115 research outputs found
Smoking during pregnancy and vision difficulties in children: a systematic review
No full textCigarette smoking during pregnancy is a major public health concern. Intra-uterine exposure to maternal cigarette smoking is associated with increased risks of growth and neurodevelopmental problems during childhood and later life. Few studies have focussed on visual difficulties in children in the context of maternal smoking during pregnancy. A systematic search of online databases was carried out between February and May 2013 to examine the trend in visual outcomes in children exposed to maternal cigarette smoking during intra-uterine life. Twenty-four non-randomized studies were identified. Each study was rated for quality using the Newcastle-Ottawa Scale. Most studies (n=18) reported fetal exposure to active or passive maternal cigarette smoking to be associated with an increased risk of adverse visual outcomes in children. In particular, there were higher rates of strabismus, refractive errors and retinopathy among children of women who smoked during pregnancy. These findings suggest that fetal exposure to cigarette smoke is a significant risk factor for visual problems during later life and that certain visual faculties, such as the intraocular muscles and retinal neurons, are more affected than others. The findings provide evidence in support of public health policies aimed at reducing fetal exposure to smoking by advising both women and their partners to quit smoking during pregnancy.Nuffield Department of Obstetrics and Gynaecology; Li Ka Shing Foundation; Li Ka Shing Scholarship from the Nuffield Department of Population Health, University of Oxford; Bill and Melinda Gates Foundation via the INTERGROWTH-21st Project; Nuffield Department of Obstetrics and Gynaecology, University of OxfordSCI(E)[email protected]
The INTERGROWTH-21st project neurodevelopment package: A novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children
No full textBackground The International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Project is a population-based, longitudinal study describing early growth and development in an optimally healthy cohort of 4607 mothers and newborns. At 24 months, children are assessed for neurodevelopmental outcomes with the INTERGROWTH-21st Neurodevelopment Package. This paper describes neurodevelopment tools for preschoolers and the systematic approach leading to the development of the Package. Methods An advisory panel shortlisted project-specific criteria (such as multi-dimensional assessments and suitability for international populations) to be fulfilled by a neurodevelopment instrument. A literature review of well-established tools for preschoolers revealed 47 candidates, none of which fulfilled all the project's criteria. A multi-dimensional assessment was, therefore, compiled using a package-based approach by: (i) categorizing desired outcomes into domains, (ii) devising domain-specific criteria for tool selection, and (iii) selecting the most appropriate measure for each domain. Results The Package measures vision (Cardiff tests); cortical auditory processing (auditory evoked potentials to a novelty oddball paradigm); and cognition, language skills, behavior, motor skills and attention (the INTERGROWTH-21st Neurodevelopment Assessment) in 35–45 minutes. Sleep-wake patterns (actigraphy) are also assessed. Tablet-based applications with integrated quality checks and automated, wireless electroencephalography make the Package easy to administer in the field by non-specialist staff. The Package is in use in Brazil, India, Italy, Kenya and the United Kingdom. Conclusions The INTERGROWTH-21st Neurodevelopment Package is a multi-dimensional instrument measuring early child development (ECD). Its developmental approach may be useful to those involved in large-scale ECD research and surveillance efforts
Extraction and degradation rate analysis of calcium phosphate from diverse fish Bones: A comparative study
No full textConverting waste fish bones into bioactive materials presents an innovative and eco-friendly approach to materials science. Fish bones, often discarded as waste in the seafood industry, are rich in calcium (Ca) and phosphorous (P), making them ideal precursors for Calcium phosphate (CaP) materials. In this study, different kinds of CaP materials were successfully extracted from diverse fish bone types like Carp fish (CF), Atlantic bonito (AB) and Gilt-head bream (GB) using a heat treatment method. The extracted white powders were characterized using X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared (FTIR), Transmission electron microscopy (TEM), and Inductively coupled plasma mass spectrometry (ICP-MS) techniques and the outcomes compared the most popular phase of CaP material like β -tricalcium phosphate (β-TCP) and Hydroxyapatite (HA) which they are synthesized using microwave refluxing equipment. The XRD pattern of the CF sample closely corresponded with the HA phase, while the AB and GB samples aligned with the biphasic calcium phosphate (HA/β-TCP) phase. The FTIR spectra analysis identified the presence of phosphate, hydroxyl, and carbonate groups. The XPS spectra determined the Ca/P ratio to range between 1.32 and 1.57. In vitro degradation studies were performed in phosphate-buffered saline (PBS) at 37 °C over 1, 3, 7, and 14 days. The ion release profiles of Ca2+ and P5+ were monitored, revealing the most significant degradation rate occurred between 7 and 14 days. The highest leaching levels of Ca ions were observed in the AB fish bones, with concentrations reaching approximately 87.35 mg/L after 14 days of immersion. Based on the results, it is concluded that the biphasic calcium phosphate derived from AB, along with its Ca, P, and other minerals content, exhibits a higher degradation rate than other samples. This indicates its potential as a promising bioactive material suitable for use as a bone tissue substitute
International standards for early fetal size and pregnancy dating based on ultrasound measurement of crown-rump length in the first trimester of pregnancy.
