Search Results (23,928)

Background: The Child and Adolescent Eating Disorder Examination Questionnaire (ChEDE-Q) is a widely used self-report screening instrument for assessing eating disorder psychopathology in young people. Evidence on the psychometric properties of the Polish-language version remains limited. This pilot study evaluated the internal consistency, dimensional structure, and BMI-related convergent validity of the Polish ChE-DE-Q in a regional youth sample. Methods: A cross-sectional design was used, including 200 participants aged 10–18 years. Item characteristics and data quality were examined. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega. Dimensional structure was evaluated with exploratory factor analysis (EFA) based on a polychoric correlation matrix and confirmatory factor analysis (CFA) comparing one-factor, four-factor, and bifactor models. Convergent validity was examined using Spearman’s rank correlations with BMI and linear regression analyses with BMI z-scores. Results: The global score showed high internal consistency (α = 0.898; ω = 0.900). Subscale reliability ranged from acceptable to high. EFA supported a multidimensional solution. In CFA, the bifactor model showed the best fit among the tested alternatives (CFI = 0.742; TLI = 0.681; RMSEA = 0.122; SRMR = 0.084), but none of the tested models achieved fully satisfactory absolute fit. The global score correlated positively with BMI (rho = 0.282; p < 0.001) and was significantly associated with BMI z-score in regression analysis (B = 0.334; p < 0.001). Conclusions: The Polish ChEDE-Q global score demonstrated strong internal consistency and preliminary BMI-related convergent validity. The findings provide initial support for a general factor and for using the global score in screening-oriented research; however, the pilot character of the study and the suboptimal absolute fit indices indicate that further validation in larger and more heterogeneous samples is required. Full article

Respiratory support requirement among children hospitalized with pneumonia is a key marker of disease severity and resource needs, yet scalable risk stratification tools for routine hospital settings in Southern Vietnam remain limited. Background: This study aimed to develop and evaluate clinical and laboratory-based multivariable models to predict respiratory support requirement in children under five hospitalized with pneumonia, using a routine care dataset. Methods: We conducted a retrospective cohort study conducted at a tertiary pediatric hospital in Southern Vietnam (July 2024–November 2025), children aged 2–59 months hospitalized with pneumonia were included after predefined exclusions. The outcome was the maximum (worst) level of respiratory support required during hospitalization (oxygen therapy, CPAP, or invasive mechanical ventilation), analyzed as a binary endpoint (any support vs. none) for model development. Candidate predictors included bedside clinical variables (age < 12 months, malnutrition, recurrent pneumonia, cyanosis, tachypnea, chest indrawing) and complete blood count-derived inflammatory indices. Univariable logistic regression was used for crude associations. Two multivariable logistic regression models were built: Model 1 (clinical-only) and Model 2 (clinical + neutrophil-to-lymphocyte ratio [NLR]; primary). Discrimination was assessed using area under the ROC curve (AUC), and calibration was evaluated using the Hosmer–Lemeshow test and observed-to-expected (O:E) ratio. Results: A total of 1797 children were included; 154 (8.6%) required respiratory support. In the primary model, independent predictors were age < 12 months (aOR 2.57, 95% CI 1.69–3.92), malnutrition (aOR 4.33, 2.56–7.33), recurrent pneumonia (aOR 1.82, 1.18–2.81), cyanosis (aOR 24.02, 7.41–77.87), chest indrawing (aOR 4.19, 2.73–6.43), and higher NLR (per 1 unit: aOR 1.49, 1.38–1.60), while tachypnea was not independently associated after adjustment. Discrimination improved from Model 1 (AUC 0.754) to Model 2 (AUC 0.840; 95% CI 0.806–0.874). At the optimal probability cut-off (0.122), Model 2 achieved sensitivity 66.2%, specificity 86.2%, PPV 31.1%, NPV 96.5%, and accuracy 84.5%. Calibration was acceptable (Hosmer–Lemeshow p = 0.662; O:E = 1.00). Conclusions: A simple clinical model strengthened by NLR provided good discrimination and calibration for predicting respiratory support requirement among children under-five hospitalized with pneumonia in Southern Vietnam. This approach may support early triage, prioritization of monitoring intensity, and escalation readiness in resource-constrained settings, although external validation is warranted. Full article

