Search Results (21,692)

Aims: To investigate the global epidemiological characteristics of lower respiratory infection (LRI) burden caused by Streptococcus pneumoniae (SP) from 1990 to 2021. Methods: Using data from the Global Burden of Disease (GBD) study 2021, we systematically analyzed Streptococcus pneumoniae-related (SP-related) LRI burden, focusing on mortality, disability-adjusted life years (DALYs), and temporal trends by age, gender, geographic region, and socio-demographic index (SDI) quintiles. Decomposition analysis assessed the influence of epidemiological shifts, population growth, and aging on age-standardized mortality rates (ASMRs), while an autoregressive integrated moving average (ARIMA) model projected future trends. Results: Between 1990 and 2021, the global SP-related LRI death number decreased from 1,028,083 (95% uncertainty interval (UI): 923,782–1,146,074) to 505,268 (95% UI: 454,335–552,539), and the ASMR dropped from 19.28 (95% UI: 17.32–21.49) to 6.40 (95% UI: 5.76–7.00) per 100,000. The age distribution consistently exhibited a clear two-tiered pattern, gradually shifting from being predominantly composed of young children to being dominated by older adults. Disparities were stark across SDI quintiles, low-SDI regions exhibited up to 100-times-higher under-five mortality than high-SDI regions. Geographic distribution showed the highest ASMRs in sub-Saharan Africa and the lowest in Canada, the United States, and Australia, with Mongolia and Finland showing the largest reductions in mortality. Epidemiological changes were the most significant factor in ASMR reduction. Conclusions: The SP-related LRI burden has decreased globally but remains a major health concern, especially in low-SDI regions. Targeted public health interventions, particularly for neonates and elderly adults, are essential to address persistent disparities and further reduce mortality. Full article

This study presents the development of an innovative multifunctional cup holder designed to enhance safety, usability, and sustainability. Addressing common issues such as accidental spills, heat retention, and structural stability, the proposed design incorporates adjustable fixation and heating functionalities. The research applies a systematic design approach, applying the Theory of Inventive Problem Solving (TRIZ) methodology to resolve design contradictions and enhance product functionality. By integrating human factors considerations and universal design principles, the cup holder aims to improve user experience and accessibility. The design features a vacuum-based adjustable fixation system to prevent tipping, a controlled heating mechanism to maintain beverage temperature, and a shock-absorbing structure for enhanced durability. To evaluate whether the final design meets user expectations, a SERVQUAL questionnaire was used to collect user feedback, which was then analyzed using the Importance–Performance Analysis combined with the Kano model (IPA-Kano model). The results revealed an overall importance score of 4.347 and a satisfaction score of 3.943. Key strengths identified include reliable shock resistance, effective fixation, and ease of operation, while areas such as brand reputation and temperature control precision were found to require improvement due to their high importance but low performance. These insights confirm that the proposed design effectively enhances stability, thermal performance, and user convenience, while aligning with users’ expectations. By addressing critical functional and safety needs, this research advances the development of practical, user-centered innovations in everyday product design. Full article

Background/Objectives: Dyslexia and dysgraphia are common childhood neurodevelopmental disorders characterized by persistent reading and writing difficulties, despite normal intelligence and access to education. While typically described as cognitive–linguistic deficits, emerging research suggests potential links to orofacial dysfunction and emotional regulation issues. This study examines associations between stomatognathic anomalies, emotional dysregulation, and early indicators of dyslexia-dysgraphia risk in preschool children, aiming to strengthen early screening and intervention strategies. Methods: A cross-sectional case–control study included 689 Romanian children aged 5–7 from 11 kindergartens. Screening involved the ACTIV-BURLEA psychometric battery to evaluate language, motor, and cognitive abilities. Clinical assessments targeted dental arch form, occlusal balance, and tongue and lip function. Emotional regulation was evaluated using a standardized child behavior scale. Thirty-two children were identified as at risk for dyslexia-dysgraphia and followed longitudinally, and then compared to matched controls. Statistical analysis employed chi-square tests, Pearson correlations, t-tests, and logistic regression. Results: At follow-up, 74.19% of at-risk children received confirmed diagnoses. Tongue dysfunction (TD) (OR = 4.81, p = 0.06) and emotional dysregulation (ED) (OR = 3.94, p = 0.09) emerged as key risk indicators, though not statistically significant. Tongue dysfunction (TD) correlated with school avoidance (r = 0.76, p < 0.01), while occlusal anomalies (OAs) correlated with emotional distress (ED) (r = 0.64, p < 0.05). Conclusions: The findings suggest that early dyslexia-dysgraphia risk involves orofacial and emotional components. Tongue dysfunction (TD), occlusal disturbances (OA), and emotional dysregulation (ED) may offer important clinical markers. Integrating dental and emotional assessments into preschool screening may improve early identification and enable personalized intervention. Full article

