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Background: Air pollution causes many respiratory disorders, especially in children and the elderly. These disorders include asthma exacerbations, bronchiolitis, and pneumonia. Research on the association between air pollution and respiratory disorders helps to reevaluate environmental policies in developing countries. Methods: This descriptive cross-sectional study was conducted on 932 children with respiratory manifestations admitted from December 2017 to December 2019 at the Emergency Department of Akbar Children's Hospital of Mashhad University of Medical Sciences, Mashhad, Iran. Air pollution indices such as concentration of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matter (PM) smaller than 2.5 and 10 μm and other parameters, including the air quality index (AQI), air temperature, and humidity level from 2017 to 2019, were retrieved from Mashhad Environmental Pollution Monitoring Center. Demographic and clinical data of patients were collected from patients' hospital documents. We used descriptive analytical methods such as central tendency, variability, and frequency distribution to report and analyze demographic and clinical data through tables and diagrams. The association between air pollution indices and respiratory manifestations was examined by the Spearman correlation test. The correlation between the AQI and total hospital admissions and asthma-related hospital admissions was also evaluated by the Spearman correlation test. Results: Hospital admissions due to respiratory manifestations were not associated with the AQI of each month (p-value = 0.794). The concentration of SO2 was correlated with respiratory-related hospital admissions (correlation coefficient = 0.487, p-value = 0.016) but not asthma attacks. Conclusion: Generally, our cross-sectional study showed no statistically considerable association between air pollution and hospital admissions due to respiratory manifestations and asthma attacks in children. Of the air pollution indices, only SO2 concentration was associated with respiratory-related hospital admissions but not asthma attacks. [ABSTRACT FROM AUTHOR]

The field of artificial intelligence (AI) is presently having a substantial influence on the advancement of career counseling education by enabling tailored guidance and evidence-based decision-making for learners. This paper aims to provide an overview about the utilization of AI in Bangladesh's early career planning education. The utilization of AI has already been deployed in many first world country, however this is quite new to the third world country like Bangladesh. Significantly, artificial intelligence (AI) has surpassed its traditional function in professional growth and extended its reach to encompass social and emotional education. The examination of AI studies in Bangladesh requires the careful examination of several elements, such as cognitive advancement, parental engagement and oversight, and cultural heritage. This paper reveals overall all the facets of implementing AI in career planning in context of Bangladesh. Although there are several limits associated with the utilization of artificial intelligence for career assessment, it has undeniably yielded a multitude of benefits and discoveries. In the result, the two areas of data-informed making choices and career exploration are where the phenomena mentioned above are most frequently seen. Additionally, there is a growing need for cultural competency in the educational sector for both the delivery of individualized career counseling and AI-assisted employment suggestions. [ABSTRACT FROM AUTHOR]

Slum areas in Ethiopia have high poverty status. In addition, they possess poor water and sanitation accesses such as unsafe drinking water, a lower number of sanitation facilities and poor hygienic conditions. These scenarios are important in the occurrence of diarrhea among under five children's. However, there are many studies conducted on diarrhea among under five children in Ethiopia, unfortunately, the majority usually didn't give enough coverage for the burden of diarrhea among under five children in slum areas. This study aimed to determine the prevalence of diarrhea and associated factors among under five children in slum areas of Gondar City. This community-based cross-sectional study was conducted in slum areas of Gondar City among under five children from March 28 to April 28, 2023. A multi-stage sampling technique was used to collect a sample of 836 through interview-administered methods using a structured data collection tool. The collected data was manually checked for completeness, coded, and entered into EPI Info version 7.1.5.2 software. It was then exported to Stata version 14.1 software for descriptive analysis, as well as bivariable and multivariable binary logistic regression analyses, to identify factors associated with diarrhea among under five children. The prevalence of diarrhea among under five children at 95% confidence interval was 24.64% (CI 21.71–27.56). Mothers/caretakers age < 25 years (AOR = 1.88, 95% CI 1.16–3.06), mothers/caretakers age between 28 and 31 years (AOR = 1.82, 95% CI 1.08–3.05), mothers/caretakers who had no formal education (AOR = 3.18, 95% CI 1.86–5.41), mothers/caretakers who had primary education (AOR = 1.67, 95% CI 1.09–2.57), income level between 4877 and 5643 Ethiopian Birr (AOR = 1.81, 95% CI 1.04–3.15), family size greater than five (AOR = 1.54, 95% CI 1.00–2.36), flies around the house (AOR = 2.27, 95% CI 1.38–3.73), playground not clean (AOR = 2.70, 95% CI 1.62–4.50), breastfed for ≥ 1 year (AOR = 0.63, 95% CI 0.41–0.97), mothers/caretakers who did not wash their hands before food preparation and eating (AOR = 2.31, 95% CI 1.39–3.58), mothers/caretakers who did not wash their hands after visiting latrine (AOR = 1.60, 95% CI 1.07–2.38) were significantly associated factors with diarrhea among under five children in slum areas of Gondar City. The study indicates that the prevalence of diarrhea was higher among under five children in slum areas of Gondar City. The Gondar City Administration Education Bureau should give great emphasis on improving mother's and caretaker's education. In addition, the Gondar City Administration Health Bureau should educate mothers and caretakers about breastfeeding, sanitation, and hygiene in the slum areas of Gondar City. [ABSTRACT FROM AUTHOR]

Background: Chronic cough in children is a challenging symptom for clinicians. So, we aimed in this study to evaluate the diagnostic role of flexible bronchoscope in differentiating between the underlying causes of chronic wet cough and chronic cough associated with wheeze. Methods: This was a prospective cross-sectional study conducted on children referred to Tanta University Hospitals and Ain-Shams University Hospitals between January 2021 and January 2023, presenting with a primary complaint of chronic cough lasting more than 4 weeks. The children were further classified into two groups: the first group included children with chronic wet cough not associated with wheezing (Cohort A) and the second group included children with chronic cough associated with wheezing (Cohort B). Results: The study enrolled 64 children. During clinical evaluation, 25 (39.1%) children had a chronic cough without wheezing and 39 (60.9%) had a chronic wheezy cough. Bronchoscopic examination findings indicated a notable disparity between the two groups of patients with chronic cough (p=0.006). Among Cohort A patients, the most prevalent bronchoscopic observation was purulent inflammatory secretions in 16 cases (64.0%), followed by congenital airway anomalies in 3 cases (12.0%). Conversely, Cohort B patients exhibited congenital airway anomalies as the primary finding in 14 cases (35.9%), followed by purulent secretions in 7 cases (17.9%). Conclusion: Flexible bronchoscopy is a valuable and safe tool for diagnosing chronic cough in children. It helped differentiate between the underlying causes of chronic cough in children with and without wheezing. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the effect of iron deficiency anemia (IDA) on the severity of symptoms in infants hospitalized for acute bronchiolitis. Methods: This is a case–control study, which was carried out on 80 infants from November 2022 to April 2023. The study involved 60 infants ranging in age from 2 months to 2 years, who were admitted to the Pediatric Pulmonology Unit and met the diagnostic criteria for acute bronchiolitis. Furthermore, a control group of 20 apparently healthy infants was incorporated into the study. Results: This study showed that patients with moderate and severe bronchiolitis exhibited notably reduced levels of hemoglobin, HCT, MCV, MCH, and MCHC. Concerning the iron status, a substantial decrease in serum iron and increase in TIBC in the severe group (P = 0.012, 0.001, respectively). No substantial correlation was detected between the severity of acute bronchiolitis and serum ferritin levels. Hemoglobin and serum iron were found to be independent predictors of the severity of acute bronchiolitis. Conclusions: Infants suffering from IDA exhibit increased vulnerability to acute bronchiolitis. The low levels of hemoglobin and serum iron may function as prognostic indicators for the severity of the condition in infants with acute bronchiolitis. [ABSTRACT FROM AUTHOR]

Background: Describe trends in perpetrator characteristics and firearm use in pediatric homicides across the United States. Methods: Multiply-imputed data from the Federal Bureau of Investigation's 1976–2020 Supplementary Homicide Reports were used to estimate perpetrator characteristics (sex, age, and relationship to victim) and firearm use in pediatric homicides. Descriptive analyses were stratified by victim age group, sex, race, and five-year time periods. Results: Family members were the most common perpetrator of infant and toddler (ages 0–4) and child (ages 5–12) homicides, whereas acquaintances accounted for the majority of adolescent (ages 13–19) homicides. Perpetrator characteristics vary across victim sex and race, particularly among adolescents. Despite overall stability, there were changes in perpetrator characteristics from 1976 to 2020. There was a sustained increase in the proportion of homicides committed with a firearm. In 2016–2020, the proportion of firearm-involved homicides was an all-time high for infant and toddler (14.8%), child (53.1%), and adolescent victims (88.5%). Conclusions: Policy interventions that improve family stability and well-being may be most effective at preventing infant, toddler, and child homicides, whereas programs that target peer and community relationships, as well as policies that focus on firearm access, may be more crucial for preventing adolescent homicides. [ABSTRACT FROM AUTHOR]

