Search Results (219)

Background/Objectives: Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women. Methods: To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases). Results: Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15–1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05–1.19) per 5 cm, 1.18 (1.02–1.36) per 100 g/d, 1.42 (1.27–1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61–0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53–0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk. Conclusions: Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect. Full article

U-shaped architectures have achieved exceptional performance in medical image segmentation. Their aim is to extract features by two symmetrical paths: an encoder and a decoder. We propose a lightweight U-Net incorporating reverse attention and a preprocessing framework for accurate retinal vessel segmentation. This concept could be of benefit to portable or embedded recognition systems with limited resources for real-time operation. Compared to the baseline model (7.7 M parameters), the proposed U-Net model has only 1.9 M parameters and was tested on the DRIVE (Digital Retinal Images for Vesselness Extraction), CHASE (Child Heart and Health Study in England), and HRF (High-Resolution Fundus) datasets for vesselness analysis. The proposed model achieved Dice coefficients and IoU scores of 0.7871 and 0.6318 on the DRIVE dataset, 0.8036 and 0.6910 on the CHASE-DB1 Retinal Vessel Reference dataset, as well as 0.6902 and 0.5270 on the HRF dataset, respectively. Notably, the integration of the reverse attention mechanism contributed to a more accurate delineation of thin and peripheral vessels, which are often undetected by conventional models. The model comprised 1.94 million parameters and 12.21 GFLOPs. Furthermore, during inference, the model achieved a frame rate average of 208 FPS and a latency of 4.81 ms. These findings support the applicability of the proposed model in real-world clinical and mobile healthcare environments where efficiency and Accuracy are essential. Full article

In Colombia and Mexico, an increase in emotional, behavioral, and eating problems in adolescents has been documented after the pandemic. The objective was to characterize the relationship between internalizing and externalizing behaviors in adolescents with eating disorders in Colombia and Mexico according to the adolescents’ self-report and the parents’ report. In Colombia, 17 adolescents between 12 and 18 years old (M = 15.4; SD = 1.8) and one of their parents (n = 17); in Mexico, 8 adolescents between 12 and 17 years old (M = 14.6; SD = 1.6) and one of their parents (n = 8) were evaluated. The parents completed the Child Behavior Checklist (CBCL), and the adolescents completed the self-report (YSR) and the EAT-26. The analyses showed a statistically significant correlation between eating problems and anxiety/depression of the YSR (r = 0.39; p = 0.031). Statistically significant differences (p < 0.05) were found in the CBCL scores for externalizing problems, somatic complaints, and rule-breaking behavior; all scores were higher in the Colombian sample. The findings provided partial support for differences between adolescents with eating disorders and parental reports. A higher percentage of clinical levels was reported by adolescents compared to their parents, except for the anxious/depressive and aggressive behavior subscales. Full article

Background: Health-related quality of life (HRQoL) has emerged as a meaningful outcome measure in clinical trials and healthcare interventions in children with cerebral palsy (CwCP). We assessed the construct validity and internal consistency of the Italian version of the Paediatric QoL inventory (PedsQL^TM) 4.0 Generic Core Scales (GCS) and PedsQL^TM 3.0 Cerebral Palsy Module (CPM). Methods: A total of 125 CwCP and their parents were enrolled. Participants completed both the GCS and the CPM modules, and the results were compared to those of a sample of 121 healthy peers and their parents. The dimensionality of the two modules was assessed through exploratory factor analysis. Construct validity was assessed by a known-groups method evaluating the differences between CwCP and healthy sample. Results: Only a few GCS subscales were unidimensional, while all CPM subscales proved to be unidimensional, except for the Speech and Communication subscales of child self-reports. GCS internal consistency was good for all subscales of the parent proxy-reports, as well as for the Physical Activities and Psychosocial Health subscales of child self-reports. CPM internal consistency was good for both parent proxy-reports and—with a few exceptions—child self-reports. As for the PedsQL^TM validity, the GCS proved effective in discriminating between CwCP and healthy participants; the CPM showed a significant association between lower neurofunctional abilities and lower HRQoL. Parent–child concordance shows that child self-report scores were always higher than the those of the proxy-reports for both the GCS and CPM modules. Conclusions: The present study confirms the internal consistency and construct validity of the Italian version of both PedsQL^TM modules. In CwCP, greater functional disability resulted in lower HRQoL scores, and there was significant discrepancy between the parent and child ratings. Full article

