04 and 284.66 ± 20.37 vs. 406.61 ± 47.77, p = 0.01, respectively). The combined white matter model demonstrated an AUC of 0.76 and a sensitivity of 0.86, indicating greater discriminatory power compared to the basal ganglia.
Conclusion: Ultrasound radiomics reveals distinct differences in brain texture between HEU and HU newborns, with significant findings in both basal ganglia and white matter features. These results highlight the potential of radiomics in identifying subtle neuroanatomical variations. Further research is needed to explore the neurodevelopmental implications of these findings.
背景：与未接触艾滋病毒（HU）的婴儿相比，每年有超过100万的胎儿暴露于艾滋病毒和母亲抗逆转录病毒治疗（ART）但仍未感染艾滋病毒（HEU）的婴儿神经发育迟缓的风险更高。目的：我们探索使用脑超声放射组学，特别是纹理分析，作为早期成像神经发育的生物标志物，比较新生儿在子宫内HIV暴露状态的结果。方法：在博茨瓦纳的一项前瞻性观察研究中，对足月新生儿（≥37周妊娠）进行脑超声检查。从基底节区和脑室周围白质中提取放射学超声特征，包括一阶统计量、行程长度和共现矩阵参数。根据胎儿暴露于母体艾滋病毒进行统计比较。评估单个特征的诊断性能，并使用逻辑回归将特征组合起来进行整体性能评估。结果：33例婴儿（HEU: 20, HU: 13）纳入分析。HEU组基底节区异质性（176.6±10.76 vs. 205.97±13.26,p = 0.04）和熵值（0.37±0.01 vs. 0.41±0.01,p = 0.03）显著低于HU组，灰度非均匀性（310.04±15.32 vs. 352.37±24.20,p = 0.06）显著低于HU组，表明HEU组基底节区实质复杂性降低。这些综合放射学特征的AUC为0.72，特异性为0.86。在白质中也观察到类似的趋势，HEU婴儿的异质性略低（191.66±14.32 vs 231.76±17.34,p = 0.06）。HEU组灰度不均匀性和跑程不均匀性显著低于对照组（1996.87±157.06 vs. 2487.43±223.67,p = 0.04; 284.66±20.37 vs. 406.61±47.77,p = 0.01）。联合白质模型的AUC为0.76，灵敏度为0.86，与基底节区相比具有更强的分辨能力。结论：超声放射组学显示HEU和HU新生儿的脑质地存在明显差异，基底节区和白质特征均有显著差异。这些结果突出了放射组学在识别细微神经解剖学变异方面的潜力。需要进一步的研究来探索这些发现对神经发育的影响。
{"title":"Brain ultrasound radiomics identify textural differences in basal ganglia and white matter between full term newborns HIV-exposed uninfected and HIV-unexposed in Botswana.","authors":"Laith R Sultan, Karen I Ramirez-Suarez, Sara Rae Schenkel, Monica Miranda Schaeubinger, Carmen Cerron-Vela, Samuel W Kgole, Gosego Masasa, Boitshepo Phale, Joseph Makhema, Thuso Mokane, Elizabeth D Lowenthal, Kathleen M Powis, Hansel J Otero","doi":"10.1016/j.earlhumdev.2025.106368","DOIUrl":"10.1016/j.earlhumdev.2025.106368","url":null,"abstract":"<p><strong>Background: </strong>Over 1 million infants born annually with fetal exposure to HIV and maternal antiretroviral treatment (ART) who remain HIV-uninfected (HEU) are at higher risk of neurodevelopmental delays compared to infants HIV-unexposed (HU).</p><p><strong>Objective: </strong>We explored the use of brain ultrasound radiomics, specifically texture analysis, as an early imaging neurodevelopmental biomarker, comparing findings by newborn in utero HIV exposure status.</p><p><strong>Methods: </strong>Brain ultrasound was performed on full-term newborns (≥ 37 weeks gestation) enrolled in a prospective observational study in Botswana. Radiomic ultrasound features, including first-order statistics, run-length, and co-occurrence matrix parameters, were extracted from the basal ganglia and periventricular white matter. Statistical comparisons were conducted based on fetal exposure to maternal HIV. The diagnostic performance of individual features was assessed, and logistic regression was used to combine the features for overall performance evaluation.</p><p><strong>Results: </strong>Thirty-three infants (HEU: 20, HU: 13) were included in the analysis. The basal ganglia of HEU infants exhibited significantly lower heterogeneity (176.6 ± 10.76 vs. 205.97 ± 13.26, p = 0.04) and entropy (0.37 ± 0.01 vs. 0.41 ± 0.01, p = 0.03), and marginally lower gray level non-uniformity (310.04 ± 15.32 vs. 352.37 ± 24.20, p = 0.06) compared to HU infants, suggesting reduced parenchymal complexity. These combined radiomic features yielded an AUC of 0.72 with a specificity of 0.86. Similar trends were observed in the white matter, where HEU infants demonstrated marginally lower heterogeneity (191.66 ± 14.32 vs. 231.76 ± 17.34, p = 0.06). Gray level non-uniformity and run length non-uniformity were significantly lower in the HEU group (1996.87 ± 157.06 vs. 2487.43 ± 223.67, p = 0.04 and 284.66 ± 20.37 vs. 406.61 ± 47.77, p = 0.01, respectively). The combined white matter model demonstrated an AUC of 0.76 and a sensitivity of 0.86, indicating greater discriminatory power compared to the basal ganglia.</p><p><strong>Conclusion: </strong>Ultrasound radiomics reveals distinct differences in brain texture between HEU and HU newborns, with significant findings in both basal ganglia and white matter features. These results highlight the potential of radiomics in identifying subtle neuroanatomical variations. Further research is needed to explore the neurodevelopmental implications of these findings.</p>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"106368"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The influence of intrauterine conditions on later weight gain remains unclear. We examined the associations of birth size characteristics (weight, length, and ponderal index (PI)) with body mass index (BMI) trajectories and fluctuation in adolescence and adulthood using a twin design, which provides insights into the role of genetic and environmental factors.
