Search Results (982)

Introduction: Fever is one of the most common reasons for Paediatric Emergency Department (PED) visits, often driven by parental anxiety and misconceptions about fever management. This study aimed to evaluate the knowledge, attitudes, and practices of parents regarding childhood fever to identify gaps and guide targeted educational interventions. Understanding parental behaviors is crucial for improving care outcomes and reducing unnecessary PED utilization. Methods: This study is a descriptive cross-sectional study. The sample of this study consists of a total of 440 parents of children admitted to the Paediatric Emergency Department (PED) with complaints of fever. Convenience sampling was used to select the participants. Data were collected using a questionnaire covering sociodemographics, a form surveying the parents’ fever knowledge and attitude, and the validated parents’ fever management scale (Turkish version). The data were analyzed using the SPSS 22.0 statistical program. Results: Most parents (95.5%) reported prior experience with childhood fever, yet 54.1% lacked a regular physician. Common fever detection methods included tactile assessment (56.4%) and thermometers (27.3%). Parental concern arose at 39 °C (48.6%). Cold applications (41.6%) and antipyretics (21.1%) were frequent interventions. The mean PFMS-TR score was high (34.97 ± 4.27), indicating elevated caregiver burden. Scores varied significantly by the child’s age (higher for infants, p = 0.044) and maternal education (higher for educated mothers, p = 0.008). Satisfaction with healthcare staff correlated with higher scores (p = 0.024). Negative correlations emerged between parental age, number of children, and fever management scores (p < 0.05). Conclusions: Parents exhibited high interventionist behaviors and persistent knowledge gaps, underscoring the need for targeted education programs. Educational programs targeting fever management, tailored to parental demographics and misconceptions, are essential. Healthcare providers, particularly pediatric nurses, should prioritize clear communication and evidence-based guidance to empower parents and reduce unnecessary healthcare burdens. Future research should expand to diverse geographic and cultural settings to enhance generalizability. Full article

Background: Although there is substantial research into individual nutrients during pregnancy, such as folate, iron, and vitamin D, little is known about the impact of mixtures of essential nutrients. We investigated the associations between mixtures of maternal essential minerals and vitamin concentrations and child cognition and executive functions at age 7. Methods: Data from 348 mother–child pairs in the Growing up in Singapore Towards Healthy Outcomes birth cohort with both plasma nutrient and neurodevelopmental outcome data were used. Gestational fasting plasma samples between 26 and 28 weeks of gestation were analyzed for 10 essential minerals and 12 B and D vitamers. Child cognition and executive functions at 7 years were assessed using the Wechsler Abbreviated Scale of Intelligence 2nd Edition (WASI-II) [n = 331] and the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF-2) [n = 348], respectively. Generalized weighted quantile sum regression (gWQS) was used to investigate the associations between nutrient mixtures and child cognitive executive function scores. Single-nutrient analysis using covariate-adjusted multivariable regressions was performed as a sensitivity analysis. Results: A one-quartile increase in the positively weighted nutrient mixture index was associated with higher block design T-scores (β = 2.17, 95% CI: 0.03, 4.31). Additionally, the negatively weighted mixture was associated with lower block design (β = −2.25, 95% CI: −4.92, 0.41, p = 0.02) and perceptual reasoning (β = −1.94, 95% CI: −5.17, 1.29, p = 0.04) scores in boys only. We found no association between the nutrient mixture and BRIEF-2 subscale T-scores. Conclusions: In this study, we found that a positively weighted nutrient mixture index of maternal gestational minerals and vitamins was associated with a greater ability in children to analyze and understand abstract visual items. Full article

Outbreaks of Ips hauseri, a major bark beetle pest in Central Asian Picea schrenkiana forests, have intensified under climate warming and prolonged droughts. However, the reproductive behavior and gallery construction strategies of this species remain poorly understood, limiting our ability to predict its population dynamics. Here, we dissected 219 galleries from infested spruce trees in Hami, Xinjiang, during an outbreak period (2024–2025). We identified 11 distinct gallery morphologies, with harem size (number of females per male) ranging from one to seven. Gallery length was positively correlated with egg production. Reproductive output peaked at a harem size of five, beyond which both gallery dimensions and fecundity declined. Host tree diameter at breast height (DBH) significantly influenced gallery complexity, with larger trees supporting more maternal galleries. Upward-oriented galleries were longer and contained more eggs than downward ones. Intraspecific competition, mediated by gallery adjacency and spatial orientation, strongly affected offspring development. Our results demonstrate that I. hauseri exhibits flexible gallery architecture and reproductive adjustments in response to resource availability and competition—a behavioral plasticity that likely contributes to its outbreak potential. Monitoring gallery morphology and harem size could enhance early detection and population forecasting for this increasingly damaging forest pest. Full article

