Search Results (134)

Background/Objectives: Prolonged hospitalization of clinically stable preterm infants may lead to nosocomial infections, interfere with breastfeeding, and hinder parent-infant bonding. We evaluated the impact of an early discharge program with hospital-at-home (HaH) on hospital stay and clinical outcomes among preterm infants. Methods: A retrospective case–control study was conducted in a tertiary neonatal unit (Spain). Fifty infants managed with HaH (2016–2020) were compared with ninety-six controls receiving conventional in-hospital care. Baseline characteristics, growth, and clinical events up to 12 months were collected. Analyses included bivariate comparisons and multiple linear regression for length of stay, adjusted for gestational age, birth weight, sex, and parental factors. Results: Baseline characteristics were comparable between groups. Discharge weight was lower in HaH infants (1865 vs. 2130 g; p < 0.001), but no differences were observed at 6 or 12 months. Length of stay was shorter in HaH infants (26.3 vs. 33.8 days; p = 0.081), and the multivariable model showed an independent 5.5-day reduction (β −5.53; 95% CI −10.96 to −0.11; p = 0.046). Exclusive breastfeeding was more frequent (74% vs. 59%; p = 0.08) and significantly longer in HaH infants (141.9 vs. 81.1 days; p = 0.024). No increases were found in complications at discharge, emergency visits (28% vs. 32%; p = 0.7), or readmissions (18% vs. 31%; p = 0.2). Conclusions: Among clinically stable preterm infants, early discharge with HaH was associated with a shorter hospital stay and longer exclusive breastfeeding duration, without evidence of increased morbidity or healthcare use; however, causal inference cannot be established due to the observational design. These findings support the implementation of nurse-led HaH programs as a safe, family-centered strategy for neonatal care. Full article

Monitoring vital signs in the Neonatal Intensive Care Unit (NICU) typically relies on wired skin sensors, which can limit mobility, cause skin issues, and interfere with parent–infant bonding. Wireless sensors offer promising alternatives, but evaluations to date often emphasize accuracy alone, lack NICU-specific validation, and rarely use standardized frameworks. Our objective was to develop and apply a comprehensive framework for evaluating the feasibility, safety, and accuracy of wireless monitoring technologies using a wireless pulse oximeter, the Anne limb (Sibel Health, USA), in real-world NICU conditions. A prospective study was conducted on a diverse NICU population. A custom system enabled synchronized data recordings from both standard and wireless devices. Feasibility was assessed as signal coverage across a variety of daily care activities and during routine procedures. Safety was evaluated through skin assessments after extended wear. Accuracy was examined sample-by-sample and interpreted using the Clarke Error Grid for clinical relevance. The wireless oximeter device showed high feasibility with reliable Bluetooth connection across a range of patients and activities (median wireless PPG coverage = 100%, IQR: 99.85–100%). Skin assessments showed no significant adverse effects. Accuracy was strong overall (median bias 1.34%, 95% LoA −3.63 to 6.41), with most data points within clinically acceptable Clarke error grid zones A and B, though performance declined for infants on supplemental oxygen. This study presents a robust, multidimensional framework for evaluating wireless monitoring devices in NICUs and offers recommendations for future research design and reporting. Full article

Background: Self-directed lifestyle modifications are essential for managing symptoms in individuals diagnosed with irritable bowel syndrome (IBS). This study incorporated longitudinal multi-omics profiling to estimate the mechanisms underlying responses to a nurse-led person-centered self-management intervention in young adults with IBS. Methods: This pre-post study was nested within a 12-week parent randomized controlled trial (NCT03332537). Biospecimens (stool and blood) and clinical outcomes were collected at baseline and post-intervention. Symptoms were assessed using the Brief Pain Inventory and PROMIS^® short forms. Host transcriptomic profiling was performed using RNA sequencing, and gut microbial composition was analyzed via 16S rRNA sequencing. Host transcriptomic co-expression and microbial co-abundance modules were identified via weighted gene co-expression network analysis. Associations between multi-omics modules and symptoms were evaluated using linear mixed-effect models. Results: Among the 20 participants, most were non-Hispanic (75%), White (75%), and female (65%). The intervention significantly reduced self-reported pain severity (p = 0.019) and pain interference (p = 0.013). Decreased associations were observed between pain phenotypes and a microbial module enriched in core metabolic pathways (interference: β = −4.7, p < 0.001; severity: β = −2.4, p = 0.02). Anxiety strengthened associations with host transcriptomic cellular energy metabolism pathways post-intervention (p < 0.05). The intervention attenuated associations between fatigue, sleep disturbance, and immune–inflammatory transcriptomic and microbial adaptation modules (p < 0.05). Conclusions: Findings suggest that the IBS self-management intervention induces symptom-specific biological responses, implicating distinct host–microbe pathways. Larger longitudinal studies are warranted to validate these omics-based symptom signatures. Full article