Data and methods
Data from two Finnish twin cohorts including 9850 twin individuals (48 % males) were used. Weight and length or height were measured at birth and at different ages during adolescence and adulthood (11.5–37 years in FinnTwin12; 16–34 years in FinnTwin16). BMI trajectories across different stages of adolescence and adulthood were calculated as the difference in BMI divided by the time elapsed between measurements. BMI fluctuation was assessed as the variance of BMI trajectories at each stage. Linear regression models were used to examine the associations of birth size characteristics with BMI trajectories and fluctuation in adolescence and adulthood. Interactions between baseline BMI and birth characteristics were assessed. Within-pair analysis was performed to assess whether the identified associations persist while controlling for genetic effects.
Results
BMI trajectories during early adolescence were positively associated with birth PI and negatively with birth weight and length. BMI trajectories during middle adolescence were positively associated with birth length and negatively with birth weight. PI showed a negative association with BMI trajectories in late adolescence. Moreover, BMI fluctuation in adulthood was negatively associated with birth weight and length. No significant interactions were found between birth size characteristics and baseline BMI in explaining BMI trajectories and fluctuation at different stages of adolescence and adulthood. Among the identified associations, none remained significant in within-pair analysis.
Conclusion
Our findings suggest that birth size has a long-term influence on BMI development. However, these associations may not be due to the intrauterine environment but may rather indicate the role of shared genetic factors.
{"title":"Associations of birth size with BMI trajectories and fluctuation across adolescence and adulthood: A longitudinal study of two Finnish twin cohorts","authors":"Alvaro Obeso , Aline Jelenkovic , Gabin Drouard , Jaakko Kaprio , Karri Silventoinen","doi":"10.1016/j.earlhumdev.2025.106373","DOIUrl":"10.1016/j.earlhumdev.2025.106373","url":null,"abstract":"<div><h3>Introduction</h3><div>The influence of intrauterine conditions on later weight gain remains unclear. We examined the associations of birth size characteristics (weight, length, and ponderal index (PI)) with body mass index (BMI) trajectories and fluctuation in adolescence and adulthood using a twin design, which provides insights into the role of genetic and environmental factors.</div></div><div><h3>Data and methods</h3><div>Data from two Finnish twin cohorts including 9850 twin individuals (48 % males) were used. Weight and length or height were measured at birth and at different ages during adolescence and adulthood (11.5–37 years in FinnTwin12; 16–34 years in FinnTwin16). BMI trajectories across different stages of adolescence and adulthood were calculated as the difference in BMI divided by the time elapsed between measurements. BMI fluctuation was assessed as the variance of BMI trajectories at each stage. Linear regression models were used to examine the associations of birth size characteristics with BMI trajectories and fluctuation in adolescence and adulthood. Interactions between baseline BMI and birth characteristics were assessed. Within-pair analysis was performed to assess whether the identified associations persist while controlling for genetic effects.</div></div><div><h3>Results</h3><div>BMI trajectories during early adolescence were positively associated with birth PI and negatively with birth weight and length. BMI trajectories during middle adolescence were positively associated with birth length and negatively with birth weight. PI showed a negative association with BMI trajectories in late adolescence. Moreover, BMI fluctuation in adulthood was negatively associated with birth weight and length. No significant interactions were found between birth size characteristics and baseline BMI in explaining BMI trajectories and fluctuation at different stages of adolescence and adulthood. Among the identified associations, none remained significant in within-pair analysis.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that birth size has a long-term influence on BMI development. However, these associations may not be due to the intrauterine environment but may rather indicate the role of shared genetic factors.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106373"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-23DOI: 10.1016/j.earlhumdev.2025.106371
Marek Kociuba , Sławomir Kozieł , Raja Chakraborty , Zofia Ignasiak , Piotr Sorokowski
Background
The relationship between the second (2D) and fourth finger (4D) of the hand (2D:4D) is considered to be a proxy indicator of prenatal- testosterone (PT) and estrogen (PE) exposure in the first trimester of pregnancy. A lower 2D:4D indicates relatively higher PT exposure and vice versa. The 2D:4D is generally higher in women than in men. Lower 2D:4D is associated with greater physical ability, strength, better athletic performance, and a propensity for jobs that require more physical fitness and are more risky.
