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Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) are related to cognitive dysfunction and mental disability. These genes, along with folate and vitamin B12 levels, are regulators of one-carbon metabolism, which synthesizes S-adenosylmethionine (SAM) as a methyl donor for arsenic methylation. The aim of this study was to explore whether polymorphisms of MTHFR and MTR influence arsenic methylation capacity and plasma folate and vitamin B12 levels and if these influences cause developmental delay in preschool children. A total of 178 children with developmental delay and 88 without developmental delay were recruited from August 2010 to March 2014. A high-performance liquid chromatography–hydride generator and atomic absorption spectrometer were used to determine urinary arsenic species. Plasma folate and vitamin B12 concentrations were measured by SimulTRAC-SNB radioassay. Polymorphisms of MTHFR C677T, MTHFR A1298C, and MTR A2756G were examined by polymerase chain reaction and restriction fragment length variation. The results show that MTHFR C677T C/T and T/T genotypes had a lower risk of developmental delay than the C/C genotype (odds ratio [OR] = 0.47; 95% confidence interval, 0.26–0.85). Subjects with the MTHFR C677T C/C genotype had significantly lower plasma folate and vitamin B12 levels than those with the MTHFR C677T C/T and T/T genotype. The MTHFR C677T C/C genotype combined with high total urinary arsenic and poor arsenic methylation capacity indices significantly increased the OR of developmental delay in a dose–response manner. This is the first study to show the combined effect of MTHFR C677T genotype and poor arsenic methylation capacity on developmental delay. [ABSTRACT FROM AUTHOR]

Developmental delay has been associated with inefficient arsenic methylation capacity in preschool children. Folate and vitamin B12 are important nutrients that produce s-adenosylmethionine during single-carbon metabolism and provide methyl groups for arsenic methylation. The aim of the present study was to explore whether plasma folate and vitamin B12 levels influence arsenic methylation capacity and in turn are related to developmental delay in preschool children. A case–control study was conducted in 178 children with developmental delay and 88 normal children, who were recruited from Shin Kong Wu Ho-Su Memorial Teaching Hospital from August 2010 to March 2014. Arsenite (AsIII), arsenate (AsV), monomethylarsonic acid (MMAV), and dimethylarsinic acid (DMAV) in the urine was determined by high-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. Plasma folate and vitamin B12 levels were measured using a SimulTRAC-SNB radioassay. The results show that the combination of high plasma folate and high vitamin B12 levels were correlated with efficient arsenic methylation capacity (low MMAV %, low InAs %, and high DMAV %). High MMAV % significantly increased and high DMAV % and secondary methylation index decreased the odds ratio (OR) of developmental delay in a dose-dependent manner in both low plasma folate and low vitamin B12 (low/low) groups; the multivariate OR and 95% confidence interval were 5.01 (0.83–30.06), 0.21 (0.04–1.23), and 0.20 (0.03–1.20), respectively. This is the first study to show that the combination of high plasma folate and high vitamin B12 levels increases arsenic methylation capacity and indirectly decreases the OR of developmental delay in preschool children. [ABSTRACT FROM AUTHOR]

