Journal Description
Children
Children
is an international, peer-reviewed, open access journal on children’s health published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Pediatrics)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 13.8 days after submission; acceptance to publication is undertaken in 2.5 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.4 (2022);
5-Year Impact Factor:
2.6 (2022)
Latest Articles
Comparison between the Clancy Behavior Scale and the Modified Checklist for Autism in Toddlers in Taiwan
Children 2024, 11(5), 557; https://doi.org/10.3390/children11050557 - 06 May 2024
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(1) Background: Precise diagnosis and early intervention are crucial for toddlers with autism spectrum disorder (ASD) to achieve a better prognosis. This study investigated the efficacy of the Clancy Behavior Scale (CBS) and Modified Checklist for Autism in Toddlers (M-CHAT) in detecting ASD
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(1) Background: Precise diagnosis and early intervention are crucial for toddlers with autism spectrum disorder (ASD) to achieve a better prognosis. This study investigated the efficacy of the Clancy Behavior Scale (CBS) and Modified Checklist for Autism in Toddlers (M-CHAT) in detecting ASD among toddlers under 30 months of age. (2) Methods: A total of 215 toddlers (117 with ASD and 98 with development delays) aged between 18 and 29 months participated in this study. All the primary caregivers of these toddlers were recruited to complete the CBS and M-CHAT. (3) Results: The findings indicated that the accuracy of the CBS and M-CHAT was promising, and the short forms of these two instruments performed better than their full versions. The CBS:9 critical items presented a sensitivity of 0.75 and a specificity of 0.74, while the M-CHAT:14 brief items showed a sensitivity of 0.72 and a specificity of 0.85. (4) Conclusions: The diagnostic accuracy of high-risk ASD toddlers improved via the combination of CBS and M-CHAT, particularly when the information gathered from these two instruments were consistent. The findings may provide implications for enhancing the early detection of ASD.
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Open AccessReview
Dysfunctional Breathing in Children: A Literature Review
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Georgia Karkouli, Konstantinos Douros, Dafni Moriki, Paraskevi Moutsatsou, Ioanna Giannopoulou, Eirini Maratou and Despoina Koumpagioti
Children 2024, 11(5), 556; https://doi.org/10.3390/children11050556 - 06 May 2024
Abstract
Dysfunctional breathing (DB) describes a respiratory condition that is mainly characterized by abnormal breathing patterns, affecting both children and adults, often leading to intermittent or chronic complaints and influencing physiological, psychological, and social aspects. Some symptoms include breathlessness; dizziness; palpitations; and anxiety, while
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Dysfunctional breathing (DB) describes a respiratory condition that is mainly characterized by abnormal breathing patterns, affecting both children and adults, often leading to intermittent or chronic complaints and influencing physiological, psychological, and social aspects. Some symptoms include breathlessness; dizziness; palpitations; and anxiety, while its classification lies in breathing pattern disorders and upper airway involvement. Its prevalence among the pediatric population varies with a female overrepresentation, while the existence of comorbidities in DB, such as asthma, gastro-esophageal reflux, nasal diseases, and anxiety/depression, frequently leads to misdiagnosis or underdiagnosis and complicates therapeutic approaches. The basic diagnostic tools involve a detailed history, physical examination, and procedures such as structured light plethysmography, cardiopulmonary exercise testing, and laryngoscopy when a laryngeal obstruction is present. The management of DB presumes a multidimensional approach encompassing breathing retraining, disease-specific advice through speech and language therapy in the presence of laryngeal obstruction, psychotherapy for fostering self-efficacy, and surgical therapy in a structural abnormality. The current review was developed to provide a summary of classifications of DB and epidemiological data concerning the pediatric population, comorbidities, diagnostic tools, and therapeutic approaches to enhance the comprehension and management of DB in children.
Full article
(This article belongs to the Special Issue Updates on Lung Function, Respiratory and Asthma Disease in Children)
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Open AccessArticle
Evaluation of the Psychometric Properties of the Movement Assessment Battery Second Edition (M-ABC2): A Cross-Sectional Study
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Eleonora Scarfò, Michela Ranucci, Anna Berardi, Rachele Simeon and Giovanni Galeoto
Children 2024, 11(5), 555; https://doi.org/10.3390/children11050555 - 05 May 2024
Abstract
This cross-sectional study assessed the psychometric properties of the movement assessment battery for children second edition (M-ABC2) in Italian children with typical development, focusing on reliability and percentile rank establishment. The M-ABC2 is widely utilized but lacks validation in Italian populations. One hundred
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This cross-sectional study assessed the psychometric properties of the movement assessment battery for children second edition (M-ABC2) in Italian children with typical development, focusing on reliability and percentile rank establishment. The M-ABC2 is widely utilized but lacks validation in Italian populations. One hundred and eight children were recruited. Test-retest reliability was evaluated using intra-class correlation coefficients (ICCs), indicating good to excellent reliability across age groups, albeit with outliers requiring further scrutiny. Standard scores and percentile ranks were established, revealing age-related variations in motor performance. Noteworthy differences in completion times and error rates were observed among the age groups, highlighting the dynamic nature of motor development. While the findings provide valuable insights for clinicians and researchers, limitations such as sample size and geographic representation should be addressed in future studies. This study underscores the importance of employing reliable assessment tools for comprehensive understanding and effective intervention in pediatric motor development.
