Children

26 pages, 554 KiB

Open AccessReview

Proteomic Signatures of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Narrative Review

by Maria-Myrto Dourdouna, Elizabeth-Barbara Tatsi, Vasiliki Syriopoulou and Athanasios Michos

Children 2024, 11(10), 1174; https://doi.org/10.3390/children11101174 (registering DOI) - 26 Sep 2024

Abstract

Background/Objectives: Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of COVID-19. MIS-C has overlapping features with other pediatric inflammatory disorders including Kawasaki Disease (KD), Macrophage Activation Syndrome (MAS), Toxic Shock Syndrome and sepsis. The exact mechanisms responsible for the clinical overlap [...] Read more.

Background/Objectives: Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of COVID-19. MIS-C has overlapping features with other pediatric inflammatory disorders including Kawasaki Disease (KD), Macrophage Activation Syndrome (MAS), Toxic Shock Syndrome and sepsis. The exact mechanisms responsible for the clinical overlap between MIS-C and these conditions remain unclear, and biomarkers that could distinguish MIS-C from its clinical mimics are lacking. This study aimed to provide an overview of how proteomic methods, like Mass Spectrometry (MS) and affinity-based proteomics, can offer a detailed understanding of pathophysiology and aid in the diagnosis and prognosis of MIS-C. Methods: A narrative review of relevant studies published up to July 2024 was conducted. Results: We identified 15 studies and summarized their key proteomic findings. These studies investigated the serum or plasma proteome of MIS-C patients using MS, Proximity Extension, or Aptamer-based assays. The studies associated the proteomic profile of MIS-C with laboratory and clinical parameters and/or compared it with that of other diseases including acute COVID-19, KD, MAS, pediatric rheumatic diseases, sepsis and myocarditis or pericarditis following COVID-19 mRNA immunization. Depending on the method and the control group, different proteins were increased or decreased in the MIS-C group. The limitations and challenges in MIS-C proteomic research are also discussed, and future research recommendations are provided. Conclusions: Although proteomics appear to be a promising approach for understanding the pathogenesis and uncovering candidate biomarkers in MIS-C, proteomic studies are still needed to recognize and validate biomarkers that could accurately discriminate MIS-C from its clinical mimics. Full article

(This article belongs to the Special Issue Virulence Factors, Antimicrobial Resistance and Genomics in Pediatric Infectious Diseases)

15 pages, 664 KiB

Open AccessArticle

Effects of an 8-Week Active Play Intervention on Body Composition and Fundamental Motor Skills in Preschool Children

by Katherine E. Spring, Danielle Lang, Melissa M. Pangelinan and Danielle D. Wadsworth

Children 2024, 11(10), 1173; https://doi.org/10.3390/children11101173 (registering DOI) - 26 Sep 2024

Abstract

Objective: Examine the effect of an 8-week teacher-guided active play intervention on preschoolers’ body composition and fundamental motor skills. Methods: Participants were from two local preschool centers randomly assigned to either the intervention (n = 25, 3.91 ± 0.53 years) or the [...] Read more.

Objective: Examine the effect of an 8-week teacher-guided active play intervention on preschoolers’ body composition and fundamental motor skills. Methods: Participants were from two local preschool centers randomly assigned to either the intervention (n = 25, 3.91 ± 0.53 years) or the control group (n = 25, 3.69 ± 0.81 years). All measures were assessed at baseline (week 0), post-intervention (weeks 9–11), and follow-up (weeks 30–33). Bioelectrical Impedance assessed body composition (fat mass (FM) and fat-free mass (FFM)). The Peabody Developmental Motor Scales, Second Edition (PDMS-2) assessed fundamental motor skills (gross motor quartile (GMQ)). Results: A significant Group × Time interaction for GMQ at post-intervention (p = 0.03), with the intervention group scoring significantly higher on GMQ. A significant main effect of Time (p < 0.001) indicated that GMQ increased in both groups across the 33-week period. For FM, a significant main effect of Time at both post-intervention (p < 0.05) and follow-up testing (p < 0.001) indicated that participants increased FM over the 33-week period. Lastly, there was a significant main effect of Time for FFM at post-intervention (p = 0.003) and follow-up (p < 0.001). Interestingly, there was a significant Group x Time interaction (p < 0.05) at follow-up testing showing that FFM increased over time but significantly more for the control group. Conclusions: Results indicate that active play interventions might be a successful pathway to improve gross motor skills in young children. Further research is needed to understand the effect that active play interventions have on body composition in preschoolers. Full article

(This article belongs to the Section Global Pediatric Health)

14 pages, 958 KiB

Open AccessArticle

The Effects of Exergames on Physical Fitness, Body Composition and Enjoyment in Children: A Six-Month Intervention Study

by Santo Marsigliante, Giulia My, Gianmarco Mazzotta and Antonella Muscella

Children 2024, 11(10), 1172; https://doi.org/10.3390/children11101172 - 26 Sep 2024

Abstract

Background/Objectives: Physical inactivity in children can lead to decreased physical fitness and reduced enjoyment of physical activity. This study aimed to evaluate the impact of exergaming on physical fitness, body composition and perceived enjoyment in elementary school children. Methods: Sixty-four male students (mean [...] Read more.

