Search Results (1,045)

Gestational weight gain (GWG) and birth weight (BW) have a multifactorial etiology, which makes identifying the most influential determinants difficult. The association between variants of the FTO and LEPR genes has been explored as contributing factors to obesity in various age groups; however, their role in GWG and BW in adolescent mothers and their offspring is uncertain. To determine whether the presence of polymorphisms rs9939609 (FTO) and rs1137101 (LEPR) is associated with gestational weight gain and newborn weight in a cohort of adolescent mothers. Methods: A prospective cohort study of 305 mother-child dyads was conducted between 2020 and 2024. Genotyping of the single nucleotide variants (SNVs) rs9939609 of the FTO gene and rs1137101 of the LEPR gene was performed using real-time PCR and high-resolution melting analysis (qPCR-HRM), using maternal peripheral blood and umbilical cord blood samples. GWG, BW, energy intake, and other perinatal data were recorded and classified. Genetic data from 305 mother–offspring dyads were analyzed. The median maternal age was 16 years, and 71.4% had a normal pre-pregnancy body mass index (BMI). The most frequent genotypes were TT for FTO rs9939609 and AG for LEPR rs1137101. In both groups, the genotypic distribution significantly deviated from Hardy–Weinberg equilibrium (p < 0.0001). The AA genotype of FTO was associated with a higher probability of excessive gestational weight gain (GWG) after adjustment for pre-pregnancy BMI and dietary and sociodemographic factors. High protein and lipid intake increased the risk of excessive GWG, whereas adequate intake of carbohydrates and legumes showed a protective effect. An initial significant association was identified between the LEPR rs1137101 variant (AA allele) and low birth weight (LBW); however, this association was lost after adjustment for confounding factors. The FTO rs9939609 variant was significantly associated with GWG. On the other hand, the LEPR rs1137101 variant in the offspring showed an association with BW categorized by percentiles (in crude analysis), while the FTO variant showed no relationship with birth weight. Full article

Background/Objective: Myopia has become a prominent public health issue in China, significantly impacting the visual health of children and adolescents. The condition is characterized by a high incidence rate, increasing prevalence, and a trend toward earlier onset, highlighting the critical need for early and accurate diagnosis. Current clinical diagnostic methods primarily depend on subjective evaluations by optometrists and the use of isolated parameters, leading to inefficiencies and inconsistent outcomes. Moreover, there remains a lack of diagnostic tools that can effectively integrate multi-parameter analysis while ensuring robust data privacy protection. This study aims to develop an artificial intelligence (AI) diagnostic model that achieves objective, accurate, and safe diagnosis of myopia in children without cycloplegia through multi-parameter fusion and to enable local deployment. The proposed model is intended to be a reliable tool for clinical applications and large-scale screening projects, while ensuring strong protection of patient privacy. Methods: We built a transparent, rule-driven AI framework using clinical guidelines. Key ocular parameters—visual acuity, spherical equivalent, axial length, corneal curvature, and axial ratio—were encoded as logical rules in Python and incorporated via instruction fine-tuning. The model was trained and validated on retrospective clinical data (70% training, 15% validation, 15% test) using five algorithms: gradient boosting, logistic regression, random forest, SVM, and XGBoost. Performance was evaluated using accuracy, precision, recall, F1 score, and mean AUC across classes. Results: The model classifies refractive status into five categories: hyperopia, pre-myopia, mild, moderate, and high myopia. All five different algorithms demonstrated excellent diagnostic and classification performance. Gradient boosting achieved the best overall performance, with an accuracy of 98.67%, an F1 score of 98.67%, and a mean AUC of 0.957—outperforming all other models. Conclusions: This study successfully developed an artificial intelligence-based myopia diagnosis system for children under non-dilated pupil conditions. The system is interpretable and privacy-preserving, and has excellent diagnostic and classification performance, making it suitable for clinical decision support and large-scale screening applications. It has great potential to promote the development of early intervention, precision prevention, and control strategies for childhood myopia. Full article

