Children

10 pages, 1417 KiB

Open AccessArticle

Changes in Protein Levels during the Storage and Warming of Breast Milk in a Domestic Environment

by Penprapa Siviroj, Jetsada Ruangsuriya and Krongporn Ongprasert

Children 2024, 11(9), 1133; https://doi.org/10.3390/children11091133 - 18 Sep 2024

Background/Objectives: Storage and warming can impact the protein concentration of breast milk (BM). This study aimed to explore the effects of routine BM handling, from storage to warming, on BM protein concentration. Methods: Forty BM samples were collected from 40 mothers [...] Read more.

Background/Objectives: Storage and warming can impact the protein concentration of breast milk (BM). This study aimed to explore the effects of routine BM handling, from storage to warming, on BM protein concentration. Methods: Forty BM samples were collected from 40 mothers with full-term infants. Fresh BM samples were analyzed within 24 h of expression as a baseline. Additional samples were stored in a refrigerator for up to 4 days and in either a freezer compartment of a refrigerator with a separate door (refrigerator freezers) or a deep freezer for up to 6 months. We compared four warming techniques: rapid thawing in water at 25 °C and 37 °C immediately after freezer removal, and slow thawing in a refrigerator for 12 h, followed by warming in water at 25 °C and 37 °C. The protein concentration was measured using the Lowry method. Results: No significant decrease in BM protein concentration was observed across all storage conditions compared to baseline. BM with a higher protein content benefited more from storage in deep freezers than in refrigerator freezers. Thawing immediately after removal from the freezer at 25 °C preserved significantly higher total protein levels compared to alternative heating techniques. Conclusions: Our findings support the recommendation for mothers to store BM in either type of freezer for up to 6 months. Our results suggest that rapid thawing at 25 °C is the most effective method for preserving protein levels compared to other thawing techniques used in our study. Full article

(This article belongs to the Special Issue Infant and Early Childhood Nutrition)

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17 pages, 1384 KiB

Open AccessArticle

Indulgent Parenting and Adolescents’ Maladjustments: The Roles of Cultural Context and Parental Gender

by Qinglan Feng, Yanyun Yang and Ming Cui

Children 2024, 11(9), 1132; https://doi.org/10.3390/children11091132 - 18 Sep 2024

Abstract

Background/Objectives. Adolescence is a critical developmental stage marked by the exploration of independence and self-identity. In this study, we aimed to examine the association between indulgent parenting (characterized by high responsiveness and low demandingness) and adolescents’ maladjustments across emotional, behavioral, and social domains. [...] Read more.

Background/Objectives. Adolescence is a critical developmental stage marked by the exploration of independence and self-identity. In this study, we aimed to examine the association between indulgent parenting (characterized by high responsiveness and low demandingness) and adolescents’ maladjustments across emotional, behavioral, and social domains. Methods. Using a cross-cultural sample of high school students from the U.S. (n = 268) and China (n = 189), we tested the hypotheses that indulgent parenting was associated with adolescents’ maladjustments, and that such association varied by cultural context (U.S. vs. China) and parental gender. Results. The results from Bayesian structural equation modeling supported the hypotheses, showing significant associations between indulgent parenting and adolescents’ maladjustments and differences in the associations across cultures and parental gender. Conclusions. The findings highlighted the need for culturally informed parenting programs to foster healthy adolescent development. Full article

(This article belongs to the Special Issue Advances in Mental Health and Well-Being in Children)

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19 pages, 716 KiB

Open AccessArticle

Parental Knowledge, Attitudes, and Practices Regarding Early Childhood Caries in Bihor, Romania: A Cross-Sectional Study

by Abel Emanuel Moca, Raluca Iulia Juncar, Rahela Tabita Moca, Mihai Juncar, Rebeca Daniela Marton and Luminița Ligia Vaida

Children 2024, 11(9), 1131; https://doi.org/10.3390/children11091131 - 18 Sep 2024

Abstract

Background/Objectives: Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living [...] Read more.

Background/Objectives: Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living environment on parents’ knowledge, attitudes, and practices (KAP) regarding ECC in Bihor County, Romania, using a KAP-type questionnaire. Methods: A cross-sectional study was conducted between March and September 2024, utilizing an online KAP questionnaire distributed via social networks. The sample comprised 419 parents of children under six years old. Respondents provided socio-demographic data and answered questions regarding their knowledge, attitudes, and practices concerning ECC prevention, treatment, and oral health. Statistical analysis was conducted using Chi-square tests to assess associations between demographic factors and parental KAP. A p-value of less than 0.05 was considered statistically significant. Results: Of the 419 respondents, 83.1% were female, and 62.5% were between the ages of 31 and 40. Significant gender-based differences were found in knowledge about pain from caries (93.7% of female participants vs. 81.7% of male participants, p = 0.004) and the importance of brushing twice daily (93.7% of female respondents vs. 80.3% of male respondents, p = 0.010). Younger parents (aged 18–30) were more likely to affirm the effectiveness of fluoride (65.4%) compared to those aged 31–40 (53.1%, p = 0.02). Urban parents were more likely to correctly identify the timing of tooth eruption (59.1% vs. 52.6% of rural parents, p = 0.021). Conclusions: The study highlights gender, age, and urban–rural disparities in parental knowledge and attitudes towards ECC. These findings underscore the need for targeted educational interventions to improve oral health outcomes and reduce ECC prevalence in the Bihor region. Tailored public health strategies addressing demographic factors could enhance preventive oral health behaviors and reduce the healthcare burden associated with untreated dental caries. Full article