Background/Objectives: Physical inactivity in children can lead to decreased physical fitness and reduced enjoyment of physical activity. This study aimed to evaluate the impact of exergaming on physical fitness, body composition and perceived enjoyment in elementary school children. Methods: Sixty-four male students (mean age 9.5 years) were randomly assigned to an exergaming group (EG, n = 32), engaging in Kinect Adventures three times a week for six months, or a control group (CG, n = 32), which continued standard physical education. Assessments were conducted pre- and post-intervention, including anthropometric measures, physical fitness tests (standing long jump, countermovement jump, sit-and-reach, 20-m sprint), aerobic fitness (20-m shuttle run), and perceived enjoyment measured with the PACES scale. Results: The EG demonstrated significant reductions in body weight, BMI, and relative fat mass compared to the CG (p < 0.01). Improvements in physical fitness were evident in EG, with increases in standing long jump distance (+12.8%; p < 0.0001), countermovement jump height (+65%, p < 0.0001), and flexibility (+75%; p < 0.0001). Aerobic fitness improved significantly in EG (+87.8m) compared to CG. Perceived enjoyment was notably higher in EG, especially at week three, compared to CG (69.3 ± 5.8 vs. 44.2 ± 11.6; p < 0.0001). Conclusions: Exergaming offers benefits for physical fitness and body composition in children, while also enhancing enjoyment. Incorporating exergames into physical education programs could be an effective strategy for addressing childhood obesity, improving physical skills, and increasing student enjoyment, encouraging long-term physical activity adherence. Full article

(This article belongs to the Special Issue Movement Behaviors and Health-Related Physical Fitness in Pediatric Population)

► Show Figures

Figure 1

7 pages, 227 KiB

Open AccessArticle

Effect of an In-Home Palivizumab Administration Program for Children with Medical Complexity

by Hina Emanuel, Aravind Yadav, Julie C. Eapan, Maria Caldas-Vasquez, Tomika S. Harris, Katrina McBeth, Fatima Boricha, Janice John, Ivan G. Magana Ceballos., Giuseppe N. Colasurdo, Maria E. Tellez, Tina Reddy, Wilfredo De Jesús-Rojas and Ricardo A. Mosquera

Children 2024, 11(10), 1171; https://doi.org/10.3390/children11101171 - 26 Sep 2024

Abstract

Background: In-home palivizumab administration programs (PH) have shown promise in reducing RSV-associated infections. These programs may be particularly beneficial for children with medical complexity (CMC) by limiting their exposure to healthcare-associated infections (HAIs) from non-RSV-related pathogens during transportation and visits to medical facilities. [...] Read more.

Background: In-home palivizumab administration programs (PH) have shown promise in reducing RSV-associated infections. These programs may be particularly beneficial for children with medical complexity (CMC) by limiting their exposure to healthcare-associated infections (HAIs) from non-RSV-related pathogens during transportation and visits to medical facilities. Methods: In this prospective study, 41 children with CMC less than 2 years of age were randomized by their health insurance to receive PH or in the clinic (PC) during the RSV season (October 2018–April 2019). Patients were stratified by home ventilation. The primary outcome was the total number of face-to-face encounters. Secondary outcomes were unscheduled clinic visits and hospitalizations secondary to the non-RSV LRTIs. Standard frequentist and Bayesian analyses were performed. Results: All demographic factors and strata were matched between PH (“n” = 13, mean age 22 mo. SD ± 1), and PC (“n” = 28, mean age: 18 mo. SD ± 1). There was a decrease in the number of total face-to-face encounters (adjusted for mechanical ventilation and baseline diagnosis) [(4.5 vs. 8.8), (RR: 1.8, 95% CI: 1.3–2.5, p = 0.001)], and hospitalizations [(0.3 vs. 1.25), (RR: 3.8, 95% CI: 1.3–11.3, p = 0.016)], in the PH vs PC groups. Bayesian analysis showed a 93% probability of benefit in favor of fewer face-to-face encounters in the PH group. Conclusions: This study suggests that PH administration may reduce healthcare utilization in CMC. Minimizing exposure to healthcare facilities and supporting home-based interventions are promising strategies for this population. Full article

18 pages, 703 KiB

Open AccessArticle

Validation of the Mediating Effect of Parenting Stress in the Relationship between Work-Family Strains and Gains and Marital Satisfaction for Fathers in Korea

by Si-Young Lee and Hye-Sun Jung

Children 2024, 11(10), 1170; https://doi.org/10.3390/children11101170 - 26 Sep 2024

Abstract

Background/Objectives: This study aimed to examine the relationship between Korean fathers’ work-family strains and gains and marital satisfaction and to validate the mediating effect of parenting stress in the relationship. Methods: This study used the 14th-year survey data of the Panel Study of [...] Read more.

Background/Objectives: This study aimed to examine the relationship between Korean fathers’ work-family strains and gains and marital satisfaction and to validate the mediating effect of parenting stress in the relationship. Methods: This study used the 14th-year survey data of the Panel Study of Korean Children (PSKC) conducted by the Korea Institute of Child Care and Education (KICCE), the latest available data. The PSKC is a longitudinal study of children’s growth and development from birth in the Republic of Korea. After excluding datasets containing missing values from the data collected from 2150 respondents, the data were extracted from the survey responses collected from 1130 respondents, and descriptive statistical analysis, path analysis, and mediating effect analysis were conducted. Results: First, Korean fathers’ work-family strains had a positive (+) influence on parenting stress (β = 0.658, p < 0.001). Second, Korean fathers’ work-family strains had a negative (−) influence on marital satisfaction (β = −0.185, p < 0.001). Third, Korean fathers’ work-family gains did not have a statistically significant influence on parenting stress (β = 0.016, p = 0.632). Fourth, Korean fathers’ work-family gains had a positive (+) influence on marital satisfaction (β = 0.381, p < 0.001). Fifth, Korean fathers’ parenting stress did not have a statistically significant influence on marital satisfaction (β = 0.011, p = 0.783). Sixth, the indirect effect of work-family strains on marital satisfaction via parenting stress (β = 0.013, 95% Bias-corrected CI = −0.042∼0.075) was statistically significant, and specifically, it had a partial mediating effect. Seventh, the indirect effect of work-family gains on marital satisfaction via parenting stress (β = 0.028, 95% Bias-corrected CI = 0.005∼0.051) was statistically significant, and specifically, it had a partial mediating effect. Conclusions: This study aims to provide the basic data for various family support policies for fathers by understanding the current status of work-family balance for fathers in modern society, as well as by examining the effects of parenting stress in the relationship with marital satisfaction. Full article

(This article belongs to the Section Global Pediatric Health)

► Show Figures

Figure 1

11 pages, 222 KiB

Open AccessArticle

Early Results of an Innovative Scalable Digital Treatment for Diabetes Distress in Families of School-Age Children with Type 1 Diabetes

by Susana R. Patton, Jessica S. Pierce, Nicole Kahhan, Matthew Benson, Mark A. Clements and Larry A. Fox

Children 2024, 11(10), 1169; https://doi.org/10.3390/children11101169 - 26 Sep 2024

Abstract

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, ‘Remedy to Diabetes Distress’ (R2D2). Methods: We randomized 34 families (mean child age [...] Read more.

