Search Results (110)

Background: The 2022 conflict in Ukraine triggered mass migration, leading to a significant influx of Ukrainian refugee children into Poland. This situation raises concerns about hepatitis B virus immunity, as Ukraine’s hepatitis B vaccination coverage has been inconsistent compared to Poland’s high vaccination rates. Objective: To evaluate hepatitis B immunity and infection prevalence among Ukrainian refugee children residing in Southern Poland and to assess implications for vaccination strategies in the host country. Methods: A prospective cross-sectional study was conducted on 1322 Ukrainian refugee children (0–18 years) presenting to a pediatric infectious diseases department in Southern Poland between February 2022 and March 2024. Data on vaccination history, demographic characteristics, and selected laboratory parameters, including hepatitis B surface antigen and anti-HBs antibody levels, were collected. Protective immunity was defined as anti-HBs antibody levels ≥10 IU/L. Results: Among the participants (mean age 9.9 years; 50.2% female), 83.2% were reported as vaccinated according to national immunization programs, but only 64.9% demonstrated protective anti-HBs antibody levels. Protective antibody prevalence declined significantly with age, with less than half of adolescents aged 15–18 years showing immunity. Five children (0.4%) were diagnosed with chronic hepatitis B, four of whom were unvaccinated. Conclusions: This study identifies a significant gap in hepatitis B immunity among Ukrainian adolescent refugees residing in Southern Poland, with less than half possessing protective anti-HBs antibody levels. This immunity gap and the high risk of sexual transmission of the hepatitis B virus in adolescents highlight the urgent need for comprehensive surveillance, screening, and catch-up vaccination programs. Full article

Clinical and animal studies suggest that multiple brain systems are involved in mediating reward-motivated and related emotional behavior including the consumption of commonly used drugs and palatable food, and there is evidence that the repeated ingestion of or exposure to these rewarding substances may in turn stimulate these brain systems to produce an overconsumption of these substances along with co-occurring emotional disturbances. To understand this positive feedback loop, this review focuses on a specific population of hypothalamic peptide neurons expressing melanin-concentrating hormone (MCH), which are positively related to dopamine reward and project to forebrain areas that mediate this behavior. It also examines neurons expressing the peptide hypocretin/orexin (HCRT) that are anatomically and functionally linked to MCH neurons and the molecular systems within these peptide neurons that stimulate their development and ultimately affect behavior. This report first describes evidence in animals that exposure in adults and during adolescence to rewarding substances, such as the drugs alcohol, nicotine and cocaine and palatable fat-rich food, stimulates the expression of MCH as well as HCRT and their intracellular molecular systems. It also increases reward-seeking and emotional behavior, leading to excess consumption and abuse of these substances and neurological conditions, completing this positive feedback loop. Next, this review focuses on the model involving embryonic exposure to these rewarding substances. In addition to revealing a similar positive feedback circuit, this model greatly advances our understanding of the diverse changes that occur in these neuropeptide/molecular systems in the embryo and how they relate, perhaps causally, to the disturbances in behavior early in life that predict a later increased risk of developing substance use disorders. Studies using this model demonstrate in animals that embryonic exposure to these rewarding substances, in addition to stimulating the expression of peptide neurons, increases the intracellular molecular systems in neuroprogenitor cells that promote their development. It also alters the morphology, migration, location and neurochemical profile of the peptide neurons and causes them to develop aberrant neuronal projections to forebrain structures. Moreover, it produces disturbances in behavior at a young age, which are sex-dependent and occur in females more than in males, that can be directly linked to the neuropeptide/molecular changes in the embryo and predict the development of behavioral disorders later in life. These results supporting the close relationship between the brain and behavior are consistent with clinical studies, showing females to be more vulnerable than males to developing substance use disorders with co-occurring emotional conditions and female offspring to respond more adversely than male offspring to prenatal exposure to rewarding substances. It is concluded that the continued consumption of or exposure to rewarding substances at any stage of life can, through such peptide brain systems, significantly increase an individual’s vulnerability to developing neurological disorders such as substance use disorders, anxiety, depression, or cognitive impairments. Full article

