Journal Description
Children
Children
is an international, peer-reviewed, open access journal on children’s health published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Pediatrics)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 13.8 days after submission; acceptance to publication is undertaken in 2.5 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.4 (2022);
5-Year Impact Factor:
2.6 (2022)
Latest Articles
Primary and Secondary Variants of Callous-Unemotional Traits in Community Youths: Differences in Anticipatory Fear
Children 2024, 11(3), 359; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030359 (registering DOI) - 19 Mar 2024
Abstract
Callous-unemotional (CU) traits refer to a cluster of characteristics such as low empathy, lack of remorse, and insensitivity to the emotions of others, delineating a group of youth at high risk for severe antisocial behavior. Two variants—primary and secondary CU—have been theorized to
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Callous-unemotional (CU) traits refer to a cluster of characteristics such as low empathy, lack of remorse, and insensitivity to the emotions of others, delineating a group of youth at high risk for severe antisocial behavior. Two variants—primary and secondary CU—have been theorized to have different underlying mechanisms, although mixed findings have been reported. The current study examined if the variants differ in their level of anticipatory fear in 92 youths from the community (mean age = 14.2 years, range = 12.3–16.4 years; 43.5% female). Participants completed a countdown task while their heart rate and skin conductance responses were recorded. Parents and youths completed the inventory of callous-unemotional traits and the child behavior checklist. Compared to the control group (low CU/low anxiety), the primary CU group (high CU/low anxiety) showed prolonged heart rate deceleration in anticipation of the impending aversive stimulus. The secondary CU group (high CU/high anxiety) did not differ from the other two groups on heart rate or skin conductance responses. This prolonged heart rate deceleration in the primary CU group is interpreted in the context of the passive vagal coping theory of antisocial behavior which hypothesizes that an over-engagement of the parasympathetic nervous system reduces the impact of a socializing punishment, which in turn predisposes individuals to antisocial behavior. Findings provide further support for the distinct etiology of two variants of CU traits.
Full article
(This article belongs to the Special Issue Unravelling the Association between Fear and Psychopathic Traits in Children and Adolescents)
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Open AccessCase Report
Complication of Orthodontic Treatment: A Case Report on Severe Apical Root Resorption (ARR) in a Patient with Turner Syndrome
by
Joanna Laskowska, Anna Paradowska-Stolarz, Lucía Miralles-Jordá, Dorota Schutty and Marcin Mikulewicz
Children 2024, 11(3), 358; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030358 (registering DOI) - 18 Mar 2024
Abstract
External apical root resorption in permanent teeth is a multifactorial process influenced by a variety of local and systemic factors. This report describes a case of multiple and severe apical root resorptions in a patient with Turner syndrome. The condition was discovered in
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External apical root resorption in permanent teeth is a multifactorial process influenced by a variety of local and systemic factors. This report describes a case of multiple and severe apical root resorptions in a patient with Turner syndrome. The condition was discovered in a young female with Turner syndrome after 30 months of orthodontic treatment with fixed appliance. The purpose of this report is to present reports by other authors on the potential causes of the increased risk of tooth resorption in patients with Turner syndrome and to share insights derived from its course, highlighting the implications and lessons learned. Patients with Turner syndrome are not ideal candidates for orthodontic treatment. Prior to commencing orthodontic treatment, it is essential to carefully consider the potential benefits of the therapy compared to the risk associated with exacerbating root resorption. In the case of Turner syndrome patients, where there is an elevated risk of such complications, a thorough analysis should be conducted to determine whether the expected benefits of the treatment outweigh the potential hazards to the patient’s dental health.
Full article
(This article belongs to the Section Pediatric Dentistry)
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Open AccessArticle
The Relationship between Auditory Analysis and Dictation Skills among Jordanian Fourth-Grade Students with Learning Difficulties
by
Ahmad Abdelhameed Al-Makahleh
Children 2024, 11(3), 357; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030357 - 18 Mar 2024
Abstract
This study aims to explore the skills of Jordanian Arabic-speaking fourth graders with learning difficulties in terms of auditory analysis and dictation tests. It mainly aims to investigate the relationship between students’ abilities to perform auditory analyses and dictation tests. The sample in
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This study aims to explore the skills of Jordanian Arabic-speaking fourth graders with learning difficulties in terms of auditory analysis and dictation tests. It mainly aims to investigate the relationship between students’ abilities to perform auditory analyses and dictation tests. The sample in the study consists of 110 Jordanian fourth graders, who are then divided into 54 students with learning difficulties who are diagnosed as having a satisfactory level of reading and writing and 56 typically developing students. The students are asked to respond to two tests, the auditory analysis and the phonological awareness test, which are prepared by the researcher himself. The results demonstrate a statistically significant positive correlation between the auditory analysis and dictation skills of fourth-grade students with learning difficulties. This means that improving the auditory analysis skills corresponds to an increase in the dictation skills of these students. The results also reveal a statistically significant correlation between auditory analysis and dictation skills in typically developing students.