Background: Reading problems are the most prevalent type of specific learning disability. Reading problems usually result from phonological deficits; however, it is unclear how much other linguistic abilities are impacted as well. Objective: To study different language parameters and cognitive skills in a group of Egyptian children with reading problems to better understand the difficulties that need to be considered in rehabilitation programs for those children. Methods: A case–control study was conducted on 30 children with reading problems having IQs above 85 and 30 normal control children matched for age and gender (their ages ranged from 7 to 9 years and 11 months). They underwent testing for dyslexia by the Arabic dyslexia assessment test, language evaluation using the Receptive Expressive Arabic Language Scale (REAL scale), and the Stanford-Binet intelligence scale, fifth edition. Results: There were highly significant correlations between the severity of dyslexia and total language scores, most of REAL scale subtests. Also, highly significant correlations were detected between the severity of dyslexia and the total IQ, verbal IQ, and verbal working memory subtests. The linear regression model revealed a highly significant association between dyslexia and expressive language scaled scores, total language scaled scores, and a significant association with expressive vocabulary and understanding oral instructions subtests of REAL scale. Additionally, a highly significant association has been detected between dyslexia and the verbal working memory subtest of the Stanford-Binet test. Correlations between total language scores and intellectual abilities (total IQ, verbal IQ, and non-verbal IQ) revealed highly significant positive results. Conclusion: Deficits in both receptive and expressive language were observed in children with reading problems. Expressive vocabulary, listening comprehension, and verbal working memory subtests are the most affected language and cognitive skills. [ABSTRACT FROM AUTHOR]

High childhood disease prevalence and under-five mortality rates have been consistently reported in Nigeria. Vaccination is a cost-effective preventive strategy against childhood diseases. Therefore, this study aimed to identify the determinants of Incomplete Vaccination (IV) among children aged 12–23 months in Nigeria. This cross-sectional design study utilized the 2018 Nigeria Demographic and Health Survey (NDHS) dataset. A two-stage cluster sampling technique was used to select women of reproductive age who have children (n = 5475) aged 12–23 months. The outcome variable was IV of children against childhood diseases. Data were analyzed using Integrated Nested Laplace Approximation and Bayesian binary regression models (α0.05). Visualization of incomplete vaccination was produced using the ArcGIS software. Children’s mean age was 15.1 ± 3.2 months and the median number of vaccines received was four. Northern regions contributed largely to the IV. The likelihood of IV was lower among women aged 25–34 years (aOR = 0.67, 95% CI = 0.54–0.82, p < 0.05) and 35–49 years (aOR = 0.59, 95%CI = 0.46–0.77, p < 0.05) compared to younger women in the age group 15–24 years. An increasing level of education reduces the risk of odds of IV. Other predictors of IV were delivery at the health facility (aOR = 0.64, 95% CI = 053–0.76, p < 0.05), and media exposure (aOR = 0.63, 95%CI = 0.54–0.79, p < 0.05). Mothers’ characteristics explained most of the variability in the IV, relatively to smaller overall contributions from the community and state-level factors (p < 0.05). The level of IV against childhood diseases was high in Nigeria. However, disparities exist across the regions and other socioeconomic segments of the population. More efforts are required to improve vaccination sensitization programs and campaigns in Nigeria. [ABSTRACT FROM AUTHOR]

The increasing prevalence of myopia worldwide presents a significant public health challenge. A key strategy to combat myopia is with early detection and prediction in children as such examination allows for effective intervention using readily accessible imaging technique. To this end, we introduced DeepMyopia, an artificial intelligence (AI)-enabled decision support system to detect and predict myopia onset and facilitate targeted interventions for children at risk using routine retinal fundus images. Based on deep learning architecture, DeepMyopia had been trained and internally validated on a large cohort of retinal fundus images (n = 1,638,315) and then externally tested on datasets from seven sites in China (n = 22,060). Our results demonstrated robustness of DeepMyopia, with AUCs of 0.908, 0.813, and 0.810 for 1-, 2-, and 3-year myopia onset prediction with the internal test set, and AUCs of 0.796, 0.808, and 0.767 with the external test set. DeepMyopia also effectively stratified children into low- and high-risk groups (p < 0.001) in both test sets. In an emulated randomized controlled trial (eRCT) on the Shanghai outdoor cohort (n = 3303) where DeepMyopia showed effectiveness in myopia prevention compared to NonCyc-based model, with an adjusted relative reduction (ARR) of −17.8%, 95% CI: −29.4%, −6.4%. DeepMyopia-assisted interventions attained quality-adjusted life years (QALYs) of 0.75 (95% CI: 0.53, 1.04) per person and avoided blindness years of 13.54 (95% CI: 9.57, 18.83) per 1 million persons compared to natural lifestyle with no active intervention. Our findings demonstrated DeepMyopia as a reliable and efficient AI-based decision support system for intervention guidance for children. [ABSTRACT FROM AUTHOR]

Background: Thoracotomy is one of the surgical procedures most burdened by chronic post-operative pain. There is poor evidence regarding the possibility that even in pediatric patients, thoracotomy can be followed by post-operative pain. The primary objective of this analysis is to identify associations with home pain therapy, pain intensity, and possible protective factors acting on chronic pain in this population. Methods: A retrospective cross-sectional study was conducted at Ospedale Pediatrico Bambino Gesù IRCCS. The study included pediatric patients undergoing thoracotomy. For statistical analyses, a logistic model and a zero-inflated strategy were implemented to explore associations and predict factors related to home-based analgesic therapy and pain intensity. Results: Gender and age were identified as significant factors in the assignment of home therapy, with males having over seven times the risk compared to females (OR = 7.06, 95% CI = [2.11, 29.7]). At the last measurement, pain intensity was positively associated with age and the number of pain events during the week. Conclusions: The study highlights significant factors influencing post-thoracotomy pain management in pediatric patients. These findings underscore the importance of tailored pain management strategies that consider gender and age to improve post-operative care and outcomes in pediatric thoracotomy patients. [ABSTRACT FROM AUTHOR]

Children in rural communities consume more energy-dense foods relative to their urban peers. Identifying effective interventions for improving energy intake patterns are needed to address these geographic disparities. The primary aim of this study was to harness the benefits of physical activity on children's executive functioning to see if these improvements lead to acute changes in eating behaviors. In a randomized crossover design, 91 preadolescent (8-10y; M age = 9.48 ± 0.85; 50.5% female; 85.7% White, 9.9% Multiracial, 9.9% Hispanic) children (86% rural) completed a 20-minute physical activity condition (moderate intensity walking) and time-matched sedentary condition (reading and/or coloring) ~ 14 days apart. Immediately following each condition, participants completed a behavioral inhibition task and then eating behaviors (total energy intake, relative energy intake, snack intake) were measured during a multi-array buffet test meal. After adjusting for period and order effects, body fat (measured via DXA), and depressive symptoms, participants experienced significant small improvements in their behavioral inhibition following the physical activity versus sedentary condition (p = 0.04, Hedge's g = 0.198). Eating behaviors did not vary by condition, nor did improvements in behavioral inhibition function as a mediator (ps > 0.09). Thus, in preadolescent children, small improvements in behavioral inhibition from physical activity do not produce acute improvements in energy intake. Additional research is needed to clarify whether the duration and/or intensity of physical activity sessions would produce different results in this age group, and whether intervention approaches and corresponding mechanisms of change vary by individual factors, like age and degree of food cue responsivity. [ABSTRACT FROM AUTHOR]

Purpose: Congenital accessory navicular bone (ANB) is a common variant in the foot and is prone to cause several clinical symptoms. Wearing custom-made foot orthosis is considered a desirable option; however, there is limited evidence of its effectiveness. This study aims to report the mid-term effect of foot orthosis for symptomatic pediatric ANBs. Methods: School-age children with symptomatic ANBs combined with flexible flatfoot in the authors' institute were recruited and got custom-made foot orthosis treatment. They were followed up over 4 years. The general characteristics of these children were collected before treatment, including age, gender, and body mass index (BMI). The indicators of foot symptoms, including frequency and location of pain, visual analogue scale (VAS), arch index (AI), and hind foot valgus angle (HVA), were measured during pretreatment and at the last follow-up. Results: Twenty-seven children were recruited for this study. After 4 years of custom-made foot orthosis treatment, significant improvements showed in pain frequency, VAS, AI, and HVA (P < 0.001). Type II ANBs showed a higher pain index pretreatment (P < 0.001) and reduced after treatment (P < 0.001). Conclusion: Mid-term effect of custom-made foot orthosis is inspiring in clinical symptoms of pediatric congenital ANBs combined with flexible flatfoot and may be an optional nonoperative treatment. [ABSTRACT FROM AUTHOR]

