Search Results (18,687)

Background/Objectives: The clinical presentation of homozygous familial hypercholesterolemia (HoFH) and severe heterozygous familial hypercholesterolemia (sHeFH) often demonstrates substantial overlap, as low-density lipoprotein cholesterol (LDL-C) levels may fall within similar ranges in both conditions. Methods: In this single-center 10-year retrospective study at the University of Debrecen, Hungary, we present the clinical characteristics of patients with 6 HoFH and 6 sHeFH diagnosed by genetic testing, discuss the diagnostic limitations encountered in clinical practice, and outline the key components of therapeutic management. Results: The mean age at diagnosis was lower in the HoFH group (31.83 ± 19.5 vs. 41.83 ± 15.9 years). The differences in total cholesterol (13.48 ± 7.4 vs. 11.02 ± 3.5 mmol/L) and LDL-C levels (10.89 ± 6.6 vs. 8.58 ± 3.26 mmol/L) between the groups were not statistically significant. Interestingly, vascular complications were more frequent in sHeFH group as well (4 vs. 1 patients). In neither the HoFH nor the sHeFH group were we able to achieve the target LDL-C levels, due in part to the specific features of the reimbursement system, patient and parental preferences, the extremely high baseline LDL-C levels, and certain genetic characteristics. Conclusions: Our findings highlight the importance of genetic testing-based personalized therapy in these specific patient subpopulations. We emphasize that serum LDL-C alone is insufficient to distinguish between HoFH and sHeFH patients, and that therapeutic challenges should be anticipated in both groups arising partly from limited patient adherence as well as from financial constraints. Full article

Based on the cognitive-behavioral model of pathological internet use (PIU), this study examined the longitudinal impact of parenting styles on college students’ PIU and the roles played by rumination and environmental sensitivity. A total of 652 freshmen were tracked three times over one year by means of Parenting Style Questionnaire, the Pathological Internet Use Scale, the Rumination Thinking Scale and the High Sensitivity Personality Questionnaire. T1 positive parenting significantly negatively predicted T3 PIU, while T1 negative parenting significantly positively predicted T3 PIU; T2 rumination partially mediated the longitudinal relationship between T1 parenting styles and T3 PIU; environmental sensitivity plays a moderating role in both the direct pathway and the first half pathway of the mediating effect of parental rearing styles on pathological Internet use through rumination thinking, and the results of the moderating effect support the differential susceptibility model. We found that the indirect effect of parenting styles on PIU among college students through rumination was moderated by environmental sensitivity. Specifically, environmental sensitivity strengthened the pathway from parenting styles and rumination to PIU. Full article

Background/Objectives: Eating disorders (EDs) in adolescents are increasingly prevalent. In South Tyrol, a bilingual region in Northern Italy, not only actual gender and age prevalences can be compared to screening rates, but even the comparability of screening tools across languages can be examined. Methods: A cross-sectional analysis integrated clinical registry data with representative, online school-recruited adolescents (11 to 17) self-reports. 166 clinically diagnosed cases and 1465 screened adolescents (1246 German, 219 Italian), were examined. The SCOFF questionnaire (cutoff ≥ 2 for German and ≥3 for Italian), body mass index, body image perception, psychosocial and lifestyle indicators in proxy and self-reports were examined using descriptive statistics and logistic regression. Results: The clinical dataset for 2024 has a prevalence rate of 0.4%. The SCOFF screening tool identified symptomatic cases in 10.6%, and an age-increasing trend among females. The overall SCOFF-prevalence did not differ between language versions, although responses to individual items varied significantly. Predictors of ED included body image, psychosomatic complaints, problematic social media use, and low social support, with differences between genders. Parents tended to underestimate their children’s perception of being “too thick.” Conclusions: In early adolescence, preventive strategies are needed and targeted interventions in late adolescence. For early detection and intervention, gender-sensitive prevention and active parental involvement is needed. The SCOFF questionnaire demonstrates utility across both languages, but bilingual comparison highlights the need for culturally adapted tools and cross-language validation. Full article