Preeclampsia (PE), a major cause of perinatal morbidity and mortality, is frequently under-recognized as an early indicator of future cardiovascular (CV) disease. This study examines early-onset preeclampsia (eoPE) across three phases—pre-pregnancy, diagnosis, and follow-up—to dynamically reclassify risk of eoPE in the second-trimester and assess long-term CV implications. A case-control study involving 50 women with eoPE (diagnosed before 34 weeks) and 50 matched controls with uncomplicated pregnancies employed supervised machine learning to develop two predictive models: one for reevaluating first-trimester eoPE risk, with test sensitivity/specificity of 95.0% (92.2–97.8%)/99.0% (97.6–100.0%) and another for predicting post-pregnancy hypertension (HT), with test sensitivity/specificity of 74.1% (67.2–80.9%)/89.1% (85.5–92.8%). Metaheuristic methods identified key features for risk reevaluation and prediction, achieving high predictive performance using routine early pregnancy data and diagnostic information. These findings should be interpreted with caution due to the sample size limitations. Additionally, unsupervised machine learning on follow-up data (median 7.5 years postpartum) was used to explore how pregnancy conditions shape long-term health in eoPE patients. Full article

Background/Objectives: Despite growing interest in giftedness, the differences in daily participation between gifted and typically developing children remain understudied and insufficiently understood. Exploring these differences may provide valuable insights into the unique needs and support required for gifted children compared to their typically developing peers. This comparative exploratory study aims to examine the differences between gifted and typically developing children’s daily participation patterns in home, school, and community environments and their parents’ perspectives and explore underlying developmental characteristics that may predict their participation. Methods: Parents of 215 children (8–18 years; 53% boys) in a gifted group (n = 136) and a matched typically developing children group (n = 79) completed the Five-to-Fifteen-revised questionnaire and the Child and Adolescent Scale of Participation. Results: We found no significant between-group differences in daily participation. However, we noted significant correlations in each group between the questionnaires’ participation domains (r = −0.243 to −0.460 in the gifted group, and r = −0.57 to −0.78 in the typically developing children group). Social and memory skills predicted 24% of the gifted children’s participation, and social and mental skills predicted 65% of the typically developing children’s participation. Conclusions: The results indicate similar participation patterns of gifted children and typically developing children. Social skills are a key element enabling daily participation among children in both groups. Full article

This study investigates age-related differences in motor unit (MU) properties and neuromuscular control during isometric elbow flexion across the human lifespan. High-density surface electromyography (sEMG) was recorded from the biceps brachii of 44 participants, divided into three groups: Child (8–14 years), Adult (20–40 years), and Elder (65–80 years). MU spike trains were extracted noninvasively by sEMG decomposition. Then the discharge rate, MU action potential (MUAP) morphology, recruitment threshold, and common neural drive were quantified and compared across age groups. This study provides novel insights into force tracking performance, revealing that both children and elders exhibit higher errors compared to young adults, likely due to immature or declining motor control systems. Significant differences in MU discharge patterns were observed across force levels and age groups. Children and elders displayed lower MU discharge rates at low force levels, which increased at higher forces. In contrast, adults demonstrated higher MU action potential peak-to-peak amplitudes (PPV) and recruitment thresholds (RTs), along with steeper PPV-RT slopes, suggesting a narrower RT range in children and older adults. Principal component analysis revealed a strong correlation between common neural drive and force across all groups, with neural drive being weaker in elders. Overall, young adults exhibited the most efficient and synchronized MU control, while children and older adults showed distinct deviations in discharge intensity, recruitment strategies, and neural synergy. These findings comprehensively characterize MU adaptations across the lifespan, offering implications for developmental neurophysiology and age-specific neuromuscular diagnostics and interventions. Full article

