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1) PMID: 30146896 DOI: 10.1177/0145445518796203
% 2020 Behavior modification
* Efficacy of Habit Reversal Training in Children With Chronic Tic Disorders: A Within-Subject Analysis.
- The aim of this study is to evaluate a cognitive-behavioral treatment for children and adolescents with tic disorder including habit reversal training (HRT) in a sample of children and adolescents (n = 27). Multiple outcome measures were used to assess the effects of the treatment on tic symptoms. In addition, impairment/subjective burden ratings and the self-efficacy to control tics were assessed. A within-subject design with two phases (8 weeks diagnostic; 16 sessions treatment) was analyzed using multilevel modeling (MLM). During the treatment phase, significant improvements in tic symptoms, impairment, and self-efficacy to control tics were found on most outcome measures. Treatment effects were found on the clinical rating of tic symptoms (Yale Global Tic Severity Scale [YGTSS]), the self-efficacy to control tics, and the video-observed motor tic frequency by comparing the improvements during treatment with the course of the outcome measures during the preceding diagnostic phase.

2) PMID: 30395002 DOI: 10.1097/BPB.0000000000000565
% 2020 Journal of pediatric orthopedics. Part B
* Postanesthesia alternation of lower limb contractures in children with spastic cerebral palsy.
- The aim of this study was to clarify the effects of general anesthesia (GA) on joint range of motion (ROM) in children with spastic cerebral palsy (SCP). Eighty-four SCP cases (mean age 8.4 years) admitted for first corrective surgery were retrospectively reviewed. Lower limb ROM were measured 1 day before operation and immediately after GA. Contracture of hip, knee, and ankle joints decreased significantly after GA, with + 11.1° (39.5%) for the hip abduction angle, -3.7° (18.0%) for the Thomas test, -15.0° (19.1%) for the popliteal angle, + 6.6° (39.8%) and 7.0° (109%) for ankle dorsiflexion with knee flexion and extension, respectively (all P < 0.001). These changes were correlated positively to pre-GA contracture and body weight, negatively to age, but independent of preoperative functional level, geographic classification of SCP, or modified Ashworth scale. On the basis of these findings, routine post-GA reassessments of joint ROM before corrective surgeries were recommended for pediatric SCP cases.

3) PMID: 30489445 DOI: 10.1097/BPB.0000000000000569
% 2020 Journal of pediatric orthopedics. Part B
* Percutaneous low-energy osteotomy in treatment of pathological coronal knee deformities in pediatrics.
- The aim of this study was to assess the safety and efficacy of percutaneous low-energy osteotomy and casting in treatment of pathological coronal knee deformities in children equal or younger than 6 years. A prospective nonrandomized case series study was conducted. A total of 62 (109 limbs) patients with pathological coronal knee deformities were treated by percutaneous low-energy osteotomy and casting and observed over 3-10 years. The pathological nature was variable (rickets, Blount disease, dysplasia, after trauma, or after infection). The average age at the time of surgery was 4.5 years (range: 3-6 years). Clinical and radiological outcomes were evaluated annually and at the end of follow-up period. There was a statistically significant improvement of the clinical appearance and the radiological parameters regarding mechanical axis deviation and tibiofemoral angle at the end of follow-up period. The total complication rate was 6.4%, with only four limbs with overcorrection and three limbs with recurrence. Percutaneous osteotomy is a simple, safe, and effective option in the treatment of children with coronal knee deformities equal or younger than 6 years.

