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Purpose: The aim of this study was to investigate the effect of agility ladder training combined with plyometric or multidirection speed drills, on performance in young female volleyball players. Methods: Seventy-six young female volleyball players were randomly distributed into 3 maturity-matched groups: (1) the agility ladder + plyometric drills group, (2) the agility ladder + multidirection speed drills group, and (3) the control group. Both experimental groups followed a 6-week training program, twice weekly, in addition to the regular volleyball training sessions, while the control group participated only in the regular volleyball training sessions. Assessments pretraining and posttraining included countermovement jump, 20-m sprint, and agility T test. Results: Both experimental groups improved T-test performance (P <.005) but only agility ladder + multidirection speed drills group outperformed the control group (P <.05). Conclusions: Agility ladder training programs combined with either plyometric or speed drills can improve change of direction performance in young female volleyball players but only the combination of agility ladder with multidirection speed drills is more effective than volleyball training per se. The small effectiveness of these protocols may be attributed to the short training period, or to the fact that training elements were combined in a single session. This hypothesis remains to be further investigated. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence from globally diverse samples on the prevalence and correlates of meeting the global guideline of 180 minutes per day of total physical activity (TPA) among 3- to 4-year-olds. Methods: Cross-sectional study involving 797 (49.2% girls) 3- to 4-year-olds from 17 middle- and high-income countries who participated in the pilot phases 1 and 2 of the SUNRISE International Study of Movement Behaviours in the Early Years. Daily step count was measured using thigh-worn activPAL accelerometers. Children wore the accelerometers for at least one 24-hour period. Children were categorized as meeting the TPA guideline based on achieving ≥11,500 steps per day. Descriptive analyses were conducted to describe the proportion of meeting the TPA guideline for the overall sample and each of the sociodemographic variables, and 95% CIs were calculated. Multivariable logistic regression was used to determine the sociodemographic correlates of meeting the TPA guideline. Results: Mean daily step count was 10,295 steps per day (SD = 4084). Approximately one-third of the sample (30.9%, 95% CI, 27.6–34.2) met the TPA guideline. The proportion meeting the guideline was significantly lower among girls (adjusted OR [aOR] = 0.70, 95% CI, 0.51–0.96) and 4-year-olds (aOR = 0.50, 95% CI, 0.34–0.75) and higher among rural residents (aOR = 1.78, 95% CI, 1.27–2.49) and those from lower middle-income countries (aOR = 1.35, 95% CI, 0.89–2.04). Conclusions: The findings suggest that a minority of children might meet the TPA guideline globally, and the risk of not meeting the guideline differed by sociodemographic indicators. These findings suggest the need for more surveillance of TPA in young children globally and, possibly, interventions to improve childhood health and development. [ABSTRACT FROM AUTHOR]

The detrimental impact of extreme heat exposure on the health and well-being of children is widely acknowledged. The direct and indirect effects of climate change have led to an increased risk of certain cardiovascular events which may be particularly harmful to children who are born with, or develop, heart disease. Purpose: To highlight the worrying paucity of investigative research aimed at differentiating how higher ambient temperatures further tax an already compromised cardiovascular system in children. Methods: This commentary describes basic thermoregulatory concepts relevant to the healthy pediatric population and summarizes common heart diseases observed in this population. Results: We describe how heat stress and exercise are important factors clinicians should more readily consider when treating children with heart disease. Countermeasures to physical inactivity are suggested for children, parents, clinicians, and policymakers to consider. Conclusions: As sudden, excessive heat exposures continue to impact our rapidly warming world, vulnerable populations like children with underlying heart conditions are at greater heat health risk, especially when coupled with the negative physical activity and fitness trends observed worldwide. [ABSTRACT FROM AUTHOR]

Many consumers are caregivers and, as part of caregiving, frequently make food choices for their dependents. This research examines how food choices made for children influence the healthiness of parents' subsequent self-choices. Whereas prior work focuses on choices for the self (others) as based on self-needs (other-needs), the authors theorize when and why self-choices involve consideration of other-needs. Five studies, including a nursery school field study, test the effect of choosing healthy food for a child on the healthiness of parents' self-choices, focusing on the role of anticipating potentially sharing self-choices with one's child. Potential sharing increased parents' likelihood of making an unhealthy subsequent self-choice if they first made a healthy choice for their child. This effect was driven by parents' present-focused parenting concerns about whether one's child would eat and enjoy healthy options chosen for them. This effect was mitigated when parents instead had future-focused parenting concerns. Additionally, this effect was mitigated after making an initial choice for the child that was (1) unhealthy or (2) healthy but relatively liked by the child. This research contributes to understanding how choices for others shape choices for the self and offers important marketing and policy implications. [ABSTRACT FROM AUTHOR]

Background: This study examined the after-school activities of Japanese elementary school children in which little information is available for understanding the process by which participation in organized activities leads to the decrease in children's independent mobility. Methods: One thousand eight hundred and twenty-four mothers of elementary school children participated in an online survey. The mothers responded to the questions on the number of lessons (or cram schools) their children attended weekdays, as well as their children's behavior after classes, and parents providing transportation when their children go out to play. Results: The proportion of children attending lessons and/or cram schools increased as their grades progressed. A significant interaction existed between the degree of parental transportation and grade in terms of whether or not the children attended lessons and/or cram schools. Parental involvement included pick up or drop-off for a large percentage of younger children without lessons, whereas the degree of parental involvement was greater for older children attending lessons. In other words, parents of children without attending lessons or cram schools tended to allow children to engage in independent activities when they reached the higher grades, whereas parents of children who frequently attended lessons and cram schools tended to remain involved in transporting their children, even when they reached the higher grades. Conclusions: The results suggested that the participation of children in organized activities leads to a routine of parental pickup and/or drop-off, which renders difficult the facilitation of opportunities for children to independently participate in play activities. [ABSTRACT FROM AUTHOR]

Background: Around 40% of Australian children do not participate in sport. Cost is a major barrier to participation, particularly for children from low socioeconomic backgrounds. This study aimed to evaluate the uptake of a population-level children's sports subsidy scheme, including sociodemographic differences in uptake. Methods: A state-wide cross-sectional analysis comparing sports voucher claimants (primary school-aged children with a valid Medicare or Australian visa number) from the 2019 financial year with population census data from South Australia. Chi-square was used to examine whether the percentage of eligible children who claimed a voucher differed based on age, sex, socioeconomic status (SES), and geographical remoteness. Subgroup analyses were conducted for the lowest 2 socioeconomic disadvantage deciles, split by gender. Scatterplots were used to compare sports between high and low SES children. Results: A total of 74,668 children claimed sports vouchers (45.5% of eligible children). Children who were relatively younger, female, from low socioeconomic backgrounds, and from major cities were least likely to claim the voucher. The 5 most common sports were Australian rules football (30.2%), netball (13.6%), soccer (13.1%), gymnastics (10.4%), and basketball (5.7%), with the popular sports similar for high and low SES children. Conclusions: Future work is needed to understand how Sports Voucher, and sport participation rates have changed over time, and to improve voucher uptake among girls, city dwellers, and low SES children. [ABSTRACT FROM AUTHOR]

Purpose: This paper aimed to examine moderate-to-vigorous physical activity (MVPA) levels in physical education. Method: A review of reviews was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The screening process, data extraction, assessment of the risk of bias, and analysis of the results were carried out independently by two reviewers. A total of eight systematic reviews from six databases, which included 224 studies, involving more than 80,000 students (elementary, middle, and high school), enrolled in more than 450 schools worldwide were unpacked. Results: Students fail to meet the 50% recommendation of MVPA lesson time, irrespective of country, school stage, gender, or MVPA measures. Physical education-based interventions increased students' MVPA during lessons (range 14.3%–24%) compared with control groups. Conclusion: Physical education is uniquely positioned to provide physical activity opportunities for students, but teachers must target the provision of adequate MVPA levels, which is not currently happening. [ABSTRACT FROM AUTHOR]