Background: Deep angiomyxoma (DAM) is a slow-growing benign tumor with high risk of local recurrence after surgical resection. Although DAM in a lower extremity is extremely rare, clinicians must be aware of its possible occurrence. Suspicion can be made based on clinical examination and radiological imaging but final diagnosis is confirmed on histopathological examination and immunohistochemistry. We intend to present an extremely rare case of DAM in the knee, managed successfully with marginal excision. Case Presentation: A 4-year-old male child presented with the complains of a painless, progressively increasing, soft, non-tender, and fluctuant swelling in his right knee. The plain radiograph showed a non-calcified soft-tissue swelling and MRI revealed a multi-loculated cystic lesion with multiple septations. A pre-operative diagnosis of a benign cystic lesion was made. It was managed by marginal excision of the tumor and a histological diagnosis of DAM was made. IHC staining showed positivity for SMA, CD34 and vimentin were focally positive, while desmin and calponin were negative. At 12 months of follow-up, the patient had a normal painless gait and full knee ROM, without any local recurrence. Conclusion: DAM is a rare tumor which is often misdiagnosed. In this report, we present a rare case of benign cystic lesion which turned out to be DAM on HPE of resected specimen. Marginal excision of this lesion revealed good outcomes with no recurrence until 12 months of final follow-up. With this, we conclude that surgical excision should be the gold standard in cases of DAM. [ABSTRACT FROM AUTHOR]

The outdoor thermal comfort (OTC) of children is more specific than that of adults, and the complex influence of outdoor activity spaces on children's thermal comfort warrants further investigation. To investigate the outdoor thermal comfort baseline (OTCB) of children in Hangzhou and explore the thermal impact of outdoor surfaces on children, a survey was conducted in six typical outdoor activity spaces in Hangzhou, China, during spring and summer utilizing physical measurements, questionnaire surveys, and the universal thermal climate index (UTCI). This study analyzed the differences in thermal perception among children in Hangzhou in different seasons, their OTCB, and the impact of surface reflectance (Rs) on children's OTC. The results indicated the following: 1) In spring, children in Hangzhou generally felt comfortable, but their discomfort with heat noticeably increased in summer. 2) The neutral UTCIs (NUTCIs) for Hangzhou children were 11.6 °C (spring) and 27.7 °C (summer), and the NUTCI ranges (NUTCIRs) were 9.7–17.5 °C (spring) and 25.7–30.0 °C (summer); additionally, the thermal acceptability ranges (TARs) were 13.2–25.2 °C (spring) and 11.8–34.8 °C (summer). 3) A high Rs made children feel more uncomfortable with heat, which was primarily due to the space's total shortwave and longwave radiation, which peaked between 14:00 and 15:00. 4) Based on the research findings, corresponding bioclimatic design strategies were proposed. Recommendations include using high Rs underlays with shading, composite underlays, or the future adoption of thermochromic coatings. Keeping permeable underlays moist is essential for activating their cooling mechanisms. Fundamental safety measures are imperative. This study provides valuable data for urban planners and landscape designers to create public spaces suitable for children's outdoor activities, contributing to a harmonious and unified living environment. [ABSTRACT FROM AUTHOR]

Phonology is a widely discussed topic that is studied in detail by linguists, psycholinguists, philologists, pedagogues, and last, but not least, by speech and language pathologists. The assessment methods do inform us about the phonological processes and phonological delays in details by comparing the results with those of a normative sample and offer an opportunity to gradate the severity of the disorder, which is individual and can vary significantly in individual children. The aim of the study is to present evidence of the validity and reliability of a phonological assessment tool developed to assess the phonological inventory of Bulgarian preschool children. For this purpose, an author's test was developed and conducted among 382 Bulgarian children. Results The present study provided evidence of validity and reliability (internal consistency) for this phonological assessment tool, confirming the reliability of its three subtests. Conclusions The present findings provide strong evidence of the validity and reliability of this phonological assessment tool. [ABSTRACT FROM AUTHOR]

Prolonged disorder of consciousness (DoC) is a rising challenge. Pediatric data on diagnosis and prognosis of prolonged DoC were too limited and heterogeneous, making it difficult to define the natural course and evaluate the prognosis. The present study explored the emergence from the Minimally Conscious State (eMCS) incidence at different months postinjury drawing the natural course, and detected the predictors of the incidence in children with prolonged DoC. A hospital-based prospective cohort study was conducted. Kaplan–Meier curves, as well as univariate and multivariate COX regression analysis, were performed. The study enrolled 383 pediatric DoC individuals, including 220 males (57.4%), with an average age of 3.9 (1.9–7.3) years. The median duration between onset and rehabilitation is 30.0 (21.0–46.0) days. At enrollment, the ratio of vegetative state/unresponsive wakefulness syndrome (VS/WUS) to MCS is 78.9%–21.1%. Traumatic brain injury and infection are the major etiologies (36.8% and 37.1%, respectively), followed by hypoxia cerebral injury (12.3%). For children with prolonged DoC, the cumulative incidence of eMCS at months 3, 6, 12, and 24 was 0.510, 0.652, 0.731, 0.784 VS 0.290, 0.418, 0.539, 0.603 in the traumatic VS non-traumatic subgroup, respectively. For children in a persistent vegetative state (PVS), the cumulative incidence of emergence at months in 3, 6, 12, 24, 36 and 48 was testified as 0.439, 0.591, 0.683, 0.724, 0.743 and 0.743 in the traumatic subgroup, and 0.204, 0.349, 0.469, 0.534, 0.589 and 0.620 in the non-traumatic subgroup. Participants who exhibit any of the following four demographical and/or clinical characteristics—namely, older than 4 years at onset, accepted rehabilitation within 28 days of onset, remained MCS at enrollment, or with etiology of traumatic brain injuries—had a significantly positive outcome of consciousness recovery (eMCS). Moreover, both prolongation of the central somatosensory conductive time (CCT) (level 2) and absence of N20 (level 3) independently predict a negative outcome. In children with prolonged DoC, we found that 12 months postinjury was critical to eMCS, and a preferred timepoint to define chronic vegetative state (VS). The characteristics including age, etiology, time before rehabilitation, consciousness state, and SEP results were useful predictors of conscious recovery. Trial registration Registered 06/11/2018, the registration number is chiCTR1800019330 (chictr.org.cn). Registered prospectively. [ABSTRACT FROM AUTHOR]

The association between composite dietary antioxidant index (CDAI) and asthma remains unclear. Our study aimed to investigate the association of CDAI with asthma in children aged 3–18 years in the United States. Cross-sectional analyses were carried out on 18,118 children aged 3–18 years old. Data was obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2020. The Composite Dietary Antioxidant Index (CDAI) was measured by assessing the consumption of six dietary antioxidants (vitamin A, vitamin C, vitamin E, zinc, selenium and carotenoids). The association between CDAI and asthma was explored using multivariate weighted logistic regression, subgroup analyses, and sensitivity analyses. Among the 18,118 participants, 2045 (11.3%) reported a diagnosis of asthma by a healthcare provider. In both the crude and adjusted models, the odds ratios (ORs) for asthma with CDAI were not significant. Specifically, in the fully adjusted model, the OR for T2 was 0.98 (95% CI 0.83, 1.17) and the OR for T3 was 1.00 (95% CI 0.76, 1.31). Subgroup analyses by sex, age and BMI category also showed no significant associations. Sensitivity analyses, including weighted logistic multivariate analyses adjusting for family history of asthma, confirmed the absence of a significant association between CDAI and asthma. Our study showed no significant association between CDAI and asthma in children and adolescents. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine whether there are proven associations between CO-RADS categorizations and clinical and laboratory findings in children diagnosed with COVID-19 infection. Methods: This is a retrospective observational study that includes the clinical and radiological data of pediatric patients who were admitted to both Minia University Hospital and Minia Insurance Hospital with a confirmed diagnosis of COVID-19, detected via reverse transcriptase PCR (RT-PCR) from nasopharyngeal swabs obtained between June 2022 and February 2023. Patients were divided into 5 groups based on the severity of involvement in chest CT. Results: This study involved a total of 62 children who were confirmed to have COVID-19 infection. The most commonly observed symptoms in these children were fever (91.9%), shortness of breath (88.7%), and cough (87.1%). In addition, vomiting (24.2%), diarrhea (12.9%), impaired consciousness (11.2%), and convulsions (9.7%) were also reported. Significant differences were observed between CO-RADS classes in relation to patient gender, severity of respiratory distress, presence of cough, occurrence of diarrhea, elevated LDH levels, and prognosis. Conclusion: The CO-RADS classification exhibited positive correlations with inflammatory biomarkers such as total leucocytic count, LDH, D-dimer, serum ferritin, and AST. Conversely, the CO-RADS classification showed negative correlations with ionized calcium levels, hemoglobin, and platelet count. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the effectiveness of OM-85 BV in treating recurrent acute tonsillitis in children and adults during the first year after treatment, as well as to identify response predictors. Results: The study included 92 patients, and there was a significant decrease in the number of acute tonsillitis cases after OM-85 BV treatment (p < 0.001). Exposure to tobacco smoke predicts non-response or partial response to treatment (OR 5.24, p = 0.005, 95% CI 1.646–16.671/OR 4.57, p = 0.014, 95% CI 1.362–15.339). Conclusions: The study concludes that OM-85 BV is effective in preventing new episodes of tonsillitis in patients with a history of recurrent acute tonsillitis. Patients exposed to tobacco smoke tend to have a poorer response to treatment. [ABSTRACT FROM AUTHOR]