4) PMID: 28799409 DOI: 10.1177/1073191117725169
% 2020 Assessment
* Use of the Brief Shame and Guilt Questionnaire in Deaf and Hard of Hearing Children and Adolescents.
- No assessment tools are available to measure shame and guilt in children who are deaf or hard of hearing (DHH), while these self-conscious emotions might play a role in the frequently noted social and behavioral problems in this group. Therefore, the aim of this study was to validate the Brief Shame and Guilt Questionnaire (BSGQ) in DHH children. In addition, we examined associations of shame and guilt with social anxiety, self-esteem, delinquency, and psychopathic behaviors. A sum of 225 hearing (Mage = 11.62 years) and 108 DHH (Mage = 11.82 years) participants completed the self-report BSGQ. Multigroup confirmatory factor analysis confirmed the two-factor structure (i.e., shame and guilt) of the BSGQ in the DHH group. Measurement invariance was established across both groups. However, the DHH group reported lower levels of self-conscious emotions in comparison with the hearing group. The BSGQ showed good concurrent validity, where shame was associated with higher levels of social anxiety and lower levels of self-esteem, and guilt was associated with lower levels of delinquency and psychopathic behavior in both groups. Future research should investigate the potential behavioral consequences of lower reported levels of self-conscious emotions in DHH youth.

5) PMID: 29096523 DOI: 10.1080/13557858.2017.1398313
% 2020 Ethnicity & health
* Prevalence and correlates of depressive symptoms in secondary school children in Dhaka city, Bangladesh.
- Objectives: Depression is a leading contributor to the global burden of disease, and often starts at a young age. Depression in young people can increase the risk of unhealthy lifestyle behaviour and can lead to substantial disability, social problems, poor health, and suicide. Other research has examined depressive symptoms among adult populations in Bangladesh, but little is known about other age groups. The aim of this study was to assess the prevalence and socio-demographic correlates of depressive symptoms among secondary school children of Dhaka city, Bangladesh.Design: A self-completed questionnaire was administered to 898 students from eight secondary schools of Dhaka, the capital City of Bangladesh. Of the respondents, 755 (372 males, 383 females; average age 14.26 years; SD 1.15) completed the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). A score of 10 or more was used to indicate depressive symptoms. Parents completed a separate questionnaire to provide individual and household/family-level data. Generalized Estimating Equations (GEE) was used to assess sociodemographic and lifestyle factors associated with adolescent depressive symptoms.Results: Among the responding adolescents, 25% reported depressive symptoms with prevalence more common among females than males (30% vs. 19%). Factors significantly associated with symptoms of depression included being female, aged 15-16 years, self-perception of non-normal weight, feeling unsafe at school, sleep disturbance, low life satisfaction, high intake of sugary drinks, and regularly skipping breakfast.Conclusion: Depressive symptoms are prevalent among secondary school children in urban Bangladesh. Interventions for adolescents with depressive symptoms could focus on lifestyle practices such as weight management, personal safety, sleep hygiene and healthy eating.

6) PMID: 30189798 DOI: 10.1080/10503307.2018.1519267
% 2020 Psychotherapy research : journal of the Society for Psychotherapy Research
* Interaction structures as predictors of outcome in a naturalistic study of psychodynamic child psychotherapy.
- Objective: The first aim of this study was to identify interaction structures (IS), which refer to clusters of items characterizing the course of psychotherapy in terms of reciprocal interaction patterns between the therapist and the child, secondly to assess their trends over the course of treatment, and finally investigate which IS predict outcome in long-term psychodynamic child psychotherapy.Method: The sample included 52 children with externalizing and internalizing problems. 192 sessions were rated with the use of the Child Psychotherapy Q-Set (CPQ). Outcome was assessed with the Child Behavior Checklist (CBCL) Total Problems, and Children's Global Assessment Scale (CGAS).Results: A principal components analysis resulted in four IS, theoretically named Therapeutic Alliance, Children's Emotion Expression, Child -Centered Technique and Psychodynamic Technique. Multilevel Modeling (MLM) analyses indicated significant linear growth on Psychodynamic Technique. Multiple regression analyses indicated that Psychodynamic Technique positively predicted changes on CBCL Total Problems and CGAS. In contrast, Child-Centered technique negatively predicted change on CBCL Total Problems, however follow up interaction analyses showed that externalizing children who received more Child-Centered technique showed more improvement on this scale.Discussion: Findings point to empirically derived components of psychodynamic child psychotherapy and provide preliminary answers about which aspects may facilitate change.

