-
ABSTRACT
01: Parent-mediated
social communication therapy for young children
with autism (PACT):
long-term follow-up
of a randomised controlled trial.
01
、针对自闭症幼儿的父母介导的社区沟通疗法（
PACT
）
：随机对照试验的长期随访
杂志（
THE
LANCET
）
< br>发表年份（
2016
）
期刊影响因子（
53.254
）
Background
:
It
is
not
known
whether
early
intervention
can
improve
long-term
autism
symptom
outcomes.
We
aimed
to
follow-
up
the
Preschool
Autism
Communication
Trial
(PACT),
to
investigate
whether
the
PACT
intervention
had
a
long-term
effect
on
autism
symptoms and continued effects on
parent and child social interaction.
Methods
: PACT was a
randomised controlled trial of a parent-mediated
social communication
intervention for
children aged
2
–
4
years
with core autism. Follow-up
ascertainment was done
at three
specialised clinical services centres in the UK
(London, Manchester, and Newcastle)
at
a median of 5.75 years (IQR
5.42
–
5.92) from the original
trial endpoint. The main blinded
outcomes were the comparative severity
score (CSS) from the Autism Diagnostic Observation
Schedule
(ADOS)
自闭症诊断观察量表
,
the
Dyadic
Communication
Assessment
Measure
(DCMA)
of
the
proportion
of
child
initiatiations
when
interacting
with
the
parent,
and
an
expressive-receptive
language
composite.
All
analyses
followed
the
intention-to-treat
principle.
Findings
:
121
(80%)
of
the
152
trial
participants
(59
[77%]
of
77
assigned
to
PACT
intervention vs 62 [83%] of 75 assigned
to treatment as usual) were traced and consented
to
be assessed between July, 2013, and
September, 2014. Mean age at follow-up was 10.5
years
(SD 0.8). Group difference in
favour of
赞同
the PACT
intervention based on ADOS CSS of
log-
odds effect size (ES) was 0.64 (95% CI
0·
07 to 1·
20) at treatment
endpoint and ES 0.70
(95% CI
?0
.05 to 1.47) at follow-up,
giving an overall reduction in symptom
severity over the
course
of
the
whole
trial
and
follow-up
period
(ES
0.55,
95%
CI
0.14
to
0.91,
p=0.004).
Group difference
in DCMA child initiations at follow-up showed a
Cohen's d ES of 0.29 (95%
CI ?0.02 to
0.57) and was significant over the course of
t
he study (ES 0.33, 95% CI 0.11 to
0.57, p=0.004). There were no group
differences in the language composite at follow-up
(ES
0.
15, 95% CI
?0
.23 to 0.53).
Interpretation
:
The
results
are
the
first
to
show
long-term
symptom
reduction
after
a
randomised controlled
trial
of early intervention in autism spectrum disorder.
They support
the clinical value of the
PACT intervention and have implications for
developmental theory.
02
：
Burden, risk
factors, and comorbidities of behavioural and
emotional problems in Kenyan
children:
a population-based study
02
、
肯尼亚儿童的行为和情绪问题的负担、危险因素以及合并症：一项基于人群的研究
杂志（
LANCET
PSYCHIATRY
）
发表年份（
2017
）
期刊影响因子（
15.233
）
背景：
Three-quarters
of
the
burden
of
mental
health
problems
精神卫生问题
occurs
in
low-
and-middle-income
countries,
but
few
epidemiological
studies
of
these
problems
in
preschool children from
sub-Saharan
Africa
撒哈拉以南
have been
published.
Behavioural
and
emotional
problems
often
start
in
early
childhood,
and
this
might
be
particularly
important in
Africa, where the incidence of perinatal
围产期
and early risk factors is
high.
We therefore aimed to estimate
the prevalence and risk factors of behavioural and
emotional
problems in young children in
a rural area on the Kenyan coast.
