Subjects -> HEALTH AND SAFETY (Total: 1464 journals)
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    - HEALTH AND SAFETY (686 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (686 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
ACM Transactions on Computing for Healthcare     Hybrid Journal  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 30)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 3)
African Health Sciences     Open Access   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 40)
Aging and Health Research     Open Access   (Followers: 3)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 11)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access  
American Journal of Family Therapy     Hybrid Journal   (Followers: 7)
American Journal of Health Economics     Full-text available via subscription   (Followers: 24)
American Journal of Health Education     Hybrid Journal   (Followers: 36)
American Journal of Health Promotion     Hybrid Journal   (Followers: 24)
American Journal of Health Sciences     Open Access   (Followers: 11)
American Journal of Health Studies     Full-text available via subscription   (Followers: 14)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 34)
American Journal of Public Health     Full-text available via subscription   (Followers: 207)
American Journal of Public Health Research     Open Access   (Followers: 31)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 9)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 10)
Annals of Health Law     Open Access   (Followers: 7)
Applied Biosafety     Hybrid Journal   (Followers: 2)
Applied Ergonomics     Hybrid Journal   (Followers: 18)
Apuntes Universitarios     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 12)
Archivos de Prevención de Riesgos Laborales     Open Access  
ASA Monitor     Full-text available via subscription   (Followers: 18)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 7)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 5)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Asian Journal of Population Sciences     Open Access   (Followers: 8)
Asian Journal of Social Health and Behavior     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 8)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 5)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 14)
Bijzijn XL     Hybrid Journal  
Biograph-I : Journal of Biostatistics and Demographic Dynamic     Open Access   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 7)
Biosafety and Health     Open Access  
Biosalud     Open Access  
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access   (Followers: 1)
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 19)
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 54)
Buletin Penelitian Kesehatan     Open Access  
Buletin Penelitian Sistem Kesehatan     Open Access  
Cadernos de Educação, Saúde e Fisioterapia     Open Access  
Cadernos de Saúde     Open Access  
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 13)
Canadian Family Physician     Partially Free   (Followers: 14)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 16)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 27)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 2)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
CASUS : Revista de Investigación y Casos en Salud     Open Access  
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access  
Child and Adolescent Obesity     Open Access   (Followers: 3)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access  
Chinese Journal of Physiology     Open Access   (Followers: 1)
CHRISMED Journal of Health and Research     Open Access   (Followers: 1)
Christian Journal for Global Health     Open Access   (Followers: 1)
Ciencia & Salud     Open Access  
Ciencia & Trabajo     Open Access  
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 1)
Ciencia, Tecnología y Salud     Open Access  
Cities & Health     Hybrid Journal   (Followers: 5)
Cleaner and Responsible Consumption     Open Access  
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
Clocks & Sleep     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
Community Health     Open Access   (Followers: 6)
Conflict and Health     Open Access   (Followers: 8)
Contact (CTC)     Open Access  
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal  
D Y Patil Journal of Health Sciences     Open Access   (Followers: 4)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal  
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal   (Followers: 1)
Digital Health     Open Access   (Followers: 11)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 12)
Discover Social Science and Health     Open Access   (Followers: 14)
Diversity and Equality in Health and Care     Open Access   (Followers: 10)
Diversity of Research in Health Journal     Open Access   (Followers: 1)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Open Access   (Followers: 2)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 23)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 25)
EcoHealth     Hybrid Journal   (Followers: 6)
Education for Health     Open Access   (Followers: 9)
Egyptian Journal of Nutrition and Health     Open Access   (Followers: 1)
Egyptian Journal of Occupational Medicine     Open Access   (Followers: 2)
electronic Journal of Health Informatics     Open Access   (Followers: 7)
ElectronicHealthcare     Full-text available via subscription   (Followers: 2)
Emerging Trends in Drugs, Addictions, and Health     Open Access   (Followers: 1)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 3)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 7)
EsSEX : Revista Científica     Open Access  
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access  
Ethics & Human Research     Hybrid Journal   (Followers: 4)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 7)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 6)
Ethnicity & Health     Hybrid Journal   (Followers: 16)
Eurasian Journal of Health Technology Assessment     Open Access   (Followers: 1)
EUREKA : Health Sciences     Open Access  
European Journal of Health Communication     Open Access  
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Exploratory Research in Clinical and Social Pharmacy     Open Access  
Expressa Extensão     Open Access  
F&S Reports     Open Access  
Face à face     Open Access  
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Hybrid Journal   (Followers: 13)
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Relations     Partially Free   (Followers: 11)
FASEB BioAdvances     Open Access   (Followers: 1)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 3)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 10)
Food Hydrocolloids for Health     Open Access  
Food Quality and Safety     Open Access   (Followers: 2)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Neuroergonomics     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Frontiers of Health Services Management     Partially Free   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 2)
Galen Medical Journal     Open Access  
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 7)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access   (Followers: 2)
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Annual Review     Open Access   (Followers: 2)
Global Health Innovation     Open Access   (Followers: 2)
Global Health Journal     Open Access   (Followers: 2)
Global Health Promotion     Hybrid Journal   (Followers: 16)
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Public Health     Open Access   (Followers: 16)
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Mental Health     Open Access   (Followers: 13)
Global Reproductive Health     Open Access   (Followers: 1)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Global Transitions Proceedings     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 7)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 23)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 19)
Health and Human Rights     Open Access   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 64)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 2)
Health Care Analysis     Hybrid Journal   (Followers: 12)
Health Equity     Open Access   (Followers: 4)
Health Information : Jurnal Penelitian     Open Access  

        1 2 3 4 | Last

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Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2227-9067
Published by MDPI Homepage  [249 journals]
  • Children, Vol. 10, Pages 174: Acknowledgment to the Reviewers of Children
           in 2022

    • Authors: Children Editorial Office Children Editorial Office
      First page: 174
      Abstract: High-quality academic publishing is built on rigorous peer review [...]
      Citation: Children
      PubDate: 2023-01-17
      DOI: 10.3390/children10020174
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 175: The Impact of a Family-Centred Intervention
           for Parents of Children with Developmental Disabilities: A Model Project
           in Rural Ireland

    • Authors: Roy McConkey, Pauline O’Hagan, Joanne Corcoran
      First page: 175
      Abstract: The greater risk of poor mental health and social isolation, experienced by parents of children with developmental disabilities, is compounded by family circumstances and living in rural settings. Often parents receive little personal support. Family-centred interventions have been recommended internationally for promoting children’s development, as well as boosting parental wellbeing. Yet, in many countries, current service provision is predominately child-focused and clinic-centred. An innovative, family-centred support service was designed and evaluated in a rural county of Ireland. Support staff visit the family home every month for around one year with regular check-ins by phone. The service aims included setting developmental goals for the child that were agreed with parents, alongside actions to address the personal needs of parents and siblings. In addition, community activities are identified or created to promote the social inclusion of the child and family in local communities, as well as locating opportunities for social activities for mothers. To date, 96 families with 110 children have been involved and three monthly reviews have been undertaken of each child’s progress. Baseline measures on parents’ mental health and social isolation were gathered and repeated when parents had completed their involvement with the project, along with qualitative information regarding the parents’ experiences. Most children attained their learning targets, alongside those selected as personal goals by parents; in particular, parents reported their child’s greater involvement in community activities, increased knowledge and skills, and with more confidence and resilience. Significant increases in parental well-being scores were reported, but there was a limited impact on their social participation and that of their child. This evidence-based model of provision is an example of how current social care provision for families who have a child with developmental disabilities could be cost-effectively re-envisioned even in rural areas.
      Citation: Children
      PubDate: 2023-01-17
      DOI: 10.3390/children10020175
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 176: Assessment of Orthodontic Treatment Need and
           Oral Health-Related Quality of Life in Asthmatic Children Aged 11 to 14
           Years Old: A Cross-Sectional Study

    • Authors: Adrián Curto, Fátima Mihit, Daniel Curto, Alberto Albaladejo
      First page: 176
      Abstract: This study investigated the need for orthodontic treatment in asthmatic children aged 11 to 14 years and how the treatment affected their oral health-related quality of life (OHRQoL). Materials and Methods: This cross-sectional study was conducted at the dental clinic of the University of Salamanca in 2020–2022. The study selected a consecutive sample of 140 children with asthma (52.1% girls; 47.9% boys). This study used the Orthodontic Treatment Needs Index (OTN) to analyze the need for orthodontic treatment and the Children’s Perception Questionnaire (CPQ11–14) to assess OHRQoL. Results: Sex and age did not significantly influence the need for orthodontic treatment, although age may be considered influential for OHRQoL concerning oral symptoms (p < 0.01), functional limitations (p < 0.05), and total score on the CPQ11–14 questionnaire (p < 0.05): the younger the age, the greater the effect of the need for orthodontic treatment on OHRQoL. The social well-being of the patients was much more significantly impacted by the need for orthodontic treatment (15.7 ± 1.91) than by oral symptoms (7.64 ± 1.39), which were the least impacted. In all parts of the CPQ11–14 questionnaire and in the patients’ total scores, we observed significant agreement (p < 0.01) that treatment influenced OHRQoL. Conclusion: An inverse relationship exists between the severity of the treatment needed and OHRQoL.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020176
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 177: A Multicentre Italian Study on the
           Psychological Impact of an Inconclusive Cystic Fibrosis Diagnosis after
           Positive Neonatal Screening

    • Authors: Antonella Tosco, Diletta Marino, Sara Polizzi, Valentina Tradati, Rita Padoan, Claudia Giust, Benedetta Fabrizzi, Giovanni Taccetti, Lucia Merli, Vito Terlizzi
      First page: 177
      Abstract: Background: An inconclusive diagnosis of cystic fibrosis (CF) after positive newborn screening (NBS) may cause parental distress. We compared the psychological impact of CF transmembrane conductance regulator-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID), and clear CF diagnosis, on parents. Methods: The participants were administered the Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, and the Italian version of the Impact of Event Scale-Revised as quantitative tools and semi-structured interviews as qualitative tools. Parental experience, child representation, relationships, future information, and perception of health status were investigated. Interviews were recorded and transcribed verbatim maintaining anonymity. Results: Thirty-two families were enrolled: sixteen with CF and CRMS/CFSPID, respectively. Anxiety and depression values were high in both groups, as were the measurement of traumatic impact subscales: avoidance, intrusiveness, and hyperarousal. The children’s health was evaluated by respective parents as being nearly healthy. Conclusions: Our results highlight negative psychological impacts, including emotional and affective representations, on parents of children with inconclusive CF diagnosis compared with those with clear diagnosis.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020177
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 178: Senhance Robotic Platform in Pediatrics:
           Early US Experience

    • Authors: Maria Consuelo Puentes, Marko Rojnica, Thomas Sims, Robert Jones, Francesco M. Bianco, Thom E. Lobe
      First page: 178
      Abstract: Introduction: Different robotic systems have been used widely in human surgery since 2000, but pediatric patients require some features that are lacking in the most frequently used robotic systems. Hypothesis: The Senhance® robotic system is a safe and an effective device for use in infants and children that has some advantages over other robotic systems. Methods: All patients between 0 and 18 years of age whose surgery was amenable to laparoscopy were offered enrollment in this IRB-approved study. We assessed the feasibility, ease and safety of using this robotic platform in pediatric patients including: set-up time, operative time, conversions, complications and outcomes. Results: Eight patients, ranging from 4 months to 17 years of age and weighing between 8 and 130 kg underwent a variety of procedures including: cholecystectomy (3), inguinal herniorrhaphy (3), orchidopexy for undescended testes (1) and exploration for a suspected enteric duplication cyst (1). All robotic procedures were successfully performed. The 4-month-old (mo), 8 kg patient underwent an uneventful robotic exploration in an attempt to locate a cyst that was hidden in the mesentery at the junction of the terminal ileum and cecum, but ultimately the patient required an anticipated laparotomy to palpate the cyst definitively and to excise it completely. There was no blood loss and no complications. Robotic manipulation with the reusable 3 mm instruments proved successful in all cases. Conclusions: Our initial experience with the Senhance® robotic platform suggests that this is a safe and effective device for pediatric surgery that is easy to use, and which warrants continued evaluation. Most importantly, there appears to be no lower age or weight restrictions to its use.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020178
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 179: Telephone Referral to a Paediatric Emergency
           Department: Why Do Parents Not Show Up'

    • Authors: Mélanie Freiermuth, Christopher J. Newman, Judit Villoslada
      First page: 179
      Abstract: Medical call centres can evaluate and refer patients to an emergency department (ED), a physician or provide guidance for self-care. Our aim was (1) to determine parental adherence to an ED orientation after being referred by the nurses of a call centre, (2) to observe how adherence varies according to children’s characteristics and (3) to assess parents’ reasons for non-adherence. This was a prospective cohort study set in the Lausanne agglomeration, Switzerland. From 1 February to 5 March 2022, paediatric calls (<16 years old) with an ED orientation were selected. Life-threatening emergencies were excluded. Parental adherence was then verified in the ED. All parents were contacted by telephone to respond to a questionnaire regarding their call. Parental adherence to the ED orientation was 75%. Adherence decreased significantly with increasing distance between the place the call originated and the ED. The child’s age, sex and health complaints within calls had no effect on adherence. The three major reasons for non-adherence to telephone referral were: improvement in the child’s condition (50.7%), parents’ decision to go elsewhere (18.3%) and an appointment with a paediatrician (15.5%). Our results offer new perspectives to optimise the telephone assessment of paediatric patients and decrease barriers to adherence.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020179
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 180: Evaluation of Serum Biomarkers and
           Electroencephalogram to Determine Survival Outcomes in Pediatric
           Post-Cardiac-Arrest Patients

    • Authors: Magda El-Seify, Mennatallah O. Shata, Sondos Salaheldin, Somia Bawady, Ahmed R. Rezk
      First page: 180
      Abstract: Cardiac arrest causes primary and secondary brain injuries. We evaluated the association between neuron-specific enolase (NSE), serum S-100B (S100B), electroencephalogram (EEG) patterns, and post-cardiac arrest outcomes in pediatric patients. A prospective observational study was conducted in the pediatric intensive care unit and included 41 post-cardiac arrest patients who underwent EEG and serum sampling for NSE and S100B. The participants were aged 1 month to 18 years who experienced cardiac arrest and underwent CPR after a sustained return of spontaneous circulation for ≥48 h. Approximately 19.5% (n = 8) of patients survived until ICU discharge. Convulsions and sepsis were significantly associated with higher mortality (relative risk: 1.33 [95% CI = 1.09–1.6] and 1.99 [95% CI = 0.8–4.7], respectively). Serum NSE and S100B levels were not statistically associated with the outcome (p = 0.278 and 0.693, respectively). NSE levels were positively correlated with the duration of CPR. EEG patterns were significantly associated with the outcome (p = 0.01). Non-epileptogenic EEG activity was associated with the highest survival rate. Post-cardiac arrest syndrome is a serious condition with a high mortality rate. Management of sepsis and convulsions affects prognosis. We believe that NSE and S100B may have no benefit in survival evaluation. EEG can be considered for post-cardiac arrest patients.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020180
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 181: Pediatric Glaucoma—From Screening,
           Early Detection to Management

    • Authors: Ruyue Shen, Venice S. W. Li, Mandy O. M. Wong, Poemen P. M. Chan
      First page: 181
      Abstract: Pediatric glaucoma (PG) covers a rare and heterogeneous group of diseases with variable causes and presentations. Delayed diagnosis of PG could lead to blindness, bringing emotional and psychological burdens to patients’ caregivers. Recent genetic studies identified novel causative genes, which may provide new insight into the etiology of PG. More effective screening strategies could be beneficial for timely diagnosis and treatment. New findings on clinical characteristics and the latest examination instruments have provided additional evidence for diagnosing PG. In addition to IOP-lowering therapy, managing concomitant amblyopia and other associated ocular pathologies is essential to achieve a better visual outcome. Surgical treatment is usually required although medication is often used before surgery. These include angle surgeries, filtering surgeries, minimally invasive glaucoma surgeries, cyclophotocoagulation, and deep sclerectomy. Several advanced surgical therapies have been developed to increase success rates and decrease postoperative complications. Here, we review the classification and diagnosis, etiology, screening, clinical characteristics, examinations, and management of PG.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020181
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 182: Long-Term Outcome of Pediatric Patients with
           Anti-NMDA Receptor Encephalitis in a Single Center

    • Authors: Pei-Yu Wu, Ching-Shiang Chi, Chi-Ren Tsai, Yao-Lun Yang, Hsiu-Fen Lee
      First page: 182
      Abstract: Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common autoimmune encephalitis in children. There is a high probability of recovery if treated promptly. We aimed to analyze the clinical features and long-term outcomes of pediatric patients with anti-NMDA receptor encephalitis. Method: We conducted a retrospective study with definite diagnoses of anti-NMDA receptor encephalitis in 11 children treated in a tertiary referral center between March 2012 and March 2022. Clinical features, ancillary tests, treatment, and outcomes were reviewed. Results: The median age at disease onset was 7.9 years. There were eight females (72.7%) and three males (27.3%). Three (27.3%) patients initially presented with focal and/or generalized seizures and eight (72.7%) with behavioral change. Seven patients (63.6%) revealed normal brain MRI scans. Seven (63.6%) had abnormal EEG results. Ten patients (90.1%) received intravenous immunoglobulin, corticosteroid, and/or plasmapheresis. After a median follow-up duration of 3.5 years, one patient was lost to follow-up at the acute stage, nine (90%) had an mRS ≤ 2, and only one had an mRS of 3. Conclusions: With the early recognition of anti-NMDA receptor encephalitis based on its clinical features and ancillary tests, we were able to treat patients promptly with first-line treatment and achieve favorable neurological outcomes.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020182
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 183: Evaluating the Arterial Stiffness as a
           Useful Tool in the Management of Obese Children

    • Authors: Monica Simina Mihuta, Dana Stoian, Andreea Borlea, Cristina Mihaela Roi, Oana-Alexandra Velea-Barta, Ioana Mozos, Corina Paul
      First page: 183
      Abstract: Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject’s medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients’ vascular health and should be considered a reliable tool in the management of obese children.
      Citation: Children
      PubDate: 2023-01-18
      DOI: 10.3390/children10020183
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 184: A Prospective Evaluation of the Effects of
           the COVID-19 Pandemic on Youth with Primary Headache Disorders

    • Authors: Mark Connelly, Jennifer Dilts, Madeline Boorigie, Trevor Gerson
      First page: 184
      Abstract: Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = −2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = −2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020184
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 185: Household Food Insufficiency and Chronic
           Pain among Children in the US: A National Study