The article emphasizes that in order to improve the protection of children's rights during military conflicts and combat domestic violence, to identify facts of domestic violence against children, to improve and unify the forms of collecting, analyzing, summarizing and taking into account statistical data on cases of all forms of violence based on gender and domestic violence and the effectiveness of measures taken in these cases. Domestic violence is one such phenomenon that only worsens in the period of military aggression, while it can remain invisible or have an inadequate level of response from society due to many reasons. The problem of domestic violence is not new. This is especially true for children and teenagers. However, just as before the war, so now, children who are witnesses of domestic violence are not always recognized as victims. They are recognized as victims only if physical violence was directly directed against the child. Which, after all, a child who has witnessed domestic violence is obviously wrong, because the child who has witnessed domestic violence has at least already been harmed, in particular to his mental health. Different statistical forms in the subjects of prevention and counteraction to domestic violence, as well as their failure to take into account the features of today's global challenges, make it impossible to qualitatively analyze data on the effectiveness of the system of prevention and counteraction to domestic violence / gender-based violence and lead to a lack of comprehensive scientific research on the impact of the pandemic and war on the situation of domestic violence / gender-based violence. At the same time, it is important to take into account in statistical forms vulnerable categories of affected persons, such as women, children, persons with disabilities, for the purpose of further analysis of such information and formation of effective assistance programs for such categories of persons based on the received data. [ABSTRACT FROM AUTHOR]

The article analyzes the norms of family legislation of Ukraine regarding the determination of the child’s place of residence in case of divorce. The purpose of the research is to study the process of decision-making by guardianship and guardianship bodies, to evaluate the effectiveness of their activities, which will contribute to ensuring the best interests of the child and equal rights of parents. Particular attention is paid to determining the role of guardianship and care authorities in this process. It has been established that their participation is possible in two forms: 1) resolution by the body of guardianship and custody of the dispute on the determination of the child’s place of residence; 2) provision of a written opinion of the body of guardianship and guardianship during the consideration of cases by the court on the determination of the child’s place of residence. It has been proven that the role of guardianship and guardianship authorities in determining the place of residence of a child is significant, as they are involved in the event of a lack of consensus between parents regarding the residence of a minor child. The process of decision-making by guardianship and guardianship bodies is characterized. The main stages in solving the issue of determining the child’s place of residence with the participation of the guardianship and guardianship authorities are highlighted: 1. Appeal to the parents’ guardianship and guardianship authorities. 2. Conducting by guardianship and care authorities a conversation with the parents and drawing up a certificate of examination of the child’s living conditions. 3. Decision-making by guardianship and guardianship bodies is based on the analysis of conditions and consideration of the child’s opinion and is formed in the form of a conclusion. Important evaluation criteria are the parents’ attitude towards the fulfillment of parental duties, the child’s personal attachment to each parent, the child’s health and other circumstances of significant importance. The main principles that guardianship and guardianship authorities should be guided by when determining a child’s place of residence are analyzed, such as ensuring the best interests of the child and equal rights of parents. Special attention is paid to problematic aspects that arise during decision-making by guardianship and guardianship bodies, which include the establishment of the child’s true psycho-emotional state by a psychologist, ensuring the child’s appearance in court or the guardianship body and custody at a permanent pre-war place of residence. [ABSTRACT FROM AUTHOR]

Background: LHX3 is a gene encoding a LIM-homeodomain transcription factor important for the fetal development of several organs, such as the pituitary gland, spinal motor neurons and the inner ear. Pathogenic and likely pathogenic variants in the LHX3 gene are infrequent and result in a rare syndrome known as combined pituitary hormone deficiency-3, CPHD3. Methods: We have studied hearing and vestibular functions in a group of eight individuals, aged 8–36 years, all of whom were homozygous for a specific variant in the LHX3 gene at chromosome 9q34. We reexamined the results of consecutive hearing tests from newborn until April 2024. Results: Our data showed that all the tested patients had progressive sensorineural hearing deficiency ranging from moderately severe to complete loss. We have performed vestibular testing in six patients and, for the first time, demonstrated that a mutation in the LHX3 gene not only affects hearing, but is also associated with vestibular impairment. Conclusion: The human pathogenic variant c.455-2A > G in the LHX3 gene on chromosome 9q34, which present as a founder mutation in the population in northern Sweden, is responsible for phenotypes associated with progressive hearing loss and balance impairment. These findings prove that the LHX3 gene is crucial for the function of both the cochlear and vestibular organs. [ABSTRACT FROM AUTHOR]

This review aimed to determine whether photobiomodulation therapy (PBMT) is a safe and effective alternative for treating and preventing OM in children. The database search was carried out on PubMed, Embase, and Cochrane. Gray literature was also consulted through Google Scholar. Among 20 studies included, no adverse effect was reported, and only one study did not show any evidence of benefit from the use of PBMT. The analgesic effect of PBMT was emphasized and its action in accelerating the healing process and reducing the severity, duration and even incidence of OM was also noted. Evidence was found to encourage the use of PBMT to treat OM in pediatric patients. Higher quality studies must be developed in order to clarify the PBMT prophylactic effect and the best protocols for each clinical situation. The protocol of this review was registered on PROSPERO (CRD42023418109). [ABSTRACT FROM AUTHOR]

Purpose: There is some evidence that trace element and mineral deficiencies may promote the occurrence of febrile seizures. However, the role of these elements in the occurrence of complex seizures in children with FS has not been comprehensively investigated. The present study was conducted to evaluate this issue. Methods: In a cross-sectional study, 220 patients including 110 febrile and 110 FS children aged 6–60 months were studied. Blood samples were taken and serum zinc, potassium, sodium, magnesium and calcium levels were measured. Demographic and clinical characteristics were also recorded. Results: The patients were similar in age and sex. Higher serum zinc levels decreased the risk of seizure (RR = 0.95, p-value = 0.0001) and complex seizure (OR = 0.96, p-value = 0.03). Higher serum sodium levels decreased the risk of complex seizures (OR = 0.85, p-value = 0.023). Higher serum potassium levels were associated with a lower risk of seizure (OR = 0.55, p-value = 0.035). Serum calcium and magnesium levels were not associated with the risk of seizure and complex seizure. A BMI at the upper end of the normal range decreased the risk of complex seizures (OR = 0.83, p-value = 0.05). Male sex increased the risk of complex seizure (OR = 4.14, p-value = 0.016). Conclusions: Low serum levels of zinc, potassium and sodium are risk factors for seizure and complex seizure in febrile children. Male sex is also a risk factor for complex seizures. The time from fever to seizure was shorter in younger children. Children with a BMI at the upper end of the normal range have a lower risk of having a complex seizure. [ABSTRACT FROM AUTHOR]

Background: Streptococcus pyogenes is a common gram-positive bacterium, belonging to group A Streptococcus (GAS), and is responsible for causing a range of clinical conditions. Brain abscess caused by GAS is uncommon in pediatric infectious diseases, and GAS brain abscess without acute infectious symptoms has been rarely reported. Case presentation: We present a case of one GAS brain abscess in a previously healthy child with unusual clinical manifestations of decreased muscle strength in the left limbs. The right frontal lobe mass lesion was resected using a microscope-based neuronavigation system. A sole defectively beta-hemolytic Streptococcus pyogenes was isolated from the lesion. The patient's peripheral blood whole-exome and the pathogen's whole-genome sequencing were performed respectively, revealing a heterozygous mutation in the interferon regulatory factor-8 (IRF8) gene in the patient and lack of hyaluronic acid capsules in Streptococcus pyogenes (genotype emm22). The patient eventually recovered after prompt surgical drainage of the abscess and appropriate antibiotic treatment. Conclusions: It is important to pay attention to Streptococcus pyogenes brain abscesses with mild clinical manifestations. Upon reviewing all the cases of pediatric GAS brain abscess reported in the published literature, we discovered that early diagnosis and treatment are crucial factors that impact the prognosis of GAS brain abscess. [ABSTRACT FROM AUTHOR]

