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Volume 12
Issue 5
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Children, Volume 12, Issue 5 (May 2025) – 53 articles

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12 pages, 748 KiB  
Article
Can the Oxygen Saturation Index Predict Severe Bronchopulmonary Dysplasia?
by Hulya Ozdemir, Sinem Gulcan Kersin, Asli Memisoglu, Ibrahim Kandemir and Hulya Selva Bilgen
Children 2025, 12(5), 582; https://doi.org/10.3390/children12050582 (registering DOI) - 30 Apr 2025
Abstract
Background/Objectives: Even with improvements in perinatal care, bronchopulmonary dysplasia (BPD) continues to be a major challenge, especially in smaller and more premature infants. Early detection of severe BPD can improve treatment outcomes. This study aims to evaluate the correlation between the oxygen [...] Read more.
Background/Objectives: Even with improvements in perinatal care, bronchopulmonary dysplasia (BPD) continues to be a major challenge, especially in smaller and more premature infants. Early detection of severe BPD can improve treatment outcomes. This study aims to evaluate the correlation between the oxygen saturation index (OSI) and severe BPD/death in preterm infants, with a focus on the OSI’s predictive value. Methods: In this retrospective observational study, infants with a gestational age of less than 32 weeks who required either invasive or non-invasive mechanical ventilation were included. Ventilator settings and OSI values were collected on days 3, 7, 14, 21, and 28 of life. The correlations between postnatal OSIs and outcomes such as death or severe BPD were analyzed using logistic regression. Results: Out of the 210 eligible infants, 54 (25.7%) either died or were diagnosed with severe BPD. In our study, OSI values on postnatal days 14, 21, and 28 were significantly higher in preterm infants who developed severe BPD or died, with mean OSI-14, OSI-21, and OSI-28 values of 4.9, 3.5, and 2.8, respectively. The OSI showed the highest sensitivity and specificity on postnatal days 14 and 21, with cut-off points of 3.6 and 3.1, respectively. We built a basic chart to predict severe BPD/death with OSI-14 and OSI-21 and delivery room intubation with 86% sensitivity and 84.5% specificity (increasing up to 98.8% specificity). Conclusions: This study showed that the diagnostic power of the OSI in predicting severe BPD or death was highest for OSI-14 and OSI-21. We demonstrated that calculating the OSI, a non-invasive clinical tool, can predict severe BPD/death in infants born before 32 weeks as early as the 14th day of life. Full article
(This article belongs to the Special Issue Bronchopulmonary Dysplasia: Challenges and Advances)
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13 pages, 288 KiB  
Article
Cardiorespiratory Fitness in Spanish Youth: The Roles of Sex, Age, Body Composition, and Healthy Lifestyle Habits in Cor-School Study
by Saül Aixa-Requena, Álvaro Pano-Rodríguez, Vicenç Hernández-González, Enric Conesa-Milian, Abraham Batalla-Gavaldà, Jose Vicente Beltrán-Garrido, Isaac López-Laval, Francisco Corbi, Rosa Arnau-Salvador and Joaquín Reverter-Masia
Children 2025, 12(5), 581; https://doi.org/10.3390/children12050581 (registering DOI) - 29 Apr 2025
Abstract
Background/Objectives: Cardiorespiratory fitness (CRF) is a key indicator of current and future health in children and adolescents, and is influenced by both physiological and behavioral factors. This study examined the associations between CRF, body composition, and health-related habits in 685 children and [...] Read more.
Background/Objectives: Cardiorespiratory fitness (CRF) is a key indicator of current and future health in children and adolescents, and is influenced by both physiological and behavioral factors. This study examined the associations between CRF, body composition, and health-related habits in 685 children and adolescents (aged 8–16 years) who regularly participated in extracurricular sports programs in northeastern Spain. Methods: Participants underwent anthropometric assessments, completed a 20 m shuttle run test to evaluate CRF, and filled out validated questionnaires on physical activity levels, sleep quality, and adherence to the Mediterranean diet. Results: Significant sex differences were observed, with boys achieving higher CRF performance (p < 0.001), primarily associated with greater muscle mass (p < 0.001) and lower body fat percentage (p < 0.001). Age positively correlated with improved CRF (p < 0.001), whereas higher body mass index (p = 0.003) and fat mass (p = 0.020) negatively impacted fitness outcomes. Conclusions: These findings underscore the critical role of physical activity and optimal body composition in promoting cardiorespiratory fitness among youth, emphasizing the importance of targeted interventions to foster healthy behaviors from early childhood. Future research should adopt longitudinal designs to better elucidate the dynamic interactions between lifestyle factors, body composition, and physical fitness throughout childhood and adolescence. Full article
(This article belongs to the Section Global Pediatric Health)
16 pages, 340 KiB  
Article
Child Abuse and Family Social Support: The Practice of Resolutions Approach
by Annemariek J. W. Sepers, Marija Maric and Trudy M. Mooren
Children 2025, 12(5), 580; https://doi.org/10.3390/children12050580 (registering DOI) - 29 Apr 2025
Abstract
Background/Objectives: Child abuse is a devastating problem, and effective interventions are needed. Interventions incorporating social support have been found to be more effective in reducing parental abuse than those that do not. The resolutions approach (RA) emphasizes collaborating with the family’s social network. [...] Read more.
Background/Objectives: Child abuse is a devastating problem, and effective interventions are needed. Interventions incorporating social support have been found to be more effective in reducing parental abuse than those that do not. The resolutions approach (RA) emphasizes collaborating with the family’s social network. The present study aims to examine the role of social networks in RA. Methods: This report presents the cases of two families (children aged 8–18) who are alleged to have committed child abuse. A mixed-method study was conducted. Qualitative data based on in-depth interviews, and quantitative data obtained by repeated assessments following a single-case design were integrated. Incidents of child abuse were assessed before treatment, at the end of treatment, and at follow-up, using the Conflict Tactics Scales. An idiosyncratic measurement was administered every fortnight during the intervention. Results: In both families, members acknowledged the value of involving their social network and reported decreased incidents of child abuse. One family succeeded in involving the network, and in this family, aggressive behavior stopped soon after RA started. Results were maintained during follow-up. In the other family, aggression stopped after the baseline period, according to the parents, but not according to their youngest child. Conclusions: Although the involvement of social support is prescribed through the intervention protocol, several challenges hamper its realization. Recommendations are formulated for how to involve social network members in the context of family therapy when child safety is at risk. RA might be a valuable intervention to stop child abuse, but it needs further research. Full article
(This article belongs to the Section Global Pediatric Health)
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14 pages, 1629 KiB  
Article
Characteristics, Outcomes and Mortality Risk Factors of Pediatric In-Hospital Cardiac Arrest in Western China: A Retrospective Study Using Utstein Style
by Jiaoyang Cao, Jing Song, Baoju Shan, Changxin Zhu and Liping Tan
Children 2025, 12(5), 579; https://doi.org/10.3390/children12050579 (registering DOI) - 29 Apr 2025
Abstract
Background: Pediatric in-hospital cardiac arrest (IHCA) remains a critical health challenge with high mortality rates. Limited data from Western China prompted this study to investigate the characteristics of IHCA using the Utstein style. Methods: A retrospective analysis of 456 pediatric patients [...] Read more.
