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1) PMID: 32815672 DOI: 10.17392/1192-21
% 2021 Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
* Oxidative stress markers in initial therapy and remission of nephrotic syndrome and serum malondialdehyde level predictor from routine laboratory test.
- Aim To compare oxidative stress state of children with nephrotic syndrome at the first week of treatment and in remission, and to predict malondialdehyde (MDA) level from routine laboratory tests. Methods This cross-sectional study involved 80 1-18 years old children with nephrotic syndrome, who were divided into two groups: initial group (40 children in the first week of therapy) and remission group (40 children in remission). Demographic characteristics of the patients were taken by a questionnaire. Laboratory tests were measured in the initial group; in the remission group negative or trace proteinuria was measured for three consecutive days. Serum urea, creatinine, albumin, total cholesterol, MDA, superoxide dismutase, glutathione peroxidase, and urine albuminto-creatinine ratio (UACR) were measured and compared between the groups. Albumin, total cholesterol, and UACR were subjected to predict high serum MDA using a mean of all patients' MDA level as a cutoff. Results There were higher albumin levels and lower UACR, total cholesterol, and MDA in the remission group compared to the initial group. Albumin and UACR showed good accuracy, and total cholesterol showed very good accuracy to predict serum MDA level more than 1.35 µmol/L. Conclusion Children with nephrotic syndrome in the first week of therapy showed a higher oxidative stress state than the children in remission. Serum albumin, serum total cholesterol, and UACR can predict serum MDA level with good accuracy.

2) PMID: 33155460 DOI: 10.17392/1196-21
% 2021 Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
* Left to right shunt congenital heart disease as a risk factor of recurrent pneumonia in under five-year-old children: a single centre experience in Bandung Indonesia.
- Aim Children with congenital heart diseases are at the greater risk of respiratory tract infection such as pneumonia. Recurrent pneumonia is one of the most major challenge for paediatric physicians. The aim of this study is to investigate risk factors of congenital heart diseases to recurrent pneumonia children. Methods This was a retrospective study of under five-year-old children hospitalized in Hasan Sadikin General Hospital Bandung Indonesia from 2015 to 2018. Congenital heart diseases and pneumonia, as well as recurrent pneumonia, were identified. Congenital heart diseases diagnosis with and without pneumonia were reviewed. Results Of 6997 hospitalized children, in 1258 (18.0%) congenital heart diseases were found, of which 232 (18.4%) had recurrent pneumonia. Most of those had left to right (L to R) shunt, 213 (91.8%). Congenital heart diseases in children aged under 1 year, 144 (62%) were more preponderant than in those aged 1-5 years. More than a half, 119 (51.3%) were males. Left to right shunt was documented as having recurrent pneumonia, of which patent ductus arteriosus and ventricular septal defect were the most common type in congenital heart diseases. Ventricular septal defect had a possibility for recurrent pneumonia by 1.551 times, and malnutrition 2.591 times. Conclusion Ventricular septal defect and malnutrition were identified as risk factors for recurrent pneumonia. Those patients require multidisciplinary approach to prevent respiratory complications.

3) PMID: 33179100 DOI: 10.3892/mmr.2020.11676
% 2021 Molecular medicine reports
* Dexmedetomidine attenuates sevoflurane‑induced neurocognitive impairment through α2‑adrenoceptors.
- It has been reported that sevoflurane induces neurotoxicity in the developing brain. Dexmedetomidine is an α2 adrenoceptor agonist used for the prevention of sevoflurane‑induced agitation in children in clinical practice. The aim of the present study was to determine whether dexmedetomidine could prevent sevoflurane‑induced neuroapoptosis, neuroinflammation, oxidative stress and neurocognitive impairment. Additionally, the involvement of α2 adrenoceptors in the neuroprotective effect of dexmedetomidine was assessed. Postnatal day (P)6 C57BL/6 male mice were randomly divided into four groups (n=6 in each group). Mice were pretreated with dexmedetomidine, either alone or together with yohimbine, an α2 adrenoceptor inhibitor, then exposed to 3% sevoflurane in 25% oxygen. Control mice either received normal saline alone or with sevoflurane exposure. Following sevoflurane exposure, the expression of cleaved caspase‑3 was detected by immunohistochemistry in hippocampal tissue sections. In addition, the levels of tumor necrosis factor‑α (TNF‑α), interleukin (IL)‑1β, IL‑6 and malondialdehyde, as well as superoxide dismutase (SOD) activity in the hippocampus were measured. At P35, the learning and memory abilities were assessed in each mouse using a Morris water maze test. Dexmedetomidine significantly decreased the expression of activated caspase‑3 following sevoflurane exposure. Moreover, dexmedetomidine significantly decreased the levels of TNF‑α, IL‑1β and IL‑6 in the hippocampus. SOD activity also increased in a dose‑dependent manner in dexmedetomidine‑treated mice. MDA decreased in a dose‑dependent manner in dexmedetomidine‑treated mice. Lastly, sevoflurane‑induced learning and memory impairment was reversed by dexmedetomidine treatment. By contrast, co‑administration of yohimbine significantly attenuated the neuroprotective effects of dexmedetomidine. These findings suggested that dexmedetomidine exerted a neuroprotective effect against sevoflurane‑induced apoptosis, inflammation, oxidative stress and neurocognitive impairment, which was mediated, at least in part, by α2 adrenoceptors.

4) PMID: 33318720 DOI: 10.1016/j.childyouth.2020.105781
% 2021 Children and youth services review
* Possible Age-Related Progression of Attentional Impairment in ADHD and Its Attenuation by Past Diagnosis and Treatment.
- Objective: The aim of the study is to evaluate attentional impairment in different age groups with ADHD. Method: In all, 58 children, 73 adolescents, and 104 adults with ADHD were evaluated using the Test of Variables of Attention (TOVA). Subjects with comorbidities or psychotropic treatment were not included. Results: Considering Response Time Variability (RTV), adults were 10.6 and 4.0 times more likely to be severely impaired (standard score < 40) than children and adolescents, respectively. Adults were twice as likely as adolescents to be very impaired (standard score< 70) in Omissions. Considering d' (decrement of attentional performance over time), all severely impaired participants were adults. Age predicted impairment in Attention Performance Index (API), RTV, and d', but not Omissions or Commissions. Past treatment with stimulants predicted less impairment in d', past diagnosis predicted less impairment in RTV, and each predicted less impairment in Omissions and API. Conclusion: Adults had more attentional impairment than children and adolescents. Past diagnosis and treatment were associated with less ADHD-related attentional impairment.

5) PMID: 30806589 DOI: 10.1080/08869634.2019.1581470
% 2021 Cranio : the journal of craniomandibular practice
* Treatments of sleep bruxism in children: A systematic review and meta-analysis.
- Objective: Treatment of sleep bruxism (SB) in children is not well established. The aim of this study was to develop evidence-based recommendations on SB therapy in children between the ages of 2 and 17. Methods: A systematic review and meta-analysis was conducted. Literature searches were performed using MedLine (PubMed), Web of Science, Scopus, and the Cochrane Library (November 30 2017). Results: The search strategy identified 268 potential articles; 10 papers were included in the qualitative synthesis and 3 in the meta-analysis, for a total of 94 patients. Hydroxyzine therapy showed the strongest efficacy on SB (OR 10.63; CI 95%, 1.48 to 76.08). Flurazepam and Melissa officinalis therapies presented lower grades of association with decreased SB symptoms. Conclusions: Data on treatments of SB in children are limited. Future studies with a proper design, conducted on a meaningful number of patients, and based on standardized and developed diagnostic criteria are desperately needed.

6) PMID: 30070594 DOI: 10.1177/1087054718790010
% 2021 Journal of attention disorders
* Difference in Psychic Distress Lived by Parents With ADHD Children and Parents With Healthy Children: Focus on Gender Differences.
- Objective: ADHD has a complex and negative influence on the family system. The aim of this study was to analyze the perception of emotional distress in a group of parents of children with ADHD. Method: A sample was recruited from the public health system ADHD Unit at Sant Joan de Déu Hospital (Barcelona). The parents of 60 children with newly diagnosed ADHD and the parents of 60 healthy children were included. Results: Higher levels of distress in families with children with ADHD were seen. The distress is present in both parents, with a higher prevalence in the mothers group. A positive correlation was found between ADHD symptoms in the children and the distress reported by parents. A three times higher rate of separations and divorce among parents of children with ADHD was seen. Conclusion: ADHD in children and adolescents increases the emotional distress reported by parents, mainly related to the severity of symptoms present in the children.

7) PMID: 33370789 DOI: 10.1352/1944-7558-126.1.14
% 2021 American journal on intellectual and developmental disabilities
* On the Developmental Trajectories of Relational Concepts Among Children and Adolescents With Intellectual Disability of Undifferentiated Etiology.
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8) PMID: 33370790 DOI: 10.1352/1944-7558-126.1.45
% 2021 American journal on intellectual and developmental disabilities
* Language Improvement Following Pivotal Response Treatment for Children With Developmental Disorders.
- Given the high prevalence of communication deficits in developmental disorders, there is need for efficient early interventions. The aim of this pilot study is to examine benefits of pivotal response treatment (PRT) for improving language in young children with developmental disorders without autism spectrum disorder. Parents of 15 children with developmental disorders received weekly PRT parent training for 12 weeks. Standardized parent-rated assessments were administered at baseline and post-treatment to measure changes in language. Structured laboratory observation indicated children demonstrated significantly greater frequency of utterances and improvement on standardized questionnaires measuring expressive language and adaptive communication skills following PRT. Findings suggest that PRT may be efficacious in improving language abilities among children with developmental disorders.

9) PMID: 33385256 DOI: 10.1007/s10578-020-01113-2
% 2021 Child psychiatry and human development
* Measuring Traumatic Reactions in Palestinian Children: A Psychometric Assessment of the Children Revised Impact of Event Scale-Arabic Version (CRIES-13A).
- The aim of the present study was to test the measurement model and measurement invariance of the Impact of Event Scale (Arabic version) in a large sample of Palestinian children. We estimated (Study 1; n = 610) the measurement model using confirmatory factor analysis. In Study 2 (n = 864), we conducted multigroup (girls and boys) tests of measurement invariance. We pooled the data collected from the participants in the first two studies (Study 3, N = 1474) to assess overall score reliability, as well as the IES' convergent and divergent validity vis-à-vis other measures of child wellbeing and mental health. The outcomes of the statistical analyses supported an invariant 13-item measurement model (intrusion, avoidance, and hyperarousal) for CRIES-13A. Intrusion and hyper-arousal together made up a first-order domain of symptoms (re-experiencing). The combined findings of these studies suggest that the CRIES-13A displays robust psychometric properties and may be used in contexts of military violence.

10) PMID: 33386484 DOI: 10.1007/s10519-020-10034-8
% 2021 Behavior genetics
* The Role of Remembered Parenting on Adult Self-Esteem: A Monozygotic Twin Difference Study.
- Self-esteem is an attitude about the self that predicts psychopathology and general well-being. Parenting practices have been shown to be related to self-esteem, but these estimates are confounded because parents and children share genes. The aim of the present study was to use the monozygotic (MZ) twin difference design to isolate the non-shared environmental impact of remembered parenting on self-esteem. In a sample of 1328 adults (345 MZ twin pairs, 319 DZ twin pairs), retrospective reports of maternal and paternal affection were related to self-esteem, all of which were significantly heritable. Using MZ difference scores, paternal affection differences, but not maternal affection differences, were significantly related to self-esteem differences. These results suggest that parenting provided by the father directly impacts self-esteem through non-shared environmental mechanisms. Maternal affection, on the other hand, impacts self-esteem through shared genes (not shared environment, as shared environment was not a significant aspect of self-esteem). This has implications for parenting intervention programs.

11) PMID: 33387122 DOI: 10.1007/s10096-020-04129-7
% 2021 European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
* Lyme neuroborreliosis in Swedish children-PCR as a complementary diagnostic method for detection of Borrelia burgdorferi sensu lato in cerebrospinal fluid.
- The aim of this study was to evaluate polymerase chain reaction (PCR) as a diagnostic method for the detection of Borrelia burgdorferi s.l. in CSF of Swedish children with LNB. This study was performed retrospectively on CSF and serum samples collected from children evaluated for LNB (n = 233) and controls with other specific neurological disorders (n = 59) in a Swedish Lyme endemic area. For anti-Borrelia antibody index, the IDEIA Lyme Neuroborreliosis kit (Oxoid) was used. Two in-house real-time PCR assays targeting the 16S rRNA gene were evaluated (TaqMan® and LUX™). Among patients classified as LNB cases (n = 102), five children (5%) were Borrelia PCR-positive in CSF with the TaqMan® assay. In the Non-LNB group (n = 131), one patient was Borrelia PCR positive with the TaqMan® assay. Among controls (n = 59), all CSF samples were PCR negative. When amplifying and sequencing ospA, we found B. garinii (n = 2), B. afzelii (n = 2), B. bavariensis (n = 1), and one untypable (n = 1). With the LUX™ technology, all CSF samples were PCR negative. The TaqMan® assay could detect only few cases (n = 6) of B. burgdorferi s.l. in CSF among children with LNB and the sensitivity was very low (5%). However, using larger CSF volumes and centrifugation of samples, the PCR technique could still be useful as a complementary diagnostic method when evaluating LNB. Furthermore, detection of spirochete DNA in clinical matrices, including CSF, is the method of choice for studying epidemiological aspects of LNB, a tick-borne emerging disease.

12) PMID: 33389301 DOI: 10.1007/s10803-020-04820-w
% 2021 Journal of autism and developmental disorders
* Comparison of Serum VEGF, IGF-1, and HIF-1α Levels in Children with Autism Spectrum Disorder and Healthy Controls.
- The aim of this study was to determine whether serum VEGF, IGF-1, and HIF-1α levels differed between Autism Spectrum Disorder (ASD) patients and healthy controls. A total of 40 children with ASD and 40 healthy controls aged 4-12 years were included. Serum levels of VEGF, IGF-1, and HIF-1α were measured using commercial enzyme-linked immunosorbent assay kits. Serum IGF-1 levels were found to be statistically significantly higher in the ASD group than in the control group. Serum HIF-1α levels were borderline significantly lower in the ASD group. There was no statistically significant difference in serum VEGF levels between the two groups. IGF-1 and HIF-1α may play a potential role in the etiopathogenesis of ASD.

13) PMID: 33389393 DOI: 10.1007/s10903-020-01125-z
% 2021 Journal of immigrant and minority health
* Early Life Exposure to Food Insecurity is Associated with Changes in BMI During Childhood Among Latinos from CHAMACOS.
- Early life exposures have been associated with obesity later in life. We aim to assess the association between early life exposure to food insecurity and change in BMI throughout childhood and adolescents. Food security status and growth variables from 243 Mother-child dyads from the Center for the Health Assessment of Mothers and Children of Salinas study were assessed 7 times over a 12-year period. Generalized log linear models with Poisson distributions and linear regression models were implemented to assess the associations between early life food insecurity and obesity and growth. Early life food insecurity was associated with a 0.43 (0.01, 0.82) kg/m2 decrease in BMI from age 2 to 3.5, and a 0.92 kg/m2 (0.38, 1.46) increase in BMI among boys from ages 3.5 to 5, after adjusting for covariates. Sex and age modify the association between early life exposure to food insecurity and BMI.