Full article
Open AccessArticle
Association between Second-Hand Exposure to E-Cigarettes at Home and Exacerbations in Children with Asthma
by
Serena Costantino, Arianna Torre, Simone Foti Randazzese, Salvatore Antonio Mollica, Federico Motta, Domenico Busceti, Federica Ferrante, Lucia Caminiti, Giuseppe Crisafulli and Sara Manti
Children 2024, 11(3), 356; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030356 - 18 Mar 2024
Abstract
Several studies have shown the effects of e-cigarettes in adults. Nowadays, few data are available in the pediatric population. This study aims to assess the relationship between asthma exacerbations and home exposure to e-cigarettes. We conducted a pilot, retrospective, monocenter, observational study. Demographic
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Several studies have shown the effects of e-cigarettes in adults. Nowadays, few data are available in the pediatric population. This study aims to assess the relationship between asthma exacerbations and home exposure to e-cigarettes. We conducted a pilot, retrospective, monocenter, observational study. Demographic and clinical data were collected, including number of asthma exacerbations, need for rescue therapy and/or therapeutic step-up, and Asthma Control Test (ACT) and children-Asthma Control Test (c-ACT) scores. The cohort consisted of 54 patients (5–17 years old), divided into two groups: A, including patients exposed to e-cigarette aerosols; B, including unexposed patients. The statistical analysis showed no relevant variation in the number of asthma symptomatic days and need for rescue therapy in group A versus group B (p = 0.27 and 0.19, respectively). There were no statistically significant variations when also considering the number of patients who needed a therapeutic step-up (p = 0.3). The mean values of ACT and c-ACT were, respectively, 17.2 ± 7.6 and 18.3 ± 5.6 in group A and 19.6 ± 3.8 and 14.6 ± 5.8 in group B (p = 0.3 and 0.4, respectively). Although we did not find a statistically significant correlation between second-hand e-cigarette exposure and asthma exacerbations, our findings suggest that asthmatic children exposed second-hand to e-cigarettes may have increased risk of asthma symptomatic days. Future research is warranted.
Full article
(This article belongs to the Special Issue Medical Statistics and Clinical Epidemiology in Children)
Open AccessArticle
Investigation of Dental and Oral Health in Children and Adolescents with Special Support Needs from a Child and Adolescent Psychiatric Perspective
by
Dustin Fornefeld, Oliver Fricke, Andreas G. Schulte and Peter Schmidt
Children 2024, 11(3), 355; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030355 - 17 Mar 2024
Abstract
Background: The current literature lacks scientific research on child and adolescent psychiatrists’ (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. Methods: A
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Background: The current literature lacks scientific research on child and adolescent psychiatrists’ (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. Methods: A questionnaire-based cross-sectional study was conducted among members of the Professional Association for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany. Results: Out of the association members, 10.9% (n = 109) participated, with 5.2% (n = 52; 38f/14m) completing the questionnaire. Dental and oral health topics were discussed with one-fifth of the patients (19.2%), while 11.5% reported that they were “never” a part of their therapy. Patient-related concerns about dental and oral health were primarily brought into the context of child and adolescent psychiatric work. Dental treatment anxieties were prominent. Only 3.8% of the participants regularly assigned diagnoses related to dental status. The CAPPS employ a bio-psycho-social model for the genesis of oral health-related conditions in Children and Adolescents with Special Needs. Conclusions: CAPPS have a foundation in relationship-based work for assessing oral and dental healthcare and providing recommendations for further dental care. Regional networking and science must be further developed.
Full article
(This article belongs to the Special Issue Oral Health of Children with Autism Spectrum Disorder)
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Open AccessArticle
A Comparison of the Effects of Supervised versus Home Schroth Exercise Programs with Adolescent Idiopathic Scoliosis
by
Kadriye Tombak, İnci Yüksel, Umut Ozsoy, Yılmaz Yıldırım and Sezen Karaşin
Children 2024, 11(3), 354; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030354 - 17 Mar 2024
Abstract
(1) Background: Schroth exercise can reduce the deformity of the spine and improve the life quality and the body image of patients with adolescent idiopathic scoliosis (AIS). (2) Methods: The study began with 49 participants, aged 10–16 years old, who were diagnosed with
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(1) Background: Schroth exercise can reduce the deformity of the spine and improve the life quality and the body image of patients with adolescent idiopathic scoliosis (AIS). (2) Methods: The study began with 49 participants, aged 10–16 years old, who were diagnosed with AIS. At the end of the study, 37 patients were randomly assigned to either the Supervised (n = 19) or Home-Based Schroth Exercise Group (n = 18) and completed the study. Both groups were treated for seven days a week over twelve weeks. For all patients, body rotation measurements were performed with a scoliometer, surface asymmetry analysis was carried out using an Artec Eva 3D scanner, health-related quality of life was evaluated by the Scoliosis Research Society-22 (SRS-22) questionnaire, and the perception of the cosmetic deformity was assessed by the Walter Reed Visual Assessment Scale (WRVAS). All the measurements were repeated before and after the 12-week treatment. (3) Results: Post-treatment scoliometric measurements showed a significant decrease in body rotation in both groups (p < 0.05). Similarly, both groups observed significant positive changes in SRS-22 and WRVAS scores (p < 005). RMS values were statistically significant in both groups; the difference was only statistically significant in the thoracic anterior arm subparameter (p < 0.05). (4) Conclusion: The Schroth exercise for both groups with AIS improved body symmetry, quality of life, and body image.