Background: Pediatric in-hospital cardiac arrest (IHCA) remains a critical health challenge with high mortality rates. Limited data from Western China prompted this study to investigate the characteristics of IHCA using the Utstein style. Methods: A retrospective analysis of 456 pediatric patients with IHCA (2018–2022) at the Children’s Hospital of Chongqing Medical University assessed demographics, arrest characteristics, outcomes and mortality risk factors. The primary outcome was survival to discharge; the secondary outcomes included return of spontaneous circulation (ROSC) > 20 min, 24 h survival, and favorable neurological outcomes. Logistic regression was used to identify the mortality risk factors. Results: ROSC > 20 min was achieved in 78.07% of cases, with 37.94% surviving to discharge (86.13% of survivors had favorable neurological outcomes). Etiological stratification identified general medical conditions (52.63%) as the predominant diagnoses, with surgical cardiac patients demonstrating superior resuscitation outcomes (ROSC > 20 min: 86.84%, discharge survival: 64.04%). Initial arrest rhythms predominantly featured non-shockable patterns, specifically bradycardia with poor perfusion (79.39%), whereas shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia) constituted only 4.17% of cases. Multivariable regression analysis identified five independent risk factors: vasoactive infusion before arrest (OR = 7.69), CPR > 35 min (OR = 13.92), emergency intubation (OR = 5.17), administration of >2 epinephrine doses (OR = 3.12), and rearrest (OR = 8.48). Notably, prolonged CPR (>35 min) correlated with higher mortality (8.96% survival vs. 48.54% for 1–15 min), yet all six survivors with CPR > 35 min had favorable neurological outcomes. Conclusions: These findings underscore the persistent challenges in pediatric IHCA management while challenging the conventional CPR duration thresholds for futility. The identified mortality risk factors inform resuscitation decision making and future studies. Full article
(This article belongs to the Special Issue Emergency Management and Treatment Strategies in Children Cardiac Arrest)
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16 pages, 433 KiB  
Article
Summer Success: SKIPing to Motor Competence for Disadvantaged Preschoolers
by Dimetrius Brandon, Ruri Famelia, E. Kipling Webster and Jacqueline D. Goodway
Children 2025, 12(5), 578; https://doi.org/10.3390/children12050578 (registering DOI) - 29 Apr 2025
Abstract
Background: Disadvantaged children often enter kindergarten with delays in fundamental motor skill (FMS) competence, which is critical for future physical activity engagement. The Summer Success—Successful Kinesthetic Instruction for Preschoolers (SS-SKIP) program was designed to address these developmental gaps, with a short, intensive [...] Read more.
Background: Disadvantaged children often enter kindergarten with delays in fundamental motor skill (FMS) competence, which is critical for future physical activity engagement. The Summer Success—Successful Kinesthetic Instruction for Preschoolers (SS-SKIP) program was designed to address these developmental gaps, with a short, intensive intervention. This pilot study evaluated the impact of a 4-week SS-SKIP program on FMS, perceived motor competence (PMC), and executive function (EF). Methods: Twenty-one preschool children (mean age = 62.62 ± 4.61 months) from disadvantaged communities participated in an intensive, month-long (240 min) program. FMS were assessed using the Test of Gross Motor Development-2 (TGMD-2), PMC was evaluated using the Pictorial Scale for Perceived Competence, and EF was measured via the Head–Toes–Knees–Shoulders (HTKS), Go/No-Go, and Sorting cards tests. Standing long jump was measured in meters. A pretest–post-test design assessed program impact using 2 Gender X 2 Session MANOVAs/ANOVAs on dependent variables. Results: Analysis of differences in baseline measures of FMS competence and EF by Gender and Session revealed no significant main effects of Gender, Session, or their interaction across measures (all p > 0.05). Repeated measures ANOVAs by Gender revealed a significant main effect for Time for locomotor standard scores (p < 0.001), object control standard scores (p < 0.001), and HTKS scores (p < 0.001), indicating improvement from pretest to post-test. By contrast, jump distance, PMC, Go/No-Go and Card Sorting scores were non-significant (p > 0.05). Conclusions: A short, intense SS-SKIP FMS intervention significantly enhanced FMS and improved HTKS performance. This pilot study was limited by the lack of a control group and small N. These findings underscore the potential of short, targeted interventions in addressing early motor delays in disadvantaged preschoolers, warranting further investigation into their long-term impacts. Full article
(This article belongs to the Special Issue Promoting Healthy Lifestyles in Children and Adolescents)
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10 pages, 204 KiB  
Article
Second Attempt for Patent Ductus Arteriosus (PDA) Closure: Room for Acetaminophen? A Retrospective Single-Center Experience at Gaslini Children’s Hospital
by Samuele Caruggi, Andrea Calandrino, Gaia Cipresso, Marcella Battaglini, Paolo Massirio, Francesco Vinci, Irene Bonato, Chiara Andreato, Federica Mela, Lorenzo Curcio, Alessandro Parodi and Luca Antonio Ramenghi
Children 2025, 12(5), 577; https://doi.org/10.3390/children12050577 (registering DOI) - 29 Apr 2025
Abstract
Background: The diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA) occurs in 55% of very low birth weight (VLBW) preterm infants. There is no agreement on the best approach to ensure a quick hsPDA closure. Drug treatment of hsPDA fails in approximately [...] Read more.
Background: The diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA) occurs in 55% of very low birth weight (VLBW) preterm infants. There is no agreement on the best approach to ensure a quick hsPDA closure. Drug treatment of hsPDA fails in approximately 20% of cases with an increasing risk of prolonged ventilation, BPD, and NEC, as well as the need for surgical duct ligation. This study aims to highlight the efficacy of ibuprofen versus acetaminophen in the case of a second cycle of medical therapy after the failure of the first pharmacological approach for hsPDA closure. Methods: Every VLBW infant admitted to our NICU and treated for hsPDA was included in our retrospective research. Information about the clinical course, hsPDA diagnosis and treatment, and common complications associated with preterm birth was collected. A comparison was made between patients treated with acetaminophen or ibuprofen to assess effectiveness in hsPDA closing. Results: A total of 286 VLBW infants were included. First-course ibuprofen was effective in 87 of 115 infants (75.7%) treated, acetaminophen in 138 of 171 (80.7%). Second-course therapy with ibuprofen was effective in 62.5% of the patients, while acetaminophen was effective in 69.2%. No statistically significant difference was observed in the first-course and second-course success rates. Conclusions: This study confirms that acetaminophen is not inferior to ibuprofen in the closure of hsPDA in VLBW infants. Our data demonstrate that a second course of medical therapy after the failure of the first course could help close the majority of hsPDA cases without surgery. Full article
(This article belongs to the Special Issue Providing Care for Preterm Infants)
12 pages, 919 KiB  
Article
Influence of Screen Time on Physical Activity and Lifestyle Factors in German School Children: Interim Results from the Hand-on-Heart-Study (“Hand aufs Herz”)
by Jennifer Wieprecht, Delphina Gomes, Federico Morassutti Vitale, Simone Katrin Manai, Samar Shamas, Marcel Müller, Maren Baethmann, Anja Tengler, Roxana Riley, Guido Mandilaras, Nikolaus Alexander Haas and Meike Schrader
Children 2025, 12(5), 576; https://doi.org/10.3390/children12050576 (registering DOI) - 29 Apr 2025
Abstract
Background/Objectives: Today, digital technologies are integral to children’s lives; their increasing use, however, may raise health concerns. This study aims to examine the effect of screen time on physical activity and lifestyle factors in German school children. Methods: As part of [...] Read more.
Background/Objectives: Today, digital technologies are integral to children’s lives; their increasing use, however, may raise health concerns. This study aims to examine the effect of screen time on physical activity and lifestyle factors in German school children. Methods: As part of the prospective hand-on-heart-study (“Hand-aufs-Herz”), a comprehensive cardiovascular system check-up examination was conducted on 922 German schoolchildren. The pupils were asked for a self-report on their daily physical activities and club sports. The examinations on-site contained measurements of the pupils’ weight and height as well as their physical fitness, which was assessed by a stair-climbing test. Results: A large proportion of pupils had a screen time of more than 2 h daily, regardless of the day of the week (63–76%). In fact, pupils with a screen time ≥ 2 h were more likely to achieve poor grades in school (weekday ORs 3.23, 95% CI 1.76, 5.95; weekend ORs 3.28, 95% CI 1.53, 7.00) and not be members of a sports club (weekday ORs 2.35, 95% CI 1.68, 3.29; weekend ORs 2.13, 95% CI 1.44, 3.14). Pupils who did not meet both recommendations for physical activity and screen time walked <5000 steps daily (60%), had a high proportion of overweight/obesity (40%), were non-swimmers (38.5%), spent ≥7 h sitting (35.8%), and slept fewer hours than recommended (30%). It has also been shown that longer screen time has a negative impact on the lifestyle of children and young people. Conclusions: Our results show that excessive screen time in children is linked to higher weight and an unhealthy lifestyle, increasing long-term cardiovascular risks. Public health initiatives aimed at reducing screen time, promoting physical activity, and encouraging healthier habits are essential to improve children’s overall health and prevent future chronic diseases. Full article
(This article belongs to the Special Issue The Health Effects of Daily Physical Activity Behaviours in Children: Physical and Psychological Outcomes)
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12 pages, 571 KiB  
Article
Family Factors and the Psychological Well-Being of Children and Adolescents with Inflammatory Bowel Disease—An Exploratory Study
by Chantal Hieronymi, Kalina Kaul, Jan de Laffolie, Burkhard Brosig and on behalf of Cedata-GPGE AG
Children 2025, 12(5), 575; https://doi.org/10.3390/children12050575 (registering DOI) - 29 Apr 2025
Abstract
Background/Objectives: The aim of our study was to examine the influence of family structure and the number of siblings on psychological problems and illness-related emotions in children and adolescents with inflammatory bowel disease (IBD) and the relationship between emotional coping in children [...] Read more.