14) PMID: 33389435 DOI: 10.1007/s10943-020-01122-4
% 2021 Journal of religion and health
* "I Took the Trouble to Make Inquiries, So I Refuse to Accept Your Instructions": Religious Authority and Vaccine Hesitancy Among Ultra-Orthodox Jewish Mothers in Israel.
- Voluminous scholarship has shown that religious leaders play an important role in helping patients cope with health issues. There is, however, little research on the impact of religious leaders on parents' decision-making processes pertaining to childhood vaccination. Ultra-orthodox Jewish religious leaders (rabbis) are considered authorities on health issues, and most of them encourage parents to vaccinate their children. Yet, there have been several recent outbreaks of measles in the ultra-orthodox population in Israel, as well as in other countries. The aim is to study the role played by rabbis in the decision-making process of Israeli ultra-orthodox Jewish parents with regard to vaccination. In-depth interviews were conducted during 2019 with ten Israeli ultra-orthodox Jewish mothers who do not vaccinate their children. The interviewees acknowledged that rabbis generally advocate vaccination. Yet they do not consult them and at times even disregard their instructions. The interviewees search for information on vaccination for themselves (mostly online) and decide not to vaccinate their children based on their assessment of risk. Contrary to the scholarly literature that points to the central role of religious leaders in dealing with health issues, the ultra-orthodox mothers' decision not to vaccinate their children appears to have been made despite the rabbis' instructions and not for religious reasons. These mothers' decision-making process is similar to that of mothers who do not vaccinate their children in other countries with respect to the aspect of gender, the search for information, and the reasons reported. Contacting the ultra-orthodox mothers directly and addressing their concerns about risk increase vaccination rates among the ultra-orthodox Jewish population.

15) PMID: 33390638 DOI: 10.1016/j.childyouth.2020.105906
% 2021 Children and youth services review
* The experience of social distancing for families with children and adolescents during the coronavirus (COVID-19) pandemic in Uruguay: Difficulties and opportunities.
- The social distancing measures implemented to contain the coronavirus (COVID-19) pandemic worldwide have created a series of emotional and economic challenges. The aim of the present work was to explore the experiences of families with children and adolescents during the coronavirus (COVID-19) pandemic in Uruguay. An online study was conducted in March 2020 with 1725 parents with children under 18 years old. A series of closed and open-ended questions about their family life since the implementation of social distancing measures were asked, addressing the following topics: how they had felt, changes they had experienced in their daily life, children's daily routine, changes implemented in relation to child-care, changes they had perceived in children's eating patterns, changes in their relationship with their children, changes in their children's mood and behavior, and their reaction to those changes. Results showed that the coronavirus pandemic elicited negative feelings in the majority of participants, mainly related to worry, fear, anxiety and uncertainty. Social distancing measures caused a major disruption in daily habits, which were mostly attributed to changes in work-related activities and the closure of educational institutions. Changes in children's mood and behavior were perceived by the majority of the participants, who mainly referred to boredom, agitation and restlessness. Although some participants reported difficulties to cope with children's behavior during social distancing, others valued the opportunity of spending more time with their children. In terms of children's eating patterns, changes related to both an increase and a decrease in the consumption of healthy foods were observed. Results from the present work have relevant implications for public health policy and practice by highlighting the importance of providing emotional and psychological support to people during social distancing measures and providing insights for the design of communication campaigns and interventions.

16) PMID: 33393410 DOI: 10.1080/17518423.2020.1866706
% 2021 Developmental neurorehabilitation
* Classification of Congenital Zika Syndrome: Muscle Tone, Motor Type, Body Segments Affected, and Gross Motor Function.
- Aim: To identify abnormalities in muscle tone and motor function associated with congenital Zika syndrome (CZS). Method: A cross-sectional observational study involving 96 children (55 males) with CZS at a mean (SD) age 35.2 ± 2.9 months. Children's muscle tone was investigated using the pull to sit, scarf sign, shoulder suspension and ventral suspension tests and the modified Ashworth scale (MAS). Motor impairment was determined using the Gross Motor Function Classification System (GMFCS) and body segments most affected with motor impairment. Results: 58 (60,5%) children tested positive for ≥1 maneuver used to evaluate muscle tone, while 38 (39.5%) tested negative in all the tests. MAS score was >0 for at least one of the appendicular muscles in 91 children (94.8%). In 88 children (91.7%), all four limbs were affected. Conclusion: Findings suggestive of axial hypotonia and appendicular hypertonia associated with severe motor impairment were prevalent in children with CZS.

17) PMID: 33393436 DOI: 10.1080/16549716.2020.1861922
% 2021 Global health action
* Is exclusive breastfeeding for six-months protective against pediatric tuberculosis?
- Experts recommend exclusive breastfeeding from birth to six months because it protects against deadly childhood illness, including respiratory tract infections and diarrhea. We hypothesized that exclusive breastfeeding would decrease the risk of active tuberculosis (TB) in children. We analyzed cross-sectional data from 279 children in Lima, Peru aged 6 to 59 months with TB symptoms and a close adult contact with TB. Mothers self-reported breastfeeding, and children were evaluated for TB per national guidelines. To quantify the association between exclusive breastfeeding and TB, we estimated prevalence ratios using a generalized linear model with a log link, binomial distribution, and robust variance. Twenty-two percent of children were diagnosed with TB and 72% were exclusively breastfed for six months. We found no evidence that six months of exclusive breastfeeding was associated with TB disease in either bivariate analyses (prevalence ratio [PR] = 1.5; 95%CI = 0.8-2.5) or multivariable analyses adjusting for sex and socioeconomic status (adjusted PR = 1.6; 95%[CI] = 0.9-2.7). In post hoc analyses among children whose close TB contact was their mother, we found evidence of a weak positive association between breastfeeding and TB (aPR = 2.1; 95%[CI] = 0.9-4.9). This association was not apparent among children whose close contact was not the mother (aPR = 1.2; 95%[CI] = 0.6-2.4). Our results raise the possibility that children who are breastfed by mothers with TB may be at increased risk for TB, given the close contact. Due to the cross-sectional study design, these results should be interpreted with caution. If these findings are confirmed in longitudinal analyses, future interventions could aim to minimize TB transmission from mothers with TB to breastfeeding infants.

18) PMID: 33397153 DOI: 10.1080/21622965.2020.1862656
% 2021 Applied neuropsychology. Child
* Investigating the compatibility, interchangeability, and clinical usability of BOT2-BF and BOT2-SF in primary school-aged children with and without developmental dyslexia.
- The aim of our study was to determine the sensitivity and specificity levels of BOT2-BF and BOT2-SF tests applied to children with developmental dyslexia and to examine their clinical usability. This study was designed as a case-controlled study. 82 (study group 41, control group 41) 7-12 year children were included. The study occurred three stages. In the first place, the similarities and differences of BOT2-BF and BOT2-SF tests observed in clinical practices were examined by taking the feedback of experts and test correlations. In the second step, BOT2-BF and BOT2-SF tests were examined with reference to the Core Outcome Set (COS) evaluation criteria. In the last step, in order to examine the sensitivity and specificity levels of the tests, assessments were performed in two groups with 1-week intervals. According to the COS results, the BOT2-BF test was examined better than the BOT2-SF test under cross-cultural validity title. The sensitivity and specificity of BOT2-SF were 0.92 and 0.51, and for BOT2-BF were 0.92 and 0.41, respectively. This study will help clinicians working on children with developmental dyslexia to decide the type of test they will use to evaluate and easy access to materials motor proficiency.

19) PMID: 33401541 DOI: 10.3390/jcm10010137
% 2021 Journal of clinical medicine
* Validity and Reliability of a Tool for Accelerometric Assessment of Balance in Scholar Children.
- In Pediatrics, balance is assessed through low-sensitivity clinical tests which identify developmental alterations at already advanced stages that cannot be detected at earlier stages. Therefore, the aim of this study was to develop an easily applicable quantitative tool that can be used to evaluate postural control. Consequently, a cross-sectional study was carried out with 91 healthy children. All of them performed a series of six accelerometric functional tests and four clinical tests of balance (Modified Flamingo Test, Bar Test, Babinski-Weil Test, and Fukuda Stepping Test). The Bar Test obtained mild inverse correlations with accelerations produced in the mediolateral axis and the root mean square of all the tests in monopodal support. The Flamingo Test obtained direct correlations with the root mean square of the tests in monopodal support and with the mediolateral axis of the monopodal tests and gait. The pediatric balance assessment scale consists of three factors and eleven items extracted from five accelerometric functional tests: the monopodal balance test with six items, normal gait test with three items, and bipodal balance test with two items. This tool is easy to apply and allows analysis in the evaluation of the balance state based on the accelerations of the center of mass.

20) PMID: 33401738 DOI: 10.3390/ijerph18010286
% 2021 International journal of environmental research and public health
* Children's Active School Travel: Examining the Combined Perceived and Objective Built-Environment Factors from Space Syntax.
- Increasing active school travel (AST) among children may provide the required level of daily physical activity and reduce the prevalence of obesity. Despite efforts to promote this mode, recent evidence shows that AST rates continue to decrease in suburban and urban areas alike. The aim of this research study, therefore, is to facilitate our understanding of how objective and perceived factors near the home influence children's AST in an understudied city, İstanbul, Turkey. Using data from a cross-sectional sample of students aged 12-14 from 20 elementary schools (n = 1802) and consenting parents (n = 843), we applied a nominal logistic regression model to highlight important predictors of AST. The findings showed that street network connectivity (as measured by two novel space syntax measures, metric reach and directional reach) was the main deciding factor for active commuting to school, while parents' perceptions of condition of sidewalks and shade-casting street trees were moderately significant factors associated with AST. Overall, this study demonstrated the significance of spatial structure of street network around the homes in the potential for encouraging AST, and more importantly, the need to consider objective and perceived environmental attributes when strategizing means to increase this mode choice and reduce ill-health among children.

21) PMID: 33403675 DOI: 10.1002/dev.22082
% 2021 Developmental psychobiology
* Maternal expressions of positive emotion for children predicts children's respiratory sinus arrhythmia surrounding stress.
- The aim of this study is to assess whether positive emotional exchanges (i.e., emotion coregulation) within the mother-child dyad play a protective role in children's physiological response to a distressing task. Specifically, we test whether positive emotion coregulation among mothers and their preschool-aged children is associated with children's respiratory sinus arrhythmia (RSA) at baseline, during, and following a frustration task. One hundred Singaporean mother-child dyads (Mchildage  = 3.5 years) participated in a standardized "Laughing Task" in which positive emotional constructs were measured. Children also participated in a frustration task while RSA was continuously monitored. Hierarchical linear regressions revealed that greater maternal positive emotional responses to children were associated with child RSA at baseline and in recovery from frustration, but not during frustration. These findings have implications for the important role that positive emotion responsivity from mothers may play in children's developing autonomic response systems, and underscore the need for longitudinal work on this topic.

22) PMID: 33406642 DOI: 10.3390/medicina57010037
% 2021 Medicina (Kaunas, Lithuania)
* Evaluation of Chromosomal Structural Anomalies in Fertility Disorders.
- Background and objectives: Reproductive disorders may occur not only due to environmental factors (air pollution, stressful lifestyle, previous abortions or the use of contraceptives) but also due to genetic factors. Materials and Methods: The aim of the study was to identify the range and frequency of chromosomal aberrations in couples (n = 99) with infertility or recurrent miscarriages in Lithuania. The data were collected from the out-patient medical histories. The couples were divided into three groups based on pregnancy, childbirth and the number of miscarriages. The Chi-square test was used to carry out the statistical analysis, and the statistical significance was (p < 0.05). Results: There were 6.6% (n = 13) structural changes observed in the karyotype tests. Chromosomal aberrations were found in 3% (n = 6) of the subjects, while 3.6% (n = 7) of them had chromosomal length polymorphisms. No difference was found between the aberration frequency in the karyotypes of men and women (p > 0.05). The most common aberrations were balanced translocations (23.1%, n = 3) which accounted for 15.4% of the reciprocal (n = 2) and 7.7% of the Robertsonian type (n = 1) of translocations. The most frequent aberrations were found in couples with the inability to conceive (42.9% (n = 3), p = 0.031). The childless couples and those with recurrent miscarriages showed an aberration rate of 8.2% (n = 5), while in the couples with at least one child it was 16.1% (n = 5). The group of couples unable to conceive had a significantly higher aberration rate of 28.6% (n = 2), p = 0.029. Miscarriages in partners' families accounted for 8.1%. Miscarriages on the female side of the family accounted for 4.5% (n = 9), on the male side it accounted for 2.5% (n = 5) and on both sides it accounted for 1.1% (n = 2). There were no statistically significant differences observed between the female and male sides (p > 0.05). The miscarriages observed in the second group of couples (childless with ≥2 miscarriages) were more frequent at 18.1% (n = 11), in the third group (having children ≥2 miscarriages) they were less frequent at 12.9% (n = 4), while no miscarriages were recorded in the first group of infertile couples. In total, 3% of the identified significant chromosomal aberrations were likely to trigger miscarriages or the inability to conceive. Conclusions: In couples with reproductive disorders, chromosomal mutations and chromosomal length polymorphisms were found at similar rates: 3% vs. 3.6%. The highest aberration rate was found in couples that were unable to conceive, a lower one was found in a group with children and ≥2 miscarriages, and the lowest one was found in a childless group of subjects with ≥2 miscarriages. The miscarriage rate in partner families was 8.1%; however, no difference was found between the male and female sides.

23) PMID: 33407022 DOI: 10.1080/02640414.2020.1864985
% 2021 Journal of sports sciences
* Effects of a 10-week active recess program in school setting on physical fitness, school aptitudes, creativity and cognitive flexibility in elementary school children. A randomised-controlled trial.
- The aim of this study was to assess the effects of a 10-week active recess programme in school setting on physical fitness, school aptitudes, creativity and cognitive flexibility in children. A total of 114 children (age range = 8-12 years old, 47.3% girls) participated in this study. The students were randomly assigned to two groups, experimental group (EG) and control group (CG). The EG performed a programme of physical exercise at moderate to vigorous intensity with cognitive engagement for 10 weeks, three times a week. Physical fitness, school aptitudes, creativity, and cognitive flexibility were tested. Non-significant differences were found in physical fitness (both pre-test and post-test) between groups. The EG experienced significant improvements in all school aptitudes, creativity and cognitive flexibility (TMT test). In addition, the EG showed greater increase (p<0.05) than the CG in all variables of school aptitudes (p<0.01), creativity (p<0.001) and cognitive flexibility (p<0.05). Significant correlation between ∆ TMT-B and ∆ VO2max (r=-0.289, p=0.031) was found. In conclusion, active recess based on high intensity training can be a proper tool to improve some cognitive skills, such as school aptitudes, creativity, and cognitive flexibility.

24) PMID: 33409588 DOI: 10.1007/s00431-020-03909-9
% 2021 European journal of pediatrics
* The impact of COVID-19 on a tertiary care pediatric emergency department.
- The restrictive measures required to face the recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may impact patterns of healthcare utilization. Our aim was to provide an insight into the change in the use of a pediatric emergency department (ED) during the SARS-CoV-2 pandemic. The medical records of the children seen in our pediatric ED during March and April 2020 were retrospectively reviewed. Consequently, these were compared to the medical records of 2018 and 2019 from the same time period and from other control periods (January-February 2019 and 2020, and July-August 2018 and 2019). The total number of ED visits declined by 73% from 2019 to 2020 (3051 vs 818). Significant variations were observed in the distribution of children between triage categories: the proportion of patients who was given a green-code showed a 0.59-fold decrease in comparison to 2019 (95% CI 0.5-0.69), while a relative increase in the proportion of yellow codes was observed (OR 1.46, 95% CI 1.2-1.78).Conclusion: Quarantine measures significantly impacted on the total number of patients and on the reasons for visiting them in our pediatric ED. This substantial decrease in pediatric care may either be due to lower rates of acute infections because of social distancing, or to parents' or caregivers' reticence to risk exposure to SARS-CoV-2 in a health-care setting. What is known: • A recent outbreak of a novel coronavirus responsible for a severe acute respiratory syndrome is spreading globally. • Restrictive measures may impact patterns of healthcare utilization, as observed in other previous outbreaks. What is new: • This study shows significant variations in the distribution of children among triage categories during the COVID-19 pandemic. • Discharge diagnosis was significantly different as well, in particular a relative increase in the proportion of children presenting with traumatic injuries and a decrease of viral infections were observed.