Aim
The aim of the present study was to examine the differences in 2D:4D, if any, between three groups of men in Poland: military students (N = 250), soldiers of the Land Forces (N = 106) and volunteers of the Territorial Defense Force (N = 202).
Method
This cross-sectional study was carried out in Military University of Land Forces (MULF) in Wroclaw, Poland. The measurements included body height, body weight and the lengths of the second and fourth fingers in both hand of each participant.
Results
The results showed significantly lower 2D:4D in land forces soldiers and military students than those belonged to the Territorial Defense Force.
Conclusion
The results indicated the possible impact of fetal androgens on specific human abilities as well as choices for challenging occupations.
{"title":"Variation in digit ratio (2D:4D) across different types of military services in Poland","authors":"Marek Kociuba , Sławomir Kozieł , Raja Chakraborty , Zofia Ignasiak , Piotr Sorokowski","doi":"10.1016/j.earlhumdev.2025.106371","DOIUrl":"10.1016/j.earlhumdev.2025.106371","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between the second (2D) and fourth finger (4D) of the hand (2D:4D) is considered to be a proxy indicator of prenatal- testosterone (PT) and estrogen (PE) exposure in the first trimester of pregnancy. A lower 2D:4D indicates relatively higher PT exposure and vice versa. The 2D:4D is generally higher in women than in men. Lower 2D:4D is associated with greater physical ability, strength, better athletic performance, and a propensity for jobs that require more physical fitness and are more risky.</div></div><div><h3>Aim</h3><div>The aim of the present study was to examine the differences in 2D:4D, if any, between three groups of men in Poland: military students (N = 250), soldiers of the Land Forces (N = 106) and volunteers of the Territorial Defense Force (N = 202).</div></div><div><h3>Method</h3><div>This cross-sectional study was carried out in Military University of Land Forces (MULF) in Wroclaw, Poland. The measurements included body height, body weight and the lengths of the second and fourth fingers in both hand of each participant.</div></div><div><h3>Results</h3><div>The results showed significantly lower 2D:4D in land forces soldiers and military students than those belonged to the Territorial Defense Force.</div></div><div><h3>Conclusion</h3><div>The results indicated the possible impact of fetal androgens on specific human abilities as well as choices for challenging occupations.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106371"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to examine physical and craniofacial growth patterns in preschool-aged children with microcephaly and evaluate their potential clinical significance.
Methods
A total of 130 children (76 boys, 54 girls) aged 1–5 years with microcephaly (head circumference <−3 standard deviations) were enrolled in this prospective study at a tertiary care hospital, with 130 age- and sex-matched healthy controls. Nine craniofacial dimensions (head circumference, head length, head width, physiognomic facial length, morphological facial length, minimum frontal diameter, bizygomatic diameter, bigonial diameter, and total jaw height) were measured every six months using standardized techniques and instruments. Body weight and height were also recorded. Data analysis involved comparison of growth parameters using Mann-Whitney tests and correlation analysis to explore relationships between head circumference and other physical measurements.
Results
Children with microcephaly exhibited significantly reduced body weight, height, and cranial dimensions compared to controls (p < 0.001). There was a higher incidence of underweight (36.69 %), stunted (40.89 %), and wasted (34.45 %) children within this group. The majority of microcephalic children had a brachycephalic head shape, with broad faces and wide foreheads. Facial measurements differed by sex: boys showed shorter physiognomic facial lengths, while girls had longer faces, suggesting sex-specific craniofacial trends in microcephaly. A significant correlation was found between head circumference and body dimensions, though jaw-related measurements were independent.
Conclusions
Children with microcephaly demonstrated considerable growth deficits and altered craniofacial development emphasizing the need for comprehensive assessments. The findings highlight the importance of early, targeted interventions to address the complex growth and developmental challenges in these children.
{"title":"Growth deficits and craniofacial dynamics in preschool children with microcephaly: A comprehensive study","authors":"Anusha Doraiswamy , Neha Sudhera , Arushi Gahlot Saini , A.K. Bhalla , Pratibha Singhi , Harvinder Kaur","doi":"10.1016/j.earlhumdev.2025.106392","DOIUrl":"10.1016/j.earlhumdev.2025.106392","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to examine physical and craniofacial growth patterns in preschool-aged children with microcephaly and evaluate their potential clinical significance.</div></div><div><h3>Methods</h3><div>A total of 130 children (76 boys, 54 girls) aged 1–5 years with microcephaly (head circumference <−3 standard deviations) were enrolled in this prospective study at a tertiary care hospital, with 130 age- and sex-matched healthy controls. Nine craniofacial dimensions (head circumference, head length, head width, physiognomic facial length, morphological facial length, minimum frontal diameter, bizygomatic diameter, bigonial diameter, and total jaw height) were measured every six months using standardized techniques and instruments. Body weight and height were also recorded. Data analysis involved comparison of growth parameters using Mann-Whitney tests and correlation analysis to explore relationships between head circumference and other physical measurements.</div></div><div><h3>Results</h3><div>Children with microcephaly exhibited significantly reduced body weight, height, and cranial dimensions compared to controls (<em>p</em> < 0.001). There was a higher incidence of underweight (36.69 %), stunted (40.89 %), and wasted (34.45 %) children within this group. The majority of microcephalic children had a brachycephalic head shape, with broad faces and wide foreheads. Facial measurements differed by sex: boys showed shorter physiognomic facial lengths, while girls had longer faces, suggesting sex-specific craniofacial trends in microcephaly. A significant correlation was found between head circumference and body dimensions, though jaw-related measurements were independent.</div></div><div><h3>Conclusions</h3><div>Children with microcephaly demonstrated considerable growth deficits and altered craniofacial development emphasizing the need for comprehensive assessments. The findings highlight the importance of early, targeted interventions to address the complex growth and developmental challenges in these children.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106392"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-05DOI: 10.1016/j.earlhumdev.2025.106348
Eeva Mäkilä , Mikael O. Ekblad , Päivi Rautava , Anna Nyman , Annika Lind , Helena Lapinleimu , Leena Haataja , Sirkku Setänen , on behalf of the PIPARI Study Group
Children born very preterm have an increased risk for motor impairments. We aimed to evaluate motor performance at 5 years in children born very preterm with and without motor impairment using the parental questionnaire Five-to-Fifteen (FTF).
