Search Results (84)

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

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

Background: Tongue piercing has gained popularity among teenagers and young adults as a form of self-expression, cultural identity, and fashion. However, patients are often unaware of the harmful effects tongue piercings can have on their oral health. Despite its popularity, this form of body modification carries considerable risk, particularly when performed or maintained without proper care. This review summarizes findings from clinical case reports, observational studies, and previous literature reviews, with a focus on the clinical outcomes of tongue piercings and their appropriate management. Methods: An internet-based literature review was conducted to evaluate the short- and long-term oral health implications of tongue piercings. Only articles published between January 1990 and April 2025 were included. The databases searched were PubMed, Google Scholar, Scopus, and Web of Science, using keywords such as “tongue piercing,” “oral piercing,” “oral complications,” and “dental trauma.” Results: The literature revealed that tongue piercings can lead to numerous adverse effects on oral health, including dental fractures, gingival recession, enamel wear, and localized tissue overgrowth, in addition to localized and systemic infections. The presence of foreign objects in the oral cavity, combined with poor oral hygiene, habitual trauma, and long-term contact with oral tissues, often worsens these complications. Conclusions: The results of this literature review suggest that tongue piercings pose significant and often underestimated risks to oral health. Clinicians should remain vigilant, educate patients on potential complications, and be well-equipped to prevent, monitor, and manage associated dental problems effectively in clinical practice. Full article

This story began half a century ago with the discovery of an unusually high presence of tryptophan (Trp, W) in transthyretin (TTR), one of the three carrier proteins of thyroid hormones. With the Trp-rich retinol-binding protein (RBP), TTR forms a plasma complex implicated in the delivery of retinoid compounds to body tissues. W has the lowest concentration among all AAs involved in the sequencing of human body proteins. The present review proposes molecular maps focusing on the ratio of W/AA residues found in the sequence of proteins involved in immune events, allowing us to ascribe the guidance of inflammatory processes as fully under the influence of W. Under the control of cytokine stimulation, plasma biomarkers of protein nutritional status work in concert with major acute-phase reactants (APRs) and with carrier proteins to release, in a free and active form, their W and hormonal ligands, interacting to generate hot spots affecting the course of acute stress disorders. The prognostic inflammatory and nutritional index (PINI) scoring formula contributes to identifying the respective roles played by each of the components prevailing during the progression of the disease. Glucagon demonstrates ambivalent properties, remaining passive under steady-state conditions while displaying stronger effects after cytokine activation. In developing countries, inappropriate weaning periods lead to toddlers eating W-deficient cereals as a staple, causing a dramatic reduction in the levels of W-rich biomarkers in plasma, constituting a novel nutritional deficiency at the global scale. Appropriate counseling should be set up using W implementations to cover the weaning period and extended until school age. In adult and elderly subjects, the helpful immune protections provided by W may be hindered by the surge in harmful catabolites with the occurrence of chronic complications, which can have a significant public health impact but lack the uncontrolled surges in PINI observed in young infants and teenagers. Biomarkers of neurodegenerative and neoplastic disorders measured in elderly patients indicate the slow-moving elevation of APRs due to rampant degradation processes. Full article

Background/Objectives: BRIGHTLIGHT was the national evaluation of adolescent and young adult (AYA) cancer services in England. BRIGHTLIGHT results were not available when the most recent healthcare policy (NHSE service specifications for AYA Cancer) for AYA was drafted and therefore did not consider BRIGHTLIGHT findings and recommendations. We describe the co-development and delivery of a Policy Lab to expedite the implementation of the new service specification in the context of BRIGHTLIGHT results, examining the roles of multi-stakeholders to ensure service delivery is optimised to benefit AYA patients. We address the key question, “What is the roadmap for empowering different stakeholders to shape how the AYA service specifications are implemented?”. Methods: A 1-day face-to-face policy lab was facilitated, utilising a unique, user-centric engagement approach by bringing diverse AYA stakeholders together to co-design strategies to translate BRIGHTLIGHT evidence into policy and impact. This was accompanied by an online workshop and prioritisation survey, individual interviews, and an AYA patient workshop. Workshop outputs were analysed thematically and survey data quantitatively. Results: Eighteen professionals and five AYAs attended the face-to-face Policy Lab, 16 surveys were completed, 13 attended the online workshop, three professionals were interviewed, and three AYAs attended the patient workshop. The Policy Lab generated eight national and six local recommendations, which were prioritised into three national priorities: 1. Launching the service specification supported by compelling communication; 2. Harnessing the ideas of young people; and 3. Evaluation of AYA patient outcomes/experiences and establishing a national dashboard of AYA cancer network performance. An animation was created by AYAs to inform local hospitals what matters to them most in the service specification. Conclusions: Policy and research evidence are not always aligned, so when emerging evidence does not support current guidance, further exploration is required. We have shown through multi-stakeholder involvement including young people that it was possible to gain a different interpretation based on current knowledge and context. This additional insight enabled practical recommendations to be identified to support the implementation of the service specification. 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