25) PMID: 33410271 DOI: 10.1002/aur.2467
% 2021 Autism research : official journal of the International Society for Autism Research
* The Revised Children's Communication Checklist-2 (CCC-R): Factor Structure and Psychometric Evaluation.
- The Children's Communication Checklist-2 (CCC-2) is often applied to assess pragmatic language impairment which is highly prevalent in autism spectrum disorder (ASD) and several mental health conditions. We replicated previous findings on the limited applicability of the CCC-2 in clinical samples and the inconsistent findings concerning the factor structure. The aim of the present study was, thus, to develop a concise, simplified, and revised version of the CCC-2 in a large German-speaking sample. Four groups of children and adolescents aged 4 to 17 years were included: ASD (n = 195), intellectual disability (ID, n = 83), diverse mental health conditions (MHC, n = 144) and a typically developing control group (TD, n = 417). We reduced the original number of items from 70 to 39, based on item analysis, exploratory factor analysis and the exclusion of communication-unrelated items. The revised version, CCC-R (α = 0.96), consists of two empirically derived factors: a pragmatic-language (α = 0.96) and a grammatical-semantic-language factor (α = 0.93). All clinical groups (ASD, ID, and MHC) had significantly increased CCC-R total scores, with the highest scores being in the neurodevelopmental disorder groups (ASD and ID). In addition, we found group-specific patterns of elevated pragmatic-language scores in the ASD group and grammatical-semantic scores in the ID group. The CCC-R was comparable to the CCC-2 in distinguishing ASD from the other groups. The CCC-R is proposed as a simplified and easily applied, clinical questionnaire for caregivers, assessing pragmatic language impairments across neurodevelopmental disorders and mental health conditions. LAY SUMMARY: The CCC-2 is a questionnaire designed to identify children who have problems in the social use of language, however, it is limited in its clinical application and exhibits inconsistent factors. We have created a shorter and simpler version of the CCC-2 that we have called the CCC-R which overcomes the previous limitations of CCC-2. It consists of two subscales: pragmatic language and grammatical-semantic language. The CCC-R can be used as a short and clinically relevant caregiver questionnaire which assesses pragmatic language impairments in children and adolescents.

26) PMID: 33411152 DOI: 10.1007/s10875-020-00960-x
% 2021 Journal of clinical immunology
* Clinical and Immunological Features of 96 Moroccan Children with SCID Phenotype: Two Decades' Experience.
- Severe combined immunodeficiency (SCID) is a heterogeneous group of primary immunodeficiency diseases (PIDs) characterized by a lack of autologous T lymphocytes. This severe PID is rare, but has a higher prevalence in populations with high rates of consanguinity. The epidemiological, clinical, and immunological features of SCIDs in Moroccan patients have never been reported. The aim of this study was to provide a clinical and immunological description of SCID in Morocco and to assess changes in the care of SCID patients over time. This cross-sectional retrospective study included 96 Moroccan patients referred to the national PID reference center at Casablanca Children's Hospital for SCID over two decades, from 1998 to 2019. The case definition for this study was age < 2 years, with a clinical phenotype suggestive of SCID, and lymphopenia, with very low numbers of autologous T cells, according to the IUIS Inborn Errors of Immunity classification. Our sample included 50 male patients, and 66% of the patients were born to consanguineous parents. The median age at onset and diagnosis were 3.3 and 6.5 months, respectively. The clinical manifestations commonly observed in these patients were recurrent respiratory tract infection (82%), chronic diarrhea (69%), oral candidiasis (61%), and failure to thrive (65%). The distribution of SCID phenotypes was as follows: T-B-NK+ in 44.5%, T-B-NK- in 32%, T-B+NK- in 18.5%, and T-B+NK+ in 5%. An Omenn syndrome phenotype was observed in 15 patients. SCID was fatal in 84% in the patients in our cohort, due to the difficulties involved in obtaining urgent access to hematopoietic stem cell transplantation, which, nevertheless, saved 16% of the patients. The autosomal recessive forms of the clinical and immunological phenotypes of SCID, including the T-B-NK+ phenotype in particular, were more frequent than those in Western countries. A marked improvement in the early detection of SCID cases over the last decade was noted. Despite recent progress in SCID diagnosis, additional efforts are required, for genetic confirmation and particularly for HSCT.

27) PMID: 33411175 DOI: 10.1007/s10096-020-04131-z
% 2021 European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
* Diagnosis of SARS-CoV-2 in children: accuracy of nasopharyngeal swab compared to nasopharyngeal aspirate.
- The tests currently used for the identification of SARS-CoV-2 include specimens taken from the upper and lower respiratory tract. Although recommendations from the World Health Organization prioritise the usage of a nasopharyngeal swab (NS), nasopharyngeal aspirates (NPA) are thought to be superior in identifying SARS-CoV-2 in children. To our knowledge, however, no paediatric study has been published on the subject. The aim of this study is to evaluate the diagnostic performances of NS referred to NPA for SARS-CoV-2 in children. We calculated the sensitivity and specificity of the NS referred to the NPA of the whole sample and considered both age and collection period as covariates in different analyses. We collected 300 paired samples. The NS had a specificity of 97.7% and a sensitivity of 58.1%. We found similar results for the group of subjects ≥ 6 years old, while for subjects < 6 years old, the sensitivity was 66.7% and the specificity 97.8%. Considering period as a covariate, the sensitivity and specificity for patients hospitalised in March (31 patients, 52 records) were 70.0% and 97.6%, while for patients involved in the follow-up (16 patients, 57 records), they were 57.2% and 89.7%. The NS has a low sensitivity in detecting SARS-CoV-2 in children when referred to the NPA, whereas its specificity is high. Our results suggest that in children under 6 years of age, NSs should be preferred whenever possible. Though statistically not significant, the sensitivity of the NS rises when performed before the NPA.

28) PMID: 33411375 DOI: 10.1111/pai.13447
% 2021 Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
* Impact of age on adherence and efficacy of peanut oral-immunotherapy using a standardized protocol.
- Peanut oral immunotherapy (POIT) has been shown to be an effective therapy in peanut allergic children, as it improves food allergy-related quality of life [1-2] . Randomized controlled trials and observational, real world studies have shown that POIT may be effective and safe in children of all ages, although starting POIT at a younger age may be more efficacious and safer [3,5, 8] . Furthermore, initiation of POIT at a younger age may have higher rates of sustained unresponsiveness [3] . However, there has not been formal evaluation of this concept, using a standardized protocol [6] . The aim of our study was to examine associations between the age at initiation of POIT, and the safety of POIT, using a standardized protocol for all patients.

29) PMID: 33412234 DOI: 10.1016/j.peptides.2020.170491
% 2021 Peptides
* Polymorphism of the Bradykinin Type 2 Receptor Gene Modulates Blood Pressure Profile and Microvascular Function in Prepubescent Children.
- Previous reports reveal that +9/-9 polymorphism of the bradykinin B2 receptor (BDKRB2) is suggestive of cardiometabolic diseases. The aim of this study was to examine the impact of BDKRB2 + 9/-9 polymorphism genotypes on the blood pressure parameters and microvascular function in prepubescent children. We screened for BDKRB2 + 9/-9 polymorphism in the DNA of 145 children (86 boys and 59 girls), and its association with body composition, blood pressure levels, biochemical parameters, and endothelial function was determined. No significant association of the BDKRB2 genotypes with gender (P=0.377), race (P=0.949) or family history of cardiovascular disease (CVD) (P=0.858) was observed. Moreover, we did not identify any interaction between BDKRB2 genotypes with a phenotype of obesity (P=0.144). Children carrying the +9/+9 genotype exhibited a significant linear trend with higher levels of systolic blood pressure and pulse pressure (P<0.001). Moreover, the presence of +9 allele resulted in a decrease of reactive hyperemia index, showing a decreasing linear trend from -9/-9 to +9/+9, wherein this parameter of endothelial function was the lowest in the +9/+9 children, intermediate in the +9/-9 children, and the highest in the -9/-9 children (P<0.001). There was a significant inverse correlation between reactive hyperemia index and systolic blood pressure (r= - 0.348, P< 0.001) and pulse pressure (r= - 0.399, P< 0.001). Our findings indicate that the +9/+9 BDKRB2 genotype was associated with high blood pressure and microvascular dysfunction in prepubescent Brazilian children.

30) PMID: 33412969 DOI: 10.1080/17518423.2020.1869337
% 2021 Developmental neurorehabilitation
* Trunk Control and Upper Limb Function of Walking and Non-walking Duchenne Muscular Dystrophy Individuals.
- Aim: To verify and compare trunk control and upper limb functionality (ULs) in walking and non-walking DMD individuals, with that of individuals without dystrophinopathies.Method: Cross-sectional study, with children without dystrophinopathy (healthy control group) and in walking and non-walking DMD children evaluated by the following scales: Segmental Control Evaluation Trunk (SATCo); Performance of Upper Limb (PUL) and Jebsen-Taylor Test (JTT).Results: There was a difference between the groups in trunk control and ULs function by the PUL scale, but there was no difference between walking and the reference group in all JTT subtests; The JTT writing subtest was not different between groups. There was a strong correlation between PUL and SATCo, both had a strong correlation with disease staging and a weak correlation with JTT.Conclusions: There is relevance to the evaluation of trunk control and ULs function of walking and non-walking DMD.

31) PMID: 33413038 DOI: 10.1080/00221325.2020.1868969
% 2021 The Journal of genetic psychology
* The Use of Dyadic Reading in Stimulating the Comprehension of Emotions.
- According to the model proposed by Pons, Doudin, and Harris , children develop nine components of emotion comprehension between the ages of three to twelve. Studies reveal that children's comprehension of emotions can be stimulated by adults reading books designed for this purpose to preschool-aged children. The aim of this study is to explore whether dyadic reading is an effective strategy for stimulating emotion comprehension in school-aged children. Elementary school children (3rd, 4th and 5th grade) participated in the experimental or the control group. The Test of Emotion Comprehension (TEC) was administered at pretest and post-test. Participants in the experimental group read the books on emotion comprehension for five sessions, while participants in the control group read classroom books. Results revealed that reading the emotion comprehension books increased the TEC post-test scores significantly from pretest for children in the experimental group, compared to the control group. For the Components Reminder, Belief and Morality scores at post-test were significantly increased from pretest for children in the experimental group, compared to the control group. Results suggest that dyadic book readings are successful in helping children with both complex components of their emotion comprehension and simpler ones. This intervention could be of use for teaching school-aged children emotion comprehension easily, effectively, and at low-cost.

32) PMID: 33413969 DOI: 10.1016/j.ram.2020.11.004
% 2021 Revista Argentina de microbiologia
* Intestinal parasites in child and youth populations of Argentina: Environmental factors determining geographic distribution.
- The transmission of intestinal parasites is generally considered to be "mediated by the environment" which suggests that they are particularly sensitive to the changes that occur in it. The aim of the present study was to evaluate the environmental variables that act as risk factors for intestinal parasitosis in children and youths in Argentina. The association between environmental variables related to temperature, precipitation and soil and parasitosis found in children and youths from different provinces was evaluated, including land use/cover classes obtained from satellite images. Of the total population analyzed, 66.9% of the participants were parasitized. The total number of identified parasite species was 17 and the most prevalent were Blastocystis sp. (42.2%), Enterobius vermicularis (33.6%) and Giardia lamblia (17.0%). Infection by protozoa, and by G. lamblia in particular, was greater when the mean summer temperature was higher (OR=1.2 for both). Blastocystis sp. and geohelminths were greater due to an increase in isothermality (OR=1.1 and 1.2, respectively). The risk of infection with Ascaris lumbricoides was associated with an increase in the temperature in the wettest quarter (OR=1.2). Hookworm infection was associated with an increase in the normalized difference vegetation index (OR=32.5). Most of participants infected with hookworms lived in areas with abundant arboreal-shrubby and agropastoral use vegetation. The heterogeneous distribution of enteric parasites is indicative of the wide environmental variability of Argentina.

33) PMID: 33415466 DOI: 10.1007/s00431-020-03891-2
% 2021 European journal of pediatrics
* Lower HbA1c targets are associated with better metabolic control.
- Previous studies have suggested that clear HbA1c target setting by the diabetes team is associated with HbA1c outcomes in adolescents. The aim of this study was to evaluate whether this finding is consistent in a larger cohort of children from centers participating in the SWEET international diabetes registry. A questionnaire was sent out to 76 SWEET centers, of which responses from 53 pediatric centers were included (70%). Descriptive outcomes were presented as median with lower and upper quartile. The association between the centers' target HbA1c and mean outcome HbA1c was calculated using linear regression adjusted for age, diabetes duration, sex, and gross domestic product. Median age of the children in the studied centers (n = 35,483) was 13.3 [12.6-14.6] years (49% female). Of the 53 centers, 13.2% reported an HbA1c target between 6.0 and 6.5%, 32.1% had a target between ≥ 6.0 and 7.0%, 18.9% between ≥ 7.0 and 7.5%, and 3.8% between ≥ 7.5 and 8.5%. No specific target value was reported by 32.1% of all centers. Median HbA1c across all centers was 7.9 [7.6-8.3] %. Adjusted regression analysis showed a positive association between HbA1c outcome and target HbA1c (p = 0.005).Conclusions: This international study demonstrated that a lower target for HbA1c was associated with better metabolic control. It is unclear whether low target values result in better metabolic control, or lower HbA1c values actually result in more ambitious target values. This target setting could contribute to the differences in HbA1c values between centers and could be an approach for improving metabolic outcomes. What is Known: • Target setting of HbA1c is important in children and adolescents with type 1 diabetes. • The optimal therapeutic approach of children with type 1 diabetes requires a trained multidisciplinary team. What is New: • Lower HbA1c targets are associated with better metabolic control. • No associations between the composition of the diabetes teams and metabolic control could be demonstrated.

34) PMID: 33415467 DOI: 10.1007/s00431-020-03893-0
% 2021 European journal of pediatrics
* Parental presence during pediatric retrieval: the caregiver's perspective.
- The presence of family at the bedside of critically ill children is recommended, as part of "family-centered care." The study aimed to understand if such recommendation was applied by our neonatal and pediatric retrieval team and the second aim was their perception of parental presence. We first conducted a 6-month monocentric prospective observational study where the transport teams had to rate parental presence after each retrieval. A second survey was filled out by all team members, to explore their perception of parental presence in a general manner, without referring to a specific transport. Three hundred seventeen questionnaires from the prospective survey were returned, with parents being present in the ambulance for 47% of retrievals. There was a significant difference in parental accompaniment between newborns (< 24 h) and older children. The parental presence was rated as neutral or positive for 99% of transportation, whereas approximately ¼ of the crew feared "a priori" parental presence during transport in the second survey.Conclusion: This study suggests at least one parent was present at almost half of the retrievals conducted in our sample during the study period. Very few negative experiences were reported in the prospective study by the caregivers who allowed parental presence. What is Known: •The concept of family-centered care is an approach that recognizes the importance of family engagement and involvement and encourages collaboration between families and healthcare professionals. •Parents wish to accompany their child. What is New: •The perception of parental presence, by transport team members, was neutral or positive in 99% of retrievals during the study. •Newborns' parents were less present during retrieval than older children's parents.