Background/Objectives: Parental involvement is essential in managing type 1 diabetes mellitus (T1DM) in children, particularly with the growing use of continuous glucose monitoring (CGM). Validated tools assessing parental self-efficacy in this context remain limited. This study aimed to validate the Parental Self-Efficacy Scale for Diabetes Management (PSESDM) among parents of children using a CGM sensor and to examine its associations with diabetes outcomes and parental characteristics. Methods: A cross-sectional study was conducted involving 106 parent–child dyads at a university pediatric diabetes center. Parents completed the Hungarian PSESDM. Data regarding children’s HbA1c level were recorded, along with standard measures of their general and diabetes-specific quality of life (EQ-5D-Y-3L, PedsQL Diab); data regarding parents’ health literacy (Chew), fear of hypoglycemia (HFS), health-related quality of life (EQ-5D-5L), and capability well-being (ICECAP-A) were also collected. The PSESDM’s reliability, internal consistency, and discriminant and criterion validity were assessed using standard statistical methods. Results: The PSESDM demonstrated good internal consistency (Cronbach’s α = 0.857) and strong item–total correlations (range: 0.678–0.791). Higher parental self-efficacy was significantly associated with better glucose control (lower HbA1c, r_s = −0.50) and weakly correlated with the child’s diabetes-specific quality of life (r_s = 0.20). Among parental characteristics, self-efficacy correlated strongly with capability well-being (r_s = 0.52), moderately with health literacy (r_s = −0.30), and showed no difference between socio-demographic subgroups, except for the subgroup related to income. Conclusions: The PSESDM is a valid and reliable tool for measuring self-efficacy in parents of children with T1DM using CGM sensors. Its associations with children’s HbA1c levels, diabetes-specific quality of life, and parental characteristics support its clinical relevance and potential use in identifying families at risk for poorer diabetes outcomes. Full article

Background: Gamma-glutamylcysteine synthetase catalyzes the first and rate-limiting step in the synthesis of glutathione. Gamma-glutamylcysteine synthetase deficiency is a very rare condition that has so far been detected so far in nine patients from seven families worldwide. The inheritance of this disorder is autosomal recessive. Methods: We report a case of 4.11-year-old boy, of Arab-Muslim origin, living in an Arab town in Israel who presented at the age of 2 days with severe anemia, reticulocytosis, and leukocytosis. Investigation for common causes of hemolytic anemia was negative (peripheral blood smear was normal, and he had a negative Coombs test, normal G6PD, and normal flow cytometry spherocytosis). The anemia worsened during the following days (hemoglobin (Hb): 7.2 g/dL) and he needed several blood transfusions. NGS (next-generation sequencing) gene panel analysis was performed. Results: In an NGS gene panel analysis for hereditary hemolytic anemias, we found a homozygotic change in the GCLC gene—G53.385.643c379C > T(homo)pArg127Cys—which confirms the diagnosis of gamma-glutamylcysteine synthetase deficiency. An additional rare change was found in this case in the GCLC gene, with unknown clinical significance: g.53373917, c 828 + 3A > G. Except for chronic anemia (Hb levels around 8 g/dL), the child has normal physical and neurological development. Conclusions: This study reports a rare case of gamma-glutamylcysteine synthetase deficiency in a 4.11-year-old Arab-Muslim boy from Israel who presented with severe anemia at 2 days old, aiming to document the first such case in the Middle East and contribute to the medical literature on this extremely rare condition that has only been detected in nine patients worldwide. Genetic analysis revealed a homozygotic change in the GCLC gene, confirming the diagnosis, and while the patient experiences chronic anemia, he maintains normal physical and neurological development, adding valuable insights to the understanding of this rare genetic disorder. An additional rare change was found in this case in the GCLC gene, with unknown clinical significance: g.53373917, c 828 + 3A > G. Full article