Recent years have witnessed a concerning rise in early-onset eating disorders (EDs), prompting a re-evaluation of their etiology, diagnosis, and treatment within pediatric populations. This perspective article synthesizes emerging evidence on the multifactorial origins of EDs in children, emphasizing a biopsychosocial framework that integrates genetic, epigenetic, psychological, and environmental factors. While early manifestations often diverge from adolescent or adult profiles—marked by somatic complaints, selective eating, and ritualistic behaviors—the disorders significantly interfere with developmental milestones. The COVID-19 pandemic has further exacerbated vulnerabilities, acting as a catalyst for disordered eating behaviors through increased familial stress, isolation, and disrupted routines. Central to this framework is the role of parental psychopathology and parent–child feeding interactions, which profoundly shape children’s emotional regulation and attachment patterns. Recent studies also underscore genetic susceptibilities—especially variants in the DRD4 and DAT1 genes—and epigenetic modifications that may mediate the transmission of risk across generations. The article reviews evidence from observational and genomic studies, highlighting how altered gene expression linked to early environmental stress contributes to the heterogeneity of EDs. Finally, it evaluates prevention and intervention strategies, including family-based treatments, digital health tools, and school-based programs. These strategies are essential for timely detection, individualized care, and reducing long-term impairment. Overall, the paper advocates for a nuanced understanding of EDs in children—recognizing their complex origins and developmental implications—to inform clinical practice, public health policy, and future research in pediatric mental health. Full article

The literature has been scarce in addressing parental interference/family abduction and its relationship with depressive symptoms. Due to this, the objective of this study was to examine the association between family abduction/parental interference and depressive symptoms in a national sample of 11,568 children and adolescents aged 12 to 18 from Chile. Robust linear regression models were conducted to assess how these experiences are related to depressive symptoms while controlling for age. Our results show that children and adolescents who reported these experiences in their lives presented higher levels of depressive symptoms. Additionally, although all forms of caregiver victimization were associated with depressive symptoms, parental interference/family abduction also showed a significant association, even when controlling for sociodemographic variables. These findings highlight the need for attention to the phenomenon of family abduction/parental interference, especially concerning its potential associations with mental health outcomes such as depression. Theoretically, the study contributes to the limited body of research on this form of caregiver victimization, and practically, it provides evidence that may inform future prevention strategies and mental health policies targeting children and adolescents exposed to high-conflict family dynamics in the Chilean context. Full article

Background/Objectives: Despite the striking prevalence of pediatric chronic pain (20% of youth), its impact on culturally diverse populations, particularly Asian families, remains underexplored. The existing literature on parent protective behaviors predominantly focuses on Non-Hispanic White (NHW) families, where such behaviors often exacerbate pain outcomes, therefore informing a core treatment target in clinical practice. This study aims to explore the role of parent protective behaviors in relation to global and pain-related distress in Asian families in comparison to NHW counterparts. Methods: A sample of 1415 youth (Asian: n = 236; NHW: n = 1179) aged 8 to 17 completed a survey prior to their evaluation at a tertiary pain clinic. Bivariate correlations and independent-sample t-tests were conducted to assess differences in anxiety, depression, pain-related distress, and parent protective behaviors between groups. Multiple regression analyses were used to determine whether parent protective behaviors moderated the relationship between global distress and pain-related outcomes. Results: Asian youth reported significantly lower pain intensity and pain interference than NHW youth, while Asian parents reported significantly higher protective behaviors. Parent protective behaviors moderated the association between global distress (depression and anxiety) and pain catastrophizing for Asian families only. A three-way interaction (ethnicity x parent protective behaviors, global distress, B = −0.22, p < 0.001; B = −0.18, p < 0.01) revealed that protective behaviors influenced the distress–pain catastrophizing link differently by ethnicity. Conclusions: Differences were observed in the Asian youth’s experience of pain in comparison to their NHW counterparts. This study highlights the importance of considering culturally nuanced approaches in treating pediatric chronic pain, particularly when working with Asian families. Full article