35) PMID: 33415470 DOI: 10.1007/s00787-020-01706-1
% 2021 European child & adolescent psychiatry
* Parental experiences of homeschooling during the COVID-19 pandemic: differences between seven European countries and between children with and without mental health conditions.
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36) PMID: 33419063 DOI: children8010025 target=_blank>10.3390/children8010025
% 2021 Children (Basel, Switzerland)
* Play in Children with Neurodevelopmental Disorders: Psychometric Properties of a Parent Report Measure 'My Child's Play'.
- Play is essential in childhood, allowing for a positive trend in development and learning. Health professionals need useful tools to assess it, especially in the case of children with neurodevelopmental disorders. The aim of this study was to validate and cross-culturally adapt the My Child's Play questionnaire and to find out if this instrument allows us to differentiate the play of children with neurodevelopmental disorders from the play of children with neurotypical development. A total of 594 parents completed the questionnaire. A confirmatory factor analysis was conducted, which showed a similar structure to the English version: (1) executive functions; (2) environmental context; (3) play characteristics; and (4) play preferences and interpersonal interactions. The reliability of the analysis was high, both for the whole questionnaire and for the factors it comprises. The results provide evidence of the potential usefulness of the My Child's Play questionnaire for determining play needs and difficulties of children; moreover, this tool can also be used to plan intervention programs according to the needs of each child and family.

37) PMID: 33423302 DOI: 10.1111/sms.13917
% 2021 Scandinavian journal of medicine & science in sports
* Active commuting to school among 36,781 Spanish children and adolescents: A temporal trend study.
- This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n=18,343; 8.93±1.68) and adolescents (n=18,438; 14.11±1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth were found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term.

38) PMID: 33426690 DOI: 10.1111/sjop.12707
% 2021 Scandinavian journal of psychology
* Initial validation of the Basque version of the Parental Burnout Assessment (B-PBA).
- The aim of the present study was to validate the Parental Burnout Assessment in a Basque sample of parents. The Basque version of the PBA (B-PBA) was administered to 250 parents, with at least one child living at home. We investigated whether the four-dimensional structure of the PBA held in a sample of male and female parents. Furthermore, we examined the relationships between PBA and several sociodemographic variables such as participants' age, gender, number of children, family type, level of education, socioeconomic level, being in paid employment, and time spent with children. The results confirm the four-factor structure of the B-PBA including exhaustion in one's parental role, contrast with previous parental self, feelings of being fed up, and emotional distancing from one's children. The B-PBA shows good psychometric properties. Regarding sociodemographic variables, mothers present higher levels of parental burnout in comparison with fathers. In the rest of the sociodemographic variables there are weak relationships regarding parental burnout. In the discussion, we provide feedback on the hypotheses and results obtained and we interpret the results; we highlight the relevance of the parental burnout construct in the Basque Country; and we present practical implications as well as future perspectives.

39) PMID: 33428802 DOI: 10.1002/jdn.10089
% 2021 International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience
* Animal models of Attention-Deficit Hyperactivity Disorder (ADHD).
- Attention-Deficit Hyperactive Disorder (ADHD) is a heterogeneous neuropsychiatric disorder characterized by three primary symptoms hyperactivity, attention deficit, and impulsiveness, observed in both children and adults. In childhood, this disorder is more common in boys than in girls, and at least 75% will continue to suffer from the disorder until adulthood. Individuals with ADHD generally have poor academic, occupational, and social functioning resulting from developmentally inappropriate levels of hyperactivity and impulsivity, as well as impaired ability to maintain attention on motivationally relevant tasks. Very few drugs available in clinical practice altogether abolish the symptoms of ADHD therefore, to find new drugs and target it is essential to understand the neuropathological, neurochemical, and genetic alterations which lead to progression of ADHD. With this contrast, an animal study is the best approach because animal models provide relatively fast invasive manipulation, rigorous hypothesis testing, as well as it provides a better angle to understand the pathological mechanisms involved in disease progression. Moreover, animal models, especially for ADHD, serve with good predictive validity would allow the assessment and development of new therapeutic interventions, with this aim, the present review collect the various animal models on the single platform so that the research can select an appropriate model to pursue his study.

40) PMID: 33428967 DOI: 10.1016/j.neuroscience.2020.12.030
% 2021 Neuroscience
* Neurodevelopment of posture-movement coordination from late childhood to adulthood as assessed from bimanual load-lifting task: an ERP study.
- In a bimanual task, proprioception provides information about position and movement of upper arms. Developmental studies showed improvement of proprioceptive accuracy and timing adjustments of muscular events from childhood to adulthood in bimanual tasks. However, the cortical maturational changes related to bimanual coordination is not fully understood. The aim of this study was to investigate cortical correlates underlying motor planning and upper limb stabilization performance at left (C3) and right (C4) sensorimotor cortices using event-related potential (ERP) analyses. We recruited 46 participants divided into four groups (12 children: 8-10 years, 13 early adolescents: 11-13 years, 11 late adolescents: 14-16 years and 10 young adults: 20-35 years). Participants performed a bimanual load-lifting task, where the left postural arm supported the load and the right motor arm lifted the load. Maximal amplitude of elbow rotation (MA%) of the postural arm, reaction time (RT) and EMG activity of biceps brachii bilaterally were computed. Laplacian-transformed ERPs of the electroencephalographic (EEG) signal response-locked to motor arm biceps EMG activity onset were analyzed over C3 and C4. We found a developmental effect for behavioral and EEG data denoted by significant decrease of MA% and RT with age, earlier inhibition of the biceps brachii of the postural arm in adults and earlier EEG activation/inhibition onset at C3/C4. Amplitude of the negative wave at C4 was higher in children and early adolescents compared to the other groups. In conclusion, we found a maturational process in cortical correlates related to motor planning and upper limb stabilization performance with interhemispheric lateralization appearing during adolescence. Findings may serve documenting bimanual performance in children with neurodevelopmental disorders.

41) PMID: 33430062 DOI: 10.3390/s21020406
% 2021 Sensors (Basel, Switzerland)
* The Sensor Hub for Detecting the Developmental Characteristics in Reading in Children on a White vs. Colored Background/Colored Overlays.
- This study investigated the influence of white vs. 12 background and overlay colors on the reading process in twenty-four school-age children. Previous research reported that colors could affect reading skills as an important factor in the emotional and physiological state of the body. The aim of the study was to assess developmental differences between second and third grade students of an elementary school, and to evaluate differences in electroencephalography (EEG), ocular, electrodermal activities (EDA) and heart rate variability (HRV). Our findings showed a decreasing trend with age regarding EEG power bands (Alpha, Beta, Delta, Theta) and lower scores of reading duration and eye-tracking measures in younger children compared to older children. As shown in the results, HRV parameters showed higher scores in 12 background and overlay colors among second than third grade students, which is linearly correlated to the level of stress and is readable from EDA measures as well. Our study showed the calming effect on second graders of turquoise and blue background colors. Considering other colors separately for each parameter, we assumed that there are no systematic differences in reading duration, EEG power band, eye-tracking and EDA measures.

42) PMID: 33430177 DOI: children8010028 target=_blank>10.3390/children8010028
% 2021 Children (Basel, Switzerland)
* The Epidemiological and Clinical Findings from the Latvian Registry of Primary Congenital Glaucoma and Evaluation of Prognostic Factors.
- Background and objectives: primary congenital glaucoma (PCG) is a rare, potentially blinding disease that affects children worldwide. The aim of the study was to describe the epidemiological and clinical characteristics, outcomes for newly diagnosed patients with PCG, as well as evaluate the prognostic factors that are related to the outcomes. Materials and Methods: a retrospective cohort study was conducted at a tertiary referral centre among patients diagnosed with PCG. Evaluation of the clinical data was performed preoperatively at three, six, and 12 months after the surgery and at the last follow-up. Results: during the 15 years of follow-ups, 24 eyes of 18 patients were diagnosed with PCG. Unilateral and bilateral PCG constituted 50% of cases each. A slight male predominance was observed (55.6% vs. 44.4%), with a relative risk of 1.3. The incidence of PCG was 1:19,033 live births. The mean age of the patients at the time of diagnosis was 10.1 ± 10.0 months, with a diagnostic delay of 2.0 ± 1.9 months. Furthermore, 75% of patients indicated an enlargement of an eyeball, followed by excessive tearing (58.3%) and corneal opacity (41.7%). After 85.9 ± 51.2 months, the mean intraocular pressure (IOP) value was 14.6 ± 4.9 mmHg. Surgical treatment provided sufficient IOP control in 75% of PCG cases at the last follow-up visit. The only prognostic factor that was related to the outcome of IOP control that was statistically significant was axial length at the time of diagnosis. Conclusions: the incidence of PCG in Latvia was 5.3 patients per 100,000 live births. PCG was more common among males than females with a relative risk of 1.3. The enlargement of an eyeball was the leading clinical sign.

43) PMID: 33430702 DOI: 10.1080/19490976.2020.1865708
% 2021 Gut microbes
* Microbial and metabolic features associated with outcome of infliximab therapy in pediatric Crohn's disease.
- Gut microbial dysbiosis and altered metabonomics have been implicated in the pathogenesis of Crohn's disease (CD). The aim of our study was to characterize the gut microbiome structure and metabolic activities in pediatric CD patients with different clinical outcomes after infliximab (IFX) therapy. Fecal samples were collected from 20 healthy children and 29 newly diagnosed pediatric CD patients. 16S rRNA/ITS2 gene sequencing and targeted metabolomics analysis were applied to profile the gut bacterial microbiome, mycobiome, and metabolome, respectively. Pediatric CD patients exhibited lower relative abundances of short-chain fatty acids (SCFAs)-producing bacteria including Faecalibacterium, Clostridium clusters IV and XIVb, Roseburia, and Ruminococcus, which were correlated with reduced fecal levels of SCFAs. Decreased unconjugated bile acids (BAs) pool size and a lower unconjugated/conjugated BAs ratio were associated with reduced relative abundances of Bifidobacterium and Clostridium clusters IV and XIVb which contain bile salt hydrolases (BSH) genes. IFX treatment enriched the BSH-producing bacteria in CD subjects, which may explain a decreased level of conjugated BAs and an increase in unconjugated BAs as well as the unconjugated/conjugated BAs ratio. Furthermore, a sustained response (SR) of IFX therapy was associated with higher abundances of Methylobacterium, Sphingomonas, Staphylococcus, and Streptococcus, and higher fecal concentrations of amino acids, including L-aspartic acid, linoleic acid, and L-lactic acid at baseline. Our study suggests that the effects of IFX might be partially mediated by enriching bacteria taxa that producing SCFAs and BSH thereby inhibiting inflammation and restoring the BA metabolism. Some fecal bacteria and metabolites may be predictive of outcomes of IFX therapy for pediatric CD patients.

44) PMID: 33432830 DOI: 10.1080/01635581.2020.1869275
% 2021 Nutrition and cancer
* The Effect of Nutritional Support on the Disease Progression and Survival in Pediatric Patients with Solid Tumors.
- Cancer is one of the leading causes of death for children; however, appropriate nutritional status can positively affect survival. The aim of this study was to determine to what extent malnutrition risk screening and intensified nutrition support, provided by a professional team, promoted disease progression and survival in pediatric patients with solid tumors. 145 pediatric cancer patients (average age 6.3 ± 5.6 and 6.7 ± 5.4 years) with solid tumors undergoing chemotherapy participated in the study. Two 3-year periods were studied: 2009-2011 and 2012-2014. Patient characteristics and treatment protocols were identical, but in Period 2, with the foundation of our nutrition support team malnutrition risk screening was made mandatory upon every hospital admission. As a result of intensified nutrition support the time from diagnosis to completion of treatment (802 vs. 512 day, p < 0.001) and the need for antimycotic treatment reduced significantly (47.8% vs. 29.1%, p = 0.036). The total percentage of surviving children was 60.3% and 75.0% in Period 1 and 2 respectively. Decrease in weight-for-height percentile during treatment and central nervous system tumors are significant predictors of a less favorable survival. Malnutrition risk screening and intensified nutrition therapy have positive effects on nutritional status and therefore patient survival in pediatric cancer patients.

45) PMID: 33432850 DOI: 10.1080/08820139.2020.1870489
% 2021 Immunological investigations
* Evaluation of IL1B rs1143634 and IL6 rs1800796 Polymorphisms with Autism Spectrum Disorder in the Turkish Children.
- Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder caused by genetic, environmental and immunological factors. It is known that neural development processes are affected by immune functions. The aim of this study is to evaluate the relationship between cytokines IL6 and IL1B gene polymorphisms in ASD. Methods: DNA isolations were performed in 95 children diagnosed with ASD and 84 unrelated healthy children, single-nucleotide changes in IL6 (rs1800796) and IL1B (rs1143634) genes were determined by using Real-Time PCR (Real-Time Polymerase Chain Reaction) method. Results: IL6 rs1800796 polymorphism presented an elevated risk for the development of ASD with CG genotype and dominant model (CG+GG vs. CC), CG+GG carriers (OR = 1.867, p = 0.057; OR = 1.847, p = 0.055, respectively). CT genotype in IL1B rs1143634 polymorphism associated with 2.33 times elevated risk of autism and showed a significant association compared to wild-type CC genotype (p = 0.02). IL1B rs1143634 polymorphism presented a significantly elevated risk for the development of ASD with recessive model (CC+CT vs.TT), TT genotype (OR = 8.145, p = 0.02). Conclusion: This study concludes that rs1143634 is associated with the risk of ASD in Turkish children. Determining these polymorphisms in a larger sample group may contribute to understanding the etiology of ASD and developing new treatment protocols. Abbreviations: ASD: Autism spectrum disorder; DNA: Deoxyribonucleic acid; IL6: Interleukin 6; IL1B: Interleukin 1 beta; Real-time PCR: Real-time polymerase chain reaction; JAK-STAT: The Janus kinase/signal transducers and activators of transcription; MAPK: The mitogen-activated protein kinase; 5'UTR: The 5' untranslated region; IL1α: Interleukin 1 alpha; IL-1Ra: Interleukin 1 receptor antagonist; NF-κB: Nuclear factor-kappa B; DSM-V: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; M-CHAT: Modified Checklist for Autism in Toddlers; EDTA: Ethylenediaminetetraacetic acid; gDNA: Genomic DNA; HWE: Hardy-Weinberg equilibrium; ANK2: Ankyrin 2; NL3: Neuroligin-3; XRCC4: X-ray repair cross complementing 4.

46) PMID: 33433731 DOI: 10.1007/s00296-020-04766-3
% 2021 Rheumatology international
* Indian SLE Inception cohort for Research (INSPIRE): the design of a multi-institutional cohort.
- Systemic lupus erythematosus (SLE) cohorts across the world have allowed better understanding of SLE, including its bimodal mortality, and the impact of social factors and ethnicity on outcomes. The representation of patients from South Asia has been poor in the existing SLE cohorts across the world. Hence, we planned to initiate an inception cohort to understand the diversity of lupus in India. Indian SLE Inception cohort for REsearch (INSPIRE), planned over 5 years is a multi-centric cohort of adult and childhood lupus patients of Indian origin, fulfilling the SLICC-2012 classification criteria, with an aim to provide cross-sectional information on demography, ethnicity, socio-economic status, standard disease variables, quality of life, and prospective information on new events like hospitalization, infections, pregnancies, changes in disease activity, and damage. One of the other deliverables of this project is the establishment of a biorepository. The instruments to be used for each variable and outcome were finalized, and a web-enabled case report form was prepared to encompass SLEDAI, BILAG, SLICC damage scores, and Lupus quality-of-life index.Ten centers located in different geographic areas of India would enroll patients who are seen for the first time after the start of the study. In the first 8 months, 476 patients (63 children, 36 males) have been enrolled with a median disease duration of 10 (IQR 4-17) months and mucocutaneous features being the most prevalent clinical manifestations. INSPIRE is the first prospective Indian SLE cohort to study the diversity of Indian patients.