Paediatric Focal Segmental Glomerulosclerosis (FSGS) is a leading cause of steroid-resistant nephrotic syndrome and progressive kidney failure in children. Early subclassification into primary, secondary, genetic, or undetermined forms is crucial for guiding appropriate management. Primary FSGS typically necessitates immunosuppressive therapy, whereas secondary FSGS benefits from supportive measures and treatment of the underlying cause. Emerging treatments—including SGLT2 inhibitors, endothelin receptor antagonists, and APOL1-targeted agents—show promise in reducing proteinuria and preserving kidney function. Insights into podocyte biology, including TRPC channel dysregulation and fibrotic signalling pathways, are opening new therapeutic avenues. As research continues to evolve, the future of paediatric FSGS management lies in individualised, pathophysiology-driven therapies that may significantly improve clinical outcomes. Full article

This study examines whether and how community schools’ integrated student support services (academic, socioemotional, health, and family support) contributed to improving whole-child/youth development and reducing systemic inequalities of students’ learning/wellness outcomes across New York State under the Every Student Succeeds Act (ESSA). Applying a quasi-experimental method with propensity score matching to the state’s 2018–2023 school survey and report card databases, it provides new evidence on the efficacy of community school programs on average and by subgroups (race/ethnicity, poverty, disability, English language learner, and housing status). The results of matched comparisons between community schools and non-community schools are mixed, after considering their differences in terms of student demographics and baseline conditions. Overall, community schools showed policy implementation fidelity with more state funding, policy-aligned practices, and school-based health centers/clinics. However, community schools had no discernable impacts on academic achievement and chronic absenteeism overall, except that the operation of school-based health centers was associated with a reduction in absenteeism. In contrast, community schools had more positive impacts on high school graduation rates, particularly among disadvantaged minority students; the impacts are attributable to policy-aligned practices, set-aside funding, and school-based health center dental programs. Educational policy and research implications are discussed. Full article

Background/Objectives: Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants, often resulting in prolonged neonatal intensive care unit (NICU) stays and significant parental stress. The experiences of parents navigating their preterm infant’s early NICU journey are important to support clinical trials to improve infant outcomes. Aim: The aim of this study was to explore parental perceptions of their infant’s health progression during the first 10 days of life through personal diary entries and their correlation with the echo scans assessments, as part of the Exploring Right vEntricular function applicability in a Prediction mOdel to identify pReterm infanTs with early BronchoPulmonary Dysplasia (REPORT-BPD) feasibility study. Methods: An embedded qualitative design was employed, utilising thematic analysis of 17 parent diaries. Parents of preterm infants (<32 weeks of gestation) admitted to a NICU documented their daily experiences. Thematic analysis was applied to ensure a rigorous, inductive examination of emerging themes. Findings: Four main themes were identified: (1) developing parent–infant relationships, highlighting the emotional impact of separation and the significance of bonding; (2) health and well-being of premature infants and family, reflecting parental vigilance, cautious optimism, and emotional distress; (3) parents navigating support and the NICU environment, describing challenges related to medical procedures, communication with staff, and adapting to a highly technical setting; and (4) emotions and protective gestures, illustrating parental resilience, coping mechanisms, and the innate drive to protect their child. Conclusions: Parental experiences in the NICU were shaped by emotional turmoil, uncertainty, and the need for support in navigating their infant’s care. Diaries provided an effective means for parents to express their experiences; they could serve as a communication tool in clinical trials to provide a deeper understanding of the development of the recruited preterm infants. Full article