Peer bullying is when one or more children systematically engage in aggressive behavior towards another child whom they consider weak. Children with hearing loss face many challenges due to the limitations of their hearing. In addition to these difficulties, the problems become even worse if they are exposed to peer bullying. Children with hearing loss may have more difficulty with social communication and interaction. This can increase the risk of being bullied by peers because bullying is often based on perception or the balance of power against differences. Peer bullying against children with hearing loss can have serious short- and long-term consequences. In the short term, it can increase a child's stress level, damage their self-confidence and self-esteem, and negatively impact their mental health. Problems such as depression, anxiety, and social isolation may occur in children who are exposed to peer bullying in the long term. Therefore, it is extremely important to protect children with hearing loss against peer bullying and to carry out preventive studies. Strengthening the sense of confidence of children with hearing loss and integrating them into society is of critical importance for their healthy development. [ABSTRACT FROM AUTHOR]

The health benefits of regular physical activity (PA) in youth are well-documented. Yet the adherence rate to PA guidelines among youth worldwide is alarmingly deficient with only 19% of youth worldwide adhering to the World Health Organization guidelines. This is reflective of a global proliferation of a physical inactivity pandemic among youth. The negative consequences of physical inactivity on health are profound, as they threaten to persist into adulthood, exacerbating the burden of preventable health issues. There is persuasive evidence that vigorous PA generates physical fitness and health benefits surpassing those of low- or moderate-intensity activity in youth. In addition, indications show that the adherence rate to vigorous PA among youth exceeds that relative to for low- or moderate-intensity activity. As a result, promoting vigorous PA can help mitigate the global issue of low adherence to PA in youth. Therefore, in this Current Opinion paper, we argue that vigorous PA, compared to low or moderate-intensity activity, holds greater significance for youth's health and physical fitness. Additionally, the potential implications derived from the existing evidence regarding vigorous PA on the current guidelines for youth are discussed. Key Points: The health benefits of regular physical activity in youth are well-established. Yet the adherence rate to physical activity guidelines among youth worldwide is alarmingly deficient with around 80% of youth worldwide not adhering to the World Health Organization guidelines. Persuasive evidence derived from observational, controlled interventions, as well as narrative and systematic reviews with meta-analysis, indicate that vigorous physical activity generates positive effects exceeding those induced by low- or moderate-intensity activity on youth health and physical fitness. The next generation of physical activity recommendations should place a greater emphasis on the significance of vigorous physical activity for youth. [ABSTRACT FROM AUTHOR]

Background: Music learning induces significant neural changes, enhancing auditory, verbal, and visuospatial skills, IQ, and speech perception. Research studies reveal structural and functional brain plasticity due to music training in adults and children. While musical abilities are linked to formal training, the existence of "musical sleepers" with heightened speech perception without formal training is noteworthy in adults. This study addresses the gap in understanding such phenomena in children, exploring psychophysical abilities in musically adept children, and aiming to impact rehabilitation models. Materials and method: A pre-experimental study involved 164 typically developing children (mean age: 9.93) without musical training. Musical abilities were evaluated using the abbreviated version of Montreal Battery for Evaluation of Musical Abilities (MBEMA) test in DMDX software, covering melody, rhythm, and memory subtests. Psychophysical tests in MATLAB assessed temporal, frequency, intensity, timbre, and binaural resolution. Results: Using a median split based on MBEMA test scores (median: 42), 84 children exhibited poor musical abilities, while 80 showed good ones. Descriptive statistics for MBEMA scores and psychophysical tests were conducted. As data did not follow normal distribution, non-parametric inferential statistics were employed. Mann–Whitney U tests revealed significant differences favouring good musical abilities in all assessments: gap deduction (p = 0.01), pitch discrimination at 500 Hz and 4 kHz (p = 0.00), intensity discrimination at 500 Hz (p = 0.00) and 4 kHz (p = 0.01), profile analysis (p = 0.01), interaural level difference (p = 0.023), and interaural time difference (p = 0.038). Spearman correlation showed highest correlation with pitch discrimination at 500 Hz (r = − 0.538), 4 kHz (− 0.416), intensity discrimination at 4 kHz (r = − 0.367), and 500 Hz (r = − 0.311), profile analysis (r = − 0.313), interaural level difference (r = − 0.276), and gap deduction (r = − 0.235). All were significant (p < 0.01), except for the interaural time difference. Conclusion: Children excelling in music surpassed those with weaker abilities in psychophysical tasks. This echoes past research, underscoring auditory discrimination's influence on musical skills in untrained children. These results potentially support the concept of musical sleepers in children. Key predictors include pitch discrimination, while interaural time difference exhibited minimal correlation. Utilising such assessments may predict musical training outcomes for children with auditory disorders, but additional robust statistical investigation is necessary. [ABSTRACT FROM AUTHOR]

Background: SMA is a hereditary neuromuscular disease that causes progressive muscle weakness and atrophy. Several studies have shown that the burden of SMA is very high at many levels. Functional assessment tools currently used do not completely address the impact of the disease in patients' life. The objective of this qualitative study was to identify aspects of SMA that are relevant to patients and to design items useful for assessment purposes. Results: Five focus group sessions were run during an annual SMA families meeting in Madrid, Spain. Focus groups were composed by parents of SMA type I children, sitter children type II-III, parents of sitter children type II-III, adult patients, and parents of walker children. Two trained facilitators conducted the focus groups using a semi-structured guideline to cover previously agreed topics based on the input of a Scientific and Patient Advisory Committee. The guideline was adapted for the different groups. According to what was communicated by participants, SMA entails a high burden of disease for both patients and their parents. Burden was perceived in physical, psychological, and social areas. Patient's physical domain was the most relevant for participants, especially for parents of non-ambulant children, followed by limitations of motor scales to capture all changes, parents psychological burden, treatment expectations and patient's psychological burden. Ten domains were the main areas identified as impacted by the disease: mobility and independence, fatigue and fatigability, infections and hospital consultations, scoliosis and contractures, vulnerability, pain, feeding, time spent in care, breathing, and sleep and rest. Conclusions: This study confirms the necessity of evaluating other aspects of the disease that are not assessed in the functional motor scale. Measures of other aspects of the disease, such as pain, fatigue, feeding, should be also considered. A patient-reported outcomes instrument measuring such aspects in a valid and reliable way would be very useful. This study generated a list of new items relevant to be systematically measured in the assessment of the impact of SMA on the patients' everyday life. [ABSTRACT FROM AUTHOR]

The aim of this study was to test the morphometric features affecting 20-m sprint performance in children at the first level of primary education using machine learning (ML) algorithms. In this study, 130 male and 152 female volunteers aged between 6 and 11 years were included. After obtaining demographic information of the participants, skinfold thickness, diameter and circumference measurements, and 20-m sprint performance were determined. The study conducted three distinct experiments to determine the optimal ML technique for predicting outcomes. Initially, the entire feature space was utilized for training the ML models to establish a baseline performance. In the second experiment, only significant features identified through correlation analysis were used for training and testing the models, enhancing the focus on relevant predictors. Lastly, Principal Component Analysis (PCA) was employed to reduce the feature space, aiming to streamline model complexity while retaining data variance. These experiments collectively aimed to evaluate different feature selection and dimensionality reduction techniques, providing insights into the most effective strategies for optimizing predictive performance in the given context. The correlation-based selected features (Age, Height, waist circumference, hip circumference, leg length, thigh length, foot length) has produced a minimum Mean Squared Error (MSE) value of 0.012 for predicting the sprint performance in children. The effective utilization of correlation analysis in the selection of relevant features for our regression model suggests that the features selected exhibit robust linear associations with the target variable and can be relied upon as predictors. [ABSTRACT FROM AUTHOR]