Urticaria is a mast cell-mediated disorder commonly encountered in women of reproductive age, making its interaction with pregnancy clinically relevant. Gestation induces profound hormonal and immunologic adaptations—including shifts between Th1/Th17 and Th2/Treg responses and sustained exposure to sex steroids and placental hormones—that can modulate mast cell reactivity. As a result, chronic urticaria (CU) shows heterogeneous behavior during pregnancy: approximately half of patients improve, one third worsen, and the remainder remain stable. Pregnancy also presents several urticaria-like dermatoses, notably polymorphic eruption of pregnancy (PEP/PUPPP), atopic eruption of pregnancy (AEP) and pemphigoid gestationis (PG), as well as rare hormone-induced hypersensitivity reactions. Additionally, systemic disorders such as intrahepatic cholestasis of pregnancy (ICP), chronic kidney disease–associated pruritus and urticarial vasculitis may mimic urticaria but differ markedly in prognosis, maternal–fetal risk and management. Given this complexity, accurate diagnosis requires integration of temporal pattern, lesion morphology and duration, distribution, systemic features and targeted investigations, as outlined in the diagnostic algorithm proposed. Most pregnancy-specific eruptions are benign, whereas PG, ICP and urticarial vasculitis warrant prompt recognition due to potential fetal implications. Management of CU in pregnancy generally follows standard guidelines, with second-generation H1-antihistamines as first-line therapy and omalizumab reserved for severe refractory cases. Full article

Background and Objectives: Gestational hypertension (GH) is increasingly recognized as an early manifestation of maternal cardiovascular vulnerability. Ambulatory blood pressure monitoring (ABPM) enables the evaluation of circadian blood pressure behavior, and a non-dipping blood pressure pattern (NDBP), defined as a nocturnal systolic decline of <10%, has been associated with endothelial dysfunction, placental hypoperfusion, and adverse pregnancy outcomes. However, the prognostic value of NDBP for postpartum chronic hypertension (PPCHT) remains insufficiently explored. Materials and Methods: This retrospective observational study included 196 women with gestational hypertension beyond 20 weeks of gestation who underwent ABPM between 2013 and 2025. Patients were classified as dippers (≥10% nocturnal systolic decline) or non-dippers (<10%). The primary outcome was postpartum chronic hypertension, defined as a persistent office blood pressure ≥ 140/90 mmHg or continued antihypertensive therapy at 12-month follow-ups. Secondary outcomes included fetal growth restriction (FGR), preeclampsia, and hypertensive complications. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of PPCHT and FGR. Results: In the cohort, 124 women (63.3%) exhibited a non-dipping blood pressure pattern. At 12 months postpartum, 93 women (47.4%) developed chronic hypertension. Non-dipping was significantly more frequent among women with PPCHT compared with those that remained normotensive (75.3% vs. 52.4%). Non-dippers also demonstrated higher rates of fetal growth restriction and preeclampsia. In multivariable analysis, NDBP remained independently associated with PPCHT after adjustments for age and daytime blood pressure parameters. Furthermore, NDBP and elevated daytime systolic blood pressure were independent predictors of FGR. Conclusions: A non-dipping blood pressure pattern is highly prevalent in gestational hypertension and is independently associated with both fetal growth restriction and postpartum chronic hypertension. Incorporating ABPM-derived circadian blood pressure phenotyping into antenatal assessments may improve risk stratification and support targeted postpartum cardiovascular surveillance strategies. Full article