Background: This study examined the predictive effect of parental marital satisfaction on suicidal behaviors among preadolescents and adolescents in China, with positive youth development (PYD) attributes as a mediator. Methods: A total of 3665 matched pairs of students (aged 9–19, 51.3% boys) and their parents completed questionnaires, with parental marital satisfaction reported by parents and suicidal behaviors (ideation, plan, and attempt) and PYD attributes reported by students. Results: The prevalence of overall suicidal behavior was 15.5% in this sample, with a higher prevalence observed among those with lower parental education levels. Hierarchical regression and structural equation modeling analyses revealed that: (1) after controlling for socio-demographic variables, parental marital satisfaction negatively predicted suicidal behaviors; (2) PYD attributes negatively predicted suicidal behaviors, accounting for the largest proportion of variance (ΔR² range = 0.036–0.102); (3) parental marital satisfaction was positively correlated with PYD attributes; and (4) PYD attributes partially mediated the predictive relationship between parental marital satisfaction and suicidal behavior, with a significant indirect effect (β = −0.06) accounting for 56.6% of the total effect. Conclusions: This study illuminates protective pathways through which a positive family environment cultivates individual competencies, ultimately contributing to reduced suicidal behavior. Full article

Background: Cervical cancer remains a leading cause of cancer-related deaths among women in Nigeria. In 2023, the Government of Nigeria, with support from Gavi and partners, introduced the single-dose human papillomavirus (HPV) vaccine through a phased, school-based campaign. The first phase was launched in October 2023 across 16 states, followed by a second phase in May 2024 that expanded coverage to the remaining states and the Federal Capital Territory. This study evaluates the additional impact of a behavioral insights–informed digital intervention, comprising a social media campaign amplified by trained pharmacists serving as local influencers, implemented in 2025 to increase acceptance and uptake of HPV vaccination during routine immunization. Methods: A pre-test/post-test quasi-experimental design with a control group was implemented in three Nigerian states in 2025 to assess the additional impact of a behavioral insights–informed social media campaign designed to strengthen social approval for HPV vaccination, increase awareness of vaccination locations, and reinforce caregivers’ recognition of their adolescent daughters’ desire to be vaccinated. Messages were amplified by trained pharmacists who served as local influencers. Caregivers of adolescent girls aged 9–17 years were recruited online through targeted Facebook and Instagram advertisements during Nigeria’s transition from school-based HPV vaccination campaigns to routine immunization. Caregivers in treatment areas were exposed to geofenced social media advertisements on Facebook and Instagram and pharmacist counseling, while those in control areas were not. Logistic regression models using a difference-in-difference approach estimated the campaign’s effect on HPV vaccination, controlling for caregiver and adolescent characteristics. Additional statistical models assessed the campaign’s impact on caregivers’ motivation and ability—key drivers of behavior according to the Fogg Behavior Model. Results: HPV vaccination increased at a significantly higher rate in the treatment compared to the control area. The adjusted odds of an adolescent girl being vaccinated were 1.48 times higher in the treatment area at follow-up (95% CI: 1.14–1.92). Adjusted marginal effects indicated that exposure to the campaign increased the probability of vaccination by 8.9 percentage points relative to the control group. The rate at which caregivers’ motivation (aOR = 1.31, 95% CI: 1.00–1.70) and ability (knowing where to get vaccinated: aOR = 1.38, 95% CI: 1.07–1.79; ease of vaccination: aOR = 1.59, 95% CI: 1.22–2.06) increased was also higher in the treatment area. There was no relative increase in intervention versus control groups in factual knowledge regarding HPV vaccination. Conclusions: A behavioral insights–informed social media campaign in which pharmacists served as influencers was associated with higher HPV vaccine uptake during routine immunization. The higher rate of vaccination observed in intervention areas was associated with higher rates of caregiver motivation and ability but not with higher rates of caregiver knowledge. These findings are consistent with the potential of behavioral insights–informed digital campaigns to complement routine immunization efforts and improve vaccine uptake in low- and middle-income countries. Full article