Background/Objectives: The aim of our study was to examine the influence of family structure and the number of siblings on psychological problems and illness-related emotions in children and adolescents with inflammatory bowel disease (IBD) and the relationship between emotional coping in children and parents. Methods: CEDNA is a nationwide German online paper-based questionnaire administered between October 2021 and April 2022. Adolescents with IBD, aged 12 to 17 years, and parents of children aged 0 to 17 years with diagnosed IBD, were included. SAS was used for descriptive statistics and logistic regression analysis was performed using R Studio (PBC; 2023.06.0 + 421). Results: 1158 participants (450 adolescents and 708 parents) were included in the study. A two-parent household could not be associated with mental illness as a comorbidity in pediatric IBD patients (p = 0.06) but was shown to decrease the risk of sadness (p < 0.001), helplessness (p < 0.01), and feeling left alone and lonely (p < 0.05). A single-parent household increased the risk of sadness (p = 0.001), helplessness (p = 0.002), and loneliness (p = 0.006). Having one to two siblings was associated with a lower risk of mental health problems (p = 0.03) and reduced anxiety (p = 0.005). An association was also found between parents and children’s emotional coping skills. Conclusions: Further research on family structure and siblings in pediatric IBD is needed, given the potential impact on children’s psychological well-being. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
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14 pages, 1626 KiB  
Article
Development of Communication and Language Skills in Children with Hematological–Oncological Disorders: Challenges and Perspectives
by Giusy Melcarne, Giulia Marangon, Roberta Maria Incardona, Anna Agostinelli, Silvia Montino, Silvia Sorbara, Alessandra Biffi and Marta Tremolada
Children 2025, 12(5), 574; https://doi.org/10.3390/children12050574 (registering DOI) - 29 Apr 2025
Abstract
Children with onco-hematological diseases require intensive medical treatments that can affect various aspects of their development. In addition to the disease itself, what influences the course of development most are the neurotoxic effects of therapies and frequent hospitalizations, especially if they occur in [...] Read more.
Children with onco-hematological diseases require intensive medical treatments that can affect various aspects of their development. In addition to the disease itself, what influences the course of development most are the neurotoxic effects of therapies and frequent hospitalizations, especially if they occur in the first three years of the child’s life. Among these challenges there is the potential for language delay, a condition that can impact their communication abilities and overall development. Background/Objectives: The aim of this study is to examine communicative and linguistic development in a small group of young children diagnosed with different forms of leukemia, rhabdomyosarcoma, and CNS tumors, recruited through the Hematology–Oncology Clinic of the Department of Child and Woman Health (University of Padova). Methods: Child direct (Griffiths III, PinG, PCGO) and parent indirect assessments (PVB, ABAS-II, ASCB) were provided. Results: Griffiths communication subscale scores in children were mainly below average (55.6%), and 44.4% attested at the clinical level in ABAS-II, with the ability to understand being significantly higher than the production of words. However, the two levels of assertiveness–responsiveness obtained balance in 66.7% of cases, and using the Griffiths personal subscale, only 22.2% of children attested below average. Conclusions: Understanding and addressing children’s communication needs is crucial to improve the quality of life of these young patients and foster optimal communicative and linguistic development despite the obstacles they face in order to implement interventions designed specifically for this type of population and their respective families, if necessary. Full article
(This article belongs to the Section Pediatric Hematology & Oncology)
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13 pages, 599 KiB  
Article
Sensitization Patterns to Aeroallergens and Food Allergens Among Children with Atopic Asthma in Southwestern Saudi Arabia
by Ali Alsuheel Asseri, Mashael Abdualslam Abuaqil, Abdulaziz Saud Alotaibi, Wajd Abdualslam Abuaqil, Abdulaziz Saeed Alqahtani, Lama Ali Asiri, Mona Alkhayri, Amal Y. Moshebah and Faten M. ElAbd
Children 2025, 12(5), 573; https://doi.org/10.3390/children12050573 (registering DOI) - 29 Apr 2025
Abstract
Background and Objectives: Asthma is a prevalent chronic respiratory disease in children, with increasing rates in Saudi Arabia. Allergen sensitization plays a crucial role in asthma development and severity. This study aimed to investigate the prevalence and clinical impact of aeroallergen and food [...] Read more.
Background and Objectives: Asthma is a prevalent chronic respiratory disease in children, with increasing rates in Saudi Arabia. Allergen sensitization plays a crucial role in asthma development and severity. This study aimed to investigate the prevalence and clinical impact of aeroallergen and food sensitization in children with asthma in Southwestern Saudi Arabia. Materials and Methods: A retrospective chart review was conducted at Abha Maternity and Children’s Hospital, including 194 children aged 3–12 years with atopic asthma. Sensitization to 26 common aeroallergens and food allergens was assessed using the EUROLINE Allergy test. Associations between sensitization patterns, atopic comorbidities (allergic rhinitis and eczema), and asthma-related outcomes (hospitalizations, medication use, and school absenteeism) were analyzed. Results: A high prevalence of sensitization was observed (74.2% for aeroallergens; 56.7% for food allergens). Aeroallergen sensitization was associated with older age (p < 0.001), male sex (p = 0.026), allergic rhinitis (p < 0.001), eczema (p = 0.295), and increased asthma morbidity, including hospitalizations (p = 0.002) and corticosteroid use (p = 0.012). Food sensitization was associated with eczema (p < 0.001) but did not significantly impact other asthma outcomes. Poly-sensitization was associated with a higher prevalence of eczema (p = 0.003). Dust mite sensitization was a strong independent predictor of severe asthma (adjusted odds ratio = 4.4, 95% CI = 1.7–11.8, p = 0.003). Conclusions: This study demonstrates a high prevalence of aeroallergen and food sensitization among children with atopic asthma in Southwestern Saudi Arabia, with distinct sensitization patterns and associated comorbidities. Aeroallergen sensitization, particularly to dust mites, was associated with increased asthma morbidity, highlighting the importance of comprehensive sensitization assessment in this population. While limited by its retrospective design, this study provides valuable insights into the interplay between sensitization and childhood asthma, informing future research and clinical practice. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
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28 pages, 1825 KiB  
Article
Letter and Word Processing in Developmental Dyslexia: Evidence from a Two-Alternative Forced Choice Task
by Daniela Traficante, Pierluigi Zoccolotti and Chiara Valeria Marinelli
Children 2025, 12(5), 572; https://doi.org/10.3390/children12050572 (registering DOI) - 29 Apr 2025
Abstract
Background/Objectives: The present study aimed to investigate letter processing in children with dyslexia and typically developing readers as a function of the type of orthographic context. Methods and Results: In Experiment 1A, children performed a two-alternative forced choice task (Reicher–Wheeler paradigm) using as [...] Read more.