    • Authors: See Wan Tham, Emily F. Law, Tonya M. Palermo, Flavia P. Kapos, Jason A. Mendoza, Cornelius B. Groenewald
      First page: 185
      Abstract: This study aimed to determine the prevalence of pediatric chronic pain by household food sufficiency status and examine whether food insufficiency would be associated with greater risk for chronic pain. We analyzed data from the 2019–2020 National Survey of Children’s Health of 48,410 children (6–17 years) in the United States. Across the sample, 26.1% (95% CI: 25.2–27.0) experienced mild food insufficiency and 5.1% (95% CI: 4.6–5.7) moderate/severe food insufficiency. The prevalence of chronic pain was higher among children with mild (13.7%) and moderate/severe food insufficiency (20.6%) relative to children in food-sufficient households (6.7%, p < 0.001). After adjusting for a priori covariates (individual: age, sex, race/ethnicity, anxiety, depression, other health conditions, adverse childhood events; household: poverty, parent education, physical and mental health; community: region of residence), multivariable logistic regression revealed that children with mild food insufficiency had 1.6 times greater odds of having chronic pain (95% CI: 1.4–1.9, p < 0.0001) and those with moderate/severe food insufficiency, 1.9 higher odds (95% CI: 1.4–2.7, p < 0.0001) relative to food-sufficient children. The dose–response relationship between food insufficiency and childhood chronic pain highlights the importance of further research to identify underlying mechanisms and evaluate the impact of food insufficiency on the onset and persistence of chronic pain across the lifespan.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020185
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 186: School Dental Services Theoretical
           Model-Based on Geographic Information System in Al-Madinah, Saudi Arabia

    • Authors: Amal Aqeeli, Alla T. Alsharif, Marc Tennant, Estie Kruger
      First page: 186
      Abstract: The study aimed to design a geographic theoretical model for school dental services (SDS) in Al-Madinah, Saudi Arabia (SA), using a geographic information system (GIS). The location of all primary public schools and the student population at each school were obtained from the General Administration of Education in Al-Madinah Al-Munawwarah Region website. The geographic modeling for SDS was analyzed using GIS according to two models. A scenario was developed to simulate the demand for dental care for the two models based on schoolchildren’s estimated oral health profile. The areas with the higher number of schools; higher number of students; and dense child population as presented in the map suggest the future location of SDS. The total number of dentists required to work in SDS settings was 415 for the first model, and 277 for the second model. The suggested average number of dentists per district in the highest child population density districts is 18 dentists in the first model, compared to 14 in the second model. Establishing SDS is suggested as a solution to the persistently high prevalence of dental caries among schoolchildren in Al-Madinah and SA in general. A model was suggested for SDS with a guide of the proposed SDS locations and the number of dentists to hire for the services to meet the child population’s oral health needs.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020186
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 187: Should Perirectal Swab Culture Be Performed
           in Cases Admitted to the Neonatal Intensive Care Unit' Lessons Learned
           from the Neonatal Intensive Care Unit

    • Authors: Aysen Orman, Yalcin Celik, Guliz Evik, Gulden Ersöz, Necdet Kuyucu, Berfin Ozgokce Ozmen
      First page: 187
      Abstract: Serial perirectal swabs are used to identify colonization of multidrug-resistant bacteria and prevent spread. The purpose of this study was to determine colonization with carbapenem-resistant Enterobacterales (CRE) and vancomycin-resistant Enterococci (VRE). An additional purpose was to establish whether sepsis and epidemic associated with these factors were present in the neonatal intensive care unit (NICU), to which infants with hospital stays exceeding 48 h in an external healthcare center NICU were admitted. Perirectal swab samples were collected in the first 24 h by a trained infection nurse using sterile cotton swabs moistened with 0.9% NaCl from patients admitted to our unit after hospitalization exceeding 48 h in an external center. The primary outcome was positivity in perirectal swab cultures, and the secondary outcomes were whether this caused invasive infection and significant NICU outbreaks. A total of 125 newborns meeting the study criteria referred from external healthcare centers between January 2018 and January 2022 were enrolled. Analysis revealed that CRE constituted 27.2% of perirectal swab positivity and VRE 4.8%, and that one in every 4.4 infants included in the study exhibited perirectal swab positivity. The detection of colonization by these microorganisms, and including them within the scope of surveillance, is an important factor in the prevention of NICU epidemics.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020187
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 188: Kaposi Sarcoma in a Child after Fanconi
           Anemia-Induced Haploidentical Hematopoietic Stem Cell Transplant: A Case

    • Authors: Mohammed Saud Alsaidan, Ohoud Zaid Aljarbou, Waleed Alajroush
      First page: 188
      Abstract: Kaposi sarcoma is relatively common after solid organ transplantation, but very rare after hematopoietic stem cell transplant (HSCT). Here we are reporting a rare case of Kaposi sarcoma in a child after HSCT. An 11-year-old boy with Fanconi anemia was treated by haploidentical HSCT from his father. Three weeks after transplantation, the patient developed severe graft-versus-host disease (GVHD) which was treated by immunosuppressive therapy and extracorporeal photopheresis. Approximately 6.5 months after HSCT, the patient had asymptomatic nodular skin lesions over the scalp, chest, and face. Histopathological examination showed typical findings of Kaposi sarcoma. Later, additional lesions in the liver and oral cavity were confirmed. Liver biopsy was positive for HHV-8 antibodies. The patient was continued on Sirolimus which was already being used for the treatment of GVHD. Cutaneous lesions were also treated with topical timolol 0.5% ophthalmic solution. Within six months, cutaneous and mucous membrane lesions were completely resolved. Follow-up abdominal ultrasound and MRI showed the disappearance of the hepatic lesion.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020188
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 189: Risk Factors of Language Delay at Two Years
           of Corrected Age among Very-Low-Birth-Weight Preterm Infants: A
           Population-Based Study

    • Authors: Wei-Lun Tseng, Chia-Huei Chen, Jui-Hsing Chang, Chun-Chih Peng, Wai-Tim Jim, Chia-Ying Lin, Chyong-Hsin Hsu, Tzu-Yu Liu, Hung-Yang Chang, on behalf of the Taiwan Premature Infant Follow-up
      First page: 189
      Abstract: Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the Bayley Scale of Infant Development, third edition, were included using a population-based cohort database. Language delay was defined as mild to moderate if the composite score was between 70 and 85 and severe if the score was < 70. Multivariable logistic regression analysis was used to identify the perinatal risk factors associated with language delay. The study comprised 3797 VLBW preterm infants; 678 (18%) had a mild to moderate delay and 235 (6%) had a severe delay. After adjusting for confounding factors, low maternal education level, low maternal socioeconomic status, extremely low birth weight, male sex, and severe intraventricular hemorrhage (IVH) and/or cystic periventricular leukomalacia (PVL) were found to be significantly associated with both mild to moderate and severe delays. Resuscitation at delivery, necrotizing enterocolitis, and patent ductus arteriosus requiring ligation showed significant associations with severe delay. The strongest factors predicting both mild to moderate and severe language delays were the male sex and severe IVH and/or cystic PVL; thus, early targeted intervention is warranted in these populations.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020189
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 190: Dietary Intake by Toddlers and Preschool
           Children: Preliminary Results from a Michigan Cohort

    • Authors: Natalie R. JaBaay, Nikita H. Nel, Sarah S. Comstock
      First page: 190
      Abstract: Identifying the consumption patterns of toddlers and preschool children is critical to evaluating their potential for healthy development and future heath trajectories. The purpose of this longitudinal cohort study was to describe breastfeeding, nutritional trends, and dietary diversity in 12-to-36-month-old children in a Michigan cohort. Mothers completed surveys when their children were 12 (n = 44), 24 (n = 46) and 36 months old (n = 32). Mothers reported their child’s dietary intake in the past 24 h and intake of specific foods in the past year. About 95% of 12-to-24-month-old children in the study population were ever breastfed, with 70% consuming human milk at 6 months and just over 40% at 12 months. Over 90% of participants gave their child a bottle since birth, with 75% providing human milk and 69% giving formula. Consumption of juice significantly increased with age and ~55% of the 36-month-old children consumed juice. A larger proportion of children consumed soda, chocolate, and candy as they aged. Though dietary diversity numerically increased with child age, this did not reach significance. Gut microbiota composition and structure was not associated with diet diversity. This research lays the foundation for future work to determine which nutritional interventions may be most effective in this population.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020190
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 191: Association between Family Environment and
           Adolescents’ Sexual Adaptability: Based on the Latent Profile
           Analysis of Personality Traits

    • Authors: Rui Zhao, Jun Lv, Yan Gao, Yuyan Li, Huijing Shi, Junguo Zhang, Junqing Wu, Ling Wang
      First page: 191
      Abstract: Sexual adaptation plays an important role in psychosexual health. Our study aimed to investigate the relationship between the family environment and sexual adaptability among adolescents with different personality traits. A cross-sectional study was conducted in Shanghai and Shanxi province. A total of 1106 participants aged 14–19 was surveyed in 2019, including 519 boys and 587 girls. Univariate analyses and mixed regression models were performed to assess the association. Girls had a significantly lower average score of sexual self-adaptation compared to boys (4.01 ± 0.77 vs. 4.32 ± 0.64, p < 0.001). We found that the family environment did not impact boys’ sexual adaptation in different personality groups. For girls in a balanced group, expressiveness factors improved their sexual adaptability (p < 0.05), intellectual–cultural orientation and organization promoted social adaptability (p < 0.05) and active–recreational orientation and control decreased their social adaptability (p < 0.05). In the high-neuroticism group, cohesion facilitated sexual control (p < 0.05), while conflict and organization reduced sexual control ability, and active–recreational orientation decreased sexual adaptation (p < 0.05). No factors associated with the family environment were found to influence sexual adaptability in groups with low neuroticism and high ratings in other personality factors. Compared with boys, girls demonstrated lower sexual self-adaptability, and their overall sexual adaptability was more susceptible to the family environment.
      Citation: Children
      PubDate: 2023-01-19
      DOI: 10.3390/children10020191
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 192: Vertebral Body Tethering in AIS
           Management—A Preliminary Report

    • Authors: Aurélien Courvoisier, Alice Baroncini, Clément Jeandel, Clémentine Barra, Yan Lefevre, Federico Solla, Richard Gouron, Jean-Damien Métaizeau, Marie-Christine Maximin, Vincent Cunin
      First page: 192
      Abstract: Vertebral Body Tethering (VBT) is a recently developed surgical technique for the treatment of progressive and severe scoliosis in patients with significant growth potential. It has been used since the first exploratory series, which showed encouraging results on the progressive correction of the major curves. This study reports on a retrospective series of 85 patients extracted from a French cohort, with a follow-up at a minimum of two years after a VBT with recent screws-and-tether constructs. The major and compensatory curves were measured pre-operatively, at the 1st standing X-ray, at 1 year, and at the last available follow-up. The complications were also analyzed. A significant improvement was observed in the curve magnitude after surgery. Thanks to growth modulation, both the main and the secondary curves continued to progress over time. Both the thoracic kyphosis and lumbar lordosis remained stable over time. Overcorrection occurred in 11% of the cases. Tether breakage was observed in 2% of the cases and pulmonary complications in 3% of the cases. VBT is an effective technique for the management of adolescent idiopathic scoliosis patients with residual growth potential. VBT opens an era of a more subtle and patient-specific surgical management of AIS that considers parameters such as flexibility and growth.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020192
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 193: A Retrospective Study Comparing Outcomes of
           Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss

    • Authors: Mihaela Visoiu, Senthilkumar Sadhasivam
      First page: 193
      Abstract: Introduction: The continuous paravertebral blockade as part of the multimodal pain protocol is an effective regional technique to control pain after the Nuss procedure. We investigated the effectiveness of clonidine as an adjunct to paravertebral ropivacaine infusion. Methods: We conducted a retrospective study of 63 patients who underwent Nuss procedures and received bilateral paravertebral catheters. Data on demographics, surgical, anesthesia, and block characteristics, numeric rating pain scores (NRS), opioids consumption, hospital length of stay, complications, and side effects from medication administration were collected in children who received paravertebral ropivacaine 0.2% infusion without (N = 45) and with clonidine (1 mcg/mL) (N = 18). Results: The two groups had similar demographics, although the clonidine group had higher Haller indices (6.5 (4.8, 9.4) vs. 4.8 (4.1, 6.6), p = 0.013). The clonidine group required less morphine equivalent/kg on postoperative day 2 (median, interquartile range 0.24 (0.22, 0.31) vs. 0.47 (0.29, 0.61) p = 0.002). There was no difference in median NRS pain scores. Both groups had similar catheter infusion durations, hospital length of stay, and complication rates. Conclusion: A postoperative pain management plan that includes paravertebral analgesia, including clonidine as an adjunct, may be considered to minimize opioid administration for patients undergoing primary Nuss repair.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020193
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 194: Monitoring of Auditory Function in Newborns
           of Women Infected by SARS-CoV-2 during Pregnancy

    • Authors: Enrico Apa, Maria Teresa Presutti, Cecilia Rossi, Maria Federica Roversi, Salvatore Neri, Giancarlo Gargano, Giovanni Bianchin, Valeria Polizzi, Valeria Caragli, Daniele Monzani, Alberto Berardi, Silvia Palma, Elisabetta Genovese
      First page: 194
      Abstract: Background: Gestational SARS-CoV-2 infection can impact maternal and neonatal health. The virus has also been reported to cause newborn sensorineural hearing loss, but its consequences for the auditory system are not fully understood. Objective: The aim of this study was to evaluate the impact of maternal SARS-CoV-2 infection during pregnancy on newborn’ hearing function during the first year of life. Methods: An observational study was conducted from 1 November 2020 to 30 November 2021 at University Modena Hospital. All newborns whose mother had been infected by SARS-CoV-2 during pregnancy were enrolled and underwent audiological evaluation at birth and at 1 year of age. Results: A total of 119 neonates were born from mothers infected by SARS-CoV-2 during pregnancy. At birth, five newborns (4.2%) presented an increased threshold of ABR (Auditory Brainstem Evoked Response), but the results were confirmed only in 1.6% of cases, when repeated 1 month later, while the ABR thresholds in all other children returned to normal limits. At the 1-year follow-up, no cases of moderate or severe hearing loss were observed, while concomitant disorders of the middle ear were frequently observed. Conclusions: Maternal SARS-CoV-2 infection, regardless of the trimester in which it was contracted, appears not to induce moderate or severe hearing loss in infants. It is important to clarify the possible effect of the virus on late-onset hearing loss and future research is needed.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020194
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 195: Indications and Timing of Guided Growth

    • Authors: Mark F. Siemensma, Christiaan van Bergen, Eline van Es, Joost W. Colaris, Denise Eygendaal
      First page: 195
      Abstract: Osseous deformities in children arise due to progressive angular growth or complete physeal arrest. Clinical and radiological alignment measurements help to provide an impression of the deformity, which can be corrected using guided growth techniques. However, little is known about timing and techniques for the upper extremity. Treatment options for deformity correction include monitoring of the deformity, (hemi-)epiphysiodesis, physeal bar resection, and correction osteotomy. Treatment is dependent on the extent and location of the deformity, physeal involvement, presence of a physeal bar, patient age, and predicted length inequality at skeletal maturity. An accurate estimation of the projected limb or bone length inequality is crucial for optimal timing of the intervention. The Paley multiplier method remains the most accurate and simple method for calculating limb growth. While the multiplier method is accurate for calculating growth prior to the growth spurt, measuring peak height velocity (PHV) is superior to chronological age after the onset of the growth spurt. PHV is closely related to skeletal age in children. The Sauvegrain method of skeletal age assessment using elbow radiographs is possibly a simpler and more reliable method than the method by Greulich and Pyle using hand radiographs. PHV-derived multipliers need to be developed for the Sauvegrain method for a more accurate calculation of limb growth during the growth spurt. This paper provides a review of the current literature on the clinical and radiological evaluation of normal upper extremity alignment and aims to provide state-of-the-art directions on deformity evaluation, treatment options, and optimal timing of these options during growth.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020195
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 196: Development and Evaluation of a Virtual
           Model for Fetal Alcohol Spectrum Disorder (FASD) Assessment and Diagnosis
           in Children: A Pilot Study

    • Authors: Seema King, Colleen Burns, Brent Symes, ShawnaLee Jessiman, Amber Bell, Hasu Rajani
      First page: 196
      Abstract: The diagnostic process for fetal alcohol spectrum disorder (FASD) involves a multi-disciplinary team and includes neurodevelopmental, physical, and facial assessments and evidence of prenatal alcohol exposure during the index pregnancy. With the increased use of virtual care in health care due to the pandemic, and desire of clinics to be more efficient when providing timely services, there was a need to develop a virtual diagnostic model for FASD. This study develops a virtual model for the entire FASD assessment and diagnostic process, including individual neurodevelopmental assessments. It proposes a virtual model for assessment and diagnosis of FASD in children and evaluates the functionality of this model with other national and international FASD diagnostic teams and caregivers of children being assessed for FASD.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020196
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 197: Fathers’ Experiences of Caring for a
           Child with a Chronic Illness: A Systematic Review

    • Authors: Shelley Spurr, Cynthia A. Danford, Karyn J. Roberts, Debbie Sheppard-LeMoine, Fernanda Machado Silva-Rodrigues, Michelle Darezzo Rodrigues Nunes, Leslie Darmofal, Anne L. Ersig, Mandie Foster, Barbara Giambra, Stacee Lerret, Michele Polfuss, Lindsay Smith, Suja Somanadhan
      First page: 197
      Abstract: The prevalence of children living with chronic health conditions is increasing worldwide and can disrupt family roles, relationships, function, and parental involvement in family caregiving. The purpose of this systematic review was to explore fathers’ experiences and involvement in caring for a child with a chronic condition. Systematic searches using seven databases were conducted. Study criteria included (1) peer-reviewed original research in English, Spanish, French, or Portuguese, (2) children less than 19 years of age with a chronic condition, (3) fathers (biological or guardian) as direct informants, and (4) outcomes addressing fathers’ experience, perceptions, and/or involvement in the child’s care. Data were synthesized from ten articles reflecting eight separate studies that utilized quantitative designs. Three areas of focus were identified: Family Functioning, Father’s Psychological Health, and Need for Support. Data suggested increased involvement from the father in caring for their child with a chronic condition was associated with improved family functioning, increased anxiety and distress, decreased self-esteem, and increased need for support. This review revealed a paucity of data regarding fathers’ experiences and involvement when caring for a child with a chronic condition, with that available primarily from developed countries. Rigorous empirical studies are needed to deepen understanding of how fathers are involved in the care of their child with a chronic condition.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020197
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 198: Home Immunization with Palivizumab-A
           Randomized Pilot Study Describing Safety Aspects and Parents’

