CNS Structural Anomalies in Iranian Children with Global Developmental Delay

How to Cite This Article: Zamani GH, Shervin Badv R, Niksirat A, Alizadeh H. CNS Structural Anomalies in Iranian Children with Global Developmental Delay. Iran J Child Neurol. 2013 Winter; 7 (1):25-28. ObjectiveCentral Nervous system (CNS) malformations are one of the most important causes of global developmental delay (GDD) in Children. About one percent of infants with GDD have an inherited metabolic disorder and 3-10 percent have a chromosomal disorder. This study aimed to survey the frequency of brain structural anomalies and their subtypes among the variety of etiologic factors in children with GDD in our patients.Materials & MethodsThis study used the results of neuroimaging studies [unenhanced brain Magnetic Resonance Imaging (MRI)] of all children who had been referred for evaluation of GDD to outpatient Clinic of Pediatric neurology at Children’s Medical Center affiliated to Tehran University of Medical Science between September 2009 and September 2010.ResultsIn this study, unenhanced brain MRI was performed on 405 children, of which80 cases (20 percent) had brain structural anomalies. In 8.7 percent of the cases, previous history of brain structural disorders existed in other children of the family and 20 percent of mothers had inadequate consumption of folate during pregnancy.ConclusionBased on the results of this study, unenhanced cranial MRI seems to be a fundamental part of evaluation in all children with GDD. Adequate folate consumption as prophylaxis as well as genetic counseling can be worthy for high-risk mothers who have previous history of CNS anomaly or miscarriage to avoid repeated CNS anomalies in their next pregnancies. References1. Fenichel M. Clinical Pediatric Neurology: A Signs and Symptoms Approach. 6th ed. Philadelphia: Saunders; 2009. p. 119-52.2. A guide to investigation of children with developmental delay in East Anglia 2005Available from:http://www. phgfoundation.org/file/2366.3. Williams J. Global developmental delay–globally helpful? Dev Med Child Neurol 2010;52(3):227.4. Shevell M, Ashwal S, Donley D, Flint J, Gingold M, Hirtz D, et al. Practice parameter: Evaluation of the child with global developmental delay: Report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society. Neurology 2003;60(3):367-80.5. Whiting K. Investigating the child with learning difficulty.Current Pediatrics 2001;11(4):240-7.6. Aicardi J. The etiology of developmental delay. Semin Pediatr Neurol 1998;5(1):15-20.7. Von Wendt L, Rantakallio P. Congenital malformations of the central nervous system in a 1-year birth cohort followed to the age of 14 years. Childs Nerv Syst.1986;2(2):80-2.8. Kuzniecky R, Murro A, King D, Morawetz R, Smith J, Powers R, et al. Magnetic resonance imaging in childhood intractable partial epilepsy: Pathologic correlations. Neurology1993;43:681-7.9. Massimi L, Paternoster G, Fasano T, et al: On the changing epidemiology of hydrocephalus. Childs Nerv Syst. 2009;25(7):795-800.10. Warkany J, Lemire RJ, Cohen Jr MM. Mental retardation and congenital malformations of the central nervous system. Chicago: Year Book Medical Publishers; 1981.11. Petrini J, Damus K, Johnston RB Jr. An overview of infant mortality and birth defects in the United States. Teratology. 1997;56(1-2):8-10.12. Rosano A, Botto LD, Botting B, Mastroiacovo P. Infant mortality and congenital anomalies from 1950 to 1994: an international perspective. J Epidemiol Community Health 2000; 54(9):660-6.13. Cordero JF. Finding the causes of birth defects. The New England Journal of Medicine. 1994;331(1):48-9.14. Srour M, Mazer B, Shevell MI. Analysis of Clinical Features Predicting Etiologic Yield in the Assessment of Global    Developmental    Delay.Pediatrics    2006 ;118(1):139-45.15. Meral O, Burak T, Nur A. Etiologic evaluation in 247 children with GDD at Istanbul, Turkey. J Trop Pediatr 2005;51(5):310-3.16. World Health Organization. Weekly Iron-Folic Acid Supplementation (WIFS) in women of reproductive age: its role in promoting optimal maternal and child health. Geneva, World Health Organization, 2009. WHO/NMH/ NHD/MNM/09.2. p. 2. 

Examining the role of export competitive advantages on export performance

This paper investigates the role of export competitive advantage on export performance in food industry. The proposed study designs a questionnaire in Likert scale and distributes it among 280 randomly selected experts in food industry and Cronbach alpha has been calculated as 0.827. The study has applied factor analysis to find important factors influencing export performance. Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett's Test of Sphericity have been performed to validate the results and they both validated the questionnaire. The results of the survey have determined six effective groups including product development, e-commerce, marketing planning, organizational performance, competitiveness and supply chain management

Western Fires are Burning Higher in the Mountains at Unprecedented Rates: It’s a Clear Sign of Climate Change