Full article
(This article belongs to the Special Issue Early Detection, Diagnosis, Psychological and Cognitive Assessment and Intervention in Children with Neurodevelopmental Disorder)
Open AccessCase Report
Use of an Orthodontic and Otolaryngological Approach in an Infant with Holoprosencephaly
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Angela Galeotti, Giovanni Carlo De Vincentiis, Emanuela Sitzia, Giuseppe Marzo, Wanda Maldonato, Gaia Bompiani, Maria Beatrice Chiarini Testa, Alessandra Putrino, Andrea Bartuli and Paola Festa
Children 2024, 11(5), 554; https://doi.org/10.3390/children11050554 - 05 May 2024
Abstract
Holoprosencephaly is a complex human brain malformation resulting from incomplete cleavage of the prosencephalon into both hemispheres. Congenital nasal pyriform aperture stenosis (CNPAS) is sometimes found in patients with mild forms of holoprosencephaly. Surgical treatment is required. Low-invasive surgical approaches involve balloon dilation
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Holoprosencephaly is a complex human brain malformation resulting from incomplete cleavage of the prosencephalon into both hemispheres. Congenital nasal pyriform aperture stenosis (CNPAS) is sometimes found in patients with mild forms of holoprosencephaly. Surgical treatment is required. Low-invasive surgical approaches involve balloon dilation of the pyriform opening. We present the case of an 8-day-old girl diagnosed with holoprosencephaly, CNPAS, and the presence of a solitary median maxillary central incisor. Once examined by neonatologist, geneticist, pneumologist, otolaryngologist, and pediatric dentist, a combined otolaryngological–orthodontic approach was used. The obstruction of the right nasal cavity was treated by widening the nasal cavities and stabilizing them with a balloon dilation technique. After surgery, the respiratory space was increased by applying a neonatal palatal expander plate (NPEP) considering the palatal deformity: ogival shaped, anterior vertex growth direction, reduction of transverse diameters. The NPEP promoted distraction of the median palatine suture and assisted the nasal dilation. Therefore, after the insertion of NPEP, the physiological sucking–swallowing mechanism was activated. In infants with CNPAS, NPEP can be useful to ensure the safe stability of nasal dilation. A multidisciplinary approach is fundamental. In our experience, the close collaboration between an otolaryngologist and orthodontist is essential for the management of the patient with CNPAS.
Full article
(This article belongs to the Special Issue Advances of Oral Surgery in Dental and Facial Conditions for Children)
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Open AccessFeature PaperArticle
Epidemiology and Healthcare Utilization in Pediatric Multiple Sclerosis and Neuromyelitis Optica: A Nationwide Population-Based Study in South Korea (2016–2020)
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Hyewon Woo, Junho Hwang, Sun Ah Choi and Soo Ahn Chae
Children 2024, 11(5), 553; https://doi.org/10.3390/children11050553 - 05 May 2024
Abstract
Pediatric multiple sclerosis (MS) and neuromyelitis optica (NMO) are rare acquired demyelinating syndrome with limited epidemiological data available, particularly in non-Western setting. This study aimed to demonstrate the epidemiology of pediatric MS and NMO in South Korea and to analyze of healthcare utilization
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Pediatric multiple sclerosis (MS) and neuromyelitis optica (NMO) are rare acquired demyelinating syndrome with limited epidemiological data available, particularly in non-Western setting. This study aimed to demonstrate the epidemiology of pediatric MS and NMO in South Korea and to analyze of healthcare utilization and economic burden associated with these conditions. Using a nationwide population-based database from the Korean Health Insurance Review and Assessment Service database, we identified pediatric cases (age < 20 years) of MS and NMO from 2016 to 2020. We analyzed incidence, prevalence, healthcare utilization and medical costs. The study found low age-standardized incidence and prevalence rates for pediatric MS and NMO in South Korea. There was a marked disparity in healthcare utilization between urban and rural areas. Most healthcare interactions occurred in tertiary hospitals in urban settings, particularly in Seoul. The study also highlighted the substantial economic burden associated with the management of rare diseases, with annual variability in medical costs. Pediatric MS and NMO are extremely rare in South Korea, with significant regional disparity in healthcare utilization. The findings emphasize the need for targeted healthcare policies to improve access and reduce disparities, particularly for chronic and rare diseases requiring specialized care.
