Search Results (533)

Background: Patients diagnosed with melanoma are at increased risk of developing multiple primary melanomas (MPMs). Identifying clinical and genetic factors associated with MPM is critical for implementing personalized surveillance strategies. This study aims to describe the clinical, histopathological, and genetic characteristics of patients with MPM managed in a tertiary hospital and to contextualize findings within the current literature. Methods: We conducted a retrospective review of patients diagnosed with two or more primary melanomas between 2010 and 2023 at a tertiary dermatology unit. Demographic data, personal and family cancer history, phototype, melanoma characteristics, genetic testing, staging, treatments, and outcomes were collected. These data were compared with findings from the recent literature. Results: Thirteen patients (ten males, three females; median age: 59 years) were found to have a total of 33 melanomas. Most patients had Fitzpatrick phototype II and no immunosuppression. The number of melanomas per patient ranged from two to five. Synchronous lesions were observed in two patients. Common locations included the trunk and extremities. Histologically, 57% were in situ melanomas, and subsequent melanomas were generally thinner than the index lesion. Two patients showed progression to advanced disease. One patient was positive for MC1R mutation; the rest were negative or inconclusive. Additional phenotypic and environmental risk factors were extracted from patient records and are summarized as follows: Ten patients (76.9%) had Fitzpatrick skin phototype II, and three (23.1%) had phototype III. Chronic occupational sun exposure was reported in four patients (30.8%), while five (38.5%) recalled having suffered multiple sunburns during childhood or adolescence. Eight patients (61.5%) presented with a total nevus count exceeding 50, and five (38.5%) exhibited clinically atypical nevi. None of the patients reported use of tanning beds. Conclusions: Our findings are consistent with the existing literature indicating that patients with MPM often present with thinner subsequent melanomas and require long-term dermatologic follow-up. The inclusion of genetic testing and phenotypic risk factors enables stratified surveillance and supports the application of personalized medicine in melanoma management. Full article

Identifying predictors of pro-environmental behaviors (PEBs) can not only figure out who concerns about the environment most but also inform possible pathways that advance or inhabit such prosocial actions. Most past studies and theories focus on factors that reside within personal characteristics or sociopsychological mechanisms rather than taking a holistic view that integrates these two elements into a framework. This study investigates how socioeconomic status (SES) correlates with PEBs, integrating both structural and psychological mechanisms. Drawing on the Stimulus–Organism–Response (SOR) theoretical framework, this paper examines the paradox whereby individuals with higher SES exhibit more frequent environmental actions yet demonstrate lower willingness to pay (WTP)—a form of economic sacrifice. Using nationally representative data from the 2021 Chinese General Social Survey (CGSS), our structural equation modeling reveals that adulthood SES positively correlates with environmental values and behaviors but negatively correlates with WTP. This challenges the traditional linear assumption that greater willingness necessarily leads to greater action. Additionally, while childhood SES predicts adult SES, it shows no direct effect on environmental engagement. These findings highlight multidimensional pathways by which SES shape environmental actions, necessitating differentiated policy approaches to build a sustainable world. Full article

Background/Objectives: The increasing population of childhood cancer survivors presents new challenges for healthcare systems worldwide. While advances in oncological treatments have dramatically improved survival rates, survivors face a broad spectrum of late effects that extend beyond the biological to encompass profound psychological and social dimensions. Methods: This quasi-systematic review synthesizes data from recent studies on adolescent survivors, revealing significant disruptions in cognitive function, mental health, social integration, education, romantic relationships, and vocational outcomes. Results: This review highlights the inadequacy of a solely biomedical model and advocates for a biopsychosocial approach to long-term follow-up care. An emphasis is placed on the necessity of personalized, interdisciplinary, and developmentally informed interventions, especially in countries like Poland, where structured survivorship care models remain underdeveloped. Conclusions: The findings underscore the importance of integrating medical, psychological, and social services to ensure adolescent cancer survivors achieve not only physical recovery but also meaningful life participation and emotional well-being. Full article