Background/Objectives: Endometrial cancer (EC) is a multifactorial disease influenced by metabolic, hormonal, and environmental factors. Trace and macroelements play a critical role in cellular homeostasis, oxidative stress, and tumor progression; however, their relationship with EC grading and clinical characteristics remains insufficiently understood. Methods: This study evaluated the concentrations of selected macro- and trace elements (Na, K, Ca, P, Mg, Mn, Cu, Zn, Be, As, Cr, Mo, Ti, Tl, Pb) in patients with endometrial cancer (G1–G3) and a control group (C). Elemental analysis was performed using inductively coupled plasma optical emission spectrometry (ICP-OES). Associations between elemental concentrations and clinicopathological variables, including age, body mass index (BMI), menopausal status, diabetes, and smoking, were assessed using appropriate statistical tests, including ANOVA with Tukey’s post hoc analysis and Student’s t-test. Multivariate regression analysis was performed to identify independent predictors of elemental alterations. Results: Significant differences in elemental concentrations were observed across EC grading. Higher-grade tumors were associated with increased levels of Ca, P, Mg, and Mn, while Na and K showed a decreasing trend with tumor progression. No statistically significant differences were observed for Zn, Ti, Tl, or Pb across histological grades. Stratified analyses demonstrated that clinical and metabolic factors had a limited and selective impact on elemental profiles. Age and BMI were associated with minor variations in selected elements, whereas menopausal status, diabetes, and smoking showed predominantly non-significant or inconsistent effects. Multivariate analysis identified histological grade as the primary determinant of elemental alterations, while other variables exhibited weaker or element-specific associations. Conclusions: Elemental homeostasis in endometrial cancer is primarily associated with tumor progression rather than systemic metabolic or lifestyle factors. Changes in Ca-, P-, Mg-, and Mn-related pathways may reflect tumor-driven metabolic reprogramming, whereas most trace elements remain relatively stable. These findings suggest that elemental profiling may provide insight into EC biology, although its clinical utility requires further investigation. Full article

Background/Objectives: Sleep is an important biobehavioral process that supports child and adolescent health and development. However, many prior studies examining sleep and mental health have relied on total sleep scores, which may mask the heterogeneity of sleep disturbances. Youth exposed to childhood adversity are at increased risk for sleep disturbances and poor mental health, and thus it is important to examine the links between sleep and mental health within adversity-exposed samples, such as those involved with the child welfare system. Methods: This study used latent class analysis to identify underlying patterns of sleep disturbances and examine differences in mental health symptoms (assessed at baseline and at an 18-month follow-up) across the identified subgroups in a sample of child welfare-involved adolescents (N = 1041, M_age = 13.63 years, SD = 1.86). Our sample was derived from the second cohort of the National Survey on Child and Adolescent Well-Being (NSCAW) study. Results: We identified three subgroups of sleep disturbances: no sleep disturbances (38%), sleeping more than peers and overtired (16%), and trouble maintaining sleep (47%). We found significant mean differences in mental health symptoms across subgroups. Across internalizing, externalizing, and post-traumatic stress disorder (PTSD) symptoms at baseline and at an 18-month follow-up, those in the no sleep disturbances subgroup had overall lower levels of symptoms compared to those in the trouble maintaining sleep subgroup, which had higher levels of symptoms. Compared to those in the sleeping more than peers and overtired subgroup, the trouble maintaining sleep subgroup had higher levels of PTSD symptoms at baseline, and higher levels of externalizing and PTSD symptoms at the follow-up. Those in the sleeping more than peers and overtired subgroup had significantly higher levels of internalizing, externalizing, and PTSD symptoms at baseline compared to the no sleep disturbances subgroup, but there were no significant differences at the 18-month follow-up. Conclusions: The current study highlights the importance of considering the heterogeneity of sleep disturbances to identify child welfare-involved youth who may be more at risk for sleep disturbances and poor mental health and to inform more targeted sleep interventions for this population. Full article