(This article belongs to the Special Issue Public Health and Preventive Medicine for Children)

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13 pages, 1977 KiB

Open AccessReview

Progress in the Application of Bronchoscopic Cryotherapy in Pediatric Pulmonary Diseases

by Xiaofen Tao, Shuxian Li, Hujun Wu, Fang Jin, Guoping Jin and Lei Wu

Children 2024, 11(9), 1130; https://doi.org/10.3390/children11091130 - 18 Sep 2024

Abstract

Cryotherapy in interventional bronchoscopy is a new treatment modality which has recently been made available for the pediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this work was to elaborate on the application progress of [...] Read more.

Cryotherapy in interventional bronchoscopy is a new treatment modality which has recently been made available for the pediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this work was to elaborate on the application progress of cryotherapy in pediatric pulmonary diseases and also to assess indications, success rates, and complications of airway cryotherapy in children. In summary, cryotherapy via flexible bronchoscopy is a safe and feasible method. The application scope in pediatrics is similar to that in adults, and it is mainly used in airway obstructive diseases. However, it is primarily caused by benign conditions, and the interventional treatment mainly seeks to provide long-lasting symptomatic alleviation. Thus, prevention, treatment, and prognosis of long-term complications are issues that should be carefully considered in pediatric applications. Full article

(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)

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9 pages, 206 KiB

Open AccessArticle

Correlation between Bronchopulmonary Dysplasia and Cerebral Palsy in Children: A Comprehensive Analysis Using the National Inpatient Sample Dataset

by Abdulrahman Al-Matary, Sameh Abozaid, Mustafa Al Suliman, Mohammed Alsubaie, Faisal K Aldandan, Faisal Mohammed Alzehairi, Huda Yahya Alyahyawi, Abrar Nayel Alsharief, Ghadeer Ghazi Alahmadi, Faris Althubaiti, Naseem Alyahyawi, Ahlam Mazi, Ahmed Abu-Zaid, Hind Alnajashi and Reem Abdullah Alyoubi

Children 2024, 11(9), 1129; https://doi.org/10.3390/children11091129 - 18 Sep 2024

Abstract

Background: The existing literature lacks conclusive evidence regarding the relationship between bronchopulmonary dysplasia (BPD) and cerebral palsy (CP). This large epidemiological study aimed to explore the co-occurrence of BPD and CP among children. Methods: This retrospective cohort analysis utilized the National [...] Read more.

Background: The existing literature lacks conclusive evidence regarding the relationship between bronchopulmonary dysplasia (BPD) and cerebral palsy (CP). This large epidemiological study aimed to explore the co-occurrence of BPD and CP among children. Methods: This retrospective cohort analysis utilized the National Inpatient Sample (NIS) dataset from 2016 to 2019, investigating pediatric patients with BPD and CP diagnoses. Descriptive and inferential statistics, including univariate and multivariate regression analyses, were conducted to explore the association between BPD and CP. Results: Overall, 3,951,039 patients were analyzed. Among them, 28,880 patients had CP (n = 796 with BPD and n = 28,084 without BPD). The rates of intraventricular hemorrhage grade 3 and 4, central nervous system anomalies, chromosomal disorders, retinopathy of prematurity (≥grade 3), periventricular leukomalacia, prematurity, and low birth weight were significantly higher in the CP-with-BPD arm contrasted to the CP-without-BPD arm. Univariate regression demonstrated a significant BPD–CP association (odds ratio [OR] = 7.78, 95% confidence interval [CI]: 7.24–8.37, p < 0.0001). Multivariate analysis, adjusting for various confounders, reinforced this association (OR = 5.70, 95% CI: 5.17–6.28, p < 0.0001). We observed a significant association between increasing prematurity in neonates with BPD and an elevated risk of CP. Conclusions: This nationwide study identified a strong correlation between the co-occurrence of BPD and CP, though it does not establish causality. Rigorous adjustments revealed that patients with BPD appear to have a six-fold increased likelihood of being diagnosed with CP later on, compared to those without BPD. While aligned with the existing literature, this study represents the largest sample size with recommendations for targeted preventive strategies to mitigate the burden of CP. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

