Search Results (2,487)

Computational thinking (CT) is increasingly recognized as a foundational skill in primary education, yet its developmental progression in the early school years remains underexplored. This study examined CT as a competence comprising three core concepts—sequences, loops, and conditionals—through a cognitive developmental lens. A total of 517 students in Grades 1 to 3 in Greece were assessed using the Greek adaptation of the Beginners Computational Thinking Test (BCTt), a validated tool for young learners. To examine performance trends, conceptual interrelations, and learner profiles, we employed repeated-measures ANOVAs, correlation analysis, and cluster analysis. The results showed that students performed highest in sequences, followed by loops and conditionals, with statistically significant differences across concepts. This pattern was also reflected in the cluster analysis, which identified three distinct student profiles differing in both overall performance and conceptual emphasis. Overall, the findings underscore the progressive nature of CT development and highlight the need for instruction aligned with students’ cognitive readiness and conceptual growth. Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYAs: 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). Central to this is the TYA multidisciplinary team (MDT) and an outreach model coordinating care between hospitals. We previously reported similar outcomes regardless of care location. Aims: To compare TYA experiences of care with healthcare professionals’ perspectives of the service they deliver. Methods: Mixed methods across England and Wales were used. The TYA-MDT identified TYAs who then received a postal invite to a cross-sectional survey capturing experiences of places of care, treatment, healthcare professional support (HCP), mental health, sexuality/fertility, clinical trials and care coordination. Comparisons were made based on exposure to care in a specialist TYA environment within 6 months of diagnosis: all-TYA-PTC (all care in the TYA-PTC, n = 70, 28%), no-TYA-PTC (no care in the TYA-PTC (n = 87, 35%): care delivered in a children/adult unit only), and joint care (care in a TYA-PTC and in a children’s/adult unit, n = 91, 36%). HCP perspectives were captured by rapid ethnography. Results: A total of 250/1056 (24%) TYAs participated. Overall, 200 (80%) rated their teams as excellent/good for helping them prepare for treatment. No evidence of significant differences existed between categories of care for proportions receiving support from key TYA-related professionals: TYA cancer nurse specialists (all-TYA-PTC n = 58, 91%; joint care n = 71, 88%; no-TYA-PTC n = 64, 82%) and social workers (all-TYA-PTC n = 30, 55%; joint care n = 36, 48%; no-TYA-PTC n = 28, 38%). A trend of diminishing support from youth support co-coordinators existed (all-TYA-PTC 63%; joint care 49%; no-TYA-PTC 40%, p = 0.069). This may explain why few differences in patient experiences existed across categories of care. Forty-nine HCPs participated. They were more critical in their interpretation of care, highlighting inequity in resources and challenges in some pathways and coordination. Conclusions: Similar access to age-appropriate support across care settings is likely to reflect recruitment methods. When TYAs are known to the MDT, age-appropriate care can be mobilized beyond TYA units, which could explain the equitable outcomes observed across different care locations in young people who responded to the survey. Nevertheless, gaps persist in communication and coordination, particularly within joint care models, and in the involvement of allied health professionals such as dieticians and physiotherapists, whose input is essential for rehabilitation and return to normal life. Strengthening these areas will require continued investment in workforce capacity and digital infrastructure to support genuinely coordinated, developmentally appropriate TYA cancer care. Full article

Patellar maltracking is among the most common causes of anterior knee pain after total knee arthroplasty (TKA), underscoring the need for accurate prevention and treatment. Therefore, the purpose of this narrative review is to provide a comprehensive overview of current evidence on post-TKA tracking, focusing on component alignment, preoperative patient assessment, and revision treatment options. A PubMed database search was performed, leveraging the literature from the last 20 years, and the results were qualitatively synthesized. According to current studies, several precautions should be taken to prevent patellofemoral stress and, consequently, patellar maltracking, such as avoiding internal rotation, valgus alignment, and excessive flexion of the femoral component and internal rotation of the tibial component. Regarding alignment strategies, kinematic alignment appears to offer potential benefits over mechanical alignment in certain functional outcomes and patient satisfaction scores. However, these differences should be interpreted cautiously as they may not always exceed the minimal clinically important difference. Furthermore, recent evidence indicates that quadriceps biomechanics influence TKA outcomes, potentially suggesting that conventional surgical approaches may need to be individualized, though these preliminary findings require prospective validation. Currently, robotic-assisted surgery represents a developmental direction for patient-tailored interventions and offers great promise for better prosthesis customization to the individual patient. Integration of imaging data with dynamic soft-tissue assessment enables more predictable reconstruction of joint kinematics. Regarding surgical treatment, the selection of specific methods requires a prior clinical and radiographic assessment. Indications range from patellar maltracking direction and component malrotation to patient preferences and rehabilitation potential. Ultimately, the future of TKA relies on personalized interventions to prevent complications and improve patient outcomes. This evolution is driven by the shift from mechanical alignment to kinematic alignment, alongside quadriceps tendon assessment and intraoperative robotic-assisted measurement, all aimed at optimizing the accuracy of implant positioning. Full article