This prospective follow-up study included 132 children born very preterm (gestational age < 32 weeks and/or birth weight ≤ 1500 g) without neurodevelopmental impairment at 2 years. Parents filled out the FTF regarding the neurodevelopment of their 5-year-old children. Higher scores indicated more difficulties. The Movement Assessment Battery for Children — Second Edition (MABC-2) was performed to evaluate the motor outcome at 11 years. Total test scores ≤15th percentile denoted motor impairment.
There were 23 (17.4 %) children with motor impairment. A 1-point increase in the FTF motor skills mean scores increased the risk of motor impairment to 19-fold (OR 19.1, 95 % CI 3.5–104.5, p = 0.001). Children with motor impairment had higher mean scores in the FTF motor skills compared to children without motor impairment (mean 0.56 vs. 0.26, p < 0.001), but also in Executive functions (0.63 vs. 0.40, p = 0.001), Perception (0.35 vs. 0.18, p < 0.001), Memory (0.51 vs. 0.31 p = 0.01) and Language (0.45 vs. 0.25, p = 0.02), respectively.
Motor impairment was almost 20 times more likely when motor difficulties increased by 1 point in the FTF questionnaire. Moreover, children with motor impairment had more difficulties in all other developmental domains of the FTF. Based on these findings, the FTF parental questionnaire might be a useful tool in children's preventive health care to early identify motor impairment and its negative associations.
早产儿患运动障碍的风险更高。我们的目的是用父母问卷5 - 15 （FTF）来评估5岁时有或没有运动障碍的早产儿的运动表现。这项前瞻性随访研究包括132名早产儿(胎龄<；32周和/或出生体重≤1500克)2岁时无神经发育障碍。家长们填写了关于他们5岁孩子神经发育的FTF。分数越高，说明难度越大。采用儿童运动评估系列-第二版（MABC-2）来评估11岁时的运动结果。总分≤15百分位为运动障碍。运动障碍患儿23例（17.4%）。FTF运动技能每增加1分，意味着运动障碍的风险增加19倍（OR 19.1, 95% CI 3.5-104.5, p = 0.001）。运动障碍儿童的FTF运动技能平均得分高于无运动障碍儿童(平均0.56比0.26,p <；0.001)，而且执行功能（0.63 vs. 0.40, p = 0.001），感知(0.35 vs. 0.18, p <；0.001)，记忆（0.51 vs. 0.31 p = 0.01）和语言（0.45 vs. 0.25, p = 0.02）。当运动障碍在FTF问卷中增加1分时，运动障碍的可能性几乎增加了20倍。此外，运动障碍儿童在FTF的所有其他发展领域都有更多的困难。基于这些发现，FTF父母问卷可能是儿童预防性保健的有用工具，可以早期识别运动障碍及其负面关联。
{"title":"Parental Five-to-Fifteen questionnaire in identifying motor difficulties at 5 years in children with later motor impairment: A longitudinal follow-up study of very preterm infants","authors":"Eeva Mäkilä , Mikael O. Ekblad , Päivi Rautava , Anna Nyman , Annika Lind , Helena Lapinleimu , Leena Haataja , Sirkku Setänen , on behalf of the PIPARI Study Group","doi":"10.1016/j.earlhumdev.2025.106348","DOIUrl":"10.1016/j.earlhumdev.2025.106348","url":null,"abstract":"<div><div>Children born very preterm have an increased risk for motor impairments. We aimed to evaluate motor performance at 5 years in children born very preterm with and without motor impairment using the parental questionnaire Five-to-Fifteen (FTF).</div><div>This prospective follow-up study included 132 children born very preterm (gestational age < 32 weeks and/or birth weight ≤ 1500 g) without neurodevelopmental impairment at 2 years. Parents filled out the FTF regarding the neurodevelopment of their 5-year-old children. Higher scores indicated more difficulties. The Movement Assessment Battery for Children — Second Edition (MABC-2) was performed to evaluate the motor outcome at 11 years. Total test scores ≤15th percentile denoted motor impairment.</div><div>There were 23 (17.4 %) children with motor impairment. A 1-point increase in the FTF motor skills mean scores increased the risk of motor impairment to 19-fold (OR 19.1, 95 % CI 3.5–104.5, <em>p</em> = 0.001). Children with motor impairment had higher mean scores in the FTF motor skills compared to children without motor impairment (mean 0.56 vs. 0.26, <em>p</em> < 0.001), but also in Executive functions (0.63 vs. 0.40, <em>p</em> = 0.001), Perception (0.35 vs. 0.18, <em>p</em> < 0.001), Memory (0.51 vs. 0.31 <em>p</em> = 0.01) and Language (0.45 vs. 0.25, <em>p</em> = 0.02), respectively.</div><div>Motor impairment was almost 20 times more likely when motor difficulties increased by 1 point in the FTF questionnaire. Moreover, children with motor impairment had more difficulties in all other developmental domains of the FTF. Based on these findings, the FTF parental questionnaire might be a useful tool in children's preventive health care to early identify motor impairment and its negative associations.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106348"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-05DOI: 10.1016/j.earlhumdev.2025.106358
Maciej Henneberg , Iwona Rosset , Elżbieta Żądzińska