Background/Objectives: The present study aimed to investigate letter processing in children with dyslexia and typically developing readers as a function of the type of orthographic context. Methods and Results: In Experiment 1A, children performed a two-alternative forced choice task (Reicher–Wheeler paradigm) using as probes either high-frequency words, pronounceable pseudo-words, or unpronounceable non-words. The group differences in letter recognition were clearly distinguished from those present in typical word and pseudo-word reading conditions (Experiment 1B), as a global factor was present only in the latter case. In Experiment 2, the two-alternative forced choice task required the child to search for the target letter in the subsequent multi-letter string (i.e., words, pseudo-words, or non-words), thus reducing the memory load. Detecting the target letter was more difficult in a word than in a pseudo-word or non-word array, indicating that the word form’s lexical activation interfered with the target’s analysis in both groups of children. In Experiment 3, children performed the two-alternative forced choice task with symbols (Greek letters) either in the Reicher–Wheeler mode of presentation (Experiment 3A) or in the search condition (Experiment 3B). Children with dyslexia performed identically to typically developing readers in keeping with the selectivity of their orthographic difficulties. Conclusions: The present data indicate that children with dyslexia suffer from an early deficit in making perceptual operations that require the conjunction analysis of a set of letters. Still, this deficit is not due to an inability to scan the letter string. The deficit is confined to orthographic stimuli and does not extend to other types of visual targets. Full article
(This article belongs to the Special Issue Cognitive and Linguistic Development in Children and Adolescents: 2nd Edition)
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10 pages, 235 KiB  
Article
Bronchiolitis: A Real-Life Report of Increasing Compliance to Treatment Guidelines
by Melodie O. Aricò, Francesco Accomando, Daniela Trotta, Anthea Mariani, Claudia Rossini, Claudio Cafagno, Letizia Lorusso, Enrico Valletta, Desiree Caselli and Maurizio Aricò
Children 2025, 12(5), 571; https://doi.org/10.3390/children12050571 (registering DOI) - 28 Apr 2025
Viewed by 37
Abstract
Background: Bronchiolitis accounts for a substantial number of pediatric hospitalizations and its epidemiology closely parallels that of respiratory syncytial virus (RSV), its principal etiological agent. International guidelines recommend supportive therapy based primarily on oxygen supplementation and hydration. Methods: This study aimed to assess, [...] Read more.
Background: Bronchiolitis accounts for a substantial number of pediatric hospitalizations and its epidemiology closely parallels that of respiratory syncytial virus (RSV), its principal etiological agent. International guidelines recommend supportive therapy based primarily on oxygen supplementation and hydration. Methods: This study aimed to assess, across three pediatric wards, the impact of internal monitoring and targeted educational interventions on adherence to bronchiolitis management guidelines. Focus was placed on evaluating the effectiveness of tailored strategies in enhancing the appropriateness of treatment practices. Each center independently developed an audit and feedback strategy aligned with local practices and available resources. In Center 1, monthly staff meetings included guideline refreshers throughout the epidemic season. Center 2 appointed two attending physicians to monitor treatment prescriptions and report deviations. Center 3 established an internal protocol through staff consensus, followed by monthly review sessions. In this retrospective analysis, all consecutive patients admitted with bronchiolitis during the winter seasons of 2022–2023 and 2023–2024 (Period 2) were compared with those admitted in 2021–2022 (Period 1). Results: A total of 623 infants under 24 months of age were included, 451 (72%) of whom tested positive for RSV. Their median length of hospital stay was 6 days; 26 infants (4%) required intensive care, and no deaths were recorded. A comparative analysis of the treatment modalities used—high-flow nasal cannula (HFNC) oxygen therapy, inhaled medications, corticosteroids, and antibiotics—revealed a reduced use of non-recommended therapies (e.g., nebulized β2-agonists, steroids, and antibiotics) in Period 2, alongside heterogeneous patterns in HFNC use. Center-specific strategies, tailored to team dynamics and resource availability, effectively promoted greater adherence to evidence-based guidelines. Conclusions: Our findings suggest that structured internal interventions can lead to more appropriate bronchiolitis management and the improved standardization of care. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
13 pages, 267 KiB  
Article
Effect of Physical Activity Participation on Lifestyle Habits and School Life Among Korean Children
by Seungok An, Su-Yeon Roh and Jeonga Kwon
Children 2025, 12(5), 570; https://doi.org/10.3390/children12050570 (registering DOI) - 28 Apr 2025
Viewed by 42
Abstract
Objectives: This study explored the impact of physical activity (PA) participation on the lifestyle habits and school life of Korean elementary school students. Methods: We collected survey data from 28,514 elementary school students participating in the 2023 Student Health Examination conducted by the [...] Read more.
Objectives: This study explored the impact of physical activity (PA) participation on the lifestyle habits and school life of Korean elementary school students. Methods: We collected survey data from 28,514 elementary school students participating in the 2023 Student Health Examination conducted by the Korea Ministry of Education. PA participation was the independent variable, defined as whether elementary school students participate in exercise that makes them out of breath or sweat more than three times a week. The variables related to lifestyle habits included breakfast intake, amount of sleep, TV viewing, gaming/Internet use, thoughts about running away from home, perceived body image, and body mass index. The variables for school life included experiences of being bullied, the need for counseling regarding school life problems, and the need for counseling for distress. The collected data were analyzed using frequency analysis, chi-squared tests, and multivariate logistic regression analyses. Results: PA was significantly associated with regular breakfast intake, sufficient sleep, limited television viewing, reduced gaming/Internet use, and a positive perception of body image. Specifically, regarding breakfast intake, the average odds ratio (OR) was 1.160 for always having it. Regarding the amount of sleep, the average OR was 0.836 for less than 6 h, 0.692 for 6–7 h, and 0.767 for 7–8 h. Regarding TV viewing, the average OR was 0.831 for yes. For gaming, the average OR was 0.770 for yes. Regarding perceived body image, the average OR was 1.429 for slightly thin, 1.487 for normal, and 1.400 for slightly fat. Conclusions: These results suggest that children’s PA facilitates the formation of good lifestyle habits; therefore, it should be actively encouraged in children. Full article
(This article belongs to the Special Issue Childhood and Teenage Learning, Lifestyle, Health Factors and Physical Activity in Children)
10 pages, 419 KiB  
Article
Interleukin-2 Receptor as a Marker of Oxidative Stress in Paediatric Patients with Chronic Kidney Disease or Hypertension
by Nataša Marčun Varda, Mirjam Močnik, Martina Filipič, Evgenija Homšak, Mateja Svetej and Sonja Golob Jančič
Children 2025, 12(5), 569; https://doi.org/10.3390/children12050569 (registering DOI) - 28 Apr 2025
Viewed by 31
Abstract
Background/Objectives: Oxidative stress and systemic inflammation are significant contributors to the development and progression of cardiovascular disease, causing adverse effects on vascular health and atherosclerosis from an early age. Patients with established cardiovascular risk factors commonly exhibit markers indicating heightened oxidative stress [...] Read more.
Background/Objectives: Oxidative stress and systemic inflammation are significant contributors to the development and progression of cardiovascular disease, causing adverse effects on vascular health and atherosclerosis from an early age. Patients with established cardiovascular risk factors commonly exhibit markers indicating heightened oxidative stress and inflammation. Our study sought to assess the levels of interleukin-2 receptor, which could serve as an early indicator of cardiovascular damage due to oxidative stress and inflammation in at-risk children. Methods: The study comprised 46 paediatric patients with chronic kidney disease, 50 paediatric patients with hypertension, and 33 healthy controls. Anthropometric measurements, pulse wave velocity, body composition, routine laboratory tests, and measurements of interleukin-2 receptor levels were conducted for all participants. Results: Interleukin-2 receptor levels were notably lower in patients with hypertension (p < 0.001) and those with overweight/obesity (p < 0.001) with several associated measures. Interleukin-2 receptor levels exhibited significant negative correlations with various anthropometric measurements, body composition, and liver damage and a positive correlation with kidney function tests. Conclusions: Children diagnosed with hypertension or obesity exhibited notably lower interleukin-2 receptor levels. Full article
(This article belongs to the Section Pediatric Nephrology & Urology)
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16 pages, 2241 KiB  
Review
Improving Postoperative Pediatric Recovery by Efficient Recovery Room Care—A Comprehensive Review
by Lisa Korell and Frank Fideler
Children 2025, 12(5), 568; https://doi.org/10.3390/children12050568 (registering DOI) - 28 Apr 2025
Viewed by 47
Abstract
Background/Objectives: Efficient postoperative recovery room care in pediatric patients is crucial for optimizing perioperative safety, patient outcome, and effective pain management. However, this area is frequently underemphasized, leading to higher complication rates compared to the operating room, which in turn increases healthcare [...] Read more.