Background: Children with juvenile idiopathic arthritis (JIA) may experience chronic pain, contributing to psychological distress. Objective: The objective was to assess neuropsychological functions and behavioral skills in patients with JIA and identify demographic and disease-related factors influencing these outcomes. Methods: This cross-sectional study evaluated 112 patients at the Division of Pediatric Rheumatology, Semmelweis University (2015–2016). Participants completed psychological assessments using the Child Behavior Checklist and Woodcock–Johnson III Tests. Examined variables included demographic (age and sex), clinical (age at diagnosis and disease activity), and treatment-related factors (therapy type and duration). Treatment groups comprised (a) combination therapy with TNF inhibitor and methotrexate (MTX) (n = 60), (b) MTX monotherapy (n = 34), and (c) TNF inhibitor monotherapy (n = 18). Results: Neuropsychological variables showed no clinically significant differences between treatment groups. These skills were unaffected by age, sex, therapy duration, or disease activity. Pathological behavioral scores were significantly higher (p < 0.05) in younger patients (<7 years), with females showing greater susceptibility to anxiety and depression (p < 0.05). Conclusions: No clinically significant psychological impairments were observed in our cohort. Further research is warranted to clarify the significance of abnormal behavioral scores. Psychological care provision remains vital for improving the quality of life in JIA patients. Full article

Introduction: Post-Intensive Care Syndrome in Pediatrics (PICS-P) for families is a growing concern as receiving care in the Pediatric Intensive Care Unit (PICU) improves child survival. PICU parental stress may cause post-discharge psychiatric symptoms. Understanding personality-related distress is key for early intervention. This study examined whether parental personality traits correlate with such symptoms for PICS-P prevention. Methods: A cohort pilot study was conducted at a Japanese university hospital PICU (eight beds, 200–300 annual admissions, mandatory critical care consultation) between January and September 2022. Participants were parents of children admitted for longer than 1 week. Personality traits were investigated using the Big-Five-based test, and psychiatric symptoms were investigated using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the PTSD Checklist-5 (PCL-5). The correlation between personality traits and psychiatric symptoms was investigated. Results: Among the 53 subjects who met the inclusion criteria, 25 gave consent to participate in this study. The correlation analysis revealed distinct patterns. Agreeableness demonstrated negative correlations: a moderately significant negative correlation with PTSD symptoms (ρ = −0.612, p < 0.05) and non-significant negative correlations with anxiety (ρ = −0.238) and depression (ρ = −0.060). Conversely, neuroticism exhibited positive correlations: a moderately significant positive correlation with anxiety symptoms (ρ = 0.539, p < 0.05), alongside non-significant positive correlations with depression (ρ = 0.318) and PTSD symptoms (ρ = 0.327). Regarding other personality traits, extraversion showed negative correlations with anxiety (ρ = −0.282), depression (ρ = −0.399), and PTSD (ρ = −0.438), conscientiousness displayed positive correlations with anxiety (ρ = 0.318), depression (ρ = 0.127), and PTSD (ρ = 0.467), while openness exhibited negative correlations with anxiety (ρ = −0.333), depression (ρ = −0.312), and PTSD (ρ = −0.309), although none of these associations were statistically significant. Conclusions: Lower levels of agreeableness and higher levels of neuroticism in parents are significantly associated with increased PTSD and anxiety symptoms, respectively, in the PICU setting. These personality traits may serve as predictors of parental psychological distress, suggesting their utility in informing targeted PICS-P interventions and preventative strategies. Full article

The aim of this paper was to evaluate health, psychological distress, and functioning during the COVID-19 pandemic among Danish adults with and without a history of mental illness. Data were drawn from three online surveys conducted in May 2020 (n = 3134), January 2021 (n = 1170), and January 2022 (n = 1174) as part of the Danish contribution to the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT). The prevalence of mental and physical health issues, psychological distress (stress, sleep problems, loneliness, and boredom) and levels of functioning (self-care, interpersonal relationships, hobbies/leisure, and work/education) were evaluated at four different time points stratified by history of mental illness. Findings indicated that physical health was not differentially affected between people with and without prior mental illness. However, mental health declined significantly more among respondents with a history of mental illness. While levels of stress did not differ between the two groups, boredom was more pronounced in May 2020 among those with prior mental illness. Loneliness was significantly higher in this group in January 2021. Sleep disturbances were more pronounced for respondents with former mental illness during the whole period. A decline in functioning was observed in people both with and without a former mental illness. It seemed a little more pronounced for people with mental illness but seldom reached statistical significance. For all measures of health, distress, and functioning, 10–20% of respondents reported improvements in health, distress, and functioning during the pandemic, with stress showing the most improvement—one third of participants reported feeling less stressed. In most of the parameters measured, the influence of the COVID-19 pandemic seemed to decrease with time. However, the effects were not uniform, and more investigations are needed to understand the whole picture. Full article