This study evaluates the mechanical behavior and durability of a silty soil stabilized with Portland cement and recycled ground glass powder (GGP). The porosity–cement index (η/C_iv) was applied to predict unconfined compressive strength ($q_u$), splitting tensile strength ($q_t$), and accumulated mass loss (ALM) under wetting–drying cycles. Mixtures were prepared with cement contents of 3%, 6%, and 9%, GGP contents of 5%, 15%, and 30%, and dry unit weights of 13.5, 14.5, and 15.5 kN/m³, and were cured for 7, 28, and 90 days. The experimental program consisted of a large dataset, comprising 486 mechanical tests (unconfined compressive and splitting tensile strength) and 81 durability tests, providing a robust basis for both empirical modeling and machine learning analysis. The results confirmed a strong power-law relationship between η/C_iv and both $q_u$ and $q_t$, achieving high coefficients of determination (R² > 0.98). The strength coefficient (A) increased consistently with curing time and GGP addition, indicating enhanced pozzolanic reactivity and matrix densification. After 90 days, $q_u$ increased by over 250% and $q_t$ by nearly 700%. Durability tests revealed exponential reductions in ALM with higher density and binder content, achieving values below 0.5% for the densest mixtures, which contained 30% GGP. These findings validate the η/C_iv index as an effective predictor of strength and durability in soil–cement–GGP geomaterials, establishing a solid basis for future integration with machine learning models. The implementation of twenty-eight machine learning presets for predicting $q_u$, $q_t$, and ALM demonstrated that the Matern 5/2 Gaussian Process Regression and the trilayered neural network are the most suitable algorithms, achieving R² values higher than 0.987 in both the validation and testing stages. Full article

Background: Congenital toxoplasmosis remains a significant cause of fetal morbidity worldwide. This case–control study aimed to identify sociodemographic, dietary, and behavioral factors associated with Toxoplasma gondii infection during pregnancy in Italy by comparing infected women with seronegative controls, and to evaluate modifiable risk behaviors and treatment-related outcomes among affected patients. Methods: This case–control study included 201 pregnant women (100 with T. gondii infection and 101 seronegative controls). Participants completed a structured questionnaire on sociodemographic factors, diet, environmental exposures, and preventive behaviors. Clinical data were collected for infected women and analyzed using SPSS v27.0. Results: Sociodemographic and obstetric characteristics did not differ between groups. Infected women were more likely to live in rural areas (p < 0.001), have a lower educational level (p = 0.009), consume unpasteurized dairy products and cured meats (p < 0.05), purchase food from farmers or butchers (p = 0.01), and do not check food preparation practices when eating outside the home. High-risk animal-related behaviors were also more common among cases (p < 0.001). Despite similar baseline awareness, adherence to preventive measures was lower among cases; most infections were diagnosed in the first trimester and treated with spiramycin with good tolerability. Conclusions: Maternal toxoplasmosis is mainly associated with modifiable behavioral and environmental factors, underscoring the need for targeted, preconception counseling to reduce the risk of congenital infection. Full article

Hepatoblastoma is the predominant primary liver malignancy in children, and outcomes remain poor for patients with metastatic disease. Long non-coding RNAs (lncRNAs) regulate tumor behavior, but their role in metastatic hepatoblastoma is not well defined. This study investigates the expression and functional significance of the lncRNA, maternally expressed gene 3 (MEG3), in a metastatic hepatoblastoma model. RNA sequencing comparing the metastatic hepatoblastoma cell line, HLM_2, with its parental HuH6 cell line identified MEG3 as being significantly upregulated in metastatic cells. MEG3 expression was examined using hepatoblastoma patient datasets and validated using qPCR in cell lines, orthotopic tumors, and COA67 patient-derived xenografts. The effects of siRNA MEG3 knockdown in HLM_2 cells on clonogenicity, migration, and invasion were evaluated. The effects of MEG3 overexpression on migration and invasion were assessed in HuH6 cells. MEG3 was significantly upregulated in metastatic cells and orthotopic tumors compared with controls. MEG3 silencing reduced clonogenicity, tumorsphere formation, migration, and invasion. MEG3 overexpression increased migration and invasion. These findings indicate that MEG3 contributes to an aggressive tumor phenotype, highlighting the need for further examination into its mechanistic role in hepatoblastoma and its potential as a biomarker or therapeutic target. Full article