7) PMID: 31055992 DOI: 10.1080/17518423.2019.1604579
% 2020 Developmental neurorehabilitation
* Frequency, Characteristics and Risk Factors of Aggressive Incidents in a Paediatric Rehabilitation Setting: A Prospective Survey.
- Aim: Aggressive incidents (AI) are a serious concern in health care and can have negative effects on the physical and emotional well-being staff. This study aimed to determine frequency, characteristics and risk factors for aggressive behavior.Methods: AI were recorded during six months by the staff in a pediatric rehabilitation clinic using the evaluation form for AI (EVA). Patients were divided into the study group (patients who were involved in AI) and controls.Results: 14/105 (13%) of patients were involved in 79 AI. 0.44 AI per day occurred. Most often AI occurred on Mondays and 98% included physical, 22% verbal aggression. Most frequent target (43%) were nurses, followed by therapists (31.6%).Significant risk factors for AI were: previous aggressive behavior (p = .038), lower cognitive and higher mobility sub-scores in the WeeFIM. Conclusion: Findings emphasize the magnitude of AI in pediatric rehabilitation and thus the importance of implement preventive strategies.Abbreviations: ADL: Activity of daily living; AI: Aggressive Incidents; CFCS: Communication Function Classification System; EVA: Recording aggressive incidents (Erfassung von Aggressionsereignissen); GMFCS: Gross Motor Function Classification System; MACS: Manual Ability Classification System; SOAS-R: Staff Observation of Aggression Scale-Revised; WeeFIM: Functional Independence Measure for Children; WPV: Workplace violence.

8) PMID: 31832189 DOI: 10.3892/mco.2019.1954
% 2020 Molecular and clinical oncology
* Clinical and reproductive outcomes of fertility-sparing surgery in stage I epithelial ovarian cancer.
- The aim of the present study was to evaluate the oncologic safety and reproductive outcome in patients with stage I epithelial ovarian cancer (EOC) treated with fertility-sparing surgery (FSS). Women aged ≤40 years with stage I EOC who had undergone FSS between 2000 and 2010 were retrospectively reviewed. Survival was examined using the Kaplan-Meier method and statistical significance was analyzed using the log-rank test. A total of 29 EOC patients (stage IA, n=14; stage IC1 n=6; stage IC3, n=9) from seven participating institutions belonging to the Tohoku Gynecologic Cancer Unit were enrolled. After a median follow-up duration of 60.6 months (range, 6-135 months), five patients (17.2%) experienced tumor recurrence. The respective five-year relapse-free survival (RFS) and overall survival (OS) rates were 90.9 and 100% for stage IA/IC1, and 43.8 and 87.5% for stage IC3. Significant differences in RFS were observed between stage IA/IC1 and IC3 patients (P=0.026). However, there was no significant difference in OS between patients with 1A/1C1 and those with 1C3 (P=0.712). After FSS, seven pregnancies occurred in five patients, which resulted in the birth of six healthy children. The results of the present study confirmed that FSS may be an acceptable treatment method for stage IA and IC1 EOC, exhibiting a favorable reproductive outcome. However, the safety of FSS for treating stage IC3 EOC is uncertain and warrants further investigation.