This review aimed to determine whether photobiomodulation therapy (PBMT) is a safe and effective alternative for treating and preventing OM in children. The database search was carried out on PubMed, Embase, and Cochrane. Gray literature was also consulted through Google Scholar. Among 20 studies included, no adverse effect was reported, and only one study did not show any evidence of benefit from the use of PBMT. The analgesic effect of PBMT was emphasized and its action in accelerating the healing process and reducing the severity, duration and even incidence of OM was also noted. Evidence was found to encourage the use of PBMT to treat OM in pediatric patients. Higher quality studies must be developed in order to clarify the PBMT prophylactic effect and the best protocols for each clinical situation. The protocol of this review was registered on PROSPERO (CRD42023418109). [ABSTRACT FROM AUTHOR]

Introduction: Children diagnosed with endocrine disorders may exhibit atypical development and may encounter challenges in language, academic, and cognitive skills, as well as social–emotional issues. The objective of this study was to identify potential therapeutic requirements in the areas of language, cognition, and mathematical skills among children with endocrine disorders who experience school failure. This will enable an early evaluation of speech and language disorders and the planning of interventions to be possible. Methods: In this study, children with endocrine disorders were compared with their normally developing peers in terms of language, cognition, mathematical skills, and psychosocial characteristics. In this study, 15 children diagnosed with endocrine disorders (8 females, 7 males; mean age: 10, SD: 2) and 15 children with normal development (8 females, 7 males; mean age: 10, SD: 2) participated. The participants were subjected to the Test of Language Development-Primary: Fourth Edition Turkish Revision (TOLDP-4:T), the Turkish Nonword Repetition Test (TNRT), the Turkish Multilingual Sentence Repetition Test (LITMUS-TR), the Wechsler Intelligence Scale for Children (WISC-R), the Problem-Solving Test (PST), the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), the Coopersmith Self-Esteem Inventory (CSEI), and the Child Behavior Checklist (CBCL). Results: The findings of the study indicate that children with endocrine disease have lower performance in language, cognition, and mathematical skills compared to their healthy peers. Otherwise, they do not differ in terms of social–emotional status assessed by psychological scales. Discussion: These findings suggest that while children with endocrine disorders face challenges in academic and cognitive domains, their social-emotional development remains relatively unaffected. Early identification and intervention in language, cognition, and mathematical skills may help address the academic struggles of these children, potentially improving their school performance and overall well-being. [ABSTRACT FROM AUTHOR]

Introduction: Current evidence suggests that early maladaptive schemas are affected in attention deficit hyperactivity disorder (ADHD). Most of the studies on the subject have been conducted with adults, but the number of studies conducted with adolescents with ADHD is quite limited. The aim of this study was to evaluate early maladaptive schemas in adolescents diagnosed with ADHD. Methods: The study included 66 patients diagnosed with ADHD and 70 healthy adolescents who were similar to the case group in terms of age and gender. Clinical evaluation of the case and control groups were performed with "The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (K-SADS-PL-DSM-5-T)". "Conners-Wells Adolescent Self-Report Scale - Revised Short Form (CASS-RS)" and "Set of Early Maladaptive Schema Questionnaires for Children and Adolescents between the ages of 10-16" were administered to all participants. Results: It was determined that the schema scores of "dependence/incompetence", "vulnerability to harm or illness", "entitlement/grandiosity", "insufficient self-control", "subjugation" were significantly higher in the ADHD group than in the control group. A negative, significant relationship was found between age and "enmeshment/undeveloped self", "entitlement/grandiosity" and "insufficient self-control" schema scores. There was no significant difference between schema scores in terms of gender in the ADHD group. Additionally, no significant relationship was found between the education level of the parents, family income levels and schema scores. A significant positive relationship was found between the CASS-RS scores and all schema scores. As a result of the regression analysis, it was determined that CASS-RS scores positively predicted all schema scores, while the age variable negatively predicted only the schema scores of "enmeshment/undeveloped self". Discussion: Results of this study showed that there were significant differences in adolescents in the ADHD group compared to the control group in terms of early maladaptive schemas, and that ADHD symptom levels was associated with early maladaptive schemas. [ABSTRACT FROM AUTHOR]

Introduction: Suicide in children is a significant and unacceptable global phenomenon. This paper provides a descriptive overview of the children presenting in the first five years (2016-2021) of the implementation of the Zero Suicide Framework (ZSF) and Suicide Prevention Pathway (SPP) at a Child and Youth Mental Health Service in Queensland, Australia. Methods: Basic demographic variables (sex, age, socioeconomic status), and changes in presentations over time, are presented for 1,048 children. Completeness of selected SPP components relating to care planning and universal interventions are examined as an indicator of fidelity to the SPP model of care. The paper then focuses on the cohort of children who received care through the SPP in 2020, describing their demographic characteristics and baseline clinical scores. Result: There was an increase in admissions each year and children presented with a diverse range of clinical needs. The SPP greatly increased the provision of first line interventions for patients. Discussion: A standardized approach to suicide prevention improves consistency in management. These findings may inform the use of the ZSF/SPP in child mental health settings globally. [ABSTRACT FROM AUTHOR]

Background: Malaria is a major cause of ill health and death in children in Africa. The disease also imposes a severe social and economic burden on households and health systems and is strongly associated with poverty. This study summarizes the most up-to-date cost of treating severe malaria in children in Africa. Methods: A systematic search was conducted in PubMed, Embase, Cinahl, and Web of Science databases. Google and Google Scholar were searched for grey literature followed by scanning of the reference lists of the previous systematic reviews. The search was limited to children < 12 years, malaria-endemic countries in Africa, and the English language. All costs were adjusted to the year 2023. Results: 19 studies conducted in 12 countries were identified: 14 reported provider costs, and 11 household costs. Out of the 19 studies found, 11 were published before 2018 while 11 reported data that are currently more than ten years old. Studies varied methodologically and in the scope of resources included to estimate the cost. The provider costs ranged from USD 27 in Uganda to USD 165 per patient in Kenya (median value USD 90), while household costs ranged from USD 13 in Kenya to USD 245 per patient in Gabon (median value USD 50). All identified household malaria treatment costs except one represented catastrophic health expenditure, making out more than 10% of the monthly Gross National Income per capita in the respective countries. Conclusion: Evidence on the cost of treating severe malaria in children in Africa is scarce. However, the few existing studies show that severe malaria in children imposes a significant economic burden on the providers and households. More studies are needed, particularly in high-burden high-impact countries, to inform resource allocation decisions. [ABSTRACT FROM AUTHOR]

