Search Results (280)

Background/Objectives: Malocclusion is one of the most prevalent oral health concerns in paediatric dentistry, with anterior open bite (AOB) and posterior crossbite (PCB) being among the most common forms. Non-nutritive sucking habits (NNSHs), including digit-sucking habits (DSHs) and pacifier-sucking habits (PSHs), have been linked to malocclusion development. While both habits are known to impact dental and skeletal development, their comparative effects remain unclear. This systematic review and meta-analysis aims to determine the difference in the development and prevalence of anterior open bite and posterior crossbite between patients with digit-sucking and pacifier-sucking habits. Materials and Methods: An exhaustive review of the literature was conducted on the 25 November 2024 across three databases, namely EBSCOhost (including PubMed-Medline), Web of Science and Scopus. The following PICO question was constructed for the systematic review: “In children and teenagers, is there a difference in the development and prevalence of malocclusions (Anterior Open bite & Posterior Crossbite) between patients with a history of digit sucking habits and patients with a history of pacifier sucking habits?”A meta-analysis was also performed with the selected studies, and the software used to carry out the meta-analysis was R 4.3.1 (R Core Team (2023)). Results: From the initial search, 102 articles were found and a further 11 articles were obtained from manual findings. 12 articles were included in the final systematic review and meta-analysis. The meta-analysis indicated that the risk of AOB and PCB was increased by both DSH and PSH. Conclusions: Both DSH and PSH significantly increased the risk of AOB and PCB. PSH posed a significantly higher risk than DSH for PCB development (OR = 2.66, p < 0.001), while no significant difference in AOB prevalence was observed between DSH and PSH (OR = 1.77, p = 0.150). Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYA:16–24 years at diagnosis) require specialist care. In England, Principal Treatment Centers (PTCs) exist, delivering enhanced care exclusively within the PTC or as ‘joint care’ with designated hospitals (DHs). We examined whether joint care impacted patient-reported outcomes when compared to care at one site. Methods: A cross-sectional survey was conducted in England, Scotland, and Wales. This included validated measures of quality of life (QoL), anxiety and depression, health status, social support, and illness perception. Comparisons were made based on young people’s exposure to specialist care within 6 months of diagnosis, defined as care in a TYA PTC: all-TYA-care (all care in a TYA unit), no-TYA-care (no care in a TYA unit, care delivered in a children’s/adult unit only), and joint-care (care in a TYA-PTC and in a children’s/adult unit). Results: Overall, 260/1009 (25.8%) participants responded (England n = 241; Scotland/Wales n = 19). Due to different healthcare policies, statistical analysis was applied to England only. Mean QoL scores were <69.7, the threshold indicating impaired QoL (mean 58.65, standard deviation 20.13). After adjustment for confounding factors, no clinically significant differences in mean QoL between categories existed. The adjusted mean difference for all-TYA-care (n = 66) versus no-TYA-care (n = 89) was −2.28 units (95% confidence interval (CI: −8.85 to 4.29) and for joint-care versus no-TYA-care (n = 85), −4.35 units (CI: −10.34 to 1.63). Similarly, no notable differences in social support, anxiety, depression, or illness perception between categories existed. Patients receiving all-TYA-care had a lower average health status compared with no-TYA-care (difference in means −0.09 (CI:−0.18 to −0.01). Conclusions: No evidence that patient-reported outcomes differ by categories of care existed. This may suggest the evolution of TYA cancer services has led to similar outcomes regardless of care category. However, given the small sample size it is not possible to draw firm conclusions. Full article