Background: Growth hormone deficiency (GHD) is one of the primary endocrine-related causes of short stature in pediatric patients; while neonatal GHD symptoms are well-documented in populations with known genetic and/or organic causes, their exact prevalences in pediatric patients categorized as having idiopathic GHD remains unclear. Materials and Methods: We retrospectively analyzed the medical records of patients with idiopathic GHD followed at the Pediatric Endocrinology Unit of the Fondazione Policlinico Universitario A. Gemelli IRCCS starting from January 2010. We analyzed information from 190 patients with idiopathic GHD and examined the prevalences of the most common neonatal signs and symptoms of neonatal GHD. We also included an age- and sex-matched control group that consisted of patients without a confirmed diagnosis of GH deficiency to assess significant differences in the frequencies of neonatal symptoms between the two cohorts. Results: Regarding neonatal GHD symptoms, the prevalence was the highest for hypoglycemia (n = 53, 27.9%), which was managed through the intravenous administration of glucose in 21 out of 53 cases. Prolonged jaundice that lasted more than 5 days was observed in 37 patients (19.5%) and required phototherapy in 20 out of 37 patients, while exchange transfusion was not performed in any patient. Hyperglycemia and feeding difficulties (n = 17, 8.9%) were less frequent, while the other symptoms were relatively rare. Compared with the control group, the prevalence of hypoglycemia was significantly higher in the GHD patient group (p-value = 0.000016). Conclusions: In our cohort of pediatric patients with idiopathic GHD, the prevalences of neonatal signs and symptoms of GHD was low, except for neonatal hypoglycemia observed in 27.9% of the analyzed patients. Although these are not specific signs of idiopathic GHD, it is beneficial to investigate this information in the medical history during the clinical assessment of the child. Full article

Background: Knowing the oral-health-related quality of life (OHRQoL) status of pediatric patients would be helpful in analyzing their level of dental anxiety before their first visit to a pediatric dentist. However, few studies have analyzed OHRQoL and anxiety in early adolescent patients. The aim of this study was to describe the OHRQoL and anxiety levels of early adolescents, according to age and sex, at their first dental examination. Methods: A cross-sectional study was conducted on early adolescents (11–14 years old) attending their first dental examination in 2023–2024. OHRQoL was assessed using the Spanish version of the Child Perceptions Questionnaire 11–14 (CPQ-Esp11-14) and anxiety using the State–Trait Anxiety Inventory in Children (STAIC). Results: A total of 130 early adolescents were assessed, with an average age of 12.6 years (±1.06) and an equal sex distribution (65 boys and 65 girls). Among the analyzed sample, the OHRQoL dimension with the highest score was social well-being (15.01 ± 10.7), whereas the oral symptoms dimension (8.6 ± 4.25) had the lowest impact. There were no statistically significant differences between female and male early adolescents in the anxiety state or anxiety-trait dimensions or in the dimension of OHRQoL, except for oral symptoms, which were higher in boys (9.48 ± 4.51 versus 7.72 ± 3.81). Similarly, no significant differences were found based on age regarding anxiety or OHRQoL. Conclusions: Considering the limitations of this study, it can be concluded that higher levels of anxiety negatively impacted the OHRQoL of the early adolescent population studied. Full article