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, ‘Remedy to Diabetes Distress’ (R2D2). Methods: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access to digital treatment materials for 10 weeks. We examined the feasibility and acceptability of R2D2. We used the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, parent and child, respectively) to examine treatment effects by time and delivery arm. We performed sensitivity analyses to characterize families who responded to R2D2. Results: It was feasible for families to access R2D2 mHealth content independently, though attendance at telehealth visits was variable. Parents and children reported high satisfaction scores. There were significant pre-post reductions in PPAIDC (p = 0.026) and PAIDC (p = 0.026) scores but no differences by delivery arm. There were no differences in child age, sex, race, or pre-treatment HbA1c for responders versus non-responders, though families who responded reported higher PPAID-C scores pre-treatment (p = 0.01) and tended to report shorter diabetes duration (p = 0.08). Conclusions: Initial results support the acceptability and treatment effects of R2D2 regardless of the frequency of adjunctive virtual visits. Characterizing responders may help to identify families who could benefit from R2D2 in the future. Full article

(This article belongs to the Special Issue Innovative Psychosocial Interventions in Children and Adolescents Living with Type 1 Diabetes)

15 pages, 2422 KiB

Open AccessArticle

Pediatric Dentists’ Practice Patterns in the Screening, Diagnosis, and Management of Temporomandibular Disorders

by Caroline M. Sawicki and Linda Sangalli

Children 2024, 11(10), 1168; https://doi.org/10.3390/children11101168 - 26 Sep 2024

Abstract

Background/Objectives: Pain associated with temporomandibular disorders (TMDs) is the main non-odontogenic cause of orofacial pain among youth. Pediatric dentists are often the first healthcare practitioners to perform a comprehensive oral examination in children, which should include evaluation of the temporomandibular joint, masticatory muscles, [...] Read more.

Background/Objectives: Pain associated with temporomandibular disorders (TMDs) is the main non-odontogenic cause of orofacial pain among youth. Pediatric dentists are often the first healthcare practitioners to perform a comprehensive oral examination in children, which should include evaluation of the temporomandibular joint, masticatory muscles, and surrounding structures for signs and/or symptoms of TMD. This study assessed pediatric dentists’ practice patterns in the screening, diagnosis, and management of TMD. Methods: A 19-item online survey was used to assess pediatric dentists’ clinical practice patterns and perceived knowledge and comfort levels in the screening, diagnosis, and management of TMD. The survey was distributed in July 2024, with a one-month window open for the study. Confidence levels and perceived knowledge were compared according to years from graduation and frequency of TMD screening assessment with ANOVA or independent t-test, as appropriate. Open-ended items were analyzed thematically. Results: A total of 206 pediatric dentists and pediatric dentistry residents participated in this study. A share of 72.8% of respondents reported that up to 25% of their patients per week present with signs and symptoms of TMD. About one-fifth of pediatric dental providers never complete a screening history for TMD (22.1%) or a clinical assessment of TMD-related structures (21.6%). There was overall low self-perceived knowledge and confidence among pediatric dentists regarding the diagnosis, screening, and management of TMD in children and adolescents, regardless of the number of years from graduation. Respondents who reported seeing up to 50% of TMD patients reported significantly more knowledge and confidence in diagnosing pediatric TMD than those who encountered fewer TMD patients. An overwhelming majority (81.6%) indicated a need for continuing education courses and training focused on the management of TMD in pediatric patients. Conclusions: Providers reported low confidence and self-perceived knowledge about TMD in pediatric populations, a high rate of referral of patients with TMD, and a particular interest for professional development opportunities focused on management of TMD. Full article

(This article belongs to the Special Issue Oral Heath Disparities in Children and Adolescents: Determinants and Challenges)

► Show Figures

Figure 1

11 pages, 741 KiB

Open AccessSystematic Review

Effects of High-Velocity Spinal Manipulation on Quality of Life, Pain and Spinal Curvature in Children with Idiopathic Scoliosis: A Systematic Review

by Mario Piqueras-Toharias, Alfonso Javier Ibáñez-Vera, Ana Belén Peinado-Rubia, Daniel Rodríguez-Almagro, Rafael Lomas-Vega and Ana Sedeño-Vidal

Children 2024, 11(10), 1167; https://doi.org/10.3390/children11101167 - 26 Sep 2024

Viewed by 141

Abstract

Background/Objectives: Scoliosis is a condition that involves deformation of the spine in the coronal plane and commonly appears in childhood or adolescence, significantly limiting a person’s life. The cause is multifactorial, and treatment aims to improve the spinal curvature, prevent major pathologies, and [...] Read more.