Background/Objectives: Sensory properties of food, such as taste and smell, are the main factors influencing the preference or rejection of a given food product, especially among children. The aim of this study was to compare the food preferences of teenagers with diabetes to those of a group of healthy children. Additionally, we assessed the influence of children’s taste perception on food preferences. Methods: The study involved 102 adolescents with type 1 diabetes aged 11–15, including 55 girls and 47 boys. We used a questionnaire that consisted of 63 photos of various food products, dishes, and drinks. For the taste evaluation, we used paper strips impregnated with four basic tastes (sweet, sour, bitter, and salty). Results: Healthy teenagers were more likely to self-report preferences for sweet foods. The overall preference score for sweet products included in the study was higher in the control group. The median score for this group was 4.21 (3.92–4.42), and for the diabetes group, the median score was 4.03 (3.68–4.26) (p = 0.0008). Preferences for bitter-tasting vegetables and fruits were clearly higher in teenagers with type 1 diabetes. The overall preference score for bitter taste products included in the study was higher in the diabetes group. The median score for this group was 3.71 (3.00–4.14), and for the control group, the median score was 2.86 (2.14–3.50) (p < 0.0001). Conclusions: Adolescents with diabetes showed greater acceptance of certain bitter-tasting foods compared to their healthy peers. Lower preferences for sweet and higher preferences for bitter foods can be taken into account in establishing nutritional plans for adolescents with type 1 diabetes. Full article

This paper explores the initial steps of transgenerational language change in exile by comparing the varieties of “Common” Tibetan as spoken by parents born in Amdo, Tibet, and by their teenager children, born in Tibet or in South Asia, who arrived in France at an early age and who have spent all or most of their schooling in France. In these families, the parents speak a variety of Amdo Tibetan as their first language, which does not allow for inter-comprehension with “Common” Tibetan. They have acquired “Common” Tibetan during their stay in South Asia before they moved to France. The paper follows a descriptive approach to analyze the structural (dis)similarities between the parents’ and the children’s varieties of “Common” Tibetan. It also documents intra-generational variation (1) within the parents’ generation, where we can observe a variable extent of retention for Amdo Tibetic features, and (2) within the children’s generation, where variation is usually due more to the (often contact-induced) linguistic changes than to the retention of some of their parents’ linguistic features. Full article

Osteosarcoma (OS) is the most common bone-based cancer in both the US and the world in children, teenagers, and young adults. It is an aggressive form of sarcoma which forms mainly in the long bones of the legs and arms, often metastasizing prior to diagnosis. Every year across the globe, there are approximately 28,000 new cases, yet this sarcoma remains difficult to manage with standard treatments, partly due to its solid and immune resistant tumor microenvironment (TME). The quantity of research conducted on OS because of these difficulties has greatly increased over the past decade, meaning a comprehensive review of new findings on the TME may prove beneficial. This article aims to give a broad overview of the components of the TME of osteosarcoma, discuss its resistances and detrimental effects, and illustrate current and future immune therapy treatments which effectively target the microenvironment. Additionally, it will seek to highlight any knowledge gaps in the current literature and propose further studies to improve clinical outcomes. These studies could be beneficial in increasing drug and treatment efficacy for OS. Full article

Marshmallows are confectioneries that are popular among children and teenagers around the world. Barbecues and the consumption of grilled marshmallows, especially by children, have become fashionable in many countries. Grilled marshmallows may contain carcinogenic polycyclic aromatic hydrocarbons (PAHs). Hydroxy-PAHs (OH-PAHs) concentration in the urine of volunteers after the consumption of grilled marshmallows, as biomarkers of exposure to PAHs, have been determined. A total of 24 participants consumed marshmallows grilled under similar conditions. Urine samples were collected before and after the consumption of grilled marshmallows. 1-hydroxypyrene and 9-hydroxyphenanthrene concentrations in urine samples were determined using the HPLC-FLD technique after enzymatic hydrolysis and isolation by solid-phase extraction (SPE). The average concentration of 1-hydroxypyrene was 0.21 ± 0.16 µg/g creatinine and of 9-hydroxypenanthrene was 2.78 ± 2.55 µg/g creatinine. The concentrations of OH-PAHs in the urine of volunteers eating colored grilled marshmallows were higher compared to the consumption of white ones. In the case of 9-hydroxyphenanthrene this difference was statistically significant p < 0.05. Grilled marshmallows constitute a source of exposure to PAHs, especially in the group of children and adolescents. Even consumption of small or moderate amounts of grilled marshmallows resulted in a significant increase in concentrations of PAH metabolites in the urine compared to the level of these compounds before the intake. Full article