Background/Objectives: Stuttering is a neurodevelopmental disorder of speech fluency. It emerges most commonly between 2 and 5 years old, often causing social exclusion and stigma. In Latin America, cultural misconceptions regarding its causes exacerbate these psychosocial challenges. This study validated a culturally adapted instrument for Chile to measure public attitudes toward stuttering. The instrument provides a psychometrically sound method to assess and address stigma within educational and community settings. Methods: A total of 756 Chilean adults (mean age = 36.7 years, SD = 15.8; 64% women, 36% men) were recruited using stratified probability sampling to reflect the national demographics. Ethical approval and informed consent were obtained. The subsection underwent rigorous cross-cultural adaptation (translation, expert review, cognitive debriefing n = 30, pre-testing n = 50). Analysis employed polychoric matrices, EFA, CFA with WLSMV, and multiple reliability/validity indices. Results: Joint analysis showed poor fit (CFI = 0.72, RMSEA = 0.12), confirming independence. Beliefs (14 items): three-factor CFA fit excellent (CFI = 0.993, RMSEA = 0.034); factors: competence/normality (α = 0.85), psychological causes (α = 0.78), and help/support (α = 0.72). Reactions (11 items): four-factor fit adequate (CFI = 0.97, RMSEA = 0.043); factors: distant concern (α = 0.82), personal concern (α = 0.79), media sources (α = 0.75), and formal sources (α = 0.77). Validity was supported; bifactor models favored multidimensionality. Conclusions: The adapted subsection is psychometrically robust and effectively captures Chilean-specific attitudes toward childhood stuttering. It provides a reliable tool for quantifying public stigma and misconceptions, particularly in educational and school contexts, thereby supporting the design of targeted school-based policies and interventions to reduce bullying, promote inclusion, and safeguard the psychosocial well-being of children and adolescents who stutter. Full article

Background: Most individuals develop smoking habits in adolescence, highlighting the need for a smoking prevention program targeted at this age group. The use of “Implementation Intentions” (If-Then plans) about how to refuse a cigarette combined with anti-smoking messages has been shown to be effective in the UK. However, there is a scarcity of data regarding school-based smoking prevention interventions among adolescents available to countries with high tobacco consumption rates, like Greece. Objectives: To describe the cultural adaptation procedure and the evaluation protocol for the school-based “Implementation Intentions” program aimed at reducing tobacco use susceptibility among Greek adolescents aged 13–16 in school settings. Methods: The present study is part of the EU-funded FRESHAIR4Life Program. We will use a mixed-methods approach with a pre- and post-intervention design in six conveniently selected secondary schools in Heraklion, Crete, Greece, to measure the intervention’s Reach, Effectiveness, Adoption, Implementation, and Maintenance using the RE-AIM framework. The study plans to involve three Master Trainers (MTs), 20–25 school teachers (to be trained by the MTs), and approximately 480 students. Participating schools will receive the “Implementation Intentions” intervention, which is based on a goal-setting technique where individuals commit to perform a particular behavior when a specific context arises. The study will consist of five sequential phases: Phase I involves training three Master Trainers (MTs) using the International Primary Care Respiratory Group (IPCRG’s) Teach-the-Teacher (TtT) curriculum, specifically focused on the implementation of our intervention. In Phase II, workshops will be held to co-create and culturally adapt the intervention. Phase III will involve teachers trained by MTs on delivering the intervention. In Phase IV, teachers will deliver the intervention among students in their schools. Data will be collected pre- and post-intervention through surveys, session logs, fidelity observations, feedback forms, and follow-up interviews or focus groups (Phase V). Quantitative data will be analyzed descriptively and by using paired t-tests and multiple linear regression analyses, while qualitative data will undergo thematic analysis. Discussion: The study protocol’s potential benefits extend beyond educating Greek adolescents on the risks associated with smoking. Active participation will empower and motivate young people to make informed, healthy choices. We expect the results could help create more effective, context-specific interventions, support policy changes aimed at decreasing the prevalence of adolescent smoking in Crete, Greece, and potentially be used by other countries as well. Full article