10 pages, 723 KiB

Open AccessArticle

Effects of Dance Music on Motor Skills and Balance in Children: An Observational Cohort Study

by Tadashi Ito, Hideshi Sugiura, Kentaro Natsume, Sho Narahara, Yoshifumi Sugimoto, Emi Matsuzawa, Hitomi Fujita, Yuji Ito, Kazunori Yamazaki, Natsuki Shimizu, Koji Noritake and Nobuhiko Ochi

Children 2024, 11(9), 1128; https://doi.org/10.3390/children11091128 - 18 Sep 2024

Abstract

Background/Objectives: During the COVID-19 pandemic, children in Japan were restricted from sports and outdoor activities. Regular physical activity is essential for healthy growth and development in children, with recommendations advocating for activities such as strength training. However, the long-term effects of the restrictions [...] Read more.

Background/Objectives: During the COVID-19 pandemic, children in Japan were restricted from sports and outdoor activities. Regular physical activity is essential for healthy growth and development in children, with recommendations advocating for activities such as strength training. However, the long-term effects of the restrictions have not been fully investigated. This study aimed to evaluate the effectiveness of an “exercise class”, specifically a dance program, designed to improve motor function in elementary school children affected by the coronavirus disease 2019 (COVID-19) pandemic, which may have compromised their motor function. Methods: The dance program was developed by a sports science teacher, a professional dancer, and a physical therapist, and it was evaluated in a community-based participatory study. Trained dance instructors conducted one-hour dance sessions in a medical center, held once a week for two months from June to August 2023. A physical therapist and dance instructors led the elementary school children. Outcome measures included grip strength, lower extremity muscle strength, back muscle strength, dynamic balance function during movement, physical activity time, and body fat percentages. Descriptive statistics were used for analysis. Results: Twenty-four children aged 6–9 years participated in the exercise class over a two-month period. Improvement was observed in grip strength, lower extremity muscle strength, and dynamic balance function during movement. However, physical activity time, body fat percentages, and back muscle strength did not change. Conclusions: The results indicated a significant improvement in motor skills. Dance is an inexpensive program that elementary school children can enjoy while improving their motor skills. Full article

(This article belongs to the Section Global Pediatric Health)

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10 pages, 1793 KiB

Open AccessArticle

Post-Pandemic Epidemiology of Respiratory Infections among Pediatric Inpatients in a Tertiary Hospital in Shanghai, China

by Siyuan Lan, Changjuan Gu, Shuanglong Lu, Ning Zhou and Xiaohong Qiao

Children 2024, 11(9), 1127; https://doi.org/10.3390/children11091127 - 17 Sep 2024

Abstract

Background: After the removal of the three-year epidemic control restrictions, Chinese children were confronted with heightened risks of respiratory infections. We aimed to investigate the post-pandemic (2023) epidemiology of respiratory infections among pediatric inpatients in a tertiary hospital in Shanghai, China, and compare [...] Read more.

Background: After the removal of the three-year epidemic control restrictions, Chinese children were confronted with heightened risks of respiratory infections. We aimed to investigate the post-pandemic (2023) epidemiology of respiratory infections among pediatric inpatients in a tertiary hospital in Shanghai, China, and compare it with the pre-pandemic (2019) levels. Methods: A total of 2644 pediatric inpatients were enrolled based on discharge time and divided into group 2019 (n = 1442) and group 2023 (n = 1202). Information on the demographic characteristics, diagnoses, and pathogen test results (Mycoplasma pneumoniae, MP; Chlamydia pneumoniae, CP; Legionella pneumophila, LP; Influenza A, IFA; Influenza B, IFB; Parainfluenza virus, PIV; respiratory syncytial virus, RSV; Coxsackie virus, COX; Adenovirus, ADV; Epstein–Barr virus, EBV) was collected and analyzed. Results: Significant increases were found in the overall test positivity rates (64.6% vs. 46.7%), mixed infection rates (17.4% vs. 9%), and proportion of severe cases (25.5% vs. 3.7%) after the pandemic than those before it. Compared with 2019, the incidences of MP, IFA, LP, RSV, and ADV remarkably increased, while those of IFB and COX decreased, with no obvious differences noted for CP, PIV, and EBV in 2023. A significantly higher MP-positive detection rate was noticed in children aged 1–6 years in 2023 than in 2019. The incidence of RSV infection began to rise in August 2023, earlier than the conventional epidemic season. Conclusions: Compared with the pre-pandemic levels, the overall test positivity rates of atypical pathogens and viruses among pediatric inpatients significantly increased, and alterations in the disease spectrum, epidemic season, and age of prevalence were observed after the COVID-19 pandemic. Full article

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9 pages, 2710 KiB

Open AccessCase Report

Isolated Radial Nerve Palsy in a Newborn Due to a Congenital Myofibroma: A Rare Case of Peripheral Nerve Injury

by Serena Chiellino, Viola Fortini, Chiara Castellani and Pierluigi Vasarri

Children 2024, 11(9), 1126; https://doi.org/10.3390/children11091126 - 15 Sep 2024

Abstract

Isolated musculoskeletal infantile myofibroma is a rare tumor of pediatric age. The majority of cases are seen in children under two years old, but it can occur at any age as a painless enlarging mass that involves bone, skin, or soft tissue, typically [...] Read more.