9) PMID: 27956479 DOI: 10.1177/0886260516682522
% 2020 Journal of interpersonal violence
* Immediate and Long-Term Mental Health Outcomes in Adolescent Female Rape Survivors.
- Rape is considered a stressful trauma and often has long-lasting health consequences. Compared with adult females, limited data exist on the psychological impact of rape in adolescents. The aim of this study was to assess the prevalence and associated factors of emotional distress in a cohort of adolescent rape survivors in Cape Town. Participants in this prospective longitudinal study were 31 adolescent female rape survivors recruited from a rape clinic in Cape Town and assessed within 2 weeks of the assault. Assessment measures included a sociodemographic questionnaire and initial screening with the Child and Adolescent Trauma Survey (CATS), the patient-rated Children's Depression Inventory (CDI), and the Multidimensional Anxiety Scale for Children (MASC). The CATS, CDI, and MASC were repeated at 1, 3, 6, 9, and 12 months post enrollment. Psychiatric diagnoses were made with the clinician-administered Mini International Neuropsychiatric Interview-Child and Adolescent version (MINI-Kid). At baseline, on the MINI-Kid, a definitive diagnosis of major depressive episode was endorsed in 22.6% of the participants. Stress-related disorders were found in 12.9%, whereas 16.1% had anxiety disorders. There was no diminution of symptoms on self-reported psychopathology measures at follow-up assessment over the five follow-up time points, suggesting persistent psychopathology over a 1-year period despite repeated clinical assessments and supportive counseling. Symptoms of anxiety, depression, and posttraumatic stress disorder in this sample of adolescent female rape survivors were high at enrollment and found to be persistent, underlining the need for long-term support, screening, and evidence-based follow-up care.

10) PMID: 31845565 DOI: 10.17392/1067-20
% 2020 Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
* Incidence and outcome of traumatic brain injury in paediatric population of Bosnia and Herzegovina: a single centre experience.
- Aim To evaluate the incidence, modalities of treatment and outcome in paediatric patients with traumatic brain injury (TBI). Methods A retrospective cross-sectional study including 353 paediatric patients with head injury was carried out in the Department of Neurosurgery of University Clinical Centre Sarajevo during the period 1 July 2006 - 30 June 2012 (72 months). For each patient the lowest Glasgow Coma Scale (GCS) was established and the patient was accordingly classified as suffering from mild, moderate or severe TBI. Neuroimaging data included computer tomography (CT). Survival rates and method of treatment were compared according to age group, and matched with the total number of patients examined. Results A total of 353 children with head trauma were identified. A severe TBI (GCS < 8) was found in 33 (out of 353) children, mostly in the age group 11-18. Falls were the most common cause of trauma, followed by traffic accidents. Falls were the most common mechanism in the infants, preschool, and school children up to 10 years old; children aged 11-18 showed a higher rate of traffic accidents comparing to children younger than 3 years. Of 353 patients, 49 (13,9%) required surgical procedure, 304 (86.1%) were threated conservatively. Survival rate was 96.6 %. Conclusion The majority of hospitalized patients qualify for medical treatment and surgical intervention is reserved for selected cases. Thus, the adequate pre-hospital care is essential.

11) PMID: 31865931 DOI: 10.1017/S0305000919000631
% 2020 Journal of child language
* Dynamic interaction patterns of monolingual and bilingual infants with their parents.
- Bilingual children show a number of advantages in the domain of communication. The aim of the current study was to investigate whether differences in interactions are present before productive language skills emerge. For a duration of 5 minutes, 64 parents and their 14-month-old infants explored a decorated room together. The coordination of their behaviors in the modalities of action, language, and gesture was coded. The results showed no differences in interactions across different language statuses. In two additional analyses, we first compared monolinguals and bilinguals with caregivers who shared the same language and culture. Results showed the same pattern of non-difference. Second, we compared bilinguals with caregivers from different cultures. The rate and duration of coordination differed across infants with different cultural backgrounds. The findings suggest that exposure to two languages is not sufficient to explain the previously identified beneficial effects in the communicative interactions of bilingual children.