Abstract Inefficient arsenic methylation capacity has been associated with developmental delay in preschool children. Selenium has antioxidant and anti-inflammatory properties that protect experimental animals from chemically induced neurotoxicity. The present study was designed to explore whether plasma selenium levels affects arsenic methylation capacity related to developmental delay in preschool children. A case-control study was conducted from August 2010 to March 2014. All participants were recruited from the Shin Kong Wu Ho-Su Memorial Teaching Hospital. In total, 178 children with a developmental delay and 88 children without a delay were recruited. High-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry were used to determine urinary arsenic species, including arsenite (AsIII), arsenate (AsV), monomethylarsonic acid (MMAV), and dimethylarsinic acid (DMAV). Plasma selenium levels were measured by inductively coupled plasma mass spectrometry. As results, plasma selenium concentration was significantly inversely associated with the odds ratio (OR) of developmental delay. Plasma selenium concentration was positively associated with arsenic methylation capacity [percentage of inorganic arsenic and percentage of MMAV (MMAV%) decreased, and percentage of DMAV (DMAV%) increased]. High plasma selenium concentration and high DMA% significantly and additively interacted to decrease the OR of developmental delay; the OR and 95% confidence interval were 0.40 (0.18–0.90). This is the first study to show a combined dose-response effect of plasma selenium concentration and that efficient arsenic methylation capacity decreased the OR of developmental delay in preschool children. Highlights • Plasma selenium concentration was significantly inversely associated with the odds ratio of developmental delay. • Increases in plasma selenium concentration increased the arsenic methylation capacity. • High plasma selenium concentration and high DMA% significantly and additively interacted to decrease the OR of developmental delay. [ABSTRACT FROM AUTHOR]

Inefficient arsenic methylation capacity has been associated with developmental delay in children. The present study was designed to explore whether polymorphisms and haplotypes of arsenic methyltransferase ( AS3MT ), glutathione-S-transferase omegas ( GSTOs ), and purine nucleoside phosphorylase ( PNP ) affect arsenic methylation capacity and developmental delay. A case-control study was conducted from August 2010 to March 2014. All participants were recruited from the Shin Kong Wu Ho-Su Memorial Teaching Hospital. In total, 179 children with developmental delay and 88 children without delay were recruited. Urinary arsenic species, including arsenite (As III ), arsenate (As V ), monomethylarsonic acid (MMA V ), and dimethylarsinic acid (DMA V ) were measured using a high-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. The polymorphisms of AS3MT , GSTO , and PNP were performed using the Sequenom MassARRAY platform with iPLEX Gold chemistry. Polymorphisms of AS3MT genes were found to affect susceptibility to developmental delay in children, but GSTO and PNP polymorphisms were not. Participants with AS3MT rs3740392 A/G + G/G genotype, compared with AS3MT rs3740392 A/A genotype, had a significantly lower secondary methylation index. This may result in an increased OR for developmental delay. Participants with the AS3MT high-risk haplotype had a significantly higher OR than those with AS3MT low-risk haplotypes [OR and 95% CI, 1.59 (1.08–2.34)]. This is the first study to show a joint dose-response effect of this AS3MT high-risk haplotype and inefficient arsenic methylation capacity on developmental delay. Our data provide evidence that AS3MT genes are related to developmental delay and may partially influence arsenic methylation capacity. [ABSTRACT FROM AUTHOR]

Abstract: Environmental exposure to lead or mercury can cause neurodevelopmental damage. Arsenic is another neurotoxicant that can affect intellectual function in children. This study was designed to explore the difference of arsenic methylation capacity indices between with and without developmental delay in preschool children. We also aimed to identify whether blood levels of lead or mercury modify the effect of arsenic methylation capacity indices. A cross sectional study was conducted from August 2010 to March 2012. All participants recruited from the Shin Kong Wu Ho-Su Memorial Teaching Hospital. In all, 63 children with developmental delay and 35 children without developmental delay were recruited. Urinary arsenic species, including arsenite (AsIII), arsenate (AsV), monomethylarsonic acid (MMAV) and dimethylarsinic acid (DMAV) were measured with a high-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. Lead and mercury levels of red blood cells were measured by inductively coupled mass spectrometry. All participants underwent developmental assessments to confirm developmental delays, including evaluations of gross motor, fine motor, speech-language, cognition, social, and emotional domains. Urinary total arsenic and MMAV percentage were significantly positively associated and DMAV percentage was negatively associated with the risk of developmental delay in a dose-dependent manner after adjustment for blood lead or mercury levels and other risk factors. A multivariate regression analysis indicated that blood lead level and arsenic methylation capacity each independently contributed to the risk of developmental delay. This is the first study to show that arsenic methylation capacity is associated with developmental delay, even without obvious environmental arsenic exposure. [Copyright &y& Elsevier]