Background: The outcomes of recent advancements in pediatric tracheostomy remain unclear. This study was conducted to identify the trends in pediatric tracheostomy in Taiwan. Methods: This population-based survey was conducted using data from Taiwan's National Health Insurance Research Database. We identified inpatients younger than 18 years who had undergone tracheostomy in Taiwan between 2000 and 2019. The study period was divided into subperiods (2000-2004, 2005-2009, 2010-2014, and 2015-2019). We analyzed patient characteristics and trends related to age, gender, hospital level, surgical indications, hospital stay duration, and mortality rates. The trends were analyzed for all pediatric patients (age <18 years) and infants (age <1 year). Results: This study included 2465 pediatric patients (mean age: 8.7 ± 6.9 years; boys: 64%). The incidence of pediatric tracheostomy decreased from 3.3 events per 100,000 individuals in 2000 to 2.1 events per 100,000 individuals in 2019 (P for trend <.001). The proportion of infants who received tracheostomy increased from 22.8% in 2000-2004 to 32.5% in 2015-2019 (P for trend =.06). The proportion of pediatric patients who received tracheostomy at medical centers increased and those at regional hospitals or district hospitals decreased (74.7%-81.0% vs 25.3%-19.0%, P for trend =.003). The proportion of pediatric patients with trauma or brain injury as a surgical indication decreased from 36.6% to 28.7% (P for trend =.001). The duration of intensive care unit (ICU) stays increased from 30 days in 2000-2004 to 50 days in 2015-2019 (P for trend <.001), and that of hospital stay increased from 58 days in 2000-2004 to 71 days in 2015-2019 (P for trend =.001). The 5-year mortality rate slightly decreased from 38.0% in 2000-2004 to 33.3% in 2005-2009 and 31.0% in 2010-2014 (P for trend =.006). Conclusions: Our findings revealed that during the study period, the number of pediatric patients receiving tracheostomy decreased, but the proportion of infants receiving tracheostomy increased. The trends in pediatric tracheostomy indicated extended ICU stay, prolonged hospital stay, and reduced 5-year mortality rates. [ABSTRACT FROM AUTHOR]

Background: Malnutrition remains a significant concern in many societies. This study systematically reviewed the effects of probiotics, prebiotics, and synbiotics on anthropometric measures in malnourished children, focusing on changes in weight, height, and respiratory infections (primary outcomes), and head circumference, hemoglobin, hematocrit, and body mass index (BMI) as secondary outcomes. Methods: This systematic review and meta-analysis involved searching various databases in both Persian and English, including Scopus, Web of Science Core Collection, Cochrane Library, Science Direct, and PubMed up to October 5, 2024. Non-randomized controlled trials (RCTs) were excluded. The Cochrane Handbook Risk of Bias Version 2 tool was used to assess risk of bias, and RevMan 5.3 software was employed for analysis. Subgroup analyses were conducted based on the type of supplement received. Meta-regression was applied to identify factors influencing results, and the GRADE approach was used to evaluate evidence certainty. Results: Twelve studies with a total of 3,086 children (aged up to 6 years, equally distributed between boys and girls) were included. All children were malnourished without underlying illnesses. Limitations of the study included variations in intervention type, dose, duration, and timing of outcome measurement. Meta-analysis revealed that probiotics, prebiotics, and synbiotics may increase weight (6 trials, mean difference: 0.33 kg, 95% CI: 0.15 to 0.50, low certainty of evidence), while probiotics and synbiotics may increase height compared to control groups (5 trials, mean difference: 0.44 cm, 95% CI: 0.02 to 0.85, low certainty of evidence). However, probiotics and synbiotics did not show a statistically significant effect on lower respiratory tract infections (5 trials, risk ratio: 0.84, 95% CI: 0.68 to 1.04, moderate certainty of evidence). Meta-regression indicated that intervention type, sample size, and follow-up duration were not significant moderators for outcomes related to weight, height, or respiratory infections. Conclusion: The current evidence suggests that probiotics, prebiotics, and synbiotics supplements may help manage malnutrition-related outcomes in malnourished children, but further research with stronger study designs is needed to confirm these findings due to the low certainty of evidence. [ABSTRACT FROM AUTHOR]

Introduction: An examination of preschool children's perceptions and attitudes towards the environment and forests has recently been conducted. However, little research has focused on preschool children's and their parents' perceptions of clean and dirty forests. Investigating these perceptions is essential to increase children's interest in and sensitivity to the environment, thereby fostering their development as responsible individuals who protect the natural world. Methods: This study aimed to address this knowledge gap by examining the perceptions of clean and dirty forests held by 40 5–6-year-old students and 40 parents, randomly selected from two preschools: one attended by children from high socioeconomic families and the other by children from low socioeconomic families, in a Mediterranean coastal city in southwestern Turkey. A semi-structured questionnaire was used to collect sociodemographic information and perceptions of clean and dirty forests. Additionally, drawing sheets were distributed to the students to illustrate their concepts of clean and dirty forests. Results: The results indicated that individuals with higher educational levels had more complex and conscious perceptions of clean forests. Children considered abstract concepts, such as supernatural forces and fossil fuels, while parents focused on awareness and conservation status. Conversely, parents and children with lower levels of education tended to concentrate on more concrete and everyday factors, such as litter and natural disasters. Individuals with higher socioeconomic status generally associated forest cleanliness with conscious behaviors and conservation, whereas those with lower socioeconomic status linked it more with polluting factors. Discussion: This investigation provides valuable insights into the management and control of local forests by incorporating the perspectives of children and their parents, promoting responsible and sustainable tourism practices. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Childhood is considered crucial in the establishment of future oral microbiota. However, the precise period of oral microbiota development remains unclear. This study aimed to identify the progression of oral microbiota formation in children. We longitudinally investigated the salivary microbiota of 54 children across 13 time points from 1 wk to 60 mo (5 y) old and their parents at 2 time points as a representative sample of the adult microbiota. Using next-generation sequencing, we obtained 10,000 gene sequences of the 16s rRNA V1-V2 region for each sample. The detection rate in children of 110 operational taxonomic units commonly detected in more than 85% of mothers and fathers, defined as the main constituent bacteria, was 25% at 1 wk old, increased to 80% between 6 and 18 mo old, and reached approximately 90% by 36 mo old. Early main constituent bacteria detected at 1 wk old were limited to Streptococcus, Rothia, and Gemella. At 6 to 18 mo old, the detection rates of various main constituent bacteria, including Neisseria, Haemophilus, and Fusobacterium, increased. UniFrac distance analysis showed that the oral microbiota of children approached that of adults at 6 to 18 mo old. In the weighted UniFrac distance index, unlike the unweighted index, there were no significant changes in children between 36 and 60 mo old from adults, and microbiota formation at 60 mo old was sufficiently advanced to be included within the range of adult individual differences. Our findings suggest that the initial 36 mo, particularly the period from 6 to 18 mo old, consists of a time window for oral microbiota maturation. In addition, the development of microbiota during this period may be critical for future oral disease prevention. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to establish and characterize patient-derived intestinal organoids (PDOs) from children with Crohn's disease (CD). Methods: To generate PDOs, endoscopic biopsy specimens were obtained from non-inflamed duodenal bulbs of normal controls and CD patients. To verify the presence of PDOs, histological staining and quantitative reverse transcription polymerase chain reaction (RTqPCR) analyses were performed. Results: PDOs were successfully established in normal controls (n=2) and CD patients (n=2). Hematoxylin and eosin staining of formalin-fixed, paraffin-embedded PDO sections revealed crypt and villus structures, whereas immunofluorescence staining with EpCAM and DAPI confirmed the epithelial-specific architecture of the PDOs. RT-qPCR results revealed a significant increase in Lgr5, Si, and Chga gene expression and a decrease in Olfm4 and Muc2 expression in CD patients compared to normal controls, suggesting altered stem cell activity and mucosal barrier function ( p<0.05). Conclusion: We successfully established and characterized PDOs in children with CD, providing a valuable tool for understanding the pathophysiology of the disease and evaluating potential therapeutic approaches. The differential gene expression of PDOs in CD patients might be caused by the complex interplay between epithelial adaptation and inflammation in the intestinal epithelium. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa. Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA. The frequency of IL-7RαlowCX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn's disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn's disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001). Conclusion: Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7RαlowCX3CR1+ and integrin α4β7+ CD4+ T T cells might be highly associated with the pathogenesis of ulcerative colitis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Disruptive, Impulse-Control, and Conduct disorders (DIC) affect 5 million children in the United States and often require comprehensive and long-term behavioral health care for which sustained parental involvement is essential. Our research team is developing an intervention to improve parental engagement in the behavioral health care of their children with DIC. The intervention, which will be a modification of an evidence-based shared decision-making intervention called DECIDE, will include a parent component and a provider component. AIM : To determine the acceptability of the provider component of the modified DECIDE intervention. METHODS : The provider intervention is an asynchronous self-paced online training program made up of five modules: introduction, shared decision-making, perspective-taking, attributional errors, and being a responsive provider. The training was piloted with 41 providers in two public child and adolescent treatment programs. Following completion of the training, semi-structured interviews were conducted with the providers to assess the acceptability of the training. The interviews were analyzed with conventional content analysis. RESULTS : The provider training was well received by providers, and many had made practice changes based on what they had learned. Several offered recommendations for improvement, most notably the need to tailor the training based on provider role, discipline, and level of expertise. CONCLUSIONS : The feedback given by providers will be used to refine future iterations of the provider training component of the modified DECIDE intervention. Psychiatric nurses and other clinicians may draw from strategies incorporated in the training program to improve parent engagement in the treatment of children with DIC. [ABSTRACT FROM AUTHOR]