Objective
Numerous child growth studies showed the adolescent growth spurt in body height to the extent that its presence became a dogma applied to humans as a species. However, observations of growth in the 19th c. and in small traditional societies showed for some children a steady growth without visible pubertal spurt. Recently, substantial variation in the age at puberty and the magnitude of growth acceleration during puberty have been observed.
Methods
Longitudinal height growth data of 110 girls aged 6–18 years (1314 height measurements in total) from a homogenous socio-economic situation were analysed by fitting polynomial regressions on age and assessing their first and second derivatives (growth velocity and acceleration).
Results
Among 110 girls, 18 (16 %) showed a steady growth with no spurts, while others' accelerations were highly variable. Girls who experienced a growth spurt had a mean age at peak height velocity of 11.2 years and a mean peak height velocity of 69.3 mm, comparable to many other studies. There was a negative correlation between adult height and variation in individual accelerations (r-0.24, p = 0.01) – girls whose accelerations differed less yearly (lower spurt) achieved greater adult heights.
Conclusions
Human growth at adolescence is highly variable, polymorphic, to the extent that the growth in height without the distinct pubertal spurt is also a normal polymorphic variant. Girls who had no significant growth spurt attained the same adult height at exactly the same age as their “spurting” peers.
客观：大量的儿童生长研究表明，青少年身高的快速增长，以至于它的存在成为一种教条，适用于人类这个物种。然而，对19世纪和小型传统社会的成长观察表明，一些儿童的成长稳定，没有明显的青春期爆发。最近，已经观察到青春期年龄和青春期生长加速幅度的实质性变化。方法对同质社会经济条件下的110名6 ~ 18岁女孩（共1314个身高测量值）的纵向身高增长数据进行年龄拟合多项式回归分析，并评估其一阶导数和二阶导数（生长速度和加速度）。结果在110名女生中，18名（16%）表现出稳定增长，没有突发性增长，而其他女生的加速变化很大。经历生长突增的女孩的平均年龄峰值高度速度为11.2岁，平均峰值高度速度为69.3毫米，与许多其他研究相媲美。成人身高与个体加速度变化呈负相关（r-0.24, p = 0.01），加速度差异较小的女孩成年身高较高。结论人的青春期生长具有高度的多变性和多态性，在一定程度上身高的生长没有明显的青春期发育突增也是一种正常的多态变异。没有显著生长突增的女孩在与“突增”的同龄人完全相同的年龄达到了相同的成年身高。
{"title":"Pubertal growth spurt does not occur in some normally growing Polish girls, suggesting an evolutionary origin of adolescent growth polymorphism","authors":"Maciej Henneberg , Iwona Rosset , Elżbieta Żądzińska","doi":"10.1016/j.earlhumdev.2025.106358","DOIUrl":"10.1016/j.earlhumdev.2025.106358","url":null,"abstract":"<div><h3>Objective</h3><div>Numerous child growth studies showed the adolescent growth spurt in body height to the extent that its presence became a dogma applied to humans as a species. However, observations of growth in the 19th c. and in small traditional societies showed for some children a steady growth without visible pubertal spurt. Recently, substantial variation in the age at puberty and the magnitude of growth acceleration during puberty have been observed.</div></div><div><h3>Methods</h3><div>Longitudinal height growth data of 110 girls aged 6–18 years (1314 height measurements in total) from a homogenous socio-economic situation were analysed by fitting polynomial regressions on age and assessing their first and second derivatives (growth velocity and acceleration).</div></div><div><h3>Results</h3><div>Among 110 girls, 18 (16 %) showed a steady growth with no spurts, while others' accelerations were highly variable. Girls who experienced a growth spurt had a mean age at peak height velocity of 11.2 years and a mean peak height velocity of 69.3 mm, comparable to many other studies. There was a negative correlation between adult height and variation in individual accelerations (r-0.24, <em>p</em> = 0.01) – girls whose accelerations differed less yearly (lower spurt) achieved greater adult heights.</div></div><div><h3>Conclusions</h3><div>Human growth at adolescence is highly variable, polymorphic, to the extent that the growth in height without the distinct pubertal spurt is also a normal polymorphic variant. Girls who had no significant growth spurt attained the same adult height at exactly the same age as their “spurting” peers.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106358"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neonatal withdrawal syndrome is characterized by withdrawal symptoms in neonates because of the discontinuation of transplacental drug transfer after delivery. This study aimed to examine the risk factors for withdrawal symptoms to clarify the impact of the number of neuropsychiatric drugs administered during pregnancy.
