Percentile curves provide valuable information on developmental course and age-specific variability of sleep duration for the health care professional who deals with sleep problems in pediatric practice.

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Timed performance in specific motor tasks is an essential component of a neurological examination applied to children with motor dysfunctions. This article provides centile curves describing normal developmental course and interindividual variation of timed performances of non-disabled children from 5 to 18 years. In a cross-sectional study (n=662) the following motor tasks were investigated: repetitive finger movements, hand and foot movements, alternating hand and foot movements, sequential finger movements, pegboard, and dynamic and static balance. Intraobserver, interobserver, and test-retest reliability for timed measurements were moderate to high. Timed performances improved throughout the entire prepubertal period, but differed among various motor tasks with respect to increase in speed and when the 'adolescent plateau' was reached. Centile curves of timed performance displayed large interindividual variation for all motor tasks. At no age were clinically relevant sex differences noted, nor did socioeconomic status significantly correlate with timed performance. Our results demonstrate that timed motor performances between 5 and 18 years are characterized by a long-lasting developmental change and a large interindividual variation. Therefore, a well standardized test instrument, and age-specific standards for motor performances are necessary preconditions for a reliable assessment of motor competence in school-age children.

Treatment, and even more so, care of children with Type I (insulin-dependent) diabetes mellitus is a difficult and demanding task for parents as well as for health professionals. Aiming for good metabolic control is often hindered by the dynamics of the disease, an insufficiency of insulin therapy, the impossibility of an exact control of carbohydrate intake and the irregularities of daily life. The knowledge of the risk of long-term vascular complications and the permanent uncertainty of threatening hypoglycaemia as an immediate complication, is a great burden for the responsible paediatric diabetologist and thus narrows his or her therapeutic possibilities.There is now clear evidence that poor long-term metabolic control is the crucial factor for developing late vascular complications [1 ± 3]. In addition, there is growing evidence that the quality of metabolic control even during pre-pubertal years greatly influences Diabetologia (2002) Abstract Aims/hypothesis. Good metabolic control in diabetic children is already crucial before puberty to prevent diabetic complications later in life. However, tight metabolic control could increase the risk of severe hypoglycaemia, which might be responsible for impaired intellectual performance later in life. The purpose of this prospective longitudinal study was to evaluate the relevance of long-term metabolic control and hypoglycaemia possibly affecting the intellectual development of young children with Type I (insulin-dependent) diabetes mellitus.Methods. The intellectual development in 64 diabetic children between the ages of 7 and 16 years was assessed at least four times using the German version of the Hamburg Wechsler intelligence scale for preschool children, Children-Revised and by the ªAdap-tives Intelligenz Diagnostikumº (Adaptive Intelligence Diagnosticum). Data were analysed longitudinally compared with a control group.Results. A significant decline in performance by age 7 and in verbal intelligence quotient between age 7 and 16 years was observed in diabetic boys diagnosed before the age of 6 but not in those diagnosed later and not in diabetic girls. The deterioration of intellectual performance in boys diagnosed at a very young age was not associated with the occurrence of severe hypoglycaemic episodes but was correlated with the degree of metabolic deterioration at diagnosis and with high long-term average of glycated haemoglobin. Conclusion/interpretation. Our study in diabetic children shows that the male sex, diagnosis at a young age, metabolic condition at diagnosis and long-term metabolic control, rather than experienced hypoglycaemic attacks are risk factors for intellectual development. [Diabetologia (2002) 45: 108±114]

Bed sharing and nocturnal wakings are common during early childhood. Developmental changes in separation-attachment processes, cognitive capabilities to develop self-recognition and nighttime fears, and motor locomotion may contribute to the particular age trend of night wakings and bed sharing during early childhood.

Height growth velocity curves between 4.5 and 17.75 years were estimated, using smoothing spline functions, for 112 boys and 110 girls from the Zurich Longitudinal Study (1955--1976). Parameters characterizing the growth process, such as peak height velocity and age at peak height velocity, were calculated directly from the estimated curves. The variability of parameters describing the adolescent growth spurt is large, both between and within sexes. Peak height, defined as increase of height velocity during the growth spurt, and age at peak height velocity both characterize the sex difference in growth in a highly significant manner. Peak height of at least 4 cm/year is found in 70% of the boys, but in only 11% of the girls. The age at peak height velocity averages 12.2 years in girls and 13.9 years in boys and has a wide range of 5.7 years and 3.8 years respectively. The sex difference in adult height of 12.6 cm is composed of the following 4 factors: +1.6 cm caused by more prepubertal growth in boys, +6.4 cm by the boys' delay in spurt, +6.0 cm by the more extensive spurt in boys and -1.4 cm by more post-spurt growth in girls. Correlations between parameters indicate that the adult height depends neither on the duration of growth, nor on the duration and height of the peak. Minimal pre-spurt height velocity and peak height velocity, but not peak height, are age- and height-dependent. Partial correlations given adult height reveal two compensating mechanisms between growth in the prepubertal and in the pubertal period. Small prepubertal height and low height velocity with respect to adult height are followed by a late adolescent spurt and vice versa. Small height at the onset of the spurt with respect to adult height is followed by a longer lasting, but not higher spurt and vice versa.

Significance Inducing the growth of new blood vessels by specific factors is an attractive strategy to restore blood flow in ischemic tissues. Vascular endothelial growth factor (VEGF) is the master regulator of angiogenesis, yet clinical trials of VEGF gene delivery failed. Major challenges include the need to control the tissue distribution of factor dose and the duration of expression. Here, we developed a highly tunable fibrin-based platform to precisely control the dose and duration of VEGF protein delivery in tissues. Optimized delivery of fibrin-bound VEGF ensured normal, stable, and functional angiogenesis and improved perfusion of ischemic tissues, without genetic modification and with limited duration of VEGF delivery. These findings suggest a strategy to improve both safety and efficacy of therapeutic angiogenesis.

Associated movements (AMs) are the most frequently assessed parameters of movement quality in children with motor dysfunctions. In this article, reference curves of duration and degree of AMs from 5 to 18 years are provided. In a cross-sectional study of non-disabled children (n=662) duration and degree of AMs were estimated at six specific ages while children performed repetitive finger, hand, and foot movements, alternating hand and foot movements, diadochokinesis, sequential finger movements, pegboard, stress gaits, and dynamic balance. Moderate-to-high intraobserver and interobserver reliability for the assessment of AMs were noted. Duration and degree of AMs displayed a non-linear developmental course that was a function of the motor task's complexity. AMs decreased most with age in repetitive movements, less in alternating and sequential movements, and least in the pegboard and dynamic balance. Reference curves demonstrated large interindividual variations for duration and degree of AMs. Both the variable developmental course and large interindividual variation need to be taken into account in the assessment of movement quality of school-age children. In contrast to timed performance, considerable sex differences for AMs were observed.