Childhood Obesity, Hypothalamic Inflammation, and the Onset of Puberty: A Narrative Review.

The onset of puberty, which is under the control of the hypothalamic-pituitary-gonadal (HPG) axis, is influenced by various factors, including obesity, which has been associated with the earlier onset of puberty. Obesity-induced hypothalamic inflammation may cause premature activation of gonadotropin-releasing hormone (GnRH) neurons, resulting in the development of precocious or early puberty. Mechanisms involving phoenixin action and hypothalamic microglial cells are implicated. Furthermore, obesity induces structural and cellular brain alterations, disrupting metabolic regulation. Imaging studies reveal neuroinflammatory changes in obese individuals, impacting pubertal timing. Magnetic resonance spectroscopy enables the assessment of the brain's neurochemical composition by measuring key metabolites, highlighting potential pathways involved in neurological changes associated with obesity. In this article, we present evidence indicating a potential association among obesity, hypothalamic inflammation, and precocious puberty.

Alterations in Appetite-Regulating Hormones in Girls with Central Early or Precocious Puberty.

The prevalence of central precocious puberty (CPP) in girls has increased worldwide and is often associated with obesity in childhood as well as high fat/high glycemic index diets. Evidence suggests that subjects with obesity present with alterations in appetite-regulating hormones. The arcuate and paraventricular nuclei of the hypothalamus are the centers of action of appetite hormones, as well as the location of gonadotropin-releasing hormone (GnRH) neurons, the activation of which results in the onset of puberty. This anatomical proximity raises the question of possible alterations in appetite-regulating hormones in patients with CPP. Furthermore, diet-induced hypothalamic inflammation constitutes a probable mechanism of the pathophysiology of CPP, as well as alterations in appetite-regulating hormones in young children. In this article, we summarize the evidence investigating whether girls with CPP present with alterations in appetite-regulating hormones. We present evidence that leptin concentrations are elevated in girls with CPP, ghrelin concentrations are lower in girls with CPP, nesfatin-1 and orexin-A concentrations are elevated among girls with premature thelarche, and insulin concentrations are increased in girls with early menarche.

Video-Based Eye Blink Identification and Classification.

Blink detection and classification can provide a very useful clinical indicator, because of its relation with many neurological and ophthalmological conditions. In this work, we propose a system that automatically detects and classifies blinks as "complete" or "incomplete" in high resolution image sequences zoomed into the participants' face, acquired during clinical examination using near-Infrared illumination. This method utilizes state-of-the-art (DeepLabv3+) deep learning encoder-decoder neural architecture -DLED to segment iris and eyelid in both eyes in the acquired images. The sequence of the segmented frames is post-processed to calculate the distance between the eyelids of each eye (palpebral fissure height) and the corresponding iris diameter. These quantities are temporally filtered and their fraction is subject to adaptive thresholding to identify blinks and determine their type, independently for each eye. The proposed system was tested on 15 participants, each with one video of 4 to 10 minutes. Several metrics of blink detection and classification accuracy were calculated against the ground truth, which was generated by three (3) independent experts, whose conflicts were resolved by a senior expert. Results show that the proposed system achieved F1-score 95.3% and 80.9% for the classification of complete and incomplete blinks respectively, collectively for all 15 participants, outperforming all 3 experts. The proposed system was proven robust in handling unexpected participant movements and actions, as well as glare and reflections from the spectacles, or face obstruction by facemasks.