Prevalence and Influencing Factors of Wheezing and Asthma Among Preschool Children in Urumqi City: A Cross-sectional Survey

Background: To investigate the prevalence and indoor environmental influencing factors of wheezing and asthma among preschool children in Urumqi, Xinjiang, China to provide a strong basis for prevention and control. Methods: In August 2019, a cross-sectional epidemiological study involving 8153 preschool children was conducted in 60 kindergartens in Urumqi. The mean age of the children who participated in the survey was 5.27 ± 1.10 years. Additionally, 51.9% were boys, 86.9% were Han Chinese, and an 81.53% survey response rate was observed. The childhood wheeze and asthma survey used was the ALLHOME-2 questionnaire, and the childhood home dwelling and living environment survey used was the DBH questionnaire. Partial adjustments were made according to the geographical environment of Urumqi and the living habits of the residents.Results: The prevalence of wheezing and asthma in children was 4.7% and 2.0%, respectively. Multivariate unconditional logistic regression results suggested that ethnicity (odds ratio (OR)=1.39, 95% confidence interval (95%CI)=1.05–1.84), birth pattern (OR=1.24, 95%CI=1.00–1.53), family history of asthma (OR=5.00, 95%CI=3.36–7.44), carpet or floor bedding at home (OR=1.40, 95%CI=1.05–1.87), purchasing new furniture in the mother’s residence during pregnancy (OR=1.58,95%CI=1.06–2.36), pet keeping in the residence at age 0–1 (OR=1.55, 95%CI=1.13–2.13), passive smoking in the child's residence (OR=1.35, 95%CI=1.01–1.80), and having mould or hygroma in the child's residence at age 0–1 (OR=1.72, 95%CI=1.12–2.64) were risk factors for wheezing. In addition, sex (OR=0.73, 95%CI=0.59-0.90) was a protective factor for wheezing. Birth pattern (OR=1.46, 95%CI=1.06–2.00), family history of asthma (OR=7.06,95%CI=4.33–11.53), carpet or floor bedding at home (OR=2.20, 95%CI=1.50–3.23), and pet keeping in the residence at age 0–1 (OR=1.64, 95%CI=1.04–1.83) were risk factors for asthma, whereas gender (OR=0.58, 95% CI=0.42–0.80) was a protective factor for asthma. Conclusion: This survey indicates that preschool children in Urumqi have a higher risk of wheezing and asthma. Risk factors that may cause an elevated risk of wheezing or asthma have also been identified.

Dynamic finite-element simulations reveal early origin of complex human birth pattern

Human infants are born neurologically immature, but whether this originates from conflicting selection pressures between bipedal locomotion and encephalization as suggested by the obstetrical dilemma remains controversial. Australopithecines are ideal for investigating this trade-off as they have a bipedally adapted pelvis, yet relatively small brains. Our finite-element birth simulations based on different pelvic reconstructions and a range of fetal head sizes indicate that australopithecines already possessed a human-like rotational birth pattern. Since only newborn head sizes smaller than those predicted for non-human primates leave adequate space for soft tissue between the bony pelvis and fetal skull, our data imply that australopithecines had secondarily altricial newborns and likely evolved cooperative breeding to care for their helpless infants. These prerequisites for advanced cognitive development therefore seem to have been corollary to skeletal adaptations to bipedal locomotion that preceded the appearance of the genus Homo and the increase in encephalization.

Analysing the seasonality of births in mainland China

The seasonality of human births varies in different countries and regions. Explanations for this variation have been divided into biological and behavioural factors. This paper documents birth seasonality in mainland China using data for a large sample from Chinaʼs Fifth National Population Census (FNPC) conducted in 2000. The main method used was the decomposition of monthly time series birth data into annual, seasonal and random trends. The results show large seasonal birth fluctuations, with a salient peak of October births. The study hypothesis is that this seasonal birth pattern is partially due to a home-bound wave of movement of people after the annual Spring Festival. Subsequent analysis of the calculated de-trended monthly births provided supportive evidence for this hypothesis. Further in-depth analysis showed that the magnitude of births varied with location and family characteristics. This result should inform researchers in the field of economics, where seasonality of births has been previously regarded as exogenous.

Seasonality of month of birth in children and adolescents with autoimmune thyroiditis: a continuing conundrum

Background The aim of this study was to analyze the seasonal birth month pattern in young patients with autoimmune thyroiditis and compare it with youth controls. Methods Medical records of a total of 298 children and adolescents of Greek origin, with a diagnosis of Hashimoto thyroiditis (HT) before the age of 21 years that were born from 1987 to 2010 were retrospectively reviewed. In addition, 298 consecutive subjects that were born from 1988 to 2012 and evaluated in a tertiary unit for any reason, served as controls, provided that they had no personal or family history of thyroid or any other autoimmune disease. Results Significant differences were found between children and adolescents with HT and healthy controls in the yearly pattern of month of birth distribution (p=0.029). During month-by-month analysis, it was shown that the highest and lowest predispositions to HT were among those born in spring (March) (odds ratio [OR] 2.34, p=0.005), and autumn (November) (OR 0.49, p=0.035), respectively. A binary logistic regression model also revealed that season of birth and sex were the only factors that remained related to HT disease, even after adjustment for confounding factors such as year of birth and age (p<0.001, Nagelkerke r-square 0.151). Conclusions This study suggests that the effect of certain seasonal factors during fetal development, reflected by the seasonal differences in birth pattern, in children and adolescents with autoimmune thyroiditis could contribute to long-term programming of an autoimmune response against the thyroid gland. Further studies are needed to demonstrate a clear cause and effect relationship between month of birth and HT.

Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern

ObjectiveCongenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10–20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort.MethodsThe influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies.ResultsThere was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity did not influence the development of heart block in either group. Maternal age in Ro/La-positive pregnancies with a child affected by heart block was, however, significantly higher than in pregnancies resulting in babies without heart block (p<0.05).Seasonal timing of pregnancy influenced the outcome. Gestational susceptibility weeks 18–24 occurring during January–March correlated with a higher proportion of children with heart block and lower vitamin D levels during the same period in a representative sample of Swedish women and a corresponding higher proportion of children with heart block born in the summer (p<0.02). Maternal age or seasonal timing of pregnancy did not affect the outcome in Ro/La-negative pregnancies.ConclusionThis study identifies maternal age and seasonal timing of pregnancy as novel risk factors for heart block development in children of Ro/La-positive women. These observations may be useful for counselling when pregnancy is considered.