Methods
This was a retrospective observational study including 344 neonates born to 341 mothers receiving neuropsychiatric drugs, including antipsychotics, antidepressants, antiepileptics, and anxiolytics/sedatives during pregnancy. The presence of withdrawal symptoms was assessed using the Isobe score, comprising 15 symptoms. Multivariable logistic regression analysis was performed to identify significant risk factors for the presence of withdrawal symptoms.
Results
Withdrawal symptoms developed in 178 (51.7 %) neonates. The frequency of neonates with withdrawal symptoms was higher in neonates born to mothers receiving ≥3 neuropsychiatric drugs compared to those born to mothers receiving 1–2 neuropsychiatric drugs (73.2 % vs. 45.0 %; P < 0.001). By multivariable logistic regression analysis, the presence of withdrawal symptoms was associated with the concurrent use of ≥3 neuropsychiatric drugs during pregnancy (adjusted odds ratio, 2.24; 95 % confidence interval, 1.09–4.62; P = 0.029) and the maternal use of antipsychotics (adjusted odds ratio, 1.77; 95 % confidence interval, 1.06–2.94; P = 0.028).
Conclusions
The concurrent use of ≥3 neuropsychiatric drugs during pregnancy and the maternal use of antipsychotics were significant risk factors for the presence of withdrawal symptoms.
目的新生儿戒断综合征的特点是新生儿因分娩后停止经胎盘药物转移而出现戒断症状。本研究旨在检查戒断症状的危险因素，以阐明怀孕期间服用神经精神药物数量的影响。方法本研究是一项回顾性观察性研究，包括341名母亲在怀孕期间服用神经精神药物，包括抗精神病药、抗抑郁药、抗癫痫药和抗焦虑药/镇静剂所生的344名新生儿。使用Isobe评分评估戒断症状的存在，包括15种症状。进行多变量logistic回归分析以确定出现戒断症状的重要危险因素。结果178例（51.7%）新生儿出现戒断症状。接受≥3种神经精神药物治疗的母亲所生的新生儿出现戒断症状的频率高于接受1-2种神经精神药物治疗的母亲所生的新生儿（73.2% vs 45.0%; P < 0.001）。经多变量logistic回归分析，出现戒断症状与妊娠期间同时使用≥3种神经精神药物（校正优势比2.24,95%可信区间1.09 ~ 4.62,P = 0.029）和母体使用抗精神病药物（校正优势比1.77,95%可信区间1.06 ~ 2.94,P = 0.028）相关。结论孕期同时使用≥3种神经精神药物及母体使用抗精神病药物是发生戒断症状的重要危险因素。
{"title":"Association of neonatal withdrawal syndrome with concurrent use of multiple neuropsychiatric medications in pregnant women","authors":"Miyako Nakagawa , Kosuke Doki , Mana Obata-Yasuoka , Hiromi Hamada , Daisuke Hitaka , Yayoi Miyazono , Hidetoshi Takada , Masato Homma","doi":"10.1016/j.earlhumdev.2025.106385","DOIUrl":"10.1016/j.earlhumdev.2025.106385","url":null,"abstract":"<div><h3>Aim</h3><div>Neonatal withdrawal syndrome is characterized by withdrawal symptoms in neonates because of the discontinuation of transplacental drug transfer after delivery. This study aimed to examine the risk factors for withdrawal symptoms to clarify the impact of the number of neuropsychiatric drugs administered during pregnancy.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study including 344 neonates born to 341 mothers receiving neuropsychiatric drugs, including antipsychotics, antidepressants, antiepileptics, and anxiolytics/sedatives during pregnancy. The presence of withdrawal symptoms was assessed using the Isobe score, comprising 15 symptoms. Multivariable logistic regression analysis was performed to identify significant risk factors for the presence of withdrawal symptoms.</div></div><div><h3>Results</h3><div>Withdrawal symptoms developed in 178 (51.7 %) neonates. The frequency of neonates with withdrawal symptoms was higher in neonates born to mothers receiving ≥3 neuropsychiatric drugs compared to those born to mothers receiving 1–2 neuropsychiatric drugs (73.2 % vs. 45.0 %; <em>P</em> < 0.001). By multivariable logistic regression analysis, the presence of withdrawal symptoms was associated with the concurrent use of ≥3 neuropsychiatric drugs during pregnancy (adjusted odds ratio, 2.24; 95 % confidence interval, 1.09–4.62; <em>P</em> = 0.029) and the maternal use of antipsychotics (adjusted odds ratio, 1.77; 95 % confidence interval, 1.06–2.94; <em>P</em> = 0.028).</div></div><div><h3>Conclusions</h3><div>The concurrent use of ≥3 neuropsychiatric drugs during pregnancy and the maternal use of antipsychotics were significant risk factors for the presence of withdrawal symptoms.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106385"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public health measures during the COVID-19 pandemic have been shown to affect parents' physical and emotional closeness with their preterm infant in the NICU. However, no study has explored the effects of these restrictions on new mothers' perinatal trajectory.