Background: The first 1000 days of life, from conception to 2 years of age, represent a critical window during which nutrition can exert long-lasting effects on neurodevelopment, immune maturation, and susceptibility to prematurity-related morbidity. Docosahexaenoic acid (DHA) is a key structural n-3 long-chain polyunsaturated fatty acid of the brain and retina, characterized by rapid fetal accretion during the third trimester. Methods: We conducted a narrative review of studies published from March 2015 up to December 2025, including randomized controlled trials, follow-up studies, and systematic reviews/meta-analyses about DHA supplementation during pregnancy, lactation, infancy and early childhood, and its role on development. Results: Across the first 1000 days, DHA supplementation improves biochemical DHA status, particularly in populations with low baseline levels (moderate to high level of evidence), while clinical outcomes remain heterogeneous. During pregnancy, some benefits in specific cognitive and behavioral domains have been demonstrated, whereas effects on global cognition and long-term behavior are frequently null (moderate evidence). Visual outcomes appear favorable, with improvements in visual acuity (moderate evidence). In preterm infants, enteral DHA—often combined with arachidonic acid (ARA)—is feasible and well tolerated. DHA may reduce inflammatory markers and necrotizing enterocolitis risk when in equilibrium with ARA (low to moderate evidence), while no evidence supports the link between DHA and reduced risk of bronchopulmonary dysplasia and retinopathy of prematurity (moderate evidence). Neurodevelopmental outcomes are mixed: neuroimaging studies suggest enhanced white matter maturation with DHA + ARA, whereas most trials show no clear benefit regarding standardized developmental scores (moderate evidence). Conclusions: DHA is biologically essential during the first 1000 days, but its clinical impact depends on timing, dose, baseline status, and prematurity-related context. The balance between DHA and ARA, rather than DHA supplementation alone, emerges as a key determinant of clinical efficacy, supporting a shift toward precision-based nutritional strategies in early life. Full article

Background/Objectives: Children and adolescents on the autism spectrum often experience delays in both gross and fine motor skills, which can limit their participation in physical activity and everyday tasks. Methods: This narrative review synthesizes evidence from 88 peer-reviewed studies examining fundamental motor skills, broader motor competence, and perceived motor competence in individuals aged 3–18 years with a formal diagnosis of autism. Results: Across the literature, children with autism consistently demonstrate lower proficiency in locomotor and object control skills compared with their typically developing peers, while perceived competence emerges as an important factor influencing motivation and engagement. Intervention studies—most commonly school-based or structured physical activity programs—generally report short-term improvements in motor performance, although outcomes vary depending on study design, dosage, and assessment tools. The review also highlights substantial methodological heterogeneity and a notable lack of evidence concerning adolescents, underscoring the need for longitudinal and developmentally sensitive research. Conclusions: Practical implications are discussed for creating supportive movement environments in educational and adapted physical activity settings. This review follows a narrative synthesis approach informed by a structured search strategy. Full article

This study aims to elucidate the miRNA regulatory mechanisms during the developmental process of Kazakh horse testes at 1 and 3 years of age. Through miRNA sequencing and bioinformatics analysis of testicular tissues from 1-year-old and 3-year-old horses, a developmentally stage-specific miRNA expression profile was constructed. A total of 1640 miRNAs were identified, among which 437 (380 up-regulated and 57 down-regulated) exhibited significant differential expression between the two age groups, including eca-miR-16, eca-miR-17, eca-miR-103, and eca-miR-199a-5p. Functional enrichment analysis revealed that the target genes of these differentially expressed miRNAs were primarily involved in key processes such as oxidative stress response, hormone receptor signaling regulation, and cytoskeletal remodeling, suggesting that testicular maturation depends on a complex post-transcriptional regulatory network. Further KEGG analysis revealed significant enrichment of classic reproductive signaling pathways, including PI3K/AKT, Wnt/β-catenin, Hippo, and TGF-β, indicating their synergistic roles in spermatocyte proliferation/differentiation and testicular homeostasis establishment. Although limited by a small sample size, this study elucidates the molecular mechanisms underlying male reproductive maturation in Kazakh horses at the post-transcriptional regulatory network level, providing preliminary theoretical support and potential markers for evaluating stallion reproductive performance and molecular breeding. Full article