    • Authors: Christina Ebersjö, Eva Berggren Broström, Inger Kull, Anna Lindholm Olinder
      First page: 198
      Abstract: Among prematurely born infants and newborns with chronic conditions, a respiratory syncytial virus (RSV) infection may cause (re-)admission and later respiratory complications. Therapeutic protection is possible with monthly injections of a specific monoclonal antibody, palivizumab, during RSV season. Standard care is giving up to five injections in clinic-based settings. Immunization at home could be an alternative to standard care for vulnerable infants to reduce the number of revisits and associated risk of RSV infection. The aim of this randomized pilot trial was to evaluate safety aspects and explore parents’ preferences of home versus hospital immunization with palivizumab during one RSV season. Immediate adverse events (AEs) were observed and registered by a pediatric specialist nurse. Late-onset AEs were reported by parents. Parents’ perceptions were collected through a questionnaire and analyzed using content analysis. The study population consisted of 43 infants in 38 families. No immediate AEs occurred. Three late-onset AEs were reported in two infants in the intervention group. Three categories emerged in the content analysis: (1) protect and watch over the infant, (2) optimal health and well-being for the whole family, and (3) avoid suffering for the infant. The study results show that home immunization with palivizumab is feasible if safety aspects are considered and that parental involvement in the choice of place for immunization after a neonatal intensive care experience can be important.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020198
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 199: Validation of a New Soccer Shooting Test
           Based on Speed Radar Measurement and Shooting Accuracy

    • Authors: Felix Engler, Andreas Hohmann, Maximilian Siener
      First page: 199
      Abstract: Due to poor results, the German talent identification and development of the German soccer association DFB no longer performs a shooting test since a few years. The aim of this study was to create and validate a new soccer shooting test that allows valid conclusions to be drawn from the shooting quality of youth soccer players about their overall soccer skills. The shooting test was performed with a total of 57 male club players (age: 15.24 ± 0.864 years) from four different teams from the first, second, fifth, and the seventh division of the respective age group (under 15-year-olds until under 17-year-olds). Each subject took one shot at maximum shot speed and eight target shots, measuring accuracy and the shot speed. A multivariable linear regression analysis with forward selection revealed significant values for the variables average shot speed nondominant leg (p < 0.001) and total score (p = 0.004; accuracy × speed of every target shot). Based on these two variables, the soccer skills could be derived from the shooting skills of the adolescents in 57.4% of the cases. The study shows the importance of a good technique with the nondominant leg and of the ability to shoot accurately as well as fast simultaneously.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020199
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 200: Effects of Musical Classes on Motor
           Creativity According to Age, Sex, and Weight Status in Young Students: A
           Music-Oriented versus Conventional Education Plan

    • Authors: Athos Trecroci, Gabriele Signorini, Raffaele Scurati, Dario Colella, Gaetano Raiola, Marta Rigon, Pietro Luigi Invernizzi
      First page: 200
      Abstract: Motor creativity can be influenced by the specificity of the school–class environments (music-based education plans) and individual characteristics. This study aimed to investigate the effects of music oriented and conventional education plans on rhythmic perceptive capacity, motor creativity, and skill- and health-related fitness components in young students according to age, sex, and weight status. One hundred sixty-three young Italian students from elementary (second and fourth grade) and middle school (sixth and eighth grade) were enrolled in the study according to their education plan (music oriented or conventional). All participants were tested for rhythmic perceptive capacity (Stambak’s test), motor creativity (Divergent Movement Ability test), skill-related (Körperkoordinationstest Für Kinder), and health-related (Multistage Fitness test) components. Individuals were also considered according to age (elementary and middle school), sex, and weight status. Significant age × education plan and sex × education plan interactions (p < 0.01) were found in motor creativity (locomotor and stability skills) and motor competence (balance and jumping-like activities). No significant weight status × education plan interaction was found. The predominant role of music in the music-oriented education plan appeared to foster the ability to enhance motor creativity in elementary and middle school students compared to the conventional plan. Moreover, music-oriented experience also seems relevant for expressing and exhibiting motor competence (i.e., balance) in relation to sex.
      Citation: Children
      PubDate: 2023-01-20
      DOI: 10.3390/children10020200
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 201: Localization and Laparoscopic Excision of

    • Authors: Yu-Jung Liou, Shu-Chao Weng, Paul Chia-Yu Chang, Chuen-Bin Jiang, Hung-Chang Lee, Wai-Tao Chan, Cheng-Yu Ho, Pao-Shu Wu, Chun-Yan Yeung
      First page: 201
      Abstract: Heterotopic pancreas (HP) is defined as pancreatic tissue lacking vascular or anatomic connection with the normal pancreas. Surgical resection is often indicated for symptomatic gastric HP. However, intraoperative identification of gastric HP is often difficult during laparoscopic surgery. Herein, we describe a patient with gastric HP, which was marked with SPOT® dye (GI Supply, Camp Hill, PA, USA). The dye was seen clearly laparoscopically facilitating total excision of the lesion. The final pathology report confirmed the presence of heterotopic pancreatic tissue including pancreatic acini, small pancreatic ducts tissue with islets of Langerhans in the deep gastric submucosal area. There were no postoperative complications, and the patient was symptom-free. To the best of our knowledge, this was the first case report in the literature in which endoscopic tattooing of gastric HP before laparoscopic resection was performed. This method of localization was simple and reliable in children.
      Citation: Children
      PubDate: 2023-01-22
      DOI: 10.3390/children10020201
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 202: Long-Term Outcome Following Liver
           Transplantation for Primary Hepatic Tumors—A Single Centre
           Observational Study over 40 Years

    • Authors: Christoph Leiskau, Norman Junge, Frauke E. Mutschler, Tobias Laue, Johanna Ohlendorf, Nicolas Richter, Florian W. R. Vondran, Eva-Doreen Pfister, Ulrich Baumann
      First page: 202
      Abstract: The incidence of pediatric liver tumors in general has been rising over the last years and so is the number of children undergoing liver transplantation for this indication. To contribute to the ongoing improvement of pre- and post-transplant care, we aim to describe outcome and risk factors in our patient cohort. We have compared characteristics and outcome for patients transplanted for hepatoblastoma to other liver malignancies in our center between 1983 and 2022 and analysed influential factors on tumor recurrence and mortality using nominal logistic regression analysis. Of 39 children (16 f) who had transplants for liver malignancy, 31 were diagnosed with hepatoblastoma. The proportion of malignant tumors in the transplant cohort rose from 1.9% (1983–1992) to 9.1% in the current decade (p < 0.0001). Hepatoblastoma patients were transplanted at a younger age and were more likely to have tumor extent beyond the liver. Post-transplant bile flow impairment requiring intervention was significantly higher compared to our total cohort (48 vs. 24%, p > 0.0001). Hearing loss was a common side effect of ototoxic chemotherapy in hepatoblastoma patients (48%). The most common maintenance immunosuppression were mTor-inhibitors. Risk factors for tumor recurrence in patients with hepatoblastoma were higher AFP before transplant (AFPpre-LTX), a low ratio of AFPmax to AFPpre-LTX and salvage transplantation. Liver malignancies represent a rising number of indications for liver transplantation in childhood. Primary tumor resection can spare a liver transplant with all its long-term complications, but in case of tumor recurrence, transplantation might have inferior outcome. The rate of acute biopsy-proven rejections and biliary complications in comparison to our total transplant cohort needs further investigations.
      Citation: Children
      PubDate: 2023-01-22
      DOI: 10.3390/children10020202
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 203: Nutritional Aspects of Juvenile Idiopathic
           Arthritis: An A to Z for Dietitians

    • Authors: Maria G. Grammatikopoulou, Konstantinos Gkiouras, Vasiliki Syrmou, Tonia Vassilakou, Theodora Simopoulou, Chistina G. Katsiari, Dimitrios G. Goulis, Dimitrios P. Bogdanos
      First page: 203
      Abstract: Juvenile idiopathic arthritis (JIA) represents a chronic, autoimmune, rheumatic musculoskeletal disease with a diagnosis before 16 years of age. Chronic arthritis is a common manifestation in all JIA subtypes. The nature of JIA, in combination to its therapy often results in the development of nutrition-, gastrointestinal (GI)- or metabolic-related issues. The most-common therapy-related nutritional issues involve methotrexate (MTX) and glucocorticosteroids (GCC) adverse events. MTX is a folic acid antagonist, thus supplementation with folic acid in required for improving GI side effects and correcting low serum levels. On the other hand, long-term GCC administration is often associated with hyperglycemia, insulin resistance and growth delay. This relationship is further aggravated when more joints are affected and greater doses of GCC are being administered. Apart from stature, body mass index z-scores are also suboptimal in JIA. Other signs of malnutrition include decreased phase angle and muscle mass, especially among patients with polyarthritis JIA. Evidence also points to the existence of an inverse relationship between disease activity and overweight/obesity. Specific dietary patterns, including the anti-inflammatory diet, might confer improvements in selected JIA outcomes, but the level of available research is yet insufficient to draw safe conclusions. The majority of patients exhibit suboptimal vitamin D status; hence, supplementation is recommended. Collectively, the evidence indicates that, due to the age of onset and the complexity of the disease, along with its pharmacotherapy, children with JIA are prone to the development of several nutritional problems, warranting expert monitoring. Vitamin deficiencies, oral and GI-problems limiting dietary intake, faltering growth, overweight and obesity, physical inactivity, or impaired bone health are among the many nutritional issues in JIA requiring dietitian support.
      Citation: Children
      PubDate: 2023-01-23
      DOI: 10.3390/children10020203
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 204: Efficacy of the Simeox® Airway Clearance
           Technology in the Homecare Treatment of Children with Clinically Stable
           Cystic Fibrosis: A Randomized Controlled Trial

    • Authors: Dorota Sands, Katarzyna Walicka-Serzysko, Justyna Milczewska, Magdalena Postek, Natalia Jeneralska, Aleksandra Cichocka, Ewa Siedlecka, Urszula Borawska-Kowalczyk, Laurent Morin
      First page: 204
      Abstract: Background: Cystic fibrosis (CF) patients require regular airway clearance therapy (ACT). The aim of this study was to evaluate homecare therapeutic effects of a new ACT (Simeox®) added to the optimal standard of care, including home chest physiotherapy, in the treatment of clinically stable children. Methods: Forty pediatric CF patients (8–17 years old) with stable disease were randomized 1:1 in a single-center, prospective, open-label, cross-over trial into two groups: with or without Simeox®. Lung function (impulse oscillometry, spirometry, body plethysmography, multi-breath nitrogen washout) results, health-related quality of life, and safety were assessed during the study after 1 month of therapy at home. Results: A significant decrease in proximal airway obstruction (as supported by improvement in airway resistance at 20 Hz (R20Hz) and maximum expiratory flow at 75% of FVC (MEF75)) compared to the control group was observed after 1 month of therapy with the device. Lung-clearance index was stable in the study group, while it worsened in the control group. In addition, the device group demonstrated a significant increase in the Cystic Fibrosis Questionnaire—Revised (CFQ-R) physical score. No side effects were identified during the study. Conclusions: Simeox® may improve drainage of the airways in children with clinically stable CF and could be an option in chronic treatment of the disease.
      Citation: Children
      PubDate: 2023-01-23
      DOI: 10.3390/children10020204
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 205: Abdominal Cryptorchidism with Complete
           Dissociation between the Testis and Deferent Duct Mimicking Testicular
           Regression Syndrome

    • Authors: Vladimir V. Sizonov, Alexey G. Makarov, Johannes M. Mayr, Vladimir V. Vigera, Mikhail I. Kogan
      First page: 205
      Abstract: Complete separation of the deferent duct from the epididymis in cryptorchid testes residing in the abdomen is an extremely rare variant of developmental disorders of the testis and epididymis. Available sources mention only three clinical cases similar to our observations. The unique anatomic aspects of this disorder hamper the correct diagnosis of an intra-abdominal cryptorchid testis. Two boys with nonpalpable left-sided cryptorchidism underwent diagnostic laparoscopy, revealing an intra-abdominally located testis. The epididymis was completely separated from the deferent duct, and the epididymis and testis were supplied by testicular vessels. Exploration of the inguinal canal revealed blind-ending deferent ducts. The testis was brought down through the inguinal canal and fixed in the scrotum in both boys. The follow-up examination at 6 months revealed no signs of testicular atrophy or malposition of the testis in either patient. With our observations in mind, the exclusive use of a transscrotal or transinguinal approach as the initial surgical exploration in the treatment of patients with nonpalpable forms of cryptorchidism may be inappropriate. Careful laparoscopic examination of the abdominal cavity is indispensable in children with suspected testicular regression syndrome or nonpalpable forms of cryptorchidism.
      Citation: Children
      PubDate: 2023-01-23
      DOI: 10.3390/children10020205
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 206: Characterization of MRI White Matter Signal
           Abnormalities in the Pediatric Population

    • Authors: Katharina J. Wenger, Caroline E. Koldijk, Elke Hattingen, Luciana Porto, Wiebke Kurre
      First page: 206
      Abstract: (1) Background and Purpose: The aim of this study was to retrospectively characterize WMSAs in an unselected patient cohort at a large pediatric neuroimaging facility, in order to learn more about the spectrum of the underlying disorders encountered in everyday clinical practice. (2) Materials and Methods: Radiology reports of 5166 consecutive patients with standard brain MRI (2006–2018) were searched for predefined keywords describing WMSAs. A neuroradiology specialist enrolled patients with WMSAs following a structured approach. Imaging characteristics, etiology (autoimmune disorders, non-genetic hypoxic and ischemic insults, traumatic white matter injuries, no final diagnosis due to insufficient clinical information, “non-specific” WMSAs, infectious white matter damage, leukodystrophies, toxic white matter injuries, inborn errors of metabolism, and white matter damage caused by tumor infiltration/cancer-like disease), and age/gender distribution were evaluated. (3) Results: Overall, WMSAs were found in 3.4% of pediatric patients scanned at our and referring hospitals within the ten-year study period. The majority were found in the supratentorial region only (87%) and were non-enhancing (78% of CE-MRI). WMSAs caused by autoimmune disorders formed the largest group (23%), followed by “non-specific” WMSAs (18%), as well as non-genetic hypoxic and ischemic insults (17%). The majority were therefore acquired as opposed to inherited. Etiology-based classification of WMSAs was affected by age but not by gender. In 17% of the study population, a definite diagnosis could not be established due to insufficient clinical information (mostly external radiology consults). (4) Conclusions: An “integrated diagnosis” that combines baseline demographics, including patient age as an important factor, clinical characteristics, and additional diagnostic workup with imaging patterns can be made in the majority of cases.
      Citation: Children
      PubDate: 2023-01-24
      DOI: 10.3390/children10020206
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 207: A Creative and Movement-Based Blended
           Intervention for Children in Outpatient Residential Care: A Mixed-Method,
           Multi-Center, Single-Arm Feasibility Trial

    • Authors: Susanne Birnkammer, Claudia Calvano
      First page: 207
      Abstract: The COVID-19 pandemic led to psychological distress among children and adolescents. Due to multiple psychosocial burdens, the youth in residential care were especially exposed to an increased risk of mental health problems during the pandemic. In a multi-center, single-arm feasibility trial, N = 45 children and adolescents aged 7–14 years were allocated to a 6-week blended care intervention, conducted in six outpatient residential child welfare facilities. The intervention covered a once weekly face-to-face group session for guided creative (art therapy, drama therapy) and movement-oriented (children’s yoga, nature therapy) activities. This was accompanied by a resilience-oriented mental-health app. Feasibility and acceptance analyses covered app usage data and qualitative data. Effectiveness was determined by pre-post comparisons in quantitative data on psychological symptoms and resources. Further, subgroups for poorer treatment outcome were explored. The intervention and app were considered to be feasible and were accepted by residential staff and the children. No significant pre-post changes were found across quantitative outcomes. However, being female, being in current psychosocial crisis, a migration background, or a mentally ill parent were correlated with change in score of outcomes from baseline. These preliminary findings pave the way for future research on blended care interventions among at-risk children and adolescents.
      Citation: Children
      PubDate: 2023-01-24
      DOI: 10.3390/children10020207
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 208: Efficacy of Liraglutide in Obesity in
           Children and Adolescents: Systematic Review and Meta-Analysis of
           Randomized Controlled Trials

    • Authors: Alejandra Cornejo-Estrada, Carlos Nieto-Rodríguez, Darwin A. León-Figueroa, Emilly Moreno-Ramos, Cielo Cabanillas-Ramirez, Joshuan J. Barboza
      First page: 208
      Abstract: In the past few decades, childhood obesity has become a significant global health issue, impacting around 107.7 million children and adolescents globally. There is currently minimal usage of pharmacological therapies for childhood obesity in the pediatric population. This research assessed the efficacy of liraglutide in treating childhood and adolescent obesity. Until 20 October 2022, a systematic literature review was done utilizing PubMed, Scopus, Web of Science, and Embase databases. The search phrases “liraglutide”, “pediatric obesity”, “children”, and “adolescents” were utilized. Using the search method, a total of 185 articles were found. Three studies demonstrating liraglutide’s effectiveness in treating child and adolescent obesity were included. The selected research was done in the United States. As an intervention, liraglutide was administered to 296 participants at a maximal dosage of 3.0 mg. All examined trials were in phase 3. This comprehensive analysis revealed no clinically significant differences between liraglutide and body weight (kg; MD −2.62; 95%CI −6.35 to 1.12; p = 0.17) and body mass index (kg/m2; MD −0.80; 95%CI −2.33 to 0.73, p = 0.31). There was no evidence that liraglutide increased hypoglycemia episodes (RR 1.08; 95%CI 0.37 to 3.15; p = 0.79), or side consequences. However, it was shown that the medicine might help reduce BMI and weight combined with a healthy diet and regular exercise. A lifestyle change may have favorable consequences that will be assessed in the future for adjunctive therapy. PROSPERO database (CRD42022347472)
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020208
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 209: Impact of Early Hemoglobin Levels on
           Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children

    • Authors: Catherine Gire, Ninon Fournier, Johanna Pirrello, Stéphane Marret, Hugues Patural, Cyril Flamant, Véronique Pierrat, Monique Kaminski, Pierre-Yves Ancel, Barthélémy Tosello, Julie Berbis
      First page: 209
      Abstract: Objective: To evaluate, in very preterm infants, the hemoglobin (Hb) levels during the first 24 h and the neurodevelopment outcomes at 24 months of corrected age. Design, setting, and patients: We conducted a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2. The eligible study participants were live-born singletons who were born before 32 weeks of gestational age, with early Hb levels who were admitted to the neonatal intensive care unit. Main outcome measures: The early Hb levels for an outcome survival at 24 months of corrected age without neurodevelopmental impairment were measured. The secondary outcomes were survival at discharge and without severe neonatal morbidity. Results: Of the 2158 singletons of <32 weeks with mean early Hb levels of 15.4 (±2.4) g/dL, 1490 of the infants (69%) had a follow-up at two years of age. An early Hb of 15.2 g/dL is the minimum receiving operating characteristic curve at the 24 months risk-free level, but the area under the curve at 0.54 (close to 50%) indicates that this rate was not informative. In logistic regression, no association was found between early Hb levels and outcomes at two years of age (aOR 0.966; 95% CI [0.775–1.204]; p = 0.758) but rather there was a correlation found with severe morbidity (aOR 1.322; 95% CI [1.003–1.743]; p = 0.048). A risk stratification tree showed that male newborns of >26 weeks with Hb of <15.5 g/dL (n = 703) were associated with a poor outcome at 24 months (OR 1.9; CI: [1.5–2.4] p < 0.01). Conclusions: Early low Hb levels are associated with major neonatal morbidities in VP singletons, but not with neurodevelopment outcomes at two years of age, except in male infants of >26 Weeks GA.
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020209
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 210: Circulating Nitric Oxide and Metabolic
           Syndrome in Arab Children and Adolescents: A Case–Control Study