Little research has studied verb inflection and argument structure complexity effects in teenagers with developmental language disorders (DLDs). However, verb production and comprehension deficits that characterize younger children with DLD might persist over time. Seventeen French-speaking teenagers with DLD and seventeen controls (typical language, TL group) were tested with fLEX, an application designed to assess lexical and inflectional production and comprehension of three different verb types: intransitives, transitives and ditransitives, i.e., verbs that require none, one or two overt complements. Participants performed three tasks: action naming, sentence production and sentence comprehension involving third singular and plural present tense. Both groups performed similarly on action naming. Subject–verb agreement errors characterized participants with DLD both in sentence production and comprehension; however, verb–argument structure had no effect on any of the tasks. These results characterize verb deficits in teenagers with DLD as affecting inflectional processes rather than lexical ones: they are found in production and comprehension, persist until adolescence and are thus a target for evaluation and intervention in French-speaking teenagers. Results are discussed from a cross-linguistic perspective and in light of current theories on DLD. Full article

Background/Objectives: The impact of COVID-19 in Africa has been controversial. Data from African countries are heterogeneous and generally scarce. Many regions are also highly endemic for other infectious diseases like malaria, and it has been suggested that the low incidence and mortality of COVID-19 in malaria-endemic regions could have been related to cross-immunity between malaria and SARS-CoV-2. The aim of this study was to determine the prevalence of SARS-CoV-2 and circulating variants as well as the frequency of co-infections with malaria in Equatorial Guinea. Methods: We conducted antigen tests for SARS-CoV-2 and microscopy malaria examinations in 1556 volunteer participants at six health centres in Bioko and Bata from June to October 2021 and performed SARS-CoV-2 whole-genome sequencing on positive samples to determine the diversity and origin of circulating variants. Results: We report 3.03% of SARS-CoV-2 and 22.25% of malaria prevalence over the sampling period; SARS-CoV-2 cases were found at a similar frequency in all age groups, whereas malaria was most frequent in children and teenagers. Six cases of malaria and SARS-CoV-2 co-infection were found, representing 0.37% prevalence. Genome sequences of 43 SARS-CoV-2 isolates are reported, most of which belong to the lineage Delta and, according to pandemic-scale phylogenies, were introduced from Europe on multiple occasions. Conclusions: This study is relevant in providing first-time estimates of the real prevalence of SARS-CoV-2 in this malaria-endemic country, with the identification of circulating variants, their origin, and co-occurrence with malaria. These data regarding the impact of the pandemic and co-infection with endemic diseases are relevant in future pandemics preparedness. Full article

Background/Objective: After the relaxation of acute containment measures during the COVID-19 pandemic, Europe experienced a substantial rebound of non-COVID infections surpassing pre-pandemic levels and causing significant clinical burden. The aim of our study is to analyze outpatient prescription data in Germany, France, Italy, Belgium, the UK, and Poland in order to assess trends and disparities in the post-COVID landscape. Methods: The present cross-sectional study utilized data from six independently collected datasets containing details from longitudinal prescription (LRx) databases. We aimed to evaluate changes in the number of antibiotic prescriptions issued in 2022 (the first post-pandemic year) compared to 2021 (a pandemic year), as well as subsequent developments in 2023 and 2024. Analyses were stratified by age group and by sex. In addition, the most frequently prescribed antibiotics in each year and country were reported. Results: All countries experienced a marked increase in antibiotic use in 2022 compared to 2021. The year-on-year growth in 2022 ranged from +12.0% in France to a substantial +39.3% in Belgium. Germany, Poland, and the UK also showed strong increases of over 25%, while Italy rose by 21.5%. Growth slowed in 2023 and stabilized or declined in 2024, particularly in Poland, Italy, and Belgium. Pediatric antibiotic use surged in 2022, especially among children under 10 (+75% in the UK), then leveled off and even declined in some cases in 2024, while the number of antibiotic prescriptions in older adults either decreased or increased only slightly. Germany and the UK showed continued pediatric antibiotic use increases through 2023. Amoxicillin dominated prescriptions in most countries, but drug choice patterns varied widely by country. Conclusions: This study shows a clear increase in outpatient antibiotic prescriptions issued across Europe after the COVID-19 pandemic, particularly among children and teenagers. Although the overall trends are now starting to level out, some countries still show rising numbers. These findings underscore the importance of a renewed focus on antibiotic stewardship programs, particularly in outpatient and primary care settings. Full article