The Western U.S. appears headed for another dangerous fire season, and a new study shows that even high mountain areas once considered too wet to burn are at increasing risk as the climate warms. Nearly two-thirds of the U.S. West is in severe to exceptional drought right now, including large parts of the Rocky Mountains, Cascades and Sierra Nevada. The situation is so severe that the Colorado River basin is on the verge of its first official water shortage declaration, and forecasts suggest another hot, dry summer is on the way. Warm and dry conditions like these are a recipe for wildfire disaster

The Role of Urban Agriculture Approach in Food Supply and Export Ability (Case Study of Neishabour in Iran)

The growth of cities and the increase of urban population in recent years has caused many problems for the health of the environment and citizens. On the other hand, given that urbanism is inevitable, we must think of ways to reduce the pressure on nature by cities and improve economic and social indicators in cities. Urban agriculture will play an effective role in establishing a logical relationship between urban needs and improving the economic situation. In this research, the study of the role of urban agriculture from an economic point of view, especially in the field of food supply and export ability has been emphasized. The research method is descriptive-analytical and based on collecting survey data (field). The main research tool is a questionnaire. Its validity was confirmed by elites and its reliability was confirmed by completing 30 questionnaires through Cronbach's alpha at a level greater than 0.70. The study population was 264,375 citizens living in Neishabour. The sample size was determined by Cochran's formula equal to 384 people. The results showed that urban agriculture is significant in food supply and export ability at a level of less than 0.05. The city's agriculture can be effective in improving the export of organic products, fruits and vegetables, exports of ornamental and medicinal plants, branding of products, as well as in supplying fresh vegetables, providing healthy food, improving the quality of nutrition and protein. Urban agriculture has a significant level of less than 0.05 in urban development indicators such as improving the urban environment, improving employment, improving citizens' incomes, creating attractive urban spaces, rainwater consumption, etc. From the people's point of view, it is possible to cultivate crops such as peaches, Damask rose, poultry breeding, etc., according to the available spaces. The study of the role of urban agriculture through structural equations shows that the total effect is 0.81 and in total urban agriculture can explain about 56% of the variance of role-playing and two variables of meeting food needs and export ability

Managing computational complexity through using partitioning, approximation and coordination

Problem: Complex systems are composed of many interdependent subsystems with a level of complexity that exceeds the ability of a single designer. One way to address this problem is to partition the complex design problem into smaller, more manageable design tasks that can be handled by multiple design teams. Partitioning-based design methods are decision support tools that provide mathematical foundations, and computational methods to create such design processes. Managing the interdependency among these subsystems is crucial and a successful design process should meet the requirements of the whole system which needs coordinating the solutions for all the partitions after all. Approach: Partitioning and coordination should be performed to break down the system into subproblems, solve them and put these solutions together to come up with the ultimate system design. These two tasks of partitioning-coordinating are computationally demanding. Most of the proposed approaches are either computationally very expensive or applicable to only a narrow class of problems. These approaches also use exact methods and eliminate the uncertainty. To manage the computational complexity and uncertainty, we approximate each subproblem after partitioning the whole system. In engineering design, one way to approximate the reality is using surrogate models (SM) to replace the functions which are computationally expensive to solve. This task also is added to the proposed computational framework. Also, to automate the whole process, creating a knowledge-based reusable template for each of these three steps is required. Therefore, in this dissertation, we first partition/decompose the complex system, then, we approximate the subproblem of each partition. Afterwards, we apply coordination methods to guide the solutions of the partitions toward the ultimate integrated system design. Validation: The partitioning-approximation-coordination design approach is validated using the validation square approach that consists of theoretical and empirical validation. Empirical validation of the design architecture is carried out using two industry-driven problems namely the a hot rod rolling problem’, ‘a dam network design problem’, ‘a crime prediction problem’ and ‘a green supply chain design problem’. Specific sub-problems are formulated within these problem domains to address various research questions identified in this dissertation. Contributions: The contributions from the dissertation are categorized into new knowledge in five research domains: • Creating an approach to building an ensemble of surrogate models when the data is limited – when the data is limited, replacing computationally expensive simulations with accurate, low-dimensional, and rapid surrogates is very important but non-trivial. Therefore, a cross-validation-based ensemble modeling approach is proposed. • Using temporal and spatial analysis to manage the uncertainties - when the data is time-based (for example, in meteorological data analysis) and when we are dealing with geographical data (for example, in geographical information systems data analysis), instead of feature-based data analysis time series analysis and spatial statistics are required, respectively. Therefore, when the simulations are for time and space-based data, surrogate models need to be time and space-based. In surrogate modeling, there is a gap in time and space-based models which we address in this dissertation. We created, applied and evaluated the effectiveness of these models for a dam network planning and a crime prediction problem. • Removing assumptions regarding the demand distributions in green supply chain networks – in the existent literature for supply chain network design, there are always assumptions about the distribution of the demand. We remove this assumption in the partition-approximate-compose of the green supply chain design problem. • Creating new knowledge by proposing a coordination approach for a partitioned and approximated network design. A green supply chain under online (pull economy) and in-person (push economy) shopping channels is designed to demonstrate the utility of the proposed approach

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