Full article
(This article belongs to the Special Issue Recent Advances in Pediatric-Onset Multiple Sclerosis)
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Open AccessReview
The Potential Impact of the Gut Microbiota on Neonatal Brain Development and Adverse Health Outcomes
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Maria Tzitiridou-Chatzopoulou, Jannis Kountouras and Georgia Zournatzidou
Children 2024, 11(5), 552; https://doi.org/10.3390/children11050552 - 05 May 2024
Abstract
Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut–brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period
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Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut–brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period from birth to three years old may yield the greatest benefits. Investigating the substantial link between the gut and brain during this crucial developmental phase raises fundamental issues about the role of microorganisms in human health and brain development. This underscores the importance of focusing on the prevention rather than the treatment of neurodevelopmental and neuropsychiatric disorders. The present review examines the gut microbiota from birth to age 3, with a particular focus on its potential relationship with neurodevelopment. This review emphasizes the immunological mechanisms underlying this relationship. Additionally, the study investigates the impact of the microbiome on cognitive development and neurobehavioral issues such as anxiety and autism. Importantly, it highlights the need to integrate mechanistic studies of animal models with epidemiological research across diverse cultures to better understand the role of a healthy microbiome in early life and the implications of dysbiosis. Furthermore, this review summarizes factors contributing to the transmission of gut microbiome-targeted therapies and their effects on neurodevelopment. Recent studies on environmental toxins known to impact neurodevelopment are also reviewed, exploring whether the microbiota may mitigate or modulate these effects.
Full article
(This article belongs to the Special Issue Exploring the Brain-Gut Connection in Children)
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Open AccessArticle
Investigation of Liver X Receptor Gene Variants and Oxysterol Dysregulation in Autism Spectrum Disorder
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Tuğba Menteşe Babayiğit, Güvem Gümüş-Akay, Merve Çikili Uytun, Özlem Doğan, Muhittin A. Serdar, Gökçe Yağmur Efendi, Ayşe Gökçe Erman, Esra Yürümez and Didem Behice Öztop
Children 2024, 11(5), 551; https://doi.org/10.3390/children11050551 - 05 May 2024
Abstract
The NR1H2 gene produces the Liver X Receptor Beta (LXRB) protein, which is crucial for brain cholesterol metabolism and neuronal development. However, its involvement in autism spectrum disorder (ASD) remains largely unexplored, aside from animal studies. This study is the first to explore
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The NR1H2 gene produces the Liver X Receptor Beta (LXRB) protein, which is crucial for brain cholesterol metabolism and neuronal development. However, its involvement in autism spectrum disorder (ASD) remains largely unexplored, aside from animal studies. This study is the first to explore the potential link between autism and rs2695121/rs17373080 single nucleotide polymorphisms (SNPs) in the regulatory regions of NR1H2, known for their association with neuropsychiatric functions. Additionally, we assessed levels of oxysterols (24-Hydroxycholesterol, 25-Hydroxycholesterol, 27-Hydroxycholesterol), crucial ligands of LXR, and lipid profiles. Our cohort comprised 107 children with ASD and 103 healthy children aged 2–18 years. Clinical assessment tools included the Childhood Autism Rating Scale, Autistic Behavior Checklist, and Repetitive Behavior Scale-Revised. Genotyping for SNPs was conducted using PCR-RFLP. Lipid profiles were analyzed with Beckman Coulter kits, while oxysterol levels were determined through liquid chromatography–tandem mass spectrometry. Significantly higher total cholesterol (p = 0.003), LDL (p = 0.008), and triglyceride (p < 0.001) levels were observed in the ASD group. 27-Hydroxycholesterol levels were markedly lower in the ASD group (p ≤ 0.001). ROC analysis indicated the potential of 27-Hydroxycholesterol to discriminate ASD diagnosis. The SNP genotype and allele frequencies were similar in both groups (p > 0.05). Our findings suggest that disturbances in oxysterol metabolism, previously linked to neurodegeneration, may constitute a risk factor for ASD and contribute to its heterogeneous phenotype.