Objective: To examine the correlation of function, quality of life (QOL), and parental impact on developmental delayed children. Methods: Sixty parents of children with developmental delays ( M: F = 36:24, mean age 4 years and 2 months) and 56 parents of age-sex matched typical development children were included. Pediatric Outcomes Data Collection Instrument and Child Health Questionnaire for children, World Health Organization-QOL, Impact on Family Scale, and Hospital Anxiety and Depression Scale for parents were assessed. Results: Functional performance was correlated with physical component of QOL in children (correlation coefficients: 0.7-0.9; p < 0.01), age of children (0.3-0.4; p < 0.05) and parents (0.3; p < 0.05), maternal employment (0.3-0.4; p < 0.05), parental QOL (0.3-0.4; p < 0.01), family impact (−0.3 to −0.5; p < 0.01), and parental emotion (−0.3 to −0.4; p < 0.05). Conclusions: Children who exhibited higher levels of function had higher QOL, as did their parents, and less parental impact. [ABSTRACT FROM AUTHOR]

Metal exposure and lifestyle are important risk factors for osteoporosis. Our study aimed to investigate the association between red blood cell lead and cadmium, total urinary arsenic, and plasma selenium levels and bone mineral density (BMD). In addition, we explored whether alcohol and coffee consumption modified the association between BMD and metals and metalloids. In total, 437 participants who underwent adult or senile physical examinations were recruited. Bone loss was defined as a calcaneus BMD T-score of <-1. Blood cadmium and lead and plasma selenium levels were measured using inductively coupled plasma mass spectrometry. Levels of urinary arsenic species were determined using high-performance liquid chromatography-hydride generator-atomic absorption spectrometry. The total urinary arsenic level was defined as the sum of the levels of urinary arsenic species. The BMD T-scores decreased significantly with increasing blood lead levels. The BMD T-scores also showed a downward trend with increasing total urinary arsenic levels. The odds ratio (OR) and 95% confidence interval (CI) for bone loss in patients with blood lead levels >57.58 versus 35.74 μg/dL were 1.98 and 1.17-3.34. In addition, the greater the lead or arsenic exposure and alcohol intake was the higher the OR for bone loss with multivariate ORs of 2.57 (95% CI 1.45-4.56) and 2.96 (95% CI 1.67-5.22), respectively. To the best of our knowledge, this study is the first to demonstrate that high total urinary arsenic or blood lead levels and frequent or occasional alcohol consumption had a significant multiplicative interaction for increasing the OR for bone loss., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hsueh, Huang, Chen, Shiue, Lin and Hsieh.)

Unlabelled: This prospective, randomized controlled study investigated the effects of short-term interactive video game playing among children with developmental delays participating in traditional rehabilitation treatment at a rehabilitation clinic. One hundred and one boys and 46 girls with a mean age of 5.8 years (range: 3 to 12 years) were enrolled in this study. All patients were confirmed to suffer from developmental delays, and were participating in traditional rehabilitation treatment. Children participated in two periods of 4 weeks each, group A being offered intervention of eight 30-minute sessions of interactive video games in the first period, and group B in the second, in addition to the traditional rehabilitation treatment. The physical, psychosocial, and total health of the children was periodically assessed using the parent-reported Pediatric Quality of Life Inventory-Generic Core Scales (PedsQL); and the children's upper extremity and physical function, transfer and basic mobility, sports and physical functioning, and global functioning were assessed using the Pediatric Outcomes Data Collection Instrument. Parental impact was evaluated using the PedsQL-Family Impact Module for family function, PedsQL-Health Satisfaction questionnaire for parents' satisfaction with their children's care and World Health Organization-Quality of Life-Brief Version for quality of life. Compared with the baseline, significant improvements of physical function were observed in both groups (5.6 ± 19.5, p = 0.013; 4.7 ± 13.8, p = 0.009) during the intervention periods. No significant improvement of psychosocial health, functional performance, or family impact was observed in children with developmental delays. Short-term interactive video game play in conjunction with traditional rehabilitation treatment improved the physical health of children with developmental delays., Trial Registration: ClinicalTrials.gov NCT02184715.