12) PMID: 31873070 DOI: 10.1080/19932820.2019.1705633
% 2020 The Libyan journal of medicine
* Enamel defects and caries prevalence in preterm children aged 5-10 years in Dubai.
- Background: Enamel defects (EDs) are commonly reported dental findings in preterm/low birthweight children. EDs potentially increase caries susceptibility.Aim: To assess the prevalence of EDs and dental caries in a group of preterm children (aged 5-10 years) in Dubai, United Arab Emirates (UAE).Methodology: A retrospective cohort study of medical records of 62 preterm children (mean age 8.1 ± 1.54) and 62 full-term children (mean age 8.1 ± 1.73) of both genders born in a UAE children's hospital were studied. These children were dentally assessed for EDs and caries by a calibrated examiner.Results: EDs were 4.34 times more prevalent among preterm children [odd ratio (OR) = 4.338, CI 95% [2.010-9.366]. The prevalence of EDs in the pre-term group was 58.15%, significantly higher (P < 0.01) than the full-term control group (24.2%). Birth weight, intubation and type of delivery were statistically significant factors contributing to EDs. In the primary dentition, the mean dmft was 4.61 ± 4.30, while in the permanent dentition DMFT was 0.38 ± 0.99. There was a statistically significant difference in permanent teeth caries experience amongst pre-term children compared to the full-term control as measured by DMFT (P = 0.008).Conclusion: EDs and dental caries in permanent dentition in the pre-term group were significantly higher than the full-term group.

13) PMID: 28030984 DOI: 10.1177/1087054716684378
% 2020 Journal of attention disorders
* Clinical and Neuropsychological Characteristics of ADHD According to DSM-5 Age-of-Onset Criterion in Korean Children and Adolescents.
- Objective: The aim of this study was to compare the clinical features and neuropsychological profiles of children and adolescents with ADHD according to the age-of-onset defined in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Method: We compared the following three groups: early-onset ADHD group (onset before age 7, n = 86), late-onset ADHD group (onset between ages 7 and 12, n = 58), and the control group (n = 88). Results: Both early-onset and late-onset ADHD groups had more symptoms and functional impairments than the control group. Also, both ADHD groups scored higher on ADHD Rating Scale, Parent General Behavior Inventory, majority of the subscales of Social Responsiveness Scale, Hyperactivity subscale of Korean Personality Rating Scale for Children, and Omission Errors of Visual Continuous Performance Test compared with the control group. Conclusion: Our results support the extension of age-of-onset criterion made in DSM-5.

14) PMID: 28388850 DOI: 10.1177/1087054717700978
% 2020 Journal of attention disorders
* Auditory and Visual Executive Functions in Children and Response to Methylphenidate: A Randomized Controlled Trial.
- Objectives: The aim of the study was to assess auditory and visually based executive functions (EFs) and the effect of methylphenidate (MPH) in children with ADHD. Methods: Thirty-six boys between the ages of 8.3 and 9.7 years with ADHD and 36 matched controls were included. The study group was randomized into MPH and placebo for 7 days each in a crossover design. A Cued Choice Reaction Time (CCRT) test that included incongruent cuing was administered at baseline and following 1 and 2 weeks. Results: The difference between the study and control groups was more evident with visual cues and incongruent cuing. Increased gains by children with predominantly hyperactive-impulsive\combined (HI\C) type of ADHD were observed under MPH. Conclusions: The differences between children with ADHD and typical children are more pronounce under incongruent auditory cuing . The gains attributable to MPH are more specific to tasks involving auditory and visual EFs and in children with HI\C type ADHDs.

15) PMID: 28748725 DOI: 10.1177/1087054717720719
% 2020 Journal of attention disorders
* Recent Trends in the Prescribing of ADHD Medications in Canadian Primary Care.
- Objective: The aim of this study was to describe the prevalence and incidence of ADHD medication prescribing, by age and gender, from 2005 to 2015 in Canadian primary care. Method: A population-based retrospective cohort study was conducted to evaluate the prescribing of ADHD medications between 2005 and 2015 using electronic medical record data. Yearly prevalence and incidence of ADHD medication prescribing were calculated for preschoolers (up to 5 years old), school-aged children (6-17 years old), and adults (18-65 years old) along with a description of the types of ADHD medications prescribed between 2005 and 2015. Results: Between 2005 and 2015, there was a 2.6-fold increase in the prevalence of ADHD medication prescribing to preschoolers, a 2.5-fold increase in school-aged children, and a fourfold increase in adults. There was a corresponding rise in incidence of prescribing although this rise was moderate and estimates were much lower compared with prevalence. The most commonly prescribed medication was Methylphenidate (65.0% of all ADHD medications prescribed). Conclusion: Although the prevalence of ADHD has remained stable over time, this study found an increase in the prescribing of ADHD medications in all age groups between 2005 and 2015. Incidence of new prescriptions was small relative to prevalence, suggesting that longer term treatments are being adopted.