Background/Objectives: Mental health awareness is rising; thus, neurological and psychiatric side effects also benefit from increased attention from the medical and scientific community. Ibuprofen is a well-known non-steroidal anti-inflammatory drug (NSAID) that is often available over-the counter (OTC) for both adults and children, expressing good efficacy in reducing pain and fever through non-selective cyclooxygenase inhibition. As ibuprofen has already been associated with different neuropsychiatric disorders, the aim of this study was to perform an up-to-date analysis of such signals detected in the cases reported in EudraVigilance (EV). Methods: The disproportionality analysis offered a contextual insight into the real-world situation depicted in the analyzed database. Results: From the total cases reported for ibuprofen (n = 58,911), 13.9% contained nervous system disorders (n = 8214) and 10.7% entailed psychiatric disorders (n = 6295). The cases were distributed between all age groups, with a sensible higher incidence in teenagers and in women in general. Severe cases, including deaths, have been reported. By comparison with ketoprofen, acetylsalicylic acid, and diclofenac, ibuprofen presented a higher probability of reporting psychiatric and behavioral symptoms. Regarding cognitive and attention disorders and disturbances, no disproportionate signal was observed between ibuprofen and all other NSAIDs. Sleep disturbances (hypersomnia, narcolepsy and sleep paralysis) are reported as more probable for ibuprofen than for acetylsalicylic acid, naproxen, and diclofenac. A higher risk of reporting suicidal and self-injurious behaviors was noted for ibuprofen versus all other selected NSAIDs. A limitation of the study can be noted as due to suspected causality, not an established one, and EV reports cannot accurately determine adverse drug reaction frequencies. Conclusions: Considering that ibuprofen is easily accessible as an OTC drug and the higher probability of reporting several neuropsychiatric adverse effects as shown by this study, patient counseling, when possible, and general education for the public are valuable tools in managing these adverse reactions. Full article