Purpose: To investigate the relationship between oculomotor skills, phorias, and visual symptoms in pediatric population aged 5 to 8 years. Methods: A cross-sectional study was conducted with 120 children, divided into three age groups. Each participant underwent a full optometric examination, including the Maddox test for dissociated phoria, and the Northeastern State University College of Optometry (NSUCO) and Developmental Eye Movement (DEM) tests for oculomotor function. In addition, the Convergence Insufficiency Symptom Survey (CISS V-15) questionnaire was administered to assess visual symptoms. Results: The prevalence of binocular and oculomotor dysfunctions varied by age and sex. Differences in saccadic and pursuit eye movement performance were observed between groups. Older children showed patterns of association between phoria measurements, oculomotor performance, and possible visual symptoms, particularly in girls over 6 years of age. Conclusions: This study provides additional descriptive data for the pediatric population and highlights that oculomotor dysfunction and phoria frequently coexist. Symptom scores measured by the CISS V-15 tended to increase with age. The results should be considered preliminary and potentially hypothesis-generating, pending the future availability of a validated questionnaire to assess phoria-related symptoms in children from 5 years of age. Overall, this study underscores the importance of comprehensive binocular vision assessments in school-aged children. Full article

Changes in microbial composition during early infancy by various factors (mode of delivery, nutritional practices, antibiotic usage, and environmental influences) have been correlated with observable variances in cognitive abilities, temperament, stress response, and the predisposition to neurodevelopmental disorders. Consequently, microbiota-targeted interventions such as probiotics, prebiotics, and synbiotics are being explored as avenues to enrich beneficial microbial taxa, enhance short-chain fatty acid production, fortify mucosal immunity, and mitigate inflammatory responses during these critical periods. Preclinical research, primarily in experimental animal models, has demonstrated a causal link between microbiota composition and developmental processes such as myelination, synaptic plasticity, and socio-emotional behaviors, whereas human evidence remains largely associative and heterogeneous. A notable gap exists in the current literature, which typically centers on gastrointestinal, psychiatric, or preterm outcomes, without a focused investigation into neurodevelopmental assessments within the first three years. To bridge this gap, we conducted a systematic review and meta-analysis of randomized controlled trials assessing the impact of probiotics, prebiotics, and synbiotics on neurodevelopment and behavior in infants aged 0–36 months. Our primary objective was to establish whether microbiota-targeted strategies confer discernible neurodevelopmental benefits, alongside elucidating the mechanisms underpinning the relationship between microbial modulation and early brain development. Full article

The complexity of physiological signals provides insight into the maturation and functional organization of the developing brain. This study investigated age-related changes in electroencephalographic (EEG) signal complexity and their association with behavioral variability in 240 participants aged 6 to 29 years. EEG signals were recorded during the resting state, and Multiscale Entropy (MSE) was computed across 34 temporal scales, grouped into fine, medium, and coarse scales. Behavioral variability was assessed using measures from Oddball and Delayed Match-to-Sample tasks. Quadratic regression analyses characterized age-related changes in MSE across scalp regions, and Pearson correlations evaluated associations between age-adjusted residuals of MSE and behavioral variability. The results showed that MSE changed with age across temporal scales in all cortical regions. Developmentally, MSE showed a significant age-related increase at fine scales across the entire scalp, region-specific decreases at medium scales, and a generalized decrease at coarse scales. Behavioral variability decreased with age across both tasks. Notably, fine-scale age residual MSE in central and posterior regions was negatively correlated with the coefficient of variation in the Oddball task, indicating that higher neural complexity supports more stable performance. These findings suggest scale- and region-specific age-related changes in neural complexity and suggest that fine-scale MSE captures aspects of brain maturation related to behavioral stability beyond traditional variability measures. Full article