Background/Objectives: Multiple micronutrient supplements (MMS) are more effective in improving maternal and birth outcomes compared to iron and folic acid (IFA) supplementation during pregnancy. High adherence to MMS is critical to achieving all the anticipated health benefits. Therefore, to ensure successful program implementation of transitioning to MMS in Cambodia, implementation research has been prioritized. The objective of this study was to assess the relevance, acceptability, utility and short-term, exploratory adherence outcomes of three behavioral interventions designed to support adherence to daily MMS intake and to promote healthy pregnancy practices. Methods: This mixed-methods study, conducted in four provinces in Cambodia, involved 12 focus group discussions (FGD) with 36 pregnant women who were exposed to three distinct behavioral interventions (family support, a tracking calendar, and educational videos). FGDs were held after three weeks of exposure to each intervention. Data was analyzed using a COM-B model, with inductive codes added to capture emerging themes. Results: Family support emerged as the most preferred and perceived as the most effective intervention, with participants consistently valuing the presence, encouragement, and practical assistance offered by husbands and other close family members. The second most preferred were educational videos, which were perceived to effectively convey key messages in an engaging, relatable way, overcoming literacy barriers. Finally, the calendar supported habit formation and appealed to first-time mothers but posed challenges for low-literacy users. Across interventions, findings reflect participants’ perceived effectiveness and preferences rather than comparative efficacy. Conclusions: This study provided insights into Cambodian women’s preferences and experiences with three distinct interventions designed to improve adherence over a short-term, 3-week exposure period per intervention. An integrated, multilevel approach that combines family-focused, educational, and system-level strategies is recommended for further piloting and scale-up, with longer-term studies needed to assess comparative efficacy for adherence and health outcomes. Full article

Background/Objectives: Maternal immunization against respiratory syncytial virus (RSV) is an emerging strategy to protect infants during early life when they are most vulnerable to severe RSV infection. However, little is known about the willingness to receive maternal RSV vaccination in China, where the vaccine has not yet been officially approved for marketing. This study aimed to assess the willingness to receive maternal RSV vaccination among women who are currently pregnant and those planning pregnancy in Guangzhou, and to identify the key determinants influencing vaccination willingness. Methods: A cross-sectional survey was conducted in April 2025 among 406 women at Guangzhou Women and Children’s Medical Center, China. Participants completed a self-administered questionnaire covering predisposing factors, enabling resources, health behaviors and awareness, and need factors. Logistic regression analyses were used to identify factors associated with vaccine willingness. A nomogram prediction model was constructed based on significant predictors. Results: Overall, 67.2% (n = 273) of participants reported willingness to receive maternal RSV vaccination. Younger maternal age, higher levels of social support, moderate or high perceived RSV risk, a history of HPV vaccination, and having medical insurance were independently associated with higher willingness to vaccinate. A predictive nomogram incorporating these factors demonstrated good discrimination (AUC = 0.753) and calibration. Age-stratified analysis revealed differing concerns across age groups, with vaccine safety and neonatal protection being the most cited factors influencing decision-making. Conclusions: This study provides the first evidence on maternal RSV vaccination willingness in southern China and highlights several psychosocial and demographic factors influencing vaccine intentions. The nomogram offers a practical tool to estimate individual willingness and guide targeted communication. These findings have implications for future maternal RSV vaccine application strategies in China. Full article

Parental practices strongly influence offspring development, and parental alcohol use may affect parenting behavior. However, most studies have focused on child-related outcomes. This review instead examined associations between parental drinking and parenting practices. Following PRISMA guidelines, a systematic search in MEDLINE, PsycINFO, Embase, and Scopus identified 9053 articles. Of these, 222 full texts were screened by two reviewers, and 77 were included for critical appraisal. After quality assessment, 68 studies published between 1991 and 2026 were reviewed. Studies were included if they (i) measured parental alcohol use as a predictor and parenting practices as an outcome, (ii) involved offspring under 20 years, (iii) had a quantitative design, (iv) were peer-reviewed and published in English, and (v) excluded pregnancy measures and alcohol/parenting treatment interventions. Parenting factors (e.g., parent–child relationship, monitoring, communication, discipline, conflict, abuse) were categorized and grouped into general and alcohol-specific practices. Parental drinking was categorized into alcohol use disorders (AUD) and non-dependent alcohol use. Sixty-four studies reported at least one significant association between parental drinking and poorer parenting practices. Mixed results were observed for non-dependent drinking and alcohol-specific parenting. Some associations varied with parental gender. Overall, different drinking patterns appear to be linked to impaired parenting quality. Despite being the most common pattern of alcohol use, non-dependent drinking remains understudied in parenting research. The present review highlights several critical gaps in the literature, particularly regarding the relationship between non-dependent drinking, maternal AUD, and parenting practices. Moreover, contextual factors, such as socioeconomic status and gender differences, are insufficiently explored, limiting the understanding of heterogeneity in risk and outcomes. Future research would benefit from employing robust longitudinal designs and expanding geographical representation, in order to capture variation across sociocultural contexts and enhance the generalizability of findings. Full article