Full article
(This article belongs to the Special Issue New Trends in Physical Therapy for Children)
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Open AccessArticle
Parental Burnout and Child Behavior: A Preliminary Analysis of Mediating and Moderating Effects of Positive Parenting
by
Aline Woine, María Josefina Escobar, Carolina Panesso, Dorota Szczygieł, Moïra Mikolajczak and Isabelle Roskam
Children 2024, 11(3), 353; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030353 - 16 Mar 2024
Abstract
Despite its significant growth over the past fifteen years, research on parental burnout is just beginning to explore the relationships of the syndrome with child behavior. Previous research with adolescents has shown the existence of associations between parental burnout and internalizing and externalizing
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Despite its significant growth over the past fifteen years, research on parental burnout is just beginning to explore the relationships of the syndrome with child behavior. Previous research with adolescents has shown the existence of associations between parental burnout and internalizing and externalizing behaviors in the offspring. The current study is an attempt to (i) replicate this preliminary evidence specifically among Chilean preschool children and (ii) explore the mediating/moderating effects of positive parenting that may be involved in these putative associations. A sample of 383 Chilean mothers participated in this cross-sectional online study. The results confirmed the associations between parental burnout and child internalizing and externalizing behaviors. We also observed that positive parenting was a mediator in the relationship linking parental burnout and the child’s internalizing (full mediation) and externalizing (partial mediation) behaviors. Positive parenting also partially mediated the association between the child’s externalizing behavior and parental burnout. Our results further suggested that the child’s externalizing behavior was possibly a more substantial contributing factor to parental burnout than the child’s internalizing behavior.
Full article
(This article belongs to the Special Issue Advances in Mental Health and Well-Being in Children)
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Open AccessArticle
Associations between Prepartum and Postpartum Maternal Symptoms of Depression, Anxiety and Stress Related to COVID-19 Pandemic and Childhood Sensory Avoidance: Results from Conception Study
by
Delphine Aubin, Jessica Gorgui, Anick Bérard and Sarah Lippé
Children 2024, 11(3), 352; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030352 - 16 Mar 2024
Abstract
Background: Prepartum and postpartum maternal symptoms of stress, anxiety and depression are likely to influence the child’s sensory processing through hormonal alterations and an influence on mother–child interactions. Objective: We investigated the associations between maternal prepartum and postpartum symptoms of depression, anxiety and
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Background: Prepartum and postpartum maternal symptoms of stress, anxiety and depression are likely to influence the child’s sensory processing through hormonal alterations and an influence on mother–child interactions. Objective: We investigated the associations between maternal prepartum and postpartum symptoms of depression, anxiety and stress related to the COVID-19 pandemic and childhood sensory avoidance at 18 months. Methods: Longitudinal data from 409 participants followed during the COVID-19 pandemic were used. They completed questionnaires during pregnancy and up to 18 months after delivery. Maternal distress symptoms were assessed prenatally and at 18 months postnatally using the Edinburgh Postnatal Depression Scale, the Generalized Anxiety Disorders 7-item Scale and a 10-point scale assessing the level of stress felt related to the COVID-19 pandemic. Child sensory avoidance was assessed at 18 months postpartum using the Infant/Toddler Sensory Profile—Second Edition. Pearson correlations and multiple regressions measured the associations between maternal distress symptoms and child sensory avoidance. Results: Prepartum and 18-month postpartum maternal depression and anxiety were significantly correlated with childhood sensory avoidance (p < 0.05). Together, these variables explained 7.18% (F = 2.12, p < 0.05) of the variance of childhood sensory avoidance. Conclusions: These results support the contributory effect of prepartum and postpartum maternal distress on childhood sensory development.