Isolated musculoskeletal infantile myofibroma is a rare tumor of pediatric age. The majority of cases are seen in children under two years old, but it can occur at any age as a painless enlarging mass that involves bone, skin, or soft tissue, typically accompanied by compression symptoms. Perineural involvement is extremely rare in myofibromas. Neurological impairment can occur during infancy but isolated nerve palsy, particularly in peripheral nerves within the upper extremity, is very uncommon. Neonatal radial nerve palsy is a rare entity caused by different conditions. Among these, we mention local tumors affecting peripheral nerves, such as myofibroma. There are few cases described in the literature, which mainly concern adult patients. The authors present a case of congenital isolated radial nerve palsy in a newborn with MF of the right elbow, which resulted in impairment of the wrist and finger extension. Following a six-month monitoring period, the patient underwent surgical treatment to restore function to his right wrist and hand. This involved excising the infiltrated radial nerve segment associated with palliative surgery. Despite the benignity of this lesion, severe nerve damage and perineural involvement may require surgical treatment with nerve resection and reconstruction. Full article

(This article belongs to the Special Issue Pediatric Upper Extremity Pathology)

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10 pages, 240 KiB

Open AccessArticle

Effect of Muscle Strength on Functionality after Shoulder Tendon Transfer in Brachial Plexus Birth Injury: Is There a Relationship between Them?

by Zeynep Hoşbay, Gülsena Utku Umut, Müberra Tanrıverdi, Okyar Altaş and Atakan Aydın

Children 2024, 11(9), 1125; https://doi.org/10.3390/children11091125 - 14 Sep 2024

Abstract

Background/Objectives: Secondary problems in BPBI occur due to decreased muscle strength in the upper extremities. Comprehensive assessment methods are necessary to understand structural problems and to plan appropriate interventions in children with BPBI. We investigated the relationship between distal muscle strength, range of [...] Read more.

Background/Objectives: Secondary problems in BPBI occur due to decreased muscle strength in the upper extremities. Comprehensive assessment methods are necessary to understand structural problems and to plan appropriate interventions in children with BPBI. We investigated the relationship between distal muscle strength, range of motion (ROM), and functionality by comparing distal muscle strength on the affected and unaffected sides in patients with BPBI who underwent shoulder tendon transfer. Methods: A total of 25 children with BPBI, 13 (52%) girls and 12 (48%) boys, aged 4–7 years (mean age: 5.98 ± 1.27 years), who had undergone shoulder tendon transfer surgery at least one year prior to the study were included. The muscle strength of the elbow, forearm, and wrist were assessed using the MicroFET^®2 Digital Hand Dynamometer. The ROM of the elbow, forearm, and wrist were measured using the universal goniometer. The Pediatric Evaluation of Disability Inventory (PEDI) was used for functionality assessment. Results: The strength of the elbow flexor–extensor, forearm pronator–supinator, and wrist extensor muscles on the affected side was greater than on the unaffected side in all children (p < 0.001). No correlation was found between muscle strength, ROM, and functionality in the affected extremity (p > 0.005). Conclusions: Although children with BPBI have good shoulder function after shoulder tendon transfer, structural problems in the distal extremities may affect their functionality during daily life. Distal joint strengthening and ROM exercises, as well as bimanual functional activities, should be included in the rehabilitation programs of children with BPBI after shoulder tendon transfer. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

10 pages, 584 KiB

Open AccessArticle

Lactoferrin in Pediatric Chronic Kidney Disease and Its Relationship with Cardiovascular Risk

by Chun-Yi Ho, Pei-Chen Lu, Wei-Ling Chen, Wei-Ting Liao, Chien-Ning Hsu and You-Lin Tain

Children 2024, 11(9), 1124; https://doi.org/10.3390/children11091124 - 13 Sep 2024

Abstract

Background: Pediatric CKD is associated with a high risk of cardiovascular disease (CVD). Early detection of subclinical CVD in childhood CKD can be achieved through various cardiovascular (CV) assessments, including carotid intima–media thickness (cIMT), ambulatory blood pressure monitoring (ABPM), and arterial stiffness indices. [...] Read more.