    • Authors: Osama E. Amer, Shaun Sabico, Malak N. K. Khattak, Nasser M. Al-Daghri
      First page: 210
      Abstract: Background: Metabolic syndrome (MetS) represents a cluster of known cardiometabolic risk factors, which elevates the risk of type 2 diabetes mellitus (T2DM), atherosclerotic cardiovascular disease (CVD) and chronic kidney disease (CKD) in adults and, only recently, even in children and adolescents. Circulating nitric oxide (NOx) has been observed to influence MetS risk factors in adults, but this has been scarcely investigated in children. The aim of the present study was to determine whether circulating NOx levels correlate with known components of MetS in Arab children and adolescents. Methods: Anthropometrics, serum NOx, lipid profile and fasting glucose levels were measured in 740 Saudi Arabs aged 10–17 years (68.8% girls). The presence of MetS was screened using the criteria of de Ferranti et al. Results: Overall, serum NOx levels were significantly higher in MetS participants compared to non-MetS (25.7 µmol/L (10.1–46.7) versus 11.9 µmol/L (5.5–22.9), p < 0.001) even after adjustments for age, BMI and sex. With the exception of elevated blood pressure, higher circulating NOx significantly increased the odds for MetS and its components. Lastly, receiver operating characteristics (ROC) showed that NOx, as a diagnostic marker for MetS, had good sensitivity and was higher in boys than girls (all MetS participants: area under the curve (AUC) = 0.68, p < 0.001), (girls with MetS: AUC = 0.62, p = 0.002), (boys with MetS: AUC = 0.83, p < 0.001)). Conclusions: MetS and most of its components were significantly associated with circulating NOx levels in Arab adolescents and may be a promising diagnostic biomarker for MetS.
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020210
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 211: Children First, a Debate on the Restrictions
           to Tackle COVID-19

    • Authors: Sergio Verd
      First page: 211
      Abstract: Sometimes, when a public health disaster strikes, mandatory freedom-limiting restrictions must be enforced in order to save lives. During the first waves of the COVID-19 pandemic, the customary and necessary exchange of ideas in academia drastically changed in most countries, and the absence of debate on the restrictions enforced became evident. Now that the pandemic seems to be drawing to an end, the aim of this article is to spark clinical and public debate on the ethical issues concerning pediatric COVID-19 mandates in an attempt to analyze what happened. With theoretical reflection, and not empirical inquiry, we address the mitigation measures which proved detrimental to children despite being beneficial to other segments of the population. We focus on three key points: (i) the sacrifice of fundamental children’s rights for the greater good, (ii) the feasibility of cost–benefit analyses to make public health decisions and restrictions which affect children, and (iii) to analyze the impediments to allowing children’s voices to be heard concerning their medical treatment.
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020211
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 212: Anthropometry and Physical Performance in
           13-Year-Old Australian Talent-Identified Male and Female Athletes Compared
           to an Age-Matched General Population Cohort

    • Authors: Paul Larkin, Todd Carlon, Benjamin Sortino, Sam Greer, Tennille Cuttiford, Gyan Wijekulasuriya, Calvin Pane
      First page: 212
      Abstract: Talent-identified male and female athletes are assumed to have greater speed and power than the general population at a given age. However, a comparison of the jump and sprint performance of an Australian cohort of male and female youth athletes from various sports to age-matched controls has not occurred. Therefore, the aim of this study was to compare anthropometric and physical performance markers between ~13-year-old talent-identified youth athletes and general population Australian youth. The anthropometry and physical performance in talent-identified youth athletes (n = 136, 83 males) and general population youth (n = 250, 135 males) were tested during the first month of the school year in an Australian high school within a specialized sports academy. Talent-identified females were taller (p < 0.001; d = 0.60), sprinted faster (20 m: p < 0.001; d = −1.16), and jumped higher (p < 0.001; d = 0.88) than general population youth females. Similarly, talent-identified males sprinted faster (20 m: p < 0.001; d = −0.78) and jumped higher (p < 0.001; d = 0.87) than general population youth males, but were not taller (p = 0.13; d = 0.21). Body mass was not different between groups for males (p = 0.310) or females (p = 0.723). Overall, youth, particularly females, who are trained in a variety of sports, exhibit greater speed and power during early adolescence compared to their age-matched peers, with anthropometric differences only occurring in females at 13 years of age. Whether talented athletes are selected because they exhibit these traits or whether speed and power are developed through sport participation requires further investigation.
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020212
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 213: Effects of the Whole-Body Vibration Exercise
           on Sleep Disorders, Body Temperature, Body Composition, Tone, and Clinical
           Parameters in a Child with Down Syndrome who Underwent Total
           Atrioventricular Septal Defect Surgery: A Case-Report

    • Authors: Luiza Torres-Nunes, Patrícia Prado da Costa-Borges, Laisa Liane Paineiras-Domingos, José Alexandre Bachur, Ana Carolina Coelho-Oliveira, Danúbia da Cunha de Sá-Caputo, Mario Bernardo-Filho
      First page: 213
      Abstract: Background: The health and developmental issues of people with Down syndrome (DS) are complex and are associated with many medical, psychological, and social problems from childhood through into adulthood. DS children have an increased risk of multiorgan comorbidities, including congenital heart disease. Atrioventricular septal defect (AVSD) is a congenital heart malformation that often occurs in DS people. Aim: Physical activity and exercise are recommended for patients with cardiovascular disease and are considered to be the gold standard of cardiac rehabilitation. Whole-body vibration exercise (WBVE) is considered a form of exercises. The aim of this case report is to show the effects of WBVE on sleep disturbances, body temperature, body composition, tone, and clinical parameters in a child with DS with corrected total AVSD. The subject is a 10-year-old girl, with free-type DS, who underwent surgery to correct a total AVSD at 6 months. She underwent periodic cardiological monitoring and was released to perform any type of physical exercise, including WBVE. WBVE improved sleep quality and body composition. Conclusion: WBVE leads to physiological effects that benefit the DS child.
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020213
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 214: Kindergarten Affordances for Physical
           Activity and Preschoolers’ Motor and Social–Emotional

    • Authors: Mariana Moreira, Guida Veiga, Frederico Lopes, Derek Hales, Carlos Luz, Rita Cordovil
      First page: 214
      Abstract: This study examined the relationship between the quality of the kindergarten physical and social environment to promote physical activity (PA) and preschoolers’ motor and social–emotional competence. Two Portuguese kindergartens (Gondomar city) were selected from a pool of seventeen with an assessment of kindergarten PA best practices (one with high PA practices, the other with low). Thirty-six children (M = 4.42; SD = 1.00 years) without neuromotor disorders participated in this study. Motor and social–emotional competence were assessed with standardized motor skills tasks and parent report of child behaviors. Children from the kindergarten with higher compliance with PA best practices showed significantly better motor competence. No statistically significant differences were found for social–emotional competence scores. These findings emphasize the critical importance of kindergarten in promoting preschoolers’ motor competence by assuring a physical and social environment that enhances their PA practice. This is a particularly relevant concern for directors and teachers during the post-pandemic period, given the developmental delays and decreases in physical activity preschool children experienced across the pandemic period.
      Citation: Children
      PubDate: 2023-01-25
      DOI: 10.3390/children10020214
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 215: Impact of Thin Meconium on Delivery and
           Early Neonatal Outcomes

    • Authors: Hanoch Schreiber, Adi Shilony, Reut Batia Amrami, Gal Cohen, Ofer Markovitch, Tal Biron-Shental, Sofia Bauer-Rusek, Shmuel Arnon, Michal Kovo
      First page: 215
      Abstract: Several reports regarding the effects of thin meconium on maternal and neonatal outcomes are contradictory. This study evaluated the risk factors and obstetrical outcomes during deliveries complicated with thin meconium. This retrospective cohort study included all women with a singleton pregnancy, who underwent trial of labor >24 weeks of gestation, in a single tertiary center, over a six-year period. Obstetrical, delivery, and neonatal outcomes were compared between deliveries with thin meconium (thin meconium group) to deliveries with clear amniotic fluid (control group). Included in the study were 31,536 deliveries. Among them 1946 (6.2%) were in the thin meconium group and 29,590 (93.8%) were controls. Meconium aspiration syndrome was diagnosed in eight neonates in the thin meconium group and in none of the controls (0.41%, p < 0.001). In multivariate logistic regression analysis, the following adverse outcomes were found to be independently associated with increased odds ratio (OR) for thin meconium: intrapartum fever (OR 1.37, 95% CI 1.1–1.7), instrumental delivery (OR 1.26, 95% CI 1.09–1.46), cesarean delivery for non-reassuring fetal heart rate (OR 2.0, 95% CI 1.68–2.46), and respiratory distress requiring mechanical ventilation (OR 2.06, 95% CI 1.19–3.56). Thin meconium was associated with adverse obstetrical, delivery, and neonatal outcomes that should receive extra neonatal care and alert the pediatrician.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020215
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 216: Neurosurgical Treatment and Outcome of
           Pediatric Skull Base Lesions: A Case Series and Review of the Literature

    • Authors: Ladina Greuter, Tim Hallenberger, Raphael Guzman, Jehuda Soleman
      First page: 216
      Abstract: Introduction: Pediatric skull base lesions occur rarely and are of various etiologies. Traditionally, open craniotomy has been the treatment of choice; however, nowadays, endoscopic approaches are increasingly applied. In this retrospective case series, we describe our experience in treating pediatric skull base lesions and provide a systematic overview of the literature on the treatment and outcome of pediatric skull base lesions. Methods: We conducted a retrospective data collection of all pediatric patients (< 18 years) treated for a skull base lesion at the Division of Pediatric Neurosurgery, University Children’s Hospital Basel, Switzerland, between 2015 and 2021. Descriptive statistics and a systematic review of the available literature were additionally conducted. Results: We included 17 patients with a mean age of 8.92 (±5.76) years and nine males (52.9%). The most common entity was sellar pathologies (n = 8 47.1%), with craniopharyngioma being the most common pathology (n = 4, 23.5%). Endoscopic approaches, either endonasal transsphenoidal or transventricular, were used in nine (52.9%) cases. Six patients (35.3%) suffered from transient postoperative complications, while in none of the patients these were permanent. Of the nine (52.9%) patients with preoperative deficits, two (11.8%) showed complete recovery and one (5.9%) partial recovery after surgery. After screening 363 articles, we included 16 studies with a total of 807 patients for the systematic review. The most common pathology reported in the literature confirmed our finding of craniopharyngioma (n = 142, 18.0%). The mean PFS amongst all the studies included was 37.73 (95% CI [36.2, 39.2]) months, and the overall weighted complication rate was 40% (95% CI [0.28 to 0.53] with a permanent complication rate of 15% (95% CI [0.08 to 0.27]. Only one study reported an overall survival of their cohort of 68% at five years. Conclusion: This study highlights the rarity and heterogeneity of skull base lesions in the pediatric population. While these pathologies are often benign, achieving GTR is challenging due to the deep localization of the lesions and eloquent adjacent structures, leading to high complication rates. Therefore, skull base lesions in children require an experienced multidisciplinary team to provide optimal care.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020216
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 217: Iatrogenic Neonatal Esophageal Perforation:
           A European Multicentre Review on Management and Outcomes

    • Authors: Eva Sorensen, Connie Yu, Shu-Ling Chuang, Paola Midrio, Leopoldo Martinez, Mathew Nash, Ingo Jester, Amulya K. Saxena
      First page: 217
      Abstract: Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (n = 1), first change (n = 5), and after multiple changes (n = 2). Site of perforation was known in six (distal n = 3, proximal n = 2 and middle n = 1). Diagnosis was established by respiratory distress (n = 4), respiratory distress and sepsis (n = 2) and post-insertion chest X-ray (n = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020217
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 218: The Use of Stress Cardiovascular Imaging in
           Pediatric Population

    • Authors: Sara Moscatelli, Francesco Bianco, Andrea Cimini, Mario Panebianco, Isabella Leo, Chiara Bucciarelli-Ducci, Marco Alfonso Perrone
      First page: 218
      Abstract: Although not frequent in the pediatric population, ischemia could occur in children due to several congenital and acquired disease. Stress imaging is key for the non-invasive evaluation of myocardial abnormalities and perfusion defect in this clinical setting. Moreover , beyond ischemia assessment, it can provide complementary diagnostic and prognostic information in valvular heart disease and cardiomyopathies. When performed using cardiovascular magnetic resonance, it could detect, in addition, myocardial fibrosis and infarction, increasing the diagnostic yield. Several imaging modalities are currently available for the evaluation of stress myocardial perfusion. Advances in technologies have also increased the feasibility, safety and availability of these modalities in the pediatric age group. However, despite the established role of stress imaging and its increasing use in daily clinical practice, there are currently no specific guidelines, and little data are available in the literature on this topic. The aim of this review is to summarize the most recent evidence on pediatric stress imaging and its clinical application with a focus on the advantages and limitations of each imaging modality currently available.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020218
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 219: Protective Role of Self-Regulatory Efficacy:
           A Moderated Mediation Model on the Influence of Impulsivity on
           Cyberbullying through Moral Disengagement

    • Authors: Marinella Paciello, Giuseppe Corbelli, Ileana Di Pomponio, Luca Cerniglia
      First page: 219
      Abstract: During online interactions, adolescents are often exposed to deviant opportunities. In this context, the capacity to regulate one’s behavior is essential to prevent cyberbullying. Among adolescents, this online aggressive behavior is a growing phenomenon, and its deleterious effects on teenagers’ mental health are well known. The present work argues the importance of self-regulatory capabilities under deviant peer pressure in preventing cyberbullying. In particular, focusing on two relevant risk factors, i.e., impulsivity and moral disengagement, we examine (1) the mediation role of moral disengagement in the process leading to cyberbullying from impulsivity; (2) the buffering effect of the perceived self-regulatory capability to resist deviant peer pressure in mitigating the effect of these impulsive and social–cognitive dimensions on cyberbullying. Moderated mediation analysis was performed on a sample of 856 adolescents; the results confirm that the perceived self-regulatory capability to resist peer pressure effectively mitigates the indirect effect of impulsivity through moral disengagement on cyberbullying. The practical implications of designing interventions to make adolescents more aware and self-regulated in their online social lives to counter cyberbullying are discussed.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020219
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 220: Exploring the Effects of Tasks with
           Different Decision-Making Levels on Ball Control, Passing Performance, and
           External Load in Youth Football

    • Authors: Coutinho, Kelly, Santos, Figueiredo, Pizarro, Travassos
      First page: 220
      Abstract: This study aimed to understand how the design of decision-making tasks affects youth football players’ ball control, passing performance, and external load. A total of 16 male youth football players (age: 12.94 ± 0.25 years) competed in various tasks based on the following levels of decision-making: (i) low decision-making (Low DM), which consisted of a predefined ball control and passing sequence; (ii) moderate decision-making (Mod DM), which consisted of maintaining possession in a square with four players and two balls while maintaining the same position; and (iii) high decision-making (High DM), which consisted of a 3 vs. 3 + 2 neutral players ball possession game. The study design consisted of a pre–post design (a 6 min pre-test game, a 6 min intervention, and a 6 min post-test game). The players’ ball control and passing performance were measured using the game performance evaluation tool and notational analysis, while GPS data were used to determine their physical performance. The pre–post test analysis revealed decrements in players’ ability to identify more offensive players after the Mod DM task (W = 9.50, p = 0.016), while there was an increase in their ability to receive the ball towards the space following the High DM task (t = −2.40, p = 0.016). Analysis between groups showed lower values in most ball control variables for the Low DM task compared to the Mod DM task (ball control execution, p = 0.030; appropriateness, p = 0.031; motor space, p = 0.025), while there were also lower values in the distance covered while sprinting (p = 0.042). Overall, prescriptive tasks (Low DM) that are repetitive in nature may affect players’ perceptual attunement, whereas static tasks (e.g., Mod DM) may limit their ability to locate players in more offensive positions. Moreover, game-based situations (High DM) seem to acutely enhance players’ performance, possibly due to contextual dependency. Overall, coaches should carefully consider the type of practice structure when designing tasks that aim to improve players’ technical skills in youth football.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020220
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 221: Parent-Reported Changes in Ontario
           Children’s Physical Activity Levels during the COVID-19 Pandemic

    • Authors: Monika Szpunar, Matthew Bourke, Leigh M. Vanderloo, Brianne A. Bruijns, Stephanie Truelove, Shauna M. Burke, Jason Gilliland, Jennifer D. Irwin, Patricia Tucker
      First page: 221
      Abstract: The COVID-19 pandemic resulted in closures of physical-activity-supporting environments, including playgrounds, outdoor recreation facilities (e.g., basketball courts), and community centers, which impacted children’s movement opportunities. This study evaluated changes in Ontario children’s physical activity levels during the COVID-19 pandemic and explored the impact of family sociodemographic markers on children’s activity. Parents (n = 243; Mage= 38.8 years) of children aged 12 and under (n = 408; Mage= 6.7 years) living in Ontario, Canada, completed two online surveys between August and December 2020 (survey 1) and August and December 2021 (survey 2). Generalized linear mixed-effects models were used to estimate changes in the proportion of children who accumulated 60 minutes of physical activity per day pre-lockdown, during lockdown, and post-lockdown in Ontario. Results revealed a significant non-linear trajectory whereby the proportion of children achieving 60 minutes of physical activity per day pre-lockdown (63%) declined during lockdown (21%) and then increased post-lockdown (54%). Changes in the proportion of children engaging in 60 minutes of daily physical activity were moderated by several demographic variables. Efforts are needed to provide parents of young children with a wider variety of resources to ensure children are obtaining sufficient levels of physical activity regardless of the presence of community lockdowns.
      Citation: Children
      PubDate: 2023-01-26
      DOI: 10.3390/children10020221
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 222: Effect of Transcranial Direct Current
           Stimulation versus Virtual Reality on Gait for Children with Bilateral
           Spastic Cerebral Palsy: A Randomized Clinical Trial