16) PMID: 30522406 DOI: 10.1177/1087054718816172
% 2020 Journal of attention disorders
* Predictors for Receiving Medication and/or Psychotherapy in Children Newly Diagnosed With ADHD: A Longitudinal Population-Based Cohort Study.
- Objective: The aim of this study is to identify characteristics predicting the use of medication and/or psychotherapy after a first ADHD diagnosis. Method: This cohort study was based on German claims data including 12,250 treatment-naïve children aged 5 to 12 years with an incident ADHD diagnosis in 2010. Logistic regression models were used to estimate associations between children's characteristics at first diagnosis and the chosen treatment within the following 5 years. Results: Medication use was associated with male sex, an ADHD diagnosis "with hyperactivity," comorbid depression, and comorbid developmental and conduct disorders. Male sex and comorbid neurotic and somatoform, conduct, and emotional disorders were associated with psychotherapy only. Receiving both treatments-instead of medication only-was associated with comorbid depression, neurotic and somatoform, conduct, and emotional disorders. Conclusion: In case of equal access to both treatment options, patients, for example, with externalizing symptoms were more prone to receive medication and/or psychotherapy than the average child diagnosed with ADHD.

17) PMID: 31056996 DOI: 10.1177/1087054719843179
% 2020 Journal of attention disorders
* Drug Prescriptions for Children With ADHD in Japan: A Study Based on Health Insurance Claims Data Between 2005 and 2015.
- Objective: The aim of this study is to investigate the trend of prescription drugs for children with ADHD in Japan. Method: Using health insurance claims data of 3,672,951 people between January 2005 and December 2015, we investigated the trend of prescription drugs for 7,856 children with ADHD. Results: After approval in 2007, the proportion of prescriptions for methylphenidate-osmotic-controlled release oral delivery system tablets was 31.4% in 2009 (adjusted odds ratio [AOR] = 2.72; 95% confidence interval [CI] = [2.12, 3.51]) and reached a plateau approximately after 2009 (AOR = 0.96; 95% CI = [0.94, 0.98]). The proportion of prescriptions for atomoxetine increased from 6.1% in 2008 to 21.8% in 2014 (AOR = 1.12; 95% CI = [1.13, 1.18]). The proportion of prescriptions for aripiprazole and ramelteon increased (all trend p < .001). Conclusion: Prescriptions of drugs for children with ADHD have changed. We need to monitor the safety of ADHD medications among children with ADHD.

18) PMID: 31888790 DOI: 10.2500/aap.2020.41.190020
% 2020 Allergy and asthma proceedings
* The role of antioxidants and 25-hydroxyvitamin D during pregnancy in the development of allergic diseases in early school-age children - Polish Mother and Child Cohort Study.
- Purpose: Based on the available data, alterations of the antioxidant defense as well as the vitamin status in mothers may affect the prenatal process of lung and immune system development as a pathophysiological background of increased prevalence of allergic diseases. The primary aim of the current study was to assess the associations among cord blood concentrations of zinc (Zn); copper (Cu); selenium (Se); β-carotene; and vitamin A, E, and D, and the occurrence of atopic dermatitis, food allergy, allergic rhinitis, and asthma in early school-age children. Methods: We evaluated 211 children, 7-9 years old, from the Polish Mother and Child Cohort Study. the women were interviewed during pregnancy to collect demographic and socioeconomic data, and the medical and reproductive history. At delivery, umbilical cord blood plasma was sampled. Seven to nine years after the birth, the child's exposure and health status (including skin-prick test and spirometry for allergy assessment and urine sample for cotinine level) were examined. In the analyses, a multivariable model was applied. Results: Statistically significant relationships were found among Zn; Cu; Se; and vitamin A, E, and D concentrations in cord blood; and the prevalence of food allergy, allergic rhinitis, atopic dermatitis, and asthma in children ages 7-9 years after adjustment for several confounders. Conclusion: We showed an imbalance in the antioxidant defense system in cord blood, which may lead to the occurrence of allergic diseases later in life. The maternal diet may have substantial potential to modify immune tolerance and, consequently, the development of allergic disease in the offspring.Clinical trial NCT01861548, <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>.