No full textOBJECTIVES: There are no international standards for relating fetal crown-rump length (CRL) to gestational age (GA), and most existing charts have considerable methodological limitations. The INTERGROWTH-21(st) Project aimed to produce the first international standards for early fetal size and ultrasound dating of pregnancy based on CRL measurement.
METHODS: Urban areas in eight geographically diverse countries that met strict eligibility criteria were selected for the prospective, population-based recruitment, between 9 + 0 and 13 + 6 weeks' gestation, of healthy well-nourished women with singleton pregnancies at low risk of fetal growth impairment. GA was calculated on the basis of a certain last menstrual period, regular menstrual cycle and lack of hormonal medication or breastfeeding in the preceding 2 months. CRL was measured using strict protocols and quality-control measures. All women were followed up throughout pregnancy until delivery and hospital discharge. Cases of neonatal and fetal death, severe pregnancy complications and congenital abnormalities were excluded from the study.
RESULTS: A total of 4607 women were enrolled in the Fetal Growth Longitudinal Study, one of the three main components of the INTERGROWTH-21(st) Project, of whom 4321 had a live singleton birth in the absence of severe maternal conditions or congenital abnormalities detected by ultrasound or at birth. The CRL was measured in 56 women at < 9 + 0 weeks' gestation; these were excluded, resulting in 4265 women who contributed data to the final analysis. The mean CRL and SD increased with GA almost linearly, and their relationship to GA is given by the following two equations (in which GA is in days and CRL in mm): mean CRL = -50.6562 + (0.815118 × GA) + (0.00535302 × GA(2) ); and SD of CRL = -2.21626 + (0.0984894 × GA).
GA estimation is carried out according to the two equations: GA = 40.9041 + (3.21585 × CRL(0.5) ) + (0.348956 × CRL); and SD of GA = 2.39102 + (0.0193474 × CRL).
CONCLUSIONS: We have produced international prescriptive standards for early fetal linear size and ultrasound dating of pregnancy in the first trimester that can be used throughout the world
Practices in child growth monitoring in the countries of the Eastern Mediterranean Region
No full textABSTRACT Growth reference charts are among the most sensitive and valuable tools for assessing the health and development of children. A questionnaire survey was answered by 16 of the 21 ministries of health in the Eastern Mediterranean Region countries (EMR) about their use of growth charts for children under 5 years. Most of the countries (13/16) used the NCHS/WHO charts and weight-for-age was the most commonly used. Charts for height-for-age and head circumference-for-age were less commonly used. Problems in the use of charts were identified
Adherence to the Mediterranean diet and its association with environmental footprints among women of childbearing age in the United Arab Emirates
No full textPurpose: To examine the association of adherence to the Mediterranean Diet (MD) with Environmental Footprints (EFPs) among women of childbearing age in the United Arab Emirates (UAE). Methods: Data belonging to a nationally representative sample of 482 women (19–50 years) were derived from a previous survey in the UAE. In face-to-face interviews, participants completed questionnaires addressing sociodemographic, physical activity, and dietary intake characteristics; the latter assessed using a multiple pass 24-h recall. The composite Mediterranean (c-MED) index was used to examine the adherence to the MD. Metrics for the EFPs (water use, energy use, and GHG emissions) were calculated using Life Cycle Analyses. Descriptive statistics and linear regressions were used in data analysis. Results: In the study sample, the distribution of the c-MED scores was skewed to the right, indicating a low adherence to the MD. The lowest contributions to the total c-MED score were observed for legumes (2.9%) and olive oil (1.8%). The EFPs associated with food consumption per 1000 kcal were: water use: 1256.89 ± 544.95 L/day; energy use: 18.01 ± 7.85 MJ/day, and GHG: 2.46 ± 1.46 kg CO2 eq/day. After adjustment for age, energy intake, and potential confounders, being adherent to the MD was associated with 540.57 [95% CI (− 726.6; − 354.54)] units decrease in water use and 0.94 units decrease in GHG emissions [95% CI (− 1.45; − 0.43)]. Conclusions: The findings of this study revealed an inverse association between adherence to the MD and EFPs. As such, the MD may represent a promising dietary strategy to improve health outcomes and reduce the environmental impact. Public health programs addressing the low adherence to the MD among women of childbearing age in the UAE are warranted. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany
Qur'anic narrative and Isra'iliyyat in Western scholarship and in classical exegesis
No full textThe main subject of this thesis is twofold. On the one hand it analyses how the Qur'an presents stories, on the other hand it examines the classical Muslim commentators' response to the Qur'anic narration.