Background/Objectives: Scoliosis is a condition that involves deformation of the spine in the coronal plane and commonly appears in childhood or adolescence, significantly limiting a person’s life. The cause is multifactorial, and treatment aims to improve the spinal curvature, prevent major pathologies, and enhance aesthetics. The objective of this review was to determine whether high-velocity low-amplitude (HVLA) spinal manipulation is more effective than other treatments for children with idiopathic scoliosis (IS). Methods: The PubMed, Web of Science, Scopus and PEDro databases were searched for both clinical trials and cohort studies. Methodological quality was assessed via the PEDro scale (for clinical trials) and the Newcastle–Ottawa scale (for observational studies). The protocol of this systematic review was registered in PROSPERO (CRD42024532442). Results: Five studies were selected for review. The results indicated moderate improvements in pain and the Cobb angle and limited improvements in quality of life. Conclusions: HVLA spinal manipulation does not seem to have significant effects on reducing spinal deformity in IS patients, nor does it significantly impact quality of life. However, this therapy may have significant effects on reducing pain in these patients. Full article

(This article belongs to the Special Issue New Trends in Physical Therapy for Children)

► Show Figures

Figure 1

14 pages, 1548 KiB

Open AccessArticle

Introducing the Index of Caries Risk (ICR): A Comparative Study on a Novel Tool for Caries Risk Assessment in Pediatric Patients

by Patrizia Lucchi, Alice Dina Nasuti, Giovanni Franciosi, Carlo Gaeta, Simone Grandini, Francesco Saverio Ludovichetti, Sergio Mazzoleni and Giulia Malvicini

Children 2024, 11(10), 1166; https://doi.org/10.3390/children11101166 - 25 Sep 2024

Viewed by 211

Abstract

Background: The prevalence of dental caries presents a global public challenge, particularly in children. Traditional caries risk assessment tools like Cariogram are effective but often complex and resource intensive. The aim of the present study was to introduce, for the first time, a [...] Read more.

Background: The prevalence of dental caries presents a global public challenge, particularly in children. Traditional caries risk assessment tools like Cariogram are effective but often complex and resource intensive. The aim of the present study was to introduce, for the first time, a newly designed caries risk assessment (CRA) tool named Index of Caries Risk (ICR) and to evaluate its efficacy for pediatric patients. Methods: This observational study was conducted at the University Hospital of Siena (Italy), involving 55 children aged 6 to 12 years. Participants were assessed using both the newly developed ICR and the well-known Cariogram tool. The data were collected by two calibrated operators. The ICR was compared with the Cariogram tool, and a descriptive analysis and a Pearson correlation coefficient were performed. Results: Results indicated a strong positive correlation (R = 0.88, p < 0.01) between the two methods, with ICR simplifying the assessment process while maintaining efficacy. Conclusions: This study highlights the ICR’s potential to provide a practical, cost-effective alternative for routine caries risk assessment in pediatric dentistry. Despite its limitations, this research marks a preliminary investigation of a promising new CRA tool. Further research should focus on validating the ICR in the larger and more diverse pediatric population, as well as exploring its long-term effectiveness and its application in different clinical settings. Full article

(This article belongs to the Section Pediatric Dentistry & Oral Medicine)

► Show Figures

Figure 1

14 pages, 266 KiB

Open AccessArticle

Which Factors Predict L2 Receptive Vocabulary and Expressive Syntax in Bilingual Children from Low-SES Families?

by Arianna Bello, Paola Ferraresi, Susanna Pallini, Paola Perucchini and Antonia Lonigro

Children 2024, 11(10), 1165; https://doi.org/10.3390/children11101165 - 25 Sep 2024

Viewed by 179

Abstract

Introduction: The objective of the current study was two-fold. First, it aimed to estimate receptive vocabulary and expressive syntax skills in L2 Italian among early sequential/simultaneous bilingual children of migrant single-mother families with very low socioeconomic status (SES). This objective was achieved by [...] Read more.

Introduction: The objective of the current study was two-fold. First, it aimed to estimate receptive vocabulary and expressive syntax skills in L2 Italian among early sequential/simultaneous bilingual children of migrant single-mother families with very low socioeconomic status (SES). This objective was achieved by matching the participants’ performance with normative data. Secondly, this study aimed to identify which individual and language exposure factors contributed to learning L2 vocabulary and syntax. Methods: Twenty-four early sequential/simultaneous bilingual children (age range = 5.10–12.4 years) and their mothers were enrolled. Mothers answered questions about linguistic biography and demographic information. Children completed Lexical Comprehension, Sentence Repetition, and Non-Word Repetition tasks from the Language Assessment Battery for 4–12-year-olds to, respectively, assess receptive vocabulary, expressive syntax, and phonological processing. Moreover, non-verbal intellectual functioning was evaluated by the Raven’s Test. Results/Discussion: Compared to normative data, 20 children showed lower receptive vocabulary abilities (<−1.5 SD), 24 lower expressive syntax skills (−2DS), and 7 children lower phonological processing (<−1.5 DS). Moreover, L2 phonological processing and the length of L2 exposure in an educational context positively predicted L2 receptive vocabulary as well as L2 expressive syntax skills. To date, performance in L2 among early sequential/simultaneous bilingual children from migrant households and very low SES remains underexplored. Future efforts need to be directed towards the understanding of factors that impact oral competence in L2, considering that these children will also be exposed to written L2 in the school context. Full article

(This article belongs to the Special Issue Language Acquisition and Language Impairment in Children with and without Neurodevelopmental Disorders)

10 pages, 572 KiB

Open AccessArticle

Meningococcal Carriage in Children with Atypical Hemolytic Uremic Syndrome Receiving Eculizumab Therapy

by Asli Kavaz Tufan, Fatma Ozak Batibay, Gulsah Kaya Aksoy, Bora Gulhan, Beltinge Demircioglu Kilic, Ismail Dursun, Bahar Buyukkaragoz, Aysun Caltik Yilmaz, Hulya Nalcacioglu, Tulay Becerir, Nuran Cetin, Kubra Celegen, Meltem Dinleyici, Mucahit Kaya, Omer Kilic and Ener Cagri Dinleyici

Children 2024, 11(10), 1164; https://doi.org/10.3390/children11101164 - 25 Sep 2024

Viewed by 250

Abstract

Background/Objectives: Eculizumab is a first-line treatment for atypical hemolytic uremic syndrome (aHUS), and patients undergoing eculizumab therapy may become more susceptible to infection caused by Neisseria meningitidis (Nm). While meningococcal vaccination is required for patients undergoing eculizumab therapy, there is limited [...] Read more.