19) PMID: 30380355 DOI: 10.1080/19390211.2018.1481165
% 2020 Journal of dietary supplements
* Impact of Omega-3 Fatty Acids Among Other Nonpharmacological Interventions on Behavior and Quality of Life in Children with Compromised Conduct in Spain.
- The aim of this study was to assess the impact of omega-3 fatty acid supplementation among other nonpharmacological treatments on mental health and quality of life (QOL) of children with behavioral disorders. An observational multicenter study of 6- to 12-year-old children with behavior-related problems was performed in Spain with a three-month follow-up assessment. The Kidscreen-10 and Strengths and Difficulties Questionnaires (SDQ) were used to assess effectiveness of each intervention. Characteristics of study population were compared with those of the general population. Subanalyses of two homogenous subgroups, who received versus did not receive dietary supplementation with omega-3 fatty acids, were performed. The study included 942 children (69.1% male) with a mean (SD) age of 8.5 (1.8) years. Overall, patients' health status and QOL significantly improved at three months (p < .001). Scores on the SDQ also improved, with significant reductions on all subscales (p < .05). Comparison of SDQ results with the same-age general population showed higher overall scores in the study population (8.5 [5.5] vs. 18.6 [8.1], respectively) and on all the subscales (p < .001 in all cases). The omega-3 fatty acid supplementation subgroup presented greater improvements in each category of SDQ (p < .05), except for the emotion subscale. Omega-3 fatty acid supplementation alone or in combination with other nonpharmacological treatments is effective in improving children's mental health. Overall, nonpharmacological recommendations currently made by pediatricians seem to be effective in improving the perceived health status and patients' QOL and in the reduction of health problems, especially hyperactivity/inattention and conduct problems.

20) PMID: 31896167 DOI: 10.1111/sjop.12604
% 2020 Scandinavian journal of psychology
* Factor structure of the Friends and Family interview.
- The aim of this study was to specify the latent construct structure of the Friends and Family Interview (FFI: Steele & Steele, 2005) based on its dimensional scale coding protocol. The FFI is a semi-structured interview measuring attachment in middle childhood. We analyzed data from 341 FFI interviews with children aged 7-12 years, recruited in the Scandinavian Öresund Region. Exploratory Factor Analysis revealed a three-component model as best fitting the data. The first component, denoting attachment security, gathered all dimensional scales for evidence of secure base/safe haven regarding mother/father and coherence in the child's narrative style, along with scales regarding reflective functioning, self-perception, and social functioning. The second component comprised preoccupying feelings of anger, but also derogation. The third component gathered all scales coding idealization. Inter-relations among the components were consistent with attachment theory, and respondents' scores for all three components differed significantly across the four categorical attachment classifications. Affect regulation of negative emotion through anger and through derogation co-occurred, and was distinct from regulation through maintaining a belief that things are better than they appear (idealization). These two affect regulation strategies appeared commonly when reflective functioning, and an organized self-perception, and positive peer relations were less in evidence. The multi-dimensional FFI coding system appears to measure successfully these diverse features of the child's narrative provided in response to the interview. Overall, our findings support the construct validity of the FFI and provide further evidence of its usefulness for assessing attachment in middle childhood and early adolescence.