Background and Objectives: The relationship between mental health and sports injuries has become increasingly important in youth soccer, due to developmental changes in this population, the high demands of training, and the competitive pressures of sport. This cross-sectional study examined the association between injury history (no injuries, 1–2, >2 injuries), mental health indicators (anxiety, stress, depression), and differences by sex, competitive category, and playing position. Materials and Methods: 146 soccer players (79 males, 67 females; ages 12–30; mean age = 16.65, SD = 2.34 years) from youth and senior categories of a professional club in Spain completed the STAI-T (trait anxiety), DASS-21 (state anxiety, stress, depression), sociodemographic and sports-related variables (gender, sports category, playing position), and self-reported injury history: no injuries (n = 39), 1–2 injuries (n = 80), >2 injuries (n = 27). The statistical analyses performed were one-way ANOVA (ηp²), χ² tests, and Games-Howell post hoc tests. Results: 73.3% of the players reported ≥1 injury (54.8% 1–2 injuries; 18.5% >2), with no differences by gender, position, or category (χ² range: p > 0.05). The ANOVA revealed significant differences for trait anxiety (F(2, 143) = 3.68, p = 0.029, ηp² = 0.049; small-to-moderate), and state anxiety (F(2, 143) = 4.63, p = 0.014, ηp² = 0.061; moderate). No effects were found for stress/depression (p > 0.12). The post hoc test (Games-Howell) indicates that the group with no injuries showed significantly lower trait anxiety (p = 0.038, d = 0.33) vs. 1–2 injuries, and state anxiety (p = 0.012, d = 0.70) vs. >2 injuries. Stress and depression showed a non-significant upward trend. Conclusions: A greater history of injuries is associated with higher levels of anxiety in youth soccer players. The findings suggest routine assessment of anxiety and training in emotional self-regulation for injury prevention and rehabilitation. Longitudinal studies are needed to clarify the bidirectional relationship. Full article

Executive function (EF) impairments are common in children with intellectual and developmental disabilities and have a significant impact on learning and daily life. Cognitive training programs aimed at strengthening EFs may show limited feasibility and generalization. However, recent studies suggest that ecological, curriculum-embedded problem-solving activities may be more promising. This multiple-baseline single-case study tested the feasibility and efficacy of a short computational thinking and coding intervention based on problem-solving for children with sickle cell disease, a hemoglobinopathy associated with cognitive decline and EF deficits. The trial followed the What Works Clearinghouse (WWC) Version 5 guidelines for single-case research. Three 7–8-year-old children with lower-range IQ (71–82) and EF impairments completed 11 coding sessions over 5–6 weeks using code.org, with pre/post assessments of non-verbal EF (planning, inhibition, and switching), and verbal EF skills (verbal working memory, phonological fluency and semantic fluency). Results showed 100% adherence to the intervention, significant improvement in coding (IRD range = 0.69–0.79), with positive transfer effects on nonverbal planning skills (gains > 2 z-scores) and also verbal fluency (z-score gains ranging from 0.47 to 1.04). Inter-individual variability in effects was related to the child’s individual cognitive profile. Findings suggest that problem-solving, coding-based activities can be feasible and potentially beneficial for children with significant EF impairments. Full article

Parents’ priorities significantly influence decisions regarding their children’s support, reflecting parental attitudes, knowledge, and experiences. This research aimed to identify parents’ priorities when choosing professional support for their children, examine the link between these priorities and children’s current abilities, and examine which developmental domains children receive professional support and whether these domains align with parental priorities. The sample consisted of 82 parents of children aged three to six years, divided into two groups: 41 parents of children with developmental disabilities and 41 parents of children without. All participants completed a Treatment Priorities Questionnaire (TP). The results showed that parents of children with developmental disabilities prioritize Communication skills, Social relationships, and Pre-Academic skills. In contrast, parents of children without developmental disabilities focus on Self-Care and Pre-Academic skills. These priorities often relate to the child’s areas in need of improvement. While children with developmental disabilities receive appropriate support, those without often do not receive support in the areas their parents prioritize. This highlights the need for parents to also recognize and build on their child’s strengths, creating a more balanced approach to their development. Full article