Background/Objectives: This study evaluates the efficacy of hypoglossal nerve stimulation as an alternative intervention for pediatric patients with obstructive sleep apnea (OSA) unresponsive to standard therapies and examines the uniformity of therapeutic outcomes across different patient cohorts. Methods: An extensive systematic search was performed across four principal databases (PubMed, EMBASE, Cochrane Library, and Web of Science) utilizing keywords associated with pediatric OSA and hypoglossal nerve stimulation, encompassing studies up to July 2025 that provided objective polysomnographic metrics (e.g., apnea-hypopnea index [AHI] values) to enable the quantitative assessment of pre- and post-intervention effects in children. The primary outcome measured was the ratio of means (ROM), determined from pre–post data in single-group studies, with summary estimates obtained using the fixed-effects model. Results: The systematic review included nine eligible studies with a total of 140 pediatric subjects, the majority of whom were adolescents with Down syndrome. AHI meta-analysis outcomes indicated a marked improvement in OSA severity, yielding an overall ROM of 0.57 [95% confidence interval: 0.49–0.65]. The therapeutic benefit demonstrated a high degree of uniformity across cohorts, as indicated by minimal statistical heterogeneity (I² = 16%, p = 0.30). Funnel plot assessment showed no statistically significant evidence of systematic publication bias. Conclusions: Current evidence suggests that hypoglossal nerve stimulation therapy is a safe, effective, and valuable alternative for pediatric OSA patients who do not respond to conventional therapies. Full article

Background: Breaststroke performance in young swimmers is influenced by a complex interaction of anthropometric, physiological, and technical factors. However, existing studies predominantly focus on pre-selected or elite youth swimmers, limiting insight into performance development in non-elite populations without early selection bias. Purpose: This study aimed to identify key predictors of 50-m breaststroke performance and to examine longitudinal changes in selected characteristics in pre-adolescent, non-elite female swimmers. Methods: Fourteen female swimmers (baseline biological age: 10.52 ± 0.37 years) who entered swimming training without prior anthropometric or physiological selection were followed over three consecutive years. Measurements were collected at six time points and included anthropometric dimensions, body composition, aerobic and anaerobic capacity, respiratory volumes, and 50-m breaststroke performance. This investigation was a prospective longitudinal cohort study. Data were analysed using generalised estimating equations. Results: The correlation-filtered model explained 76% of the variance in 50-m breaststroke time. Chest depth (B = −0.16, p = 0.03), foot length (B = −0.17, p = 0.04), foot width (B = 0.30, p < 0.001), and shoulder width (B = −0.07, p = 0.04) emerged as significant anthropometric predictors. Maximal oxygen uptake also showed a significant association with performance (B = −0.33, p = 0.02). Conclusions: In pre-adolescent, non-elite female swimmers, selected anthropometric characteristics—particularly trunk dimensions and foot morphology—are associated with short-distance breaststroke performance. Aerobic capacity appears to play an indirect, supportive role. These findings highlight the importance of longitudinal monitoring without early selection and support a development-oriented approach to youth swimming training. Full article

Background/Objectives: Osgood–Schlatter disease (OSD) is a common overuse condition in adolescents characterized by increased stiffness of the rectus femoris muscle, which contributes to pain and functional limitations around the knee. We investigated whether repeating 10 min passive joint movements of the hip and knee produces additional immediate reductions in elevated rectus femoris (RF) stiffness in adolescents with OSD. Methods: Fifteen patients (10–14 years of age) diagnosed with bilateral OSD were included. The legs of the participants were randomly assigned to either the intervention or the non-intervention side (control). The intervention side received two sets of 10 min of passive joint movement to the hip and knee, while the control side rested. RF stiffness was measured before the intervention and immediately after one and two sets of passive joint movements. Results: On the intervention side, RF stiffness decreased significantly from pre to post-1 and from pre to post-2; however, RF stiffness did not differ significantly between post-1 and post-2. None of the parameters changed significantly on the control side (rest condition). Conclusions: Passive joint exercise beyond one repetition (one set for 10 min) did not result in a further decrease in RF stiffness and is likely unnecessary for RF muscle stiffness due to OSD. Full article