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(This article belongs to the Section Child and Adolescent Psychiatry)
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Open AccessArticle
The Utilization of Early Outpatient Care for Infants Following NICU Discharge among a National Sample
by
Janine P. Bernardo, Lisa Yanek and Pamela Donohue
Children 2024, 11(5), 550; https://doi.org/10.3390/children11050550 - 04 May 2024
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Outpatient care following discharge from a neonatal intensive care unit (NICU) is critical for streamlined transfer of care. Yet, information is lacking about the characteristics of early outpatient care. The objective of this secondary data analysis is to describe outpatient encounters (OPEs) within
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Outpatient care following discharge from a neonatal intensive care unit (NICU) is critical for streamlined transfer of care. Yet, information is lacking about the characteristics of early outpatient care. The objective of this secondary data analysis is to describe outpatient encounters (OPEs) within the first three months following the discharge of commercially insured infants admitted to NICUs in the MarketScan Research Database nationally from 2015 to 2017. Data were analyzed using descriptive statistics and logistic regression. A total of 22,214 NICU survivors were included, of whom half had an OPE within two days following discharge (quartiles 1, 3) and 90% within five days. The median number of OPEs in the first three months was five (quartiles 4, 7). A majority of first physician visits were with pediatricians (81.5%). A minority of infants with chronic conditions saw subspecialists. Term infants with delayed care had a lower risk of readmission. Spending was higher for preterm infants and those with chronic conditions. We conclude that most patients are seen shortly after discharge and by pediatricians; however, there is room for improvement. Frequent encounters and spending afflict high-risk groups with chronic conditions. Future work should examine the associations of early outpatient care with social determinants of health and other outcomes such as immunizations.
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Open AccessReview
Inflammatory Markers in Children and Adolescents with Functional Somatic Disorders: A Systematic Review
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Anne Sofie Hansen, Charlotte Ulrikka Rask and Karen Hansen Kallesøe
Children 2024, 11(5), 549; https://doi.org/10.3390/children11050549 - 03 May 2024
Abstract
Functional somatic disorders (FSDs) are common in children and adolescents. Recent findings suggest that low-grade inflammation has a role in the development and maintenance of pediatric FSDs. This systematic review included studies with original data on systemic inflammatory markers in children and adolescents
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Functional somatic disorders (FSDs) are common in children and adolescents. Recent findings suggest that low-grade inflammation has a role in the development and maintenance of pediatric FSDs. This systematic review included studies with original data on systemic inflammatory markers in children and adolescents with an FSD compared to individuals without an FSD. The literature search identified 1374 articles. After assessment, a total of 15 studies met the inclusion criteria. In total, 41 serum or plasma cytokines were assayed in a population of 696 children and adolescents. Altered cytokine levels in patients with FSDs were reported in 12 studies, whereas three studies found no significant differences when comparing patients with FSDs and controls. The cytokine levels were significantly elevated in nine studies (i.e., IL-2, IL-6, IL-8, IL-12 (p70), CRP, hsCRP, IP-10, MCP-1, sTIM-3, sCD25 and TNF-). The findings indicate that inflammatory response may have a role in the pathophysiology of pediatric FSDs. However, the included studies showed limited quality with potential risk of bias, small study populations and a narrow spectrum of included FSDs, which limits the generalizability of the results. To further explore the potential link between inflammatory markers and pediatric FSDs, future research using a longitudinal study design is recommended.
Full article
(This article belongs to the Special Issue Assessment and Treatment of Children and Adolescents with Functional Somatic Disorders)
Open AccessArticle
Vasoactive Management of Pulmonary Hypertension and Ventricular Dysfunction in Neonates Following Complicated Monochorionic Twin Pregnancies: A Single-Center Experience
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Lukas Schroeder, Leon Soltesz, Judith Leyens, Brigitte Strizek, Christoph Berg, Andreas Mueller and Florian Kipfmueller
Children 2024, 11(5), 548; https://doi.org/10.3390/children11050548 - 03 May 2024
Abstract
Objectives: Twins resulting from a complicated monochorionic (MC) twin pregnancy are at risk for postnatal evolution of pulmonary hypertension (PH) and cardiac dysfunction (CD). Both pathologies are important contributors to short- and long-term morbidity in these infants. The aim of the present retrospective
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Objectives: Twins resulting from a complicated monochorionic (MC) twin pregnancy are at risk for postnatal evolution of pulmonary hypertension (PH) and cardiac dysfunction (CD). Both pathologies are important contributors to short- and long-term morbidity in these infants. The aim of the present retrospective single-center cohort study was to evaluate the need for vasoactive treatment for PH and CD in these neonates. Methodology: In-born neonates following a complicated MC twin pregnancy admitted to the department of neonatology of the University Children´s Hospital Bonn (UKB) between October 2019 and December 2023 were screened for study inclusion. Finally, 70 neonates were included in the final analysis, with 37 neonates subclassified as recipient twins (group A) and 33 neonates as donor twins (group B). Results: The overall PH incidence at day of life (DOL) 1 was 17% and decreased to 6% at DOL 7 (p = 0.013), with no PH findings at DOL 28. The overall incidence of CD was 56% at DOL 1 and decreased strongly until DOL 7 (10%, p = 0.015), with no diagnosis of CD at DOL 28. The use of dobutamine, norepinephrine, and vasopressin at DOL 1 until DOL 7 did not differ between the subgroups, whereas the dosing of milrinone was significantly higher in Group B at DOL 1 (p = 0.043). Inhaled nitric oxide (iNO) was used in 16% of the cohort, and a levosimendan therapy was administered in 34% of the neonates. One-third of the cohort was treated with oral beta blockers, and in 10%, an intravenous beta blockade (landiolol) was administered. The maximum levosimendan vasoactive–inotropic score (LVISmax) increased from DOL 1 (12.4 [3/27]) to DOL 2 (14.6 [1/68], p = 0.777), with a significant decrease thereafter as measured at DOL 7 (9.5 [2/30], p = 0.011). Conclusion: Early PH and CD are frequent diagnoses in neonates following a complicated MC twin pregnancy, and an individualized vasoactive treatment strategy is required in the management of these infants.
Full article
(This article belongs to the Special Issue The Management of Pulmonary Hypertension in Infants and Children)
Open AccessArticle
“A ‘Cool’ Kid Wears a Brand, and Everyone’s following Him” Hierarchal Social Status in Preadolescence: A New Developmental Perspective
by
Hannah Fisher Grafy
Children 2024, 11(5), 547; https://doi.org/10.3390/children11050547 - 03 May 2024
Abstract
Inequality in hierarchical social status, especially among socially excluded children, profoundly affects preadolescents. Historically viewed through a lens of psychopathology and moral deficiencies, it challenges the education system’s approaches and interventions. This article introduces a developmental perspective, highlighting the hierarchical social status‘ role
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Inequality in hierarchical social status, especially among socially excluded children, profoundly affects preadolescents. Historically viewed through a lens of psychopathology and moral deficiencies, it challenges the education system’s approaches and interventions. This article introduces a developmental perspective, highlighting the hierarchical social status‘ role in shaping classroom cohesion, strength, and distinctiveness. This study’s phenomenological, qualitative methodology aimed to gain preliminary insight into the children’s perspectives. Drawing from 12 focus group discussions involving 140 latency-age (grade 5) children in Israel, it uniquely reveals the dynamic nature of hierarchical social status influenced by children’s connections with the group. This dynamism promotes group unity, strengthens bonds, and prioritizes collective concerns, contributing to the development of a “social self” in the latency phase. Beyond theory, this study proposes innovative interventions to address social status disparities.
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Open AccessArticle
Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain
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Kostas A. Fanti, Ioannis Mavrommatis, Beatriz Díaz-Vázquez, Laura López-Romero, Estrella Romero, María Álvarez-Voces, Olivier F. Colins, Henrik Andershed and Nicholas Thomson
Children 2024, 11(5), 546; https://doi.org/10.3390/children11050546 - 03 May 2024
Abstract
Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research
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Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child’s fearlessness and callous–unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous–unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.
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(This article belongs to the Section Child and Adolescent Psychiatry)
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Open AccessArticle
Pediatric ACL Reconstruction in Children—An Evaluation of the Transphyseal Technique’s Efficacy and Safety
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Alexandru Herdea, Mihai-Codrut Dragomirescu, Valentin Burcan and Alexandru Ulici
Children 2024, 11(5), 545; https://doi.org/10.3390/children11050545 - 03 May 2024
Abstract
Introduction: Injuries of the anterior cruciate ligament (ACL) are commonly found in the general population, both among adult and pediatric patients, and their incidence has been increasing in recent years. Most of the late literature agrees that surgical reconstruction of the ACL is
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Introduction: Injuries of the anterior cruciate ligament (ACL) are commonly found in the general population, both among adult and pediatric patients, and their incidence has been increasing in recent years. Most of the late literature agrees that surgical reconstruction of the ACL is effective in improving long-term outcomes in pediatric patients, while others in the past have pleaded for non-surgical management. Purpose/Hypothesis: Our study aims to verify if ACL reconstruction (ACLR) using transphyseal technique in skeletally immature patients will provide angular deviations or growth restrictions. Study Design: Retrospective cohort study; Level of evidence 4. Methods: We perfomed a retrospective study to verify if transphyseal ACLR in children with less than or equal to 2 years of remaining growth leads to either limb length discrepancies or axis deviations. Results: Most patients who were treated using transphyseal technique showed significant improvements in their functional scores. There were statistically significant differences in lateral distal femoral angles (LDFA) and medial proximal tibial angles (MPTA), with no clinical impact. There was no significant limb length discrepancy (LLD) during the 2-year follow-up. Conclusions: Transphyseal ACLR is safe among children who have less than or equal to 2 years of remaining growth and brings no risk of axis deviations or limb length discrepancy.
Full article
(This article belongs to the Special Issue Orthopedics and Trauma in Children: 2nd Edition)
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Open AccessReview
Updates on the Care of Cloacal Exstrophy
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Claire A. Ostertag-Hill, Patrick T. Delaplain, Ted Lee and Belinda H. Dickie
Children 2024, 11(5), 544; https://doi.org/10.3390/children11050544 - 02 May 2024
Abstract
Cloacal exstrophy is the most severe congenital anomaly of the exstrophy–epispadias complex and is characterized by gastrointestinal, genitourinary, neurospinal, and musculoskeletal malformations. Individualized surgical reconstruction by a multidisciplinary team is required for these complex patients. Not infrequently, patients need staged surgical procedures throughout
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Cloacal exstrophy is the most severe congenital anomaly of the exstrophy–epispadias complex and is characterized by gastrointestinal, genitourinary, neurospinal, and musculoskeletal malformations. Individualized surgical reconstruction by a multidisciplinary team is required for these complex patients. Not infrequently, patients need staged surgical procedures throughout childhood and adolescence. Following significant improvements in medical care and surgical reconstructive techniques, nearly all patients with cloacal exstrophy now survive, leading to an increased emphasis on quality of life. Increased attention is given to gender identity and the implications of reconstructive decisions. Long-term sequelae of cloacal exstrophy, including functional continence and sexual dysfunction, are recognized, and many patients require ongoing complex care into adulthood.
Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Colorectal Surgery)
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Open AccessArticle
A Prospective Cross-Sectional Study on the Vitamin D Status of Neonates and the Impact of Neonates’ Standard Vitamin D Supplementation on Neonatal Morbidities
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Ezgi Yangin Ergon, Bayram Ali Dorum, Hanife Gul Balki, Derya Bako and Senem Alkan Ozdemir
Children 2024, 11(5), 543; https://doi.org/10.3390/children11050543 - 01 May 2024
Abstract
(1) Background: This study aimed to determine whether standard-dose vitamin D supplementation could provide adequate levels in exclusively breastfed infants born with different cord 25(OH)D levels and to evaluate related neonatal morbidities. (2) Methods: A prospective cross-sectional study was designed in term infants.
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(1) Background: This study aimed to determine whether standard-dose vitamin D supplementation could provide adequate levels in exclusively breastfed infants born with different cord 25(OH)D levels and to evaluate related neonatal morbidities. (2) Methods: A prospective cross-sectional study was designed in term infants. Three groups were formed based on cord 25(OH)D levels; Group1 Deficiency:25(OH)D < 12 ng/mL, Group2 Insufficiency:25(OH)D = 12–19 ng/mL, and Group3 Optimum:25(OH)D = 20–100 ng/mL. Cord and 1st month 25(OH)D levels, after receiving standard-dose vitamin D prophylaxis, neonatal outcomes and anthropometric measurements were compared. (3) Results: The study involved 86 infants. Group1 Deficiency had also significantly lower 25(OH)D levels at 1st month compared to the others (p < 0.001). There was a significant positive correlation between cord and 1st month 25(OH)D levels (r = 0.78, p < 0.001). Despite the fact that the mother’s age and clothing style were similar, Group1 Deficiency mothers had higher parity numbers and used less vitamin D during pregnancy (p = 0.03, p = 0.04). Neonatal outcomes analysis revealed that newborns in Group1 Deficiency experienced more respiratory distress, transient tachypnea, and early-onset sepsis, as well as more and longer hospital stays in the first-month of life (p < 0.05). (4) Conclusions: Infants with low cord 25(OH)D levels had also lower 25(OH)D values in the 1st month of life and experienced higher rates of neonatal morbidities. Given its numerous biological activities and impact on neonatal morbidities, determining an individualized dose of vitamin D supplementation may be more accurate than using the standard approach.