Background/Objectives: Efficient postoperative recovery room care in pediatric patients is crucial for optimizing perioperative safety, patient outcome, and effective pain management. However, this area is frequently underemphasized, leading to higher complication rates compared to the operating room, which in turn increases healthcare costs. Improving pediatric recovery room care offers a significant opportunity to enhance the quality and safety of perioperative pediatric care. From an economic perspective, this is prudent; however, more importantly, every child has the right to the highest attainable standard of health, as outlined by the United Nations. Key aspects of recovery room care include ensuring adequate staffing and equipment, while also prioritizing the child’s privacy and parental presence, both of which are crucial for enhancing patient well-being. A +multimodal approach to postoperative pain management is essential for minimizing fear and stress, alongside strict adherence to established guidelines for the management of postoperative nausea, vomiting, and emergence delirium. Furthermore, addressing risk factors such as hypothermia and airway complications, as well as promoting early intake of clear fluids, plays a crucial role in optimizing pediatric recovery. Organizational strategies such as quality improvement initiatives, structured handovers, standardized care protocols with checklists, continuous staff training, and well-defined discharge criteria are further essential components to reduce translational gaps and to enhance postoperative pediatric safety. Conclusions: Improving pediatric postoperative anesthetic care is a multifaceted challenge for all healthcare providers that can significantly enhance care quality and safety while also reducing costs. Success in this area requires addressing both structural and medical factors. Full article
(This article belongs to the Section Pediatric Anesthesiology, Perioperative and Pain Medicine)
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12 pages, 537 KiB  
Article
Intraoperative Methadone Versus Non-Methadone Analgesia in Pediatric Cardiac Surgery: A Retrospective Cohort Study
by Brian Blasiole, Danielle R. Lavage, Hsing-Hua Sylvia Lin, Scott E. Licata, Sahana Sivam, Inesh Sivam, Laura M. Le and Senthilkumar Sadhasivam
Children 2025, 12(5), 567; https://doi.org/10.3390/children12050567 (registering DOI) - 28 Apr 2025
Viewed by 42
Abstract
Introduction: Methadone is an opioid-sparing opioid and it is increasingly used in children undergoing surgery due to its beneficial effects on postoperative pain scores, decreased opioid requirements, and fewer adverse effects compared to other opioids. Intraoperative methadone is not well studied in pediatric [...] Read more.
Introduction: Methadone is an opioid-sparing opioid and it is increasingly used in children undergoing surgery due to its beneficial effects on postoperative pain scores, decreased opioid requirements, and fewer adverse effects compared to other opioids. Intraoperative methadone is not well studied in pediatric cardiac surgery. We hypothesized that intraoperative methadone-based analgesia would provide comparable effectiveness in pain management to non-methadone-based analgesia, including caudal morphine, following pediatric cardiac surgery. Methods: We conducted a retrospective cohort study of 287 children undergoing cardiac surgery using single institutional electronic health records with Society of Thoracic Surgeons database outcomes. Patients were administered intravenous opioids plus caudal morphine (≤6 years) or intravenous opioids in the non-methadone group versus intravenous methadone (two 0.1 mg/kg doses given intraoperatively) with or without additional intraoperative opioids. The primary outcome was postoperative opioid use in morphine milligram equivalents (MME)/kg. Results: This study included 287 pediatric cardiac surgical patients with a mean age of 3.8 years, 59% male, and 72% White. Among 287 patients, 67 (23%) received intraoperative methadone. Unadjusted analysis showed the methadone group had lower postoperative opioid use on the day of surgery (median = 0.3 vs. 0.5 MME/kg, p = 0.005). Adjusted analyses showed there were no significant differences in postoperative opioid use, average pain, maximum pain, antiemetic use, reintubation, and use of naloxone between methadone and non-methadone groups. Hospital length of stay was 2.62 times longer (95% CI: [1.55, 4.41] p < 0.001) in the methadone group vs non-methadone group, but this was only shown in the younger children (≤6 years), who also had higher max pain scores in the methadone group. All outcomes were similar between analgesia groups in older children (>6 years). Conclusions: Intraoperative methadone-based analgesia had comparable effectiveness in postoperative opioid use, pain, and antiemetic use compared to non-methadone-based intraoperative pain management for pediatric cardiac surgery. Large prospective studies of perioperative methadone are needed to examine methadone’s analgesic benefits in children undergoing cardiac surgery. Full article
(This article belongs to the Special Issue Future Directions in Pediatric Perioperative Care: Enhanced Recovery, Regional Analgesia and Personalized Medicine)
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17 pages, 817 KiB  
Review
Cultural Approaches to Addressing Sleep Deprivation and Improving Sleep Health in Japan: Sleep Issues Among Children and Adolescents Rooted in Self-Sacrifice and Asceticism
by Jun Kohyama
Children 2025, 12(5), 566; https://doi.org/10.3390/children12050566 (registering DOI) - 27 Apr 2025
Viewed by 164
Abstract
This narrative review examines the issue of sleep deprivation among children and adolescents in Japan, exploring its cultural origins and evaluating the current state of sleep education and interventions. It emphasizes the profound influence of the Bushidō spirit, with its focus on self-sacrifice [...] Read more.
This narrative review examines the issue of sleep deprivation among children and adolescents in Japan, exploring its cultural origins and evaluating the current state of sleep education and interventions. It emphasizes the profound influence of the Bushidō spirit, with its focus on self-sacrifice and asceticism, as a core factor in the undervaluation of sleep in Japanese society. While educational initiatives and interventions highlighting the importance of sleep exist, significant limitations remain in improving sleep habits. Sleep deprivation continues to affect children and adolescents, despite its considerable impact on mental health and academic performance. This review presents a method for personalized sleep duration estimation and assesses its potential impact on improving sleep health by using optimal sleep duration calculations. The review also proposes practical steps to improve sleep duration through individualized strategies, integrating cultural context to mitigate the serious health risks associated with insufficient sleep. Ultimately, it underscores the need for targeted strategies to improve sleep among children and adolescents—particularly through personalized optimal sleep duration estimation—while advocating for a shift in cultural perspective beyond self-sacrifice and asceticism. The review highlights the importance of cultural transformation and suggests future research directions and practical applications. Full article
(This article belongs to the Special Issue Health Behaviour, Health Literacy and Mental Health in Children: 2nd Edition)
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18 pages, 3384 KiB  
Article
Altered Brain Functional Connectivity and Topological Structural in Girls with Idiopathic Central Precocious Puberty: A Graph Theory Analysis Based on Resting-State fMRI
by Lu Tian, Yan Zeng, Helin Zheng and Jinhua Cai
Children 2025, 12(5), 565; https://doi.org/10.3390/children12050565 (registering DOI) - 27 Apr 2025
Viewed by 128
Abstract
Objectives: This study aimed to investigate changes in brain functional connectivity (FC) and topological structure in girls with idiopathic central precocious puberty (ICPP) using complex network theory analysis. Methods: Resting-state fMRI data from 53 ICPP girls (ages 6–8) and 51 controls were analysed. [...] Read more.
Objectives: This study aimed to investigate changes in brain functional connectivity (FC) and topological structure in girls with idiopathic central precocious puberty (ICPP) using complex network theory analysis. Methods: Resting-state fMRI data from 53 ICPP girls (ages 6–8) and 51 controls were analysed. Graph theory was used to construct whole-brain functional networks, identify topological differences, and assess the relationship between sex hormone levels and network properties in regions with group differences. Results: RS-FC analysis revealed reduced connectivity in cognitive and emotional regulation regions in the ICPP group (p < 0.05), but enhanced connectivity in emotional perception and self-regulation areas, such as the amygdala and insula (p < 0.05), suggesting a compensatory mechanism. Graph theory showed that ICPP girls’ brain networks maintained small-world properties (γ > 1, λ ≈ 1, σ > 1). Local topological changes included decreased clustering and node efficiency in cognitive and emotional regulation regions, like the superior frontal gyrus and praecuneus (p < 0.05), while emotional regulation regions (amygdala, insula) showed increased clustering and node efficiency (p < 0.05), indicating compensation. Conclusions: This study highlights compensatory mechanisms in emotional regulation that may offset impairments in cognitive regions, offering new insights into ICPP’s neural mechanisms. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
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5 pages, 1862 KiB  
Case Report
Treatment of a Large Hemorrhagic Midbrain Cavernoma Within the Silvian Aqueduct in a Five-Year-Old Girl—A Case Report
by Matthias Krause, Armin-Johannes Michel, Johannes Koch, Johann Gradl, Johannes A. R. Pfaff, Christoph J. Griessenauer and Lorenz Stana-Hackenberg
Children 2025, 12(5), 564; https://doi.org/10.3390/children12050564 (registering DOI) - 26 Apr 2025
Viewed by 95
Abstract
Brain stem cavernomas are exceedingly rare in pediatric populations, with limited literature addressing their natural history, treatment guidelines, and counseling. We report the case of a 5-year-old girl presenting with acute neurological symptoms, including diplopia, gait ataxia, headache, and altered consciousness. Initial imaging [...] Read more.