Background: Pediatric CKD is associated with a high risk of cardiovascular disease (CVD). Early detection of subclinical CVD in childhood CKD can be achieved through various cardiovascular (CV) assessments, including carotid intima–media thickness (cIMT), ambulatory blood pressure monitoring (ABPM), and arterial stiffness indices. Lactoferrin (LF), a key functional glycoprotein found in breast milk, has been linked to several diseases and has potential as a biomarker. Methods: In our study of 102 children with CKD stages G1–G4, we explored the relationship between LF and CV risk markers. Results: We found that LF concentration was not related to the severity or underlying causes of childhood CKD, but was positively correlated with overweight/obesity. Lower LF levels were correlated with increased cIMT and elevated arterial stiffness indices. Notably, abnormalities in ABPM profiles were observed in up to 60% of the children with CKD, with low LF levels linked to nighttime hypertension, nocturnal non-dipping, and ABPM abnormalities. Conclusions: In conclusion, LF shows promise as a biomarker for detecting subclinical CVD in children with CKD. Its potential utility in early detection could be instrumental in guiding timely interventions and improving long-term CV outcomes, although further research is needed to clarify the underlying mechanisms. Full article

(This article belongs to the Special Issue Kidney Disease in Children: From Bedside to Bench and Back)

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21 pages, 1688 KiB

Open AccessArticle

A Virtual Reality Platform for Evaluating Deficits in Executive Functions in Deaf and Hard of Hearing Children—Relation to Daily Function and to Quality of Life

by Shaima Hamed-Daher, Naomi Josman, Evelyne Klinger and Batya Engel-Yeger

Children 2024, 11(9), 1123; https://doi.org/10.3390/children11091123 - 13 Sep 2024

Abstract

Background: Childhood hearing loss is a common chronic condition that may have a broad impact on children’s communication and motor and cognitive development, resulting in functional challenges and decreased quality of life (QoL). Objectives: This pilot study aimed to compare executive functions (EFs) [...] Read more.

Background: Childhood hearing loss is a common chronic condition that may have a broad impact on children’s communication and motor and cognitive development, resulting in functional challenges and decreased quality of life (QoL). Objectives: This pilot study aimed to compare executive functions (EFs) as expressed in daily life and QoL between deaf and hard-of-hearing (D/HH) children and children with typical hearing. Furthermore, we examined the relationship between EFs and QoL in D/HH children. Methods: The participants were 76 children aged 7–11 yr: 38 D/HH and 38 with typical hearing. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and Pediatric Quality of Life Inventory (PedsQL), while the child performed a shopping task in the virtual action planning supermarket (VAP-S) to reflect the use of EFs in daily activity. Results: D/HH children showed significantly poorer EFs (as measured by BRIEF and VAP-S) and reduced QoL. Difficulties in EFs were correlated with lower QoL. BRIEF scores were significant predictors of QoL domains. Conclusions: Difficulties in EFs may characterize children with D/HH and reduce their QoL. Therefore, EFs should be screened and treated. VAP-S and BRIEF are feasible tools for evaluating EFs that reflect children’s challenges due to EF difficulties in real-life contexts. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

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17 pages, 2197 KiB

Open AccessArticle

Supporting Young Children’s Physical Development through Tailored Motor Competency Interventions within a School Setting

by Ellie Huggett and Kristy Howells

Children 2024, 11(9), 1122; https://doi.org/10.3390/children11091122 - 13 Sep 2024

Abstract

Background/Objectives: This study investigated how tailored motor competency (MC) interventions within a bespoke Scheme of Work (SOW) can support young children’s physical development (PD) by enhancing fine motor skills (FMS) and gross motor skills (GMS). The objective was to enable children to meet [...] Read more.

Background/Objectives: This study investigated how tailored motor competency (MC) interventions within a bespoke Scheme of Work (SOW) can support young children’s physical development (PD) by enhancing fine motor skills (FMS) and gross motor skills (GMS). The objective was to enable children to meet curriculum developmental physical milestones. Methods: The longitudinal case study design was conducted over 19 weeks across three academic terms and focused on 25 children (12 boys and 13 girls aged between 5 and 6 years old). Interventions within the SOW were evaluated at six points to assess effectiveness and to make adjustments. Data collection included observations on FMS and GMS development. Results: Statistically significant improvements were observed in FMS and GMS after implementing the MC interventions. Notable improvements included hopping, running, climbing, kicking, catching, and using scissors (p < 0.05). Conclusions: The study underscores the importance of holistic approaches to PD, highlighting the need for early intervention and the crucial role of educators. The findings advocate for strategically planned MC interventions and practitioner observations to achieve longitudinal improvements in PD. The study recommends nationwide implementation to enhance PD outcomes, preparing children for lifelong and life-wide MC. Full article

(This article belongs to the Special Issue Movement Behaviors and Motor Skills in Early Years Children)

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12 pages, 847 KiB

Open AccessArticle

Association of Right Ventricular Dysfunction with Risk of Neurodevelopmental Impairment in Infants with Pulmonary Hypertension

by Rossana Romero Orozco, Tazuddin A. Mohammed, Kerri Carter, Shaaron Brown, Stephen Miller, Roy T. Sabo, Meredith Campbell Joseph, Uyen Truong, Megha Nair, Victoria Anderson, Jie Xu, Judith A. Voynow and Karen D. Hendricks-Muñoz

Children 2024, 11(9), 1121; https://doi.org/10.3390/children11091121 - 13 Sep 2024

Abstract

(1) Background: Pulmonary hypertension (PH) increases pulmonary vascular resistance and right ventricular (RV) afterload. Assessment of RV systolic function in PH using RV fractional area change (RV FAC) as a marker directly correlates with mortality and the need for extracorporeal membrane oxygenation (ECMO). [...] Read more.