Background: Endometrial cancer (EC) is the most common gynecological malignancy in Western countries. Although international guidelines recommend that patients with EC be treated at specialized oncology centers, many are still managed by general gynecologists. This study aimed to evaluate the influence of facility volume on treatment strategies and survival outcomes among EC patients. Methods: This is a retrospective multicenter study comparing 971 patients with EC treated at medium-volume centers (CVMs) (11–29 cases/year) with 1431 patients treated at high-volume centers (CVAs) (≥30 cases/year). Patient characteristics were recorded, including age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, comorbidities, surgical approach, lymphadenectomy, total number of lymph nodes removed, number of positive lymph nodes, length of hospital stay, histological characteristics, ESMO-ESGO (European Society for Medical Oncology–European Society of Gynaecological Oncology) classification system, adjuvant treatment, recurrence, progression-free survival (PFS), and overall survival (OS). Postoperative fever, hemoglobin changes, and blood transfusions were also reported. Results: Compared with patients treated at the MVCs, patients treated at the HVCs were younger (mean age, 65 vs. 66.4 years, p = 0.03) and had a lower rate of comorbidities (41% vs. 55%, p < 0.001). Patients treated at HVCs were mostly in higher ESMO-ESGO recurrence risk classes (p < 0.001), were treated mostly laparoscopically (58% vs. 47%, p < 0.001) and had better staging (higher number of lymph nodes harvested (mean 19 vs. 11, p < 0.001) and more peritoneal biopsies performed (27% vs. 14%, p < 0.001). HVC patients had fewer complications and received less adjuvant therapy (40% vs. 50%, p < 0.001) but, when treated, received chemotherapy more frequently, showed mostly loco-regional recurrences (34% vs. 14%) and fewer extra-abdominal recurrences (34% vs. 54%). HVC patients had better PFS and OS. Center volume was found to be an independent factor influencing PFS in multivariate analysis. Conclusions: All EC patients should be centrally managed to receive superior treatment to improve postoperative recovery and oncological outcomes, particularly for patients with more-aggressive tumors. Full article

HM Inspectorate of Probation is committed to building and utilising the evidence base for high-quality youth justice services, and to promoting excellence and having a positive impact upon those inspected and the wider sector. Research evidence and inspection findings are used to inform understanding of what helps and what hinders services and to consider system-wide change. In this article, the latest inspection and research findings in relation to the high-profile areas of serious youth violence and criminal exploitation are highlighted. The article encompasses insights from core and thematic inspections, including those from recent joint targeted area inspections (JTAIs) undertaken with other inspectorates. Alongside the JTAIs which examined multi-agency responses to serious youth violence, research was commissioned to hear directly from children and families about their experiences. Other research commissioned and published by the Inspectorate has emphasised the importance of implementing relational, child-centred and trauma-informed approaches and to optimising collaborative/partnership working across agencies and sectors. Reports have also drawn attention to the value of paying attention to the socio-ecological framework, systemic resilience, adultification biases, and both contextual and transitional safeguarding. Full article

Childhood stunting remains a major public health challenge in India and is influenced by multiple socioeconomic and environmental factors. This ecological study examined district-level correlates of childhood stunting, including Crimes Against Women (CAW), the Multidimensional Poverty Index (MPI), and drought severity, using data from NFHS-5, the National Crime Records Bureau, NITI Aayog’s MPI reports, and the Drought Atlas of India. Spatial autocorrelation and Spatial regression models were applied alongside machine learning approaches and SHAP-based Explainable AI (XAI) interpretation. Childhood stunting exhibited significant spatial clustering (Moran’s I = 0.520, p < 0.001), with hotspots in northern, central, and eastern India. Higher stunting was associated with higher birth order, low maternal BMI, child anaemia, and MPI, and negative associations with iodised salt usage, electricity access, and timely postnatal care. A significant spatial lag parameter (ρ = 0.348) indicated substantial spillover effects. Machine learning models consistently identified MPI, drought severity, and CAW as key predictors. The integrated spatial and machine learning framework identifies key correlates and spatial dependencies of childhood stunting, highlighting the need for region-specific, multisectoral interventions. Full article

Background/Objectives: Simulation-based education often lacks personalization, focusing on technical competence rather than individual student profiles. This protocol describes a study designed to evaluate whether adapting gamified narratives to nursing students’ personality profiles has the potential to support academic performance in obstetrics. This study aims to validate the integration of psychometric profiling and AI as a sustainable strategy for personalized clinical training. Methods: A cluster-randomized controlled longitudinal pilot trial will be conducted at the University of Atlántico Medio. The protocol has been submitted for registration at ClinicalTrials.gov (Registration Pending). Thirty-eight second-year nursing students meeting inclusion criteria (excluding repeaters or those with prior specialized training) will be assigned by natural practice to either a control group (generic gamification) or an experimental group (gamification adapted according to Player Personality and Dynamics Scale profiles using AI-generated content). The intervention comprises four clinical simulation sessions focusing on pregnancy and childbirth, which are managed via the Wix platform. The primary outcome is academic performance, measured as “Learning Gain” (post-test scores minus pre-test scores). Secondary outcomes include student satisfaction measured via the Gameful Experience Scale. Data will be analyzed using Mann–Whitney U tests to compare overall efficacy and intragroup evolution. To minimize observer bias, knowledge assessments will utilize automated, objective scoring, and participants will be blinded to the study hypothesis. Expected Outcomes: The study aims to establish the technical and pedagogical feasibility of integrating AI-adapted narratives into nursing curricula. It is anticipated that the personalized approach will show positive trends in learning gains and engagement patterns, providing a baseline for larger multicenter trials. Conclusions: This protocol presents a framework for “Precision Education” in nursing, shifting from “one-size-fits-all” simulations to student-centered adaptive training. The use of Generative AI makes such personalization sustainable and cost-effective for health science faculties. Full article