This research analyzed university students’ perceptions of the use of generative artificial intelligence (hereafter Gen-AI) in a higher education context. Specifically, it addressed the potential benefits and challenges related to the application of these web-based resources. A mixed method was adopted and the sample consisted of 407 teacher training students enrolled in the Early Childhood and Primary Education Degrees in the Region of Murcia in Spain. The results indicated a clear recognition of the relevance of these technological tools for teaching and learning. Respondents highlighted the potential to engage them in academic tasks, increase their motivation, and personalize their learning pathways. However, participants identified some challenges related to technology dependency, ethical issues, and privacy concerns. By understanding learners’ beliefs and assumptions, educators and educational administrations can adapt Gen-AI according to learners’ needs and preferences to improve their academic performance. In learning practice, these adaptations could involve evidence-based interventions, such as AI literacy modules or hybrid assessment frameworks, to translate findings into practice. In addition, it is necessary to adjust materials, methodologies, and the assessment of the academic curriculum to facilitate student learning and ensure that all students have access to quality education and the adequate development of digital skills. Full article

Familial hypercholesterolemia (FH) is a genetic disorder marked by significantly elevated levels of low-density lipoprotein cholesterol (LDL-C) since childhood, substantially increasing the risk of premature atherosclerosis and cardiovascular disease. While dysfunction of hepatic LDL-C receptors is the main underlying cause, the gastrointestinal tract plays a key role in cholesterol homeostasis and represents an important therapeutic target. Inhibition of intestinal cholesterol absorption has emerged as an effective strategy in the management of pediatric FH, particularly in patients for whom statins may not be the ideal first-line treatment. Ezetimibe, an inhibitor of the Niemann-Pick C1-like 1 (NPC1L1) protein, has been shown to reduce LDL-C levels in children with FH, with a greater efficacy observed when used in combination with statins. Bile acid sequestrants also enhance cholesterol excretion but are often limited by gastrointestinal side effects, while dietary interventions, such as phytosterol supplementation and fiber-enriched diets, provide additional benefits in lowering LDL-C and are generally well tolerated. Emerging therapies, including microbiota-targeted strategies and novel cholesterol absorption inhibitors, show promise for expanding future treatment options. This review explores the mechanisms of intestinal cholesterol absorption and their relevance to pediatric FH. We examine key pathways, including dietary cholesterol uptake through NPC1L1, bile acid reabsorption, and cholesterol efflux mediated by ATP-binding cassette transporters, while also discussing clinical and experimental evidence on pharmacological and dietary interventions that modulate these pathways. A deeper understanding of cholesterol metabolism, the emerging role of the gut microbiota, and innovative therapeutic agents can support the development of more effective and personalized approaches to the treatment of children with FH. Full article

Background/Objectives: Obesity among university students is a growing concern, often influenced by biological, psychological, and social factors. Few studies in Saudi Arabia have addressed this issue using a comprehensive framework. This study aims to examine the prevalence of obesity and its biopsychosocial predictors among university students, as well as their perceptions, behaviors, and comorbidities. Methods: A cross-sectional study was conducted at Jazan University during the 2024–2025 academic year. A total of 819 undergraduate students completed a structured, self-administered Arabic questionnaire. The tool assessed sociodemographic variables, body mass index (BMI) (calculated from self-reported height and weight), biological and psychological factors, social influences, lifestyle behaviors, and comorbidities. Bivariate associations were tested using chi-square analyses, and multivariate logistic regression was used to identify independent predictors of obesity. Results: The prevalence of obesity was 19.6%, and 22.6% of students were overweight. Obesity was significantly more prevalent among males (26.7%) than females (9.6%, p < 0.001) and among students aged 24 years and above (24.0%, p = 0.024). Independent predictors of obesity included being overweight in childhood (AOR = 5.23, 95% CI: 3.47–7.90), belief in a genetic predisposition (AOR = 4.66), emotional eating (AOR = 2.57), academic or personal stress (AOR = 5.36), and social pressures related to body image (AOR = 2.96). Comorbidities significantly associated with obesity included high cholesterol (AOR = 5.40), sleep disorders (AOR = 2.99), and joint pain (AOR = 1.96). More than 80% of students with obesity reported current or past weight loss attempts, and nearly 60% received medical advice to lose weight. Conclusions: Obesity among Jazan University students is significantly associated with male gender, early-life weight history, emotional and academic stress, and social pressures. Students with obesity also experience a higher burden of comorbid conditions, even at a young age. These findings highlight the need for integrated, student-centered interventions that address both the psychological and social dimensions of weight management in university settings. Full article