(1) Background: Pulmonary hypertension (PH) increases pulmonary vascular resistance and right ventricular (RV) afterload. Assessment of RV systolic function in PH using RV fractional area change (RV FAC) as a marker directly correlates with mortality and the need for extracorporeal membrane oxygenation (ECMO). However, few studies have assessed neurodevelopmental outcomes. We hypothesize that cardiac RV systolic dysfunction with lower RV FAC is associated with worse neurodevelopmental impairment (NI). (2) Methods: Retrospective study of 42 subjects with PH to evaluate neurodevelopmental outcomes in the first two years of life based on (i) subjective assessment of RV systolic function and (ii) RV FAC, a specific echocardiographic marker for RV function. (3) Results: Subjects from the initial study cohort (n = 135) with PH who had long-term follow-up were divided into RV dysfunction (study, n = 20) and non-RV dysfunction (control, n = 22) groups. RV FAC in the study vs. control group (0.18 vs. 0.25) was lower (p = 0.00017). There was no statistically significant difference in NI either with RV dysfunction or lower RV FAC. Although not significant, RV dysfunction was associated with longer mean duration of mechanical ventilation, time on ECMO, and length of stay. In the initial cohort (135), mortality was 16.3% and the percentage of NI was 62%. (4) Conclusions: Neonatal pulmonary hypertension is associated with a high degree of neurodevelopment impairment. Early RV systolic dysfunction, as identified by RV FAC, was not an optimal predictive biomarker for infants with PH and neurodevelopmental impairment. Full article

(This article belongs to the Section Pediatric Neonatology)

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11 pages, 1665 KiB

Open AccessArticle

Enhancing Telemedicine Communication for Improved Outpatient Pediatric Trauma Care

by Nariman Mokhaberi, Benjamin Schoof, André Strahl, Konrad Reinshagen and Kristofer Wintges

Children 2024, 11(9), 1120; https://doi.org/10.3390/children11091120 - 12 Sep 2024

Abstract

Introduction. Pediatric traumatology is a complex field that requires a comprehensive understanding of physeal development, remodeling potential, and the ossification process in order to ensure appropriate patient treatment. The objective of this study was to assess the willingness of practicing physicians to participate [...] Read more.

Introduction. Pediatric traumatology is a complex field that requires a comprehensive understanding of physeal development, remodeling potential, and the ossification process in order to ensure appropriate patient treatment. The objective of this study was to assess the willingness of practicing physicians to participate in a telemedicine collaboration aimed at enhancing the exchange between the outpatient and inpatient sectors and promoting the digitalization of the pediatric sector. This is in response to the growing significance of digitalization in the medical field. Methods. A survey consisting of 15 items was sent to 800 practicing trauma surgeons, pediatric surgeons, and pediatricians within a 100 km radius of Hamburg, Germany. The survey included questions about the respondents’ professional experience and telemedicine experience, as well as inquiries about possible telemedicine collaborations. Results. The response rate was 19.3%. Less than half of the participants already used telemedicine in daily practice. In general, 75% of respondents expressed an interest in collaborating with the inpatient sector. The most common reasons for hospital referral were the need for surgery, inadequate treatment of children in practice and co-assessment. The majority were in favor of flexible communication, either via video telephony, imaging applications like or messaging applications. Conclusions. The study revealed a high level of interest in telemedicine collaboration. Information exchange should be tailored to individual needs, with practitioners requiring a versatile and personalized approach that includes imaging. Strict enforcement of data protection regulations is essential. Further research is needed to evaluate the effectiveness of telemedicine collaboration in the treatment of pediatric trauma in both hospital and outpatient settings. Full article

(This article belongs to the Section Pediatric Surgery)

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13 pages, 259 KiB

Open AccessArticle

Assessment of Motor Performance and Self-Perceived Psychophysical Well-Being in Relation to Body Mass Index in Italian Adolescents

by Gaetano Altavilla, Sara Aliberti and Francesca D’Elia

Children 2024, 11(9), 1119; https://doi.org/10.3390/children11091119 - 12 Sep 2024

Abstract

Background/Objectives: The relationship between psychophysical self-perception (PSP), body mass index (BMI) and motor performance (MP) levels, in quantitative and qualitative terms, can be a very interesting connection to investigate. This study aimed to assess MP and PSP according to gender and weight differences [...] Read more.