Providing equitable, high-quality education to all children, including those with intellectual disabilities (ID), remains a critical global challenge. Traditional learning environments often fail to address the unique cognitive needs of children with mild and moderate ID. In response, this study explores the potential of tablet-based game applications to enhance educational outcomes through an interactive, engaging, and accessible digital platform. The proposed solution, GrowMore, is a tablet-based educational game specifically designed for children aged 8 to 12 with mild intellectual disabilities. The application integrates adaptive learning strategies, vibrant visuals, and interactive feedback mechanisms to foster improvements in object recognition, color identification, and counting skills. Additionally, the system supports cognitive rehabilitation by enhancing attention, working memory, and problem-solving abilities, which caregivers reported transferring to daily functional tasks. The system’s usability was rigorously evaluated using quality standards, focusing on effectiveness, efficiency, and user satisfaction. Experimental results demonstrate that approximately 88% of participants were able to correctly identify learning elements after engaging with the application, with notable improvements in attention span and learning retention. Informal interviews with parents further validated the positive cognitive, behavioral, and rehabilitative impact of the application. These findings underscore the value of digital game-based learning tools in special education and highlight the need for continued development of inclusive educational technologies. Full article

Per and polyfluoroalkyl substances (PFAS) are a class of synthetic, persistent environmental pollutants detected in biological systems and increasingly recognized for their harmful effects on human health. The liver, being a central organ in the metabolism of xenobiotics, is profoundly affected by these compounds and is a main target of PFAS-induced toxicity. The purpose of the present Scoping Review is to investigate the multiple and complex mechanisms behind PFAS hepatotoxicity, taking into consideration evidence from preclinical in vivo models. Using electronic databases (PubMed and Google Scholar), a total of 38 studies were found eligible to be extensively explored to gather information regarding PFAS toxicity toward hepatic lipid metabolism, oxidative stress, injury and inflammation. Moreover, the parental exposure of these chemicals on the offspring will be discussed as well. As illustrated in the proposed graphical abstract, PFAS exposure has been linked to the triggering of oxidative stress phenomena, mitochondrial dysfunction and hepatic inflammatory infiltrate with sex specific effects in rodents. The predominant effects manifest as the overproduction of reactive oxygen species (ROS), the disruption of hepatic lipid metabolism, and the activation of several nuclear transcription factors involved in lipid regulation, with PPAR-α being the most prominent. Considering their strong bioaccumulative properties and persistence in both the environment and the human body, legacy and emerging PFAS should be regarded as potent toxicants with a distinctive role in the onset of metabolic diseases and as a pressing issue to be addressed within regulatory policies. Full article

Background/Objectives: Undescended testis (UT) is a common congenital urological condition in boys, with an incidence of 2–8%. Orchiopexy is the recommended surgical treatment for UT, ideally performed before 12 months of age, with a latest window of 18 months. Testicular torsion (TT) is a pediatric urological emergency, occurring in 3.8 per 100,000 boys. While both UT and TT are common conditions individually, their co-occurrence in children under 18 months is rare and represents a challenging clinical scenario, especially when diagnosis and treatment are delayed, increasing the risk of testicular necrosis. Methods: This report describes two cases of testicular torsion in undescended testes in infants under 1 year of age. Both patients were presented to the hospital more than 24 h after symptom onset. Such delay led to the possibility of testicular salvage being lost due to necrosis. The first case involved a 10-month-old infant with bilateral undescended testis, who underwent orchiectomy after 36 h of torsion. The second case involved a 7-month-old baby, where a delayed diagnosis led to orchiectomy following 36 h of torsion. Both children were previously on the waiting list for orchiopexy, and in both cases contralateral orchiopexy was performed. A review of the literature on PubMed using the key-words “cryptorchid”, “undescended testis”, and “testicular torsion” revealed 36 cases of UT complicated by TT in children under 18 months, showing a high incidence of orchiectomies due to delayed diagnosis. Conclusions: Testicular torsion in undescended testis in children under 18 months is rare but associated with a high risk of gonadal necrosis. The key to improving testicular salvage rates is timely diagnosis and intervention, ideally within 6 h of symptom onset. Delayed presentation due to atypical clinical signs, such as inguinal swelling or nonspecific symptoms, complicates early detection and thus testicular salvage. Therefore, it is crucial for both parents and pediatricians to recognize the potential for torsion in cryptorchidic patients, emphasizing the importance of early surgical intervention, including orchiopexy, to prevent torsion and its associated complications. Full article