Background: Pro- and anti-inflammatory cytokines help regulate the inflammatory response. A cytokine storm is a dysregulated cytokine response associated with sepsis and other conditions that result in a hyper-inflammatory state. Extracorporeal cytokine adsorption has the potential to restore a balanced inflammatory response. Hemoperfusion with CytoSorb® (CS) appears to be a short-term mode of treatment of sepsis in both adults and children. Objective: We present a case series of eight critically ill children involving the use of hemoperfusion with CS at the University Medical Center Ljubljana to treat clinically manifested cytokine storm. Results: In our preliminary experience, it was applied without complication in five children weighing more than 10 kg, who all survived. The effect of age on complications regarding CS treatment is unclear, yet in our case series, all three patients weighing less than 10 kg died of their disease. Conclusions: In our preliminary experience, cytokine adsorption with CS remains a potential adjunctive treatment for cytokine storm in critically ill children. [ABSTRACT FROM AUTHOR]

Congenital myasthenic syndromes (CMS) are clinically and genetically heterogeneous diseases caused by mutations affecting neuromuscular transmission. Even if the first symptoms mainly occur during childhood, adult neurologists must confront this challenging diagnosis and manage these patients throughout their adulthood. However, long-term follow-up data from large cohorts of CMS patients are lacking, and the long-term prognosis of these patients is largely unknown. We report the clinical features, diagnostic difficulties, and long-term prognosis of a French nationwide cohort of 235 adult patients with genetically confirmed CMS followed in 23 specialized neuromuscular centres. Data were retrospectively analysed. Of the 235 patients, 123 were female (52.3%). The diagnosis was made in adulthood in 139 patients, 110 of whom presented their first symptoms before the age of 18. Mean follow-up time between first symptoms and last visit was 34 years [standard deviation (SD) = 15.1]. Pathogenic variants were found in 19 disease-related genes. CHRNE -low expressor variants were the most common (23.8%), followed by variants in DOK7 (18.7%) and RAPSN (14%). Genotypes were clustered into four groups according to the initial presentation: ocular group (CHRNE -LE, CHRND , FCCMS), distal group (SCCMS), limb-girdle group (RAPSN , COLQ , DOK7 , GMPPB , GFPT1), and a variable-phenotype group (MUSK , AGRN). The phenotypical features of CMS did not change throughout life. Only four genotypes had a proportion of patients requiring intensive care unit admission that exceeded 20%: RAPSN (54.8%), MUSK (50%), DOK7 (38.6%) and AGRN (25.0%). In RAPSN and MUSK patients most ICU admissions occurred before age 18 years and in DOK7 and AGRN patients at or after 18 years of age. Different patterns of disease course (stability, improvement and progressive worsening) may succeed one another in the same patient throughout life, particularly in AGRN, DOK7 and COLQ. At the last visit, 55% of SCCMS and 36.3% of DOK7 patients required ventilation; 36.3% of DOK7 patients, 25% of GMPPB patients and 20% of GFPT1 patients were wheelchair-bound; most of the patients who were both wheelchair-bound and ventilated were DOK7 patients. Six patients died in this cohort. The positive impact of therapy was striking, even in severely affected patients. In conclusion, even if motor and/or respiratory deterioration could occur in patients with initially moderate disease, particularly in DOK7 , SCCMS and GFPT1 patients, the long-term prognosis for most CMS patients was favourable, with neither ventilation nor wheelchair needed at last visit. CHRNE -LE patients did not worsen during adulthood and RAPSN patients, often severely affected in early childhood, subsequently improved. [ABSTRACT FROM AUTHOR]

Objective: Pediatric posterior fossa tumors pose diagnostic challenges due to their diverse histopathological features and variable clinical presentations. Conventional magnetic resonance imaging (MRI) serves as the initial diagnostic tool; however, additional modalities, such as diffusion-weighted imaging (DWI), are essential for refining tumor classification. This retrospective single-center study aimed to evaluate the diagnostic utility of apparent diffusion coefficient (ADC) parameters in distinguishing between the most common pediatric posterior fossa tumors. Materials and Methods: Fifty-nine patients under the age of 18 (27 females and 32 males) with histopathologically diagnosed primary posterior fossa tumors underwent pre-treatment conventional and diffusion MRI. Apparent diffusion coefficient values were measured from solid tumor regions and normal cerebellar parenchyma, with subsequent calculation of tumor/normal cerebellar ADC ratios. Results: The median ADC values for pilocytic astrocytomas (PAs) were 1786.2 ×10−6 mm² /s, ependymomas 1144.9 × 10−6 mm² /s, and for medulloblastomas 666.1 × 10−6 mm2 /s were significantly different (P < .001 for all three). Similarly, the median ADC ratios demonstrated discriminatory potential, with PAs showing the highest ratio (2.46), followed by ependymomas (1.55) and medulloblastomas (0.89) (P < .001 for all three). Receiver operating characteristic analysis revealed distinct ADC cutoffs and ratios for differentiating all tumor types from each other. Conclusion: Despite limitations, such as a small cohort size and different MRI protocols, our results show that ADC metrics are especially useful for distinguishing between the most common pediatric posterior fossa tumors. We recommend that future studies integrate advanced imaging techniques and larger cohorts to improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Objective: Atropa belladonna, known as the deadly nightshade, is one of the most poisonous plants in the world. Deadly nightshade poisoning in both children and adults has been rarely reported and is mostly in the form of case reports. The aim of this study was to illuminate the findings of weed poisoning in childhood. Materials and Methods: Clinical and laboratory findings of 54 children with acute deadly nightshade and other weed poisoning followed in our center between January 2010 and January 2022, were retrospectively reviewed. Results: In the study analyzing 54 children admitted to the pediatric intensive care unit for poisoning, 24 cases (44.4%) were attributed to deadly nightshade, with the remaining cases involving other weed poisonings. The most common symptoms were flushing, vomiting, mydriasis, gibberish, dry mouth, and tachycardia. Three patients required mechanical ventilation. No patient was dead. Patients were categorized into 2 groups: mild/moderate (no encephalopathy, n : 46) and severe poisoning (with encephalopathy, n : 8). The severe poisoning group had a higher incidence of urinary retention, incoherent speech, dry mouth, agitation, lethargy, convulsions, and coma, which led to longer intensive care unit (ICU) stays and an increased need for respiratory support (P < .05). Furthermore, a statistically significant difference was observed between deadly nightshade poisoning and other weed poisonings, particularly in the presence of symptoms such as headache, flushing, mydriasis, incoherent speech, encephalopathy, convulsions, and coma, all of which contributed to extended ICU stays and elevated respiratory support requirements (P < .05). Notably, neostigmine was administered in all cases of deadly nightshade poisoning due to the unavailability of physostigmine. Our findings showed that the first signs and symptoms of acute deadly nightshade and other weed poisoning may be severe in some children, but no death was observed. Meaningless speech, mydriasis, coma, and lachrymation were negative prognostic signs in childhood weed poisoning. We believe that neostigmine may be an alternative for deadly nightshade poisoning in cases when physostigmine is unavailable. Conclusions: Our study highlights the severity of poisonings involving deadly nightshade and other weeds in pediatric patients. Despite the significant clinical manifestations observed, no fatalities were recorded. The findings underscore the importance of early recognition and appropriate management, emphasizing the need for heightened awareness among healthcare professionals and caregivers. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the utility of laboratory ultrasonographic and Doppler ultrasonographic findings in the differentiation of simple and complicated appendicitis. Methods: A prospective study was conducted, including pediatric patients who underwent surgery with the diagnosis of appendicitis. Results: Fifty patients, who were found to have appendicitis on ultrasonographic examination, were included. The mean age was found to be 12.80 ± 3.67 years, with 30% female and 70% male. The patients were histopathologically divided into two groups: simple appendicitis (Group 1, 41 patients, 82%) and complicated appendicitis (Group 2, 9 patients, 18%). CRP (C‐reactive protein) levels (p = 0.004) and periappendiceal fatty tissue thickness (PFI) (p < 0.005) were found to be statistically significantly higher in Group 2 compared to Group 1. The portal vein (PV) diameter and peak systolic velocity (PSV) values were significantly higher in the study group compared to the control group (p = 0.033, p = 0.001). Conclusion: Doppler ultrasonographic examination did not significantly differentiate complicated from simple appendicitis. The CRP value is an independent risk factor in the diagnosis of complicated appendicitis, and the presence of a significant increase in mesenteric tissue thickness is one of the important criteria for differentiating complicated appendicitis from simple appendicitis. [ABSTRACT FROM AUTHOR]