Background: Osteosarcoma (OS) is a fast-growing malignant bone tumor that occurs most often in children and teenagers. Development of pulmonary metastasis is the primary cause of treatment failure and mortality. Our previous studies demonstrated that cytoplasmic p27 interacts with PAK1, enhancing PAK1 phosphorylation and promoting OS pulmonary metastasis. However, the cellular functions of p27 and PAK1 are primarily regulated by phosphorylation, and the roles of specific phosphorylation residues in modulating OS metastatic potential remain unclear. Methods: To study tumor invasiveness and lung metastasis, we employed a CRISPR-based knock-in method to introduce specific mutations—p27-T157A, p27-T157D, PAK1-T423E, and PAK1-K299R—into the 143B OS cell line, followed by in vitro invasion and orthotopic xenograft mouse experiments. These residues were selected for their therapeutic potential, as T157 regulates p27 nuclear–cytoplasmic shuttling, while T423 and K299 modulate PAK1 kinase activity. Results: No significant differences in pulmonary metastasis were observed across p27 mutants compared to parental controls. However, the p27-T157D mutant exhibited increased cytoplasmic mislocalization, elevated PAK1-S144 phosphorylation, and enhanced in vitro invasiveness compared to the p27-T157A mutant and parental 143B cells. The PAK1-K299R mutant, designed to be kinase-dead, showed negligible S144 phosphorylation, consistent with loss of kinase activity. Unexpectedly, this mutant displayed increased T423 phosphorylation and in vitro invasiveness, and significantly enhanced pulmonary metastasis in vivo compared to the PAK1-T423E mutant and parental controls. Conclusions: These findings highlight the complexity of targeting specific p27 and PAK1 phosphorylation sites as an anti-metastatic strategy for OS. While p27-T157 phosphorylation influences cytoplasmic localization and invasiveness, it does not significantly alter metastatic outcomes. Conversely, PAK1-T423 phosphorylation is critical in driving OS metastatic potential, and the kinase-dead K299R mutant’s unexpected pro-metastatic effect suggests that kinase-independent mechanisms or compensatory pathways may contribute to metastasis. Our findings suggest the necessity for a more comprehensive understanding of the phosphorylation dynamics of p27 and PAK1 in metastatic OS. They also indicate that conventional kinase inhibition may be insufficient and underscore the potential benefits of alternative or combinatorial therapeutic strategies, such as targeting kinase-independent functions or other upstream kinases involved in these regulatory pathways. Full article

Background: Energy drinks (EDs) are non-alcoholic, functional beverages sold worldwide in more than 165 countries. These products are very popular and often consumed by children, teenagers, and young adults to improve physical performance, reduce drowsiness, and improve memory and concentration with increased intellectual effort. However, their consumption is associated with an increased risk of various health consequences. Objectives: The purpose of this non-systematic review was to discuss the components of EDs and their effects, summarize the AEs reported in the literature associated with the consumption of EDs, and briefly characterize the possible ED-related drug interactions. Methods: Scientific evidence was extracted by searching the databases PubMed and Google Scholar. In addition, the reference lists of the retrieved papers were reviewed and cross-referenced to reveal additional relevant scientific evidence. Results: The most common ingredients in EDs are caffeine, taurine, glucuronolactone, B vitamins, the vitamin-like compound inositol, and sweeteners (sugar, fructose, glucose–fructose syrup or artificial sweeteners). Although it is difficult to conclusively prove a cause-and-effect relationship between the consumption of EDs and the observed pathophysiological abnormalities, most scientific evidence (mostly clinical case reports) indicates that both occasional and especially chronic use of EDs is associated with the occurrence of numerous adverse effects (AEs). Among these, the best documented AEs are those on the cardiovascular system. It should also be noted that the components of EDs (primarily caffeine) may have drug interactions; therefore, EDs may be an important factor influencing the safety of pharmacotherapy in patients consuming EDs. Conclusions: Consuming energy drinks lead to various health problems and may interfere with pharmacotherapy due to the potential development of drug interactions. Due to the widespread availability of EDs, their suggestive advertising aimed at the youngest customers, and ambiguous regulations, new legislative policies are required to limit the widespread consumption of such products and their negative health effects. Full article

Indigenous people possess unique health literacy issues and challenges with preventing infectious diseases. This research assessed the baseline knowledge and misinformation in the Semai indigenous subgroup in Perak state, Malaysia, and the impact of a culturally adapted health education intervention. A single-group pre-test/post-test design was used with 156 participants ranging from 7 to 69 years old, predominantly children. The survey addressed key issues of head lice, intestinal parasites, tuberculosis (TB), handwashing, and germ transmission. An interactive, multi-station health education session in the local language produced a significant increase in overall knowledge (mean score increased from 3.17 to 3.83 out of 5, p < 0.0001), with the largest increase among the adult group aged 31–50 years. This was most notable for handwashing knowledge, which had the greatest increase, and misconceptions about intestinal worms and head lice remained. Differences in outcome by age suggest the need for targeted educational strategies, particularly for teenagers and elderly individuals who achieved less gain. The results support the effectiveness of culturally tailored, community-based health education in promoting the awareness of disease among indigenous communities. The drawbacks are convenience sampling, the child dominance of the sample, and the short-term follow-up. Future emphasis should be placed on long-term, community-based intervention using culturally tailored content and digital media. Full article