The use of generative artificial intelligence (GenAI) in academic contexts has expanded rapidly in recent years, yet limited evidence exists regarding its prevalence across educational levels or its association with psychological and academic variables among adolescents and young adults. This exploratory study aimed to examine the prevalence of GenAI use for learning-related academic purposes among pre-university and university students, including gender differences, and to analyze its relationship with self-esteem, self-efficacy, academic confidence, and academic anxiety. The sample comprised 1043 participants aged 13 to 23 years (M = 16.16, SD = 2.42; 59.1% female) who completed self-report measures. Structural equation modeling was conducted controlling for gender, age, and Internet use. Overall, 95% of students reported using GenAI for academic purposes, with higher usage among university than pre-university students and among female than male students. GenAI use was significantly associated with higher academic anxiety, although the effect size was small, and no significant associations were observed with the remaining variables. These findings suggest that while GenAI use is widespread, its associations with psychological and academic variables appear to remain limited. Full article

Background: To mitigate the negative impacts of the pandemic, it is essential to understand how the associations between different types of physical activity (PA) and adolescent well-being changed before and after the COVID-19 pandemic (defined here as the period marked by students’ return to stable in-person education). This study aimed to examine gender differences in the associations between school-related PA and subjective well-being before and after the pandemic. Methods: A cross-sectional design was used, including 430 boys and 571 girls from 22 high schools. Participants completed the Youth Activity Profile questionnaire to assess school-related and school-associated PA and the WHO-5 Well-Being Index to evaluate subjective well-being. Differences in participants’ PA across segments of the school day before and after the pandemic were evaluated using the Kruskal–Wallis test, and compliance with PA recommendations was analyzed using cross-tabulation and Pearson’s chi-square tests. Results: After the pandemic, both boys and girls reported significantly lower levels of active transportation to and from school compared with the pre-pandemic period. In addition, well-being levels were significantly lower in both genders after the pandemic. Before the pandemic, boys and girls with higher well-being met the recommendations for PA to school, from school, and outside of school significantly more often than their peers with lower well-being. Higher levels of well-being were observed both before and after the pandemic in boys and girls who participated in organized PA compared with non-participants. Conclusions: This study confirms lower levels of PA and well-being among adolescents after the pandemic. In particular, PA to and from school was at a lower level after the pandemic than before the pandemic. Participation in organized PA was significantly associated with higher well-being in both boys and girls before and after the pandemic. Supporting adolescents’ participation in organized PA should be a priority when addressing the negative consequences of societal crisis situations. Improved knowledge of the associations between PA and well-being may contribute to more effective support for adolescents’ PA and greater awareness of the importance of meeting PA recommendations. Full article

Objective: To evaluate changes in emotion regulation, skin-picking disorder (SPD) severity, and repetitive thoughts and behaviors in adolescents with attention-deficit/hyperactivity disorder (ADHD) and comorbid SPD during methylphenidate treatment, and to examine the association between emotion regulation and SPD severity. Materials and Methods: This naturalistic follow-up study included 26 adolescents aged 11–17 years with ADHD and comorbid SPD. Participants received methylphenidate and were reassessed after three months. Emotion regulation, SPD severity, and repetitive thoughts and behaviors were assessed at baseline and follow-up using the Difficulties in Emotion Regulation Scale (DERS), Skin Picking Scale–Revised (SPS-R), and Repetitive Thoughts and Behaviors Scale–Child Form (RTBS-CF). Pre–post differences were analyzed using paired-sample tests, and associations were examined using correlation and linear regression analyses. Results: Significant reductions were observed in total DERS scores (p < 0.001, Cohen’s d = 1.35) and all subscales except non-acceptance (p = 0.686, Cohen’s d = 0.08). SPS-R and RTBS-CF scores decreased significantly (both p < 0.001, Cohen’s d = 1.79 and 0.91, respectively). Changes in DERS scores were moderately correlated with changes in SPS-R scores (r = 0.554, p = 0.003). Changes in emotion regulation were significantly associated with changes in SPD severity, accounting for approximately 31% of the variance in this sample. Conclusions: Methylphenidate treatment was associated with significant improvements in emotion regulation and concurrent reductions in skin-picking severity in adolescents with ADHD and comorbid SPD. Given the single-arm, pre–post naturalistic design, these findings should be interpreted as associative and exploratory rather than causal. Full article