Objective: To describe the experience of implementing social robotics as an adjuvant during the hospitalization process in pediatric oncology patients. Methods: Before and after cohort study, applying an intervention with the Lego Mindstorms EV3 kit in patients between 8 and 17 years old that are hospitalized with a cancer diagnosis. We excluded patients from the intensive care unit or when their treating physician recommended so. The intervention consisted of a three-phase workshop: an open architecture story, building a car robot using the Lego Mindstorm EV3 kit, and cooperative playing activities such as races and passing obstacles. Results: Thirteen patients received the intervention with robotic lego. The median age was 15 years (IQR = 3), and 84.6% of the population (n = 11) were male. We found significant improvement in the language (topic management p =.011 and communicative intention p =.034). Other characteristics improved, but not significantly (self-care activities index, catching). No adverse events occurred during the intervention. Conclusions: The results of this pilot study suggest that implementing social robotics during hospitalization in children with cancer is a therapeutic adjuvant and safe intervention that promotes better communication, self-care, and a physical activity improvement. For future studies, the impact of this intervention could be measured in hospitalized pediatric cancer patients. [ABSTRACT FROM AUTHOR]

Objective: To compare efficacy of proximal and distal laparoscopic ureteroureterostomy (UU) for complete duplex kidneys in children. Methods: Patients who underwent laparoscopic UU for complete duplex kidneys between December 2016 and July 2022 were reviewed retrospectively. 71 patients who had normal lower pole moiety without vesicoureteral reflux (VUR) were recruited. All of them underwent ultrasound, voiding cystourethrography (VCUG), renal scintigraphy, and magnetic resonance urography preoperatively. Proximal laparoscopic UU was performed in 35 patients and distal laparoscopic UU in 36 patients. Double J stents were placed in normal lower pole moieties. Clinical data, including general information, diagnosis, surgical management, imaging characteristics, clinical symptoms and postoperative complications (classified according to the modified Clavien–Dindo classification), and length of stay were recorded. Measurement date comparisons between groups were performed by t test, counting date were analyzed by chi-square test. Results: The study consisted of 71 patients (56 females and 15 males) with complete duplex kidneys (41 in left kidney and 30 in right kidney). The patients' mean age was 34 m (range 3–161 m) and follow-up ranged from 25 to 81 m. No significant difference was found in age and follow-up time between the two groups. Laparoscopic UU was performed in all patients successfully. The operation time of the two groups was 108.42 ± 26.95 min for distal UU vs 121.46 ± 35.15 min for proximal UU(p = 0.14). No significant difference in postoperative complications was seen between the two groups (22.2% vs 31.4%, p = 0.345). However, in terms of the grading of postoperative complications, the proximal UU group had a higher grade (3 of them had a grade of IV) and more serious complications. Conclusions: There was no significant difference in the overall incidence of complications between distal and proximal UU. Compared with proximal laparoscopic UU, distal laparoscopic UU is easier to perform with less injury to the peripheral tissues. Postoperative complications of proximal UU are more serious and more difficult to manage. We recommend complete duplex kidney ureteral reconstruction with distal UU. [ABSTRACT FROM AUTHOR]

During Ukraine's independence, the state has consistently taken measures to shape, implement, and strengthen policies in the field of protecting the rights and freedoms of children. The article provides a criminal-law characterization of domestic violence against children. Emphasizing that human life and health, honor and dignity, inviolability and safety are recognized in Ukraine as the highest social value (part 1 of Article 3 of the Constitution of Ukraine), and the rights and freedoms of individuals and their guarantees determine the content and direction of the state's activity, and the assertion and protection of the rights and freedoms of individuals are the main duty of the state (part 2 of Article 3 of the Constitution of Ukraine), it can be confidently stated that the object of domestic violence is an absolute value, and encroachments on it have a socially dangerous nature. Ukrainian criminal legislation protects social relations involving children or in their interests, with the aim of providing criminal-law means to create conditions for the normal physical, mental, and moral-spiritual development of the child. The unlawfulness of parents' actions is mostly associated with their child-rearing and stems from contradictions between the upbringing process in the actions of parents and permissible actions in legal norms. The nature of the family upbringing process requires formulating the issue of using physical force against the will of the child not as permissible but as a necessary measure. It is emphasized that physical punishments are recognized as violence based on the presence of signs of actions against the will of the child and those that degrade dignity based on causing harm to the feeling of one's own dignity. The resolution of the issue of applying force to a child as a method of upbringing is based on recognizing the child as an absolutely autonomous subject, which contradicts the existing partial legal capacity and parental responsibility. [ABSTRACT FROM AUTHOR]

Background: Because of controversial results from clinical studies comparing different dental local anesthesia methods in children, the primary objective of this randomized, split‐mouth, crossover, controlled trial was to compare pain intensity during local anaesthesia (LA) performed with a computer‐controlled LA delivery system (C‐CLADS) versus a conventional syringe (CONV). Secondary objectives included comparisons during dental treatment. Methods: Participants (4–8 years) with tooth pair requiring similar treatment were recruited from five French hospitals. The right primary molar, which was treated at the first visit, was randomly allocated to one of the anaesthesia groups (either intraosseous with C‐CLADS or infiltration with CONV), whereas the contralateral molar (treated at the second visit) was assigned to the other group. Pain intensity and behaviour outcomes, assessed with the Faces Pain and Venham revised scales, respectively, were compared between groups using Proc mixed. Stratified analyses were performed on dentition and location. Results: Among 107 participants, the analysis revealed reduced pain perception during LA in the C‐CLADS group compared with the CONV group (−0.72, 95% CI: −1.43, −0.006), but not during dental treatment. Stratified analyses showed that this effect was observed only in primary dentition (p =.006) and mandibular molars (p =.005). Behavioural issues were fewer in the C‐CLADS group than in the CONV group (p =.05) only during injection. Conclusion: C‐CLADS emerged as the preferable system in primary dentition. [ABSTRACT FROM AUTHOR]