Cultured urine-derived cells (UDCs) have been proposed as a source of material for the RNA-based molecular diagnosis of genetic disorders. Previous studies have shown that UDCs can be clonally expanded, passaged, frozen, regrown and have some stem cell characteristics, but their anatomic origin and diagnostic utility remain insufficiently explored. In this study, we cultured UDCs from 40 individuals (aged 4 to 20 years; 21 females) and extracted RNA for sequencing. We compared UDC gene expression to that of marker genes of the kidney and urinary tract segments. UDC gene expression most closely matched marker genes of parietal epithelial cells that line the inner surface of Bowman’s capsule in the kidney glomerulus. UDCs expressed VCAM1 (CD106) and POUF51 (OCT4), consistent with a progenitor cell type. UDCs also expressed 54.4% of 3125 OMIM-listed disease-causing genes. This indicated that UDCs can be used to diagnose a similar number of genetic disorders as skin fibroblasts and a wider range of genetic disorders than can be analysed by RNA extracted from whole blood. In conclusion, UDCs are a non-invasive cell source for RNA sequencing that is suitable for investigating a broad range of conditions. Full article

Children gifted for music are often described as possessing heightened perceptual and sensory abilities, yet little is known about how these abilities are understood within different family contexts or how giftedness is experienced as an identity. This mixed-methods study examined alignment between gifted children’s and parents’ perceptions of children’s mental–perceptual abilities, the role of parental musical background, and how giftedness is explained and emotionally negotiated. Twenty-two children identified as gifted for music and 25 parents completed a survey based on Gagné’s Differentiated Model of Giftedness and Talent assessing six mental–perceptual abilities, followed by semi-structured interviews. Quantitative analyses revealed a strong positive association between child and parent ratings, alongside a consistent tendency for parents to provide higher evaluations. Parental professional musical background did not significantly moderate alignment but was associated with greater variability in both children’s and parents’ ratings. Qualitative findings indicated shared experiential understandings of ability across families, alongside systematic differences in evaluative frameworks: musician parents more frequently drew on technical, comparative, and training-based standards, whereas non-musician parents relied on affective and everyday observations. Children across contexts often expressed modesty or ambivalence toward being labeled gifted, while parents balanced pride with concern about pressure. Overall, perceptions of mental–perceptual ability emerged as relationally constructed within family environments that shape how musical giftedness is recognized and supported. Full article

To comprehend the current state and future of newborn screening (NBS), it is essential to understand its history. Over the past six decades, this well-established and exemplary population-based screening program has been guided by screening principles dating back more than half a century. Advances in laboratory and point-of-care testing, diagnostic methods, and a surge of available treatments and even cures have made it challenging to balance screening criteria that have not kept pace with the current landscape. The availability to screen as well as the demand from parents and stakeholders to screen for more and increasingly complex conditions while limiting the retention of NBS specimens and genetic material has been both exciting and challenging. This paper shares the history of NBS in the United States, followed by the development and integration of genomic sequencing as a complement to current practice. It explores evidence supporting the concomitant use of biomarker- and DNA-sequencing-based approaches for NBS, how disorders are selected for inclusion, and available treatments, and offers recommendations regarding what to consider and how to proceed in this ever-changing NBS landscape. Full article