    • Authors: Asmaa Radwan, Hoda A. Eltalawy, Faten Hassan Abdelziem, Rebecca Macaluso, Megan K. O’Brien, Arun Jayaraman
      First page: 222
      Abstract: Impaired gait is a common sequela in bilateral spastic cerebral palsy. We compared the effects of two novel research interventions—transcranial direct current stimulation and virtual reality—on spatiotemporal and kinetic gait impairments in children with bilateral spastic CP. Forty participants were randomized to receive either transcranial direct current stimulation or virtual reality training. Both groups received standard-of-care gait therapy during the assigned intervention and for the subsequent 10 weeks afterward. Spatiotemporal and kinetic gait parameters were evaluated at three different times: (i) before starting the intervention, (ii) after two weeks of intervention, and (iii) 10 weeks after intervention completion. Both groups exhibited higher velocity and cadence, as well as longer stance time, step length, and stride length after intervention (p < 0.001). Only the transcranial direct current stimulation group exhibited increased maximum force and maximum peak pressure after intervention (p’s ≤ 0.001), with continued improvements in spatiotemporal parameters at follow-up. The transcranial direct current stimulation group had higher gait velocities, stride length, and step length at follow-up compared to the virtual reality group (p ≤ 0.02). These findings suggest that transcranial direct current stimulation has a broader and longer-lasting effect on gait than virtual reality training for children with bilateral spastic cerebral palsy.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020222
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 223: Validation of the Concise Assessment Scale
           for Children’s Handwriting (BHK) in an Italian Population

    • Authors: Annalivia Loizzo, Valerio Zaccaria, Barbara Caravale, Carlo Di Brina
      First page: 223
      Abstract: Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children’s Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed through a copying text. The aim of the present study was to validate the Italian adaptation of the BHK in a representative primary school population. Overall, 562 children aged 7–11 from 16 public primary schools of Rome were included and asked to copy a text in 5 min using cursive handwriting. Handwriting quality and copying speed were measured. The included population followed a normal distribution for the BHK quality scores. Sex influenced the total quality scores, whereas school level influenced the copying speed. The BHK quality score was higher in girls (p < 0.05) and resulted as a stable parameter along the school years, without significant variations with regard to the years spent in handwriting exercise (p = 0.76). The handwriting speed was influenced by school level, and significant differences were found for each of the grades from the second to the fifth (p < 0.05), but not for gender (p = 0.47). Both BHK measures represent a helpful tool for the characterization and assessment of children with handwriting difficulties. The present study confirms that sex influences total BHK quality score, while school level influences handwriting speed.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020223
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 224: Childhood Acute Lymphoblastic Leukemia
           Showing Unilateral Motor Dysfunction Prior to Chemotherapy: A Diffusion
           Tensor Tractography Study

    • Authors: Kim, Lee, Son
      First page: 224
      Abstract: This study aimed to evaluate children with lymphoblastic leukemia and examine the potential correlation between corticospinal tract (CST) injury and motor dysfunction prior to chemotherapy using diffusion tensor tractography (DTT). Nineteen consecutive patients with childhood leukemia (mean age 7.483 ± 3.1 years, range 4–12 years) with unilateral motor dysfunction who underwent DTT prior to chemotherapy and twenty healthy individuals (mean age 7.478 ± 1.2 years; range 4–12 years) were enrolled. Motor functions were evaluated by two independent investigators. The cause of neurological dysfunction was identified based on the CST state using mean fractional anisotropy (FA), mean fiber volume (FV), and CST integrity using DTT. All patients showed disrupted integrity and significantly decreased FA and FV in the affected CST compared to the unaffected CST and the control group (p < 0.05). These DTT results also corresponded to patients’ unilateral motor dysfunction. Using DTT, we demonstrated that neurological dysfunction may occur in patients with childhood acute lymphoblastic leukemia even prior to chemotherapy, and that CST injuries correlate with motor dysfunction in these patients. DTT may be a useful modality for evaluating the neural tract state in pediatric leukemia patients with neurological dysfunction.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020224
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 225: Quantitative Analysis of the Head Tilt Using
           Three-Dimensional Temporal Scan in Children with Torticollis

    • Authors: Yun, Jung, Cui, Huh, Lee, You, Kim
      First page: 225
      Abstract: The head tilt of patients with torticollis is usually evaluated subjectively in clinical practice and measuring it in young children is very limited due to poor cooperation. No study has yet evaluated the head tilt using a three-dimensional (3D) scan and compared it with other measurement methods. Therefore, this study aimed to objectively demonstrate head tilt through clinical measurements and a 3D scan in children with torticollis. A total of 52 children (30 males, 22 females; age 4.6 ± 3.2 years) diagnosed with torticollis and 52 adults (26 men, 26 women; age 34.42 ± 10.4 years) without torticollis participated in this study. The clinical measurements were performed using a goniometer and still photography methods. Additionally, the head tilt was analyzed using a 3D scanner (3dMD scan, 3dMD Inc., Atlanta, GA, USA). There was a high correlation between the other methods and 3D angles, and the cut-off value of the 3D angles for the diagnosis of torticollis was also presented. The area under the curve of the 3D angle was 0.872, which was confirmed by a moderately accurate test and showed a strong correlation compared with other conventional tests. Therefore, we suggest that measuring the degree of torticollis three-dimensionally is significant.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020225
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 226: Microbiome in Nasal Mucosa of Children and
           Adolescents with Allergic Rhinitis: A Systematic Review

    • Authors: André Costa Azevedo, Sandra Hilário, Micael F. M. Gonçalves
      First page: 226
      Abstract: The human upper respiratory tract comprises the nasal cavity, pharynx and larynx regions and offers distinct microbial communities. However, an imbalance and alterations in the nasal mucosa microbiome enhance the risk of chronic respiratory conditions in patients with allergic respiratory diseases. This is particularly important in children and adolescents once allergic rhinitis (AR) is an inflammatory disorder of the nasal mucosa, often associated with an increase in pulmonary allergic inflammation. Therefore, this systematic review aimed to collect scientific data published concerning the microbial community alterations in nasal mucosa of children and adolescents suffering from AR or in association with adenotonsillar hypertrophy (AH) and allergic rhinoconjunctivitis (ARC). The current study was performed using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Publications related to microbiome alterations in the nasal mucosa in pediatric age, studies including next-generation sequencing platforms, and studies exclusively written in the English language were some of the inclusion criteria. In total, five articles were included. Despite the scarcity of the published data in this research field and the lack of prospective studies, the genera Acinetobacter, Corynebacterium, Dolosigranulum, Haemophilus, Moraxella, Staphylococcus and Streptococcus dominate the nares and nasopharyngeal microbiome of the pediatric population regardless of their age. However, an imbalance in the resident bacterial community in the nasal mucosa was observed. The genera Acinetobacter, and Pseudomonas were more abundant in the nasal cavity of AR and AH children, while Streptococcus and Moraxella were predominant in the hypopharyngeal region of AR infants. An abundance of Staphylococcus spp. was also reported in the anterior nares and hypopharyngeal region of children and adolescents suffering from AR passive smoke exposure and ARC. These records suggest that different nasal structures, ageing, smoke exposure and the presence of other chronic disorders shape the nasal mucosa microbiome. Therefore, the establishment of adequate criteria for sampling would be established for a deeper understanding and a trustworthy comparison of the microbiome alterations in pediatric age.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020226
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 227: Morphologic Mandibular Bone Changes on
           Panoramic Radiographs of Children and Adolescents with Congenital Heart

    • Authors: Fatma Saraç, Fatih Şengül, Periş Çelikel, İbrahim Saraç, Aybike Baş, Sera Şimşek Derelioğlu
      First page: 227
      Abstract: Congenital heart disease (CHD) has effects on growth and development. However, information on how the structure of the mandibular bone is affected is limited. In the present study, we aim to compare mandibular bone structures of children affected with CHD and healthy ones through the fractal analysis method and radiomorphometric indices based on panoramic radiographs. The study consisted of 80 children (20 with cyanotic CHD, 20 with acyanotic CHD, 40 control) who were diagnosed with CHD and were treated through interventional therapy or followed up through medical therapy. Fractal dimension (FD) was performed in three different areas (angulus, corpus, and interdental bone) on 80 panoramic radiographs. Additionally, we assessed various radiomorphometric indices: mandibular cortical width (MCW), panoramic mandibular index (PMI), mandibular cortical index (MCI), and simple visual estimation (SVE). p < 0.05 was accepted as statistically significant in the analysis. Values of mean MCW, PMI, MCI, SVE, and FD measurements in children affected with CHD were found to be similar to the control group, regardless of whether they were cyanotic or acyanotic (p > 0.05). In this study, fractal analysis and radiomorphometric indices revealed no trabecular structure and mineral density changes in mandibular bone of children and adolescents with CHD compared to healthy subjects.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020227
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 228: Distal Tibial Hemimelia in Fetal
           Methotrexate Syndrome: A Case Study and Literature Review

    • Authors: Dae-Sik Jo, Seung-Hyun Lee
      First page: 228
      Abstract: Methotrexate (MTX), a folate antagonist, is used in various fields, including malignancies and rheumatoid or inflammatory autoimmune diseases. MTX is used for the non-surgical treatment of ectopic pregnancies and the elective termination of pregnancy. The teratogenic effects of MTX have been recognized since the 1960s. Fetal methotrexate syndrome (FMS) was established based on the study of congenital anomalies. Generally, there is a risk of FMS when MTX is used between four and six weeks after conception. Here, we reviewed the literature regarding MTX usage and described a case of FMS that was born with a rare anomaly, such as tibial hemimelia, in a mother who had received MTX 4 months before conception for the management of an ectopic pregnancy.
      Citation: Children
      PubDate: 2023-01-27
      DOI: 10.3390/children10020228
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 229: Not Every Dyspepsia Is Related to
           Helicobacter pylori—A Case of Esophageal Inlet Patch in a Female

    • Authors: Lorena Elena Meliț, Andreea Ligia Dincă, Reka Borka Balas, Simona Mocanu, Cristina Oana Mărginean
      First page: 229
      Abstract: Helicobacter pylori infection is one of the main causes of dyspepsia, but it is not the only cause. Esophageal inlet patches are areas of heterotopic gastric mucosa within the esophagus and are commonly located in the cervical part of the esophagus. We report the case of a 16-year-old female, previously known to display symptoms of anxiety, who was admitted to our clinic for dyspeptic symptoms lasting for approximately 1 month in spite of the treatment with proton pump inhibitors. The clinical exam revealed only abdominal tenderness in the epigastric area, while routine laboratory tests showed no abnormalities. The upper digestive endoscopy revealed a well-circumscribed salmon-pink-colored oval lesion of approximately 10 mm in the cervical esophagus, along with hyperemia of the gastric mucosa and biliary reflux. The histopathological exam established the diagnosis of esophageal inlet patch with heterotopic antral-type gastric mucosa and also revealed regenerative changes within the gastric mucosa. We continued to treat the patient with proton pump inhibitors, as well as ursodeoxycholic acid, with favorable evolution. Although rare or underdiagnosed, esophageal inlet patches should never be underestimated and all gastroenterologists should be aware of their presence when performing an upper digestive examination in a patient with dyspeptic symptoms.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020229
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 230: Orthodontic Retainers—A Critical

    • Authors: Ioannis Lyros, Ioannis A. Tsolakis, Michael P. Maroulakos, Eleni Fora, Theodoros Lykogeorgos, Maria Dalampira, Apostolos I. Tsolakis
      First page: 230
      Abstract: The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020230
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 231: Socio-Emotional Competencies Required by
           School Counsellors to Manage Disruptive Behaviours in Secondary Schools

    • Authors: Ángela Serrano, Roberto Sanz, Juan Luis Cabanillas, Elena López-Lujan
      First page: 231
      Abstract: This article identifies the socio-emotional competencies of school counsellors working with children and adolescents. The aim is to address problems related to mental health and conflict and to implement training programmes. The study sample was composed of 149 counsellors working in schools. The instruments used were the CCPES-II (questionnaire on teacher competences) and a series of open-ended questions on conflict resolution. A mixed methodology was used, with a concurrent triangulation design with two phases: a quantitative one (QUAN) and a qualitative one (QUAL). Univariate, bivariate, and correlation quantitative analyses were performed. Parametric and non-parametric tests were applied depending on the number of dependent and independent variables. The qualitative analysis was performed with the NVivo 12 computer programme, which determines word frequencies using a classic content analysis. The results confirm the relationship between socio-emotional training and rapid response to school conflict; the generalised view that conflicts are difficult to anticipate and, thus, to prevent; and the demand for specific training in socio-emotional competences, intervention strategies, more specialised school staff, more time for intervention with and support for families, and more socio-professional recognition.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020231
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 232: Evaluation of Beta-Defensin 1 and
           Mannose-Binding Lectin 2 Polymorphisms in Children with Dental Caries
           Compared to Caries-Free Controls: A Systematic Review and Meta-Analysis

    • Authors: Ghazal Hemati, Mohammad Moslem Imani, Parsia Choubsaz, Francesco Inchingolo, Roohollah Sharifi, Masoud Sadeghi, Santosh Kumar Tadakamadla
      First page: 232
      Abstract: Background and objective: Some variants in defensin beta 1 (DEFB1) and mannose-binding lectin 2 (MBL2) genes can be associated with oral diseases. Herein, we designed a systematic review and meta-analysis to evaluate the association of DEFB1 (rs11362, rs1799946, and rs1800972) and MBL2 (rs7096206 and rs1800450) polymorphisms with the susceptibility to dental caries (DC) in children. Materials and methods: A systematic literature search was conducted in the PubMed/Medline, Web of Science, Scopus, and Cochrane Library databases until 3 December 2022, without any restrictions. The odds ratio (OR), along with a 95% confidence interval (CI) of the effect sizes, are reported. Analyses including a subgroup analysis, a sensitivity analysis, and funnel plot analyses were conducted. Results: A total of 416 records were identified among the databases, and nine articles were entered into the meta-analysis. A significant relationship was found between the T allele of DEFB1 rs11362 polymorphism and DC susceptibility, and the T allele was related to an elevated risk of DC in children (OR = 1.225; 95%CI: 1.022, 1.469; p = 0.028; I2 = 0%). No other polymorphisms were associated with DC. All articles were of moderate quality. Egger’s test in homozygous and dominant models demonstrated a significant publication bias for the association of DEFB1 rs1799946 polymorphism with DC risk. Conclusions: The results demonstrated that the T allele of DEFB1 rs11362 polymorphism had an elevated risk for DC in children. However, there were only few studies that evaluated this association.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020232
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 233: Is Metabolic Syndrome Useful for Identifying
           Youths with Obesity at Risk for NAFLD'

    • Authors: Procolo Di Bonito, Anna Di Sessa, Maria Rosaria Licenziati, Domenico Corica, Malgorzata Wasniewska, Giuseppina Rosaria Umano, Anita Morandi, Claudio Maffeis, Maria Felicia Faienza, Enza Mozzillo, Valeria Calcaterra, Francesca Franco, Giulio Maltoni, Giuliana Valerio
      First page: 233
      Abstract: The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs for lipids and glucose were not changed. We analyzed MetS prevalence using this modified definition (MetS-IDFm) and its association with non-alcoholic fatty liver disease (NAFLD) in 1057 youths (age 6–17 years) with overweight/obesity (OW/OB). A comparison with another modified definition of MetS according to the Adult Treatment Panel III (MetS-ATPIIIm) was performed. The prevalence of MetS-IDFm was 27.8% and 28.9% by MetS-ATPIIIm. The Odds (95% Confidence Intervals) of NAFLD was 2.70 (1.30–5.60) (p = 0.008) for high WC, 1.68 (1.25–2.26)(p = 0.001) for MetS, 1.54 (1.12–2.11)(p = 0.007) for low HDL-Cholesterol, 1.49 (1.04–2.13)(p = 0.032) for high triglycerides and 1.37 (1.03–1.82)(p = 0.033) for high BP. No substantial difference was found in the prevalence of MetS-IDFm and frequency of NAFLD compared to Mets-ATPIIIm definition. Our data demonstrate that one third of youths with OW/OB have MetS, whichever was the criterion. Neither definition was superior to some of their components in identifying youths with OW/OB at risk for NAFLD.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020233
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 234: Mediterranean Milk Ladder: Integrating a
           Healthy Eating Plan While Reintroducing Cow’s Milk

    • Authors: Emilia Vassilopoulou, Colleen McMilin, Carina Venter
      First page: 234
      Abstract: The process of gradually reintroducing food allergens into an individual’s diet is referred to as a food allergen “ladder”, and the most recent edition of the original Milk Allergy in Primary (MAP) Care Guidelines, as well as the International Milk Allergy in Primary Care (IMAP), includes a shortened, improved, and international version with specific recipes, indicating the exact milk protein content, as well as the duration of heating and the temperature for each step of the ladder. Food allergen ladders are being used increasingly in clinical practice. The aim of this study was to develop a Mediterranean milk ladder based on the principles of the Mediterranean eating pattern. The protein content delivered in a portion of the final food product in each step of the ladder in the Mediterranean version corresponds to that provided in the IMAP ladder. Different recipes for the various steps were provided to increase acceptability and variety. Quantification of the total milk protein, casein content, and beta-lactoglobulin by Enzyme-linked immunosorbent assay (ELISA) could detect the gradual increase in concentrations, but the accuracy of the method was affected by the presence of the other ingredients in the mixtures. When developing the Mediterranean milk ladder, a key consideration was to reduce the amount of sugar by using limited amounts of brown sugar and substituting sugar with fresh fruit juice or honey for children aged older than one year. The proposed Mediterranean milk ladder includes principles of (a) healthy eating based on the Mediterranean diet and (b) the acceptability of foods across different age groups.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020234
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 235: Sudden Appearance of a Palpable Chest Wall
           Mass Secondary to Macrocystic Lymphatic Malformation: A Case Report

    • Authors: Alkwai, Alkwai, Al Namshan
      First page: 235
      Abstract: Chest wall lymphatic malformations are rare and can pose a diagnostic dilemma, particularly if they present abruptly. This case report describes a 15-month-old male toddler presenting with a left lateral chest mass. Histopathology of the surgically excised mass confirmed the diagnosis of a macrocystic lymphatic malformation. Furthermore, there was no recurrence of the lesion in the two-year follow-up period.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020235
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 236: Nutrition Profile for Countries of the
           Eastern Mediterranean Region with Different Income Levels: An Analytical

    • Authors: Hanna Leppäniemi, Eman Ibrahim, Marwa M. S. Abbass, Elaine Borghi, Monica C. Flores-Urrutia, Elisa Dominguez Dominguez Muriel, Giovanna Gatica-Domínguez, Richard Kumapley, Asmus Hammerich, Ayoub Al-Jawaldeh
      First page: 236
      Abstract: The World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions and health challenges, the nutrition status is often discussed only by using either regional or country-specific estimates. This analytical review studies the nutrition situation of the EMR during the past 20 years by dividing the region into four groups based on their income level—the low-income group (Afghanistan, Somalia, Sudan, Syria, and Yemen), the lower-middle-income group (Djibouti, Egypt, Iran, Morocco, Pakistan, Palestine, and Tunisia), the upper-middle-income group (Iraq, Jordan, Lebanon, and Libya) and the high-income group (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates)—and by comparing and describing the estimates of the most important nutrition indicators, including stunting, wasting, overweight, obesity, anaemia, and early initiation and exclusive breastfeeding. The findings reveal that the trends of stunting and wasting were decreasing in all EMR income groups, while the percentages of overweight and obesity predominantly increased in all age groups across the income groups, with the only exception in the low-income group where a decreasing trend among children under five years existed. The income level was directly associated with the prevalence rates of overweight and obesity among other age groups except children under five, while an inverse association was observed regarding stunting and anaemia. Upper-middle-income country group showed the highest prevalence rate of overweight among children under five. Most countries of the EMR revealed below-desired rates of early initiation and exclusive breastfeeding. Changes in dietary patterns, nutrition transition, global and local crises, and nutrition policies are among the major explanatory factors for the findings. The scarcity of updated data remains a challenge in the region. Countries need support in filling the data gaps and implementing recommended policies and programmes to address the double burden of malnutrition.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020236
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 237: The Family Caregiving Environment Associates
           with Adolescent Patients’ Severity of Eating Disorder and
           Interpersonal Problems: A Cross-Sectional Study