There is emerging evidence of the detrimental impact of the pandemic and associated restrictions on young people's mental health in the UK, but to date, these data have been largely quantitative. The aim of the current study was to gain a deeper understanding of young people's experiences in relation to their mental health and wellbeing during the pandemic. Seventeen young people, aged 11 to 16 years, sampled for diverse characteristics, and living in the UK, were interviewed virtually between December 2020 and February 2021. Reflexive thematic analysis was carried out by the research team, which included two young people, and five themes were developed: (1) positives; (2) worries and anxiety; (3) sadness and anger about losses; (4) mental exhaustion; and (5) support from others. Aspects of young people's individual circumstances (e.g., pre-existing mental health difficulties, special educational needs, and neurodevelopmental disorders) appeared to play a role in their experiences. Continued measurement of young people's mental health, initiatives to identify young people who have been struggling, and the provision of support (including evidence-based and accessible interventions) will be important for protecting young people from future adversities as we emerge from the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: This work aimed to establish the largest UK and Ireland consensus on myopia management in children and young people (CYP). Methods: A modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management. Results: Two rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non‐commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first‐line treatments. The role and provision of low‐concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low‐concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non‐cycloplegic axial length 6 monthly. Conclusion: Research is needed to identify those at risk of progression, the long‐term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant. [ABSTRACT FROM AUTHOR]

Aim: To explore how overcrowding affects children's health, environment and schooling. Methods: A qualitative study was conducted with individual interviews among 20 participants with occupational experience from overcrowded Stockholm areas but diverse in professions, locations and employers. The interviews were recorded, transcribed and analysed with Systematic Text Condensation. Results: Almost all participants expressed that overcrowding has a negative impact on children's health, environment and schooling – based on perceptions of precarious and different living conditions for children in overcrowded areas, for example, substandard homes, vulnerability, stress, exclusion, limited resources, lack of learning opportunities, gender differences, confinement, shame, insecurity, conflicts, risk of criminality, and bodily impact, both physical and psychological. Conclusions: Our qualitative evidence suggest that overcrowding has a negative impact on children's health, environment and schooling. [ABSTRACT FROM AUTHOR]

Extracorporeal membrane oxygenation (ECMO) support of critically ill pediatric patients is associated with increased risk of thromboembolic events, and unfractionated heparin is used commonly for anticoagulation. Given reports of acquired antithrombin (AT) deficiency in this patient population and associated concern for heparin resistance, AT activity measurement and off‐label AT replacement have become common in pediatric ECMO centers despite limited optimal dosing regimens. We conducted a retrospective cohort study of pediatric ECMO patients (0 to <18 years) at a single academic center to characterize the pharmacokinetics (PK) of human plasma‐derived AT. We demonstrated that a two‐compartment turnover model appropriately described the PK of AT, and the parameter estimates for clearance, central volume, intercompartmental clearance, peripheral volume, and basal AT input under non‐ECMO conditions were 0.338 dL/h/70 kg, 38.5 dL/70 kg, 1.16 dL/h/70 kg, 40.0 dL/70 kg, and 30.4 units/h/70 kg, respectively. Also, ECMO could reduce bioavailable AT by 50% resulting in 2‐fold increase of clearance and volume of distribution. To prevent AT activity from falling below predetermined thresholds of 50% activity in neonates and 80% activity in older infants and children, we proposed potential replacement regimens for each age group, accompanied by therapeutic drug monitoring. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to interpret plasma renin concentrations (PRCs) correctly in a clinical setting, it is essential to understand to what extent physical activity influences the concentration. Reference values for different postural positions exist for adults, but data for children are sparse. In this study, the effect of 30 min of rest on plasma renin concentrations in paediatric patients was examined. Methods: In total, 41 paediatric patients, undergoing either arginine or clonidine provocation tests for growth hormone deficiency, were included. For each stimulation test, two blood samples were drawn. One at time 0 min and one after 30 min of rest. In total, renin concentrations were determined in 86 serum samples. Results: Renin concentrations decreased from 0 to 30 min with a median value of −20.5% (inter‐quartile range: −33.0% to −12.8%). This decrease was not dependent on sex, age, medication or comorbidity, and the variance of renin did not differ between 0 and 30 min. Conclusion: Renin concentrations in children differ according to postural position, which is comparable to adults. Thus, the clinical interpretation of renin results needs to consider the preanalytical conditions applied in the local reference population. [ABSTRACT FROM AUTHOR]

Background: Oral sensory hypersensitivity has been linked with fussy eating predominantly in non-typically developing children. We hypothesized that child 'Oral' (touch, smell and taste in the mouth) and 'Social-Emotional' (response to social expectations) sensory processing are associated with child appetitive traits in typically developing preteen children. Additionally, we explored relationships between maternal sensory profiles and their offspring's sensory profile. Methods: This is secondary analysis of 130 mother-child dyads from the 9–11-year-old follow-up of the ROLO longitudinal birth cohort study. The Dunn Sensory Profile (Adolescent/Adult) and the Dunn Child Sensory Profile 2 were used to assess maternal and child sensory profiles, respectively. The Children's Eating Behaviour Questionnaire was used to assess child appetitive traits. Multiple linear regression examined associations between 'Oral' and 'Social-Emotional' segments of the child sensory profile and child appetitive traits. Associations between maternal and child sensory profiles were examined using sensory profile quadrants (Dunn's sensory processing framework). These refer to four distinct patterns of sensory processing that indicate how an individual responds to sensory input. Results: In total, 130 mother-child dyads were included. In adjusted analysis child 'Oral' sensory processing was associated with higher mean scores in the appetitive traits 'Desire to Drink' (B = 0.044, 95% CI = 0.025,0.062) and 'Food Fussiness' (B = 0.080, 95% CI = 0.059,0.101) and with lower mean scores in 'Enjoyment of Food' (B=-0.038, 95% CI -0.055,-0.022). Child 'Social-Emotional' responses were associated with higher mean scores in 'Desire to Drink' and 'Food Fussiness'. Higher scores in the maternal sensory profile quadrants of 'Sensitivity', 'Avoiding' and 'Registration' were positively associated with higher scores in the corresponding child sensory profile quadrants. Conclusion: Our findings suggest that in typically developing children presenting with fussy eating, oral sensory hypersensitivity and higher scores in social-emotional responses to sensory processing may be an underlying determinant. The relationship observed between 'Oral' and 'Social-Emotional' sensory processing segments and 'Desire to Drink' requires further research to ascertain the type of drinks being consumed and how this impacts appetite. Further research is also required to explore the influence of maternal sensory profile on their offsprings response to sensory input. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD. Methods: A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression. Results: Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721). Conclusion: Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD. [ABSTRACT FROM AUTHOR]

This systematic review evaluated accuracy of ureteric jet angles on color Doppler sonography in diagnosing vesico‐ureteric reflux (VUR) in children, using voiding cystourethrogram as the reference standard. Six databases were searched, yielding 13 eligible studies of an initial 429, 7 with comparable data. Risk of bias and applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS‐2) tool. Most studies demonstrated a correlation between increasing jet angle and VUR severity, but reporting and techniques varied, preventing meta‐analysis. Ureteric jet angle sonography may have potential as a VUR triaging tool. Further investigations with rigorous methodology are required. Funding support was obtained from Queensland University of Technology. PROSPERO Registration CRD42020159799. [ABSTRACT FROM AUTHOR]