方法：
We did a population-based
epidemiological study to assess the burden of
behavioural
and
emotional
problems
in
preschool
children
and
comorbidities
in
the
Kilifi
Health
and
Demographic
Surveillance
System
基利菲健康和
人口监测
系统
(KHDSS,
a
database
formed
of
the
population
under
routine
surveillance
linked
to
admissions
to
Kilifi
County
Hospital).
We
used
the
Child
Behaviour
Checklist
(CBCL)
儿童行为调查表
to
assess
behavioural
and
emotional
problems.
We
then
determined
risk
factors
and
medical
comorbidities
associated
with
behavioural
and
emotional
problems.
The
strength
of
associations
between
the
risk
factors
and
the
behavioural
and
emotional
problems
was
estimated using
generalised linear models, with appropriate
distribution and link functions.
结果：
3539 families were
randomly selected
from the
KHDSS. Of these, 3273 children were
assessed with CBCL. The prevalence of
total behavioural and emotional problems was
13%
(95% CI
12
–
14), for externalising
problems
外化问题
was
10%
(9
–
11), and for
internalising
problems was
22%
(21
–
24). The most common
CBCL syndrome was
somatic
problems
躯体
问题
(21%,
20
–
23),
whereas
the
most
common
DSM-IV-oriented
scale
基于精神疾病诊断
准则手
册（第四版）
was
anxiety
problems
(13%,
12
–
14).
Factors
associated
with
total
problems
included
consumption
of
cassava
(risk
ratio
5·
68,
95%
CI
3·
< br>22
–
10·
03),
perinatal
complications
(4·
34, 3·
21
–
5·
81),
seizure
disorders
(2·
90, 2·
24
–
3·
77), and
house status
(0·
11,
0·
08
–
0·
14).
Seizure
disorders
癫痫
, burn
marks
烧伤
, and respiratory
problems
呼吸道疾病
were important comorbidities of
behavioural and emotional problems.
理解
：
Behavioural
and emotional problems are common in preschool
children in this Kenyan
rural
area
and
are
associated
with
preventable
risk
factors.
Behavioural
and
emotional
problems and associated comorbidities
should be identified and addressed in young
children.
03
：
Effect
of
iodine
supplementation
in
pregnant
women
on
child
neurodevelopment:
a
randomised, double-blind,
placebo-controlled trial
03
、
孕妇补碘对儿童神经发育的影响：一项随机、双盲、安慰剂对照试验
杂志
（
Lancet
Diabetes & Endocrinology
）
发表年份
（
2017
）
期刊影响因子
（
19.313
）
Background
：
Iodine
deficiency
during
pregnancy
might
be
associated
with
reduced
intelligence quotient (IQ) score in
offspring. We assessed the effect of iodine
supplementation
in
mildly
iodine-deficient
pregnant
women
轻度碘缺乏孕妇
on
neurodevelopment
of
their
offspring in areas
where
schoolchildren were iodine
sufficient
.
Methods
：
In this
randomised, placebo-controlled trial, pregnant
women in
Bangalore
班加罗
尔
,
India,
and
Bangkok
曼谷
,
Thailand,
were
randomly
assigned
(1:1)
to
receive
200
μg
iodine
orally
once
a
day
or
placebo
until
delivery.
Randomisation
was
done
with
a
computer-generated
sequence
and
stratified
by
site.
Co-primary
outcomes
主要结果
were
verbal
and
performance
IQ
scores
on
the
Wechsler
Preschool
and
Primary
Scale
of
Intelligence
韦氏学前和小学儿童智力量表
Third
Edition
(WPPSI-III)
and
the
global
executive
composite
score
from
the
Behaviour
Rating
Inventory
of
Executive
Function-Preschool
Version
(BRIEF-P)
in
the
children
at
age
5
–
6
years.
The
trial
was
double-blinded; some
unmasking
揭盲
took
place at age 2 years for an interim
analysis
中间
分析
, but
participants and nearly all investigators remained
masked to group assignment until
age
5
–
6 years.
Analysis was by intention to treat
using mixed-effects models.