    • Authors: Giorgia Baradel, Livio Provenzi, Matteo Chiappedi, Marika Orlandi, Arianna Vecchio, Renato Borgatti, Martina Maria Mensi
      First page: 237
      Abstract: The quality of family interactions may be a critical factor for restrictive eating disorders (REDs). Adolescent patients with RED have interpersonal problems that can be inferred by observing their behaviours during family interactions. To date, the assessment of the association among RED severity, interpersonal problems, and patients’ interactive behaviours in the family is partially explored. This cross-sectional study aimed to explore how adolescent patients’ interactive behaviours observed during the Lausanne Trilogue Play—clinical version (LTPc) were associated with both RED severity and interpersonal problems. Sixty adolescent patients completed the EDI-3 questionnaire to assess RED severity using the Eating Disorder Risk Composite (EDRC) and Interpersonal Problems Composite (IPC) subscales. Moreover, patients and their parents took part in the LTPc, and patients’ interactive behaviours were coded as participation, organization, focal attention, and affective contact in all the LTPc four phases. A significant association emerged between patients’ interactive behaviours during the LTPc triadic phase and both EDRC and IPC. Better patients’ organization and affective contact significantly correlated with lower RED severity and fewer interpersonal problems. These findings suggest that investigating the quality of family relationships and patients’ interactive behaviours may contribute to better identifying adolescent patients at risk for more severe conditions.
      Citation: Children
      PubDate: 2023-01-28
      DOI: 10.3390/children10020237
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 238: The Omni Scale Is Not Suitable for Assessing
           Self-Perceived Exertion during Physical Activity in Preschoolers

    • Authors: Carlos Ayán, José C. Diz, Silvia Varela, Miguel A. Sanchez-Lastra
      First page: 238
      Abstract: Introduction: We aimed to identify the utility, reliability, and validity of an adapted version of the OMNI self-perceived exertion (PE) rating scale in preschoolers. Population and methods: Firstly, 50 (mean age ± standard deviation [SD] = 5.3 ± 0.5 years, 40% girls) performed a cardiorespiratory fitness (CRF) test twice, with a one-week interval between assessments, and rated their PE either individually or in groups. Secondly, 69 children (mean age ± SD = 4.5 ± 0.5 years, 49% girls) performed two CRF tests, separated by a one-week interval, twice and rated their self-PE. Thirdly, the heart rate (HR) of 147 children (mean age ± SD = 5.0 ± 0.6 years, 47% girls) were compared against self-rated PE after finishing the CRF test. Results: Self-assessed PE differed when the scale was administered individually (e.g., 82% rated PE with 10) or in groups (42% rated PE with 10). The scale showed poor test–retest reliability (ICC:0.314-0.031). No significant associations were found between the HR and PE ratings. Conclusions: An adapted version of the OMNI scale was found not suitable for assessing self-PE in preschoolers.
      Citation: Children
      PubDate: 2023-01-29
      DOI: 10.3390/children10020238
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 239: Inventory of Patient-Reported Outcome
           Measures Used in the Non-Operative Care of Scoliosis: A Scoping Review

    • Authors: Eric C. Parent, Matthew Vaclavik, Cody Bourgoin, Courtney Hebert, Megan Bouwmeester, Sarah Cheslock, Rebecca Collins, Stefan Potgieter, Mark Coles, Sanja Schreiber, Sabrina Donzelli, Camille Warner
      First page: 239
      Abstract: It is unclear which patient-reported outcome measures (PROMs) can assess non-operative care for scoliosis. Most existing tools aim to assess the effects of surgery. This scoping review aimed to inventory the PROMs used to assess non-operative scoliosis treatment by population and languages. We searched Medline (OVID) as per COSMIN guidelines. Studies were included if patients were diagnosed with idiopathic scoliosis or adult degenerative scoliosis and used PROMs. Studies without quantitative data or reporting on fewer than 10 participants were excluded. Nine reviewers extracted the PROMs used, the population(s), language(s), and study setting(s). We screened 3724 titles and abstracts. Of these, the full texts of 900 articles were assessed. Data were extracted from 488 studies, in which 145 PROMs were identified across 22 languages and 5 populations (Adolescent Idiopathic Scoliosis, Adult Degenerative Scoliosis, Adult Idiopathic Scoliosis, Adult Spine Deformity, and an Unclear category). Overall, the most used PROMs were the Oswestry Disability Index (ODI, 37.3%), Scoliosis Research Society-22 (SRS-22, 34.8%), and the Short Form-36 (SF-36, 20.1%), but the frequency varied by population. It is now necessary to determine the PROMs that demonstrate the best measurement properties in the non-operative treatment of scoliosis to include in a core set of outcomes.
      Citation: Children
      PubDate: 2023-01-29
      DOI: 10.3390/children10020239
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 240: Playing at the Schoolyard: “The
           Who’s, the What’s and the How Long’s” of Loose

    • Authors: Joana V. Pereira, Jadiane Dionísio, Frederico Lopes, Rita Cordovil
      First page: 240
      Abstract: Play has a key role in children psychomotor development, and the quality of play spaces can be a facilitator of the former. The physical properties of the environment, such as equipment or material available, can influence children’s behavior. However, it is not clear how the provision of different loose parts impacts children’s play patterns. This study aimed to analyze the influence of four types of loose parts on the time, frequency and number of children using them during free play sessions. We recorded the 1st, 5th and 10th sessions delivered by playworkers in a primary school, with 14 children (Mage = 9.96 years). The available loose parts were categorized, and four types of materials were chosen: tarpaulin/fabrics, cardboard boxes, plastic crates and plastic tubes. The influence of these materials on the time spent using them, frequency of use and number and sex of users (dependent variables) was analyzed. Some tendencies emerged, such as the popularity of tarpaulin/fabrics, but results showed no significant differences between materials. This could mean that the specific physical qualities of each loose part were not determiners of the behavioral domains analyzed. These findings suggest that all types of materials studied can be meaningful for children to engage with in diverse play opportunities.
      Citation: Children
      PubDate: 2023-01-29
      DOI: 10.3390/children10020240
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 241: Links between Childhood Obesity, High-Fat
           Diet, and Central Precocious Puberty

    • Authors: Valeria Calcaterra, Vittoria Carlotta Magenes, Chiara Hruby, Francesca Siccardo, Alessandra Mari, Erika Cordaro, Valentina Fabiano, Gianvincenzo Zuccotti
      First page: 241
      Abstract: In recent years, the existing relationship between excess overweight and central precocious puberty (CPP) has been reported, especially in girls. Different nutritional choices have been associated with different patterns of puberty. In particular, the involvement of altered biochemical and neuroendocrine pathways and a proinflammatory status has been described in connection with a high-fat diet (HFD). In this narrative review, we present an overview on the relationship between obesity and precocious pubertal development, focusing on the role of HFDs as a contributor to activating the hypothalamus–pituitary–gonadal axis. Although evidence is scarce and studies limited, especially in the paediatric field, the harm of HFDs on PP is a relevant problem that cannot be ignored. Increased knowledge about HFD effects will be useful in developing strategies preventing precocious puberty in children with obesity. Promoting HFD-avoiding behavior may be useful in preserving children’s physiological development and protecting reproductive health. Controlling HFDs may represent a target for policy action to improve global health.
      Citation: Children
      PubDate: 2023-01-29
      DOI: 10.3390/children10020241
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 242: Acute Kidney Injury in Very Low Birth Weight
           Infants: A Major Morbidity and Mortality Risk Factor

    • Authors: Gilad Lazarovits, Noa Ofek Ofek Shlomai, Raed Kheir, Tali Bdolah Bdolah Abram, Smadar Eventov Eventov Friedman, Oded Volovelsky
      First page: 242
      Abstract: Background and objectives: Very low birth weight (VLBW) infants are at high risk of developing acute kidney injury (AKI), presumably secondary to low kidney reserves, stressful postnatal events, and drug exposures. Our study aimed to identify the prevalence, risk factors, and outcomes associated with AKI in VLBW infants. Study design: Records of all VLBW infants admitted to two medical campuses between January 2019 and June 2020 were retrospectively reviewed. AKI was classified using the modified KDIGO definition to include only serum creatinine. Risk factors and composite outcomes were compared between infants with and without AKI. We evaluated the main predictors of AKI and death with forward stepwise regression analysis. Results: 152 VLBW infants were enrolled. 21% of them developed AKI. Based on the multivariable analysis, the most significant predictors of AKI were the use of vasopressors, patent ductus arteriosus, and bloodstream infection. AKI had a strong and independent association with neonatal mortality. Conclusions: AKI is common in VLBW infants and is a significant risk factor for mortality. Efforts to prevent AKI are necessary to prevent its harmful effects.
      Citation: Children
      PubDate: 2023-01-29
      DOI: 10.3390/children10020242
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 243: Prevalence of Burnout Syndrome and Fear of
           COVID-19 among Adolescent University Students

    • Authors: Raimundo Aguayo-Estremera, Gustavo R. Cañadas, Luis Albendín-García, Elena Ortega-Campos, Tania Ariza, Carolina S. Monsalve-Reyes, Emilia Inmaculada De la De la Fuente-Solana
      First page: 243
      Abstract: This study aimed to estimate the prevalence of burnout syndrome in adolescents entering university studies, to detect differences in burnout levels, personality factors and fear of coronavirus in a pandemic context due to COVID-19. A cross-sectional predictive study was performed with a sample that comprised 134 individuals in their first year of a Psychology degree at Spanish universities. The Maslach Burnout Inventory Student Survey, the NEO Five-Factor Inventory and the Fear of COVID-19 Scale were applied. The prevalence of burnout is estimated according to three methods: Maslach and Jackson’s severity classification, Golembiewski’s phase model and Maslach et al.’s profile model. The estimates show significant differences. The results indicated that between 9 and 21% of students were at risk of developing burnout. On the other hand, students who reported having suffered psychological consequences of the pandemic showed greater emotional exhaustion, neuroticism and fear of COVID-19, and a lower level of personal accomplishment than those who did not suffer such consequences. Neuroticism was the only significant predictor for all burnout dimensions, and fear of COVID-19 did not contribute to any of them.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020243
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 244: Effects of Rapid Palatal Expansion on the
           Upper Airway Space in Children with Obstructive Sleep Apnea (OSA): A
           Case-Control Study

    • Authors: Angela Galeotti, Roberto Gatto, Silvia Caruso, Simone Piga, Wanda Maldonato, Emanuela Sitzia, Valeria Viarani, Gaia Bompiani, Francesco Aristei, Giuseppe Marzo, Paola Festa
      First page: 244
      Abstract: Obstructive Sleep Apnea (OSA) in children needs a multidisciplinary approach. Even if the first-line treatment of pediatric OSA is adenotonsillectomy, nowadays rapid palatal expansion (RPE) is considered a valid additional treatment. The aim of this study is to evaluate cephalometric changes in upper airways dimensions after rapid palatal expansion (RPE) in children suffering from Obstructive Sleep Apnea (OSA). A total of 37 children (range age 4–10 years) with diagnosis of OSA referred to Dentistry Unit of Bambino Gesù Children’s Research Hospital IRCCS (Rome, Italy) were included in this pre-post study and underwent lateral radiographs at the start (T0) and at the end (T1) of a RPE treatment. Inclusion criteria were: diagnosis of OSA confirmed by cardiorespiratory polygraphy (AHI > 1) or pulse oximetry (McGill = >2), skeletal maxillary contraction evaluated by presence of posterior crossbite. A control group of 39 untreated patients (range age 4–11 years), in good general health, was set up. A paired T-test was used to investigate the statistical differences between T0 and T1 values in both groups. The results showed a statistically significant increase of nasopharyngeal width in the treated group after RPE treatment. Moreover, the angle that identifies mandibular divergence compared to palatal plane (PP-MP°) was significantly reduced. In the control group, no statistically significant differences were observed. The present study showed that RPE treatment determines a significant sagittal space increase in the upper airways space and a counterclockwise mandibular growth in children with OSA compared to a control group. These results suggest that a widening of the nasal cavities induced by RPE may support a return to physiological nasal breathing and promote a counterclockwise mandibular growth in children. This evidence confirms the crucial role of the orthodontist in the management of OSA in pediatric patients.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020244
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 245: Evaluation of the Cerebrospinal Fluid Flow
           Dynamics with Microvascular Imaging Ultrasound in Infants

    • Authors: Luis Octavio Tierradentro-Garcia, Levy Onyango, Rebecca Dennis, Colbey W. Freeman, Sophie Haddad, Brandi Kozak, Misun Hwang
      First page: 245
      Abstract: Purpose: Microvascular imaging ultrasound (MVI) can detect slow blood flow in small-caliber cerebral vessels. This technology may help assess flow in other intracranial structures, such as the ventricular system. In this study, we describe the use of MVI for characterizing intraventricular cerebrospinal fluid (CSF) flow dynamics in infants. Materials and methods: We included infants with brain ultrasound that had MVI B-Flow cine clips in the sagittal plane. Two blinded reviewers examined the images, dictated a diagnostic impression, and identified the third ventricle, cerebral aqueduct, fourth ventricle, and CSF flow direction. A third reviewer evaluated the discrepancies. We evaluated the association of visualization of CSF flow as detectable with MVI, with the diagnostic impressions. We also assessed the inter-rater reliability (IRR) for detecting CSF flow. Results: We evaluated 101 infants, mean age 40 ± 53 days. Based on brain MVI B-Flow, a total of 49 patients had normal brain US scans, 40 had hydrocephalus, 26 had intraventricular hemorrhage (IVH), and 14 had hydrocephalus+IVH. Using spatially moving MVI signal in the third ventricle, cerebral aqueduct, and fourth ventricle as the criteria for CSF flow, CSF flow was identified in 10.9% (n = 11), 15.8% (n = 16), and 16.8% (n = 17) of cases, respectively. Flow direction was detected in 19.8% (n = 20) of cases; 70% (n = 14) was caudocranial, 15% (n = 3) was craniocaudal, and 15% (n = 3) bidirectional, with IRR = 0.662, p < 0.001. Visualization of CSF flow was significantly associated with the presence of IVH alone (OR 9.7 [3.3–29.0], p < 0.001) and IVH+hydrocephalus (OR 12.4 [3.5–440], p < 0.001), but not with hydrocephalus alone (p = 0.116). Conclusion: This study demonstrates that MVI can detect CSF flow dynamics in infants with a history of post-hemorrhagic hydrocephalus with a high IRR.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020245
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 246: Emergency Department Admissions of Children
           with Chest Pain before and during COVID-19 Pandemic

    • Authors: Riccardo Lubrano, Vanessa Martucci, Alessia Marcellino, Mariateresa Sanseviero, Alessandro Sinceri, Alessia Testa, Beatrice Frasacco, Pietro Gizzoni, Emanuela Del Giudice, Flavia Ventriglia, Silvia Bloise
      First page: 246
      Abstract: Objectives: We compared the number of accesses, causes, and instrumental evaluations of chest pain in children between the pre-COVID-19 era and the COVID-19 period and analyzed the assessment performed in children with chest pain, highlighting unnecessary examinations. Methods: We enrolled children with chest pain admitted to our emergency department between January 2019 and May 2021. We collected demographic and clinical characteristics and findings on physical examinations, laboratory tests, and diagnostic evaluations. Then, we compared the number of accesses, causes, and instrumental assessments of chest pain between the pre-COVID-19 era and the COVID-19 era. Results: A total of 111 patients enrolled (mean age: 119.8 ± 40.48 months; 62 males). The most frequent cause of chest pain was idiopathic (58.55%); we showed a cardiac origin in 4.5% of the cases. Troponin determination was performed in 107 patients, and the value was high only in one case; chest X-rays in 55 cases and echocardiograms in 25 cases showed pathological findings, respectively, in 10 and 5 cases. Chest pain accesses increased during the COVID-19 era (p < 0.0001), with no differences in the causes of chest pain between the two periods. Conclusions: The increase in accesses for chest pain during the COVID-19 pandemic confirms that this symptom generates anxiety among parents. Furthermore, our findings demonstrate that the evaluation of chest pain is still extensive, and new chest pain assessment protocols in the pediatric age group are needed.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020246
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 247: Prevalence and Risk Factors of Asthma in
           Children and Adolescents in Rabigh, Western Saudi Arabia

    • Authors: Turki S. Alahmadi, Moustafa A. Hegazi, Hani Alsaedi, Hanaa Hamadallah, Ali F. Atwah, Abdulrahman A. Alghamdi, Haya M. Altherwi, Majd S. Alghamdi, Ebtihal M. Albeshri, Moud I. Alzanbaqi, Abubaker M. Bamakhish, Mohamed S. El-Baz
      First page: 247
      Abstract: The worldwide prevalence of asthma in children is variable. The different epidemiological definitions of asthma, the use of various methods of measurement, and the environmental variations between countries are responsible for such different prevalence rates. This study has been performed to identify the prevalence/risk factors of asthma in Saudi children/adolescents in Rabigh. A cross-sectional epidemiological survey has been conducted using the validated Arabic version of the “International Study of Asthma and Allergies in Childhood questionnaire”. Data on the sociodemographic characteristics of participants and risk factors of asthma have also been collected. Three hundred and forty-nine Children/adolescents with an age range of 5–18 years have been randomly selected for an interview from public places and houses in different regions of Rabigh City. The prevalence rates of physician-diagnosed asthma, any wheezing, and wheezing in the last 12 months among children/adolescents (mean age: 12.22 ± 4.14 years) have remarkably increased in association with the rapidly developing industrialization of Rabigh from previously recorded rates of 4.9%, 7.4%, and 6.4% in the only study that has previously been conducted in Rabigh in 1998 to 31.5%, 23.5%, and 14.9%, respectively. The univariate analysis has detected some significant risk factors for asthma. However, in younger aged children (5–9 years), allergic rhinitis, associated chronic illnesses, and viral respiratory infection-induced wheezing have remained significant risk factors of any wheezing. Drug allergy, exposure to dust, and viral respiratory infection-induced wheezing have persisted as significant risk factors for wheezing in the last 12 months. Eczema in the family, exposure to perfumes/incense, and viral respiratory infection-induced wheezing have remained as significant risk factors of physician-diagnosed asthma. The results of this survey should be useful in future targeted preventive plans/measures with special attention to improving air quality to limit the progressive increase in asthma prevalence in Rabigh, as well as in other similar industrial communities.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020247
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 248: Neuroendocrine System Adaptation during
           Consecutive Extrinsic Stimuli: A Pilot Dynamic Study