In part one we remark that the theory that the Qur'an borrowed extensively from the Bible has clouded the vision of many Western scholars. They explained the Qur'anic narratives in accordance with their preconceptions; only a few emancipated themselves from this prejudice, but some of these scholars were sensitive to the literary qualities of the Qur'anic narrative. Adopting their general approach to the Qur'anic narrative we analyse the Qur'anic narrative of the 'golden calf' episode. Here we invite the reader to step into the textual world of the Qur'an in order to appreciate its otherness. At the same time we try to show the internal coherence among the verses (and also among the surahs) to remove the assumption of the incoherence of the Qur'an which has veiled much of its literary excellence from view. In addition, this study gives us an opportunity to appreciate one of the most neglected aspects of the Qur'anic narratives, namely the relationship between the oral recitation and the written characters of the Qur'an. The written text lacks the contextual richness provided by the oral dimension for it cannot convey intonation, emphasis, and so on, but the transcription of the spoken word displays the relationship of sound and meaning within
the surahs or verses together with special emphasis upon phonological effects.
The first chapter of part two is designed to provide a general overview of the notion of isrä'iliyyät, taking into account the opinions held by both Muslim and non-
Muslim authorities. We raise two important questions regarding this technical term
When did the technical term isra'iliyyät come into general use?
Who first used it critically?
To answer these questions we analyse the commentaries of eight exegetes together with some qisas works on the 'golden calf and 'heavenly table' episodes. It is clear
that, in contrast to the view held by many Muslim and non-Muslim scholars, the technical usage of this term is a late development. Another important conclusion derived from our analysis of classical exegesis is that the commentators who use this term themselves depend on isra'iliyyät in several respects. In other words, their theory,is not in agreement with their practice. Furthermore, there are commentators who do not use the term isra'iliyyät and consistently seek to distance themselves from these reports. They also try to minimise the amount of these reports in their tafsir. According to this research, Ibn Atiyya was the first to pay more attention to the implausibility of this type of report, two centuries before Ibn Kathir's critical exegesis
Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project : a prospective longitudinal cohort study
No full textThis project was supported by a generous grant from the Bill & Melinda Gates Foundation to the University of Oxford, for which we are very grateful.OBJECTIVE To describe maternal gestational weight gain (GWG) patterns in healthy pregnancies with good maternal and perinatal outcomes of women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. DESIGN Prospective, longitudinal, observational multi-country study.SETTING Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, UK and USA, April 2009 to March 2014. PARTICIPANTS Healthy, well-nourished and educated women, enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of ≥18.50 to ≤24.99 kg/m2 in the first trimester of pregnancy.MAIN OUTCOME MEASURES Maternal weight was measured using standardised methodology and identical equipment every 5±1 weeks from the first antenatal visit (<14+0 weeks’ gestation) to delivery. After ensuring that data from the study sites could be pooled, a multi-level, mixed effect, linear regression analysis for repeated measures, adjusted for gestational age was applied to produce the GWG values. RESULTS The within-site variance (59.6%) was six times higher than the between-sites’ variance (9.6%). Total mean GWG at 40 weeks’ gestation was 13.7 (SD 4.5) kg for women with a normal first trimester BMI. Fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation are provided with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. CONCLUSIONS This is the largest standardised study of healthy, well-nourished women ever to monitor GWG prospectively in a multi-country setting. The centiles generated are very robust and should help guide recommendations on optimal GWG worldwide.Peer reviewe
The satisfactory growth and development at 2 years of age of the INTERGROWTH-21st Fetal Growth Standards cohort support its appropriateness for constructing international standards.