Findings
：
Between
Nov 18, 2008, and March 12, 2011,
832
women
entered the trial at a mean
gestational age
of 10.7
weeks
(SD 2.
7); median
urinary iodine concentration was 131 μg/L
(IQR 81
–
213).
Mean compliance with supplementation was 87%,
assessed by monthly tablet
counts.
313 children
(iodine group,
n=159; placebo group, n=154) were analysed for
verbal
and performance IQ with WPPSI-
III and 315 (iodine group, n=159; placebo group,
n=156)
for overall executive function
with BRIEF-P. Mean WPPSI-III scores for verbal IQ
were 89.5
(SD 9·
8) in the
iodine group and 90.
2 (9·8) in the
placebo group (difference ?0·7, 95% CI
?
2·
9 to
1·
5; p=0·
77), and for
performance IQ were 97.5 (12·
5) in the
iodine group and 99.1
(13·4) in the
placebo group (difference ?1·6, ?4·5 to 1·3;
p=0·44). The mean BRIEF
-P global
executive composite score was 90.6
(26·
2) in the iodine group and 91.5
(27·
0) in the placebo
group
(difference ?0·9, ?6·8 to 5·0; p=0·74). The
frequency of adverse events did not differ
between groups during gestation or at
delivery: 24 women in the iodine group and 28 in
the
placebo group reported adverse
events (iodine group: abortion, n=20; blighted
ovum, and n=2;
intrauterine death, n=2;
placebo group: abortion, n=22; blighted ovum, n=1;
intrauterine death,
n=2; early neonatal
death, n=1; and neonatal death, n=2).
I
nterpretation
：
Daily iodine
supplementation
in mildly iodine-
deficient pregnant women had
no effect
on child neurodevelopment at age
5
–
6 years.
04
：
Incidence of
and Factors Associated With Myopia and High Myopia
in Chinese Children,
Based on
Refraction Without Cycloplegia.
04
、基于无睫状肌麻痹屈光度的中国儿童近视和高度近视的发生率及相关因素
杂志（
JAMA
Ophthalmol
）
发表年份（
2018
）
期刊影响因子（
6.669
）
IMPORTANCE: Myopia
has reached epidemic levels among children in
regions of East and
Southeast Asia.
High myopia
高度近视
is associated with myopic macular degen
eration
近视
性黄斑变性
,
glaucoma
青光眼
, and retinal
detachment
视网膜脱落
.
OBJECTIVE
:
To
determine
the
incidence
of
myopia
and
high
myopia
based
on
refraction
without
cycloplegia among children in primary and junior
high schools in China.
DESIGN
, SETTING, AND
PARTICIPANTS: This
observational cohort
study
was completed
in
Guangzhou, China. It consisted of a cohort from
19 primary schools
, who were
followed
up from 2010 to 2015, and a
cohort from
22 junior high
schools
, who were followed up from
2010
to
2012.
All
schools
were
randomly
chosen
at
rates
proportional
to
the
number
of
schools in each of the city's 11 distri
cts
所有学校都是按照与学校数量成比例的随机选择的
.
Students with or without myopia in
grade 1 (primary school) or grade 7 (junior high
school)
were eligible for inclusion.
Data analysis occurred from February 2017 to
October 2017.
MAIN
OUTCOMES
AND
MEASURES:
Myopia
was
defined
as
a
spherical
equivalent
refraction
(SER)
等效球镜度数
of
-0.50
diopters
(D)
or
less,
as
measured
by
subjective
refraction
主觉验光
without
cycloplegia
睫状肌麻痹
; high
myopia was defined as a SER of
-6.0
D
or
less.
Annual
incidences
were
defined
as
the
proportion
of
participants
each
year
found
to
have
myopia
or
high
myopia
who
did
not
previously
have
the
condition
.
Height,
weight,
axial
length
(AL)
轴长
,
corneal
radius
of
curvature
(CRC)
角膜曲率半径
,
and
AL/CRC ratio were examined to assess if
these measures were associated with future myopia
or high myopia.