Background/Objectives: The relationship between psychophysical self-perception (PSP), body mass index (BMI) and motor performance (MP) levels, in quantitative and qualitative terms, can be a very interesting connection to investigate. This study aimed to assess MP and PSP according to gender and weight differences (normal weight—Nw/overweight–obese—Ov-Ob) and their relationship to BMI in Italian adolescents. Methods: In total, 144 students (F = 72; M = 72) aged between 11 and 13 y.o. participated in this study. They were divided into two groups by gender and into two subgroups based on weight (Nw/Ov-Ob). Standing long jump, sit-and-reach, 10 × 5 m shuttle and sit-up tests to assess MP were carried out, and an ad hoc questionnaire to evaluate PSP was administrated. Results: In comparing the Nw and Ov-Ob subgroups on the basis of BMI for each gender, statistically significant differences emerged in all motor skill tests administered. Regarding PSP, the Nw subgroup showed high and positive levels, while Ov-Ob showed low and negative levels, highlighting a relationship between high BMI and poor motor performance as well as negative psychophysical perception in the Ov-Ob subgroup. Conclusions: this study supports the importance of physical sport activity to regulate excess weight but also contribute to better psychophysical well-being. Full article

(This article belongs to the Special Issue Physical Education and Exercise Promotion and Intervention in Children and Adolescents for Health and Wellbeing)

13 pages, 656 KiB

Open AccessArticle

Influence of Diet on Bowel Function and Abdominal Symptoms in Children and Adolescents with Hirschsprung Disease—A Multinational Patient-Reported Outcome Survey

by Judith Lindert, Hannah Day, Marta de Andres Crespo, Eva Amerstorfer, Sabine Alexander, Manouk Backes, Carlotta de Filippo, Andrzej Golebiewski, Paola Midrio, Mazeena Mohideen, Anna Modrzyk, Anette Lemli, Roxana Rassouli-Kirchmeier, Marijke Pfaff-Jongman, Karolina Staszkiewicz, Lovisa Telborn, Pernilla Stenström, Karolin Holström, Martina Kohl, Joe Curry, Stavros Loukogeorgakis and Joseph R Davidson Show full author list Hide full author list

Children 2024, 11(9), 1118; https://doi.org/10.3390/children11091118 - 12 Sep 2024

Abstract

Introduction: This study aimed to understand the influence of diet and nutrition items on gastrointestinal symptoms in patients with Hirschsprung Disease (HD). Method: An online questionnaire was created to obtain patient-reported outcomes using the multinational Holistic Care in Hirschsprung Disease Network. This was [...] Read more.

Introduction: This study aimed to understand the influence of diet and nutrition items on gastrointestinal symptoms in patients with Hirschsprung Disease (HD). Method: An online questionnaire was created to obtain patient-reported outcomes using the multinational Holistic Care in Hirschsprung Disease Network. This was distributed in Dutch, English, German, Italian, Polish, and Swedish via patient associations. Information on demographics, the extension of disease, current diet, and the influence of food ingredients on bowel function were obtained. Results: In total, 563 questionnaires were answered by parents or patients themselves. The length of the aganglionic segment was short in 33%, long in 45%, total colonic aganglionosis (TCA) in 11%, and involved the small intestine in 10%. Overall, 90% reported following a mixed diet, and 31% reported taking probiotics, with twice as many patients taking probiotics in the TCA group compared to standard HD. Mealtimes and behaviours around eating were affected by 61%, while 77% had established food items that worsened symptoms, and of these, 80% stated that they had worked these items out themselves. A high-fibre diet was followed by 24% and 18% a low-fibre diet. Symptoms were reported, particularly from dairy in 30%, fruits in 39%, pulses in 54%, and sugar in 48%. Conclusions: This first multinational survey on diet and bowel function in HD reports an association between certain dietary items with gastrointestinal symptoms. This study can support an improved understanding of the interaction between food items and bowel function in children with HD. We suggest a multidisciplinary approach to balance dietary exclusions and support adequate growth, preventing nutrition deficiencies and enhancing quality of life. Full article

(This article belongs to the Special Issue Selected Papers from the OASIS (Holistic Care in Hirschsprung’s Disease) Meeting)

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13 pages, 621 KiB

Open AccessReview

Robot-Assisted Extravesical Ureteral Reimplantation (REVUR) in Pediatric Patients: A New Standard of Treatment for Patients with VUR—A Narrative Review

by Ciro Esposito, Claudia Di Mento, Mariapina Cerulo, Fulvia Del Conte, Francesco Tedesco, Vincenzo Coppola, Annalisa Chiodi, Giorgia Esposito, Leonardo Continisio, Marco Castagnetti and Maria Escolino

Children 2024, 11(9), 1117; https://doi.org/10.3390/children11091117 - 12 Sep 2024

Abstract

Robot-assisted extravesical ureteral reimplantation (REVUR) was described for the first time in 2004. Since then, the surgical approach of vesicoureteral reflux (VUR) has changed dramatically. The benefits of this technique are great when compared to the laparoscopic or traditional open approaches. A literature [...] Read more.