The adolescent years are pivotal in reproductive and sexual development and maturation, yet the experience of migration can severely disrupt this period, inhibiting young immigrants’ knowledge, access, and engagement with sexual and reproductive health (SRH) services. Further, young immigrants and minority populations often face persistent intersectional barriers, including language difficulties, cultural stigma, and systemic exclusion, that result in adverse SRH outcomes. Recent advances in SRH care, particularly in digital health and community-based interventions, show promise in improving access to culturally appropriate SRH services and information. Co-designing SRH programs with families and young immigrants to adequately acknowledge the unique cultural norms and barriers in SRH is essential in ensuring a high outreach of interventions. Shifts in traditional health policies are needed to ensure that immigrant and minority adolescents are not overlooked and that SRH programs incorporate culturally relevant content that is easily and widely accessible. Despite positive shifts, several barriers remain: limited disaggregated data on diverse populations, inadequate policy attention, and the insufficient scalability and funding of promising interventions. Future research and promotional efforts must prioritise the co-creation of SRH interventions with stakeholders and affected communities, ensuring that services are sustainable, culturally appropriate, and accessible to all adolescents. Full article

The global increase in early-onset cancers among adolescents and young adults has happened at the same time as the rise in the consumption of ultra-processed foods (UPFs). Far beyond their poor nutritional quality, UPFs are increasingly seen as Trojan horses, complex biological agents that interfere with many functions of the human organism. In this review, we utilise the Trojan horse model to explain the quiet and building health risks from UPFs as foods that seem harmless, convenient, and affordable while secretly delivering endocrine-disrupting chemicals (EDCs), causing chronic low-grade inflammation, altering the microbiome, and producing epigenetic alterations. We bring together new proof showing that UPFs mess up hormonal signals, harm the body’s ability to fight off harmful germs, lead to an imbalance of microbes, and cause detrimental changes linked to cancer. Important components, such as bisphenols and phthalates, can migrate from containers into food, while additional ingredients and effects from cooking disrupt the normal balance of cells. These exposures are especially harmful during vulnerable developmental periods and may lay the groundwork for disease many years later. The Trojan horse model illustrates the hidden nature of UPF-related damage, not through a sudden toxin but via chronic dysregulation of metabolic, hormonal, and genetic control. This model changes focus from usual diet worries to a bigger-picture view of UPFs as causes of life-disrupting damage. Ultimately, this review aims to identify gaps in current knowledge and epidemiological approaches and highlight the need for multi-omics, long-term studies and personalised nutrition plans to assess and reduce the cancer risk associated with UPFs. Recognising UPFs as a silent disruptor is crucial in shaping public health policies and cancer prevention programs targeting younger people. Full article

High-grade osteosarcoma (HGOS) is the most common primary malignant bone tumor in children and adolescents. Poor response to chemotherapy is linked to worse prognosis and increased risk of recurrence and metastasis. However, current assessment methods, such as tumor necrosis evaluation, are time-consuming and delay treatment decisions. Thus, identifying molecular pathways and predictive biomarkers is essential for guiding early therapeutic strategies. In this study, RNA-seq analysis of HGOS tissues revealed enrichment of cholesterol biosynthesis and mitotic pathways in poor responders. Additionally, high HMGCR expression, as analyzed from TCGA data, was associated with poor prognosis in sarcoma. Functional validation using SaOS-2 cells, which exhibited poor drug sensitivity and elevated HMGCR levels, demonstrated that simvastatin enhanced the efficacy of cisplatin and doxorubicin by inducing mitochondrial-mediated apoptosis and downregulating anti-apoptotic proteins. Simvastatin also reduced cell migration and invasion by suppressing epithelial–mesenchymal transition and extracellular matrix degradation. Mechanistically, simvastatin disrupted Ras prenylation and inhibited downstream oncogenic signaling pathways, including Akt/mTOR and Akt/GSK3, which regulate survival and metastasis-associated gene expression. These findings suggest that the cholesterol biosynthesis pathway particularly plays a critical role in chemoresistance and metastasis in HGOS and may serve as a promising predictive molecular target for guiding early therapeutic strategies. Full article