Full article
(This article belongs to the Special Issue Developmental and Behavioral Pediatrics - Volume II)
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Open AccessArticle
Comparison of Two Methods for Weaning from Nasal Continuous Positive Airway Pressure via the Cyclic Use of High-Flow Nasal Cannula or Room Air in Preterm Infants
by
Shu-Ting Yang, Hao-Wei Chung and Hsiu-Lin Chen
Children 2024, 11(3), 351; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030351 (registering DOI) - 15 Mar 2024
Abstract
Nasal continuous positive airway pressure (NCPAP) is extensively used for preterm infants experiencing respiratory distress syndrome (RDS). Weaning from NCPAP includes direct weaning or gradually extending room air exposure. However, a high-flow nasal cannula (HFNC) is an alternative weaning method. Therefore, this study
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Nasal continuous positive airway pressure (NCPAP) is extensively used for preterm infants experiencing respiratory distress syndrome (RDS). Weaning from NCPAP includes direct weaning or gradually extending room air exposure. However, a high-flow nasal cannula (HFNC) is an alternative weaning method. Therefore, this study evaluated the clinical outcomes of HFNC and progressively increasing room air duration as weaning strategies. This study enrolled 46 preterm infants with RDS receiving NCPAP support who underwent the cyclic use of NCPAP and HFNC weaning protocol as the HFNC group; a retrospective analysis included 87 preterm infants weaned from NCPAP by gradually extending room air duration as the room air group. Differences in clinical conditions, complications, and short-term outcomes between the weaning methods were compared. The mean post-menstrual age at initiating NCPAP weaning was lower in the room air group than in the HFNC group (mean ± SD, 35.2 ± 2.3 weeks vs. 33.2 ± 2.5 weeks, p < 0.001). Hospital stay duration and total respiratory therapy days were longer in the HFNC group (96 ± 38 days and 80 ± 37 days, respectively) than in the room air group (78 ± 28 days and 56 ± 25 days, respectively), with p-values of 0.006 and <0.001. In conclusion, employing HFNC for weaning from NCPAP resulted in longer hospital admissions and respiratory therapy days than the room air method. However, further studies with a larger sample size are warranted for a more comprehensive evaluation, given the limited number of enrolled patients.
Full article
(This article belongs to the Special Issue Comprehensive Care of Critically Ill Infants and Children)
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Open AccessReview
Procalcitonin and Presepsin as Markers of Infectious Respiratory Diseases in Children: A Scoping Review of the Literature
by
Giorgio Sodero, Carolina Gentili, Francesco Mariani, Valentina Pulcinelli, Piero Valentini and Danilo Buonsenso
Children 2024, 11(3), 350; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030350 - 15 Mar 2024
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Introduction: Procalcitonin and presepsin have been suggested to be able to discriminate bacterial and viral infections, also in children. This scoping review aims to better explore the available evidence around the potential role of these biomarkers in the subgroup of children with respiratory
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Introduction: Procalcitonin and presepsin have been suggested to be able to discriminate bacterial and viral infections, also in children. This scoping review aims to better explore the available evidence around the potential role of these biomarkers in the subgroup of children with respiratory infectious diseases. Methods: We performed a systematic scoping review of studies published until March 2023 in the following bibliographic databases: PubMed, EMBASE, Cochrane and SCOPUS. Results: In children with bacterial infection, procalcitonin values ranged from 0.5 ng/mL to 8.31 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.6 ng/dL to 452.8 ng/dL with PCR from 2 ng/dL to 51.7 ng/dL. In children with viral infections, procalcitonin value values ranged from 0.2 ng/dL to 0.84 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.61 ng/dL to 46.6 ng/dL. No studies on presepsin in children with respiratory infections were retrieved. Conclusions: Although the available literature is highly heterogeneous, evidence does not suggest a role of procalcitonin in accurately differentiating bacterial and viral infections in children with respiratory infections. In future, new approaches based on multiple markers may better help determine which febrile children require antibiotics.
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Open AccessBrief Report
The Risks of Phosphate Enemas in Toddlers: A Life-Threatening Unawareness
by
Alessandro Zago, Alessandro Agostino Occhipinti, Matteo Bramuzzo, Viola Ceconi, Vincenzo Colacino, Egidio Barbi and Federico Poropat
Children 2024, 11(3), 349; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030349 - 15 Mar 2024
Abstract
Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs). Objectives: Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal
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Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs). Objectives: Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians’ awareness of PcE risks. Methods: We conducted an online survey by sending a multiple-choice questionnaire to the referents of 51 PEDs and 101 FPs. We collected and compared the answers with recommendations reported by the Italian Drug Agency (AIFA) and the available literature about PcE administration. Results: Of the institutions and pediatricians receiving the questionnaire, 23 PEDs (45%) and 63 FP (62.3%) participated in the survey. Of PEDs, 95% and 33.0% of FPs treated fecal impaction with PcE. Moreover, 54% of PEDs and 86.0% of FPs did not provide treatment according to the AIFA recommendations for the daily dose. Conclusions: This study shows limited pediatricians’ awareness of the potential risks related to PcE.
Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Gastroenterology and Nutrition)
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Open AccessCase Report
False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck
by
Yuta Matsumoto, Motohiro Matsui, Akari Makidono, Atsushi Makimoto and Yuki Yuza
Children 2024, 11(3), 348; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030348 - 15 Mar 2024
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Background: Although positron emission tomography combined with computed tomography (PET-CT) plays an important role in detecting various types of childhood malignancy, it has low positive predictive value, owing to the nonspecific uptake of 18F-fluorodeoxyglucose (FDG) by normal tissue in various benign conditions. Case
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Background: Although positron emission tomography combined with computed tomography (PET-CT) plays an important role in detecting various types of childhood malignancy, it has low positive predictive value, owing to the nonspecific uptake of 18F-fluorodeoxyglucose (FDG) by normal tissue in various benign conditions. Case summary: A 5-year-old male patient with a malignant rhabdoid tumor originating in the left neck underwent primary tumor resection concurrently with ipsilateral lymph node dissection after receiving neoadjuvant chemotherapy consisting of cyclophosphamide, carboplatin, etoposide, vincristine, and doxorubicin. He later received the same adjuvant chemotherapy as well as proton therapy for the primary tumor. Sixteen months after completing the initial therapy, follow-up PET-CT revealed a novel area of glucose hypermetabolism in the right side of the tongue, which was suspected of being a recurrence. However, a physical examination and magnetic resonance imaging (MRI) demonstrated no evidence of tumor recurrence. The patient had a significant leftward deviation of the tongue, suggesting left hypoglossal nerve paralysis. Denervation of the ipsilateral intrinsic tongue muscles secondary to the treatment had caused atrophy in the ipsilateral muscles and compensatory hypertrophy in the contralateral muscles, which increased FDG uptake. Physicians should carefully confirm any diagnosis of a locally recurrent tumor because PET-CT often produces ambiguous findings.
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Open AccessArticle
Early Breathing in Very Preterm Infants during Deferred Cord Clamping (DCC) Is Related to Gestational Age and Is Not Independently Associated with Important Neonatal Outcomes: A 5-Year Cohort Study
by
Michael P. Meyer and Elizabeth Nevill
Children 2024, 11(3), 347; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030347 - 14 Mar 2024
Abstract
Deferred cord clamping (DCC) has been associated with reduced mortality in preterm infants, and a period of at least 30 s has been recommended before clamping. However, preterm infants assessed as being in need of resuscitation have often had earlier cord clamping. In
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Deferred cord clamping (DCC) has been associated with reduced mortality in preterm infants, and a period of at least 30 s has been recommended before clamping. However, preterm infants assessed as being in need of resuscitation have often had earlier cord clamping. In this study, we aimed to compare neonatal outcomes for preterm infants undergoing DCC who established early breathing movements compared to those who were not breathing. After a 5 yr recruitment period, we recently completed the ABC study, in which preterm infants <31 weeks undergoing 50 s of DCC who were not breathing by 15 s of age were randomised into two groups: one received intermittent positive pressure ventilation (IPPV) and the other was a standard group, which received no breathing support. The outcomes in the two groups were similar, and for the present analysis, the groups were combined. Infants in the ABC study were compared with the cohort excluded from the original ABC study because they were breathing by 15 s (called the Breathing Before Clamping or BBC group). There were significant differences in demographics between the ABC and BBC groups. Spontaneous preterm labour was more common in the BBC group, and these infants were more likely to be delivered vaginally. Gestational age and birth weight were significantly higher in the BBC group (p < 0.01). Soon after birth, Apgar scores were significantly higher in the BBC group, with a lower base deficit on first obtained blood gas, and a smaller proportion were intubated in the delivery room. Fewer BBC infants were hypothermic (<36.5 °C) on admission. Multivariate regression analysis indicated whether infants were breathing or not at 15 s of age was linked predominantly to gestation. Important neonatal outcomes and a composite of these outcomes (mortality, severe intraventricular haemorrhage, bronchopulmonary dysplasia) were not significantly different between the ABC and BBC groups (odds ratio for the composite outcome was 1.77 CI 0.84–3.76 corrected for gestation). For very preterm infants undergoing DCC, important neonatal outcomes were related to gestational age and not independently associated with early breathing. There was a small group (7% of total) who were deemed compromised at birth and did not undergo DCC. These infants had significantly worse neonatal outcomes.