Background/Objectives: Eculizumab is a first-line treatment for atypical hemolytic uremic syndrome (aHUS), and patients undergoing eculizumab therapy may become more susceptible to infection caused by Neisseria meningitidis (Nm). While meningococcal vaccination is required for patients undergoing eculizumab therapy, there is limited knowledge about meningococcal carriage in children with aHUS. We aimed to evaluate (1) the prevalence of Nm carriage, (2) serogroup distribution, and (3) the immunization status of children undergoing eculizumab treatment for aHUS. Methods: The Meningo-aHUS study is a prospective, multi-center study evaluating meningococcal carriage in children and adolescents in Türkiye receiving eculizumab for aHUS. We noted the age, gender, daycare, school, or university attendance, passive smoking status, previous infection and antibiotic use, and previous immunization history, including meningococcal vaccines, from the medical records of those children with aHUS. We collected nasopharyngeal samples, tested them for Nm using real-time polymerase chain reaction, and performed a serogroup analysis on the positive samples. Results: We collected nasopharyngeal samples from 62 children with aHUS. Out of 62 children, 61 (98.4%) had received at least one dose of the meningococcal vaccine. The median time since the last meningococcal vaccine dose was 15 months (1–59 months). We detected meningococcal carriage in three (4.8%, 95% CI 1.0–13.5) children, and all three strains were non-groupable (NG). No other serogroups were detected. Conclusions: Almost all the children received their risk-group meningococcal immunization, including booster doses. A 4.8% of children with aHUS carried NG meningococci and, no vaccine serogroups were detected. Patients treated with eculizumab remain profoundly susceptible to IMD due to these NG meningococcal strains. The occurrence of breakthrough cases and carriage of Nm, especially NG strains, highlights the significance of maintaining a state of constant alertness, promptly seeking medical attention, and swiftly treating any symptoms that align with IMD, regardless of their vaccination status or antibiotic prophylaxis. Full article

(This article belongs to the Section Pediatric Nephrology & Urology)

► Show Figures

Figure 1

3 pages, 159 KiB

Open AccessReply

Reply to Herrmann et al. Comment on “van Gemert et al. Asymptomatic Infant Rib Fractures Are Primarily Non-Abuse-Related and Should Not Be Used to Assess Physical Child Abuse. Children 2023, 10, 1827”

by Martin J. C. van Gemert, Marianne Vlaming, Steven C. Gabaeff, Peter G. J. Nikkels and H. A. Martino Neumann

Children 2024, 11(10), 1163; https://doi.org/10.3390/children11101163 - 25 Sep 2024

Viewed by 102

Abstract

We thank the authors of [...] Full article

12 pages, 1073 KiB

Open AccessArticle

An Epidemiological Perspective on New Pediatric Cases of Type 1 Diabetes and Vitamin D Deficiency in South-East Romania: A Retrospective Study

by Maria Ursu, Mariana Cretu-Stuparu, Gabriela Gurau, Luciana-Carmen Nitoi, Aurel Nechita and Manuela Arbune

Children 2024, 11(10), 1162; https://doi.org/10.3390/children11101162 - 25 Sep 2024

Viewed by 229

Abstract

Objectives: The aim of this study is to analyze the epidemiological characteristics and the biological profile of children from the southeast of Romania who have been newly diagnosed with type 1 diabetes (T1DM) and to investigate the potential relationships between vitamin D deficiency [...] Read more.

Objectives: The aim of this study is to analyze the epidemiological characteristics and the biological profile of children from the southeast of Romania who have been newly diagnosed with type 1 diabetes (T1DM) and to investigate the potential relationships between vitamin D deficiency and the onset of this disease, especially in the context of the COVID-19 pandemic. Methods: This is a retrospective study that included 79 children under the age of 18 who were diagnosed with T1DM at the St. Ioan Galati Children’s Emergency Clinical Hospital between 2018 and 2023. Their demographic data (age, sex, and home environment), medical history (family medical history, birth weight, Apgar score, and type of nutrition), and biological parameters, including glycemia, HbA1C, and vitamin D level, were collected. We used advanced statistical methods to compare the levels of vitamin D in the children with T1DM with a control group of nondiabetic children. Results: The demographic characteristics of new T1DM are a median age of 9 and female/male sex ratio of 1:3, with 50.6% living in urban areas, 59.5% with a normal body mass index, and 74.6% presenting with ketoacidosis. Vitamin D deficiency was found in 52% of diabetic cases compared to 2.53% in the nondiabetic controls. Conclusions: There is an increasing incidence of pediatric T1DM. Diabetic ketoacidosis was frequently diagnosed as an initial manifestation and has frequently accompanied lower levels of vitamin D. Children with T1DM showed significant vitamin D deficiencies compared to the control group, highlighting the need for the monitoring and supplementation of this vitamin. Full article

(This article belongs to the Special Issue New Research Progress on Endocrine Disorders in Infants, Children, and Adolescents)

► Show Figures

Figure 1

11 pages, 302 KiB

Open AccessArticle

Association between Academic Performance, Physical Activity, and Academic Stress in Compulsory Secondary Education: An Analysis by Sex

by Dilan Galeano-Rojas, Marina Cuadros-Juárez, Borys Bismark León Reyes, Mónica Alexandra Castelo Reyna, Claudio Farías-Valenzuela and Pedro Valdivia-Moral

Children 2024, 11(10), 1161; https://doi.org/10.3390/children11101161 - 25 Sep 2024

Viewed by 391

Abstract

Objectives: The main objective of this study is to analyze the relationships between academic performance, physical activity, and academic stress in secondary education students, while the secondary objective is to establish differences by gender in the physical activity and academic stress levels of [...] Read more.