Epidermal electronics provide a promising solution to key challenges in wearable electronics, such as motion artifacts and low signal-to-noise ratios caused by an imperfect sensor–skin interface. To achieve the optimal performance, skin-worn electronics require high conductivity, flexibility, stability, and biocompatibility. Herein, we present a nontoxic, waterborne conductive ink made of silver and child-safe slime for the fabrication of skin-compatible electronics. The ink formulation includes polyvinyl acetate (PVAc), known as school glue, as a matrix, glyceryl triacetate (GTA) as a plasticizer, sodium tetraborate (Borax) as a crosslinker, and silver (Ag) flakes as the conducting material. Substituting citric acid (CA) for GTA enhances the deformability by more than 100%. With exceptional conductivity (up to 1.17 × 10⁴ S/cm), we demonstrate the ink’s potential in applications such as an epidermal near-field communication (NFC) antenna patch and a wireless ECG system for motion monitoring. Full article

Purpose: Child-to-parent violence (CPV) is a major concern for adolescents with attention-deficit/hyperactivity disorder (ADHD). The Child-to-Parent Violence Questionnaire (CPV-Q) is a valid instrument for assessing a wide variety of CPV behaviors and the reasons; however, the psychometric properties of the Chinese version of CPV-Q (C-CPV-Q) in adolescents with ADHD have not been examined yet. This study examined the psychometric properties of both child and parent versions of C-CPV-Q in adolescents with ADHD. Participants and Methods: In total, 247 adolescents with ADHD and their parents participated in the study. Confirmatory factor analyses (CFAs) were conducted to examine the factor structure for CPV types and reasons. Internal consistency, cross-validation, and concurrent validity of the parent and child versions of C-CPV-Q were also evaluated. Results: The results of CFA found that both child and parent versions of the C-CPV-Q contained four domains of CPV types and two domains of CPV reasons in adolescents with ADHD. The correlations between parent and child reports of the C-CPV-Q assessing the same factors were stronger than those assessing different factors. Concurrent validity of the C-CPV-Q was supported by their positive correlations with internalizing, externalizing, attention deficit/hyperactivity, oppositional defiant, and conduct problems. Except for the financial aggression factor, the entire C-CPV-Q had acceptable internal consistency. Conclusions: The results indicate that the child and parent versions of the C-CPV-Q are valid instruments for assessing a wide variety of CPV behaviors and the reasons among adolescents with ADHD. Full article

Under the pressure of work and family life, parents face sub-health issues and decreasing communication with their children, while children’s physical and mental health declines due to academic stress. Moderate exercise and companionship could enhance fitness and improve parent–child relationships, driving demand for parent–child interactive fitness facilities. This study aimed to propose a design approach for parent–child interactive exercise bikes. Initially, guided by the flow–clutch state theory, which distinguishes the flow state (highly focused and joyful) from the clutch state (any performance increment or exceptional performance that occurs under pressure), we analyzed user requirements in different psychological states. The theory prioritized design features that promote sustained flow and clutch, ensuring that the product meets the dynamic needs of parents and children. Second, the Analytical Hierarchy Process (AHP) quantified the requirements, Quality Function Deployment (QFD) translated them into functions, and the function–behavior–structure (FBS) model defined the product structures. This study integrates the flow–clutch state theory with AHP-QFD-FBS, proposing a scientific and innovative design approach for the successful design of exercise bikes that meet parent–child needs. The product features novel functions and a rational structure, effectively promoting flow and clutch states to enhance parent–child interaction. This research provides a multi-method design case and practical guidance for parent–child products, benefiting family well-being and relationships. Full article

This study investigates the spatiotemporal trends and health risks of nine atmospheric heavy metals (Pb, As, Mn, Ni, Cr, Cd, Zn, Cu, Fe) in PM_2.5 across 50 Chinse cities, comparing resource-industrial cities (RICs) and general cities (GCs) before (2014–2018) and after (2019–2021) China’s 2018 Air Pollution Prevention and Control Action Plan. Post-2018, concentrations of all metals except Fe declined significantly (33–77%), surpassing PM_2.5 reductions (25%). Geospatial analysis revealed elevated heavy metal levels in northern and southern regions in China, aligning with industrial and mining hotspots. While RICs exhibited persistently higher metal concentrations than GCs, the inter-city gap narrowed post-2018, with RICs achieving greater reduction. Pre-2018, the combined non-carcinogenic hazard index (HI < 1) remained below safety thresholds, but the combined carcinogenic risk total (CRT) for children exceeded 10⁻⁴, driven primarily by As and Cr(VI). HIs were 1.5–2.0 times higher in RICs than in GCs. Post-2018, the CRT declined by 69.0–71.1%, aligning with reduced heavy metal levels. Despite improvements, CRTs necessitate targeted mitigation for As (contributing 81.1–86.2% to CRT) and Cr(VI) (11.7–14.0%). These findings validate the policy’s effectiveness in curbing industrial and vehicular emissions but underscore the need for metal-specific controls in resource-intensive regions to safeguard child health. Full article