It has been reported that strong discomfort associated with clusters of circles and holes (trypophobia), including lotus pod seeds, manifests in individuals as young as 4 or 5 years old. This study investigated how the size and number of circles within clusters affected discomfort levels in adults and in children aged 4–9 years. In Experiment 1, we confirmed that the remote experimental procedure could evoke discomfort when participants were presented with cluster images. The findings reveal that children as young as 4 or 5 years old consistently experienced discomfort when rating trypophobic images, even printed images rated in real time during video calls. In Experiment 2, we explored the impact of cluster size, considering both the size and number of circles, in a remote experiment. The results indicate that discomfort tended to increase with cluster size in both children and adults, with the effect becoming more pronounced with age. [ABSTRACT FROM AUTHOR]

Background: Children with spastic diplegic cerebral palsy (CP) often demonstrate gluteus medius weakness that causes balance deficits and frequent falling during walking. Purpose: The aim of the study was to evaluate the combined effects of functional task training with electrical stimulation of bilateral hip abductor muscles on motor abilities (standing and walking) and balance in children with spastic diplegic CP. Methods: Thirty children with diplegic CP of both sexes whose ages ranged from 7 to 10 years were assigned randomly into two equal groups. For both groups, motor abilities were assessed by gross motor function measure (GMFM), and balance (static and dynamic) was assessed by the humac balance system before and after the study. The control group received a functional training program focusing on standing walking and balance exercises. While children in the study group received the same functional training program with bilateral electrical stimulation of gluteus medius muscles for 50 min. The treatment program for both groups was conducted for 3 sessions/week for 8 weeks. Results: There were statistically significant differences between the control and study group post-treatment in GMFM as well as the center of pressure test and weight shift test in favor of the study group (p < 0.05). Conclusion: Using functional task training with electrical stimulation for treatment of children with spastic diplegic CP have significant effects on improving their motor abilities and balance that suggests using it in rehabilitation for these children. [ABSTRACT FROM AUTHOR]

Background: Detergent packets are common household products; however, they pose a risk of injuries and poisonings, especially among children. This study examined the epidemiological characteristics of pediatric injuries and poisonings related to all types of detergent packets in Canada using emergency department (ED) data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. Methods: The CHIRPP database was searched for ED visit records for injuries and poisonings related to all types of detergent packets between April 1, 2011 and October 12, 2023 (N = 2,021,814) using variable codes and narratives. Data for individuals aged 17 years and younger were analyzed descriptively. Temporal trends in the number of detergent packet-related injuries and poisonings per 100,000 CHIRPP cases were assessed using Joinpoint regression and annual percent change (APC). A proportion ratio and 95% confidence intervals (CI) were calculated to compare the proportion of detergent packet-related cases in CHIRPP during two 34-months periods, pre-COVID-19 pandemic and after the beginning of the pandemic. Results: There were 904 detergent packet-related cases among children and youth aged 17 years and younger identified in CHIRPP between April 1, 2011 and October 12, 2023, representing 59.9 cases per 100,000 CHIRPP cases. The majority (86.5%) of cases were among children aged 4 years and younger. Poisonings (58.8%) and eye injuries (30.6%) were the most frequent primary diagnoses. Unintentional ingestion (56.9%) and squeezing/breaking a detergent packet (32.3%) were the most frequent exposure mechanisms. Sixty-five patients (7.2%) were admitted to hospital. The number of detergent packet-related cases per 100,000 CHIRPP cases increased by 5.0% (95% CI 0.8, 10.2) annually between 2012 and 2022. The number of detergent packet-related poisonings per 100,000 CHIRPP cases decreased by 15.3% (95% CI − 22.3, − 10.6) annually between 2015 and 2022, whereas eye injuries showed an average annual percent increase of 16.6% (95% CI 11.2, 23.0) between 2012 and 2022. The proportion of detergent packet-related cases in CHIRPP after the beginning of the pandemic (79.9/100,000 CHIRPP cases) was 1.43 (95% CI 1.20, 1.71) times greater than pre-pandemic (55.7/100,000 CHIRPP cases). Conclusions: Detergent packet-related injuries and poisonings are a persisting issue. Continued surveillance and prevention efforts are needed to reduce detergent packet-related injuries and poisonings in Canada, particularly among children and youth. [ABSTRACT FROM AUTHOR]

Background: FMF (Familial Mediterranean Fever) is the most prevalent autoinflammatory disease. It arises due to mutations in the pyrin-encoding MEFV gene. Prolidase, an enzyme culpable of splitting the bonds of proline-containing dipeptides, is essential for matrix remodeling, collagen turnover, and cell proliferation. It has a crucial role in inflammation. Aim: To compare serum levels of prolidase between FMF children during the attack-free periods and healthy children and to correlate it with different FMF disease criteria and inflammatory marker, also to investigate if it can serve as a marker for subclinical inflammation. Results: Forty-one children diagnosed with FMF and 41 sex and age-matched apparently healthy children as a control group were included in this study, serum prolidase was measured by ELISA. The mean ± SD serum level of prolidase among FMF patients was 0.6 ± 0.2 mU/ml × 104, while among the control group, it was 1.3 ± 1.4 mU/ml × 104, a statistically significant difference existed between both groups, p value = 0.001. The level of serum prolidase was not correlated with FMF severity score, inflammatory markers, and other FMF disease criteria. Conclusion: Serum prolidase level was lower among FMF patients during the attack-free period than in the healthy control group, it was not correlated with disease severity and was not predictive of the presence of subclinical inflammation. Further studies are needed to highlight the role of serum prolidase in FMF children. [ABSTRACT FROM AUTHOR]

The minimal adverse-effect profile and positive clinical response of low-dose oral minoxidil (LDOM) have recently caused the drug to gain popularity for the treatment of hair disorders in adults. However, in the pediatric population, hesitancy still surrounds the use of oral minoxidil given the wide profile of potential side effects the drug offers. This review aims to characterize the safety and use of oral minoxidil in children for the treatment of all disorders to equip physicians with ample knowledge when prescribing oral minoxidil in the pediatric population. A total of 41 studies (19 case reports, 10 cohort studies, 7 retrospective chart reviews, and 5 case series) that reported data on 442 pediatric patients for whom oral minoxidil was used for treatment were included. Conditions for which treatment with minoxidil was described were hair disorders (83.9%, 371/442) and hypertension (11.3%, 50/442); accidental usage (4.8%, 21/442) was also noted in the literature and included in this review. This review is broken down by dosage and describes the safety and efficacy of oral minoxidil in pediatric patients aged 0 to 18 years old for the treatment of hair disorders. This review found that LDOM may represent a safe option for the treatment of hair disorders in children. This study also suggests moderate and high doses of oral minoxidil may not be safe for use in children. Additional studies are needed to further understand this drug's efficacy and safety in children. [ABSTRACT FROM AUTHOR]

Introduction: Since the majority of hospitalisations due to RSV occur in young children, the illness profoundly influences the entire family. However, comprehensive evidence regarding its overall effects remains limited. The ResQ Family study aims to investigate the burden of RSV-induced pediatric hospitalisation on affected families. Methods: Spanning the 2022–2023 RSV season, an interdisciplinary, observational study was conducted in Germany, France, Italy and Sweden. Using an online questionnaire, parents and caregivers of children (< 24 months of age) with an RSV-induced hospitalisation were recruited. Information was gathered on topics related to RSV and parental health-related quality of life (HRQoL) during the acute infection phase (t0) and 6 weeks later (t1). Descriptive evaluations of the data set were performed during t0 and regarding a potential change over the observation period (t0 vs. t1). Subgroup analysis aimed to further identify differences across the countries. Results: A total set of 138 affected parents/caregivers were included in the study, with 59 participants responding to the follow-up survey (t1). Particularly during the acute infection phase, parental HRQoL was shown to be negatively influenced by the child's RSV infection [total score (p < 0.001, d = 0.54), parent HRQoL summary score (p < 0.001, d = 0.67) and family functioning summary score (p = 0.007, d = 0.33)]. Significant disparities in disease awareness and support structures were observed across Europe, with France and Sweden showing notably higher levels. Conclusion: The ResQ Family study provides convincing evidence that RSV-associated hospitalisations in young children across Europe generate a multifaced burden for the entire family, partly even beyond the acute infection phase. Standardised approaches for disease prevention at societal, educational and policy levels are needed to guarantee every newborn the best possible start into life. Trial Registration: ClinicalTrials.gov, identifier, NCT05550545. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the intraocular differences in optical coherence tomography (OCT)-based macular curvature index (MCI) among children with anisomyopia and to investigate the relationship between MCI and the macular microvasculature. Methods: Fifty-two schoolchildren with anisometropia > 2.00 D were enrolled and underwent comprehensive examinations including cycloplegic refraction, axial length (AL), and swept source OCT/OCT angiography. OCT-based MCIs were determined from horizontal and vertical B-scans by a customized curve fitting model in MATLAB R2022 at 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea. Characteristics and topographic variation of MCI was analyzed, and the relationships with microvascularity and its associated factors were investigated. Results: MCI achieved high reliability and repeatability. There were overall larger MCIs in the more myopic eyes than the less myopic eyes in 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea (all p < 0.001). For the topographic variation, horizontal MCI was significantly greater than vertical MCI (all p < 0.001), and was the largest in 6-mm circle, followed by 3-mm and 1-mm circles. Stronger correlation of horizontal MCI with myopic severity than vertical MCI was found. Partial Pearson's correlation found MCI was negatively associated with deep capillary plexus (DCP) vessel density (p = 0.016). Eyes with a higher MCI in a 6-mm circle were more likely to have longer AL (p < 0.001), lower DCP vessel density (p = 0.037), and thinner choroidal thickness (ChT) (p = 0.045). Conclusion: Larger MCI was found in the more myopic eyes of children with anisomyopia and was significantly associated with smaller DCP density, suggesting that MCI was an important indicator of myopia-related retinal microvascularity change, and it could be a valuable metric for myopia assessment in children. [ABSTRACT FROM AUTHOR]