No full textBACKGROUND: The World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue to monitor fetal growth using numerous local charts or equations that are based on different populations for each body structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21st Project has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards are based on the same healthy pregnancy cohort. Recognizing the importance of demonstrating that, postnatally, this cohort still adhered to the World Health Organization prescriptive approach, we followed their growth and development to the key milestone of 2 years of age. OBJECTIVE: The purpose of this study was to determine whether the babies in the INTERGROWTH-21st Project maintained optimal growth and development in childhood. STUDY DESIGN: In the Infant Follow-up Study of the INTERGROWTH-21st Project, we evaluated postnatal growth, nutrition, morbidity, and motor development up to 2 years of age in the children who contributed data to the construction of the international fetal growth, newborn infant size and body composition at birth, and preterm postnatal growth standards. Clinical care, feeding practices, anthropometric measures, and assessment of morbidity were standardized across study sites and documented at 1 and 2 years of age. Weight, length, and head circumference age- and sex-specific z-scores and percentiles and motor development milestones were estimated with the use of the World Health Organization Child Growth Standards and World Health Organization milestone distributions, respectively. For the preterm infants, corrected age was used. Variance components analysis was used to estimate the percentage variability among individuals within a study site compared with that among study sites. RESULTS: There were 3711 eligible singleton live births; 3042 children (82%) were evaluated at 2 years of age. There were no substantive differences between the included group and the lost-to-follow up group. Infant mortality rate was 3 per 1000; neonatal mortality rate was 1.6 per 1000. At the 2-year visit, the children included in the INTERGROWTH-21st Fetal Growth Standards were at the 49th percentile for length, 50th percentile for head circumference, and 58th percentile for weight of the World Health Organization Child Growth Standards. Similar results were seen for the preterm subgroup that was included in the INTERGROWTH-21st Preterm Postnatal Growth Standards. The cohort overlapped between the 3rd and 97th percentiles of the World Health Organization motor development milestones. We estimated that the variance among study sites explains only 5.5% of the total variability in the length of the children between birth and 2 years of age, although the variance among individuals within a study site explains 42.9% (ie, 8 times the amount explained by the variation among sites). An increase of 8.9 cm in adult height over mean parental height is estimated to occur in the cohort from low-middle income countries, provided that children continue to have adequate health, environmental, and nutritional conditions. CONCLUSION: The cohort enrolled in the INTERGROWTH-21st standards remained healthy with adequate growth and motor development up to 2 years of age, which supports its appropriateness for the construction of international fetal and preterm postnatal growth standards
Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: Could they help against COVID-19?
No full textThe world is currently in the grips of the coronavirus disease (COVID-19) pandemic, caused by the SARS-CoV-2 virus, which has mutated to allow human-to-human spread. Infection can cause fever, dry cough, fatigue, severe pneumonia, respiratory distress syndrome and in some instances death. COVID-19 affects the immune system by producing a systemic inflammatory response, or cytokine release syndrome. Patients with COVID-19 have shown a high level of pro-inflammatory cytokines and chemokines. There are currently no effective anti-SARS-CoV-2 viral drugs or vaccines. COVID-19 disproportionately affects the elderly, both directly, and through a number of significant age-related comorbidities. Undoubtedly, nutrition is a key determinant of maintaining good health. Key dietary components such as vitamins C, D, E, zinc, selenium and the omega 3 fatty acids have well-established immunomodulatory effects, with benefits in infectious disease. Some of these nutrients have also been shown to have a potential role in the management of COVID-19. In this paper, evidence surrounding the role of these dietary components in immunity as well as their specific effect in COVID-19 patients are discussed. In addition, how supplementation of these nutrients may be used as therapeutic modalities potentially to decrease the morbidity and mortality rates of patients with COVID-19 is discussed
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