This article discusses contact and interaction between children, siblings and parents after a care order. We have collected and analyzed audio recordings of discussions between child welfare employees in Norway. In these meetings, the employees discuss and decide the extent and organization of visits and contact between parents and children under public care. Visitation mainly emerges as a risk in the discussions and thus as something that must be limited. This article shows how this risk can be seen in the context of a political or moral discourse in which these parents are given an identity and a position as “dangerous”. However, there are some exceptions. In these exceptions, parents emerge as significant and important, and contact is seen as an opportunity for the child. Here, it is the risk of not having contact that stands out. Full article

Background/Objectives: Zellweger spectrum disorder (ZSD), a rare genetic disease characterized by defects in peroxisome biogenesis, results in dysfunction of all organ systems, including feeding difficulties, gastrointestinal bleeding, and reduced overall growth. Despite this nutritional impact, no published studies have assessed dietary intake in ZSD. The purpose of this study was to determine nutrient intake in individuals with ZSD or a related peroxisomal disorder using two methods of dietary assessment as provided by family caregivers. Methods: Family caregivers participated in multiple 24 h dietary recall interviews and completed 3-day food records for their child with ZSD or a related single-enzyme peroxisomal disorder over a 6-month period. Results: Twenty-one subjects (eleven orally fed and ten enterally fed), ranging from 1 to 33 years of age, were included in the study. Energy and nutrient intake as reported by dietary recall vs. 3-day food record were highly correlated for all nutrients (r² = 0.998, p < 0.0001). Mean nutrient intakes for subjects generally achieved or exceeded DRI requirements, except for fiber (about 50% of DRI). Conclusions: These results show that dietary assessment is feasible in individuals with ZSD using caregiver input, regardless of feed modality, and that dietary intake is consistent across different methods of assessment. These findings may be applicable in dietary assessments for individuals with ZSD and similar genetic disorders and a methodological consideration in clinical interventions. Full article

Background/Objectives: Food insecurity during pregnancy is associated with higher risks of negative physical outcomes for both mother and child. This study aims to understand experiences of food insecurity among low-income Singaporean pregnant women and its impact on nutritional status. Methods: In this cross-sectional, mixed-methods study, 49 food-insecure pregnant women were recruited from KK Women’s and Children’s Hospital between November 2021 and November 2023, among which 11 in-depth interviews were conducted. Questionnaires, anthropometric measurements, 24-Hour dietary recalls, metabolic and nutritional blood tests were conducted for all subjects. Descriptive quantitative analysis was performed and integrated with qualitative thematic analysis to explain findings. Results: On average, women were overweight pre-pregnancy (body mass index 26.1 ± 6.9 kg/m²) and had low haemoglobin and 25-hydroxyvitamin D levels. Calorie intake and intake from major food groups did not meet recommendations during pregnancy, except for “Grains”. From interviews, effects of financial constraints, how participants managed their food supply and pregnancy-related symptoms, supported findings from 24-Hour dietary recalls. Conclusions: Food insecurity led to suboptimal nutritional status and diets in Singaporean pregnant women despite appearing well-nourished. Further exploration of perspectives of food-insecure mothers, healthcare providers and welfare organisations is needed to devise long-term solutions to improve food security and alleviate malnutrition. Full article