This study examines how the Norwegian Child Welfare Tribunal justifies regulating telephone and digital communication between children in public care and their parents. The regulation of such contact represents a distinct form of state interference in family life and must adhere to principles of necessity, proportionality, and respect for children’s rights. Using a thematic analysis of 34 Tribunal decisions involving 44 children, the study identifies four central themes: ensuring stability and emotional security, addressing parental behavior, balancing proportionality and necessity, and considering the child’s view. The Tribunal’s reasoning often reflects a cautious, preventive approach, prioritizing emotional stability. However, the lack of transparent assessments of necessity and inconsistent inclusion of children’s perspectives raises concerns about proportionality and children’s autonomy. Additionally, the limited involvement of children in these decisions risks making restrictions difficult to implement in practice, as children may not understand or agree with them and instead seek unregulated contact. The findings underline the need for clearer justifications and more consistent consideration of a child’s view to ensure that decisions align with their best interests and remain feasible in practice. Full article

Background/Objectives: Physical activity plays an essential role in a healthy lifestyle. For children, the development of an encouraging attitude toward exercise can define a positive life-long behaviour. Type 1 diabetes mellitus (T1DM) is a metabolic disorder that usually develops in early childhood and severely affects glucose metabolism. Associated hypo- and hyperglycaemic conditions can dramatically interfere with the patient’s everyday life. Since exercise significantly alters the glucose consumption of the body, this might influence how T1DM patients view physical activity. As parental guidance is critical in their children’s behaviour, we investigate how parents of T1DM children relate to the engagement in physical activity of their children as compared to parents of healthy children. Methods: A self-reported survey was conducted among those parents whose T1DM children were cared for at the Paediatric Clinic of the University of Debrecen, Hungary. All together, 318 children, 140 with T1DM and 178 healthy peers, participated in the study. Results: We found no significant difference in the body mass index of healthy and T1DM children and, furthermore, no significant difference was observed in HbA1c levels in exercising and non-exercising T1DM children. Nevertheless, while 67.6% of the healthy children regularly engage in physical activity, only 57.5% of T1DM children do so (p = 0.044). Importantly, parents whose T1DM child exercised regularly believed that daily PhysEd classes improved their children’s health and had positive effects on their attitude toward exercise. In contrast, parents of children who did not regularly exercise were significantly less convinced. Conclusions: These findings highlight the importance of targeted educational efforts to foster positive attitudes toward physical activity among families with T1DM children and contribute valuable insights into how parental perceptions may influence children’s engagement in exercise. Full article

The objective of this research is to examine the dynamics of parent/child well interaction in unconventional plays, an issue that has gained prominence as high-quality inventory reduces and the number of infill wells escalates. To achieve this, the research will identify and analyze the factors influencing the interaction between parent/child wells and quantify the impacts of time, distance, and geological formation within the context of the DJ basin. The short-term estimate, considered as the next 12 months of cumulative oil production, is forecasted using decline curve analysis (DCA), and the long-term estimates come from the estimated ultimate recovery (EUR) of oil. The impact of the interaction on the parent well is determined as the difference between the recovery of the pre-frac hit and the post-frac hit. The child wells are compared to unaffected wells from the same unit. The average distance between parent and child wells is kept constant, and the time gap between the pre-existing and infill wells is statistically compared to observe the impact of time. The same procedure is followed for distance, orientation, and formation. The findings indicate that stimulation of child wells can lead to a depletion-induced stress shadow around the parent wells, potentially resulting in asymmetrical fracture growth. Consequently, the proximity of parent wells may contribute to a decrease in the performance of the child wells. On the contrary, parent wells with frac hits experienced varied outcomes, including improved production, reduced production, or no noticeable change at all. When the distance between parent and child well decreases, the negative impact on child wells increases. Increasing the time gap between pre-existing wells and infill wells shows an adverse impact on child wells. The impact on child wells was not observed when the parent well had been producing for less than 5 months. An interesting pattern emerged when analyzing the orientation of wells; child wells drilled at a perpendicular angle to their parent wells did not exhibit changes in performance. Within the geological context, the Niobrara Formation was found to have a more substantial negative impact on well interactions than the Codell Formation. In conclusion, time and distance play a crucial role in parent/child well interaction. Despite the existence of studies on parent/child well interactions within the literature, a comprehensive and detailed analysis specifically targeting the DJ Basin—particularly focusing on the intricacies of well interactions within the Niobrara and Codell Formations—has not yet been undertaken. Full article