This study aims to illustrate the impact of accumulated traumatic experiences in adolescence and to evaluate the potential of brief focal psychotherapy (BFP) as a treatment approach for complex trauma. We present the case of a 14-year-old boy who experienced vicarious gender-based violence, child abuse, early maternal separation without alternative secure attachment figures, and forced sudden migration. The patient exhibited symptoms consistent with post-traumatic stress disorder (PTSD) and complex trauma. The culturally sensitive intervention, delivered at a public child and adolescent mental health center, consisted of twenty weekly individual sessions of 45 min each, complemented by three 45 min psychoeducation sessions with the caregiver. The assessment was conducted using a multitrait and multi-informant approach, systematically gathering information across multiple domains of functioning (emotional–behavioral, physical, cognitive, self-perception, and relational) and from different sources (the adolescent, his mother, and the clinician) through clinical interviews, projective techniques, and parental feedback. The primary therapeutic focus was the establishment of a secure therapeutic alliance to facilitate emotional exploration and trauma processing. Following treatment, the patient demonstrated significant improvements in emotional regulation, family relationships, and school performance, as measured by both self-report and parental observations. This case highlights the potential of BFP in addressing complex trauma in adolescents, particularly during a developmental stage marked by increased vulnerability to the effects of chronic trauma exposure. The findings suggest that BFP can effectively reduce both acute symptomatology and broader psychosocial consequences associated with prolonged and cumulative trauma. Further research, particularly controlled studies and longitudinal follow-ups, is needed to refine and optimize the use of BFP by mental health professionals working with adolescents affected by complex trauma. Full article

Lafora progressive myoclonus epilepsy (LD, OMIM#254780, ORPHA:501) is an ultra-rare and severe autosomal recessive neurological disorder that typically manifests in early adolescence. It is characterized by the accumulation of insoluble forms of aberrant glycogen in the brain and peripheral tissues. Given the urgent need for reliable tools to monitor disease progression, we aimed to identify reliable biomarkers in minimally invasive fluids, which could also provide valuable insights into the natural history of the disease. Plasma-EDTA samples from eleven LD patients and healthy controls were analyzed to identify potential biomarkers of LD using a high-throughput assay. The findings were subsequently validated using specific enzyme-linked immunosorbent assays (ELISAs). Eleven cytokines and growth factors were identified to be significantly reduced in LD patient samples compared to healthy controls. Among these, four mediators [platelet-derived growth factor subunit B (PDGF-BB), epidermal growth factor (EGF), brain derived growth factor (BDNF), and macrophage migration inhibitory factor (MIF)] exhibited the greatest fold change between the groups and were further validated. Given the minimally invasive nature of plasma sampling and the straightforward quantification via ELISA assays, these biomarkers hold strong promise for rapid translation to the clinic, potentially enhancing early diagnosis and longitudinal disease monitoring in LD patients. Full article

Background: Oncological care of adolescent patients is often inconsistent, as they frequently fall between pediatric and adult services. The Childhood Cancer Registry of Campania (CCRC) is the Italian largest population-based registry specializing in children 0–19 years old, with a target population of approximately 1.1 million inhabitants. Material and Methods: This report presents epidemiological indicators and clinical pathways on primary brain tumors in adolescents (15–19 years) from the Campania region. Results: Over the study period (2008–2020), the cohort included 219 adolescents with newly diagnosed central nervous system (CNS) tumors with an annual average incidence rate (IR) of 48.9 cases per million/year. The 5-year observed survival rate after diagnosis of CNS tumor was 84.8%. Overall, the most common tumor site was the pituitary gland and craniopharyngeal duct, representing 22.4% of all tumors. The most frequently occurring malignant primary CNS tumor was germinoma, while the most common non-malignant tumor was pituitary adenoma. Most patients were referred to adult services and nearly half migrated outside the region to receive cancer care. Conclusions: Challenges in the care of adolescent oncology patients include limited access to specialized care, difficulties in transitioning from pediatric to adult institutions, distinct tumor biology, and the underrepresentation of adolescents in clinical trials. The care of adolescents with CNS tumors is fragmented across institutions and significant variations in practice exist between adult and pediatric practitioners. Full article