In personalized nutrition, dietary guidelines must be adapted to the physiological and developmental needs of individuals across the lifespan, especially during childhood and adolescence. These should account for nutritional status, health conditions, and early-life risk factors, including those that emerge during pregnancy. This narrative review synthesizes recent evidence (2020–2025) on the biological value of protein sources in supporting pediatric growth and development. While adequate protein intake is essential for physical and cognitive development in individuals under nineteen, excessive intake may accelerate growth and increase the long-term risks of overweight and obesity. Compared to animal-based proteins (ABPs), plant-based proteins (PBPs) carry a higher risk of nutrient deficiencies in vulnerable populations due to lower digestibility and incomplete amino acid profiles. Although plant-based diets are encouraged for environmental reasons—particularly to reduce the ecological impact of livestock—protein intake must remain appropriate for age, sex, health status, and context. Nutritional strategies must ensure an adequate supply of essential amino acids and proper micronutrient supplementation, regardless of whether children follow diets rich in ABPs, PBPs, or a combination of both. Attention to these factors is vital to balancing nutritional adequacy with long-term health and sustainability goals. Full article

Background: Few studies have investigated the impact of parental bonding on the quality of life and psychological health in kidney transplant recipients. Exploring these factors could provide valuable insights into the development of psychosocial interventions aimed at improving patients’ psychological adjustment and their overall quality of life. In this perspective, our study aimed to explore how dimensions of parental bonding, particularly maternal care and overprotection, may influence the quality of life and psychological well-being in kidney transplant recipients. By investigating these relationships, the study seeks to understand whether early maternal attachment experiences can predict psychological outcomes in adult transplant recipients. Methods: A cross-sectional study involving a sample of 99 kidney transplant recipients (69.7% males, mean age  =  52  ±  9.93 years) was conducted. Participants were recruited from the outpatient clinic of an Italian transplant center between May 2022 and July 2024. After an initial telephone interview, 1-2 interviews were performed in person to administer the questionnaires of the established protocol: the Parental Bonding Instrument (PBI) to identify the type of parental bond and the Short Form-36 (SF-36) Health Survey to evaluate the quality of life perceived by the patients. Results: Regression analyses revealed that higher perceived maternal care during childhood was positively associated with better psychological health during adulthood (β = 0.290; p < 0.05). Conversely, higher levels of perceived maternal overprotection were negatively associated with psychological health in this population (β = −0.286; p < 0.05). Conclusions: The results suggest that maternal affection and support may serve as a protective factor, while excessive maternal protection could impair the development of emotional coping mechanisms necessary for dealing with the stresses of adult life. Full article

Discipline is a significant predictor of parent–child attachment and relationship quality across the lifespan. Yet, much of the research on Black families’ disciplinary strategies uses a deficit and myopic lens that focuses on punitive punishment styles (e.g., spanking or taking away privileges). In the current exploratory qualitative study, we used an intergenerational narrative lens and thematic analysis to explore semi-structured interview data from 31 Black mothers (25–60 years, M_age = 46) in the United States around their mothers’ disciplinary practices during their childhood. We explored the connections that Black adult daughters made between their childhood disciplinary practices and their current disciplinary practices with their children, as well as their current relationships with their mothers. Adult daughters varied widely in their retrospective accounts of their mothers’ disciplinary strategies, which we categorized into three themes: (a) punitive, (b) logical, and (c) natural. We also identified three themes around how their mothers’ practices informed their current disciplinary practices with their own children: namely, (d) continuity, (e) mix, and (f) shift. Finally, we identified three themes around the current nature of their mother–daughter relationships: (g) strained, (h) progressing, and (i) healthy. The results highlighted the personal and cultural factors that informed Black women’s disciplinary strategies across two generations of mothers and revealed that when adult daughters shifted away from what they experienced during childhood—it was often towards less punitive strategies. Our exploratory findings also pointed to patterns regarding the extent to which Black adult daughters felt connected, validated, and supported by their mothers. The findings lend insight into Black mother–daughter relationship dynamics, particularly around the importance of communication patterns and emotional connection in the culture of discipline within families. Full article