Objectives: To compare the urinary bisphenol A (BPA) levels in bottle-fed and never bottle-fed infants among the under-five children and to determine the impact of bottle-feeding practices and sociodemographic factors on urinary BPA levels in under-five children. Methods: A community-based cross-sectional study was carried out on children aged between 2 to 60 months attending the Anganwadi centres in Chandigarh. Results: Urine samples were collected from 184 children, out of which 94.56% (n = 174) children had detectable urinary BPA levels. The mean (SD) BPA level was 2.74 (2.60) ng/ml and BPA was detected in 93.9% of 'ever' bottle-fed children (n = 93/99) and 95.3% of 'never' bottle-fed children (n = 81/85) (P = 0.69). On multivariate regression analysis, there were no significant predictors for high (≥ 75th percentile) urinary BPA levels. Still, the odds of urinary BPA levels ≥ 75th percentile showed higher trend for significance among children from middle/higher socioeconomic background in reference to lower socioeconomic stratum (adjusted OR 7.02; 95% CI 1.24, 133.25; P = 0.07) and among children whose feeding bottles were brushed once or twice daily in reference to group with no daily brushing (adjusted OR 3.92, 95% CI 0.95, 20.56; P = 0.07). Conclusions: Although feeding with plastic bottle did not emerge as a statistically significant risk factor for BPA exposure, yet detection of BPA levels among majority of study children signals an urgent need for unmasking exposure to other sources given the potential long-term toxicity of BPA among infants and young children. [ABSTRACT FROM AUTHOR]

AI-enabled ECGs have previously been shown to accurately predict patient sex in adults and correlate with sex hormone levels. We aimed to test the ability of AI-enabled ECGs to predict sex in the pediatric population and study the influence of pubertal development. AI-enabled ECG models were created using a convolutional neural network trained on pediatric 10-second, 12-lead ECGs. The first model was trained de novo using pediatric data. The second model used transfer learning from a previously validated adult data-derived algorithm. We analyzed the first ECG from 90,133 unique pediatric patients (aged ≤18 years) recorded between 1987–2022, and divided the cohort into training, validation, and testing datasets. Subgroup analysis was performed on prepubertal (0–7 years), peripubertal (8–14 years), and postpubertal (15–18 years) patients. The cohort was 46.7% male, with 21,678 prepubertal, 26,740 peripubertal, and 41,715 postpubertal children. The de novo pediatric model demonstrated 81% accuracy and an area under the curve (AUC) of 0.91. Model sensitivity was 0.79, specificity was 0.83, positive predicted value was 0.84, and the negative predicted value was 0.78, for the entire test cohort. The model's discriminatory ability was highest in postpubertal (AUC = 0.98), lower in the peripubertal age group (AUC = 0.91), and poor in the prepubertal age group (AUC = 0.67). There was no significant performance difference observed between the transfer learning and de novo models. AI-enabled interpretation of ECG can estimate sex in peripubertal and postpubertal children with high accuracy. [ABSTRACT FROM AUTHOR]

Background: Childhood and adolescence are critical periods for physical and mental development. For that, sounding the alarm for the warning signs and red flags of children's mental health disorders is important to promote good health and mental wellness throughout the lifespan. The aim of the study was to assess children's and adolescents' mental health in relation to parenting styles. Methods: This study used a descriptive cross-sectional design. From early May 2022 until late October 2022, Zagazig University in Egypt hosted this investigation. Subjects: For this study, 400 parents of Zagazig University staff, employees, and workers who agreed to engage in the current study were gathered as a convenience sample. Tools: In order to get the required data, three tools were utilized. Tool I: A questionnaire for interviews to gather demographic information about the participating parents and their children. Tool II: Adapted Ontario Child Health Study Emotional Behavioural Scale: Parent Version (for children 4–17 years). Tool III: Parenting style scale. Results: It was found that criteria for conduct disorder constituted the highest followed by criteria for attention deficit hyperactivity disorder and major depression disorder with a mean and standard deviation of 15.10 ± 3.7, 12.83 ± 3.4, and 11.9 ± 2.8. Also, 66% of the participating parents practiced a permissive parenting style while 18% of them practiced the authoritative style and 16% for the authoritarian style. Conclusion: It was determined that criteria of conduct disorder were the most prevalent, followed by criteria of attention deficit hyperactivity disorder and major depressive disorder. Additionally, there was high statistical significance between mental health disorders, parenting styles, and parental educational level. In order to protect children's and adolescents' mental health, this study recommended alerting parents and teachers about red flags and warning signs of mental health disorders for early detection and management. Additionally, educate parents about effective parenting methods and how to behave correctly with their children. Psychological counseling centers for seeking help should be available everywhere and announced. [ABSTRACT FROM AUTHOR]

Background: Children with congenital heart diseases (CHD) may have developmental delays including delayed language development (DLD) and learning difficulties. The purpose of this study was to observe the effects of CHD on language developmental profile and scholastic achievement (SA) with particular emphasis on prevalence of DLD and SA, potential risks, and need for early intervention. Results: This case–control study included 158 children with CHD and 145 healthy children as controls. Participants' ages ranged from 6 months to 15 years. Data were collected by reviewing clinical records and questionnaires covering potential risks, motor and language development, and SA. Potential risks were analyzed using the Fisher test, while language development and SA were compared using Mann–Whitney test. The incidences of parent consanguinity, family history of DLD, and neonatal cyanosis were higher than expected by chance in the CHD group with p-values which are < 0.001, 0.044, and < 0.001, respectively. The CHD group revealed more delay in babbling, first word production, two-word sentences, three-word sentences, narration, and SA than control group with significant differences. These comparisons' p-values are 0.002, < 0.001, 0.009, 0.029, 0.03, and 0.042 respectively with mean effect size 0.3. The language development profile in cyanotic HD showed more delay than acyanotic HD with significant differences. Conclusions: The DLD and affected SA were more prevalent in children with CHD. The risk for DLD in CHD children was multifactorial; however, the main predisposing factor was chronic hypoxia that starts in the intrauterine life in CHD. Neonates with CHD require early intervention through oxygen therapy before surgery. Early family counseling and language therapy are recommended to improve quality of life through achieving better communicative ability and academic skills. Further studies which concerned the effect of maternal oxygenation on prognosis of fetuses with CHD may be required. Also, duplication of the study including formal testing is recommended. [ABSTRACT FROM AUTHOR]

Background: The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants. Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years. In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB. Results: Significant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03). Conclusions: This article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years. [ABSTRACT FROM AUTHOR]

Background: Individual and social characteristics are attributed to violent behavior in schools, yet environmental hazards may play an understudied role. Ambient air pollution has been linked to neurological dysfunction that inhibits decision-making and may result in violent behavior in adult populations. However, little is known on how air pollution may be associated with violent behaviors in children. Methods: A cross-sectional ecologic study was designed to estimate the associations between air pollution (fine particulate matter, carbon monoxide, and nitrogen dioxide) with the occurrence of violent incidents and incidents involving a weapon among a cohort of children in Minnesota schools (2008–2012). Differences by urban and rural status of schools were also explored. Negative binomial regression models were developed to estimate incidence rate ratios (IRR) and incidence rate differences (IRD) to describe associations between air pollution and violent incidents in school settings. Results: Our results indicate that the highest levels of carbon monoxide, nitrogen dioxide and fine particulate matter concentrations were associated with increased violent disciplinary incidents. Among the total student population, the 4th quartile of carbon monoxide exposure was associated with an IRD of 775.62 (95% CI 543.2, 1008.05) violent incidents per 100,000 students per school year compared to schools in the lowest quartile of exposure. Comparing the 4th to the 1st quartiles of exposure, nitrogen dioxide and fine particulate matter had an IRD of 629.16 (95% CI 384.87, 873.46), and 510.49 (95% CI 274.92, 746.05) violent incidents per 100,000 students per school year respectively. Schools in urban settings shared a larger burden of violent incidents associated with air pollution compared to rural schools. Conclusions: Modifying environmental pollutants surrounding school environments, particularly for high exposure communities, may be a novel tool for reducing violence and subsequent injuries in schools. [ABSTRACT FROM AUTHOR]