This study aimed to assess maternal health profiles related to diet, pregnancy, and breastfeeding practices among 437 mothers with children under 24 months in a rural village in Madagascar, and to examine their association with maternal educational attainment using interviews and anthropometric data. Bivariate statistical analyses were performed to explore associations between maternal education level and all studied variables. Multivariate analyses were also conducted but did not yield reliable results and are therefore not presented. The findings showed that higher maternal education was strongly associated with better socioeconomic conditions; improved access to essential resources like food, clean water, and healthcare facilities; and greater dietary diversity. More educated women reported consuming a wider range of foods, reflecting better nutritional quality and potential benefits for maternal health. In contrast, education level did not significantly affect pregnancy-related care or breastfeeding practices as recommended by the WHO. This suggests that while education enhances women’s ability to access and choose nutritious diets, broader cultural or systemic factors may shape maternal care behaviors. Women with higher educational attainment had greater access to diverse and sufficient diets, which may contribute to improved maternal nutritional status. Sustainable interventions aimed at improving women’s education and nutritional literacy are needed to support informed dietary choices and improve maternal and child health outcomes. Full article

Background/Objectives: The present study explored the extent to which children’s executive function (EF) mediates the relationship between maternal warm parenting and children’s problem behaviors during the early school-age years. Methods: Using data from a nationally representative sample of 1516 mother–child dyads participating in the Panel Study on Korean Children, the analysis drew on parent-reported measures collected through standardized questionnaires. Results: Structural equation modeling indicated that warm, responsive maternal parenting contributed to lower levels of children’s problem behaviors both directly and indirectly by fostering stronger EF skills. Conclusions: The findings highlight the developmental importance of warm parenting practices and identify children’s EF as a central mechanism through which early caregiving environments promote behavioral adjustment. Full article

Children with autism spectrum disorder (ASD) frequently struggle with emotion regulation, which can be influenced by parental practices and the supportive role of siblings in encouraging emotional and social development. The study aimed to examine the relationship between parenting practices and emotional regulation of children with ASD and to explore the mediating role of the prosocial behavior of siblings between parenting practices and emotional regulation in children with ASD. Additionally, this study investigated the moderating role of sibling gender in the relationship between prosocial behavior and emotional regulation. A total of 600 parents/caregivers aged 25–40 years (M = 32.91, SD = 4.23) of children with ASD were selected from special education institutes in Lahore, Pakistan, using a non-probability, purposive sampling method. Although the majority of respondents were mothers (94.5%), the term parenting practices is used to reflect a family-level caregiving construct rather than exclusively maternal behavior. Data were interpreted through IBM SPSS Statistics 23 and PROCESS macros, revealing that authoritative parenting had a significant positive relation with emotional regulation in children with ASD. Results also indicated that the prosocial behavior of siblings partially mediated the relationship between authoritative parenting and emotional regulation in children with ASD. Furthermore, sibling gender significantly moderated the indirect effect, with female siblings showing stronger facilitation of emotional regulation through prosocial behaviors compared to male siblings. Full article

Peripartum depression (PPD) represents one of the most prevalent and disabling psychiatric conditions among women, yet its underlying biology remains poorly integrated across medical disciplines. Emerging evidence highlights PPD as a prototypical disorder of the heart–brain axis, where neuroendocrine changes, immune activation, and cardiovascular dysregulation converge to shape maternal vulnerability. During pregnancy and the postpartum period, abrupt fluctuations in estrogen, progesterone (P4), and placental corticotropin-releasing hormone (CRH) interact with a sensitized hypothalamic–pituitary–adrenal (HPA) axis, altering neural circuits involved in mood regulation, stress reactivity, and maternal behavior. Parallel cardiovascular adaptations, including endothelial dysfunction, altered blood pressure variability, and reduced heart rate variability (HRV), suggest a profound perturbation of autonomic balance with potential long-term implications for maternal cardiovascular health. Neuroinflammation, microglial activation, and systemic cytokine release further mediate the bidirectional communication between the heart and the brain, linking emotional dysregulation with vascular and autonomic instability. Evidence also indicates that conditions such as preeclampsia and peripartum cardiomyopathy share biological pathways with PPD, reinforcing the concept of a unified pathophysiological axis. This review synthesizes current knowledge on the neurobiological, cardiovascular, endocrine, and inflammatory mechanisms connecting PPD to maternal heart–brain health, while discussing emerging biomarkers and therapeutic strategies aimed at restoring integrative physiology. Understanding PPD as a multisystem heart–brain disorder offers a transformative perspective for early detection, risk stratification, and personalized intervention during one of the most biologically vulnerable periods of a woman’s life. Full article