Introduction: In addition to seizure care, it has been well-established that a holistic approach to the treatment of children with epilepsy that addresses the social, behavioral, and psychological dimensions also benefits their quality of life (QoL). The aim of this study was to investigate the patient and parental perceived stigma, seizure self-efficacy of children with epilepsy, and the relationship with quality of life in terms of sociodemographic and epilepsy-related factors. Method: The study group consisted of children, aged between 8 and 18 years and with a diagnosis of epilepsy of at least six months duration and their parents. Pediatric Quality of Life Inventory (PedsQL), Child-Parent Stigma Scales, and the Seizure Self-Efficacy Scale for Children (SSES-C) were used for evaluation. Results: One hundred and forty-four children (mean age 12.6 ± 2.9 years) took part, of whom 48.6% were female. The mean Child Stigma Scale score was 1.77 ± 0.82, Parent Stigma Scale score 2.41 ± 0.75, SSES-C score was 3.37 ± 0.98, and PedsQL score was 72.8 ± 18.6 for children self-reports (CsR) and 73.2 ± 18.8 for parent proxy-reports. The intraclass correlation coefficient for parent–child PedsQL indicated a good level of agreement. There was a significant negative correlation between the Child Stigma Scale and the PedsQL-CsR scores. A significant positive correlation was identified between the SSES-C scores and the PedsQL-CsR scores. Discussion: Perceptions of stigma in children with epilepsy and their parents were high in this study population. Of note, the elevated stigma perception reported by the patients had a detrimental impact on seizure self-efficacy. This relationship may affect the children's QoL and further complicates epilepsy management in this patient group. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to enhance the understanding of diastematomyelia, with a particular focus on adult-onset cases, which are infrequent and not fully elucidated. Additionally, the study sought to analyse the clinical features, diagnostic characteristics, and surgical interventions employed to manage the condition. This retrospective case series aimed to investigate diastematomyelia, a rare congenital deformation affecting the spinal cord. The study included 16 patients diagnosed with diastematomyelia, consisting of 13 pediatric cases (mean age: 7.6 years, age range: 5 months to 13 years) and 3 adult cases (mean age: 36 years, age range: 26 to 48 years). Among the paediatric cases, 9 were females, and 4 were males, while the adult cohort comprised 2 males and 1 female. The study design involved a thorough review of medical records, imaging reports, and surgical outcomes without specific inclusion or exclusion criteria. Surgical intervention emerged as the primary treatment modality for all cases, except one. Following surgical intervention, significant improvements were observed in pain management, motor function, and bladder control. Furthermore, additional findings indicated the presence of Dural Ectasia and Vertebral segmentation defects among the study population. This retrospective case series sheds light on the clinical features and surgical outcomes of diastematomyelia in both pediatric and adult patients. The findings underscore the importance of surgical intervention in alleviating symptoms and enhancing motor coordination and bladder control. [ABSTRACT FROM AUTHOR]

Aim: To examine the long‐term results and treatment effectiveness of liver transplantation (LT) in the treatment of homozygous familial hypercholesterolemia (HoFH) in children and adolescents. Method: Patients who underwent LT due to HoFH between 2007 and 2023 were included in the study. The patients' demographic data, clinical findings, preoperative and postoperative laboratory examinations, transplantation complications, and postoperative disease courses were evaluated. Results: There were five boys with an average age of 6.2 (median: 6, range 4–10) years in the study. The average total cholesterol level of the patients before transplantation was 923 (median: 950, range: 780–1002) mg/dL and the average LDL‐cholesterol level was 864 (median: 852, range: 770–957) mg/dL. No patients died of transplant‐related complications. After an average follow‐up of 9.2 (median: 9, range: 1.5–16) years, the average total cholesterol level of the patients was 197 (median: 164, range: 137–359) mg/dL, and the average LDL‐cholesterol level was 138 (median: 92, range: 85–313) mg/dL. Four (80%) patients developed atherosclerotic cardiovascular disease during follow‐up, and two (40%) died of this cause. Conclusion: LT in the treatment of HoFH did not help our patients reach the target LDL‐cholesterol level after transplantation and did not prevent the development of cardiovascular disease. Therefore, LT alone is not curative in the treatment of HoFH. [ABSTRACT FROM AUTHOR]

Background: The survival of pediatric chronic kidney disease (CKD) patients has improved in recent decades due to advances in dialysis and transplantation. However, cardiovascular disease (CVD) emerges as the main cause of mortality in patients with CKD. Objectives: To estimate cardiovascular risk in children with CKD at least 1 year after kidney transplantation. In addition, the possible association of cardiovascular risk with classic biochemical markers and potential new markers of this outcome was investigated. Methods: An observational ambidirectional (retrospective capture of risk factors and prospective study of outcomes) research including 75 patients who underwent renal transplant between 2003 and 2013 with postoperative follow‐up of at least 1 year was conducted. The outcome variables adopted were the LV mass Z‐score and the presence of coronary calcification on computed tomography using calcium Agatston score. Result: Only one patient had an elevated calcium score, and three children (4%) had an LV mass Z‐score ≥ 2.0. After multivariable analysis, only gender, serum triglyceride, and serum renalase concentration remained significantly associated with LV mass. Conclusion: The low incidence of cardiovascular changes in the population studied confirms the benefit of transplantation for the cardiovascular health of children. Nevertheless, long‐term follow‐up of these patients is recommended, given the limited duration of kidney function provided by transplantation and the high likelihood of further dialysis and kidney transplants being required in these children. [ABSTRACT FROM AUTHOR]

Purpose: An observational study of children with severe traumatic brain injury (TBI) (Approaches and Decisions in Acute Pediatric TBI [ADAPT] Trial) demonstrated the benefits of inpatient rehabilitation on functional outcomes for those with more severely impaired consciousness when medically stable. We conducted a secondary analysis to assess whether using an inpatient rehabilitation or skilled nursing facility after acute hospitalization was associated with better motor, neuropsychological, and behavioral outcomes compared to receiving only non-inpatient rehabilitation among children with severe TBI. Materials and methods: We included 180 children who used an inpatient rehabilitation or skilled nursing facility and 74 children who only received non-inpatient rehabilitation from the ADAPT trial. At 12 months post-injury, children underwent tests of motor skills, intellectual functioning, verbal learning, memory, processing speed, and cognitive flexibility. Parents/guardians rated children's executive function and behaviors. We performed inverse probability weighting to adjust for potential confounders. Results: No significant differences were found in any motor, neuropsychological, or behavioral measures between children receiving inpatient rehabilitation and children receiving only non-inpatient rehabilitation. Conclusions: Analyses of comprehensive outcomes did not show differences between children receiving inpatient rehabilitation and children receiving only non-inpatient rehabilitation, suggesting a need for more research on specific components of the rehabilitation process. IMPLICATIONS FOR REHABILITATION: Our study showed no differences in motor, neuropsychological, or behavioral outcomes at 12 months after severe traumatic brain injury (TBI) between children using an inpatient rehabilitation or skilled nursing facility and children receiving only non-inpatient rehabilitation after acute hospitalization. Children surviving severe TBI should be evaluated for the need of inpatient and outpatient rehabilitation therapies at discharge from an acute care hospital. Children with rehabilitation requirements after severe TBI should be followed up periodically to ensure the continuity of care and reduce the gaps to the needed rehabilitation therapies. [ABSTRACT FROM AUTHOR]

Objectives: To survey, analyze and discuss the scientific evidence supporting the use of acupuncture and related techniques in the management of chronic pain in the pediatric population. Sources: A survey of databases (MEDLINE, Scopus and Scielo) was carried out with search strategies, following the PRISMA statement, without limits on publication dates and languages. Clinical studies (clinical trials, single-arm, and case series) were accepted for review if they included participants aged up to 22 years. Study quality was assessed by MMAT, and the randomized clinical trial was analyzed under the STRICTA criteria. Summary of the findings: 2369 articles were retrieved. After excluding repetitions, 1335 underwent the initial selection. Only 16 articles were selected for full reading, of which 5 were included in the review, being two case series, two single-arm studies, and one randomized clinical trial. The articles were considered of good quality by the adopted criteria. Conclusion: The analyzed studies showed important clinical results such as the reduction of pain intensity, and improvement in school attendance and social life. However, there are many limitations in study design and sample size. Therefore, there is weak evidence to support the use of acupuncture in the context of pediatric chronic pain, but the positive results reinforce the need for further investigation of the topic with the conduct of larger and well-designed studies, to obtain more data and greater scientific conviction of the findings. [ABSTRACT FROM AUTHOR]