Objectives: The main objective of this study is to analyze the relationships between academic performance, physical activity, and academic stress in secondary education students, while the secondary objective is to establish differences by gender in the physical activity and academic stress levels of secondary students based on academic performance. Methods: The sample was composed of students from both sexes who attended public institutions. Data collection was conducted applying an ad hoc questionnaire for academic performance, the PAQ-C questionnaire for physical activity, and the QASSE questionnaire for academic stress. Data analysis was performed using descriptive statistics: Spearman’s correlation coefficient was used for associations, while comparisons were conducted via the Mann–Whitney U test and Kruskal–Wallis H test. Results: The results show that academic stress is negatively correlated with physical activity and academic performance. Men present significantly higher values in physical activity, while women present higher mean values in general academic stress and the academic overload dimension. Lastly, regarding academic performance, significant differences were observed in the family pressure dimension, with students who perform better academically presenting lower mean values in this dimension of academic stress. Conclusions: In conclusion, the more the general academic stress, the lower the physical activity levels and academic performance. In addition, physical activity appears as a potential coping strategy for academic stress, and its influence on academic performance should be further studied in secondary education. Full article

(This article belongs to the Special Issue The Health Effects of Daily Physical Activity Behaviours in Children: Physical and Psychological Outcomes)

10 pages, 862 KiB

Open AccessArticle

Vitamin D Deficiency and Maternal Diseases as Risk Factors for the Development of Macrosomia in Newborns

by Nazym Ailbayeva, Aliya Alimbayeva, Oxana Yurkovskaya, Raida Faizova, Sayat Tanatarov, Gulnara Taiorazova, Aizhan Abylgazinova, Andrey Orekhov, Ulzhan Jamedinova and Lyudmila Pivina

Children 2024, 11(10), 1160; https://doi.org/10.3390/children11101160 - 25 Sep 2024

Viewed by 247

Abstract

Background: The aim is to assess the association between the level of vitamin D, maternal diseases, and macrosomia in newborns. Methods: This study included 258 full-term newborns (86 newborns with macrosomia; and 172 newborns with normal weight). Enzyme immunoassays for the determination [...] Read more.

Background: The aim is to assess the association between the level of vitamin D, maternal diseases, and macrosomia in newborns. Methods: This study included 258 full-term newborns (86 newborns with macrosomia; and 172 newborns with normal weight). Enzyme immunoassays for the determination of vitamin D were performed. Results: Newborns with macrosomia were statistically significantly more likely to have severe vitamin D deficiency compared with control (13.5 ± 6.7 ng/mL vs. 21.3 ± 12.1 ng/mL; p < 0.05). In the main group, severe deficiency was found in 40.7% of newborns, in the control group this rate was 5.8% (χ² = 71,788, df = 3, p < 0.001). Multiple regression analysis shows that statistically significant risk factors for the development of macrosomia were vitamin D deficiency in the cord blood (OR = 2.29), maternal age over 36 years old (OR = 19.54), and hypothyroidism (OR = 9.35). Conclusion: the results of our study demonstrate relationship between macrosomia in newborns and vitamin D deficiency in the cord blood, maternal overweight and obesity, maternal age and thyroid disease. Full article

(This article belongs to the Section Pediatric Neonatology)

► Show Figures

Figure 1

10 pages, 722 KiB

Open AccessArticle

Internalizing Symptoms and Their Impact on Patient-Reported Health-Related Quality of Life and Fatigue among Patients with Craniopharyngioma During Proton Radiation Therapy

by Belinda N. Mandrell, Yian Guo, Yimei Li, Donna Hancock, Mary Caples, Jason M. Ashford, Thomas E. Merchant, Heather M. Conklin and Valerie Mc. Crabtree

Children 2024, 11(10), 1159; https://doi.org/10.3390/children11101159 - 25 Sep 2024

Viewed by 265

Abstract

Objective: The aim of this study was to describe fatigue, health-related quality of life (HRQOL) and brain tumor-associated symptoms after surgical resection and during proton radiotherapy, using latent class analysis (LCA), and to determine if there is class membership change among pediatric patients [...] Read more.

Objective: The aim of this study was to describe fatigue, health-related quality of life (HRQOL) and brain tumor-associated symptoms after surgical resection and during proton radiotherapy, using latent class analysis (LCA), and to determine if there is class membership change among pediatric patients with craniopharyngioma. Methods: For all patients (n = 92), demographic and disease-related/clinical variables were attained, and patient reported outcomes were collected prior to proton therapy, at week three, and at the completion of proton therapy. The mean scores for fatigue, HRQOL, and brain tumor symptoms were compared over time and profiles were identified. Factors that influenced profile status and transition probability were examined. Results: Fatigue, HRQOL, and brain tumor symptoms improved over time during proton therapy; however, a subset remained in the lower profile, profile 1, associated with increased internalizing behaviors, compared to profile 2. Conclusions: Future study should explore the bidirectional relationship of sleep, worry and anxiety in the context of ongoing radiotherapy. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

► Show Figures

Figure 1

14 pages, 1036 KiB

Open AccessArticle

The Effects of Pediatric Acute Lymphoblastic Leukemia Treatment on Cardiac Repolarization

by Diana R. Lazar, Simona Cainap, Florin Leontin Lazar, Dana Maniu, Cristina Blag, Madalina Bota, Marius C. Colceriu and Mihnea Zdrenghea

Children 2024, 11(10), 1158; https://doi.org/10.3390/children11101158 - 24 Sep 2024

Viewed by 292

Abstract

Background: In recent years, cardiac dysfunction in childhood cancer survivors has become an important issue. Studies are focusing on identifying means for the early identification of patients at risk. Considering this, our study aims to investigate 24-hour Holter electrocardiogram (ECG) repolarization changes throughout [...] Read more.