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(This article belongs to the Section Pediatric Neonatology)
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Open AccessArticle
Health-Related Quality of Life in Relation to Health Behaviour Patterns among Canadian Children
by
Xiuyun Wu, Arto Ohinmaa, Paul J. Veugelers and Katerina Maximova
Children 2024, 11(3), 346; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030346 - 14 Mar 2024
Abstract
Poor health behaviours in childhood, including sedentary behaviour, low physical activity levels, inadequate sleep, and unhealthy diet, are established risk factors for both chronic diseases and mental illness. Scant studies have examined the importance of such health behaviour patterns for health-related quality of
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Poor health behaviours in childhood, including sedentary behaviour, low physical activity levels, inadequate sleep, and unhealthy diet, are established risk factors for both chronic diseases and mental illness. Scant studies have examined the importance of such health behaviour patterns for health-related quality of life (HRQoL). This study aimed to examine the association of health behaviour patterns with HRQoL among Canadian children. Data from 2866 grade five students were collected through a provincially representative school-based survey of the 2014 Raising Healthy Eating and Active Living Kids in Alberta study. Latent class analysis was used to identify health behaviour patterns based on 11 lifestyle behaviours: sedentary behaviour (using a computer, playing video games, watching TV), physical activity (with and without a coach), sleep (bedtime on weekdays and weekends), and diet (fruit and vegetables intake, grain products, milk and alternatives, meat and alternatives). Multivariable multilevel logistic regression was applied to examine the associations of health behaviour patterns with HRQoL. Three groupings with distinct health behaviour patterns were identified: the first grouping (55%) is characterized by relatively healthy levels of sedentary behaviour, physical activity, and sleep, but a less healthy diet (“activity-focused” group). The second grouping (24%) is characterized by a relatively healthy diet, but moderately healthy levels of sedentary behaviour, physical activity, and sleep (“diet-focused” group). The third grouping (21%) is characterized by mostly unhealthy behaviours (“not health-focused” group). Students in the third and second groupings (“not health-focused” and “diet-focused”) were more likely to report lower HRQoL relative to students in the first grouping (“activity-focused”). The findings suggest that health promotion strategies may be more effective when considering the patterns of health behaviours as distinct targets in the efforts to improve HRQoL. Future research should include prospective observational and intervention studies to further elucidate the relationship between health behaviour patterns and HRQoL among children.
Full article
(This article belongs to the Section Global and Public Health)
Open AccessReview
Tibial Spine Avulsion Fractures in Paediatric Patients: A Systematic Review and Meta-Analysis of Surgical Management
by
Mehak Chandanani, Raian Jaibaji, Monketh Jaibaji and Andrea Volpin
Children 2024, 11(3), 345; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030345 - 14 Mar 2024
Abstract
Background: Tibial spine avulsion fractures (TSAFs) account for approximately 14% of anterior cruciate ligament injuries. This study aims to systematically review the current evidence for the operative management of paediatric TSAFs. Methods: A search was carried out across four databases: MEDLINE, Embase, Scopus,
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Background: Tibial spine avulsion fractures (TSAFs) account for approximately 14% of anterior cruciate ligament injuries. This study aims to systematically review the current evidence for the operative management of paediatric TSAFs. Methods: A search was carried out across four databases: MEDLINE, Embase, Scopus, and Google Scholar. Studies discussing the outcomes of the surgical management of paediatric TSAFs since 2000 were included. Results: Of 38 studies included for review, 13 studies reported outcomes of TSAF patients undergoing screw fixation only, and 12 studies used suture fixation only. In total, 976 patients underwent arthroscopic reduction and internal fixation (ARIF), and 203 patients underwent open reduction and internal fixation (ORIF). The risk of arthrofibrosis with the use of ARIF (p = 0.45) and screws (p = 0.74) for TSAF repair was not significant. There was a significantly increased risk of knee instability (p < 0.0001), reoperation (p = 0.01), and post-operative pain (p = 0.007) with screw fixation compared to sutures. Conclusions: While the overall benefits of sutures over screws and ARIF over ORIF are unclear, there is clear preference for ARIF and suture fixation for TSAF repair in practice. We recommend large-scale comparative studies to delineate long-term outcomes for various TSAF fixation techniques.