The multi-faceted nature of Selective Mutism (SM), and its comorbidity with other disorders, necessitates a comprehensive assessment process. However, evaluating children with SM presents significant challenges, including difficulties in building rapport, establishing an accurate diagnosis, and conducting formal psychological and neuropsychological assessments. This paper explores the key obstacles in assessing children with SM and provides practical recommendations for overcoming these challenges. Effective strategies for reducing anxiety during assessments include extended rapport-building phases, playful and engaging interactions, and the strategic use of parental involvement. Additionally, given the variability in SM symptoms across different settings, a multi-informant and multi-method assessment approach—including clinical observation, structured interviews, and standardized parent- and teacher-report measures—is recommended. This paper also discusses adaptations for formal testing, particularly in cognitive, language, and neurodevelopmental assessments, where SM-related speech avoidance can interfere with standardized evaluations. Nonverbal assessment tools, modifications to testing environments, and alternative response formats are proposed as potential solutions. Furthermore, we highlight the importance of differentiating SM from overlapping conditions, such as autism spectrum disorder and language impairments, to ensure accurate diagnosis and intervention planning. By implementing tailored assessment strategies, clinicians and researchers can improve diagnostic accuracy and better understand the unique needs of children with SM. This, in turn, can inform individualized treatment plans, enhance educational placement decisions, and support the overall well-being of children with SM. Full article

Children with developmental coordination disorder (DCD) have motor difficulties that interfere with their daily functions. The extent to which DCD affects children in Hong Kong has not been established. In this study, we aimed to estimate the prevalence of children suspected of DCD (sDCD) in Hong Kong and to examine the relationship between motor performance difficulties and health-related functioning. We conducted a cross-sectional survey of parents of children aged 5 to 12 years across Hong Kong (N = 656). The survey consisted of the Developmental Coordination Disorder Questionnaire (DCDQ) and short forms on global health, physical activity, positive affect, and cognitive function of the Patient-Reported Outcome Measurement Information System (PROMIS^®) parent-proxy report scales. We found that the total DCDQ score categorized 18.29% of the children as sDCD. Logistic regression revealed that household income (OR 0.776, p < 0.001) and child age (OR 1.012, p = 0.004) contributed to being categorized as sDCD. Children categorized as sDCD had lower global health (p < 0.001), less positive affect (p < 0.001), and more impaired cognitive function (p < 0.001) than children categorized as probably not DCD (nDCD). The findings of this study contribute to clarifying the extent to which DCD might affect Hong Kong children and serve as a basis to advocate for programs that address motor, health, affective, and cognitive outcomes. Further research is recommended to estimate the prevalence of a DCD diagnosis in Hong Kong. Full article

Developmental Coordination Disorder (DCD) is one of the most prevalent neurodevelopmental disorders in childhood. DCD is classified as a motor learning deficit because it interferes with the ability to learn and automate movement skills. There is a lack of information on how these children acquire complex motor skills relevant to their daily recreational or sports activities. Evidence to guide physical trainers, educators, and health professionals to select an effective type of training to improve physical fitness for children with poor motor coordination is scarce. The purpose of this study was to analyze the effect of an 8-week task-oriented basketball training program on motor coordination and motor skill-related fitness for DCD children in the school context. Motor performance and motor skill-related fitness were evaluated before and after the intervention using the Movement Assessment Battery for Children-2 (MABC-2) and Performance and Fitness Test Battery (PERF-FIT). A total of 52 children with DCD aged 8 to 9 were invited to join the intervention. Parents of 18 children accepted for their child to participate in the training program. In the remaining children, 20 identified as the most similar based on the diagnostic criteria for DCD (DSM-5) and anthropometric features (age, BMI) and were asked to participate as the usual care group. The difference in improvement on the MABC-2 and the PERF-FIT between the two groups on the two test occasions was compared using Mann–Whitney U tests. Within-group pre-post comparison on these test items was performed using the Wilcoxon signed rank test. Significant differences in all performance scores were found in favor of the training group. Post-hoc analysis revealed that the DCD training group improved significantly on MABC-2 total and subscores (p < 0.001) and on all PERF-FIT items (p < 0.001). No significant changes were found on any of the test items in the DCD usual care group. Group-based training in a more natural environment (playing games with peers in school) might help children with DCD as an adjunct to or before individual therapy. Based on our findings, we believe it is possible to work in large groups (n = 18), led by trained physical education teachers and special educators, to lessen the impact of motor coordination and physical fitness problems in children with neurodevelopmental disorders so that they can participate more easily in active games. Results of the usual care group showed that extra instruction and practice are needed for children with DCD. Full article