As survival rates for teenagers and young adults (TYAs) with cancer exceed 80%, they are living longer post treatment, yet often experience prolonged health and quality of life concerns. Many TYAs also experience unmet support needs. This study aimed to identify TYAs support needs following treatment at a UK hospital and explore how and when TYAs prefer to receive support. This study involved two phases: Phase 1 involved semi-structured interviews with 16 TYAs, 1–6 years post-treatment, aged 16–25 years at time of treatment completion and examined their experiences of support services, and preferences for future care. Phase 2 consisted of co-design workshops with eight TYAs and feedback from five healthcare/allied professionals (HCAPs) to refine and develop recommendations. Phase 1 findings revealed six key themes: (1) survivorship as disrupted continuity; (2) negotiating legitimacy and relational safety in help seeking; (3) support offered vs. support sought: pathways of referral and self-initiation; (4) emotional readiness as context dependent and non-linear; (5) support as an ecosystem, not a moment; and (6) personalised autonomy in support engagement. Phase 2 findings informed recommendations that emphasise the importance of flexible, personalised, and accessible post-treatment support, with pathways of care/support that can adapt to TYAs changing needs and preferences over time. Full article

Sexually transmitted infections (STIs) remain a global issue, causing health problems and financial burdens. This study aimed to provide an update on the invasive pathogens and analyze any associated factors in patients visiting Da Nang Dermato-Venereology Hospital who were diagnosed with genital tract infections in males and lower genital tract infections in females; 535 participants underwent clinical examinations and microbiological tests to identify the invasive microorganisms, before we analyzed previously gathered laboratory results and associated risk factors. The rate of infection was 37.6% amongst 535 participants. Treponema pallidum infection accounted for the highest rate of 21.3%, followed by HSV, standing at 6%. The prevalence of syphilis infection was highest in the 20–29 age group, standing at 51.7%. There was a positive correlation between age under 20 and infected conditions (OR = 3.78, 95% CI: 1.41–10.11, p = 0.008). Having multiple sexual partners was identified as a risk factor for infection, as those with three or more sexual partners showed a high correlation (OR = 3.19, 95% CI: 1.44–7.05, p = 0.004). The high syphilis prevalence among young adults and teenagers underscores the need for improved STI education and screening programs in Vietnam. Full article

Wrist fractures, especially those involving the elbow and distal radius, are the most common injuries in children, teenagers, and young adults, with the highest occurrence rates during adolescence. However, the demand for medical imaging and the shortage of radiologists make it challenging to ensure accurate diagnosis and treatment. This study explores how AI-driven approaches are used to enhance fracture detection and improve diagnostic accuracy. In this paper, we propose the latest version of YOLO (i.e., YOLO11) with an attention module, designed to refine detection correctness. We integrated attention mechanisms, such as Global Attention Mechanism (GAM), channel attention, and spatial attention with Residual Network (ResNet), to enhance feature extraction. Moreover, we developed the ResNet_GAM model, which combines ResNet with GAM to improve feature learning and model performance. In this paper, we apply a data augmentation process to the publicly available GRAZPEDWRI-DX dataset, which is widely used for detecting radial bone fractures in X-ray images of children. Experimental findings indicate that integrating Squeeze-and-Excitation (SE_BLOCK) into YOLO11 significantly increases model efficiency. Our experimental results attain state-of-the-art performance, measured by the mean average precision (mAP50). Through extensive experiments, we found that our model achieved the highest mAP50 of 0.651. Meanwhile, YOLO11 with GAM and ResNet_GAM attained a maximum precision of 0.799 and a recall of 0.639 across all classes on the given dataset. The potential of these models to improve pediatric wrist imaging is significant, as they offer better detection accuracy while still being computationally efficient. Additionally, to help surgeons identify and diagnose fractures in patient wrist X-ray images, we provide a Fracture Detection Web-based Interface based on the result of the proposed method. This interface reduces the risk of misinterpretation and provides valuable information to assist in making surgical decisions. Full article