The economic and health context in recent years has led to an increase in return migration of Romanians and an increased propensity to settle down in their country of origin. Remigration can be lived as a life experience with an extremely high vulnerabilising potential, with obvious consequences in terms of adaptation and psychological consequences, and a negative impact especially on children and adolescents. The present study is based on an online survey conducted between July 2023 and February 2024 among teachers in the North-East Region of Romania and had the overall objective of assessing the effects of return migration on Romanian remigrant pupils. This phenomenon was analysed on the basis of teachers’ perceptions of the behaviour of pupils who have experienced emigration, followed by remigration, equivalence of studies and integration or reintegration into the Romanian education system. Our study is exploratory and could be followed by the analysis of the same phenomenon from other perspectives (children, parents). The results of the study show that after remigration, some children and adolescents are faced with many educational and social adjustment problems for which they were not prepared. Remigration increases stress, and educational integration is in most cases a difficult process. The negative impact translates into limited opportunities for emotional, social, and intellectual development, or even behavioural disorders, which affect the quality of life of remigrant pupils and their long-term quality of life. Positive aspects of children’s remigration have also been identified. Full article

In a country where almost the totality of the native population is baptized and raised in the Catholic Church, recent surveys have shown several inconsistencies, especially among the young who claim that they do not believe. This study is a follow-up of another one that showed marked differences between the younger generation and older ones regarding the importance of religion in their life. Other surveys gave a similar picture. This study seeks to acquire a deeper understanding of the religiosity of these adolescents and young adults, this time with the use of two validated instruments. The first, the Meaning and Purpose Scales (MAPS), was meant to capture the essence of religion as a meaning-making mode. For the second, since the majority of the participants came from an organized religion, it was worth investigating the reasons why these adolescents were abandoning their religion and where they were going. This was attempted through the administration of the Adolescent Deconversion Scale (ADS). In addition, to detect deconversion-related changes, the participants were asked to undertake the Retrospective Analysis of Religiosity, a graphical method representing their religious development over the years by the plotting of a “religiosity line”. Following a number of contrasts between the test variables and others from the demographic information, a more defined and detailed picture of the religiosity of this segment of the population emerged. The absolute majority of the participants continue to profess their religion, and faith continues to be a major source of meaning in their life. In addition, there is a strong correlation between their personal sense of security and religion and the family, particularly for two-parent families. This study exposed a particular critical point in their religious journey, marking the beginning of a decline in their religion. This also coincides with the major developmental changes that take place during puberty. For the rest, perseverance in the faith journey was very strongly related to having participated for a number of years in a faith group. The family of origin and, later, belonging to a faith group seem to be decisive factors in the transmission and preservation of religiosity. As for those who left religion, the main reasons differed, including existential quests, peer influence, or simply indifference. Most, however, do not seem to have migrated to another religion or sect, and there are signs that many of them might have retained their own personal spirituality privately. Finally, it could be argued that, for some, their religious journey might not be over yet. Full article

Latin American upper-middle-income countries (LAUMICs) face significant challenges in ensuring equitable access to sexual and reproductive health (SRH) for adolescents due to socioeconomic inequalities, migration, and historical violence. This systematic review examines the barriers and facilitators to sexual and reproductive health access for adolescent girls (≤19 years old) in vulnerable situations across Latin America. Using six databases, 391 articles were reviewed; 10 met the inclusion criteria, and 10 more were included through backward search, resulting in 20 analyzed studies. Structural barriers such as economic, regulatory, and institutional constraints were found to restrict SRH access, exacerbated by social stigma and negative narratives, especially in cases involving sexual violence and clandestine abortions. Facilitators included intersectoral collaboration, preventive education, and community networks, which improved access to and the quality of services for vulnerable populations. The findings emphasize the need for sustainable strategies that address structural inequalities and stigma while strengthening health systems, and intersectoral cooperation. Comprehensive, culturally tailored education and clear regulatory frameworks are essential to achieving equitable and sustainable SRH services. These insights offer practical guidance for public policy and program design in LAUMICs, particularly for addressing the needs of marginalized adolescent populations. Full article