Background: In recent years, cardiac dysfunction in childhood cancer survivors has become an important issue. Studies are focusing on identifying means for the early identification of patients at risk. Considering this, our study aims to investigate 24-hour Holter electrocardiogram (ECG) repolarization changes throughout doxorubicin (DOX) and cyclophosphamide (CPM) administration in pediatric patients treated for acute lymphoblastic leukemia (ALL). Methods: This was an investigator-driven, single-center, prospective, observational study. Enrolled children had a baseline bedside ECG examination performed before starting chemotherapy (T0). Serial Holter ECG examinations were conducted at three moments during their treatment protocol: day 8 (T1), day 29 (T2), and day 36 (T3). This study evaluated several ECG repolarization parameters, such as the QT interval, corrected QT interval (QTc), and QTc dispersion, as well as ST segment variations. Results: We evaluated 37 children diagnosed with ALL. The T0 examination revealed that over a third of patients had a resting heart rate (HR) outside the normal range for their age and sex. During chemotherapy, statistically significant increases in both HR as well as QT and QTc dispersion values were noticed, especially during the first DOX administration. What is more, a significant increase in the percentage of patients with ST segment depression from T1 to T2 and T3 was noticed. Rhythm disturbances were rare in the study population, with only a few patients presenting ventricular or supraventricular extrasystoles. Conclusions: This study reveals silent repolarization changes occurring early during anticancer treatment in children treated for ALL. These findings could aid in a better understanding of the cardiac toxicity mechanism, and they could potentially improve cardiac risk stratification for oncologic patients. Because of the small number of patients, our results need to be validated by larger studies Full article

(This article belongs to the Special Issue Children with Leukemia and Lymphoma: Diagnosis and Management)

3 pages, 143 KiB

Open AccessEditorial

Editorial on Asymptomatic Rib Fractures and Their Relationship to Child Abuse

by Oliver J. Muensterer and Eva Möhler

Children 2024, 11(10), 1157; https://doi.org/10.3390/children11101157 - 24 Sep 2024

Viewed by 206

Abstract

Children recently published a Special Issue that focuses on child abuse and neglect as severe adverse childhood experiences [...] Full article

11 pages, 284 KiB

Open AccessCommunication

Sociodemographic Factors Associated with Video Game Addiction in Schoolchildren from the South-Central Region of Chile

by Alejandra Rodríguez-Fernández, Marcela Ruíz-De la Fuente, Eduard Maury-Sintjago, Sofía Petersen, Valentina Paredes and Bárbara Montero

Children 2024, 11(10), 1156; https://doi.org/10.3390/children11101156 - 24 Sep 2024

Viewed by 269

Abstract

Video game addiction is a worldwide concern, particularly in schoolchildren where it has impact on academic, social, and emotional spheres. The objective of this study was to determine the sociodemographic factors associated with video game addiction in schoolchildren from the south-central region of [...] Read more.

Video game addiction is a worldwide concern, particularly in schoolchildren where it has impact on academic, social, and emotional spheres. The objective of this study was to determine the sociodemographic factors associated with video game addiction in schoolchildren from the south-central region of Chile. Methods: An analytical cross-sectional study that included a sample of 308 schoolchildren was performed. Sociodemographic factors were analyzed and levels of video game addiction was assessed using the Video Game Addiction Test (VAT) developed by Chóliz and Marco. A general linear regression model (ANCOVA) (α = 0.05) was applied (STATA v16). The prevalence of video game use was 82.7%, while addiction reached 10%. Risk factors associated with the increased risk of addiction were as follows: being male (β = 13.99; p < 0.001); being in the care of another relative (β = 11.1; p < 0.001); a higher number of people in the household (β = 11.2; p < 0.001); the caregiver in employment (β = 12.8; p < 0.001); and not performing extracurricular physical activity (β = 9.9; p < 0.001). Full article

(This article belongs to the Section Global Pediatric Health)

11 pages, 481 KiB

Open AccessArticle

Measuring Food Insecurity in Children under 5 Years of Age with Acute Undernutrition in Valle Del Cauca—Colombia

by Laura Valentina Parra-Pinzon, Elisa Maria Pinzon-Gomez, Sayda Milena Pico-Fonseca, Isabel Cristina Hurtado, Ana Rocio Guzman-Benavides and Olmer Alexander Pantoja-Rodríguez

Children 2024, 11(10), 1155; https://doi.org/10.3390/children11101155 - 24 Sep 2024

Viewed by 248

Abstract

Malnutrition is a global problem that affects all countries in one or more of its forms, representing one of the greatest challenges worldwide. One of the key contributing factors is food insecurity, which must be evaluated in children with moderate and severe acute [...] Read more.

Malnutrition is a global problem that affects all countries in one or more of its forms, representing one of the greatest challenges worldwide. One of the key contributing factors is food insecurity, which must be evaluated in children with moderate and severe acute malnutrition, as they are at imminent risk of death. Objective: Our objective was to assess food insecurity among children under 5 years old with moderate, and severe malnutrition from Valle del Cauca, a state located in the southwestern region of Colombia. Methods: A descriptive observational study was conducted, including children whose weight-for-height (W/H) indicator was below 2 SD, as recorded on the World Health Organization (WHO) growth charts, or who exhibited severe malnutrition phenotypes such as marasmus or Kwashiorkor. Family and child food security were evaluated using the Latin American and Caribbean Food Security Scale (ELCSA). Results: 58.6% of households with acutely malnourished children experienced food insecurity. A statistically significant relationship was found between food insecurity and children of Afro-Colombian and Indigenous descent. According to caregivers’ perceptions, 30.2% of child malnutrition cases were related to poor feeding and caregiving practices. Conclusions: Not all children with acute malnutrition suffer from food insecurity. Therefore, the findings of this research suggest that governmental efforts should focus not only on ensuring food availability, but also on educating caregivers about the importance of a balanced and nutritious diet tailored to the specific characteristics of each region and promoting appropriate caregiving practices. Full article