Robot-assisted extravesical ureteral reimplantation (REVUR) was described for the first time in 2004. Since then, the surgical approach of vesicoureteral reflux (VUR) has changed dramatically. The benefits of this technique are great when compared to the laparoscopic or traditional open approaches. A literature search of PubMed was performed to identify articles covering any aspect of REVUR in the pediatric population. A total of 108 papers published over the period 2004–2024 were collected. Of these, 40 studies were considered valuable in terms of obtaining a complete overview of the REVUR technique. This review aimed to describe the current state of the art of REVUR and define it as the new standard technique for surgical management of selected patients with VUR. Full article

(This article belongs to the Special Issue Advances and Future Challenges of Minimally Invasive Surgery in Children: 2nd Edition)

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11 pages, 2088 KiB

Open AccessArticle

Transcutaneous Spinal Cord Stimulation Enables Recovery of Walking in Children with Acute Flaccid Myelitis

by Elizabeth Neighbors, Lia Brunn, Agostina Casamento-Moran and Rebecca Martin

Children 2024, 11(9), 1116; https://doi.org/10.3390/children11091116 - 12 Sep 2024

Abstract

Background: Limited research exists for use of transcutaneous spinal stimulation (TSS) in pediatric spinal cord injuries (SCI) to improve walking outcomes, especially in children diagnosed with SCI secondary to acute flaccid myelitis (AFM). Objective: This case series demonstrates the feasibility and efficacy of [...] Read more.

Background: Limited research exists for use of transcutaneous spinal stimulation (TSS) in pediatric spinal cord injuries (SCI) to improve walking outcomes, especially in children diagnosed with SCI secondary to acute flaccid myelitis (AFM). Objective: This case series demonstrates the feasibility and efficacy of TSS paired with gait training in children diagnosed with AFM. Methods: A total of 4 participants diagnosed with incomplete SCI secondary to AFM completed 22, 2-h therapy sessions over 5–8 weeks. TSS paired with body weight-supported treadmill training (BWSTT) was provided for the first 30 min of each session. Changes in walking function were assessed through the 6 min walk test (6MWT), Timed Up and Go (TUG), 10 m walk test (10MWT), and walking index for spinal cord injury II (WISCI-II). To assess safety and feasibility, pain, adverse events, and participant and therapist exertion were monitored. Results: All participants tolerated the TSS intervention without pain or an adverse response. Changes in the 6MWT exceeded the minimal clinically important difference (MCID) for three participants and WISCI-II exceeding the minimal detectable change (MDC) for two of the participants. Conclusions: These results demonstrate that TSS is a safe and clinically feasible intervention for pediatric patients with AFM and may supplement gait-based interventions to facilitate improvements in walking function. Full article

(This article belongs to the Special Issue Emerging Trends in Neuromodulation for Children with Neurological Conditions)

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9 pages, 961 KiB

Open AccessArticle

Adapting Child Development Assessment Tools to the Rural Indian Context

by Riti Chandrashekhar, Baldeep K. Dhaliwal, Ananya Rattani, Rajeev Seth, Suba Guruprasad, Himani Khanna and Anita Shet

Children 2024, 11(9), 1115; https://doi.org/10.3390/children11091115 - 12 Sep 2024

Abstract

Background: Child development assessment tests serve many purposes, including educational placement, identifying cognitive weaknesses, and initiating early interventions. Much of the research associated with developmental testing has been conducted in high-income countries, offering limited guidance on adapting these tests to other settings. Objectives: [...] Read more.

Background: Child development assessment tests serve many purposes, including educational placement, identifying cognitive weaknesses, and initiating early interventions. Much of the research associated with developmental testing has been conducted in high-income countries, offering limited guidance on adapting these tests to other settings. Objectives: As part of the first phase of a study exploring the impact of childhood vaccines on cognition and school attainment, we aimed to assess the feasibility of enrolling children from the community, documenting immunization, and conducting child development assessments for children between 18 months and 8 years of age in a rural setting in Haryana, India. Methods: To ensure assessments are optimally tailored to the context, child development assessment tests require valid translation and cultural adaptation. This report describes the rigorous seven-step adaptation process we designed for the contextually appropriate adaptation of the following three child development assessment tests: the Bayley Scales of Infant Development-IV, the Stanford Binet Intelligence Scale Fifth Ed. for Early Childhood, and the Wechsler Intelligence Scale for Children IV. Results: This process involved translating tests into the local language, back-translating them for accuracy, adapting them to the rural context via several iterations, and field-testing to refine and validate adaptation quality. Conclusions: This adaptation process may be beneficial for other researchers involved in adapting child development assessment tests to other settings. Further, this adaptation process may inform other researchers involved in adapting tests for diverse settings. Full article

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