It is well established that both the age of the breeder hen and the type of incubator can influence the efficiency of the hatching process. However, there is a lack of information in the literature regarding the interaction between these two factors. This study evaluated the effects of incubator type (multi-stage vs. single-stage) and breeder hen age (35 and 61 weeks) on the hatching parameters, embryonic oxidative stress, performance, carcass yield, and meat quality of male broiler chickens. The embryo livers from the multi-stage incubator presented significantly higher NADP oxidase (NOX) values (p = 0.022), indicating elevated oxidative stress. A significant interaction between breeder age and incubator type was observed for the thiol concentrations, with embryos from older hens incubated in the multi-stage system showing higher thiol levels compared to those from the single-stage system. Birds from these older breeders demonstrated increased breast yield, feed intake, and weight gain, without significant changes in feed conversion ratio. Additionally, the single-stage incubator was associated with reduced embryonic oxidative stress, lower egg weight loss during incubation, and improved early performance of chicks during the first week post-hatch. In conclusion, beyond the previously recognized benefits of single-stage incubation systems, our findings highlight their potential to mitigate oxidative stress in embryos, thereby enhancing early chick development. Full article

Parent–child discrepancies on educational expectations have a significant impact on the holistic development of children, which is crucial for building sustainable educational ecosystems. Based on 7080 samples from the 2019 OECD Survey on Social and Emotional Skills (SSES) conducted in a Chinese city, this study uses the ordinary least squares model and propensity score matching to estimate the causal effect of parent–child discrepancies on educational expectations on children’s social and emotional skills—core competencies for Education for Sustainable Development (ESD)—and further employs the bootstrap method to test its mechanism. The results show that parent–child discrepancies on educational expectations have a significant negative impact on children’s social and emotional skills, with stronger effects observed among boys and 15-year-olds. The parent–child relationship and test anxiety play a chain mediating role in this relationship. The results suggest that to advance the goals of sustainable education, parents should set reasonable educational expectations and pay attention to nurturing their children’s social and emotional skills to foster holistic development within supportive family microsystems. Full article

Objective: This study focuses on selected potential determinants of self-harm in adolescents of two age groups. The considered factors are depression, sex, and parental cohabitation. The aim of the study is to reveal the association between the mentioned factors and self-harm in younger and older adolescents. A secondary goal is to identify the prevalence of self-harm in two age groups. Self-harm is defined as the repeated occurrence of its physical forms. Methods: In the non-experimental research study, the respondents (N = 1285) were primary and secondary school pupils from Slovakia and made up two age cohorts (12–15 and 16–18 y). A battery of questionnaires consisted of the CDI, Self-Harm Inventory and a demographic questionnaire. Procedures of statistical analysis including the logistic regression were applied for data processing. Results: Depression as a risk factor for physical forms of self-harm was recognised in both age cohorts. In terms of sex as a predictor (girls), it proved to be a strong determinant of development of self-harm in the younger group. Conclusions: The results demonstrate the relevance of the need for a separate study of self-harm in boys and girls, as well as in the context of developmental peculiarities in adolescence. Full article