Several risk factors including environmental exposures, socioeconomic status, and dietary factors including dietary patterns have been considered for childhood Asthma. The present study tried to examine the association between a western-style pattern and the likelihood of asthma and its symptoms in Yazd, Iran. In the present cross-sectional study, dietary intakes of elementary and high-school children were obtained through a validated GAN questionnaire. The GAN questionnaire, derived from the ISAAC questionnaire was used to assess the symptoms of allergic diseases and their related risk factors. A western dietary pattern score considered 9 food groups including chicken eggs, margarine, butter, sugar, fast foods, soft drinks, snacks, sauce, and chocolate. In total 7667 children aged 10.9 ± 3.35 years were included in the current investigation. Boys with higher adherence to western dietary pattern had a higher risk of wheezing in the past 12 months (OR 1.37, 5% CI 1.01–1.87, P = 0.04) and this association was also observed in the whole population (OR 1.30, 5% CI 1.05–1.60, P = 0.01). However, after adjustment for confounders this relation did not remain significant in boys. Our results support the hypothesis that a western dietary pattern is associated with an increased risk of wheezing in the past 12 months in children with asthma. Future prospective studies are needed to confirm this finding. [ABSTRACT FROM AUTHOR]

The diagnosis of acute appendicitis and concurrent surgery referral is primarily based on clinical presentation, laboratory and radiological imaging. However, utilizing such an approach results in as much as 10–15% of negative appendectomies. Hence, in the present study, we aimed to develop a machine learning (ML) model designed to reduce the number of negative appendectomies in pediatric patients with a high clinical probability of acute appendicitis. The model was developed and validated on a registry of 551 pediatric patients with suspected acute appendicitis that underwent surgical treatment. Clinical, anthropometric, and laboratory features were included for model training and analysis. Three machine learning algorithms were tested (random forest, eXtreme Gradient Boosting, logistic regression) and model explainability was obtained. Random forest model provided the best predictions achieving mean specificity and sensitivity of 0.17 ± 0.01 and 0.997 ± 0.001 for detection of acute appendicitis, respectively. Furthermore, the model outperformed the appendicitis inflammatory response (AIR) score across most sensitivity–specificity combinations. Finally, the random forest model again provided the best predictions for discrimination between complicated appendicitis, and either uncomplicated acute appendicitis or no appendicitis at all, with a joint mean sensitivity of 0.994 ± 0.002 and specificity of 0.129 ± 0.009. In conclusion, the developed ML model might save as much as 17% of patients with a high clinical probability of acute appendicitis from unnecessary surgery, while missing the needed surgery in only 0.3% of cases. Additionally, it showed better diagnostic accuracy than the AIR score, as well as good accuracy in predicting complicated acute appendicitis over uncomplicated and negative cases bundled together. This may be useful in centers that advocate for the conservative treatment of uncomplicated appendicitis. Nevertheless, external validation is needed to support these findings. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic obliged people to wear personal protective equipment (PPEs), which can harm verbal communication and speech intelligibility. The first aim was to study the impact of wearing PPEs on the voice and speech parameters of phoniatricians during therapy sessions. The second aim was to study the effect of phoniatricians wearing these PPEs on auditory discrimination of the Ling's six sounds in children using unilateral cochlear implants. Methods: The study was a case–control one, done in the phoniatrics outpatient clinics at Beni-Suef University and Cairo University hospitals. Four phoniatricians participated in this study, and the Dr. Speech software analyzed their speech and voice parameters during utterance of the Ling's six sounds. Each phoniatrician uttered each Ling sound individually four times to assess fundamental frequency and intensity: first time without wearing any mask, second time while wearing a surgical mask, third time while wearing a face shield, and fourth time while wearing an N95 mask. The study also included forty patients using unilateral cochlear implants (group A) and forty children with normal peripheral hearing (group B). The phoniatricians again uttered the Ling's six sounds to assess auditory discrimination in both groups. This subjective auditory discrimination was also tested in both groups four times: first time without wearing any mask, second time while wearing a surgical mask, third time while wearing a face shield, and fourth time while wearing an N95 mask. Results and conclusion: The intensity of Ling's six sounds was significantly lowest in the face shield. Regardless of the PPE type, patients with unilateral cochlear implants showed less consonant discrimination of (mm) sound. Surgical masks and N95 provided the best acoustic performance, while face shields had the worst. [ABSTRACT FROM AUTHOR]

Rubber band constriction syndrome has been described in the literature, although there are very few case reports. Non-healing recurrent tenosynovitis and synovitis of the wrist joint demonstrating a circular rubber band on imaging has not been described before. Imaging studies showed retained circular band deep to the extensor tendons, embedded within the joint capsule. Surgical removal of the band by open incision led to a dramatic improvement in the outcome of the patient. Level of evidence V. [ABSTRACT FROM AUTHOR]

Purpose: Proximal femoral osteotomy (PFO) is a reconstructive surgical option used to improve hip containment or correct internal hip rotation gait in children with cerebral palsy (CP). A few reports describe the risk of surgical complications after PFO. The purpose of this study was to determine the risk factors associated with adverse postoperative surgical outcomes in pediatric patients with CP following PFO and to report the treatment of complications. Methods: Following institutional review board approval, 1085 (1003 primary and 82 secondary) PFO procedures were retrospectively reviewed in 563 children with CP with at least 1 year of follow-up after final surgery over an 18-year follow-up period. Demographic characteristics, motor type, gross motor function classification system (GMFCS) level, medical comorbidities, feeding tube status, seizure history, intervention type, and prevalence of PFO-related surgical complications and associated treatments were evaluated. Multivariate regression analysis was performed to determine risk factors for all surgical complications. Results: During a 5.8-year (± 3.8 years) follow-up, at least 1 surgical complication was identified in 143 (13.1%) hips in 121 (21.5%) patients after PFO in children with CP. Of these complications, the most common was heterotopic ossification (65 [6%] of hips); most of which were asymptomatic and required no treatment. Other complications included 25 (2%) nonunions, 21 (2%) deep or superficial infections, 13 (1%) delayed unions, 12 (1%) peri-implant fractures, and 7 early implant failures (0.64). The rate of revision surgery due to these complications was 13.1% (6.8% of hips), of which 41% (30 revision surgeries) were for the treatment of nonunion. Regarding the development of delayed union or nonunion, dystonia, GMFCS level IV/V, and seizure history were identified as risk factors by multivariate analysis. Conclusions: The prevalence of surgical complications after PFO was 13.1% with 6.8% of hips requiring revision surgery. Dystonia, seizure history, and nonambulatory status were the strongest predictors for the need for revision surgery after PFO. These data can be used to help counsel patients and families regarding the risks associated with PFO for children with CP. Level of proof: IV; retrospective study. [ABSTRACT FROM AUTHOR]

The primary goal of asthma management is to achieve and maintain asthma control, which can be influenced by environmental factors. This longitudinal study aimed to construct a comprehensive environmental indicator to predict asthma control in children with asthma in Palermo, Italy. The study included 179 asthmatic children aged 5–16 years. The Normalized Difference Vegetation Index (NDVI) was used to measure green cover, and the Coordination of Information on the Environment (CORINE) framework was used to assess land use based on each home address. A land use regression (LUR) model centered on the home address estimated NO2 exposure for each child using GIS. An environmental indicator, including environmental and personal exposure, was formulated using an additive value model approach. A logistic regression mixed model assessed the association between the environmental indicator and uncontrolled asthma. A probability map of uncontrolled asthma was constructed. In conclusion, a comprehensive environmental indicator proved effective in identifying areas at higher and lower risk of uncontrolled asthma. [ABSTRACT FROM AUTHOR]

Among 467 children under five hospitalized with community-acquired pneumonia, the prevalence of Haemophilus influenzae or Haemophilus haemolyticus was 60.8%, all cases were non-typable H. influenzae (NTHi) or H. haemolyticus. NTHi/H. haemolyticus PCR detection was associated with about twice the risk for severe disease. The results highlight the need for increased awareness and research efforts to investigate the role of NTHi/H. haemolyticus in severe CAP among children. [ABSTRACT FROM AUTHOR]

Growing up in socio-economic disadvantage has important and long-lasting effects on children's lives. Children from disadvantaged households often fall behind in many areas of well-being and development, with effects that continue to limit their opportunities and outcomes – including their health and labour market outcomes – long after they reach adulthood. Drawing on Europe-wide survey data from 27 countries, this paper explores how childhood socio-economic disadvantage affects later adult labour market and health outcomes and evaluates the country-level GDP-equivalent cost of childhood disadvantage due to lost employment, lost earnings, and lost health, as well as the costs of lost government revenue and extra benefit spending. Results point to large costs for societies from childhood socio-economic disadvantage, totalling on average the equivalent of 3.5% of GDP annually. We also show that the labour market penalties linked to childhood disadvantage are often smaller in countries with lower absolute levels of disadvantage. While not causal evidence, these associations suggest much of the impact of childhood disadvantage in adulthood can be mitigated with the right environment and policy set up in childhood. [ABSTRACT FROM AUTHOR]