    • Authors: Styliani A. Geronikolou, Vasilis Vasdekis, Aimilia Mantzou, Constantinos Davos, Dennis V. Cokkinos, George P. Chrousos
      First page: 248
      Abstract: This pilot repeated measures study aims to evaluate the dynamics of the autonomic nervous system (ANS), the hypothalamic–pituitary–adrenal (HPA) axis, and/or their interplay with low-level inflammation in healthy schoolchildren during consecutive extrinsic stimuli. Twenty healthy schoolchildren and adolescents aged 11–14 years (12.5 ± 1.5) were consecutively exposed to an oral task (#2) and an arithmetic task (#3) (Trier Social Stress Test for Children (TSST-C)), lasting 5 min each, and a three-minute cellular phone call (#4). Salivary cortisol (SC) was sampled at baseline (#1) and immediately after each exposure (#2, 3, and 4). Baseline serum high-sensitivity C-reactive protein (hsCRP) and cortisol levels were also assessed. ANS dynamics and complexity were measured using Sample Entropy (SampEn) at each experimental time period (#1–4). Baseline serum hCRP and cortisol correlated negatively to each other, while the ANS and HPA axis acute reactions to the three consecutive stimuli differed over time. The ANS adaptation to these stimuli included complexity modulation, which was not dependent on baseline hsCRP or cortisol, and weakened during the third stimulation. However, baseline hsCRP and cortisol had a weakening and an increasing effect on the HPA axis over time, respectively. We conclude that low-level inflammation and baseline morning cortisol level have no effect on ANS dynamics but influence the HPA axis response to consecutive external stimuli.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020248
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 249: A Parental Behavior Scale in Pediatric
           Dentistry: The Development of an Observational Scale

    • Authors: Tania Vanhée, Farah Dadoun, Astrid Vanden Abbeele, Peter Bottenberg, Wolfgang Jacquet, Isabelle Loeb
      First page: 249
      Abstract: Children’s treatment means a triangular relationship between the child, practitioner, and parent, with specific interactions influencing the procedure. The objective was to create and validate a hetero-rating scale of parental behavior and verify the correlation between child and parental behavior during pediatric dentistry sessions. Treatment sessions were recorded and evaluated, including 60 children representing three age groups. Two raters interpreted the resulting video clips using the modified Venham scale for children and the new hetero-rating scale for parents. They analyzed the videos twice and attributed scores at different time points of the appointment. The correlation between parental behavior upon entrance and the children’s behavioral at the dental office in the treatment stage was significantly positive in both raters (Kendall Tau: 0.20–0.30). Furthermore, a panel of 20 dental practitioners scored a randomized selection of five recordings per age group. The level of agreement between the two experts was higher than that between the 20 clinicians. Venham types of scale involving multiple aspects can be used in research, but their application in dental practice requires further development. The link between parental anxiety and child anxiety is confirmed, but further research is required to incorporate specific aspects of treatment and parental behavior.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020249
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 250: Tablet-Based Praxis Developed for Children
           in Primary Education Studying Natural Sciences and Mathematics

    • Authors: María-Carmen Ricoy, Cristina Sánchez-Martínez
      First page: 250
      Abstract: Information and Communication Technologies are now a common feature in classroom activities. The aim of this study was to present praxis developed for the tablet for use by primary education students (aged 6–12) studying the natural sciences and mathematics. This research is qualitative and follows the narrative-ethnographic approach. The study sample consisted of 120 primary education students and 52 educational blogs. The results and conclusions reveal praxis that is rarely innovative or ludic. The bulk of tablet-based activities were for natural sciences classes rather than mathematics, and the most common practice with the tablet in the natural sciences was information searching and content exploration. The most widely used apps were the Google search engine, YouTube and the tablet’s default apps (camera, image and video editor). Course content in the natural sciences focused on living beings and states of matter, and the activities developed for children to do on the tablet aimed to foster learning through discovery, exploration and enquiry. In mathematics, a traditional methodological approach was apparent in children’s use of the tablet for typical activities related to units of measurement.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020250
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 251: Surveying Parents of Preschool Children
           about Digital and Analogue Play and Parent–Child Interaction

    • Authors: Andreja Istenič, Violeta Rosanda, Mateja Gačnik
      First page: 251
      Abstract: The addition of digital toys to the child’s toy box has resulted in the development of the new ‘digital play’, which differs from analogue play. Research shows that digital toys are available from infancy onwards and are significantly changing the way children engage in play and communicate with parents during play. How this influences the child’s development must be established. The choice of toys and the manner in which they are used depend greatly on the parents. In the present study, parents’ opinions and experiences of their child’s digital and analogue play were explored in order to gain insight into the parents’ perceptions of the impact of different types of play on their child’s development. We were particularly interested in the differences in a child’s engagement with a toy and the child–parent interaction and communication. In this descriptive study, we administered a questionnaire in order to collect data from 306 parents of children of an average age of 3.6 years. The results show that parents perceived traditional toys as the most stimulating toys for a toddler’s sensory, motor, cognitive, and socio-emotional development. During analogue play, significantly more parent–child interaction, as well as more language input from parents and toddlers, occurred. Parents also used different intervention and mediation strategies with different types of toys.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020251
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 252: Nutritional Status and Circulating Levels of
           Fat-Soluble Vitamins in Cystic Fibrosis Patients: A Cohort Study and
           Evaluation of the Effect of CFTR Modulators

    • Authors: Michela Francalanci, Vito Terlizzi, Cristina Fevola, Giulia Di Rosa, Valentina Pierattini, Elena Roselli, Paolo Bonomi, Maria Chiara Cavicchi, Valeria Galici, Anna Silvia Neri, Chiara Bianchimani, Silvia Campana, Daniela Dolce, Novella Ravenni, Erica Camera, Tommaso Orioli, Giovanni Taccetti
      First page: 252
      Abstract: Background: Improved therapy in CF has led to an overall improvement in nutritional status. The objectives of our study are: to cross-sectionally assess nutritional status and serum levels of fat-soluble vitamins; to retrospectively evaluate the efficacy of modulators on nutritional status and fat-soluble vitamin levels. Methods: In patients younger than 2 years of age, we evaluated growth, in patients aged 2–18 years, we assessed BMI z-scores, and in adults, we assessed absolute BMI values. Levels of 25(OH)D, vitamins A, and E were measured. Results: A cross-sectional analysis was conducted on 318 patients, 109 (34.3%) with pancreatic sufficiency. Only three patients were under 2 years old. In 135 patients aged 2–18 years, the median BMI z-score was 0.11, and 5 (3.7%) patients had malnutrition (z-score ≤ 2SD). In 180 adults, the median BMI was 21.8 kg/m2. Overall, 15 (13.7%) males (M) and 18 (25.3%) females (F) were underweight (18 < BMI > 20); 3 (2.7%) M and 5 (7.0%) F had a BMI < 18. Suboptimal 25(OH)D levels were found in patients with pancreatic insufficiency. The prevalence of deficiency of vitamins A and E is low. After one year of treatment with modulators, the increase in BMI was more consistent (M: 1.58 ± 1.25 kg/m2 F: 1.77 ± 1.21 kg/m2) in elexacaftor/tezacaftor/ivacaftor (ETI)-treated patients compared with other modulators, with a significant increase in levels of all fat-soluble vitamins. Conclusions: Malnutrition is present in a limited number of subjects. The prevalence of subjects with suboptimal 25(OH)D levels is high. ETI showed a beneficial effect on nutritional status and circulating levels of fat-soluble vitamins.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020252
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 253: Gastrointestinal Disorders and Food
           Selectivity: Relationship with Sleep and Challenging Behavior in Children
           with Autism Spectrum Disorder

    • Authors: Giulia Bresciani, Prisca Da Lozzo, Sara Lega, Matteo Bramuzzo, Grazia Di Leo, Andrea Dissegna, Vissia Colonna, Egidio Barbi, Marco Carrozzi, Raffaella Devescovi
      First page: 253
      Abstract: The aim of this study was to evaluate the interaction between gastrointestinal (GI) disorders, sleep problems, and challenging behaviors in children with a diagnosis of Autism Spectrum Disorder (ASD) and their effect on parental stress. The secondary objective was to assess the frequency and type of GI and feeding disorders in a sample of children with ASD through a multidisciplinary assessment and, finally, to investigate families’ perceptions and satisfaction with the proposed multidisciplinary approach. All children underwent a comprehensive gastroenterological and neuropsychiatric evaluation supported by standardized questionnaires. Pediatric gastroenterologists, specifically trained in Applied Behavior Analysis (ABA), provided advice for parent-delivered behavioral intervention for food selectivity. Thirty-six children with an autism diagnosis (29 males, age 4.5 +/−2.2 years, mean +/− SD) were enrolled. A positive correlation between sleep problems and aggressive behavior was found, and this association was stronger in children experiencing more problematic mealtime behaviors (b = 0.788, p = 0.014). Sleep difficulties were associated with stereotyped behaviors and parent-perceived stress. Parents interviewed about the gastroenterology visit perceived this multidisciplinary approach as helpful in addressing food selectivity. This study shows that sleep and mealtime issues can have a synergistic negative impact on ASD symptoms. A multidisciplinary approach and an integrated assessment of GI, feeding problems, and sleep disorders could be helpful in diagnosing comorbidities and to provide targeted advice to parents.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020253
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 254: Sublingual Dermoid Cyst in Young Child

    • Authors: Masakazu Hamada, Rena Okawa, Katsuhiko Masuda, Fumikazu Tojo, Yuto Suehiro, Yuko Ogaya, Hiroko Kinosada, Narikazu Uzawa, Kazuhiko Nakano
      First page: 254
      Abstract: A dermoid cyst is a benign congenital lesion of ectodermal origin that can arise in any region of the body, though occurrence is rare. A young girl aged 2 years 4 months was referred to our hospital because of a painless mass in the floor of the mouth. Intraoral examination findings revealed a painless movable elastic soft mass on the floor of the mouth measuring approximately 15 mm in diameter. Magnetic resonance imaging indicated a cystic lesion, with low signal intensity shown in T1-weighted and extremely high signal intensity in T2-weighted images. These clinical findings indicated the presence of a dermoid cyst and removal was planned. Under general anesthesia with nasal intubation, surgical removal was performed through an incision on the floor of the mouth. Blunt dissection exposed the integrity of the cyst capsule, which was weakly attached to adjacent tissue. The excised mass was 19 × 14 × 11 mm in size. Histological examination findings confirmed a diagnosis of dermoid cyst. The operation was successfully completed without any complications and the postoperative course was good. It is important to properly evaluate cysts in children and provide proper treatment with appropriate timing.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020254
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 255: “Safer Births Bundle of Care”
           Implementation and Perinatal Impact at 30 Hospitals in
           Tanzania—Halfway Evaluation

    • Authors: Hege Ersdal, Paschal Mdoe, Estomih Mduma, Robert Moshiro, Godfrey Guga, Jan Terje Kvaløy, Felix Bundala, Boniphace Marwa, Benjamin Kamala
      First page: 255
      Abstract: Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-hour newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-hour newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (n = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-hour newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward.
      Citation: Children
      PubDate: 2023-01-30
      DOI: 10.3390/children10020255
      Issue No: Vol. 10, No. 2 (2023)
  • Children, Vol. 10, Pages 156: A Rare Complication of Thoracic Spine
           Surgery: Pediatric Horner’s Syndrome after Posterior Vertebral
           Column Resection—A Case Report

    • Authors: Pawel Grabala, Kinga Danowska-Idziok, Ilkka J. Helenius
      First page: 156
      Abstract: Background: Horner’s syndrome (HS) classically consists of the symptom triad of miosis, ptosis, and anhidrosis. It is caused by impairment of a certain pathway in the sympathetic nervous system. It may also appear as part of the clinical signs of other diseases and syndromes, including Pancoast tumors, intradural and/or epidural tumors, thoracic outlet syndrome, syringomyelia, brachial plexus injury, and aortic dissection. Here, we report a very rare complication of vertebral column resection in children, and we present the clinical findings of a case of Horner’s syndrome with a current literature review. Case presentation: A five-year-old child with severe congenital kyphoscoliosis qualified for surgical treatment of the spinal deformity via a posterior approach, with three-column osteotomy and fusion. Results: After successful surgery, the patient presented with HS due to distraction of the sympathetic nerve trunk and, thus, innervation to the left eye. At the 4-year follow-up, the child had fully recovered. Conclusions: Pediatric HS after posterior instrumented scoliosis correction surgery with posterior vertebral column resection of the thoracic spine is very rare. This is the first reported case of HS after posterior vertebral column resection and spinal fusion for congenital kyphoscoliosis without the use of epidural analgesia. Symptom resolution may be variable and, in some cases, delayed.
      Citation: Children
      PubDate: 2023-01-13
      DOI: 10.3390/children10010156
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 157: How Football Players’ Age Affect
           Passing Patterns of Play According to Field Location

    • Authors: Nuno Coito, Hugo Folgado, Diogo Monteiro, Bruno Travassos
      First page: 157
      Abstract: This study aimed to characterize the passing patterns that support collective tactical behaviour in football players of different ages (U15, U17, and U19) in different field zones. Two hundred and twenty-eight male players, divided into U15, U17, and U19, participated in the study. Cluster analysis was used to group the passes into three sizes (short, medium, and long). The chi-square test was used to analyse the effect of player age on game-passing patterns in each field zone. The results revealed that long and medium passes were used more in areas close to the goals and short passes in the middle area of the field, concerning all ages (p < 0.001). Furthermore, the analysis of the relative distance between the ball carrier and the receiver indicated that older players (U17 and U19) used more distant players to pass the ball in medium and long passes. These results can help coaches design small-sided games according to the players’ ages and adjust to the field’s space and the numerical relationship, thus creating a greater transfer from training to competition.
      Citation: Children
      PubDate: 2023-01-13
      DOI: 10.3390/children10010157
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 158: Gentle Touch and Sucrose for Pain Relief
           during Suctioning in Preterm Newborns—A Randomized Clinical Trial

    • Authors: Nayara Rodrigues Gomes de Oliveira, Cibelle Kayenne Martins Roberto Formiga, Bruna Abreu Ramos, Rafaela Noleto dos Santos, Nayara Nubia de Sousa Moreira, Patricia Gonçalves Evangelista Marçal, Waldemar Naves do Amaral
      First page: 158
      Abstract: Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning during hospitalization in the neonatal intensive care unit. PTNBs underwent three different suctioning procedures. The first was performed without intervention (baseline). Right after, PTNBs were randomly allocated (sucrose and gentle touch or vice versa) to the next two suctioning procedures. Two validated scales assessed pain: the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile-Revised (PIPP-R). We evaluated 50 PTNBs (mean of 28 weeks) with a mean low birth weight of 1050 g; most were under continuous positive airway pressure 37 (74%) and mechanical ventilation 41 (82%). Gentle touch was efficacious for pain relief since NIPS (p = 0.010) compared to baseline. Sucrose was also effective in reducing pain NIPS and PIPP-R (p < 0.001). Although the two interventions reduced pain, no difference was observed between gentle touch and sucrose.
      Citation: Children
      PubDate: 2023-01-13
      DOI: 10.3390/children10010158
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 159: Change in Prevalence of Hypertension among
           Korean Children and Adolescents during the Coronavirus Disease 2019
           (COVID-19) Outbreak: A Population-Based Study

    • Authors: Kyungchul Song, Se Yong Jung, Juyeon Yang, Hye Sun Lee, Ho-Seong Kim, Hyun Wook Chae
      First page: 159
      Abstract: During the coronavirus disease 2019 (COVID-19) outbreak, the prevalence of obesity increased globally; this may be associated with hypertension incidence. However, investigations on the changes in the prevalence of hypertension among children and adolescents are limited. This cross-sectional study investigated the prevalence of hypertension among 1428 youths aged 10–18 years using data from the Korea National Health and Nutrition Examination Survey 2018–2020. We assessed the prevalence of hypertension according to sex, age, body mass index (BMI), and residential district. The prevalence of hypertension increased from 7.1% to 12.5% in all participants. In the sex-specific analysis, the prevalence was found to be increased in boys. In the age-specific analysis, the prevalence was found to be increased in youths aged 13–15 years. In the BMI-specific analysis, an increase in the prevalence was prominent in the normal BMI group. In the residential district-specific analysis, the prevalence of hypertension among youth increased in urban areas. Our results show that the prevalence of hypertension increased among Korean children and adolescents during the COVID-19 outbreak. These findings suggest the importance of close monitoring of hypertension among youth during the COVID-19 pandemic.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010159
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 160: Impact of Delayed Time to Antibiotics in
           Medical and Surgical Necrotizing Enterocolitis

    • Authors: Katherine E. Chetta, Katherine G. Vincent, Bresney Fanning, Ashley B. Klumb, Justin A. Chetta, Allison M. Rohrer, Leslie H. Spence, Jeanne G. Hill
      First page: 160
      Abstract: This study investigated whether delayed receipt of antibiotics in infants with necrotizing enterocolitis (NEC) is associated with disease severity. In this retrospective, single-center cohort study of infants diagnosed with NEC over 4 years, we compared the timing of antibiotic administration in infants (time order placed to time of receipt) in medical and surgical NEC. Cases were independently reviewed, then various clinical factors were compared. Of 46 suspected cases, 25 were confirmed by a panel of radiologists with good interrater reliability (ICC 0.657; p < 0.001). Delays in antibiotic receipt were 1.7× greater in surgical than medical NEC cases (p = 0.049). Every hour after order entry increased the adjusted odds of surgical NEC by 2.4 (1.08–5.23; p = 0.032). Delayed antibiotic receipt was more common in infants with surgical than medical NEC. Larger studies will be needed to investigate if optimizing antibiotic expediency could improve intestinal outcomes.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010160
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 161: Delta Neutrophil Index Does Not
           Differentiate Bacterial Infection without Bacteremia from Viral Infection
           in Pediatric Febrile Patients