Aim
To explore mothers' perceptions regarding the impact of public health measures associated with the COVID-19 pandemic on their emotional and physical closeness to their preterm infant before, during, and after their NICU hospitalization.
Methods
This qualitative descriptive study included 14 mothers who gave birth to a preterm infant during the COVID-19 pandemic. Mothers participated in semi-structured Zoom interviews conducted between May 2021 and January 2022.
Results
Analysis of the mothers' narratives revealed that COVID-19 restrictions affected emotional and physical closeness throughout their perinatal experience. The main theme identified in mothers' accounts of the pregnancy period was “inconsistency and ignorance”. For the childbirth period, the main theme was “loneliness and disconnected contact”. During hospitalization, the emerging theme was “missed opportunities for physical and emotional closeness”. In the post-hospitalization period, mothers described the theme “connecting more versus struggling to connect due to poor mental health”.
Conclusion
According to mothers, public health measures affected their emotional and physical bond with their infants before, during, and after their NICU stay. In the event of another pandemic, it would be crucial to reassess the implemented public health measures and provide support to parents through their entire perinatal experience.
{"title":"Public health measures associated with the COVID-19 pandemic: Mothers' perceptions of emotional and physical closeness with their preterm infant before, during, and after the NICU stay","authors":"Valérie Lebel , Paméla Hamel-Hilaréguy , Sharmin Zahin , Francine de Montigny","doi":"10.1016/j.earlhumdev.2025.106343","DOIUrl":"10.1016/j.earlhumdev.2025.106343","url":null,"abstract":"<div><h3>Background</h3><div>Public health measures during the COVID-19 pandemic have been shown to affect parents' physical and emotional closeness with their preterm infant in the NICU. However, no study has explored the effects of these restrictions on new mothers' perinatal trajectory.</div></div><div><h3>Aim</h3><div>To explore mothers' perceptions regarding the impact of public health measures associated with the COVID-19 pandemic on their emotional and physical closeness to their preterm infant before, during, and after their NICU hospitalization.</div></div><div><h3>Methods</h3><div>This qualitative descriptive study included 14 mothers who gave birth to a preterm infant during the COVID-19 pandemic. Mothers participated in semi-structured Zoom interviews conducted between May 2021 and January 2022.</div></div><div><h3>Results</h3><div>Analysis of the mothers' narratives revealed that COVID-19 restrictions affected emotional and physical closeness throughout their perinatal experience. The main theme identified in mothers' accounts of the pregnancy period was “inconsistency and ignorance”. For the childbirth period, the main theme was “loneliness and disconnected contact”. During hospitalization, the emerging theme was “missed opportunities for physical and emotional closeness”. In the post-hospitalization period, mothers described the theme “connecting more versus struggling to connect due to poor mental health”.</div></div><div><h3>Conclusion</h3><div>According to mothers, public health measures affected their emotional and physical bond with their infants before, during, and after their NICU stay. In the event of another pandemic, it would be crucial to reassess the implemented public health measures and provide support to parents through their entire perinatal experience.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"209 ","pages":"Article 106343"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-08-01DOI: 10.1016/j.earlhumdev.2025.106355
Murad Gezer , Abdullah Tabakçı , Ümit Taşdemir , Mucize Eriç Özdemir , Zeycan Aytaş , Oya Demirci
Objective
Fetal ventriculomegaly (VM) is a common prenatal ultrasound finding with a wide range of etiologies and variable prognostic outcomes. This study aimed to evaluate the prenatal characteristics, genetic findings, and postnatal neurodevelopmental outcomes of fetuses diagnosed with VM, according to the severity of VM and associated abnormalities.
Methods
This retrospective single-center study includes 357 fetuses diagnosed with VM between 2020 and 2024. Cases were classified according to VM severity, laterality, and the presence of associated anomalies. Prenatal genetic tests, neurosonography, and prenatal and postnatal MRI findings were analyzed. Outcomes included the termination of pregnancy, intrauterine and postnatal death, and long-term neurodevelopmental status.
Results
Among 357 fetuses, 193 (54.1 %) had mild VM, 85 (23.8 %) had moderate VM, and 79 (22.1 %) had severe VM. 25.2 % of the cases were isolated. Additional CNS abnormalities were present in 43.1 % of the fetuses. Genetic or chromosomal abnormalities were detected in 35.7 % of the fetuses who underwent genetic testing (55 out of 154 cases). The survival rate was highest in mild (75.6 %) and isolated VM (95.6 %). A higher gestational age at diagnosis, smaller ventricular diameter, and the absence of CNS/extracranial CNS abnormalities were associated with normal neurodevelopmental outcomes. In the logistic regression analysis, the presence of CNS abnormalities, ventricular width, and gestational age at diagnosis were found to be independent predictors of neurodevelopmental status. ROC analysis in our study showed that the cut-off value of 13 mm had good discrimination to predict normal neurodevelopmental status in all cases but limited accuracy in isolated cases of VM.