(This article belongs to the Topic Children’s Diseases, Family Management, and Quality of Life)

► Show Figures

Figure 1

19 pages, 742 KiB

Open AccessArticle

Retinopathy of Prematurity in Eight Portuguese Neonatal Intensive Care Units: Incidence, Risk Factors, and Progression—A Prospective Multicenter Study

by Mariza Fevereiro-Martins, Ana Carolina Santos, Carlos Marques-Neves, Manuel Bicho and Hercília Guimarães

Children 2024, 11(10), 1154; https://doi.org/10.3390/children11101154 - 24 Sep 2024

Viewed by 261

Abstract

Background/Objectives: Retinopathy of prematurity (ROP) is a retinal neovascular disease affecting preterm infants. Identifying risk factors for its development and progression is critical for effective screening and prevention. This study aimed to analyze the incidence of ROP and identify key risk factors for [...] Read more.

Background/Objectives: Retinopathy of prematurity (ROP) is a retinal neovascular disease affecting preterm infants. Identifying risk factors for its development and progression is critical for effective screening and prevention. This study aimed to analyze the incidence of ROP and identify key risk factors for its development and progression. Methods: We conducted a prospective, observational cohort study on 455 neonates (gestational age [GA] < 32 weeks or birth weight < 1500 g) across eight Portuguese NICUs. Results: ROP incidence was 37.8%, with 4.6% requiring treatment. Multivariate analysis identified low GA and the number of red blood cell (RBC) transfusions as significant factors for ROP development and progression. After adjusting for these variables, platelet transfusions, high maximum fraction of inspired oxygen (FiO₂) in the second week, and surfactant use remained significantly associated with ROP development, while early and late sepsis, maternal chronic hypertension, and delayed enteral nutrition were associated with progression to ROP requiring treatment. Conclusions: These findings underscore the importance of addressing low GAs and adult RBC transfusions in ROP risk management and suggest that maximum FiO₂, platelet transfusions, and sepsis also play crucial roles. Larger studies are needed to validate these results and explore preventive interventions, particularly regarding the impact of multiple adult RBC transfusions on fetal hemoglobin percentages. Full article

► Show Figures

Figure 1

3 pages, 155 KiB

Open AccessComment

Comment on van Gemert et al. Asymptomatic Infant Rib Fractures Are Primarily Non-abuse-Related and Should Not Be Used to Assess Physical Child Abuse. Children 2023, 10, 1827

by Bernd Herrmann, Tanja Brüning, Sibylle Banaschak and Oliver Berthold

Children 2024, 11(10), 1153; https://doi.org/10.3390/children11101153 - 24 Sep 2024

Viewed by 373

Abstract

We are deeply concerned about the scientific quality of the article “Asymptomatic Infant Rib Fractures Are Primarily Non-abuse-Related and Should Not Be Used to Assess Physical Child Abuse” published in the journal Children in 2023 by van Gemert et al [...] Full article

11 pages, 909 KiB

Open AccessArticle

The Pulmonary Artery Pulsatility Index Provides No Additional Prognostic Information in Pediatric Pulmonary Arterial Hypertension

by Faye E. Smits, Chantal Lokhorst, Marlies G. Haarman, Mark-Jan Ploegstra, Rolf M. F. Berger and Johannes M. Douwes

Children 2024, 11(10), 1152; https://doi.org/10.3390/children11101152 - 24 Sep 2024

Viewed by 281

Abstract

Background/Objectives: The pulmonary artery pulsatility index (PAPi, calculated as (SPAP − DPAP)/mRAP) has been suggested as a measure of right ventricular–vascular coupling (RVVC) and as a prognostic parameter in cardiovascular conditions, particularly right ventricular failure. This retrospective study investigated the relationship between the [...] Read more.

Background/Objectives: The pulmonary artery pulsatility index (PAPi, calculated as (SPAP − DPAP)/mRAP) has been suggested as a measure of right ventricular–vascular coupling (RVVC) and as a prognostic parameter in cardiovascular conditions, particularly right ventricular failure. This retrospective study investigated the relationship between the PAPi and its components with disease severity parameters, the RVVC, and clinical outcomes in children with pulmonary arterial hypertension (PAH). Methods: We analyzed data from 111 children from the Dutch National Registry with PAH. The PAPi (median 6.0 [3.9–8.3]) was calculated from heart catheterization data and the RVVC was determined as the TAPSE/sPAP ratio via echocardiography (0.25 ± 0.12 mm/mmHg). Disease severity was characterized by clinical, hemodynamic, and laboratory data. Cox proportional hazard modeling assessed the PAPi’s predictive value for transplant-free survival. Results: There was no correlation between the RVVC and PAPi (R = −0.208, p = 0.111, n = 60). The PAPi correlated negatively with uric acid (R = −0.387, p < 0.001) but not with other disease severity parameters. Mean right atrial pressure correlated with multiple disease severity indicators. Transplant-free survival rates at 1, 3, and 5 years were 87%, 79%, and 73%, respectively. Neither the PAPi nor its components correlated with transplant-free survival. Conclusions: In conclusion, the PAPi does not correlate with the RVVC and this study could not demonstrate any prognostic value of the PAPi regarding disease severity or outcomes in children with PAH, challenging its utility in this population. Full article

(This article belongs to the Special Issue The Management of Pulmonary Hypertension in Infants and Children)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Children, Volume 11, Issue 10 (October 2024) – 23 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI