Search Results (17,500)

There remains a widespread lack of knowledge regarding hidradenitis suppurativa (HS) among physicians in the United States, impeding timely diagnosis and implementation of comprehensive treatment interventions. Despite the presence of supporting communities for affected adolescents and their caretakers, the overall awareness of HS remains low, and a greater consensus on the treatment of HS is needed. Current research highlights the lack of standardized pediatric guidelines for treatment of HS largely due to the varied nature of the disease and limited efficacy of current therapies. Our study aims to explore the relationship between the chronic skin condition HS and social–emotional concerns, mental health, and physical health issues in US children and adolescents. Using the Arksey and O’Malley framework and PRISMA-ScR reporting, we searched PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase for U.S. studies (2015–2025) on pediatric HS (<18 years) and social–emotional, mental health, or quality-of-life outcomes. Recommendations were synthesized, and study quality was appraised with CASP checklist methods and rigor. Ten studies (2020–2025) met inclusion criteria. Pediatric HS was associated with depression, anxiety, social withdrawal, shame, low self-esteem, and reduced quality of life. Physical comorbidities increased psychosocial burden. Socioeconomic and racial disparities worsened outcomes and access to care. Studies emphasized early diagnosis, routine screening, multidisciplinary management, and disparity-focused interventions. Findings may inform clinical practice and guide research initiatives aimed at improving outcomes for children and adolescents with HS. Full article

Background/Objectives. Spinal misalignment in childhood and adolescence may be associated with altered sensory integration and body representation. The subjective visual vertical reflects visual, vestibular, and somatosensory integration, but its relationship with pediatric spinal misalignment remains uncertain. This study investigated the subjective visual vertical using two complementary paradigms. Methods. This exploratory, single-center, cross-sectional study included participants aged 7–17 years with clinically identified spinal misalignment. Participants underwent standardized physiatric assessment and subjective visual vertical testing using a luminous-line test and the Bucket Test. Spearman’s rank correlations examined associations with clinical and radiographic variables, with false-discovery-rate control using the Benjamini–Hochberg procedure. Radiographic analyses were restricted to participants with available imaging. Results. Fifty-seven participants were included (mean age 12.8 years, SD 2.25), and all completed both tests. Mean subjective visual vertical was 0.053° (SD 0.953) with the luminous-line test and −0.561° (SD 1.165) with the Bucket Test. Radiographs were available for 21 participants. No association remained significant after false-discovery-rate correction. Two luminous-line associations were nominally significant before correction: primary lumbar curve presence (ρ = −0.278, p = 0.036) and secondary thoracolumbar curve presence (ρ = −0.324, p = 0.015); both had q = 0.721. The tests were moderately correlated (ρ = 0.493, p < 0.001). Radiographic sensitivity and subgroup analyses showed no significant findings. Conclusions. Subjective visual vertical was not robustly associated with spinal misalignment characteristics in this modest, clinically heterogeneous cohort. Larger controlled studies with standardized imaging and adequately powered severity groups are required. Full article

Pornography use during adolescence is a relevant issue from social, educational, and public health perspectives. As with other behaviours, its correlates may involve complex and nonlinear relationships. This study uses data from the 2023 Spanish Survey on Drug Use in Secondary Education (ESTUDES), a major source for analysing potentially addictive behaviours among adolescents in Spain because of its large sample size (original sample: N = 42,208; complete-case analytical sample: N = 33,543). Pornography use was modelled as a binary outcome using logistic regression, XGBoost, LightGBM, and CatBoost. The models included sociodemographic characteristics, family-related factors, parental control, substance use, selected sexual behaviours, indicators of mental well-being, and addictive Internet use. The four methods showed similar predictive performance. CatBoost achieved the highest AUC and the lowest Brier score and log loss, whereas LightGBM obtained the highest accuracy, specificity, and precision. Logistic regression yielded the highest sensitivity, negative predictive value, balanced accuracy, and F1-score. SHAP analysis identified sex as the most influential predictor, followed by addictive Internet use, cannabis and alcohol use, family conflict, and selected risky sexual behaviours. The findings suggest that pornography use among adolescents forms part of a broader behavioural and psychosocial profile. Whereas sex operated mainly as a strong direct predictor, problematic Internet use showed substantial interactions with age and cannabis and alcohol use. This study demonstrates how explainable machine learning can complement conventional regression by identifying the main correlates, nonlinear patterns, and interactions associated with adolescent pornography use. Full article

Background/Objectives: Childhood and adolescent overweight and obesity are associated with adverse body composition and impaired glucose metabolism. Probiotic and synbiotic supplementation may modulate the gut microbiota and has been proposed as a potential adjunctive strategy for obesity management. This systematic review and meta-analysis aimed to evaluate the effects of probiotic and synbiotic supplementation on body composition and glucose metabolism in children and adolescents with overweight or obesity. Methods: This review was conducted according to the PRISMA 2020 statement. PubMed, Embase, Web of Science, the Cochrane Library, and CNKI were searched from inception to 5 May 2026. Randomized controlled trials evaluating probiotic or synbiotic supplementation in children and adolescents with overweight or obesity were included. Outcomes included BMI z-score, BMI, waist circumference, body fat percentage, fasting glucose, fasting insulin, and HOMA-IR. Random-effects meta-analyses, sensitivity analyses, and subgroup analyses according to intervention type (probiotic versus synbiotic supplementation) were performed using mean differences (MDs) and 95% confidence intervals (CIs). Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated using GRADE. Results: Sixteen randomized controlled trials were included. Probiotic or synbiotic supplementation did not significantly reduce BMI z-score (MD = −0.03, 95% CI −0.11 to 0.05), waist circumference (MD = 0.60 cm, 95% CI −1.57 to 2.77), or body fat percentage (MD = −0.29 percentage points, 95% CI −1.64 to 1.06). A modest reduction in BMI was observed (MD = −0.91 kg/m², 95% CI −1.81 to −0.01), although this finding should be interpreted cautiously because no significant improvement was observed in BMI z-score. No significant effects were found for fasting glucose, fasting insulin, or HOMA-IR. Subgroup analyses showed no significant differences between probiotic and synbiotic supplementation for BMI, BMI z-score, or waist circumference, whereas a significant subgroup difference was observed for fasting glucose. Conclusions: Probiotic or synbiotic supplementation may be associated with a modest reduction in BMI; however, the certainty of this evidence was low, which limits confidence in its clinical implications. Current evidence does not support clear benefits for BMI z-score, waist circumference, body fat percentage, or glucose metabolism. The subgroup findings, particularly for fasting glucose, should be interpreted cautiously because they were based on a limited number of studies. Further high-quality randomized controlled trials are warranted. Full article

The construct of adolescent psychological well-being has long been a focus of both public discourse and scholarly inquiry. With the widespread adoption of the Internet, there have been growing concerns about adolescents’ exposure to escalating online risks. Parental mediation has been hypothesised to facilitate the guidance and regulation of adolescents’ Internet use. However, the specific mediating role of the parent–adolescent relationship in the association between problematic Internet use and psychological well-being has remained underexamined, a gap explored in the current study. Based on the theoretical underpinnings provided by Phase Three of Bronfenbrenner’s Bioecological Model of Human Development, a cross-sectional survey using validated psychometric instruments was conducted, involving 1598 students (mean age 16.0 years; 51% female) from secondary schools in Selangor, Malaysia. For data analysis, inferential statistics and partial least squares–structural equation modelling (PLS–SEM) were used to examine the complex structural relationships among the variables. Mean scores for problematic Internet use and psychological well-being indicated moderate severity levels. SEM results indicated the negative influence of problematic Internet use on psychological well-being (β = −0.104 *, p = 0.040) and parent–adolescent relationship (β = −0.241 **, p < 0.001) and a significant positive influence of parent–adolescent relationship on psychological well-being (β = 0.328 **, p < 0.001). Subsequent mediation analysis confirmed the partial mediating effect of parent–adolescent relationship (indirect association: β = −0.079) on the relationship between problematic Internet use and psychological well-being among Malaysian adolescents. This was consistent with Bronfenbrenner’s Bioecological Model of Human Development. Strengthening the parent–adolescent relationship could mitigate the adverse psychological effects of excessive Internet use. From a policy perspective, these findings supported the use of family-focused intervention as a strategy to address the adverse psychological effects of problematic Internet use among adolescents. Full article

Background: Thoracic hyperkyphosis (THK) is a postural deformity associated with pain, impaired respiratory function, reduced quality of life, scapular rhythm impairment, shoulder biomechanical alterations, and increased fall risk. While corrective exercises are commonly used, the added value of integrating specific respiratory techniques remains unclear. This systematic review and meta-analysis aimed to evaluate the effects of movement-based exercises combined with respiratory techniques on the thoracic kyphosis angle (TKA) in individuals with THK. Methods: A systematic search of PubMed, Scopus, Web of Science, CINAHL, SPORTDiscus, PEDro, and CENTRAL Cochrane Library was conducted from inception to 16 July 2026. Randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) investigating combined exercise and respiratory interventions in individuals with THK were included. The primary outcome was TKA. Two authors independently selected studies, extracted data, and assessed quality, with a third author resolving discrepancies. Risk of bias was assessed using RoB-2 for RCTs and ROBINS-I for non-RCTs. Certainty of evidence was graded using GRADE. A random-effects meta-analysis of TKA was performed using Hedges’ g. Results: Five studies involving 247 participants were included. Meta-analysis demonstrated a significant reduction in TKA following combined intervention compared with exercise alone (Hedges’ g = 0.667, 95% CI: 0.395 to 0.940, p < 0.001; I² = 39.7%). Subgroup analysis by age group revealed significant improvement in adolescents (Hedges’ g = 0.860, 95% CI: 0.532 to 1.189, p < 0.001; I² = 0%) but no significant effect in older adults (Hedges’ g = 0.241, 95% CI: −0.247 to 0.729, p = 0.333; I² = 0%). The certainty of evidence for TKA was graded as moderate, with downgrading for risk of bias, indirectness, and potential publication bias. Conclusions: Movement-based exercises combined with respiratory techniques significantly improve thoracic alignment in individuals with THK, with moderate certainty evidence, particularly in adolescents. The evidence in older adults remains inconclusive due to limited studies and structural factors. Larger, high-quality, and standardized trials are needed to confirm these effects, establish optimal treatment parameters, and evaluate long-term outcomes across diverse populations. Full article

Background and Objectives: Evidence on the acute ergogenic effects of caffeine in adolescent athletes remains limited. This systematic review quantified acute performance-related effects and summarised adverse-event reporting in this population. Methods: PubMed and Web of Science were searched from inception to 13 May 2026 and SPORTDiscus was additionally searched from inception to 15 July 2026 for placebo-controlled studies of acute, dose-defined caffeine ingestion in adolescent athletes aged 10–19 years. Paired Hedges’ g values were synthesised separately across six outcome domains using three-level random-effects models with CR2 cluster-robust inference. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE. Safety findings were summarised narratively. Results: Thirty-five studies were included, of which 32, representing a total of 726 participants, contributed 363 effect sizes. In the primary analysis, which excluded a priori a small number of extreme combat-sport count-test effects arising from implausibly small reported standard deviations (Hedges’ g > 3.0), caffeine produced a small favourable average effect on physical performance (g = 0.33, 95% CI 0.17 to 0.49). When all effect sizes were included in a sensitivity analysis, the estimate was larger but inflated by these extreme values (g = 0.43, 95% CI 0.20 to 0.67) and was accompanied by substantial heterogeneity (I² = 84%), a prediction interval crossing the null (−0.71 to 1.58), and significant small-study asymmetry. Pooled effects were not statistically significant for sport-specific performance, perceptual response, or physiology. Cognitive findings were based on only two study clusters and were highly uncertain, while psychological outcomes were summarised narratively because the evidence was too sparse and heterogeneous for a meaningful pooled estimate. Exploratory moderator analyses did not provide reliable evidence that effects differed by caffeine dose or ingestion timing. No serious adverse events were reported, but adverse-event assessment was inconsistent. Conclusions: Acute caffeine ingestion may produce a small and uncertain benefit for selected physical-performance tasks in adolescent athletes. Adverse-event reporting was inconsistent, and current evidence is insufficient to support routine caffeine use in youth sport. These findings are specific to acute caffeine exposure under controlled experimental conditions in adolescent athletes and should not be extrapolated to children, non-athlete adolescents, repeated or chronic caffeine use, or energy-drink consumption. Full article

This study aimed to investigate associations between training load (TL) calculated using the OMNI rating of perceived exertion scale (OMNI-RPE) and heart rate (HR) and velocity-derived measures of TL in non-elite adolescent team sport athletes. Fifty-four athletes participated in the study. The study was separated into two parts. In the Part A, twenty athletes completed both an easy and hard version of a simulated team game circuit outdoors on natural turf to replicate performance parameters often used in training. In part B, thirty-four different athletes completed a competitive team game played outdoors on synthetic/natural turf hockey or soccer pitches. For both Parts A and B, session OMNI TL (sOMNI-TL) was derived as a product of the session OMNI-RPE and session duration, and was correlated to Edward’s Training Impulse (TRIMP) and time spent in 0–25%, 25–50%, 50–70% and >70% peak velocity. Low-to-moderate correlations were observed between sOMNI-TL and Edwards TRIMP (r = 0.18–0.20) and velocity measures (r = 0.05–0.42) for Part A. Larger correlations were observed between sOMNI-TL and Edwards TRIMP (r = 0.53, p < 0.05) and velocity measures (r = 0.36–0.51, p < 0.05) for part B. The hypothesis that sOMNI-TL would show significant, moderate associations with heart rate and velocity-derived training load in both simulated and game conditions was only partially supported, and the results of this study do not support its use as a stand-alone measure in a practical setting. Full article

Background: Problematic digital use in adolescents and young adults has emerged as a relevant exposure for mental health and neurobiological vulnerability. However, its relationship with peripheral DNA methylation differences in neurobiologically relevant genes remains poorly synthesized. Objective: This systematic review and exploratory multilevel meta-analysis aimed to synthesize available scientific evidence on associations between phenotypes of problematic internet or smartphone use and DNA methylation differences in neurobiologically relevant genes, and to quantitatively explore the average magnitude of these associations from available data. Methods: Primary human studies were identified through a search strategy with no initial publication-year restriction; the eligible studies retrieved and included in the review were published between 2018 and 2024. The review followed PRISMA criteria and a broad, predefined eligibility strategy to capture both direct and indirect evidence. Seven studies were included in the systematic review; four provided quantifiable data for statistical synthesis, from which 41 effect sizes were harmonized. Analyses were performed in R using multilevel meta-analysis and meta-regression models with REML estimation, supplemented by sensitivity analyses with robust variance estimation. Results: The main meta-analysis revealed a significant positive association between problematic digital exposure and DNA methylation differences (Fisher's z = 0.2957; r = 0.287; 95% CI [0.1146, 0.4769]; p = 0.0020), with high heterogeneity (total I² = 93.15%). Meta-regression indicated that the type of effect and the biological direction of the finding explained a substantial proportion of the observed heterogeneity (total R² ≈ 97.4%). Significance: These findings should be interpreted as exploratory evidence of a biologically plausible association between problematic digital exposure and peripheral DNA methylation differences in neurobiologically relevant genes, rather than as causal or clinically validated biomarker evidence. The available evidence remains methodologically heterogeneous, preliminary, and dependent on a small number of independent studies, underscoring the need for larger, longitudinal, and more methodologically rigorous research in this field. Full article

Electric scooters (e-scooters) and electric bicycles (e-bikes) are established urban micromobility modes, and children and adolescents form a growing share of riders. This narrative review synthesises peer-reviewed evidence on e-scooter and e-bike injuries in patients aged 18 years or younger, covering epidemiology, mechanisms, injury patterns, clinical outcomes, comparisons with conventional devices, and prevention. Each source was classified as dedicated paediatric evidence, mixed-age evidence with extractable paediatric results, adult or mixed-age evidence used only for context, or an adult-dominated systematic review, so that the basis of every claim is explicit. The reported burden has risen across national surveillance data and single-centre series, and one population-adjusted analysis found injury rates increasing by 293% for e-bikes and by 88% for powered scooters between 2019 and 2022. Most studies lack exposure denominators, so exposure-adjusted paediatric risk remains poorly quantified and rising counts cannot be equated with rising risk. Injuries affect adolescent boys disproportionately and peak at ages 11 to 14 years. Extremity and soft-tissue injuries predominate, while a clinically important minority sustain traumatic brain injury, craniofacial and dental trauma, or severe multisystem injury. Low helmet use and higher device speeds are consistently associated with more severe outcomes, although observational designs cannot establish causal effects and device type is confounded with rider age and road exposure in every available paediatric comparison. Powered devices are associated with greater severity than non-powered counterparts. Speed limitation and helmet promotion appear promising, but paediatric-specific effectiveness evidence remains limited. Prospective paediatric research incorporating exposure denominators is the priority. Full article

Physical education (PE) is commonly justified through its contributions to physical fitness, motor skill development, sport participation, and health-enhancing physical activity. These aims remain important, but they do not fully capture PE’s potential as a curriculum context for lifestyle learning and neurobehavioral well-being. This narrative review used structured literature mapping and conceptual framework development to examine how PE may connect embodied movement experiences with motivation, stress and emotion regulation, self-efficacy, resilience, recovery-related awareness, and lifestyle self-regulation in adolescents and young adults. Literature searches were conducted iteratively in PubMed, Scopus, Web of Science Core Collection, SPORTDiscus, and ERIC, with the final search update completed on 20 June 2026. The synthesis identified a curriculum-to-lifestyle gap: existing evidence more often examines whether PE, physical activity, sport, or physical literacy is associated with health or psychological outcomes than how curriculum, teaching climate, reflection, assessment, and peer interaction may support transferable self-regulatory learning. The review therefore proposes an evidence-informed, curriculum-oriented conceptual framework linking PE design and pedagogy with proximal motivational, emotional, cognitive-regulatory, behavioral, and embodied processes. The framework does not imply that PE automatically improves mental health, directly produces neurobiological change, or replaces specialist care. Evidence is stronger for proximal educational processes than for sustained transfer beyond PE. Future research should test clearly specified curriculum mechanisms, implementation conditions, assessment approaches, and longitudinal transfer. Full article

Since the onset of the COVID-19 pandemic, children and adolescents across Europe have experienced a significant rise in mental health challenges, including anxiety, depression, and behavioural disorders. Schools have observed a marked shift in social behaviour, with increased emotional instability, social withdrawal, and attention-related issues. Simultaneously, educational systems face a growing shortage of skilled professionals, particularly in psychological support roles. While digital technologies offer partial relief, their effectiveness is limited by concerns such as screen fatigue and a lack of embodied interaction. This paper conceptualises the use of social robots as a novel intervention tool in education, grounded in the 4E cognition framework—embodied, embedded, enacted, and extended—and informed by interdisciplinary research. Using design thinking and insights from empirical and practical work, we developed five use cases for integrating robots into the Swiss MindMatters mental health promotion programme. These five use cases demonstrate how robots can facilitate emotional learning, simulate social interactions, support conflict mediation, and reduce teacher workload. By combining physical presence with adaptive behaviour, social robots, which will serve as digital twins of pedagogical partners, offer a promising, ethically sensitive extension of classroom environments, fostering deeper engagement, social competence, and cognitive development in ways traditional technologies cannot fully replicate. Full article

Adolescent mental health problems have become increasingly prominent, and everyday urban spaces may provide important support for stress relief. Focusing on adolescents aged 12–18 in Xi’an, China, this study examines three frequently used urban spaces: streets, residential communities, and parks. Based on questionnaire data, a multi-group structural equation model was estimated to test the relationships among built environment satisfaction (BES), perceived restorativeness (PR), and restorative outcomes (ROs), as well as their spatial differences. The results show that parks performed best in PR and ROs, followed by residential communities, whereas streets showed the weakest restorative performance. Across all three space types, BES significantly improved PR, and PR further promoted ROs. Parks showed both a significant direct effect and a significant indirect effect through PR, whereas communities and streets mainly relied on the mediating pathway through PR. Taken together, these findings suggest that restorative experiences cannot be explained by space-use intensity alone and are also associated with BES, PR, and space type. The study provides empirical evidence for optimizing everyday urban spaces to support adolescent mental health and socially sustainable urban development. Full article

Background: K-wire osteosynthesis is a widely used, cost-effective technique for stabilizing pediatric and adolescent fractures. The beneficial effect of perioperative antibiotic prophylaxis (PAP) and burying the K-wires below skin level to reduce infectious complications is still controversial. The goal of this study was to evaluate if the omission of PAP and leaving K-wires unburied affected the complication rate. Materials and Methods: A retrospective analysis of pediatric and adolescent K-wire osteosyntheses over a period of 11 years was performed. Records were screened for general, infectious and implant-associated complications. Follow-up was performed until the implant was removed. Results: Between January 2014 and December 2024 a total of 1022 K-wire osteosyntheses were performed and 779 were eligible for this study. Median follow-up to implant removal was 30 days [28–36 days]. At least one complication was documented in 17.6% (137/779) of the cases. Infectious complications were low at 2.6%—including 11 (1.4%) wound healing disorders and 9 (1.2%) pin site infections—and did not show difference regardless of application of PAP. No cases of osteomyelitis were observed until follow-up. Furthermore, implant-associated complications were more frequent with buried wires (10.2%; 19/187) than with unburied wires (3.4%, 20/592). Conclusions: Omitting perioperative antibiotic prophylaxis and leaving K-wires unburied in pediatric and adolescent patients undergoing closed reduction and K-wire fixation of distal radial and distal humeral fractures does not seem to increase the risk for infectious complications. Furthermore, unburied K-wires can be removed without the need for a second general anesthesia. Level of Evidence: III (retrospective cohort study). Full article