Brain stem cavernomas are exceedingly rare in pediatric populations, with limited literature addressing their natural history, treatment guidelines, and counseling. We report the case of a 5-year-old girl presenting with acute neurological symptoms, including diplopia, gait ataxia, headache, and altered consciousness. Initial imaging revealed obstructive hydrocephalus caused by a hemorrhagic lesion near the pineal region. After emergency external ventricular drainage (EVD), most symptoms resolved except for diplopia. A subsequent MRI suggested a space-occupying hemorrhagic cyst in the tectal lamina, leading to endoscopic third ventriculostomy (ETV). During ETV, a large hemorrhagic mass at the aqueduct entrance was identified but not removed due to its fragility. Following ETV, the patient improved rapidly and was discharged. However, she was readmitted with recurrent symptoms and altered consciousness. An emergency MRI indicated a progressive hemorrhagic mass lesion compressing the midbrain, necessitating surgical intervention. The patient underwent suboccipital craniotomy using a telovelar approach. The intraoperative findings included cavernoma-like tissue within the aqueduct, which was successfully resected. Histopathology confirmed hemorrhagic and angiomatous tissue, excluding a primary brain tumor. Postoperatively, the patient showed significant, progressive neurological improvement, with mild internuclear strabism, trunk ataxia, and fatigue at the last follow-up. Six months later, a follow-up MRI and cerebral angiography showed no cavernoma remnants but identified a midbrain deep venous anomaly. This case underscores the feasibility of the microsurgical resection of midbrain cavernomas in symptomatic pediatric patients, highlighting the importance of the thorough assessment of atypical hemorrhagic midbrain lesions to exclude rare vascular malformations from differential diagnoses. Full article
(This article belongs to the Section Pediatric Surgery)
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10 pages, 414 KiB  
Article
Associations Between Relative Age, Siblings, and Motor Competence in Children and Adolescents
by Daniel González-Devesa, José Carlos Diz-Gómez, Pedro Vicente-Vila, Marta Domínguez Fernández, Miguel Rodríguez Rodríguez, Rocío Carballo-Afonso, Miguel Adriano Sanchez-Lastra and Carlos Ayán-Pérez
Children 2025, 12(5), 563; https://doi.org/10.3390/children12050563 (registering DOI) - 26 Apr 2025
Viewed by 113
Abstract
Background: Motor competence is a key determinant of children’s physical, cognitive, and social development, and it is influenced by various biological and environmental factors. Among these, relative age and the presence of siblings have been proposed as potential contributors, yet their impact remains [...] Read more.
Background: Motor competence is a key determinant of children’s physical, cognitive, and social development, and it is influenced by various biological and environmental factors. Among these, relative age and the presence of siblings have been proposed as potential contributors, yet their impact remains underexplored, especially in school-aged populations. Objective: This study investigates the influence of relative age and the effects of the presence of siblings on the motor competence of children and adolescents. Methods: The motor competence level of 747 students, 381 from primary school (mean age = 8.81 ± 1.8 years) and 366 from secondary school (mean age = 13.52 ± 1.22 years), was measured by the means of the Canadian Agility and Movement Skill Assessment. Participants were queried about their birth date and whether they had any older siblings. Results: Overall, motor competence exhibited an upward trend with chronological age, reaching its peak among children aged 14 years old. Analysis revealed a significant impact of relative age effects on motor competence among primary children, with considerably higher scores in the first semester (p = 0.017). Conversely, no clear trend was observed for secondary children. Having siblings did not significantly affect motor competence proficiency. Multiple regression analysis further confirmed that relative age did not contribute to this lack of association (quarter of birth: p = 0.003; β = −0.144; siblings: p = 0.697; β = −0.019). Conclusions: These findings suggest that physical education teachers should be aware of the influence of relative age not only when assessing motor competence but also when designing and implementing their teaching practice in primary school settings. In contrast, the effect of relative age appears to be less significant in secondary education, where it may be less relevant for both evaluation and teaching practice. Further research should explore longitudinal designs and consider additional psychosocial and environmental variables to better understand how these factors influence motor competence development over time. Full article
(This article belongs to the Special Issue Physical Activity and Physical Fitness Among Children and Adolescents)
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13 pages, 866 KiB  
Article
Orthodontic Management of Class II Malocclusion with Clear Aligners: Mandibular Advancement vs. Class II Elastics
by Elisabetta Cretella Lombardo, Letizia Lugli, Roberta Lione, Patrizio Bollero, Paola Cozza and Chiara Pavoni
Children 2025, 12(5), 562; https://doi.org/10.3390/children12050562 (registering DOI) - 26 Apr 2025
Viewed by 110
Abstract
Background: This cephalometric study aimed to evaluate the effects of clear aligner therapy in growing individuals with Class II malocclusion, comparing two functional approaches: the use of Class II elastics or the Mandibular Advancement (MA). Methods: Cephalometric data from 39 patients [...] Read more.
Background: This cephalometric study aimed to evaluate the effects of clear aligner therapy in growing individuals with Class II malocclusion, comparing two functional approaches: the use of Class II elastics or the Mandibular Advancement (MA). Methods: Cephalometric data from 39 patients with Class II malocclusion treated using clear aligners either combined with Class II elastics (EL group; n = 18) or Mandibular Advancement (MA group; n = 21) were analyzed and compared with an untreated control group (UC2; n = 15). Results: Both treatment groups (EL and MA) showed a significant reduction in the ANB angle compared to the control (MA: −1.5°; EL: −2.2°; UC2: +0.2°). An increase in mandibular length, as measured by Co–Gn, was observed in both the EL and MA groups (+5.5 mm and +8.3 mm, respectively) relative to the control group. Soft tissue analysis of the Pg–TVL distance from T1 to T2 revealed the most substantial forward displacement of the chin in the MA group (MA: +2.0 ± 3.7 mm; EL: +0.5 ± 0.7 mm; UC2: −1.6 ± 3.3 mm). Vertically, the MA group exhibited a more marked decrease in the palatal-mandibular plane angle than the other groups. Both treatment modalities significantly reduced overjet and overbite from T1 to T2. Conclusions: The EL and MA appliances effectively advanced the mandible, leading to significant improvements in the sagittal relationship, overjet, and overbite while maintaining stable vertical control. Additionally, the MA group exhibited a more pronounced forward movement of the soft tissue chin. Full article
(This article belongs to the Special Issue Prevention and Orthodontic Treatment of Malocclusion in Children)
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21 pages, 303 KiB  
Article
Neuropsychological and Academic Performance in Colombian Children with Attention-Deficit Hyperactivity Disorder: A Comparative Study with a Control Group
by Daniel Landínez-Martínez, Diana Montoya-Londoño, Lorena Aguirre-Aldana, Carmen Dussán-Lubert, Carolina Robledo-Castro and Antonio Partida-Gutierrez de Blume
Children 2025, 12(5), 561; https://doi.org/10.3390/children12050561 (registering DOI) - 26 Apr 2025
Viewed by 163
Abstract
Objective: This study aimed to determine the effect of ADHD on the neuropsychological and academic performance of a sample of Colombian children in primary and secondary education compared to a control group. Method: Quasi-experimental research design involving a sample of 194 children from [...] Read more.