Objective: To investigate possible correlations between the incidence and severity of Bell's palsy and seasonal variations in Taiwan., Methods: We studied data on the incidence of Bell's palsy over a 3-year period in Taiwan. The electroneurographic quotient was used as an index for the severity of nerve involvement. A higher electroneurographic quotient indicates less severe disease., Results: Data were collected from 775 patients. We analyzed the data using the chi-square goodness-of-fit test, and the results showed that seasonality was significantly associated with the incidence of Bell's palsy among men, with the incidence increasing during the cold months (p = 0.012). A significant association was evident between age and incidence, with a higher incidence among patients aged 50 years or younger (p = 0.027). By contrast, no significant relationship was found between seasonality and either female sex or older age. No statistical association was found between the degree of nerve involvement and season of onset in patients with Bell's palsy., Conclusion: Bell's palsy increased among men and among younger patients during the cold seasons in Taiwan. No association emerged between the severity of Bell's palsy and the season of onset.

Aims: The study aims to evaluate the quality of life (QOL) and health of children with unclassified developmental delays and the impacts this had on the family., Methods: In total, 60 parents of pre-school children with unclassified developmental delays and 56 parents of age and gender-matched children with typical development were recruited. We administered the Pediatric Quality of Life Inventory (PedsQL)-Generic Core Scale and Pediatric Outcomes Data Collection Instrument to parents to evaluate the QOL and health status of their children. Parents were evaluated by World Health Organization-Quality of Life-Brief Version, PedsQL-Family Impact Module, Hospital Anxiety and Depression Scale, and PedsQL-Health satisfaction to assess the impacts of this situation on the family. Variables related to QOL and functions of children with unclassified developmental delays were analysed by stepwise regression analysis., Results: Comparing children with typical development, children with unclassified developmental delays had a significantly lower QOL (including both psychosocial and physical components) and health status. Their parents had a significantly lower QOL, family function and health satisfaction, and higher psychological distress than parents of children with typical development. Gross-motor delay impacts on QOL of these children (regression coefficient: -9.59, P < 0.05), global functioning is related to cognition delay (regression coefficient: -20.22, P < 0.01) and physical health of their parents (regression coefficient: 0.87, P < 0.01)., Conclusions: Children with unclassified developmental delays had lower QOL and health status, and their condition had greater impacts on the family than children with typical development. Gross motor and cognition development related to the QOL and global functioning in these children., (© 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

Purpose: To study the long-term changes in physical functional performance and quality of life in hemodialysis patients living in the community in Taiwan., Methods: This prospective study monitored 27 ambulatory hemodialysis patients for 16 months living in the community in Taiwan. Physical capacity (6-minute walk test, grip strength, pinch strength and chair-rising time), maximal cardiovascular fitness test, functional performance (Functional Independence Measure) and quality of life (WHOQOL-BREF) were evaluated., Results: There were 17 men and 7 women, with a mean age of 61.3 (+/- 9.0) years. The results showed significantly decreased pinch strength (right hand: from 6.4 kg to 4.5 kg, p=0.009; left hand: from 5.6 kg to 4.7 kg, p=0.017) and decreased quality of life (from 89.5 to 85.3 for WHOQOL-BREF total score, p=0.026), especially in the domain of physical health and subcategories of concentrating ability, satisfaction with working ability and sex life, and "eating foods whenever wanted," over the 16-month period. Maximal cardiovascular fitness and functional performance remained stationary during the 16-month period., Conclusion: Significantly declined pinch strength and quality of life, with maintained maximal cardiovascular fitness and functional performance, were noted in ambulatory hemodialysis patients over the 16-month period of follow-up. An intensive pinch strengthening program and overall improvement in quality of life for these patients is needed.