Among the shared pathogenetic mechanisms leading to neurodevelopmental disorders (NDDs), a dysregulated inflammatory response has been described as a convergent pathway in NDDs. This scoping review was registered in the OSF database. It was conducted in accordance with the PRISMA Extension for Scoping Reviews, utilizing a comprehensive literature search of major academic databases, including PubMed and Web of Science. The search was performed until 1 March 2025, using a combination of predefined search terms and Boolean operators (AND, OR) to ensure a comprehensive identification of relevant studies. A comprehensive summary of the evidence on immunological and neuroinflammatory pathways underlying the NDDs is shown. This review also reports evidence on early-onset presentation of schizophrenia spectrum and obsessive–compulsive disorder since clinical researchers are beginning to consider these conditions neurodevelopmental disorders. Furthermore, this review outlines the recently described clinical entity, PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome), and its clinical and pathogenetic contact points with NDDs, delineating a spectrum of disorders that share common pathogenetic pathways. This scoping review improves the awareness of immune/neuroinflammatory correlates supporting NDDs. Furthermore, it suggests adopting a transnosographic approach to neuropsychiatric disorders, including PANS as a syndromic construct that overlaps with NDDs. Full article

Backgrounds: To examine the association between stages of exercise behavior change, as defined by the transtheoretical model (TTM), and obesity progression among Chinese children and adolescents, with attention to gender and urban–rural differences. Methods: A total of 5006 Chinese children and adolescents aged 9–18 years were assessed in 2019 and followed up in 2020. Participants were categorized into five TTM stages: precontemplation, contemplation, preparation, action, and maintenance. Logistic regression models evaluated the associations between the TTM stages and obesity outcomes, including incident obesity and transitions from normal or overweight to obesity. Analyses were stratified by gender and urban–rural residence, and interaction effects were tested. Results: Compared to the maintenance stage, precontemplation (OR = 2.08, 95% CI: 1.45–2.99) and contemplation (OR = 1.48, 95% CI: 1.05–2.08) stages had higher obesity risk, with similar trends in follow-up incident obesity (precontemplation: OR = 1.63, 95% CI: 1.17–2.28; contemplation: OR = 1.47, 95% CI: 1.10–1.98). These associations were more pronounced among boys and rural residents. Significant interactions were observed between TTM stages, sex (p = 0.029), and residence (p = 0.005) in obesity transition. Conclusions: Exercise behavior stages are associated with obesity progression, particularly among boys and rural children. These findings underscore the importance of stage-specific interventions tailored to individual readiness for behavior change and contextual factors. Full article

Background/Objectives: Parenting stress is associated with parent and child mental health problems and has increased since the beginning of COVID-19. Research on paternal parenting stress is sparse—even if family models are changing increasingly with fathers being more strongly involved in caregiving for their children. This study investigated (1) overall parenting stress levels and specific parenting stress subscales in fathers with young children in comparison to mothers and (2) potential influencing factors on fathers’ and mothers’ parenting stress during the pandemic. Methods: In a cross-sectional online study, N = 368 parents (50.00% fathers) of children (0–3 years) filled out the German version of the Parenting Stress Index (EBI) and answered questions on sociodemographic and pandemic-related factors. Results: Fathers were 36.17 years (SD = 5.21) and mothers 33.65 years (SD = 4.39) old and 67.50% had a high educational background. Children (45.38% female) were 16.34 months (SD = 11.66) old. There was no significant group difference between fathers’ and mothers’ overall parenting stress (p = 0.39). Parenting stress scores in the attachment subscale were significantly higher in fathers (p < 0.001, r = 0.19). An increase in family conflicts during the pandemic had the highest impact on both paternal (ß = 0.45) and maternal (ß = 0.35) parenting stress. Conclusions: Parenting stress was equally high for fathers and mothers during the COVID-19 crisis, indicating a levelling of pre-pandemic differences due to pandemic-related factors. Future support measures should focus on reducing family conflicts and on strengthening fathers’ attachment to their child. Full article