Background/Objectives: Children and adolescents undergoing Haematopoietic Stem Cell Transplantation (HSCT) experience complex symptoms, often under-reported by patients and undetected by clinicians, which cause distress. Patient-Reported Outcome Measures (PROMs) offer a way to capture symptom experiences directly from patients, with the potential of supporting effective symptom assessment and management, yet their routine use in paediatric HSCT remains unclear. This systematic review synthesises evidence on PROMs used during inpatient paediatric HSCT care, examining their role in symptom monitoring and clinical decision-making, and identifying gaps to strengthen person-centred, developmentally appropriate care. Methods: We searched the MEDLINE, CINAHL, Embase, APA PsychINFO, and Cochrane Library in October 2024 for studies published in English between 2014 and 2025 describing the use of PROMs during inpatient paediatric (0–18 years) HSCT admission (up to Day +100 post HSCT). In March 2025, prior to data extraction, we added additional studies published by authors of included studies. Two-stage independent screening and data extraction were conducted, and the Quality Assessment with Diverse Studies (QuADS) tool was used to appraise each study. Narrative syntheses informed by Symptom Management Theory were used to compare PROM use, clinical integration, and reported impacts. Results: Seventeen studies met inclusion criteria, describing 20 PROMs used during paediatric HSCT hospitalisation. PROMs captured a wide range of physical and psychological symptoms, with pain and nausea most frequently reported. While PROMs reportedly improve symptom detection and communication, integration into routine paediatric HSCT clinical care was rare; and only two studies systematically used PROMs data to guide symptom management. Evidence of PROMs-driven improvements in HSCT clinical outcomes was scarce, and longitudinal data on symptom trajectories were limited. Conclusions: PROMs are not routinely used to inform clinical practice in paediatric HSCT, and current evidence provides only a partial understanding of symptom trajectories and lived symptom experiences during the paediatric acute transplant admission. To realise the full potential of PROMs in enhancing symptom assessment and management, systematic PROMs integration into clinical workflows is required, supported by electronic health record integration, clinician training, and longitudinal research designs that capture symptom evolution across the transplant continuum. Full article

Background: Episodic ataxia type 2 (EA2) is the most common subtype of episodic ataxia and is primarily caused by pathogenic variants in the CACNA1A gene. Although classically characterized by paroxysmal ataxia, CACNA1A-related disorders are increasingly recognized as an age-dependent phenotypic continuum that extends beyond episodic cerebellar dysfunction to include fluctuating weakness, persistent neurological signs, and neurodevelopmental impairments. Case report: A 12-year-old boy presented with episodic vertigo. His medical history was notable for infantile paroxysmal tonic upward gaze beginning at 6 months of age. From the age of 7 years, he developed frequent episodes of vertigo and ataxia lasting 2 to 3 h. At 10 years of age, he experienced an episode of acute lower limb weakness with diminished deep tendon reflexes, without prominent ataxia. Guillain–Barré syndrome was initially suspected, and he received two courses of intravenous immunoglobulin, with only transient improvement. Neurophysiological studies were largely unremarkable, except for an isolated decremental response on repetitive nerve stimulation. In addition to paroxysmal events, he exhibited persistent interictal cerebellar signs, including dysmetria, dysdiadochokinesia, and downbeat nystagmus. Neuropsychological testing revealed mild intellectual disability with prominent visuospatial deficits. Trio-based whole-exome sequencing identified a de novo CACNA1A splice donor variant (c.978 + 1G > A), confirming the diagnosis of EA2. Treatment with acetazolamide resulted in marked improvement in episodic ataxic events. Conclusions: This case highlights EA2 as part of a broader CACNA1A-related phenotypic continuum rather than a purely paroxysmal disorder. Awareness of atypical and age-dependent manifestations is crucial to avoid diagnostic pitfalls and to facilitate the timely initiation of targeted therapy and appropriate developmental support. Full article

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and may persist into adulthood, characterized by inattention, impulsivity, and hyperactivity leading to functional impairment. The global prevalence in children and adolescents ranges from 5–7%, yet data from the Eastern Province of Saudi Arabia remain limited. This study determined the prevalence of hyperactive/impulsive and inattentive symptoms among children and adolescents aged 4–18 years and identified associated factors. A cross-sectional study was conducted across major cities using validated Arabic versions of the SNAP-IV and NICHQ Vanderbilt Assessment Scale distributed online. The survey assessed ADHD symptoms, oppositional defiant disorder, conduct disorder, anxiety/depression, functional impairment, and prenatal and perinatal risk factors, with DSM-based scoring and multivariable logistic regression to identify predictors. Among 920 participants (mean age 10.7 years; 52.9% boys), 12.7% met criteria for ADHD. The inattentive subtype was most common, followed by combined and hyperactive/impulsive types. Affected children and adolescents showed academic and interpersonal difficulties. Significant predictors included younger age, birth weight <1.5 kg, psychiatric history, previous ADHD diagnosis, and family history of psychiatric or neurological disorders. ADHD symptoms were relatively common and associated with functional impairment and identifiable developmental and familial risk factors. Full article