47) PMID: 33433850 DOI: 10.1007/s12031-021-01790-1
% 2021 Journal of molecular neuroscience : MN
* Impaired Thiol/Disulfide Homeostasis in Children Diagnosed with Autism: A Case-Control Study.
- Although genetic factors occupy an important place in the development of autism spectrum disorder (ASD), oxidative stress and exposure to environmental toxicants have also been linked to the condition. The aim of this study was to examine dynamic thiol/disulfide homeostasis in children diagnosed with ASD. Forty-eight children aged 3-12 years diagnosed with ASD and 40 age- and sex-matched healthy children were included in the study. A sociodemographic data form was completed for all the cases, and the Childhood Autism Rating Scale (CARS) was applied to the patients. Thiol/disulfide parameters in serum were measured in all cases and compared between the two groups. Mean native thiol, total thiol concentrations (μmol/L), and median reduced thiol ratios were significantly lower in the ASD group than in the control group (p = 0.001 for all). Median disulfide concentrations (μmol/L), redox potential, and median oxidized thiol ratios were significantly higher in the ASD group than in the control group (p = 0.001, p = 0.001, and p = 0.001, respectively). ROC analysis revealed that area under the curve (AUC) values with "excellent discriminatory potential," for native thiol, total thiol, the reduced thiol ration, the oxidized thiol ratio, and redox potential and with "acceptable discriminatory potential" for disulfide were significantly capable of differentiating individuals with ASD from healthy individuals. No correlation was determined between the severity of autism and laboratory parameters. Impaired dynamic thiol/disulfide homeostasis was observed in children with ASD, suggesting that dynamic thiol/disulfide homeostasis in serum may be of diagnostic value in autism.

48) PMID: 29294892 DOI: 10.1177/0886260517726973
% 2021 Journal of interpersonal violence
* Factors Associated With Child Maltreatment Among Children Aged 11 to 17 Years in Community Settings of Karachi, Pakistan, Using Belsky Ecological Framework.
- Child maltreatment is considered as a global social issue and results as combined effect of parental background, socioeconomic environment, family structure, and child characteristics. The aim of this study was to determine factors associated with child maltreatment among children aged 11 to 17 years in Karachi, Pakistan. A cross-sectional survey of 800 pairs (children ranging from 11 to 17 years old and their parents) was randomly selected from 32 clusters of Karachi, using multistage cluster sampling. A structured questionnaire was adopted from the International Society for the Prevention of Child Abuse and Neglect (International Child Abuse Screening Tool for Parent [ICAST-P] and for Child [ICAST-C]). Multiple linear regression technique was used to assess the association of factors with child maltreatment score, by using STATA software. Our study found that children who always get bullied and mistreated by their siblings are at increased risk of getting maltreatment by parents (adjusted β: 10.78, 95% CI = [8.5, 13.05]).The mean estimated ICAST-C score increases by 9.86 (95% CI = [6.17, 13.55]) for children with exposure of verbal abuse and quarrel within family members. The mean estimated ICAST-C score increases by 5.09 among male children as compared with female children (95% CI = [3.65, 6.52]). Among children whose family always fight with each other and whose parents have exposure to childhood maltreatment, the mean estimated ICAST-C score increases by 22.25 (95% CI = [16.53, 27.98]). This study reflects the potential factors of child maltreatment in Karachi. Our findings provide evidence to raise awareness about child maltreatment.

49) PMID: 29294914 DOI: 10.1177/0886260517731313
% 2021 Journal of interpersonal violence
* Childhood Trauma, Gender Inequitable Attitudes, Alcohol Use and Multiple Sexual Partners: Correlates of Intimate Partner Violence in Northern Tanzania.
- Intimate partner violence (IPV), including physical, sexual, emotional, and economic violence, has profound immediate and long-term effects on individuals and communities worldwide. To date, few studies have focused on couples' reporting of IPV. The aim of this article is to present the results of a survey of couples' reporting of IPV and the individual, interpersonal, and social correlates of IPV in northern Tanzania. Four hundred fifty couples from Karatu District, Tanzania, completed a questionnaire measuring attitudes on gender norms and relations, men's experience of childhood trauma, and men's perpetration and women's experience of IPV. We found high levels of acceptance and experience of IPV: 72% of men justified a husband's perpetration of IPV, and 54% of men and 76% of women said that a woman should tolerate violence to keep her family together. The majority of women had ever experienced IPV (77.8%), and 73.6% and 69% had experienced IPV in the past 12 and 3 months, respectively. Men were significantly less likely to report that they had committed IPV: 63.6% ever, 48.9% in the past 12 months, and 46.2% in the past 3 months. Multivariate logistic regression found that younger men, men who reported gender inequitable attitudes, childhood trauma, multiple sexual partners, and alcohol use were significantly more likely to report IPV perpetration in the past 3 months. Younger women, and women with low levels of education and reported food shortages were significantly more likely to report IPV in the past 3 months. These results indicate that social and individual acceptance and justification of IPV are common. Experience of violence persists over time in many relationships. This study demonstrates the need for interventions that address individual-, interpersonal-, and community-level determinants of IPV, including attitudes regarding gender equity, exposure to violence as children and intergenerational violence, lack of education, and poverty.

50) PMID: 29294925 DOI: 10.1177/0886260517731787
% 2021 Journal of interpersonal violence
* Parental Concerns About Students' Transition Into College: Substance Use and Sexual Assault.
- Parents play an important role in the development of their college-bound children, including engagement in risk behaviors and associated consequences. Still, few studies have investigated parental concerns about their children's transition into college. The aim of this study was to describe parental concerns about substance use and sexual assault and to test differences between parents of sons and parents of daughters in their levels of concern and communication. Data are from 450 parents of incoming students to a large, midwestern university. Parents responded to questions regarding their concerns about substance use and sexual assault. Results found that parents of sons are more concerned about substance use while parents of daughters are more concerned about sexual assault. Parents of daughters also communicate more about sexual assault than parents of sons. Finally, there was a positive relationship between relationship quality and communication about sexual assault. Implications for future research and the development of parent-based prevention are explored.

51) PMID: 31032681 DOI: 10.1080/14767058.2019.1613365
% 2021 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
* Fetal heart rhabdomyomatosis: a single-center experience.
- Objectives: The primary aim of the study was to evaluate the prevalence of fetal heart tumors in a single tertiary referral center over a period of 15 years. The secondary aim was to confirm the presence of tuberous sclerosis complex (TSC) through the evaluation of germline mutation in TSC1/TSC2 and assess the outcomes in affected fetuses and newborns.Methods: A retrospective study was conducted between 2003 and 2017. Fetal echocardiography was performed in the second trimester of pregnancy in the study population. The identification of heart tumors and further follow-up were performed by a pediatric cardiologist. Molecular genetic analysis was conducted on fetuses and children in cases where TSC was suspected.Results: In total, 39,018 fetuses were examined between 2003 and 2017. Heart tumors were detected in nine fetuses and were diagnosed as rhabdomyoma in all cases. We identified mutations in one of the TSC1 or TSC2 genes in all cases with multiple rhabdomyomas (8/9). In all born children (5/9), the genetically confirmed diagnosis of TSC was established, and clinically pathological deposits in the brain were found.Conclusion: Fetal heart tumors are usually represented by rhabdomyomas having a good cardiac prognosis. However, rhabdomyoma is usually the first symptom of TSC with a subsequent brain disorder and impaired neurological development.

52) PMID: 33435327 DOI: 10.3390/ijerph18020490
% 2021 International journal of environmental research and public health
* Secular Trends in Height, Body Mass and Mean Menarche Age in Romanian Children and Adolescents, 1936-2016.
- Secular trends in anthropometric parameters have been documented in most European countries, but no data is available regarding Romanian. The aim of the study was to calculate secular trend in height, body mass and mean menarche age for Romanian children and adolescents.

53) PMID: 33435420 DOI: 10.3390/medicina57010056
% 2021 Medicina (Kaunas, Lithuania)
* Evaluation of the Diagnostic Value of Contrast-Enhanced Voiding Urosonography with Regard to the Further Therapy Regime and Patient Outcome-A Single-Center Experience in an Interdisciplinary Uroradiological Setting.
- Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1-2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.

54) PMID: 33435453 DOI: 10.3390/nu13010190
% 2021 Nutrients
* Quantification of Accidental Gluten Contamination in the Diet of Children with Treated Celiac Disease.
- A strict gluten-free diet is extremely difficult to maintain. Protracted ingestion of gluten traces (>10 mg/day) is sufficient to cause significant damage in the architecture of the small intestinal mucosa in patients on treatment for celiac disease. The aim of this study was to directly measure the level of contaminating gluten in the daily diet of celiac children following a gluten-free diet. From April 2019 to December 2019, celiac disease children (2-18 years old) on a gluten-free diet for ≥6 months were offered to participate in this prospective-observational study. Patients and their caregivers were invited to provide a representative portion (about 10 g) of all meals consumed during a 24-h period. Participants were requested to weigh all ingested food and report items in a 24-h food diary. The gluten content was quantified by the R5 sandwich enzyme-linked immunosorbent assay method. Sixty-nine children completed the protocol. Overall, 12/448 (2.7%) food samples contained detectable amounts of gluten; of them, 11 contained 5-20 ppm and 1 >20 ppm. The 12 contaminated food samples belonged to 5/69 enrolled patients. In these 5 children, the daily gluten intake was well below the safety threshold of 10 mg/day. The present findings suggest that in a country characterized by high celiac disease awareness, the daily unintended exposure to gluten of treated celiac children on regular follow-up is very low; reassuringly, the presence of gluten traces did not lead to exceed the tolerable threshold of 10 mg/day of gluten intake in the gluten-free diet.

55) PMID: 33435555 DOI: 10.3390/molecules26020301
% 2021 Molecules (Basel, Switzerland)
* Investigation of the Physical, Chemical and Microbiological Stability of Losartan Potassium 5 mg/mL Extemporaneous Oral Liquid Suspension.
- Extemporaneous oral liquid preparations are commonly used when there is no commercially available dosage form for adjustable dosing. In most cases, there is a lack of stability data to allow for an accurately assigned shelf life and storage conditions to give greater confidence of product safety and efficacy over its shelf life. The aim of this study was to evaluate the physical, chemical and microbiological stability of an extemporaneous oral liquid suspension of losartan potassium, 5 mg/mL, used to treat paediatric hypertension in Our Lady's Children's Hospital Crumlin, Ireland. The losartan content of extemporaneous oral suspensions, prepared with and without addition of water, was measured by UV and confirmed by HPLC analysis. Suspensions were stored at 4 °C and room temperature (RT) and were monitored for changes in; pH, colour, odour, re-dispersibility, Total Aerobic Microbial Count, Total Yeast and Mould Count and absence of E. coli. Results showed that suspensions prepared by both methods, stored at 4 °C and RT, were physically and microbiologically stable over 28 days. Initial losartan content of all suspensions was lower than expected at 80-81% and did not change significantly over the 28 days. HPLC and NMR did not detect degradation of losartan in the samples. Suspensions prepared in water showed 100% losartan content. The reduced initial losartan content was confirmed by HPLC and was related to the acidic pH of the suspension vehicle. Physiochemical properties of the drug are important factors for consideration in the selection of suspension vehicle for extemporaneous compounding of oral suspensions as they can influence the quality, homogeneity and efficacy of these preparations.

56) PMID: 33435836 DOI: 10.1177/1539449220985903
% 2021 OTJR : occupation, participation and health
* Imbuing Occupations with Spiritual Significance Fosters Experiences of Hope.
- In theories of occupational therapy, occupation serves as a conduit for creating meaning and well-being. A crucial component of occupational therapy is developing and maintaining hope of clients during periods of major difficulty. Understanding the relationship between hope and occupation can prove helpful in stressful situations, such as caring for children with chronic illnesses. The aim of the present study was to identify occupations that foster experiences of hope among mothers of adult children with mental illness. A qualitative approach, informed by a constructivist framework and thematic analysis, was used to interpret and explicate relevant occupation-related themes that fostered hope in four mothers. The mother-participants reported engaging in various occupations, yet only occupations that were imbued with spiritual significance fostered experiences of hope. This study brings to the forefront of occupational therapy discourse the issue of spiritual connectedness as a potential link between occupations and hope.

57) PMID: 33438514 DOI: 10.1177/1059840520986746
% 2021 The Journal of school nursing : the official publication of the National Association of School Nurses
* Needs Assessment for Eosinophilic Esophagitis Education in School Nurses.
- Over the past 2 decades, eosinophilic esophagitis (EoE) has become increasingly recognized as a common cause of gastrointestinal morbidity in children. A mainstay of treatment is food avoidance, which must be implemented in both the home and school settings for school-aged children. The aim of this study is to assess school nurses' familiarity with EoE with regard to food avoidance and treatment in the school setting. We conducted a 19-question online survey of 60 school nurses (elementary through high school) recruited from Dauphin, Lebanon, and Lancaster Counties in Pennsylvania. Results indicated that 62% of respondents were familiar with EoE. However, only 22% felt comfortable distinguishing between symptoms of EoE and food-dependent anaphylaxis. Almost all respondents (97%) were interested in learning more about EoE. We report significantly increased familiarity with food-dependent anaphylaxis in comparison with EoE among school nurses. There is an interest and need for increasing education on EoE.

58) PMID: 33439864 DOI: 10.1371/journal.pone.0223160
% 2021 PloS one
* An examination of perseverative errors and cognitive flexibility in autism.
- Perseveration is a well-replicated finding in autism. The aim of this study was to examine how the context of the task influences performance with respect to this phenomenon. We randomly assigned 137 children aged 6-12 with and without autism to complete a modified card-sorting task under one of two conditions: Children were either told the sorting rules on each trial (Explicit), or were given feedback to formulate the rules themselves (Implicit). While performance was enhanced on the Explicit condition for participants without autism, the participants with autism were disadvantaged by this manipulation. In contrast, there were few differences in performance between groups on the Implicit condition. Exploratory analyses were used to examine this unexpected result; increased autism symptomology was associated with poorer performance.

59) PMID: 33441200 DOI: 10.1017/S2040174420001385
% 2021 Journal of developmental origins of health and disease
* High-fructose diet during puberty alters the sperm parameters, testosterone concentration, and histopathology of testes and epididymis in adult Wistar rats.
- The consumption of fructose has increased in children and adolescents and is partially responsible for the high incidence of metabolic diseases. The lifestyle during postnatal development can result in altered metabolic programming, thereby impairing the reproductive system and fertility during adulthood. Therefore, the aim of this study was to evaluate the effect of a high-fructose diet in the male reproductive system of pubertal and adult rats. Male Wistar rats (30 d old) were assigned to four different groups: Fr30, which received fructose (20%) in water for 30 d and were euthanized at postnatal day (PND) 60; Re-Fr30, which received fructose (20%) for 30 d and were euthanized at PND 120; and two control groups C30 and Re-C30, which received water ad libitum and were euthanized at PND 60 and 120, respectively. Fructose induced an increase in abnormal seminiferous tubules with epithelial vacuoles, degeneration, and immature cells in the lumen. Moreover, Fr30 rats showed altered spermatogenesis and daily sperm production (DSP), as well as increased serum testosterone concentrations. After discontinuing high-fructose consumption, DSP and sperm number decreased significantly. We observed tissue remodeling in the epididymis, with a reduction in stromal and epithelial compartments that might have influenced sperm motility. Therefore, we concluded that fructose intake in peripubertal rats led to changes in the reproductive system observed both during puberty and adulthood.