Background and Objectives: The aim of this study is to evaluate impulsivity in childhood anxiety disorders and to examine its relationship with anxiety sensitivity and emotion regulation. Materials and Methods: The study group consisted of a total of 60 children aged 8–12 years diagnosed with generalized anxiety disorder (GAD, n = 30) and other anxiety disorders (n = 30). The control group consisted of 40 healthy children of similar age without a psychiatric diagnosis. Data collection forms included the Barratt Impulsiveness Scale Short Form (BIS-S), the Children’s Anxiety Sensitivity Index (ASI-3), the Emotion Regulation Checklist (ERC), and The Screen for Child Anxiety Related Emotional Disorders (SCARED). Results: Our study found no significant differences in BIS-S scores between GAD, other anxiety disorders, and the control group. The total/physical and ERC subscales of the ASI-3 were higher in the generalized anxiety disorder and other anxiety disorder group than in the control group. However, there were no significant differences in the social dimension and cognitive dimension scores of the ASI-3. It has been determined that anxiety sensitivity does not significantly mediate the relationship between emotion regulation and impulsivity, and that emotional variability/negativity is directly and completely related to impulsivity. Conclusions: Our study suggests that children with anxiety disorders experience greater difficulties in regulating their emotions compared to healthy children, and that emotional variability is directly related to impulsivity. In this context, enhancing emotion regulation skills in anxiety disorders may prove to be a pivotal factor in the efficacy of treatment and the maintenance of behavioral control. Full article

This article reports on action research which sought the perspectives of South Sudanese families and communities about their experiences and understanding of child protection. The research was grounded in cycles of interviews, consultation, and participation observation with a total of ninety-seven participants which included South Sudanese leaders and families in Australia and in Uganda. The resulting data offers a layered insight into the pressures families navigate and the strengths on which they draw to keep children connected to community and culture in Australia and the importance they place on community led approaches in which protection and safety are understood as collective responsibilities. The findings show that the collective strengths they highlight are often misunderstood within Western child protection systems. The paper concludes that meaningful partnership and developmental ways of working are essential for building trust and designing approaches that keep children safe within culture. Full article

The A* algorithm is widely used in path planning for Automated Guided Vehicles (AGVs), but the path it generates is prone to collision with random obstacles. To address this issue, this paper proposes a hybrid path planning algorithm integrating the improved A* algorithm with Dynamic Window Approach (DWA). Firstly, a global key point extraction strategy is adopted, and Bresenham’s line algorithm is used to eliminate redundant path points and turning inflection points, optimizing the conciseness and continuity of the path while redefining the child nodes of the current position. Secondly, in complex environments, the inflection points of the global path are taken as the target points of DWA to segment the path, and local dynamic planning is combined to achieve real-time obstacle avoidance. Simulation results show that compared with the traditional A* algorithm, the improved algorithm reduces the planning time by 24.19%, decreases the number of inflection points by 40.00%, and shortens the path length by 1.49%. In environments with random obstacles, the path generated by the hybrid algorithm is smoother, which can effectively enhance the local obstacle avoidance capability and improve the safety of path planning. Furthermore, physical experiments on an AGV platform with a distributed master-slave control architecture (STM32 microcontroller and Jetson embedded processor) verify the algorithm’s hardware compatibility and real-time computing performance, validating its engineering applicability in practical industrial scenarios. Full article

Background/Objectives: Renal cell carcinoma (RCC) care has been reshaped by immune checkpoint inhibitors (ICIs), now used across adjuvant and metastatic settings as PD-1/PD-L1 blockade alone, combined with anti-CTLA-4 agents, or in combination with vascular endothelial growth factor (VEGF)-targeting tyrosine kinase inhibitors (TKIs). As survival improves and systemic therapy courses extend, survivorship priorities—including fertility preservation, reproductive endocrine health, contraception, and pregnancy counselling—become increasingly relevant, even though RCC-specific oncofertility evidence remains sparse. This review examines the biological rationale and clinical considerations underpinning reproductive counselling for women of reproductive age exposed to ICIs (alone or with TKIs) in RCC. Methods: A narrative review was conducted in accordance with the SANRA framework, integrating targeted PubMed/MEDLINE searches up to 20 February 2026 and consultation of regulatory product labels to synthesize mechanistic, clinical, and safety data relevant to fertility, endocrine function, contraception, pregnancy, and breastfeeding in RCC. Results: We delineate the contemporary RCC treatment landscape to identify feasible timepoints for fertility preservation discussions and propose a pragmatic, implementation-oriented counselling framework that distinguishes evidence-secure recommendations (pregnancy avoidance during therapy, endocrine monitoring, agent-specific washout) from extrapolative domains (long-term ovarian reserve effects and post-ICI periconception safety beyond label intervals). Conclusions: By integrating a ‘multi-hit’ biological rationale, treatment context, and available human data, this review highlights RCC-specific research priorities while supporting transparent, evidence-aligned, and multidisciplinary counselling for both fertility preservation and pregnancy safety in the ICI era. Full article