The previous work on cyberbullying has shown that the number of victims is increasing, and the need for prevention is exceptionally high among younger school students (5th–9th grade). Due to the omnipresence of cyberattacks, victims can hardly distance themselves psychologically, thus experience an intrusion in almost all areas of life. The perpetrators, on the other hand, feel the consequences of their actions even less in cyberspace. However, there is a gap between the need and the existence of innovative prevention programs tied to the digital reality of the target group and the treatment of essential aspects of psychological distance. This article explores the design space, feasibility, and effectiveness of a unique VR-based cyberbullying prevention component in a human-centered iterative approach. The central idea is reflected in creating a virtual personal space invasion with virtual objects associated with cyberbullying making the everyday intrusion of victims tangible. A pre-study revealed that harmful speech texts in bright non-removable message boxes best transferred the psychological determinants associated with a personal space invasion to virtual objects contextualized in cyberbullying scenarios. Therefore, these objects were incorporated into a virtual prevention program that was then tested in a laboratory study with 41 participants. The results showed that the intervention could trigger cognitive dissonance and empathy. In the second step, the intervention was evaluated and improved in a focus group with the actual target group of children and adolescents. The improved application was then evaluated in a school workshop for 5 days with 100 children and adolescents. The children understood the metaphor of virtual space invasion by the harmful text boxes and reported the expected psychological effects. They also showed great interest in VR. In summary, this paper contributes to the innovative and effective prevention of cyberbullying by using the potential of VR. It provides empirical evidence from a laboratory experiment and a field study with a large sample from the target group of children and adolescents and discusses implications for future developments. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency and insufficiency pose global public health challenges, yet research on serum vitamin D levels in the 0–17-year-old age group in southeastern China remains limited. This study aimed to fill this gap by investigating serum 25(OH)D levels in children in the region aged 0–17 years, contributing crucial data for understanding vitamin D nutritional status. Liquid chromatography‒mass spectrometry/mass spectrometry (LC‒MS/MS) technology was used. Vitamin D testing was integrated into routine diagnostic procedures for 11,116 children in Wujiang District, Suzhou City. Among the 0–17-year age group, comprising 6348 boys and 4768 girls, the prevalence of serum 25(OH)D deficiency and insufficiency was 21.4% and 31.0%, respectively. The median serum 25(OH)D concentration was 29.72 ng/mL (21.84–39.84 ng/mL) in boys compared to 28.48 ng/mL (20.65–39.23 ng/mL) in girls. Seasonal variations were observed, with median serum 25(OH)D concentrations of 29.02 ng/mL (20.73–39.72 ng/mL) in spring, 28.79 ng/mL (21.53–39.37 ng/mL) in summer, 30.12 ng/mL (22.00–39.70 ng/mL) in autumn, and 28.58 ng/mL (19.97–39.46 ng/mL) in winter. Statistically significant differences were noted in the serum 25(OH)D levels during autumn and winter. In conclusion, the rate of adequate vitamin D levels in local children was 47.5%, revealing a relatively high prevalence of vitamin D deficiency (21.4%) and insufficiency (31.0%), especially during the post-preschool period. Advocating for vitamin D supplementation in children is crucial for ensuring adequate vitamin D support. [ABSTRACT FROM AUTHOR]

Background: F-18-flurodeoxyglucose (FDG) PET/CT is routinely used for staging, evaluation of response to treatment and follow-up of most pediatric malignancies. Cervical lymph nodes can be involved in some pediatric malignancies, but increased uptake in non-malignant cervical lymph nodes is not exceptional in this population. The aim of the present study is to identify predictors of the maximum uptake in non-malignant cervical lymph nodes in the pediatric population. Methods: 191 FDG PET/CT studies of pediatric patients without malignant involvement of cervical lymph nodes were retrospectively reviewed. The maximal Standard Uptake Value in the hottest cervical lymph node (SUVmaxCLN), as well as demographic, technical and imaging variables were recorded. The predictive effect of those variables on SUVmaxCLN was estimated using linear regression models. Results: Increased FDG activity in cervical nodes was observed in 136/191 studies (71%). The mean SUVmaxCLN was 2.2 ± 1.3. Ipsilateral palatine tonsil SUVmax, mean liver uptake, and treatment status were all statistically significant predictors of SUVmaxCLN. However, in multivariate regression analysis, only ipsilateral palatine tonsil SUVmax was found to be significant. In addition, SUVmaxCLN was greater than the mean liver uptake in 50% of all studies. This proportion was higher in younger children, reaching 77% of studies of children younger than six years. Conclusion: SUVmax in ipsilateral palatine tonsil is a strong predictor of the maximal uptake value of non-malignant cervical lymph nodes in children. The intensity of uptake in non-malignant cervical lymph nodes is frequently higher than liver uptake in children, and this tendency increases for younger patients. Trial was registered: In the internal hospital registry under TRN 0209-22-HMO on date 23.04.2022. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical use of acoustic change complex (ACC) as an objective tool in children who use hearing aids (H.As) and explore how far ACC threshold could be correlated to behavioral measures. Study design: Sixty Arabic-speaking children (34 boys & 26 girls) using binaural H.As participated in the present study. Their age ranged from 6 to 12 years. The short stimulus used in the present study to elicit ACC response was "gap in tone." Evaluation of H.As of children was performed in the form of questionnaire, aided sound field thresholds, central auditory tests, and aided/unaided cortical ACC recordings. The replicated ACC waveforms were collected and analyzed, and the aided ACC responses were compared with unaided ACC in addition to correlation of ACC-GDT to behavioral thresholds/scores. Results: The highest percent of ACC detectability achieved with gap in tone with 50-ms duration. Percent detectability reached 65% in aided condition and decreased to 25% in unaided test condition. The aided ACC wave morphology showed no significant difference when compared with unaided condition; however, a significant decrease in ACC latency was observed in the aided condition. The ACC response was elicited easily at 40-dB sensation levels or at MCL in both conditions. The ACC-GDT showed correlation to questionnaire scores rather than behavioral test (AFT). Conclusions: ACC to relatively short duration stimulus can be successfully recorded in hearing-impaired children in aided and unaided conditions. ACC response parameters (detectability and P1 latency) can reflect the benefit from H.As as an objective measure in evaluation of young children and difficult to test subjects with the usual subjective measures, and finally, ACC-GDT may add a predictive value to questionnaire scores which may help in case of inability of parents or caregivers to fulfill the entire questionnaire items. [ABSTRACT FROM AUTHOR]

Background: We recently found headache disorders to be highly prevalent among children (aged 6–11 years) and adolescents (aged 12–17) in Iran (gender- and age-adjusted 1-year prevalences: migraine 25.2%, tension-type headache 12.7%, undifferentiated headache [UdH] 22.1%, probable medication-overuse headache [pMOH] 1.1%, other headache on ≥ 15 days/month [H15+] 3.0%). Here we report on the headache-attributed burden, taking evidence from the same study. Methods: In a cross-sectional survey, following the generic protocol for the global schools-based study led by the Global Campaign against Headache, we administered the child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaire in 121 schools, purposively selected to reflect the country's diversities. Pupils self-completed these in class, under supervision. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of UdH (defined as mild headache with usual duration < 1 h). Burden enquiry was across multiple domains. Results: The analysed sample (N = 3,244) included 1,308 (40.3%) children and 1,936 (59.7%) adolescents (1,531 [47.2%] male, 1,713 [52.8%] female). The non-participating proportion was 3.4%. Mean headache frequency was 3.9 days/4 weeks, and mean duration 1.8 h. Estimated mean proportion of time in ictal state was 1.1% (1.4% for migraine, 16.5% for pMOH). Symptomatic medication was consumed on a mean of 1.6 days/4 weeks. Lost school time averaged 0.4 days/4 weeks overall (2%, assuming a 5-day week), but was eleven-fold higher (4.3 days; 22%) for pMOH. For most headache types, days of reported limited activity were several-fold more than days lost from school (45% for pMOH, 25% for other H15+). Almost one in 12 parents (7.9%) missed work at least once in 4 weeks because of their son's or daughter's headache. Emotional impact and quality-of-life scores reflected these measures of burden. Conclusions: Headache, common in children and adolescents in Iran, is associated with symptom burdens that may be onerous for some but not for most. However, there are substantial consequential burdens, particularly for the 1.1% with pMOH and the 3.0% with other H15+, who suffer educational disturbances and potentially major life impairments. These findings are of importance to educational and health policies in Iran. [ABSTRACT FROM AUTHOR]