60) PMID: 33444693 DOI: 10.1016/j.bbr.2021.113131
% 2021 Behavioural brain research
* Interactive effects of DRD2 rs6277 polymorphism, environment and sex on impulsivity in a population-representative study.
- Previous research has shown that dopaminergic dysregulation and early life stress interact to impact on aspects of impulse control. This study aimed to explore the potentially interactive effects of the rs6277 polymorphism of the dopamine D2 receptor gene (DRD2), stressful or supportive environment and sex on behavioural and self-reported measures of impulsivity, as well as alcohol use - a condition characterised by a deficit in impulse control. The sample consisted of the younger cohort (n = 583) of the longitudinal Estonian Children Personality, Behaviour and Health Study. The results showed that the CC homozygotes (suggested to have decreased striatal D2 receptor availability) who had experienced stressful life events (SLE) or maltreatment in the family prior to age 15 showed higher self-reported maladaptive impulsivity at age 15. The genotype-SLE interaction and further association with sex was also evident in the frequency of alcohol use at age 15. Lack of warmth in the family contributed to significantly higher levels of thoughtlessness and more frequent alcohol use in CC carriers at age 25, whereas family support was associated with lower thoughtlessness scores in CC males, which may suggest a protective effect of supportive family environment in this group. Together the findings suggest that DRD2 rs6277 polymorphism, in interaction with environmental factors experienced in childhood and youth may affect facets of impulsivity. Future work should aim to further clarify the sex and age-specific effects of stressful and supportive environment on the development of neuronal systems that are compromised in disorders characterised by deficits in impulse control.

61) PMID: 33447893 DOI: 10.1007/s00431-020-03913-z
% 2021 European journal of pediatrics
* Frequency of syncope as a presenting symptom in channelopathies diagnosed in childhood. Can the multivariable EGSYS score unmask these children?
- Pediatric syncope raises cardiac etiology concern as it might be the first sign of life-threatening arrhythmia syndromes. Our aim was to study the incidence of syncope as the presenting symptom in children with arrhythmia syndromes, and if known, warning signs are helpful to reveal the arrhythmic origin. All data on children with channelopathy was followed by a tertiary pediatric cardiac center between 2000 and 2018 and data were reviewed retrospectively. Forty-eight patients were enrolled, representing long QT syndrome (n = 39), catecholaminergic polymorphic ventricular tachycardia (n = 5), and Brugada syndrome (n = 4). Presenting symptoms were syncope in 13 cases [27%] (including 7 initially mislabeled as epilepsy) and sudden cardiac arrest (SCA) in 9 cases [19%]. In the rest of the group, the concern for arrhythmic etiology was raised by either an abnormal ECG during sports medicine screening (n = 13) [27%] or a positive family history of channelopathy (n = 13) [27%]. None of the patients presenting with SCA had a prior syncopal history. Six patients presenting with syncope and afterward treated with ICD had an appropriate shock. Description of witnessed syncope was available in eight out of thirteen children presenting with syncope. Multivariable EGSYS score suggested cardiac origin (≥ 3 points) in 7 out of 8 (88%) patients.Conclusions: Syncope was a relatively uncommon presenting symptom of channelopathies in this sample and did not always precede sudden cardiac arrests. However, we found that multivariable EGSYS score can identify syncope of arrhythmic origin, raising suspicion for pediatric channelopathies even in patients previously misdiagnosed with epilepsy. What is known: • Cardiac syncope is rare in children but can be the first sign of a potentially fatal primary arrhythmia syndrome and is frequently misdiagnosed as atypical/therapy-resistant epilepsy. • Multivariate EGSYS score is effective to diagnose cardiac syncope in adults. What is new: • Cardiac syncope as a presenting symptom is not common in children with cardiac channelopathies and is not often present before sudden cardiac arrest. • Multivariable EGSYS score might identify cardiac syncope in children with a hereditary and secondary channelopathy.

62) PMID: 33448897 DOI: 10.1080/15374416.2020.1846541
% 2021 Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
* Effects of the KiVa Anti-Bullying Program on Affective and Cognitive Empathy in Children and Adolescents.
- Objective: As empathy is an important predictor of both bullying and defending behavior, many anti-bullying interventions aim to increase empathy among students. However, little is known on whether these interventions enhance both affective and cognitive empathy, and whether some students are more responsive than others to empathy-raising efforts. This study examined the effects of the Finnish anti-bullying program KiVa on changes in self-reported affective and cognitive empathy and tested whether these effects varied depending on students' gender, initial levels of empathy, peer-reported bullying, and peer-perceived popularity, as well as school type (primary versus secondary school) and classroom bullying norms. Method: Multilevel structural equation modeling analyses were conducted on pretest and posttest (1 year later) data from a sample of 15,403 children and adolescents (Mage = 13.4; 51.5% girls) in 399 control and 462 intervention classrooms from 140 schools participating in the evaluation of KiVa in 2007-2009. Results: KiVa had a positive effect on affective empathy, but not cognitive empathy. The effects of the program on both types of empathy did not depend on students' gender, initial levels of empathy, bullying, or popularity, nor on school type or classroom bullying norms. Conclusion: Findings suggest that KiVa can raise students' affective empathy regardless of students' gender, status, initial empathy, or levels of bullying, and regardless of school type or classroom bullying norms.

63) PMID: 33449220 DOI: 10.1007/s00431-020-03920-0
% 2021 European journal of pediatrics
* The "price-tag" of foot health in infancy and early childhood: a cross sectional survey of UK parents.
- Children's feet are complex structures and strategies for supporting good foot health throughout childhood can be challenging. Greater awareness of the contemporary factors influencing decisions, such as footwear purchases, is needed to inform health narratives which are more closely aligned to parents' attitude and behaviours. The aim of this study was to explore parent's knowledge of children's foot health, understand the common foot health concerns and experiences with footcare services. A purposeful sampling approach was used to recruit parents of children aged 5 years and under. Participants completed a self-administered, online survey which consisted of 39 questions across six sections: (1) Participant demographics; (2) Developmental events (milestones such as crawling and walking); (3) Foot health concerns; (4) Developmental aids (products such as baby bouncers and baby walkers); (5) Footwear; and (6) Foot health information. Both adaptive and mandatory questions were used. Descriptive statistics were used to summarise closed-ended questions, and a summative content analysis was adopted to draw inferences from the text data. Two-hundred thirty-nine parents completed the survey, and this represented female participants (n = 213) aged between the ages 34-42 (n = 126) or 25-34 (n = 83) years of age. The survey generated responses from a wide geographical spread across the UK, but the majority of these were from the North West of England (n = 75) and South East of England (n = 46). Four main themes were drawn from the content analysis: (1) foot health concerns and seeking advice; (2) information and advice; (3) how parents support infant milestone events; and (4) footwear.Conclusion: This work provides insight into parents' perspective on the broad topics of children's foot health, identifying common experiences and concerns about their children's foot health and the factors which influence decision making. Understanding more about these issues will help health professionals support parents during infancy and early years. What is Known: • Maintaining good foot health throughout childhood is important and many factors influence decision making. • There is little understanding about how parents care for their children feet and their understanding of good foot health practices and services. What is New: • Insight into the common factors which influence parents' approaches to supporting early development and the typical concerns that parents encountered about their children's overall foot health and footwear. • Identifies areas of children's foot health for health professionals to target when developing information sources for parents.

64) PMID: 33450832 DOI: 10.3390/v13010100
% 2021 Viruses
* Molecular Epidemiology of Enterovirus in Children with Central Nervous System Infections.
- Limited recent molecular epidemiology data are available for pediatric Central Nervous System (CNS) infections in Europe. The aim of this study was to investigate the molecular epidemiology of enterovirus (EV) involved in CNS infections in children. Cerebrospinal fluid (CSF) from children (0-16 years) with suspected meningitis-encephalitis (ME) who were hospitalized in the largest pediatric hospital of Greece from October 2017 to September 2020 was initially tested for 14 common pathogens using the multiplex PCR FilmArray® ME Panel (FA-ME). CSF samples positive for EV, as well as pharyngeal swabs and stools of the same children, were further genotyped employing Sanger sequencing. Of the 330 children tested with FA-ME, 75 (22.7%) were positive for EV and 50 different CSF samples were available for genotyping. The median age of children with EV CNS infection was 2 months (IQR: 1-60) and 44/75 (58.7%) of them were male. There was a seasonal distribution of EV CNS infections, with most cases detected between June and September (38/75, 50.7%). EV genotyping was successfully processed in 84/104 samples: CSF (n = 45/50), pharyngeal swabs (n = 15/29) and stools (n = 24/25). Predominant EV genotypes were CV-B5 (16/45, 35.6%), E30 (10/45, 22.2%), E16 (6/45, 13.3%) and E11 (5/45, 11.1%). However, significant phylogenetic differences from previous described isolates were detected. No unusual neurologic manifestations were observed, and all children recovered without obvious acute sequelae. Specific EV circulating genotypes are causing a significant number of pediatric CNS infections. Phylogenetic analysis of these predominant genotypes found genetic differences from already described EV isolates.

65) PMID: 33450905 DOI: 10.3390/ijerph18020621
% 2021 International journal of environmental research and public health
* The Differential Heritability of Social Adjustment by Sex.
- Sex differences in social adjustment are frequently observed; however, there has been very little research on adaptability in the individual and social domains. The aim of this study was to investigate the sex difference in social abilities, such as high self-appeal, sociability, school adaptation, and home adaptation between school-age males and females. The sample for this study included both same-sex and opposite-sex twin pairs: a total of 467 twin pairs. We classified them into three groups: a group of those in lower classes of elementary school, a group of those in higher classes of elementary school, and a group of those in junior high school. The heritability of school adaptation was estimated to be 95% in males and 54% in females in the junior high school group. The full sex-limitation model showed a better fit in this group, and this means that a qualitative genetic difference exists. For school adaptation, there was no sex difference in lower elementary school classes; however, a quantitative difference appeared in higher classes of elementary school. Moreover, a qualitative difference appeared in junior high school. From this research, it became clear that sex differences in heritability exist for school adaptation, and there was a marked increase from the elementary school children to the junior high school children.

66) PMID: 33450955 DOI: 10.3390/ijerph18020616
% 2021 International journal of environmental research and public health
* Oral Health of Children from the SOS Children's Village in Croatia.
- The aim of this study was to determine the values of DMFT/DMFS and dft/dfs in the examined groups of children and the assessment of the mothers of the examined groups of children related to the oral health of their children. The research included children from the SOS Children's Village in Croatia as well as children from biological families from rural and urban areas. The children were examined by the visual-tactile method according to the standardized World Health Organization criteria. dft/DMFT and dfs/DMFS indices were calculated. An analysis of completed questionnaires was made. The children from the SOS Children's Village demonstrated the lowest mean values of the dft/dfs (2.42/3.31) and DMFT/DMFS (1.61/2.23) indices compared to children from rural and urban areas. The Kruskal-Wallis test showed a significant difference (p = 0.01) in SiC index values between the examined children. In the groups of children from the SOS Children's Village and from the rural area compared to the children from the urban area, oral hygiene was singled out as the most important factor in the analysis of the main components. An equally significant factor for all the respondents is the assessment of oral health and eating habits. The least significant factor for the group of children from the SOS Children's Village is socio-economic status, which is the most significant for the children from the urban area. The children from the SOS Children's village have the lowest dft/DMFT, dfs/DMFS, and SiC indices. The most important factor influencing oral health in the group of children from the SOS Children's Village that stands out is oral hygiene, and the least important is the socio-economic status. The assessment of oral health by the SOS mothers does not differ from the assessment of biological mothers of children from rural and urban areas.

67) PMID: 33451057 DOI: 10.3390/nu13010213
% 2021 Nutrients
* The Feasibility of the "Omega Kid" Study Protocol: A Double-Blind, Randomised, Placebo-Controlled Trial Investigating the Effect of Omega-3 Supplementation on Self-Regulation in Preschool-Aged Children.
- Self-regulation, the regulation of behaviour in early childhood, impacts children's success at school and is a predictor of health, wealth, and criminal outcomes in adulthood. Self-regulation may be optimised by dietary supplementation of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). The aim of the "Omega Kid" study is to investigate the feasibility of a protocol to investigate whether n-3 LCPUFA supplementation enhances self-regulation in preschool-aged children. The protocol assessed involved a double-blind, randomised, placebo-controlled trial of 12 weeks duration, with an intervention of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day (0.3 g EPA and 1.3 g DHA) in a microencapsulated powder compared to placebo. Children (n = 78; 40 boys and 38 girls) aged 3-5 years old were recruited and randomly allocated to the treatment (n = 39) or placebo group (n = 39). The HS-Omega-3 Index® served as a manipulation check on the delivery of either active (n-3 LCPUFAs) or placebo powders. Fifty-eight children (76%) completed the intervention (28-30 per group). Compliance to the study protocol was high, with 92% of children providing a finger-prick blood sample at baseline and high reported-adherence to the study intervention (88%). Results indicate that the protocol is feasible and may be employed in an adequately powered clinical trial to test the hypothesis that n-3 LCPUFA supplementation will improve the self-regulation of preschool-aged children.

68) PMID: 33452569 DOI: 10.1007/s00431-020-03923-x
% 2021 European journal of pediatrics
* Intracranial hemorrhage in primary immune thrombocytopenia (ITP): 20 years' experience in pediatrics.
- Incidence of intracranial hemorrhage (ICH) among children with primary immune thrombocytopenia (ITP) varies among different studies. We published data during the period of 1997-2007 of ICH in children with primary ITP, addressing risk factors and outcome. The aim of this study is to assess changes in incidence, risk factors, and outcome of ICH in children with ITP from last decade and to report the overall 20 years' experience. We compared 2008-2018 with the decade before it. Data of children with ITP and ICH during study period and ITP control cases were analyzed. Neurosurgical intervention and outcome were also reported. A total of 4340 children with primary ITP were evaluated. Twenty-five (0.63%) ICH events were reported over 2 decades. Head trauma, hematuria, and platelet counts < 10 × 109/L were the risk factors mostly associated with ICH. Overall mortality was 24%, and a further 28% had neurologic sequelae. Neurosurgical intervention was done in 12% of cases with good outcome.Conclusion: Persistent platelet counts < 10 × 109/L were a significant risk factor for ICH in both time periods, while head trauma and hematuria were more reported in the period of 2008-2018 as significant risk factors for ICH. Outcome was comparable in both periods. What is Known: • ICH is a rare complication of ITP; however, early recognition of risk factors and aggressive treatment might lead to complete recovery without sequalae. Platelet counts less than < 10 × 109/L are the main risk factor for ICH. Few studies reported other significant risk factors. What is New: • Hematuria and head trauma are significant risk factors for ICH in ITP, in addition to having a persistently low platelet count < 10 × 109/L. (more than 90 days in chronic ITP, 45 days in persistent and 21 days in acute ITP) • Combined treatment with IVIG and HDMP followed by platelet transfusion was associated with complete recovery without sequelae in almost 50% of patients.