Full article
(This article belongs to the Special Issue Pediatric Fractures—Volume II)
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Open AccessArticle
Generalized Joint Hypermobility: A Statistical Analysis Identifies Non-Axial Involvement in Most Cases
by
Mateus Marino Lamari, Neuseli Marino Lamari, Michael Peres de Medeiros, Matheus Gomes Giacomini, Adriana Barbosa Santos, Gerardo Maria de Araújo Filho, Eny Maria Goloni-Bertollo and Érika Cristina Pavarino
Children 2024, 11(3), 344; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030344 - 14 Mar 2024
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Context: Joint hypermobility (JH) represents the extreme of the normal range of motion or a condition for a group of genetically determined connective tissue disorders. Generalized joint hypermobility (GJH) is suspected when present in all four limbs and the axial skeleton, scored in
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Context: Joint hypermobility (JH) represents the extreme of the normal range of motion or a condition for a group of genetically determined connective tissue disorders. Generalized joint hypermobility (GJH) is suspected when present in all four limbs and the axial skeleton, scored in prepubescent children and adolescents by a Beighton Score (BS) ≥ 6. Parameters are also used to identify GJH in hypermobile Ehlers–Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSDs). The purpose of this study is to characterize children with JH based on the location of variables in the BS ≥ 6 and identify children with JH in the axial skeleton, upper limbs (ULs), and lower limbs (LLs) simultaneously. Methods: We analyzed 124 medical records of one- to nine-year-old children with JH by BS. Results: The characterization of GJH by combinations of the axial skeleton, ULs, and LLs simultaneously totaled 25.7%. BS = 6 and BS = 8 consisted of variables located in ULs and LLs. BS = 7 included the axial skeleton, ULs, and LLs. BS ≥ 6 represents the majority of the sample and predominantly girls. Conclusions: BS ≥ 6 represents the majority of the sample and predominantly girls. Most characterized children with GJH present BS = 6 and BS = 8 with variables located only in ULs and LLs, a condition that does not imply the feature is generalized. In children, BS = 7 and BS = 9 characterize GJH by including the axial skeleton, ULs, and LLs. These results draw attention to the implications for defining the diagnosis of hEDS and HSDs.
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Open AccessSystematic Review
Clinician- and Patient-Centred Outcomes of Digital Impressions in Infants with Cleft Lip and Palate: A Systematic Review
by
Jyotsna Unnikrishnan, Yasaman Etemad Shahidi, Mahmoud Bakr, Robert Love and Ghassan Idris
Children 2024, 11(3), 343; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030343 - 13 Mar 2024
Abstract
This systematic review examines the effectiveness of digital impressions in infants with cleft lip and palate (CLP), focusing on accuracy, operator preferences, and parents’ perceptions. The PICO-formulated focused questions assessed the accuracy and operator preference of digital impressions compared to conventional impressions in
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This systematic review examines the effectiveness of digital impressions in infants with cleft lip and palate (CLP), focusing on accuracy, operator preferences, and parents’ perceptions. The PICO-formulated focused questions assessed the accuracy and operator preference of digital impressions compared to conventional impressions in infants with cleft lip and palate, while also exploring parents’ perceptions as patient-centred outcomes. Electronic and manual searches were conducted in five databases including PubMed, Scopus, Web of Science, Embase, and Cochrane Library; to acquire grey literature, Google Scholar was also consulted. Both experimental and observational studies that used digital impressions in the clinical care of infants with CLP were included. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of the included studies. Out of 503 records, 12 studies met the inclusion criteria. The accuracy assessment included surface discrepancy and intra-arch measurements. Surface discrepancy studies showed variations in the premaxillary segments, while intra-arch measurements revealed no significant differences. Operators preferred digital impressions, citing reduced stress and streamlined workflows. Parents expressed a clear preference for digital over conventional impressions. The conclusions drawn were substantiated by weak evidence due to the limited number and the high risk of bias of the included studies. Challenges remain here, warranting continued research to enhance accuracy and assess parents’ preferences, ensuring optimal outcomes for infants with CLP.
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(This article belongs to the Special Issue Current Research on Cleft Lip in Children - Volume 2)
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Open AccessArticle
Depression and Anxiety in Pediatric Patients with Beckwith–Wiedemann Syndrome: A Pilot Study
by
Grazia D’Onofrio, Annalisa Mastromatteo, Andrea Di Francesco, Antonio Izzi, Vincenzo Marchello, Aldo Manuali, Andreaserena Recchia, Maria Pia Tonti, Maria Lazzarina Russo, Maria Pia Affatato, Alessandra Rossato, Cecilia Giuntoli, Nicola Palladino, Michele Germano, Maria Rosa Pastore and Lazzaro Cassano
Children 2024, 11(3), 342; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030342 - 13 Mar 2024
Abstract
The study’s aim was to determine the prevalence of depression and anxiety in children with Beckwith–Wiedemann syndrome (BWS) and their effects on social relationships and family acceptance. The Pediatric Symptom Checklist—35 items (PSC-35), Screen for Child Anxiety Related Emotional Disorders (SCARED), and the
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The study’s aim was to determine the prevalence of depression and anxiety in children with Beckwith–Wiedemann syndrome (BWS) and their effects on social relationships and family acceptance. The Pediatric Symptom Checklist—35 items (PSC-35), Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Vineland Adaptive Behavior Scale Second Edition (VABS-II) were administered to the children. The parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and Zarit Burden Inventory (ZBI) were administered to parents. In total, 6 patients and 10 parents were included. Patients showed a significant presence of internalizing behavior in PSC-35 (mean, 7.66 ± 3.67), anxiety symptoms (SCARED: mean, 46.33 ± 17.50) and socialization difficulties (mean, 90.83 ± 10.09). Parents reported a perceived good acceptance (mean, 56.33 ± 1.03) and a moderate control (mean, 24.17 ± 1.83), but the burden level was ranked moderate to severe (mean, 59.33 ± 16.78). It was found that the severity of the burden level reported by parents was related to internalizing behavior (OR = 2.000; 95% CI = 0.479–3.521; p = 0.022) and anxiety symptoms (SCARED total score: OR = 3.000; 95% CI = 1.479–4.521; p = 0.005) of children. During psychological counseling in the context of BWS treatment, it is important to identify specific resources that can support patients and families in dealing with stress and identify any critical areas that could hinder the adaptation process.