For adolescents and young adults (AYAs) with cancer, fertility preservation is recommended before starting gonadotoxic treatments. This is an important aspect of psychological support in the treatment of the disease. However, the enormous psychological impact of this procedure on adolescents and young adults with cancer needs to be addressed by professionals. The traumatic nature of cancer diagnosis disrupts the psychosocial development of AYAs. A young adolescent’s perception of reproduction, and in particular of sperm freezing, is greatly altered by the disease. For a teenager, the success of sperm banking results from a positive balance between facilitators and barriers, which are mentioned here. Moreover, this article proposes a symbolic interpretation of sperm banking, referring to landmarks integrated during childhood, especially in fairytales. Furthermore, it offers an original video documentary that can be used as an information support to help AYAs adhere to the process of preserving their fertility through sperm freezing. Full article

Background: Vestibular function implements head position regulation and body spatial navigation. It matures during childhood and adolescence and integrates with the completion of an individual’s motor development. Nevertheless, vestibular impairment is associated with profound paediatric hearing loss and has a negative impact on the child’s motor proficiency. Cochlear implantation (CI) is the treatment of choice for severe hearing loss, where conservative treatment plans are not appropriate or fail. The Teenager and Young Adults Cochlear Implant (TAYACI) study investigates the long-term outcomes of early implantation with respect to the hearing, speech, psychological, and balance development among CI users. Methods: This study focuses on the vestibular function and the appropriate methods for vestibular assessment. The results of two established vestibular test methods are explored: the video head impulse test (vHIT) and cervical/ocular vestibular-evoked myogenic potentials (cVEMP, oVEMP) with air and bone conduction vibration stimulation. The results of vHIT, cVEMP, and oVEMP, per implanted ear and the relation to the aetiology of hearing loss are reported. An additional dynamic visual acuity (DVA) test was included to assess clinical oscillopsia. Results: Overall abnormal lateral canal testing was detected in 35/76 (46.1%) of the implanted ears. Bone-conducted cVEMP (BC cVEMP) was pathological in 33/76 (43.3%) and BC oVEMP in 42/76 (55.3%). Lateral canal impairment was associated with the background diagnosis of the hearing loss. Oscillopsia was related to bilateral canal impairment (sensitivity 73% specificity 100%). Conclusions: Lateral canal testing together with BC VEMPs were the most reproducible modules for vestibular testing The above tests were related to each other and complemented the overall vestibular assessment. DVA is a helpful tool to screen dynamic oscillopsia in patients with bilateral vestibular impairment. Full article

Background/Objectives: The rising popularity of e-cigarette use is creating new challenges for oral healthcare. Factors such as targeted marketing, appealing flavors, and the perception that e-cigarettes are a safer alternative to traditional smoking have contributed to their widespread adoption. This trend is particularly prevalent among young adults and teenagers, many of whom turn to e-cigarettes despite having no prior history of regular cigarette use. This study aimed to evaluate dentists’ knowledge and perceptions regarding e-cigarettes, focusing on their health effects, regulatory status, and potential risks to oral health. Assessing dentists’ knowledge of e-cigarette risks is important, as they guide patients on the potential oral health dangers of vaping. E-cigarette use has been linked to several oral health problems. Methods: A cross-sectional survey was conducted among 189 dentists in Kosovo, comprising both general dentists and specialists. The questionnaire assessed participants’ awareness of e-cigarettes’ FDA approval status, their perceptions of health impacts, and their understanding of e-cigarettes’ association with oral conditions such as caries, periodontal disease, and oral cancer. Data were analyzed using SPSS 22, with significance set at p < 0.05. Results: The findings revealed significant knowledge gaps, with 74.1% of respondents being uncertain about the FDA approval status of e-cigarettes and 82.0% recognizing their harmful effects on general and oral health. Nearly half (49.7%) of the participants identified e-cigarettes as a potential risk factor for caries, while 66.1% and 64.6% associated their use with oral cancer and periodontal disease, respectively. Gender and professional specialization did not significantly influence these perceptions. Conclusions: Dentists need better education on the risks of e-cigarette use, including their harmful effects on oral health. Incorporating this knowledge into dental curricula and professional training is essential to give dentists the information needed to advise patients effectively. Raising public awareness through dental health professionals can help mitigate the oral health risks associated with e-cigarettes. Full article