69) PMID: 33453131 DOI: 10.1111/hsc.13269
% 2021 Health & social care in the community
* Comparison between attention and experiences of chronic complex patients: A multicentric study.
- The aim of this research is to explore and analyse the functional status and experiences of complex patients located at levels 3-4 of the risk pyramid of the chronic care model in primary care, within the hospital system of two regions in Spain. The design was a mixed design (COREQ). The participants were enrolled in programs for chronic complex patients and their caregivers. Sociodemographic variables were gathered, together with the following measures: the Barthel test, the Mini mental test, the Zarit questionnaire, the IEXPAC scale and the Braden scale. A semi-structured interview was conducted individually with patients in order to explore their experiences and narrative on the process of their illness and the support they had received. The sample comprised 206 chronic pluripathological patients, of whom 103 were from Cantabria and a further 103 were from Mallorca. The patient profile in both regions was very similar. There was an equal distribution across both gender and the patients were over 78 years old. They all had a basic (primary) education, an average income and required moderate physical dependence, receiving assistance primarily from their children. The qualitative analysis highlighted patients' awareness of the illness and their concern for the future, noting that, overall, patients were satisfied with the care provided by their caregivers and the health system. We can conclude that is the first multicentric study of these characteristics conducted in Spain, despite it being the country with the second largest ageing population in the world. It is important to test new organisational models with differentiating areas of advanced clinical practice in primary care, whereby both patients and their caregivers can be co-responsible within the care process.

70) PMID: 33453718 DOI: 10.1016/j.puhe.2020.11.014
% 2021 Physiological research
* Dynamic changes of high-sensitivity troponin T concentration during infancy: clinical implications.
- Cardiac troponin T determination plays a dominant role in diagnosis of myocardial pathologies. Despite generally accepted use of high-sensitive cardiac troponin T assays (hscTnT) and clearly defined cut-off limit in adults, the uncertainty persists in infants. The aim of this study was to assess plasmatic concentrations of hscTnT and describe sequential age-related dynamic changes of hscTnT in healthy infants and toddlers. Seventy-eight children (52 males/26 females) from Czech Republic aged 44 to 872 days (median, interquartile range 271; 126 to 486 days) were consecutively enrolled in the single-center, prospective observational study. Plasma concentrations of hscTnT were analyzed by the electrochemiluminescent method, age-related reference intervals were calculated using the polynominal regression model. Amongst the study population (n=78), the upper limit of hscTnT concentration defined as the 99th percentile was calculated. The 99th percentile with 95 % confidence interval at the end of 2nd, 3rd, 4th, 5th, 6th and 7th month of postnatal life were: 81 (40.6 to 63.6), 61 (36.0 to 55.3), 47 (31.9 to 48.3), 37 (28.1 to 42.3), 30 (24.7 to 37.2) and 25 (21.5 to 32.7) ng/l, respectively. Concentration of adults 99th percentile (14 ng/l) was achieved approximately at 1 year of postnatal life. Statistically significant negative correlation of hscTnT concentration with age (r=-0.81, p<0.001) was found. Significant gender differences were not found (p>0.07). The study revealed substantially increased reference intervals of hscTnT levels in infants when compared with adult population. Based on our preliminary results, the age-related interpretation of hscTnT plasmatic concentration is recommended.

71) PMID: 33455462 DOI: 10.1080/15402002.2021.1873785
% 2021 Behavioral sleep medicine
* Even a Mild Sleep Restriction Can Impact Daytime Functioning in Children with ADHD and Their Typically Developing Peers.
- Objectives/Background: Correlational studies show that short sleep is associated with negative daytime outcomes in school-aged children, but there are few experimental sleep manipulation studies to assess whether this is a causal relation. The aim of this study was to determine the impact of mild, cumulative sleep restriction on daytime functioning of typically developing (TD) children and children with attention-deficit/hyperactivity disorder (ADHD). Participants: A total of 36 school-aged children (n = 18 TD; n = 18 ADHD), aged 6-11 years participated. Methods: Children participated in two sleep conditions (order counter-balanced). The Restricted condition required a 1 h reduction of time in bed for one week, and the Controlled Typical condition was based on participant's average baseline sleep. At the end of each condition, participants attended the sleep lab for overnight polysomnography and daytime functioning assessments. Results: Children successfully reduced time in bed by ~1 h. Due to compensatory changes, total sleep time (TST) was reduced by only ~20 min, as children fell asleep faster and spent less time awake after sleep onset during the Restricted compared to Controlled Typical condition. Many daytime functions were not affected by this very mild sleep restriction, however, both groups showed significant changes in performance on an objective attention task and on a parent-rated emotional lability measure after six nights of minimal reductions in TST. There were no significant differences between groups. Conclusions: Results suggest that a very mild sleep restriction can affect children's attention and emotional regulation, even with evidence of compensatory sleep mechanisms.

72) PMID: 33456596 DOI: 10.25122/jml-2019-0084
% 2021 Journal of medicine and life
* Outcome of Children with Wilms' Tumor in Developing Countries.
- Wilms' tumor is the most common kidney tumor of childhood. The outcome of this malignant tumor has improved due to the improvement of therapeutic strategies. The most important factor in determining the prognosis of these patients is the histopathology subtype of the tumor; unfavorable histopathology is seen in only 11.5% of the patients, which accounts for 52% of deaths. Therefore, the aim of this study was to determine the outcome of children with Wilms' tumor referred to our hospital over a period of 10 years. This is a retrospective cohort study, and the target population included all patients with Wilms' tumor referred to Ali Asghar Hospital and were treated according to the National Wilms tumor study 4 (NWTS-4) protocol. All patients' data were extracted from the medical records of the department. Overall survival and event-free survival (EFS) were analyzed by the Kaplan Mayer method in the SPSS software, version 23. Fifty-two patients (24 male and 28 female patients) with Wilms' tumor were included. The mean age of the subjects was 40 months. The most common stage among boys and girls was stage II (23.08% and 28.85%, respectively). Our findings revealed that the overall five-year survival of patients was 87±5%; this figure was determined as 100% for boys and 76.8% ± 1.6 for girls (P = 0.018). Our findings show a dramatic improvement in the outcome of children with Wilms's tumor, and our results are comparable with other results from developed countries. Gender may be an independent prognostic factor of children with Wilms' tumor.

73) PMID: 33459586 DOI: 10.1099/jmm.0.001313
% 2021 Journal of medical microbiology
* Phenotypic and genetic characteristics of Streptococcus mutans isolates from site-specific dental plaque in China.
- Introduction. Streptococcus mutans is an important cariogenic microbe.Hypothesis/Gap Statement. The potential characteristics of S. mutans isolates from site-specific dental plaque are still not clear.Aim. This study aimed to investigate the phenotypic and genetic characteristics of S. mutans isolates from site-specific dental plaque in China.Methodology. We used S. mutans isolated from children with early-childhood caries (ECC) and caries-free children to compare the phenotypic and genetic characteristics of S. mutans from site-specific dental plaque samples. The ECC subjects presented two sites: a cavitated lesion and a sound surface. The caries-free subjects presented one sound surface. Growth pattern, biofilm, decrease in pH, extracellular polysaccharide, expression levels of virulence-related genes, multilocus sequence typing (MLST) and phylogenetic trees were evaluated among these three sites.Results. The phenotypes detected between the cavitated and sound surfaces of ECC children were similar. However, the capacity for biofilm formation, pH drop and expression levels of genes (gtfB and spaP) of S. mutans in the caries-free group were lower compared with those of the ECC group. We identified 44 new alleles and 77 new sequence types. More than 90 % of the children with ECC shared an identical sequence type. The distribution of sequence types among different subjects showed diversity, and child-to-child transmission was detected.Conclusions. This is the first report of MLST on site-specific dental plaques in a single subject, and indicates that S. mutans isolated from site-specific dental plaque of a single subject showed similar phenotypes as a result of the isolates were closely related.

74) PMID: 33459915 DOI: 10.1007/s10803-021-04874-4
% 2021 Journal of autism and developmental disorders
* High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study.
- The diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inventory were used to evaluate parents' depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depression. More than half the parents sought CAM interventions. Education level did not affect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents' burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be beneficial for the family unit as a whole.

75) PMID: 33460802 DOI: 10.1016/j.etap.2021.103585
% 2021 Environmental toxicology and pharmacology
* The Association Between Urinary BPA Levels and Medical Equipment Among Pediatric Intensive Care Patients.
- We aim to evaluate urinary total BPA (tBPA) levels and association with medical devices used on patients in pediatric intensive care units. This cross-sectional descriptive study included 117 critically ill children. Urinary tBPA levels were determined using high-performance liquid chromatography. General estimating equations with repeated measures analyzed the effect of interventions and devices on urinary BPA levels. A total of 292 urine samples taken from 117 child intensive care patients were studied. When age, sex, and body mass index-for age z-scores were controlled, cases having endotracheal intubation showed higher urinary tBPA levels (p = 0.003) and hemodialyzed patients had considerably higher urinary tBPA levels (p = 0.004). When confounding factors were controlled, cases using both multiple iv treatment and more than four medical devices showed higher urinary tBPA levels than their counterparts (p = 0.007 and p = 0.028, respectively). The use of certain medical devices and interventions could increase BPA exposure in pediatric intensive care patients.

76) PMID: 33461830 DOI: 10.1016/j.euroneuro.2021.01.003
% 2021 European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
* Maternal ADHD medication use during pregnancy and the risk of ADHD in children: Importance of genetic predispositions and impact of using a sibling analysis.
- Attention deficit with hyperactivity disorder (ADHD) medications in pregnancy would be associated with ADHD in children, however, estimates can be confounded by genetic predispositions and environmental factors related to the mother-child pair. We aim to quantify the risk of ADHD in children associated with ADHD medication exposures during pregnancy. A prospective cohort study and sibling analysis conducted within The Quebec Pregnancy/Child Cohort (QPC). All full-term singleton live births covered by the provincial prescription drug insurance in Quebec from 1998 to 2015 were included. ADHD medication exposure during pregnancy was defined according to trimester of use and class-specific medication. ADHD in children was defined as having at least one diagnosis or one prescription filled for an ADHD medication. Cox proportional hazards regression models were used to calculate crude and adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) in the overall cohort, the sub-cohort and the sibling analysis. Of 166,047 full-term singleton live births included, 25,454 (15.3%) had ADHD. In the overall cohort, maternal exposure to ADHD medication during pregnancy was associated with ADHD in children (aHR= 1.96, 95% CI 1.22-3.15). In the ADHD pregnant women sub-cohort (aHR= 1.56; 95% CI 0.93-2.62) and the sibling control analysis (aHR= 1.14; 95% CI 0.62-1.98), ADHD medications during pregnancy was not associated with an increased risk of ADHD in children. Our findings suggest that in utero exposure to ADHD medications was not associated with an increased risk of ADHD in children. This suggests that the association is due to genetic and/or family environmental factors.

77) PMID: 33461922 DOI: 10.1053/j.jfas.2019.03.020
% 2021 The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
* Arthroscopic Calcaneonavicular Coalition and Too-long Anterior Process of the Calcaneus Resection in Children.
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78) PMID: 33464368 DOI: 10.1007/s00431-021-03938-y
% 2021 European journal of pediatrics
* Mental health problems in children admitted with physical symptoms.
- The aim of the study was to investigate the burden of mental health problems in children and adolescents admitted to a pediatric ward with physical complaints. We conducted a retrospective study, considering all patients admitted to the pediatric ward of the IRCCS Burlo Garofolo, Trieste, Italy, between January 2015 and September 2016. We selected all patients, from 5 to 17 years old, who were admitted with physical complaints and were discharged with a diagnosis suggestive of a mental health problem: somatic symptom disorder, anxiety disorder, depressive disorder, factious disorders. For every patient, we collected demographic features, medical characteristics, health care services utilization, length of hospital stay, and after discharge referral. We selected 1456 patients; of these, 101 (6.9%) revealed a mental health problem. The median duration of symptoms was 5 months (IQR 1.5-12), and pain was the main reported symptom (69%). Of the 101 patients, 23 (23%) were affected by a previously documented chronic organic disease. Somatic symptom disorder was the most common diagnosis. In 69/78 patients (88%), a loss of social contacts emerged; 49/95 patients frequenting school (51%) had chronic school absenteeism in the previous school year.Conclusion: A considerable proportion of patients admitted to a pediatric ward with physical complaints have mental health problems. What is Known: • It has been suggested that mental health problems in children and adolescents are increasing and frequently burden on pediatric healthcare services, but how they impact on a general pediatric ward is not clear. What is New: • Among 1456 patients admitted to a general pediatric ward with physical symptoms, 101 patients (6.9%) had a mental health problem. Among them, pain was the most commonly reported symptom and somatic symptom disorder was the commonly reported diagnosis.

79) PMID: 33465005 DOI: 10.1089/jwh.2020.8671
% 2021 Journal of women's health (2002)
* Fertility and Reproductive Health in Women Physicians.
- Background: Our aim was to evaluate trends of childbearing during medical training, evaluate issues of infertility, and measure institutionalized barriers to childbearing among women physicians. Materials and Methods: Attendees of a national women physician's leadership conference (Brave Enough Women Physicians Continuing Medical Education Conference) were surveyed during the conference using Qualtrics© (2019 Qualtrics, Provo, UT), in September 2019. Survey data included demographics, training level, and medical specialty. Data related to reproductive health factors, pregnancy status and history, current number of children, medical history related to pregnancy, breastfeeding history, institutional family planning support, and use of previous fertility treatments were collected. Descriptive analyses were done using IBM SPSS v26.0. Results: Three hundred seventy-seven survey participants were included in the study. 10.6% of respondents reported at least one pregnancy during medical school, versus 78.8% as a practicing physician. Of the participants, 25.8% reported having taken off 1 month or less of clinical duties after giving birth, 39.4% reported that their job prevented breastfeeding for the desired length of time, and 52.2% reported significant workplace limitations to breastfeeding. Of them, 25.5% reported having had fertility issues in the past. Fertility drugs (72.9%) was the most common fertility treatment method used, followed by fertility tracking (54.2%). Demands of training (72.9%) and long work hours (61.5%) were the most cited factors in delaying having children as reported by women physicians. Conclusions: This study reported several barriers related to fertility, family planning, and reproductive health among women physicians. Our results highlight the need for a paradigm shift in fertility awareness and institutional support for childbearing during medical training, postgraduate training programs, and in practice for women in medicine.

80) PMID: 33465314 DOI: 10.1044/2020_LSHSS-20-00058
% 2021 Language, speech, and hearing services in schools
* The Influence of Quantitative Intervention Dosage on Oral Language Outcomes for Children With Developmental Language Disorder: A Systematic Review and Narrative Synthesis.
- Purpose The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes. Method This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3-18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool. Results Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated. Conclusions Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice. Supplemental Material https://doi.org/10.23641/asha.13570934.

81) PMID: 33466621 DOI: 10.3390/ijerph18020652
% 2021 International journal of environmental research and public health
* Insights into the Slow Uptake of Residential Lead Paint Remediation Funds: A Lancaster, Pennsylvania, Case Study.
- Lead poisoning is a preventable condition that continues to affect thousands of children each year. Given that local governments and municipalities are eligible to apply for federal funds to perform lead remediation in low-income family homes, we sought to understand how lead poisoning knowledge levels may affect the uptake of these funds. We recruited and conducted 28 in-depth, semi-structured interviews with community members from Lancaster County in the state of Pennsylvania in the USA. We audio-recorded and transcribed each interview, and analyzed each transcript for salient themes. The interviewed participants displayed a varying degree of knowledge about lead and lead poisoning. Most of the participants were unaware of the lead paint remediation funds. Participants learned about lead from various sources, such as social media, and personal experiences with lead poisoning appeared to enhance knowledge. Some participants assumed lead poisoning prevention would be addressed by other stakeholders if necessary, including healthcare professionals and landlords. The results of this study suggest that in order to increase the timely uptake of the remediation funds, community-based organizations should design interventions that aim to increase awareness and knowledge about lead poisoning and lead poisoning prevention. These interventions should be tailored for different audiences including community members, healthcare professionals, and landlords.