Background/Objectives: The prevalence of childhood obesity has recently increased, particularly during the COVID-19 pandemic, owing to lifestyle changes as a result of public health regulations and guidelines introduced by governments worldwide. The aim of our study was to evaluate the impact of novel e-Health applications in addressing childhood obesity prior to and during the COVID-19 pandemic. Methods: The study was conducted as part of the four-year European project BigO (Horizon2020, No.727688). A total of 86 children and adolescents with overweight and obesity (mean age ± standard error of the mean: 11.82 ± 0.25 years; 49 males, 37 females; 31 prepubertal, 55 pubertal) were studied prospectively for 1 year prior to the pandemic (non-COVID-19 group, n = 50) and during the pandemic (COVID-19 group, n = 36). Based on the body mass index (BMI), subjects were classified as having morbid obesity (n = 40, 46,51%) obesity (n = 21, 24.42%), overweight (n = 22, 25.58%), and normal ΒΜΙ (n = 3, 3.49%) according to the International Obesity Task Force cut-off points. The data collection system utilized the BigO technology platform, which connects to a smartphone and smartwatch to objectively record each patient’s diet, sleep, and physical activity. Participants used the BigO system continuously for 4 weeks and wore the smartwatch for specific periods during the week. Subsequently, they entered a personalized, multidisciplinary lifestyle intervention program for 4 months and used the system again for 4 weeks. Results: The key finding was a significantly higher improvement rate in BMI category among children and adolescents during the COVID-19 pandemic (58.3%) compared to before the pandemic (36%). Both groups showed significant reductions in BMI, BMI z-score, insulin resistance indices (homeostatic model assessment and quantitative insulin sensitivity check index), blood pressure, gamma-glutamyl transferase, and insulin concentrations, alongside increases in high-density lipoprotein cholesterol (p < 0.01). Notably, the COVID-19 group experienced a significantly greater reduction in BMI z-score at 12 months compared to the non-COVID-19 group (p < 0.05). Conclusions: Our results reveal that the COVID-19 group demonstrated better compliance with lifestyle interventions and experienced more significant improvements in cardiometabolic risk factors. This suggests that the innovative e-Health applications were successful in managing childhood obesity despite the challenges caused by the COVID-19 pandemic. Full article

Background and Objectives: We investigated whether early psychological trauma can contribute to the development of dysfunctional personality traits and emotional dysregulation. Personality disorders (PDs) are often characterized by using immature defense mechanisms and maladaptive coping strategies. Materials and Methods: We evaluated the relationship between early traumatic experiences, PDs, defense mechanisms, and coping strategies. A total of 90 patients aged between 18 and 70 with PDs were studied to detect different subtypes of early trauma, along with the defensive mechanisms and the prevailing coping strategies. Correlation and regression analyses aimed at establishing if specific trauma subtypes were associated with specific defense mechanisms and coping strategies. The Childhood Trauma Questionnaire—Short Form (CTQ-SF), the Defense Style Questionnaire 40 (DSQ-40), and the Coping Orientation to Problem Experienced (COPE) were used as psychodiagnostic tools. Results: Our findings determine emotional abuse, emotional neglect, and physical neglect as the most represented subtypes of trauma and underline the use of immature defense mechanisms in PD patients, while adaptive coping strategies, such as social support and positive aptitude were used. Conclusions: Early trauma, such as abuse and neglect, can be associated with dysfunctional defense mechanisms and coping strategies. This may have significant implications for managing not only pathological areas of the patient but also the functional ones. Moreover, being aware of these aspects can be useful for psychotherapy, reinforcing therapeutic alliance and reducing symptoms. Full article

Sexual minority men (SMM) experience anti-SMM stressors and have elevated rates of mental health issues compared to heterosexual men, such as depression. Importantly, strengths-based factors may directly increase wellbeing and provide a buffer against the detrimental effects of such stressors. In the present study, we integrated risk and strengths-based models to examine predictors of depression symptoms in a sample of 465 Canadian SMM across three time points using multilevel modeling. Higher scores on a measure of childhood physical abuse at baseline, and greater within-person (i.e., deviation from individual’s average) and between-person (i.e., deviation from group average) internalized homonegativity and heterosexist discrimination were associated with higher depression scores. Higher within- and between-person scores on measures of self-esteem, social support, and hope were associated with lower depression scores. Social support buffered the effects of between-person heterosexist discrimination on depression symptoms: at mean and high levels of social support, heterosexist discrimination was not associated with depression symptoms. This is the first study to disaggregate between-person and within-person effects of both risk factors and strengths-based factors among SMM, which has critical importance for the development of tailored individual-level interventions that target internalized homonegativity, hope, social support, and self-esteem to alleviate symptoms of depression among SMM. Full article