Full article
(This article belongs to the Section Pediatric Neonatology)
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Open AccessArticle
Home Musical Activities Boost Premature Infants’ Language Development
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Fabia Franco, Maria Chifa and Nina Politimou
Children 2024, 11(5), 542; https://doi.org/10.3390/children11050542 - 01 May 2024
Abstract
Infants born prematurely are considered at risk for language development delay and impairments. Using online parental reports, the present study investigated the influence of early musical experience in the home environment (Music@Home Infant Questionnaire) on language development (MacArthur–Bates Communicative Development Inventory) while controlling
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Infants born prematurely are considered at risk for language development delay and impairments. Using online parental reports, the present study investigated the influence of early musical experience in the home environment (Music@Home Infant Questionnaire) on language development (MacArthur–Bates Communicative Development Inventory) while controlling for general enrichment at home (Stim-Q Cognitive Home Environment Questionnaire) and perinatal post-traumatic stress disorder (Perinatal PTSD Questionnaire). Caregivers of 117 infants between 8 and 18 months of age (corrected age) without reported developmental difficulties completed an online survey. Results revealed that the musical home environment significantly predicted outcomes in reported infants’ receptive vocabulary and gestural communication, independently from infants’ corrected age and general enrichment of home activities. These findings constitute the first evidence that an enriched musical experience can enhance the development of early communication skills in a population at risk for language delays, namely infants born prematurely, opening the path for future intervention research in home and/or early childcare settings. Given that the majority of participants in this study were highly educated and from socioeconomically stable backgrounds, considerations regarding the generalizability of these results are discussed.
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Open AccessSystematic Review
Expanding the Phenotype of the CACNA1C-Associated Neurological Disorders in Children: Systematic Literature Review and Description of a Novel Mutation
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Lorenzo Cipriano, Raffaele Piscopo, Chiara Aiello, Antonio Novelli, Achille Iolascon and Carmelo Piscopo
Children 2024, 11(5), 541; https://doi.org/10.3390/children11050541 - 30 Apr 2024
Abstract
CACNA1C gene encodes the alpha 1 subunit of the CaV1.2 L-type Ca2+ channel. Pathogenic variants in this gene have been associated with cardiac rhythm disorders such as long QT syndrome, Brugada syndrome and Timothy syndrome. Recent evidence has suggested the possible association between
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CACNA1C gene encodes the alpha 1 subunit of the CaV1.2 L-type Ca2+ channel. Pathogenic variants in this gene have been associated with cardiac rhythm disorders such as long QT syndrome, Brugada syndrome and Timothy syndrome. Recent evidence has suggested the possible association between CACNA1C mutations and neurologically-isolated (in absence of cardiac involvement) phenotypes in children, giving birth to a wider spectrum of CACNA1C-related clinical presentations. However, to date, little is known about the variety of both neurological and non-neurological signs/symptoms in the neurologically-predominant phenotypes. Methods and results: We conducted a systematic review of neurologically-predominant presentations without cardiac conduction defects, associated with CACNA1C mutations. We also reported a novel de novo missense pathogenic variant in the CACNA1C gene of a children patient presenting with constructional, dressing and oro-buccal apraxia associated with behavioral abnormalities, mild intellectual disability, dental anomalies, gingival hyperplasia and mild musculoskeletal defects, without cardiac conduction defects. Conclusions: The present study highlights the importance of considering the investigation of the CACNA1C gene in children’s neurological isolated syndromes, and expands the phenotype of the CACNA1C related conditions. In addition, the present study highlights that, even in absence of cardiac conduction defects, nuanced clinical manifestations of the Timothy syndrome (e.g., dental and gingival defects) could be found. These findings suggest the high variable expressivity of the CACNA1C gene and remark that the absence of cardiac involvement should not mislead the diagnosis of a CACNA1C related disorder.