Intergenerational educational mobility means that adolescents graduate at a higher level (upward mobility) or lower level (downward mobility) than their parents did. Knowledge about early determinants supports upward and downward mobility at an early stage. Evidence about early determinants of educational mobility allows for the elaboration of educational strategies to minimize the correlation between family socio-economic status (SES) and student upper-secondary education level. In this longitudinal study (N = 2376), we examined the extent to which teacher and parent expectations in 7th grade (mean age: 13.2 years) predict the achievement and effort of adolescents with and without migration backgrounds and the probability of upward and downward mobility at the end of upper-secondary education. The results showed indirect effects of teacher and parent expectations on upward and downward mobility, mediated by student achievement, after controlling for gender and conscientiousness. The effects of parent expectations were stronger than the effects of teacher expectations. Effort predicted downward mobility more than achievement in mathematics and German. No differences were found between adolescents with and without migration backgrounds. In the case of the tracked Swiss education system, parents’ and teacher expectations predicted educational mobility over long periods. Full article

Osteosarcoma (OS) is the most prevalent malignant bone tumor in adolescents and young adults. OS cells grow in a permissive local microenvironment which modulates their behavior and facilitates all steps in tumor development (e.g., proliferation/quiescence, invasion/migration, and drug resistance) and contributes to their intrinsic heterogeneity. The lung parenchyma is the most common metastatic site in OS, and metastatic foci are frequently associated with a poor clinical outcome. Although multiple factors may be responsible for the disease, including genetic mutations (e.g., Rb and p53), the molecular mechanism of development of OS remains unclear, and the conventional treatment for OS is still based on a sequential approach that combines chemotherapy and surgery. Also, despite the increase in clinical trials, the survival rates for OS have not improved. Non-specific targeting therapies thus show poor therapeutic effects, along with side effects at high doses. For these reasons, many efforts have been made to characterize the complex genome of OS thanks to the whole-exome analysis, with the aim of identifying predictive biomarkers to give these patients a better therapeutic option. This review aims to summarize and discuss the main recent advances in OS molecular research for precision medicine. Full article

This essay argues that Nobel laureate Verner von Heidenstam’s campaign against naturalist aesthetics in late nineteenth-century Swedish literature was motivated, in part, by the sense of estrangement he developed from Swedish cultural life during his adolescent years as a migrant. It also contends that the aesthetic discontent he experienced in his early career foreshadowed a wider sense of alienation from place and nation that would accompany the rise of globalization and normalized migration in the twentieth century. While recent scholarship on Heidenstam’s early oeuvre situates the writer’s bibliography within the fin de siècle, this project refocuses the discussion on the contemporaneous artistic debates Heidenstam addresses in his polemic Renässans, as well as the migratory themes he explores in his 1892 novel, Hans Alienus. This approach illuminates how Heidenstam’s youthful quest for aesthetic reinvention upended the notion that artists and writers can be tethered to singular points of origin, offering new pathways for understanding the emergence of a distinct migrant literature and visual art in Sweden. Although Heidenstam’s later works took a sharp nationalistic turn and have receded from popular consciousness in contemporary times, reexamining his earliest paintings and prose as products of a migrant imagination can help scholars more firmly affix his legacy to modern and Modernist traditions, inviting fresh perspectives on his paradigm-shifting aesthetic of estrangement. Full article

The endocannabinoid signalling system (ECS) plays a critical role from the very beginning of embryogenesis. Accordingly, the ECS is engaged early on in nervous system development, starting from neurulation, supported by the identification of ECS components—both receptors and enzymes controlling endocannabinoid metabolism—at these early stages. In particular, regarding the brain, the ECS is involved in the tightly regulated sequence of events that comprise brain development, from neurogenesis to neuronal migration, morphological guidance for neuronal connectivity, and synaptic circuitry refinement. The importance of this broad role of the ECS across various brain development processes is further underscored by the growing understanding of the consequences of cannabis exposure at different developmental stages. Despite the considerable knowledge we have on the role of the ECS in brain development, significant gaps in our understanding remain, particularly regarding the long-term impact and underlying mechanisms of cannabis exposure at different developmental stages. This review provides an overview of the current state of knowledge on the role of the ECS throughout brain development, from embryogenesis to adulthood, and discusses the impact of cannabis exposure, especially during adolescence—a critical period of circuitry maturation and refinement coinciding with an increased risk of cannabis use. Full article