82) PMID: 33467193 DOI: 10.3390/ijerph18020743
% 2021 International journal of environmental research and public health
* The Appointment System Influences Uptake of Cataract Surgical Services in Rwanda.
- The aim of this study was to investigate barriers and enablers associated with the uptake of cataract surgery in Rwanda, where financial protection is almost universally available. This was a hospital-based cross-sectional study where potential participants were adults aged >18 years who accepted an appointment for cataract surgery during the study period (May-July 2019). Information was collected from hospital records and a semi-structured questionnaire was used for data collection. Of the 297 people with surgery appointments, 221 (74.4%) were recruited into the study, 126 (57.0%) of whom had attended their appointment. People more likely to attend their surgical appointment were literate, had fewer than 8 children, had poorer visual acuity, had access to a telephone in the family, received a specific date to attend their appointment, received a reminder, and reported no difficulties walking (95% significance level, p < 0.05). The most commonly reported barriers were insufficient information about the appointment (n = 40/68, 58.8%) and prohibitive indirect costs (n = 29/68, 42.6%). This study suggests that clear communication of appointment information and a subsequent reminder, together with additional support for people with limited mobility, are strategies that could improve uptake of cataract surgery in Rwanda.

83) PMID: 33467516 DOI: 10.3390/ijerph18020704
% 2021 International journal of environmental research and public health
* Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses.
- Background: Environmental health is a growing area of knowledge, continually increasing and updating the body of evidence linking the environment to human health. Aim: This study summarizes the epidemiological evidence on environmental risk factors from meta-analyses through an umbrella review. Methods: An umbrella review was conducted on meta-analyses of cohort, case-control, case-crossover, and time-series studies that evaluated the associations between environmental risk factors and health outcomes defined as incidence, prevalence, and mortality. The specific search strategy was designed in PubMed using free text and Medical Subject Headings (MeSH) terms related to risk factors, environment, health outcomes, observational studies, and meta-analysis. The search was limited to English, Spanish, and French published articles and studies on humans. The search was conducted on September 20, 2020. Risk factors were defined as any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or death. The environment was defined as the external elements and conditions that surround, influence, and affect a human organism or population's life and development. The environment definition included the physical environment such as nature, built environment, or pollution, but not the social environment. We excluded occupational exposures, microorganisms, water, sanitation and hygiene (WASH), behavioral risk factors, and no-natural disasters. Results: This umbrella review found 197 associations among 69 environmental exposures and 83 diseases and death causes reported in 103 publications. The environmental factors found in this review were air pollution, environmental tobacco smoke, heavy metals, chemicals, ambient temperature, noise, radiation, and urban residential surroundings. Among these, we identified 65 environmental exposures defined as risk factors and 4 environmental protective factors. In terms of study design, 57 included cohort and/or case-control studies, and 46 included time-series and/or case-crossover studies. In terms of the study population, 21 included children, and the rest included adult population and both sexes. In this review, the largest body of evidence was found in air pollution (91 associations among 14 air pollution definitions and 34 diseases and mortality diagnoses), followed by environmental tobacco smoke with 24 associations. Chemicals (including pesticides) were the third larger group of environmental exposures found among the meta-analyses included, with 19 associations. Conclusion: Environmental exposures are an important health determinant. This review provides an overview of an evolving research area and should be used as a complementary tool to understand the connections between the environment and human health. The evidence presented by this review should help to design public health interventions and the implementation of health in all policies approach aiming to improve populational health.

84) PMID: 33467587 DOI: 10.3390/nu13010236
% 2021 Nutrients
* Micronutrient Deficiencies and Anemia in Children with Inflammatory Bowel Disease.
- Children with inflammatory bowel disease (IBD) are at risk of developing nutrition deficiencies, particularly because of reduced intake, restrictive diets, malabsorption, and excessive nutrient loss. The aim of this study was to determine the prevalence and predictors of anemia and micronutrient deficiencies at diagnosis and one year follow up in children and adolescents with inflammatory bowel disease (IBD). Children and young adults diagnosed with IBD before the age of 17 years between 2012 and 2018 were included. Laboratory measurements including serum levels of iron, ferritin, zinc, vitamin D, vitamin A, vitamin E, selenium, copper, vitamin B12, and red blood cell (RBC) folate at diagnosis and one-year follow-up were documented as part of the Manitoba Longitudinal Pediatric Inflammatory Bowel Disease (MALPID) Cohort. A total of 165 patients with IBD were included, 87 (53%) with Crohn's disease (CD) and 78 (47%) with ulcerative colitis (UC). The prevalence of deficiencies in our cohort at diagnosis and one year follow-up, respectively, were iron (56% and 27%), ferritin (39% and 27%), zinc (10% and 6%), vitamin D (22% and 13%), vitamin A (25% and 25%), vitamin E (5% and 4%), selenium (10 and 7%), copper (17% and 27%), vitamin B12 (2% and 5%), and Red blood cell (RBC) folate (1% and 17%). Anemia was present in 57% and 25% at diagnosis and follow up respectively. In CD patients, age of diagnosis (15y-younger than 18y) was a predictor of moderate to severe anemia and albumin levels (<33 g/L) were protective against anemia. Many children with IBD suffer from anemia and micronutrient deficiencies at diagnosis and some fail to recover after one year despite being in clinical remission.

85) PMID: 33471545 DOI: 10.1021/jacs.0c12479
% 2021 Physiological research
* Cough reflex sensitivity and fractional exhaled nitric oxide in children with asthma.
- Individual studies have suggested the utility of fractional exhaled nitric oxide (FeNO) measurement in detecting cough-variant asthma and eosinophilic bronchitis in patients with chronic cough. The aim of this study was to clarify a correlation of cough reflex sensitivity and fractional exhaled nitric oxide in asthmatic children. 25 children with asthma and 15 controls were submitted to cough reflex sensitivity measurement - capsaicin aerosol in doubling concentrations (from 0.61 to 1250 micromol/l) was inhaled by a single breath method. Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Fractional exhaled nitric oxide (FeNO) measurement was included. Asthmatic children' (11 boys and 14 girls, mean age 9+/-1 years) and control group (unconfirmed diagnosis of asthma) (6 boys and 9 girls, mean age 8+/-1 years) were included into the study. FeNO vs. C2 in asthma (Spearman´s rank correlation: -0.146, p=0.49); FENO vs. C5 in asthma (Spearman´s rank correlation: -0.777, p=0.71). We found that there is no correlation between cough reflex sensitivity and fractional exhaled nitric oxide either in children with asthma or in the control group.

86) PMID: 33471546 DOI: 10.1021/jacs.0c12479
% 2021 Physiological research
* Relationship between cough reflex sensitivity and body mass index in children with chronic cough - a pilot study.
- Obesity is characterized by chronic, low-grade systemic inflammation. Obesity may also be associated with chronic cough. The aim of this pilot study was to clarify relation of cough reflex sensitivity and body mass index (BMI) in children with chronic cough. Altogether 41 children having symptoms of chronic cough were submitted to cough reflex sensitivity measurement. We assessed the relation of cough reflex sensitivity (CKR) due to BMI. Cough reflex sensitivity was defined as the lowest capsaicin concentration which evoked two (C2) or five (C5) coughs. Capsaicin aerosol in doubling concentrations (from 0.61 to 1250 micromol/l) was inhaled by a single breath method (KoKo DigiDoser; nSpire heath Inc, Louisville, CO, USA), modified by the addition of an inspiratory flow regulator valve (RIFR; nSpire heath Inc, Louisville, CO, USA). BMI was calculated. Pulmonary function was within normal range. Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Children (22 boys and 19 girls, mean age 6.8 years) cough reflex sensitivity (median, with the Inter-Quartile Range) for C2 was 19.5 (73.4) micromol/l; for C5 it was 78.1 (605.5) micromol/l. We have noticed statistically significant relation of the cough reflex sensitivity (C5) and body mass index (P<0.0001); however, the effect size was small, R2=0.03. Increase of body mass index in one unit is associated with -34.959 micromol/l decrease of C5. We did not find a statistically significant relation between C2 and BMI (P=0.41). The median value of CKR (C2) in boys is not statistically significantly different than the median value of CKR (C2) in girls (P-value 0.5). The median value of CKR (C5) in boys is not statistically significantly different than the median value of CKR (C5) in girls (P-value 0.5). Increase of body mass index in children suffering from chronic cough relates to decrease of cough reflex sensitivity (C5 value).

87) PMID: 33472097 DOI: 10.1016/j.infbeh.2020.101525
% 2021 Infant behavior & development
* Early vocabulary development: Relationships with prelinguistic skills and early social-emotional/behavioral problems and competencies.
- The aim of this longitudinal study was to investigate early vocabulary development and its relationships with prelinguistic communication skills and social-emotional/behavioral (SEB1) problems and competencies. The participants were 58 healthy Finnish-speaking children (30 girls, 28 boys). First, the concurrent relationships were investigated at the age of 18 months. Second, the relationships between prelinguistic communication skills and SEB problems and competencies at 18 months, and subsequent vocabulary scores at 24 and 30 months, were examined. Parental reports on early vocabulary (MacArthur Communicative Developmental Inventories; MCDI), prelinguistic communication skills (The Infant-Toddler Checklist of the Communication and Symbolic Behavior Scales Developmental Profile; ITC), SEB problems and competencies (Brief Infant-Toddler Social and Emotional Assessment; BITSEA) were gathered. Compared to boys, girls scored significantly higher on ITC Speech Composite at 18 months and expressive vocabulary measures at 18, 24, and 30 months. Vocabulary, as well as prelinguistic communication measures, correlated with SEB competencies at 18 months. Furthermore, vocabulary, as well as ITC Symbolic Composite and Total Score, correlated negatively with externalizing problem and SEB Total Problem scores. With regard to subsequent vocabulary development, all of the prelinguistic communication measures at 18 months correlated with vocabulary at 24 and 30 months. However, when accounted for gender and earlier vocabulary, only the associations with ITC Speech Composite and Total Score at 24 months remained significant. SEB Competencies at 18 months correlated positively, while externalizing problems at 18 months correlated negatively with vocabulary at 24 and 30 months, however, these associations did not remain significant, when accounted for gender and earlier vocabulary.

88) PMID: 33475889 DOI: 10.1007/s11010-020-04042-9
% 2021 Molecular and cellular biochemistry
* Expression of lncRNA CCAT2 in children with neuroblastoma and its effect on cancer cell growth.
- The aim of this study was to determine the expression of long-chain non-coding RNA (lncRNA) colon cancer-associated transcript 2 (CCAT2) in children with neuroblastoma and its effect on cancer cell growth. A polymerase chain reaction assay was carried out to quantify lncRNA CCAT2 miRNA in neuroblastoma cells, corresponding paracancerous cells, SH-SY5Y and SK-N-SH cells, and human umbilical vein endothelial cells (HUVEC), and two groups of children with different lncRNA CCAT2 expression were compared in clinical pathological parameters and prognosis. CCAT2-NC and si-CCAT2 were transfected into SH-SY5Y cells, separately. Then a 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay was carried out to analyze the cell proliferation, migration, and invasion ability, a flow cytometry to detect cell apoptosis, and a Western blotting (WB) assay to quantify p53 and Bcl-2 proteins. lncRNA CCAT2 expression in cancer tissues of children with neuroblastoma was notably higher than that in corresponding paracancerous tissues (P < 0.05), and children with different tissue differentiation, tumor staging, and lymph node metastasis (LNM) showed notably different lncRNA CCAT2 expression (P < 0.05). In addition, children with neuroblastoma in the high lncRNA CCAT2 expression group showed lower 3-year survival rate than those in the low expression group (P < 0.05). Multivariate analysis revealed that tissue differentiation, tumor-node-metastasis staging, LNM, and lncRNA CCAT2 expression were all independent risk factors affecting the prognosis of children with neuroblastoma (all P < 0.05). Compared with HUVEC cells, SH-SY5Y and SK-N-SH cells showed notably up-regulated lncRNA CCAT2, and the expression of it in SH-SY5Y was higher than that in SK-N-SH cells (P < 0.05). Compared with the CCAT2-NC group, the si-CCAT2 group presented notably down-regulated CCAT2 (P < 0.05). Moreover, according to the MTT assay, the si-CCAT2 group showed notably weakened cell viability and proliferation than the CCAT2-NC group (both P < 0.05), and SH-SY5Y cells in the former group were less active than those in the latter group in terms of migration and invasion. The cell apoptosis rate of SH-SY5Y cells in the si-CCAT2 was higher than that in the CCAT2-NC. The results suggested that knock down of lncRNA CCAT2 could improve the apoptosis activity of neuroblastoma cells in children. According to the WB assay, the si-CCAT2 group showed notably higher p53 expression and notably lower Bcl-2 protein expression than the CCAT2-NC group (both P < 0.05). LncRNA CCAT2 can inhibit the proliferation of neuroblastoma cells and promote their apoptosis, which provides a basis for the treatment of neuroblastoma.

89) PMID: 33477251 DOI: 10.3390/ijerph18020747
% 2021 International journal of environmental research and public health
* Personal and Environmental Risk Factors at Birth and Hospital Admission: Direct and Vitamin D-Mediated Effects on Bronchiolitis Hospitalization in Italian Children.
- Seasonal variations in UV-B radiation may influence vitamin D status, and this, in turn, may influence the risk of bronchiolitis hospitalization. The aim of this study was using a causal inference approach to investigate, simultaneously, the interrelationships between personal and environmental risk factors at birth/hospital admission (RFBH), serum vitamin D levels and bronchiolitis hospitalization. A total of 63 children (<2 years old) hospitalized for bronchiolitis (34 RSV-positive) and 63 controls were consecutively enrolled (2014-2016). Vitamin D levels and some RFBH (birth season, birth weight, gestational age, gender, age, weight, hospitalization season) were recorded. The discovered RFBH effects on the risk ok bronchiolitis hospitalization were decomposed into direct and vitamin-D mediated ones through Mediation Analysis. Winter-spring season (vs. summer-autumn) was significantly associated with lower vitamin D levels (mean difference -11.14 nmol/L). Increasing serum vitamin D levels were significantly associated with a lower risk of bronchiolitis hospitalization (OR = 0.84 for a 10-nmol/L increase). Winter-spring season and gestational age (one-week increase) were significantly and directly associated with bronchiolitis hospitalization (OR = 6.37 and OR = 0.78 respectively), while vitamin D-mediated effects were negligible (1.21 and 1.02 respectively). Using a comprehensive causal approach may enhance the understanding of the complex interrelationships among RFBH, vitamin D and bronchiolitis hospitalization.

90) PMID: 33477320 DOI: children8010053 target=_blank>10.3390/children8010053
% 2021 Children (Basel, Switzerland)
* Connection between Social Relationships and Basic Motor Competencies in Early Childhood.
- In preschool, children build new contacts and social relationships with other people. They learn to cooperate with their peers and communicate in groups. In addition to social relationships, basic motor competencies (in German: Motorische Basiskompetenzen (MOBAK)) are also seen as a central developmental goal in early childhood and are necessary for participation in the culture of sports and movement. The aim of this paper is to describe the connection between social relationships and basic motor competencies in early childhood. In this present study, the motor competencies of N = 548 preschool children (51% girls, M = 68.0 months, SD = 6.8) were tested in the competence areas of self-movement and object movement. The children's perceived social relationships were recorded from teacher and parent perspectives. The results clearly show a connection between social relationships and motor competencies in early childhood, with a stronger connection observed in boys. This finding is relevant both from a developmental and a health-oriented perspective, as it points to a link between physical and mental health, as well as technical and interdisciplinary competencies, in early childhood.

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