This article examines intergenerational social mobility as a driver of sustainable development on the case of Lithuania, a country in Eastern Europe. Using data from the European Social Survey (2020), the analysis explores how parental education and occupation shape individual educational and occupational outcomes. Descriptive, correlational, and regression analyses reveal that while structural mobility has been facilitated by Lithuania’s transition from Soviet rule to a market economy and subsequent European integration, family background remains a decisive factor. The study also highlights the key factors that promote or constrain social mobility in contemporary Lithuania. The interaction between mothers’ and fathers’ education fosters the attainment of higher levels of education, whereas mothers’ occupational status and respondents’ gender (male) appear to limit it. Similarly, the achievement of a higher occupational level is positively influenced by the interaction between parental education and the respondent’s own highest educational attainment, while negatively influenced by gender. These findings demonstrate that education not only determines social mobility but also supports the broader objectives of sustainable development by reducing inequality, fostering human capital, and advancing gender equality. The results underscore the importance of inclusive social policies that ensure equitable access to quality education and align educational opportunities with labor market demands, thereby reinforcing social mobility as a foundation for long-term social resilience and sustainability. Full article

Background/Objectives: This narrative review examines how developmentally appropriate safety and health education interventions in early childhood settings impact the incidence and severity of pediatric conditions requiring neurosurgical intervention, and which educational approaches most effectively promote neurological health and injury prevention among preschool-aged children. Methods: This narrative review employed a systematic literature search across medical and educational databases (ERIC, PsycINFO, MEDLINE, CINAHL, Education Source, and specialized neurosurgical sources) to identify relevant studies from 2000 to 2025. Results: Structured, play-based safety education in early childhood settings significantly reduces traumatic brain injury incidence. Programs integrating parent–educator partnerships have shown greater effectiveness in establishing protective behaviors than classroom-only approaches. Culturally responsive interventions have demonstrated specific success in high-risk communities, reducing complications from untreated hydrocephalus resulting from infections. Early childhood education can significantly impact recognition of neurological warning signs. Conclusions: Early, developmentally appropriate health education establishes protective behaviors that reduce pediatric neurosurgical cases. Implementation should prioritize experiential safety learning, recognition of neurological warning signs, and strong family–educator partnerships. Findings support integrating neurosurgical prevention strategies within early childhood curricula and developing interdisciplinary approaches connecting medical specialists with early childhood educators to reduce traumatic brain injuries, acquired hydrocephalus, and neural tube defects. Full article

The World Health Organization and the Centers for Disease Control and Prevention recommend seasonal influenza vaccination for all individuals aged 6 months and older. Despite high national immunization rates, the influenza vaccination coverage among Saudi children remains unclear. Parental knowledge and attitudes significantly impact children’s vaccination rates. Purpose: This study aims to evaluate parental knowledge, awareness, and attitudes regarding influenza vaccination and identify barriers to vaccination uptake among children in Al-Madinah City, Saudi Arabia. Methods: The population includes parents having children aged 6 months to 14 years. A cross-sectional survey utilizing a 33-item validated questionnaire was conducted to evaluate parental awareness, knowledge, and attitudes toward the influenza vaccine. Inferential statistics were employed to evaluate demographic factors influencing parental knowledge and attitudes toward vaccination. Results: This study surveyed 407 parents from Al-Madinah, focusing on their awareness, knowledge, and attitudes towards seasonal influenza vaccination. The sample was primarily Saudi (86.7%), with a mean age of 34 years. Most parents (95.6%) were aware of the vaccine, primarily through media and campaigns. Despite this, only 44.5% had vaccinated themselves or their children, citing perceptions of influenza as mild, vaccine ineffectiveness, and availability issues as primary reasons for non-vaccination. Knowledge about influenza varied, with most parents aware of its contagiousness (64.4%) and symptoms, but misconceptions persisted, such as believing the vaccine could cause the flu. Parental attitudes towards vaccination were mostly positive, with high trust in health information sources and a mean attitude score of 22.48 out of 35. Positive attitudes were correlated with better knowledge and more frequent infection control practices. Age, education, and medical profession status significantly influenced knowledge, while vaccine attitudes were most favorable among those vaccinated (p < 0.001). Conclusions: Most parents in Al-Madinah recognize the importance of vaccination; however, misconceptions about vaccine safety, perceived low need, and barriers such as vaccine availability persist. Sociodemographic factors, including education, income, and profession, are linked to better knowledge and more positive attitudes toward vaccination. Full article