Objective: This study aimed to determine the effect of ADHD on the neuropsychological and academic performance of a sample of Colombian children in primary and secondary education compared to a control group. Method: Quasi-experimental research design involving a sample of 194 children from Manizales, of whom 97 were diagnosed with ADHD and 97 were typically developing children. The study utilized tasks from the Child Neuropsychological Assessment (ENI) protocol to assess academic and neuropsychological performance. Results: Children with ADHD exhibited lower cognitive, linguistic, and attentional performance with greater variability than their neurotypical peers. They showed deficits in IQ, metalinguistic skills, reading, writing, memory, attention, and executive function, with increased errors and heterogeneity across tasks. Conclusions: For future research, it is necessary to address ADHD through mixed-methods studies that enrich quantitative findings with the lived experiences of children and families affected by ADHD. Additionally, further exploration is needed regarding functional impairment assessment in the Colombian and broader Ibero-American context, including its correlation with later academic performance in higher education. Full article
(This article belongs to the Special Issue Attention Deficit/Hyperactivity Disorder in Children and Adolescents)
7 pages, 17136 KiB  
Case Report
Novel KIF11 Mutation Associated with Microcephaly, Chorioretinopathy and Impaired Intellectual Development: 20 Years of Follow-Up
by Ashley H. Yaskanich, Ami Patel and Monique Leys
Children 2025, 12(5), 560; https://doi.org/10.3390/children12050560 (registering DOI) - 26 Apr 2025
Viewed by 117
Abstract
Background: KIF11 mutations are responsible for a large portion of microcephaly with or without chorioretinopathy, lymphedema or impaired intellectual development (MCLMR). Methods: This report describes longitudinal ophthalmological management of an 8-year-old male pediatric patient presenting with MCLMR diagnosed in infancy and [...] Read more.
Background: KIF11 mutations are responsible for a large portion of microcephaly with or without chorioretinopathy, lymphedema or impaired intellectual development (MCLMR). Methods: This report describes longitudinal ophthalmological management of an 8-year-old male pediatric patient presenting with MCLMR diagnosed in infancy and associated with a novel, de novo KIF11 mutation. Results: The patient presented with ophthalmological features of low visual acuity and chorioretinal atrophy and later developed bilateral retinal detachments. Syndromic features included microcephaly and developmental delay. Scleral buckling and vitrectomy were ultimately performed in both eyes, with a period of conservative management in the interim. Postoperative visual acuity was preserved in the right eye, although poor in the left eye. The patient received low-vision rehabilitation services and was able to participate in school and extracurricular activities. Conclusions: Early recognition and close monitoring of ocular and systemic manifestations of KIF11 mutations are important to optimize visual rehabilitation efforts. Full article
(This article belongs to the Special Issue Developmental Disabilities in Children: Intervention Programmes)
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29 pages, 649 KiB  
Review
Options for Regenerative Treatment with Bone Grafts in Children with Anterior Lip/Palate Cleft—A Review
by Anna Miguel-Escribano, Cosimo Galletti, Juan de Quixano-Bardaji, Francisco Real-Voltas, Luca Fiorillo, Maria Cuevas-Nunez, Fulvia Galletti and Javier Flores-Fraile
Children 2025, 12(5), 559; https://doi.org/10.3390/children12050559 (registering DOI) - 26 Apr 2025
Viewed by 164
Abstract
Anterior lip/palate cleft is a congenital deformity affecting the upper lip and palate, posing significant challenges in both aesthetic and functional aspects for children. Effective management of this condition is crucial for improving quality of life and ensuring normal development. This review aims [...] Read more.
Anterior lip/palate cleft is a congenital deformity affecting the upper lip and palate, posing significant challenges in both aesthetic and functional aspects for children. Effective management of this condition is crucial for improving quality of life and ensuring normal development. This review aims to highlight the regenerative treatment options available for children with anterior lip/palate cleft, focusing on the use of bone grafts and other advanced dental procedures. A review of the current literature and clinical practices was conducted to identify and evaluate the most effective treatment options. Emphasis was placed on regenerative techniques, particularly the use of bone grafts. Advancements in regenerative dentistry offer promising outcomes for children with anterior lip/palate cleft. Bone grafts, combined with innovative techniques such as growth factors, stem cell therapy, and distraction osteogenesis, provide effective solutions for restoring function and aesthetics. A multidisciplinary approach is essential to ensure comprehensive care and optimal results for these patients. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
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7 pages, 188 KiB  
Article
Middle Ear Disorders in Children with Down Syndrome: The Detrimental Effect on Speech and Language Development
by Ariel Tenenbaum, Avraham Ben Yaakov, Yair Peled, Malena Cohen-Cymberknoh, Diana Averbuch, Ronit Brodie and Menachem Gross
Children 2025, 12(5), 558; https://doi.org/10.3390/children12050558 (registering DOI) - 25 Apr 2025
Viewed by 74
Abstract
Objectives: Our aim was to determine the prevalence of middle ear disorders and associated risk factors that contribute to speech and language developmental delays in children with Down Syndrome. Methods: A prospective, cross-sectional study was conducted in 70 children with Down [...] Read more.
Objectives: Our aim was to determine the prevalence of middle ear disorders and associated risk factors that contribute to speech and language developmental delays in children with Down Syndrome. Methods: A prospective, cross-sectional study was conducted in 70 children with Down Syndrome between the ages of 1 and 18. Data, including complete physical and otorhinolaryngological examinations, hearing tests, and evaluation of speech and language skills, was compared to a historic typical control group. Results: Recurrent otitis media was significantly higher in the study group (56.5%) compared to the control (26%) (p = 0.05). The rate of conductive hearing loss was significantly higher in the study group (71.2%) compared to the control (14.9%) (p = 0.0001). Conductive hearing loss was statistically associated with delayed speech development (p = 0.046). Conclusions: Middle ear disorders are common in children with Down Syndrome and are associated with conductive hearing loss and delay of speech and language development. This study emphasizes the importance of routine examination of this population by an Otorhinolaryngologist and speech therapist. Full article
(This article belongs to the Special Issue Hearing Loss in Children: The Present and a Challenge for Future)
10 pages, 205 KiB  
Article
Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
by Isabella Mei Yan Cheung, Tary Yin and Akilesh Gokul
Children 2025, 12(5), 557; https://doi.org/10.3390/children12050557 - 25 Apr 2025
Viewed by 69
Abstract
Background/Objectives: Some ophthalmic antibiotics are publicly subsidised in New Zealand (NZ) for off-label use in the ear, however, this utilisation has not previously been described. This study compared the utilisation of ophthalmic chloramphenicol and ciprofloxacin in the eye and ear, among NZ children. [...] Read more.
Background/Objectives: Some ophthalmic antibiotics are publicly subsidised in New Zealand (NZ) for off-label use in the ear, however, this utilisation has not previously been described. This study compared the utilisation of ophthalmic chloramphenicol and ciprofloxacin in the eye and ear, among NZ children. Methods: This study involved clinical record review, and included 11,617 prescriptions of ophthalmic chloramphenicol and ciprofloxacin in 2022, for children aged five years or under in Auckland, NZ. Prescriptions of chloramphenicol and ciprofloxacin for eye and ear use were compared by: patient age, gender, ethnicity and socioeconomic deprivation, indication, community or hospital prescribing and number of repeat prescriptions. Statistical analysis was performed using Chi-squared test and multinomial regression. Results: Most ophthalmic ciprofloxacin was used in the ear (84%). In contrast, almost all chloramphenicol was used in the eye (96%). Post-operative use following tympanostomy tube insertion accounted for half of all hospital-prescribed ophthalmic ciprofloxacin used in the ear. Utilisation of chloramphenicol and ciprofloxacin in the eye and ear was similar, with more prescriptions for children aged one year and males, and most children received only one prescription. Māori and Pacific children generally received fewer prescriptions. Pacific children were more likely than Māori children to receive hospital-prescribed ophthalmic ciprofloxacin for use in the ear (adjusted OR 6.7, p = 0.025). Conclusions: These findings highlight the utilisation of ophthalmic ciprofloxacin in the ear in NZ children. These findings will inform decision-making in the public funding of medications, policy development in equitable medication access, and more collaborative efforts to improve antimicrobial use. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Ear and Vestibular Disorders)
14 pages, 1598 KiB  
Review
Modern Treatment of Supracondylar Humeral Fractures in Children
by Adrian Surd, Rodica Muresan, Carmen Iulia Ciongradi, Lucia Maria Sur, Lucia Raluca Ardelean, Lia Oxana Usatiuc, Kriszta Snakovszki, Camelia Munteanu and Ioan Sârbu
Children 2025, 12(5), 556; https://doi.org/10.3390/children12050556 - 25 Apr 2025
Viewed by 81
Abstract
Supracondylar humeral fractures are the most common type of elbow fractures in children. The treatment methods vary depending on the type of fracture (Gartland classification), which can be conservative or surgical. There is no clear consensus or guidelines to dictate the treatment of [...] Read more.