Plant viral diseases cause great harm to crops in terms of yield and quality. Natural products have been providing an excellent source of novel chemistry, inspiring the development of novel synthetic pesticides. The Amaryllidaceae alkaloids crinasiadine (3a), trisphaeridine (4a), and bicolorine (5a) were selected as parent structures, and a series of their derivatives were designed, synthesized, and investigated for their anti-plant virus effects for the first time. Compounds 13b and 18 exhibited comparable inhibitory activities to ningnanmycin against tobacco mosaic virus (TMV). Preliminary research into the mechanism, involving transmission electron microscopy and molecular docking studies, suggests that compound 18 may interfere with the elongation phase of the TMV assembly process. This study provides some important information for the research and development of agrochemicals with phenanthridine structures. Full article

A pseudogene is a non-functional copy of a protein-coding gene. Processed pseudogenes, which are created by the reverse transcription of mRNA and subsequent integration of the resulting cDNA into the genome, being a major pseudogene class, represent a significant challenge in genome analysis due to their high sequence similarity to the parent genes and their frequent absence in the reference genome. This homology can lead to errors in variant identification, as sequences derived from processed pseudogenes can be incorrectly assigned to parental genes, complicating correct variant calling. In this study, we quantified the occurrence of variant calling errors associated with pseudogenes, generated by the most popular germline variant callers, namely GATK-HC, DRAGEN, and DeepVariant, when analysing 30x human whole-genome sequencing data (n = 13,307). The results show that the presence of pseudogenes can interfere with variant calling, leading to false positive identifications of potentially clinically relevant variants. Compared to other approaches, DeepVariant was the most effective in correcting these errors. Full article

Cemented Sand, Gravel, and Rock (CSGR) dams have traditionally used either Conventional Vibrated Concrete (CVC) or Grout-Enriched Roller Compacted Concrete (GERCC) for protective and seepage control layers in low- to medium-height dams. However, these methods are complex, prone to interference, and uneconomical due to significant differences in the expansion coefficient, elastic modulus, and hydration heat parameters among CSGR, CVC, and GERCC. This complexity complicates quality control during construction, leading to the development of Grout-Enriched Vibrated Cemented Sand, Gravel, and Rock (GECSGR) as an alternative. Despite its potential, GECSGR has limited use due to concerns about freeze–thaw resistance. This project addresses these concerns by developing an air-entrained GECSGR grout formulation and construction technique. The study follows a five-phase approach: mix proportioning of C₁₈₀6 CSGR; optimization of the grout formulation; determination of grout addition rate; evaluation of small-scale lab samples of GECSGR; and field application. The results indicate that combining 8–12% of 223 kg/m³ cement grout with 2–2.23 kg/m³ of admixtures, mud content of 15%, a marsh time of 26–31 s. and a water/cement ratio of 0.5–0.6 with the C₁₈₀6 parent CSGR mixture achieved a post-vibration in situ air content of 4–6%, excellent freeze–thaw resistance (F300: mass loss <5% or initial dynamic modulus ≥60%), and permeability resistance (W12: permeability coefficient of 0.13 × 10⁻¹⁰ m/s). The development of a 2-in-1 slurry addition and vibration equipment eliminated performance risks and enhanced efficiency in field applications, such as the conversion of the C₁₈₀4 CSGR mixture into air-entrained GECSGR grade C9015W6F50 for the 2.76 km Qianwei protection dam. Economic analysis revealed that the unit cost of GECSGR production is 18.3% and 6.33% less than CVC and GERCC, respectively, marking a significant advancement in sustainable cement-based composite materials in the dam industry. Full article