Background and Objectives: Due to the progress made in all areas of research, pediatric patients diagnosed with acute lymphoblastic leukemia (ALL) now have an average overall survival rate of 90%. There are still discrepancies between high-income countries and limited-resource centers. The aim of this study was to analyze prognostic factors and outcome parameters in a 223-patient cohort from a single center in Romania, treated with two adapted BFM protocols. Materials and Methods: The patients diagnosed with ALL in our center were enrolled in this study from January 2016 to December 2022 and subsequently followed up until December 2024. The patients were treated first according to the ALL IC BFM 2009 protocol until June 2019 and afterwards with the ALL AIEOP BFM 2017 protocol starting with July 2019. The prognostic factors were analyzed in both subgroups and the outcomes were measured: event-free survival (EFS), overall survival (OS), cumulative incidence of relapse (CIR), relapse-free survival (RFS) and non-relapse mortality (NRM). Results: The comparison between the two subgroups revealed that every parameter improved over time: complete remission after induction (87.75% vs. 80.7%), early deaths (3.92% vs. 5.78%), deaths in remission (4.08% vs. 5.26%), 5-year EFS (73.79% vs. 70.22%), 5-year CIR (18.36% vs. 19.04%), 5-year RFS (81.76% vs. 80.97%), 5-year NRM (7.85% vs. 10.77%), and 5-year OS (88.18% vs. 82.54%). Whereas for the standard-risk group, events such as relapse or death were isolated, for intermediate-risk patients, the events were limited to a small number and did not significantly influence the overall results, and for high-risk children, the results improved significantly between the two subgroups. The worst outcomes were observed in patients with the BCR::ABL1 fusion gene, T-cell phenotype, and in teenagers, compared to the ETV6::RUNX1 fusion gene, B precursor ALL, and in smaller children, respectively. Conclusions: The 5-year OS increased in our center from 82.54% to almost 90%, with the most substantial finding being the survival rate for high-risk patients, now reaching up to 80%. The prognostic factors were age at diagnosis, genetic characteristics, and response to treatment, especially prednisone sensibility. Full article

Durable plastics are a sustainability challenge for healthcare products. Orthopedic products are regulated with strict specifications for human tissue interactions. Healthcare engineers and managers select plastic to meet the full range of material properties. Plastic is plentiful, low cost, and reliable, with established supply chains. Used plastic products can be discarded using existing waste management systems with low externality costs for orthopedic businesses. However, plastic is produced from fossil petroleum, raising issues for sustainability commitments of healthcare product companies. Barriers to the transition away from single-use plastic toward circular systems and bio-based healthcare products have been studied, but the transition is a goal that has yet to be realized. This research article reports on a transition engineering design sprint with a medium-sized orthopedic company specializing in orthoses for children and teenagers. The design sprint process engages company experts with systems perspectives on the role of unsustainable plastic in orthopedic healthcare and illuminates opportunities for capturing value in business transition. Two system transition project concepts were co-developed. The first concept is a plastics value map that aims to converge the satisfaction of essential needs with the usefulness of plastics under the limitations of a biophysically constrained future economy. The second concept is an orthopedics library data system concept that would allow reusing of fit-for-purpose used products and to inform the refurbishment of used products. In addition to an explanation of the design of the two concepts, the article presents reflections of co-design stakeholders on the usefulness and usability of the concepts. The article provides a real-world application of the co-design processes in transition engineering and the reflection by the company on the value of the results. The results indicate that the co-designed concepts could enable the company to address its sustainability aspirations and potentially resolve the dissonance of sustainability and business viability. Full article