Background/Objectives: Early manifestations of body dissatisfaction and subclinical disordered eating are increasingly recognized as important correlates of later disordered eating, underscoring the need for research in preadolescent populations. This study examined the prevalence of disordered eating risk and tested whether body-figure discrepancy and thinness-related attribution patterns were associated with disordered-eating symptomatology beyond gender and BMI among children aged 10–12 years. Methods: A total of 227 children completed the Children’s Eating Attitudes Test-26 (ChEAT-26), body-figure silhouette measures, and assessments of thinness-related social-emotional, negative, and competence attributions. Results: Overall, 16.3% of participants scored at or above the clinical cutoff for elevated eating-pathology risk, with no significant gender differences. Hierarchical regression analyses showed that the discrepancy between perceived and ideal body figure was significantly associated with disordered eating severity, although the proportion of explained variance was modest. Logistic regression further indicated that each unit increase in body-figure discrepancy was associated with a 37% increase in the likelihood of exceeding the clinical risk threshold. In contrast, thinness-related attribution indices were intercorrelated but were not significantly associated with disordered eating, nor were their effects moderated by gender. Conclusions: These findings indicate that body-image discrepancy is associated with disordered eating in late childhood, at a stage when marked gender differences are not yet evident. Although causal inferences cannot be drawn, the presence of clinically elevated symptom levels and the observed associations highlight the potential importance of early attention to body dissatisfaction in preventive efforts. Full article

Peer victimization during preadolescence constitutes a significant public mental health concern, particularly for children with special educational needs (SEN). Family relational factors, and especially paternal acceptance–rejection, may influence children’s psychosocial adjustment and vulnerability to victimization. The present study examined the associations between perceived paternal acceptance–rejection, multidimensional self-perception, and peer victimization among preadolescents with and without SEN. A total of 660 students attending the final grades of Greek primary schools (553 without SEN; 107 with formally identified SEN) completed standardized self-report measures of peer victimization, perceived paternal acceptance–rejection, and self-perception domains. Separate path analyses were conducted for each group to examine direct and indirect relational pathways. Among children without SEN, perceived paternal hostility/aggression was directly associated with peer victimization and indirectly associated through behavioral conduct problems and lower school competence. In contrast, among children with SEN, the absence of paternal warmth and perceived paternal indifference/rejection were directly associated with victimization, whereas paternal hostility was not significantly associated, and self-perception did not function as a mediator. Model fit indices indicated excellent fit in both groups. These findings suggest distinct paternal relational mechanisms underlying peer victimization depending on SEN status. Interventions aimed at preventing victimization may benefit from incorporating father-focused family components alongside school-based strategies, with particular emphasis on emotional warmth and support for children with SEN. Full article

Background: Healthy eating habits during childhood and adolescence are essential to support optimal nutritional status and may influence health in adulthood. This study assessed nutritional status and adherence to the Mediterranean diet (MD) among Albanian students. Methods: A cross-sectional study was conducted on a convenience sample of 388 students aged 9–17 years living in Vlora and Tirana. Data collected included sociodemographic information, anthropometric measurements, and KIDMED index. Factors associated with poor MD adherence were investigated using univariate analysis and multivariable logistic regression (AORs: 95% CIs). Results: Data from 388 students were included in the analysis (mean age: 13.0 ± 1.9 years; 54.1% females). Pre-adolescents (≤13 years) accounted for 53.4% of the sample, while adolescents (>13 years) accounted for 46.6%. Overall, 35% of students were overweight or obese. The mean KIDMED score indicated suboptimal MD adherence (5.5 ± 2.6), with significant differences by sex (females 5.2 ± 2.7 vs. males 5.8 ± 2.5; p = 0.03), place of residence (Vlora 5.8 ± 2.5 vs. Tirana 5.2 ± 2.6; p = 0.05), and age (≤13 years 6.1 ± 2.3 vs. >13 years 4.8 ± 2.7; p < 0.001). Adolescence was the strongest predictor of poor MD adherence (AOR 3.25; 1.96–5.38; p < 0.001). Conclusions: The MD is a key dietary pattern for supporting health across the life course. Girls and adolescents showed poorer MD profiles. Further research is needed to clarify the determinants that drive suboptimal dietary behaviors in Albanian youth, in line with growing concerns about the “hidden crisis” of adolescent nutrition. Full article