Conclusion
The severity and etiology of fetal VM significantly affect both survival and neurodevelopmental outcomes. Isolated mild VM correlated with positive outcomes, but moderate-to-severe VM and non-isolated cases had markedly poor survival rates and neurodevelopmental status. Key prognostic factors for normal neurodevelopmental status included higher gestational age at diagnosis, smaller ventricular diameters <13 mm, and the absence of CNS and non-CNS anomalies.
{"title":"Prenatal and postnatal outcomes in fetuses with ventriculomegaly: Prognostic factors insights from a single-center study","authors":"Murad Gezer , Abdullah Tabakçı , Ümit Taşdemir , Mucize Eriç Özdemir , Zeycan Aytaş , Oya Demirci","doi":"10.1016/j.earlhumdev.2025.106355","DOIUrl":"10.1016/j.earlhumdev.2025.106355","url":null,"abstract":"<div><h3>Objective</h3><div>Fetal ventriculomegaly (VM) is a common prenatal ultrasound finding with a wide range of etiologies and variable prognostic outcomes. This study aimed to evaluate the prenatal characteristics, genetic findings, and postnatal neurodevelopmental outcomes of fetuses diagnosed with VM, according to the severity of VM and associated abnormalities.</div></div><div><h3>Methods</h3><div>This retrospective single-center study includes 357 fetuses diagnosed with VM between 2020 and 2024. Cases were classified according to VM severity, laterality, and the presence of associated anomalies. Prenatal genetic tests, neurosonography, and prenatal and postnatal MRI findings were analyzed. Outcomes included the termination of pregnancy, intrauterine and postnatal death, and long-term neurodevelopmental status.</div></div><div><h3>Results</h3><div>Among 357 fetuses, 193 (54.1 %) had mild VM, 85 (23.8 %) had moderate VM, and 79 (22.1 %) had severe VM. 25.2 % of the cases were isolated. Additional CNS abnormalities were present in 43.1 % of the fetuses. Genetic or chromosomal abnormalities were detected in 35.7 % of the fetuses who underwent genetic testing (55 out of 154 cases). The survival rate was highest in mild (75.6 %) and isolated VM (95.6 %). A higher gestational age at diagnosis, smaller ventricular diameter, and the absence of CNS/extracranial CNS abnormalities were associated with normal neurodevelopmental outcomes. In the logistic regression analysis, the presence of CNS abnormalities, ventricular width, and gestational age at diagnosis were found to be independent predictors of neurodevelopmental status. ROC analysis in our study showed that the cut-off value of 13 mm had good discrimination to predict normal neurodevelopmental status in all cases but limited accuracy in isolated cases of VM.</div></div><div><h3>Conclusion</h3><div>The severity and etiology of fetal VM significantly affect both survival and neurodevelopmental outcomes. Isolated mild VM correlated with positive outcomes, but moderate-to-severe VM and non-isolated cases had markedly poor survival rates and neurodevelopmental status. Key prognostic factors for normal neurodevelopmental status included higher gestational age at diagnosis, smaller ventricular diameters <13 mm, and the absence of CNS and non-CNS anomalies.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"209 ","pages":"Article 106355"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-23DOI: 10.1016/j.earlhumdev.2025.106345
Anders L. Schram , Nadja L. Bonne , Tine B. Henriksen , Niels T. Hertel , Lotte H. Hansen , Maja C. Bjerrum , Arlen Canenguez , Martin Hulgaard , Sofie Sommer , Camilla Hesselberg , Pernille K. Vandborg , Rikke Kaae , Signe B. Thim , Morten S. Lindhard
This multi-site, controlled follow-up study investigated the impact of intensified simulation-based pediatric team training on the evolution of Apgar scores within the first 10 min. No consistent improvement was observed. The results underscore the necessity for larger-scale studies and customized scenarios to fully evaluate the potential of simulation-based training in improving neonatal outcomes.
{"title":"Simulation-based team training and changes in Apgar scores during neonatal transition: A multi-site controlled follow-up study","authors":"Anders L. Schram , Nadja L. Bonne , Tine B. Henriksen , Niels T. Hertel , Lotte H. Hansen , Maja C. Bjerrum , Arlen Canenguez , Martin Hulgaard , Sofie Sommer , Camilla Hesselberg , Pernille K. Vandborg , Rikke Kaae , Signe B. Thim , Morten S. Lindhard","doi":"10.1016/j.earlhumdev.2025.106345","DOIUrl":"10.1016/j.earlhumdev.2025.106345","url":null,"abstract":"<div><div>This multi-site, controlled follow-up study investigated the impact of intensified simulation-based pediatric team training on the evolution of Apgar scores within the first 10 min. No consistent improvement was observed. The results underscore the necessity for larger-scale studies and customized scenarios to fully evaluate the potential of simulation-based training in improving neonatal outcomes.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"209 ","pages":"Article 106345"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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