Genetic dystonias are a heterogeneous group of movement disorders characterized by involuntary, sustained muscle contractions that cause repetitive movements and abnormal postures. Often beginning in childhood, they can significantly affect quality of life. Although individually rare, genetic causes are collectively relevant in pediatric dystonias, with over 250 associated genes. Among these, TOR1A, SGCE, and KMT2B are the most frequently reported in pediatric forms. Diagnosis is challenging due to the wide clinical and genetic variability. Recent advances in genetic testing, including whole-exome and whole-genome sequencing, have improved the early identification of causative variants. Functional data on selected mutations are helping to refine genotype–phenotype correlations. Management typically requires a multidisciplinary approach. Symptomatic treatments include anticholinergics, benzodiazepines, and botulinum toxin, while deep brain stimulation can be effective in refractory cases, especially in patients with TOR1A variants. Disease-modifying therapies are also emerging, such as gene therapy for AADC deficiency, highlighting the potential of precision medicine. This review provides an updated overview of pediatric genetic dystonias, with a focus on differential diagnosis and treatment strategies. Early and accurate diagnosis, together with personalized care, is key to improving outcomes in affected children. Full article

Background/Objectives: Preschool children from low-income, ethnically diverse communities face disproportionate rates of behavioral challenges and early expulsion from early care and education (ECE) programs. This study evaluated the efficacy, feasibility, and utility of Jump Start on the Go (JS Go), a bilingual, AI-enabled mobile application. JS Go is designed to deliver a 14-week early childhood mental health consultation model in under-resourced ECE settings. Methods: This mixed-methods study compared JS Go to the standard in-person Jump Start (JS) program. Participants included 28 teachers and 114 children from six centers (three JS Go, three JS). Quantitative measures assessed teacher classroom practices and child psychosocial outcomes at baseline and post-intervention. App usability and acceptability were only evaluated post-intervention. Seven semi-structured interviews were conducted post-intervention with JS Go directors/teachers to assess the app’s feasibility for implementing the four program pillars: safety, behavior support, self-care, and communication. Results: JS Go was more effective than JS in promoting teacher classroom practices related to behavior support and resiliency. Both programs were similar in improving children’s protective factors and reducing internalizing behaviors, with consistent effects across English and Spanish-speaking children. Teachers rated the JS Go app with high acceptability, though predicted future usage showed greater variability. Rapid qualitative analysis showed that participants found the app easy to use, frequently accessed its resources, and considered it helpful for reinforcing key strategies across the four program pillars. Conclusions: JS Go is a novel approach to providing mental health consultation. It represents a promising mobile adaptation of the established JS consultation model, with important implications for future practice and research. Full article

During the early stages of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, concerns arose regarding the susceptibility of asthmatic children, one of the most common chronic conditions in childhood and a major cause of hospitalization in pediatric settings. Unexpectedly, evidences showed milder clinical courses and fewer asthma exacerbations in these patients, even if cases of critical and fatal infection, often related to specific clinical features of the patient, are not negligible. In this regard, obesity is considered not only an important comorbidity in patients with difficult-to-treat asthma but also a risk factor for more severe forms of COVID-19. These observations are of even greater concern in the context of an increase in childhood obesity that began even before the SARS-CoV-2 pandemic and has continued also as a consequence of it. Given asthma’s heterogeneity, especially in children, an endotype-based approach is crucial. This is possible through a detailed analysis of the complex metabolic pathways that correlate asthma, COVID-19 infection and obesity thanks to new high-through-put technologies, especially metabolomics, which with minimally invasive sampling, including on exhaled breath condensate (EBC), can provide precise and unbiased evidence in support of existing endotypes, making it possible to identify not only the most vulnerable individuals and thus risk stratification through specific biomarkers, but also new molecular and therapeutic targets. This review explores asthma endotypes by highlighting their shared immunometabolic pathways with COVID-19. Findings suggest that metabolomics could enable more accurate risk stratification and guide personalized interventions during viral pandemics, especially in the presence of relevant comorbidities such as obesity. Full article