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The Impact of Family Socioeconomic Status (SES) on Adolescents’ Learning Conformity: The Mediating Effect of Self-Esteem
by
Houyan Li, Bin Xiao and Guandong Song
Children 2024, 11(5), 540; https://doi.org/10.3390/children11050540 - 30 Apr 2024
Abstract
Objective: This study aimed to investigate the relationship between family socioeconomic status (SES) and adolescents’ learning conformity and self-esteem among a sample of 15–18 year-old high school students. Methods: A survey was conducted on 339 adolescents using measures of family SES, self-esteem, and
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Objective: This study aimed to investigate the relationship between family socioeconomic status (SES) and adolescents’ learning conformity and self-esteem among a sample of 15–18 year-old high school students. Methods: A survey was conducted on 339 adolescents using measures of family SES, self-esteem, and learning conformity. An intermediary effect model was constructed to examine the mediating mechanism of self-esteem in the impact of family SES on adolescents’ learning conformity. Results: In our study, we observed that male adolescents were more likely to come from families with higher socioeconomic status (SES) and exhibited relatively higher levels of self-esteem compared to female adolescents. However, this finding should be regarded as an observational outcome specific to our study sample and does not directly indicate a causal relationship between gender and family SES or self-esteem. Adolescents from rural areas were more likely to exhibit tendencies towards learning abidance and compliance. Family SES positively predicted self-esteem. The intermediary model indicated that family SES significantly positively influenced learning abidance and compliance, with self-esteem partially mediating the effects at 33.49% and 33.33%, respectively. Family SES negatively affected learning obedience, with self-esteem partially mediating the effect at 39.77%. Conclusion: Among the 15–18 year-old high school student population, family SES not only directly affects learning abidance, compliance, and obedience but also generates an indirect mediating effect through self-esteem.
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(This article belongs to the Special Issue Research on the Academic Motivation of Children and Adolescents)
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Retrospective Analysis of Fever in Pediatric Age: Our Experience over the Last 5 Years
by
Mariella Valenzise, Federica D’Amico, Giulia La Barbera, Carlo Maria Cassone, Silvia Patafi, Fortunato Lombardo, Tommaso Aversa, Malgorzata Gabriela Wasniewska, Giuseppina Salzano and Carmela Morace
Children 2024, 11(5), 539; https://doi.org/10.3390/children11050539 - 30 Apr 2024
Abstract
Background: Fever is one of the most frequent symptoms highlighted during medical assistance. Due to this great impact, our study has the purpose of analyzing the demographic and laboratory characteristics of patients hospitalized in our center and identifying predictive markers to make the
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Background: Fever is one of the most frequent symptoms highlighted during medical assistance. Due to this great impact, our study has the purpose of analyzing the demographic and laboratory characteristics of patients hospitalized in our center and identifying predictive markers to make the differential diagnosis between infectious and non-infectious fever. Methods: Our population included 220 children, collected from January 2017 to August 2022, hospitalized for continuous fever (4 days or more in duration with at least one temperature peak ≥37.5 °C) and excluded cases of discharge against medical advice and/or transfer to other operating units. Demographic (mean age at the time of admission, frequency of hospitalization, and mean days of hospitalization), laboratory, and instrumental variables were analyzed in order to find correlation with fever etiology. Results: Older age at the time of hospitalization, family history of periodic fever, fever lasting more than 8 days, and longer hospitalization are strongly associated with non-infectious fever, together with anemia, high platelet count, high CRP and ferritin, and hyponatremia at the time of admission. Paracetamol is the preferred antipyretic treatment. Echocardiogram has shown anomalies in patients with infectious fever, while ECG anomalies were detected in non-infectious fever. Conclusions: Our data underline the importance of predictive markers, such as clinical and laboratory parameters, to differentiate infectious from non-infectious fevers, but further studies are necessary.
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(This article belongs to the Special Issue Medical Statistics and Clinical Epidemiology in Children)
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The Influence of Gifted Children’s Stress Management on Parental Stress Levels
by
Maria Assunta Zanetti, Francesca Sangiuliano Intra, Livia Taverna, Antonella Brighi and Carlo Marinoni
Children 2024, 11(5), 538; https://doi.org/10.3390/children11050538 - 30 Apr 2024
Abstract
This study explores the associations between gifted children’s stress management and parental stress level. A sample of 78 primary school children and their 76 parents took part in this study. Children were screened for intelligence and emotional quotients, while parents were tested for
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This study explores the associations between gifted children’s stress management and parental stress level. A sample of 78 primary school children and their 76 parents took part in this study. Children were screened for intelligence and emotional quotients, while parents were tested for stress levels. Results show that the more children are aware of their stress-management skills, the less parents are stressed out. Moreover, the intelligence quotient is not significant in mediating this association, supporting the idea that it is not an a priori protective factor from a developmental perspective. The study findings suggest that when a child is equipped with the skills to handle stress by harnessing their emotional intelligence, it can have a beneficial effect on the entire family’s well-being. Given that these skills can be developed, and the significant positive influence they have on a child’s growth and adaptation, it is essential to offer specialized educational programs to gifted children. These programs should aim to enhance their emotional skills, which, in turn, can indirectly bolster the psychological health of the family unit as a whole.
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