RESULTS
: A total of 4741
students with or without myopia in either grade 1
for the primary
school cohort (mean
[SD] age 7.2 [0.4] years; 932 of 1975 [47.2%]
female) or grade 7 for the
junior
high
school
cohort (mean
[SD]
age
13.2
[0.5]
years;
1254
of
2670
[47.0%]
female)
were included.
Baseline mean (SD) SER was 0.31 (0.86) D among
1975 students in grade 1
vs -1.60
(2.00) D among 2670 students in grade 7.
Baseline prevalence of myopia was 12.0%
in grade 1 students (n?=?237 of 1969)
and 67.4% in grade 7 students (n?=?1795 of
2663).
The
incidence of
myopia was 20% to 30% each year throughout both
cohorts. The incidence of
high myopia was initially less than 1%
in the primary school cohort (grade 1: n?=?2 of
1825;
0.1% [95% CI, 0.0%-0.3%]), but
incidence exceeded 2% in the junior high school
cohort (in
grade 9: n?=?48 of 2044;
2.3% [95% CI, 1.0%
-3.7%]).
CONCLUSIONS
AND
RELEV
ANCE:
The
incidence
of
myopia
among
Chinese
students
based on refraction without cycloplegia
is among the highest of any cultural or ethnic
group.
If
confirmed
with
cycloplegic
refraction,
interventions
to
prevent
myopia
onset
in
Chinese
populations should be initiated in
primary schools.
基于无睫状肌麻痹屈光度
的中国学生近
视发生率是所有文化或民族中最高的。
如果确认睫状肌麻痹屈光，应在小学开始干预
中国人群中预防近视发作。
05
：
Infant
wake
after
sleep
onset
serves
as
a
marker
for
different
trajectories
in
cognitive
development.
05
、入
睡开始后婴儿的醒来作为认知发展中不同轨迹的标志
杂志（
J Child Psychol
Psychiatry
）
发表年份（
2018
）
期刊影响因子（
6.486
）
BACKGROUND:
Sleep variables have been linked to
improved functioning of learning and
memory
throughout
life
睡眠变量与改善学习和记忆功能有关
,
with
most
studies
focusing
on older children and adults.
Since infancy is a time of outstanding
plasticity
可塑性
, sleep
variables could be particularly
important for cognitive development in that age
group.
METHODS:
This is a
longitudinal study
collecting data from 40 infants at four
different time
points of
4,
6, 8 and 10 months
. Sleep variables
were assessed using
actigraphy
体动记录仪
for
a
week,
as
well
as
a
sleep
questionnaire.
Eye-tracking
was
employed
to
examine
developmental
cognitive trajectories. Infants had to remember
the location of a toy that had
previously been linked to a sound and
an eye-tracker recorded whether they were
searching
the correct location upon
hearing the sound.
眼动追踪用于检查发育认知轨迹，
婴儿必须记
住先前与声音相关的玩具的位置，并且记录他们是否在听到声音
时搜索正确的位置。
RESULTS:
Based on their trajectories between 4
and 10 months, infants were divided into
two groups who shifted their response
strategies at different time points. Those two
groups
also differed in other aspects
of their looking patterns and scored increasingly
differently in
the Ages & Stages
Questionnaire over time. Time spent awake in the
night early in life was
reduced in the
group who changed their strategy
earlier.
根据他们在
4
到
10
个月之间的轨
迹，婴儿被分成两组，他们在不同的时间点改变他们的反应策略。
< br>这两个群体在其外
观模式的其他方面也存在差异，
并且随
着时间的推移在年龄和阶段问卷中得分越来越不
同。
CONCLUSIONS:
While
previous
research
examined
the
relation
of
infant
sleep
and
cognitive functioning measured once,
this paper provides first evidence that
night wake time
can serve as
a marker for different cognitive
trajectories
.
虽然之
前的研究一度检验了婴儿
睡眠和认知功能的关系，
但本文提供了
第一个证据，即夜间唤醒时间可以作为不同认知
轨迹的标记。
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