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Acute Effects of Walking and Standing on Executive Function in Children with Attention Deficit/Hyperactivity Disorder: A Feasibility Study
by
Amanda Barudin-Carreiro, Sarah M. Camhi, Heidi I. Stanish and Julie A. Wright
Children 2024, 11(3), 341; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030341 - 13 Mar 2024
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) struggle with executive functioning (EF). While physical activity (PA) benefits EF, little is known about the impact of specific activities like standing. The purpose of this study was to evaluate the feasibility of performing a rigorous experimental
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Children with attention deficit/hyperactivity disorder (ADHD) struggle with executive functioning (EF). While physical activity (PA) benefits EF, little is known about the impact of specific activities like standing. The purpose of this study was to evaluate the feasibility of performing a rigorous experimental study to compare the effects of walking and standing on EF in children with ADHD. Six areas of feasibility were assessed: recruitment, randomization, treatment adherence, retention, acceptability of the intervention, and implementation. A randomized pilot study using three parallel conditions compared the effects of two modes of activity on EF in children 6–11 with ADHD. While there were no significant differences between walking and standing for EF, analyses suggest that it is feasible to compare effects of standing vs. walking on EF among children with ADHD. This study supports the feasibility of undertaking a larger scale study to evaluate the effect of standing on EF in children with ADHD.
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(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)
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Open AccessArticle
Suspected Simple Appendicitis in Children: Should We Use a Nonoperative, Antibiotic-Free Approach? An Observational Study
by
Patricia Reis Wolfertstetter, John Blanford Ebert, Judith Barop, Markus Denzinger, Michael Kertai, Hans J. Schlitt and Christian Knorr
Children 2024, 11(3), 340; https://0-doi-org.brum.beds.ac.uk/10.3390/children11030340 - 13 Mar 2024
Abstract
Background: Simple appendicitis may be self-limiting or require antibiotic treatment or appendectomy. The aim of this study was to assess the feasibility and safety of a nonoperative, antibiotic-free approach for suspected simple appendicitis in children. Methods: This single-center, retrospective study included patients (0–17
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Background: Simple appendicitis may be self-limiting or require antibiotic treatment or appendectomy. The aim of this study was to assess the feasibility and safety of a nonoperative, antibiotic-free approach for suspected simple appendicitis in children. Methods: This single-center, retrospective study included patients (0–17 years old) who were hospitalized at the pediatric surgery department due to suspected appendicitis between 2011 and 2012. Data from patients who primarily underwent appendectomy were used as controls. The follow-up of nonoperatively managed patients was conducted in 2014. The main outcome of interest was appendicitis recurrence. Results: A total of 365 patients were included: 226 were treated conservatively and 139 underwent appendectomy. Fourteen (6.2% of 226) of the primarily nonoperatively treated patients required secondary appendectomy during follow-up, and histology confirmed simple, uncomplicated appendicitis in 10 (4.4% of 226) patients. Among a subset of 53 patients managed nonoperatively with available Alvarado and/or Pediatric Appendicitis Scores and sonographic appendix diameters in clinical reports, 29 met the criteria for a high probability of appendicitis. Three of these patients (10.3% of 29) underwent secondary appendectomy. No complications were reported during follow-up. Conclusions: A conservative, antibiotic-free approach may be considered for pediatric patients with suspected uncomplicated appendicitis in a hospital setting. Only between 6 and 10% of these patients required secondary appendectomy. Nevertheless, the cohort of patients treated nonoperatively was likely to have also included individuals with further abdominal conditions other than appendicitis. Active observation and clinical support during the disease course may help patients avoid unnecessary procedures and contribute to spontaneous resolution of appendicitis or other pediatric conditions as the cause of abdominal pain. However, further studies are needed to define validated diagnostic and management criteria.
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(This article belongs to the Special Issue Advances in Gastrointestinal Surgery in Children)
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