Supracondylar humeral fractures are the most common type of elbow fractures in children. The treatment methods vary depending on the type of fracture (Gartland classification), which can be conservative or surgical. There is no clear consensus or guidelines to dictate the treatment of complicated supracondylar humeral fractures (Gartland types II and III). Gartland type II and III fractures are most frequently treated with closed reduction and percutaneous Kirchner-wire pinning or open reduction with K-wire pinning, depending on the degree of displacement and the orthopedic surgeon’s preference. Most studies recommend avoiding open reduction because of prolonged hospitalization and higher rates of complications. Orthopedic surgeons have different opinions regarding the Kirschner pin placement technique. Studies suggest that only lateral pinning is safe and effective, but medial and lateral pinning is proven to give more stability; there is always a risk of iatrogenic ulnar nerve damage during surgery. Modern treatment of supracondylar humeral fracture in children should focus on minimally invasive techniques and avoid open reduction, when possible, to ensure the best outcome for the patients. This scoping review’s purpose is to gather the available information on the topic in one place and to underline the lack of clear protocols. Full article
(This article belongs to the Special Issue Pediatric Orthopedic Injuries: Diagnosis and Treatment)
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23 pages, 1007 KiB  
Systematic Review
How Is the Digital Age Shaping Young Minds? A Rapid Systematic Review of Executive Functions in Children and Adolescents with Exposure to ICT
by Reinaldo Maeneja, Joana Rato and Inês Saraiva Ferreira
Children 2025, 12(5), 555; https://doi.org/10.3390/children12050555 - 25 Apr 2025
Viewed by 275
Abstract
Objectives: This review assesses how daily exposure to Information and Communication Technologies (ICTs) affects executive functions in children and adolescents and explores the roles of parents in mitigating potential negative impacts on cognitive development and emotional regulation. Methods: Following PRISMA guidelines, [...] Read more.
Objectives: This review assesses how daily exposure to Information and Communication Technologies (ICTs) affects executive functions in children and adolescents and explores the roles of parents in mitigating potential negative impacts on cognitive development and emotional regulation. Methods: Following PRISMA guidelines, a systematic search was conducted from 2022 to 2024 using PubMed, Scopus, and Cochrane Library. The study criteria included cohort studies, randomized controlled trials (RCTs), quasi-RCTs, and systematic reviews. Data extraction and risk-of-bias assessments were performed using ROBIS and ROBINS-E tools. Due to the heterogeneity of the results, a narrative synthesis was carried out. Results: Ten studies were included for analysis, comprising a total of 231,117 children from nine countries on three continents. Most studies indicated that excessive ICT exposure negatively affects executive functions, particularly working memory, inhibitory control, cognitive flexibility, and attention. Adverse effects were linked to increased screen time, poor sleep quality, and multitasking. However, two studies found no significant association, highlighting the influence of contextual factors like socioeconomic status, parental mediation, and screen content type. Shared ICT use with parents or siblings appeared to reduce negative effects. Conclusions: Excessive ICT exposure is associated with impaired executive function development in children and adolescents. Parental supervision and structured ICT use may mitigate risks. Future research should investigate moderating factors, such as socioeconomic status and ICT content, to develop guidelines for healthy digital engagement in youth. Full article
(This article belongs to the Special Issue Effects of Screen Time on Children’s Mental, Social, and Cognitive Health)
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19 pages, 689 KiB  
Article
Adolescents’ Assessment of Several Step Tracker Mobile Applications Based on Their Previous Level of Physical Activity
by Nerea Gómez-Cuesta, Adrián Mateo-Orcajada, Lourdes Meroño, Lucía Abenza-Cano and Raquel Vaquero-Cristóbal
Children 2025, 12(5), 554; https://doi.org/10.3390/children12050554 - 25 Apr 2025
Viewed by 100
Abstract
Background: Adolescents’ use of step tracker mobile applications (apps) could be influenced by their assessment of the mobile app used. Objectives: To analyze differences in the dropout rate, app assessment, and problematic mobile phone use based on prior physical activity levels and the [...] Read more.
Background: Adolescents’ use of step tracker mobile applications (apps) could be influenced by their assessment of the mobile app used. Objectives: To analyze differences in the dropout rate, app assessment, and problematic mobile phone use based on prior physical activity levels and the app used. Methods: A study with a quasi-experimental design was carried out with the participation of 240 adolescents, who were further categorized as either active or inactive. The adolescents carried out a 10-week intervention promoted as a part of the physical education curriculum, three days a week, in which they randomly used the Pokémon Go, MapMyWalk, Pacer, or Strava mobile apps after school for cardiorespiratory training. Results: The results showed a higher dropout rate from Pokémon Go in the group of inactive adolescents (p = 0.012). No differences were found in the assessment of apps based on the level of activity of the adolescents, neither overall nor when analyzing this question based on the app used (p > 0.05). As for problematic mobile phone use, only previously inactive adolescents assigned to the Pacer group significantly increased their final score after the intervention (p = 0.044), with no changes being identified in the other groups or apps (p > 0.05). Furthermore, the active adolescents showed a positive relationship between the volume of training and problematic mobile phone use (p = 0.023), specifically with the conflicting use of this device (p = 0.017). Conclusions: The inactive adolescents had a higher dropout rate when using Pokémon Go. There were no differences in app assessment between the active and the inactive participants. However, the active adolescents showed a link between their training volume and problematic mobile phone use. Full article
(This article belongs to the Special Issue Promotion of Physical Activity in Children and Adolescents from the School Setting)
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Article
Anxiety in Children: The Contribution of Parental Characteristics
by Beáta Bécsi, Jenifer Pataki and Gergő József Szőllősi
Children 2025, 12(5), 553; https://doi.org/10.3390/children12050553 - 25 Apr 2025
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Abstract
Background/Objectives: The prevalence of behavioral problems and mental health issues, including anxiety, among children is rising, potentially affecting their long-term well-being and social functioning. Therefore, this study aims to identify the key determinants of children’s health status, with a particular focus on [...] Read more.
Background/Objectives: The prevalence of behavioral problems and mental health issues, including anxiety, among children is rising, potentially affecting their long-term well-being and social functioning. Therefore, this study aims to identify the key determinants of children’s health status, with a particular focus on parental mental health, health behaviors, and socio-demographic factors. Methods: The data were sourced from a Hungarian representative database from 2019. The analysis was executed using multivariate and multiple logistic regressions. Results: Our sample consisted of data from 5603 individuals, of which 775 (14%) completed the children’s module. Significant associations were found between the parent’s tertiary education level (AOR = 3.93 [1.89–8.16]) and the child’s restlessness and anxiety, as well as between the parent’s existing depression and the child’s behavioral difficulties (AOR = 3.22 [1.97–5.28]) and anxiety (AOR = 2.43 [1.37–4.30]). Additionally, a significant association was observed between the parent’s secondary education level (AOR = 3.53 [1.51–8.27]) and the child’s health problems, which was also associated with cases of tertiary education (AOR = 3.17 [1.16–8.69]). Conclusions: Our findings suggest that parental education and mental health significantly influence children’s psychological and overall health, which is why targeted prevention and health promotion strategies are essential to support both children and families. Full article
(This article belongs to the Special Issue Health Behaviour, Health Literacy and Mental Health in Children: 2nd Edition)
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