Background/Objectives: Early pediatric cochlear implantation positively impacts early language outcomes. The Teenager and Young Adults Cochlear Implant (TAYACI) study investigates the long-term outcomes of early implantation and factors influencing variability among cochlear implant (CI) users. This article outlines participants’ background, early language outcomes, and multidisciplinary study protocol. Methods and Materials: Individuals aged 12–22 received CIs before 30 months of age, followed-up at the same hearing implant center, and adhered to a standard school curriculum were invited to participate. Out of 109 eligible CI users, 50 participated; 46 agreed to undergo clinical assessments, while four completed questionnaires only. Results: The mean age at the first CI was 15.63 months (SD = 6.0). All but one communicated with spoken language(s). Participants attended mainstream schools and had highly educated parents. Over half (56%) had received Auditory Verbal Therapy in early childhood. Earlier implantation correlated with better language understanding one year post-CI. Conclusions: Earlier implantation was associated with better early language outcomes, with parental education level and early family-centered intervention likely contributing. Future sub-studies will investigate multidisciplinary long-term effects of pediatric cochlear implantation in adolescents. Full article

In recent years, self-injury attempts have accounted for 46.2% of emergency room visits by teenagers and young adults. This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Korean college students, compare the mean number of NSSI risk factors between those with a history of NSSI and a control group with no history of thoughts or experiences of self-injury, and identify which factors have a greater influence on NSSI. The participants consisted of 403 Korean college students aged 18–29 who were divided into a subject group with a history of NSSI (n = 198) and a comparison group (n = 205) with no history of NSSI. The Functional Assessment of Self-Mutilation (FASM), Childhood Trauma Questionnaire (CTQ-SF), Social Experience Questionnaire (SEQ), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), Difficulties in Emotion Regulation Scale—16 item version (DERS-16), Experiences in Close Relationship Questionnaire-Revised (ECR-R), Rosenberg Self-Esteem Scale (RSES), Parents as Social Context Questionnaire-Kids (PSCQ-KA), and Barratt Impulsiveness Scale-11-Revised (BIS-11). The collected data were analyzed using SPSS 25.0. Before a regression analysis, a MANOVA was performed to examine the mean difference between groups of each dependent variable, and a multiple regression analysis was performed to confirm the influence. The mean difference in all risk factors in the subject group compared with the comparison group was found to be statistically significant, with an effect size of 0.8 or greater. As a result of examining the relative influence of each variable on NSSI, emotional dysregulation (t = 2.481, p = 0.014), anxiety (t = −2.109, p = 0.036), and adult attachment (t = 2.004, p = 0.046) were found to significantly influence NSSI (p = 0.05). These findings will serve as fundamental data for screening clients at risk of self-injury in counseling and treatment settings, in addition to providing preventive and therapeutic interventions. Full article

Background/Objectives: Although ADHD in adults has become visible and inclusive in recent years in diagnostic manuals, research is still limited regarding the long-term outcomes of patients with this disorder. The main objective of this research was to address the many facets of predictor variables in girls with ADHD facing unplanned pregnancies at young ages in order to improve the management of pre-, peri-, and postnatal complications that may occur, as well as for early psychiatric diagnosis and effective intervention. Methods: PubMed and Web of Science Databases were used to perform literature research, and a total of 27 records were selected and used for data extraction. Results: Related articles have included the persistence of ADHD symptoms comorbid with other disorders among girls with ADHD as a risk factor for teenage pregnancies. Conduct disorders and substance use disorders are the main co-occurrent diagnoses that increase the likelihood for teenage childbirth. Unplanned pregnancies at young ages are associated with unfavorable psychosocial trajectories both for the mother and the child. Conclusions: In this review, we emphasize the importance of predisposing factors for risky sexual behaviors and unplanned pregnancies in cases of girls with ADHD. The topic of the article draws attention to the need for uniform national individualized care of girls with ADHD, the implementation of programs to prevent academic failure and early parenthood as well as addressing comorbid obstetrical and psychiatric conditions, especially in regions where the rate of adolescent births continues to be high. Full article