Background/Objectives: Physiotherapy is a clinical discipline that provides services in healthcare centres, the community, at home, and in school. School Physiotherapy (SP) focuses its practice on children with disabilities or special motor needs during the school period. SP addresses psychomotricity, ergonomics, and posturology issues in order to improve health and academic performance. The objective of this study was to identify qualitative evidence on the experience and opinions of physiotherapists, children, parents, and teachers about school-based physiotherapy-led interventions. Methods: Metasynthesis of qualitative studies. The search included articles published between 2015 and 2025 on the PubMed, WOS, SCOPUS, and CINAHL databases. Results: The review included 15 selected studies. Three main themes emerged from this analysis: (1) Clinical and school physiotherapy: separated by a fine line. (2) Ensuring healthcare for children with specific conditions in schools. (3) The challenge of incorporating SP in educational settings. Conclusions: Physiotherapists, children, parents, and teachers perceive significant advantages in implementing SP in educational settings. Participants advocate for the development of collaborative goals and the inclusion of physiotherapists within educational teams. Understanding the experiences of physiotherapists, children, parents, and teachers may help improve SP in practice. Full article

To address real-world engineering design optimization problems, this study proposes a reinforcement learning enhanced multi-objective social network search algorithm (QMOSNS), which represents a novel approach for solving multi-objective optimization problems. QMOSNS utilizes Halton sequences for population initialization to enhance the diversity of the initial population. A multi-objective archive mechanism is implemented to store Pareto-optimal solutions and select parental individuals through a reassigned fitness evaluation strategy. Furthermore, Q-learning is incorporated to adaptively select mutation operators, thereby dynamically balancing the algorithm’s exploration and exploitation capabilities. QMOSNS was rigorously evaluated through 50 prominent case studies, including 22 unconstrained multi-objective benchmark problems, 18 constrained multi-objective benchmark problems, and 10 multi-objective engineering design problems, to comprehensively validate its computational capabilities and effectiveness. Moreover, statistical results obtained using consistent performance metrics were compared with those of other highly regarded algorithms to ensure a fair and objective performance assessment. The comparative results show that QMOSNS is robust and superior in handling a wide variety of multi-objective problems. This study underscores the efficacy of integrating reinforcement learning with social intelligence for tackling complex multi-objective optimization in engineering and computational domains. Full article

Problematic Internet use is an emerging concern in adolescent mental health and is closely linked to psychological distress and emotional regulation. This cross-sectional study analyzed self-reported data from 1550 adolescents aged 11–19 years in South Tyrol, a linguistically and culturally diverse region in Northern Italy. Problematic Internet use was measured using the validated Generalized Problematic Internet Use Scale 2 (GPIUS-2), along with standardized instruments for depressive symptoms (PHQ-2) and anxiety (SCARED-GAD). Multivariable regression analysis revealed that depression and anxiety symptoms were the strongest independent predictors of higher GPIUS-2 scores. In contrast, demographic factors such as gender, family language, urbanization, migration background, and parental education were not significantly associated with PIU. Modest associations were observed between GPIUS-2 scores and both perceived economic burden and parental use of digital control tools. Perceived family support showed a small protective effect. These findings underscore the central role of emotional vulnerability in adolescent PIU and suggest that interventions should focus on supporting mental health and adaptive coping rather than solely targeting screen time or structural family characteristics. Full article