    • Authors: Maro Kim, Jin Hee Lee, Young Ho Kwak, Hyun Kyung Kim, Hyuksool Kwon, Dongbum Suh, Do Kyun Kim, Ha Ni Lee, Jin Hee Kim, Jie Hee Jue, Soyun Hwang
      First page: 161
      Abstract: Introduction: We sought to determine whether the delta neutrophil index (DNI), a marker that is reported to be used to predict the diagnosis, prognosis, and disease severity of bacteremia and sepsis, is useful in differentiating bacterial infection without bacteremia (BIWB) from viral infections (VI) in pediatric febrile patients in the emergency department (ED). Method: We conducted a retrospective analysis of febrile patients’ medical records from the pediatric ED of the teaching hospital. The patients with BIWB and those with VI were identified with a review of medical records. The primary outcome was the diagnostic performance of DNI in differentiating BIWB from VI. The secondary outcome was a comparison of the diagnostic performances of DNI, CRP, WBC, and neutrophil count between the two groups. Results: A total of 151 (26.3%) patients were in the BIWB group, and 423 (73.7%) were in the VI group. There was no significant difference in DNI between the two groups (3.51 ± 6.90 vs. 3.07 ± 5.82, mean ± SD, BIWB vs. VI). However, CRP levels were significantly higher in the BIWB group than in the VI group (4.56 ± 5.45 vs. 1.39 ± 2.12, mean ± SD, BIWB vs. VI, p < 0.05). The AUROCs of DNI, WBC count, neutrophil levels, RDW, and CRP levels were 0.5016, 0.5531, 0.5631, 0.5131, and 0.7389, respectively, and only CRP levels were helpful in differentiating BIWB from VI. Conclusion: In the absence of bacteremia, DNI would not be helpful in differentiating BIWB from VI in pediatric febrile patients.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010161
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 162: Allogeneic Mesenchymal Stromal Cells as a
           Global Pediatric Prospective Approach in the Treatment of Respiratory
           Failure Associated with Surfactant Protein C Dysfunction

    • Authors: Gloria Pelizzo, Maria Antonietta Avanzini, Stefania Croce, Anna Mandelli, Elisa Lenta, Andrea Farolfi, Chiara Valsecchi, Salvatore Zirpoli, Giulia Lanfranchi, Eleonora Durante, Elena Zoia, Gianvincenzo Zuccotti, Valeria Calcaterra
      First page: 162
      Abstract: Mesenchymal stromal cells (MSCs) have been proposed as a new therapeutic strategy to treat congenital and acquired respiratory system diseases. We describe a case report of an 18-month-old male patient with progressive chronic respiratory failure, associated with mutations of the surfactant protein C gene (SFTPC) due to c.289G > T variant p.Gly97Ser (rs927644577) and c.176A > G variant (p.His59Arg), submitted to repeated intravenous infusions of allogeneic bone marrow (BM) MSCs. The clinical condition of the patient was monitored. Immunologic studies before and during MSC treatment were performed. No adverse events related to the MSC infusions were recorded. Throughout the MSC treatment period, the patient showed a growth recovery. Starting the second infusion, the patient experienced an improvement in his respiratory condition, with progressive adaptation to mechanical ventilation. After the third infusion, five hours/die of spontaneous breathing was shown, and after infusion IV, spontaneous ventilation for 24/24 h was recorded. A gradual decrease of lymphocytes and cell subpopulations was observed. No variations in the in vitro T cell response to PHA were determined by MSC treatment as well as for the in vitro B cell response. A decrease in IFN-γ, TNF-α, and IL-10 levels was also detected. Even though we cannot exclude an improvement of pulmonary function due to the physiological maturation, the well-known action of MSCs in the repair of lung tissue, together with the sequence of events observed in our patient, may support the therapeutic role of MSCs in this clinical condition. However, further investigations are necessary to confirm the result and long-term follow-up will be mandatory to confirm the benefits on the pulmonary condition.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010162
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 163: Levels of Physical Activity, Family
           Functioning and Self-Concept in Elementary and High School Education
           Students: A Structural Equation Model

    • Authors: Félix Zurita-Ortega, José Manuel Alonso-Vargas, Pilar Puertas-Molero, Gabriel González-Valero, José Luis Ubago-Jiménez, Eduardo Melguizo-Ibáñez
      First page: 163
      Abstract: In the adolescent population there is great concern about low levels of physical activity and low levels of family awareness of the benefits of physical exercise on physical and mental health. This study aims to determine the influence of physical activity levels, family functioning and self-concept in primary and secondary school students, as well as to develop a structural equation model as a function of weekly physical activity time. A descriptive, cross-sectional, comparative study was conducted on whether students engage in more than three hours of physical activity per week. To collect the data, instruments validated by the scientific community were used, such as the Adaptability, Partnership, Growth, Affection, and Resolve family questionnaire (APGAR) and the self-concept questionnaire form 5. The results show that those students who engage in more than 3 h of physical activity per week have higher levels of family functioning than those who do not meet this sport criterion. In addition, physically active students show higher scores on all dimensions of self-concept than those who practice less than 3 h of physical activity per week. Finally, as a conclusion, it can be affirmed that the amount of physical activity practice brings benefits to student’s mental health.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010163
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 164: The Development and Usability of a Mobile
           App for Parents of Children with ADHD

    • Authors: Costina-Ruxandra Păsărelu, Reka Kertesz, Anca Dobrean
      First page: 164
      Abstract: Background: Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT in order to increase treatment adherence, homework compliance, and parental engagement. In this paper, we describe the development process of a mobile app for parents of children with ADHD. Methods: We conducted a study to investigate parents’ perceived usability of the ADHD Coping Card. Results: The mobile app developed has a high usability. Future improvements in the app were suggested by parents. Conclusions: Given the increasing importance of digital mental health interventions in psychotherapy, it is important that future research is conducted with a higher number of participants to investigate the key factors implicated in choosing such an intervention in the future, both by parents and by mental health specialists. A mobile app can be used as an add-on in psychotherapy with parents of children with ADHD. Digital health interventions could help surpass gaps in treatment access for child mental health problems.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010164
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 165: Parent Perspectives of Ear Health and the
           Relationship with Children’s Speech and Language in the Longitudinal
           Study of Indigenous Children

    • Authors: Anita Morrow, Neil Orr, Kai Nash, Harvey Coates, Cara Cross, John Robert Evans, Hasantha Gunasekera, Samantha Harkus, Linda Harrison, Sharynne McLeod, Catherine McMahon, Katie Neal, Andrea Salins, Rona Macniven
      First page: 165
      Abstract: Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported speech and language outcomes one year later (age 5–6 years). Most parents (80.2%) reported no concern about their child’s expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children’s expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21–0.99) and receptive language (aOR = 0.24; 95% CI 0.09–0.62). Parents were less likely to have concerns about the child’s expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2–5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010165
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 166: Retrospectively Assessed Muscle Tone and
           Skin Colour following Airway Suctioning in Video-Recorded Infants
           Receiving Delivery Room Positive Pressure Ventilation

    • Authors: Gazmend Berisha, Anne Marthe Boldingh, Britt Nakstad, Elin Wahl Blakstad, Arild Erland Rønnestad, Anne Lee Solevåg
      First page: 166
      Abstract: Background: Recently, the International Liaison Committee on Resuscitation published a systematic review that concluded that routine suctioning of clear amniotic fluid in the delivery room might be associated with lower oxygen saturation (SpO2) and 10 min Apgar score. The aim of this study was to examine the effect of delivery room airway suctioning on the clinical appearance, including muscle tone and skin colour, of video-recorded term and preterm infants born through mainly clear amniotic fluid. Methods: This was a single-centre observational study using transcribed video recordings of neonatal stabilizations. All infants who received delivery room positive pressure ventilation (PPV) from August 2014 to November 2016 were included. The primary outcome was the effect of airway suctioning on muscle tone and skin colour (rated 0–2 according to the Apgar score), while the secondary outcome was the fraction of infants for whom airway suction preceded the initiation of PPV as a surrogate for “routine” airway suctioning. Results: Airway suctioning was performed in 159 out of 302 video recordings and stimulated a vigorous cry in 47 (29.6%) infants, resulting in improvements in muscle tone (p = 0.09) and skin colour (p < 0.001). In 43 (27.0%) infants, airway suctioning preceded the initiation of PPV. Conclusions: In this single-centre observational study, airway suctioning stimulated a vigorous cry with resulting improvements in muscle tone and skin colour. Airway suctioning was often performed prior to the initiation of PPV, indicating a practice of routine suctioning and guideline non-compliance.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010166
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 167: Effect of Diurnal Variation of Heart Rate
           and Respiratory Rate on Activation of Rapid Response System and Clinical
           Outcome in Hospitalized Children

    • Authors: Lia Kim, Kyoung Sung Yun, June Dong Park, Bongjin Lee
      First page: 167
      Abstract: Heart rate and respiratory rate display circadian variation. Pediatric single-parameter rapid response system is activated when heart rate or respiratory rate deviate from age-specific criteria, though activation criteria do not differentiate between daytime and nighttime, and unnecessary activation has been reported due to nighttime bradycardia. We evaluated the relationship between rapid response system activation and the patient’s clinical outcome by separately applying the criteria to daytime and nighttime in patients < 18. The observation period was divided into daytime and nighttime (8:00–20:00, and 20:00 to 8:00), according to which measured heart rate and respiratory rate were divided and rapid response system activation criteria were applied. We classified lower nighttime than daytime values into the ‘decreased group’, and the higher ones into the ‘increased group’, to analyze their effect on cardiopulmonary resuscitation occurrence or intensive care unit transfer. Nighttime heart rate and respiratory rate were lower than the daytime ones in both groups (both p values < 0.001), with no significant association with cardiopulmonary resuscitation occurrence or intensive care unit transfer in either group. Heart rate and respiratory rate tend to be lower at nighttime; however, their effect on the patient’s clinical outcome is not significant.
      Citation: Children
      PubDate: 2023-01-14
      DOI: 10.3390/children10010167
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 168: Concentric Circles: A New Ultrasonographic
           Sign for the Diagnosis of Normal Infantile Hip Development

    • Authors: Nikolaos Laliotis, Chrysanthos Chrysanthou, Panagiotis Konstandinidis
      First page: 168
      Abstract: Ultrasound (US) of the infant hip is used to diagnose developmental dysplasia of the hip (DDH). We present a new sonographic sign that describes the periphery of the femoral head and the acetabulum as two concentric circles.During 2008–2019, 3650 infants were referred for diagnosis of DDH. All underwent a clinical and US examination. We recorded the femoral head as the inner circle, within a fixed external circle, which was identified as the acetabulum. We analysed the clinical signs and risk factors. The US sign of two concentric circles was normal in 3522 infants and was classified as normal hip development. The alpha angle was >60° in 3449 (95%) infants. For the remaining 73 (5%) infants, the alpha angle was 50–60° and underwent further follow-up examination until the alpha angle was normalised. In 128 babies (3.5%), we detected the disruption of the concentric circle sign; the femoral head was found outside the acetabulum, which appeared with an upward sloping roof and the alpha angle was <50°. These infants had DDH and received appropriate treatment. Infants with a concentric circle sign and normal alpha angle are normal, whereas those with a disrupted sign are considered as having DDH.
      Citation: Children
      PubDate: 2023-01-15
      DOI: 10.3390/children10010168
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 169: Evaluating Emotional Outcomes of Medical
           Students in Pediatric Emergency Medicine Telesimulation

    • Authors: Osamu Nomura, Momoka Sunohara, Ichiro Watanabe, Taichi Itoh
      First page: 169
      Abstract: The coronavirus disease 2019 (COVID-19) pandemic has challenged the feasibility of traditional in-person simulation-based clinical training due to the public health recommendation on social distancing. During the pandemic, telesimulation training was implemented to avoid multiple students and faculties gathering in confined spaces. While medical trainees’ perceived emotions have been acknowledged as a critical outcome of the in-person simulation-based training, the impact of telesimulation on trainees’ emotions has been unexamined. We conducted an educational team-based simulation study with a pediatric case of septic shock. Seventeen and twenty-four medical students participated in the telesimulation training and in-person simulation training, respectively. The institutional pandemic social restrictions at the time of each training session determined the participant assignment to either the telesimulation training or in-person simulation training. All participants responded to the Japanese version of the Medical Emotion Scale, which includes 20 items rated on a five-point Likert-type scale before, during, and after the simulation sessions. The measured emotions were categized into four emotion groups according to two dimensions: positive or negative and activating or deactivating emotions. The one-way analysis of variance between the telesimulation and in-person simulation training revealed no significant differences in the emotions perceived by the participants before, during, and after the simulation training sessions. The perceived emotions of medical students were comparable between the telesimulation and in-person simulation training. Further longitudinal studies with larger samples and multiple variables are needed to generalize the effectiveness of telesimulation.
      Citation: Children
      PubDate: 2023-01-15
      DOI: 10.3390/children10010169
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 170: The Preventable Effect of Taekwondo Sport
           among Cadets and Junior’ Bone Mineral Density: DEXA Assessment

    • Authors: Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Hamza Alduraidi, Malik Juweid, Hussam H. Alhawari, Mousa A. Al-Abbadi, Ali M. Alabbadi, Lana Salah Subhi AlNemer
      First page: 170
      Abstract: Athletes competing in Taekwondo (TKD), the weight-category sport, tend to rapidly lose weight to achieve the desired body weight for better competitive results. Little is known about the effect of rapid weight reduction on bone mass density (BMD), especially during childhood and adolescence. The current study aimed to investigate the impact of rapid weight loss on BMD among cadets and juniors TKD athletes. A descriptive case series study design was conducted and collected from 28 males and females aged 12–17 years old, with mean age 14.4 ± 1.7. Dual-energy X-ray absorptiometry (DEXA) was used for both BMD and body composition assessment, and laboratory tests were also performed for the total calcium (Ca), TSH, free T4 (FT4), and 25-OH-vitamin D. Results showed normal levels of Ca (82.1%), TSH (96.4%), and FT4 (96.4%), whilst 85.7% had vitamin D deficiency. DEXA results showed that within male athletes, juniors had a wider range of BMD than cadets, while within females, results did not vary, with no statistical difference between both males and females. Our results suggested that children and adolescents’ BMD was positively related to TKD sport regardless of the abnormal weight loss strategies used, as evidenced by laboratory results. Children and adolescents should be conscious and practice TKD sport adopting healthy weight loss behaviors.
      Citation: Children
      PubDate: 2023-01-15
      DOI: 10.3390/children10010170
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 171: The Psychosocial Effect of Parental Cancer:
           Qualitative Interviews with Patients’ Dependent Children

    • Authors: Elise S. Alexander, Moira O’Connor, Georgia K. B. Halkett
      First page: 171
      Abstract: Background: Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent’s diagnosis is still developing and patients’ children are typically invisible in clinical practice. This study aimed to investigate how children are affected by their parent’s cancer diagnosis, from children’s perspectives. Methods: Informed by methods of grounded theory and embedded within a social constructivist framework, twelve children (ranging from 5 to 17 years) living with a parent with cancer were interviewed using a semi-structured format assisted by a novel approach derived from play- and art-based developmental literature. Results: Findings indicate that patients’ children are constantly worried and distressed, and there are barriers that can be overcome to mitigate this. Four overarching themes were identified: (I) Feeling worried and distressed; (II) Comprehending their parent’s cancer diagnosis; (III) Being disconnected from their supports; and (IV) Needing someone to talk to. Conclusions: Children experience considerable levels of ongoing worry and distress when a parent is diagnosed with cancer and have difficulties comprehending and articulating this. They also feel a level of disconnection from their usual support systems (e.g., parents) and are limited regarding who they can seek out and talk to. Mitigating children’s ongoing worries and distress by promoting the availability and accessibility of parents and other supports to children, and reducing communication barriers between children and adults, should be a primary focus of psycho-oncology research and practice.
      Citation: Children
      PubDate: 2023-01-15
      DOI: 10.3390/children10010171
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 172: Analysis of Clinical Symptoms and
           Biochemical Parameters in Odontogenic Cellulitis of the Head and Neck
           Region in Children

    • Authors: Adrianna Słotwińska-Pawlaczyk, Bogusława Orzechowska-Wylęgała, Katarzyna Latusek, Anna Maria Roszkowska
      First page: 172
      Abstract: Many cases of cellulitis in the head and neck region among hospitalized pediatric patients are related to odontogenic infections. C-reactive protein (CRP), white blood cell (WBC) count, neutrophils to lymphocytes ratio (NLR), D-dimer, and prealbumin can be used to assess the severity of odontogenic inflammation. The aim of the study is to evaluate the biochemical parameters as a predictor factor of the severity of odontogenic cellulitis in children. This study was conducted from 2020 to 2021 on patients admitted to the Department of Pediatric Otolaryngology and Pediatric Head and Neck Surgery of the Upper Silesian Children’s Health Center in Katowice. We included 40 patients aged 2–16 in the study, who were divided into two groups: research (SS-Study subject) (n = 20) and control (CS-Control subject) (n = 20). The patients underwent an interview and physical examination to assess the presence of intraoral and extraoral swelling and the presence of trismus. The patients who qualified for the study had blood taken to determine the level of CRP, WBCs, NLR, D-dimers, and prealbumin. Differences in biochemical test results in the SS and CS were statistically significant (p < 0.05). In the SS group, the mean values of biochemical parameters exceeded the clinical norm. A statistically significant positive relationship was found between CRP and extraoral swelling. The NLR correlates significantly with extraoral swelling and the length of hospitalization. D-dimer statistically correlated with trismus, extraoral swelling, and the number of anatomical spaces involved. The NLR and CRP ratio can be considered a prognostic marker of the course of infection and hospitalization time.
      Citation: Children
      PubDate: 2023-01-16
      DOI: 10.3390/children10010172
      Issue No: Vol. 10, No. 1 (2023)
  • Children, Vol. 10, Pages 173: Lung Ultrasound Role in Diagnosis of
           Neonatal Respiratory Disorders: A Prospective Cross-Sectional Study

    • Authors: Rania Ismail, Nehal M. El Raggal, Laila A. Hegazy, Hossam M. Sakr, Osama A. Eldafrawy, Yasmin A. Farid
      First page: 173
      Abstract: Lung ultrasound (LUS) has become one of the most exciting applications in neonatal point-of-care ultrasound (POCUS), yet still lacks routine clinical use. This study assesses the utility of LUS for neonatal respiratory disorders (NRDs) diagnosis and follow-up compared to chest X-ray (CXR). A prospective cross-sectional study was conducted on 100 neonates having NRDs with a gestational age ≥28 weeks, excluding those having multiple congenital anomalies, chromosomal aberrations, hydrops fetalis and/or heart failure. CXR and LUS were done on admission for diagnosis and were repeated after 7 days, or if needed earlier within the 7 days. The diagnosis of NRDs by CXR and LUS on admission and after 7 days was comparable (p > 0.05). LUS diagnosis sensitivity and specificity for respiratory distress syndrome, pneumonia, meconium aspiration syndrome, pneumothorax and pulmonary atelectasis were 94.7/100%, 97.5/95%, 92.3/100%, 90.9/98.9% and 100/97.8%, respectively. The total agreement between LUS and CXR was 98.5% with 95% CI (0.88 to 0.92). LUS and CXR had considerable agreement in the diagnosis of NRDs. Being a reliable bedside modality of diagnosis and safer than CXR, LUS may be considered an alternative method for the diagnosis of neonates with NRDs.
      Citation: Children
      PubDate: 2023-01-16
      DOI: 10.3390/children10010173
      Issue No: Vol. 10, No. 1 (2023)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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