21) PMID: 31896551 DOI: 10.2337/db19-0751
% 2020 Diabetes
* Maternal Type 1 Diabetes Reduces Autoantigen-Responsive CD4+ T Cells in Offspring.
- Autoimmunity against pancreatic β-cell autoantigens is a characteristic of childhood type 1 diabetes. Autoimmunity usually appears in genetically susceptible children with the development of autoantibodies against (pro)insulin in early childhood. The offspring of mothers with type 1 diabetes are protected from this process. The aim of this study was to determine whether the protection conferred by maternal type 1 diabetes is associated with improved neonatal tolerance against (pro)insulin. Consistent with improved neonatal tolerance, the offspring of mothers with type 1 diabetes had reduced cord blood CD4+ T cell responses to proinsulin and insulin, a reduction in the inflammatory profile of their proinsulin-responsive CD4+ T cells, and improved regulation of CD4+ T cell responses to proinsulin at 9 months of age, as compared with offspring with a father or sibling with type 1 diabetes. Maternal type 1 diabetes was also associated with a modest reduction in CpG methylation of the INS gene in cord blood mononuclear cells from offspring with a susceptible INS genotype. Our findings support the concept that a maternal type 1 diabetes environment improves neonatal immune tolerance against the autoantigen (pro)insulin.

22) PMID: 31897170 DOI: 10.3892/ol.2019.11064
% 2020 Oncology letters
* Prognostic significance of the tumor suppressor protein p53 gene in childhood acute lymphoblastic leukemia.
- The tumor suppressor protein p53 (TP53) gene is associated with various types of cancer; however, little is known about TP53 expression in patients with childhood acute lymphoblastic leukemia (ALL). The aim of the present study was to investigate the prognostic value of TP53 expression in childhood ALL. To achieve this, TP53 mRNA levels of 146 children with ALL and 23 child donors with idiopathic thrombocytopenic purpura were determined by reverse transcription-quantitative PCR. Relapse-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. The results demonstrated that TP53 mRNA level in patients with ALL was higher compared with that in the ITP donors (P=0.019). Patients with highly-expressed TP53 exhibited lower percentages of peripheral blood blast, higher platelet counts and inferior complete remission rates compared with patients with low expression of TP53. Survival analyses revealed that high TP53 expression was associated with poor OS and RFS in childhood ALL (P=0.018 and P=0.028, respectively) and was an independent prognostic factor in multivariate analysis for poor RFS (P<0.001) and OS (P<0.001). In conclusion, high TP53 expression is associated with poor outcomes and may be used as a molecular prognostic marker to be incorporated into an improved risk classification system for childhood ALL.

23) PMID: 31897849 DOI: 10.1007/s00787-019-01459-6
% 2020 European child & adolescent psychiatry
* Neuropsychological profile of children and adolescents with psychosis risk syndrome: the CAPRIS study.
- Neuropsychological underperformance is well described in young adults at clinical high risk for psychosis, but the literature is scarce on the cognitive profile of at-risk children and adolescents. The aim of this study is to describe the neuropsychological profile of a child and adolescent sample of patients with psychosis risk syndrome (PRS) compared to healthy controls and to analyze associations between attenuated psychotic symptoms and cognitive impairment. Cross-sectional baseline data analysis from a longitudinal, naturalistic, case-control, two-site study is presented. Eighty-one help-seeking subjects with PRS and 39 healthy controls (HC) aged between 10 and 17 years of age were recruited. PRS was defined by: positive or negative attenuated symptoms, Brief Limited Intermittent Psychotic Symptoms (BLIPS), genetic risk (first- or second-degree relative), or schizotypal personality disorder plus impairment in functioning. A neuropsychological battery was administered to assess general intelligence, verbal and visual memory, visuospatial abilities, speed processing, attention, and executive functions. The PRS group showed lower general neuropsychological performance scores at a multivariate level and lower scores than controls in general intelligence and executive functions. Lower scores on executive function and poorer attention were associated with high scores of positive attenuated psychotic symptoms. No association with attenuated negative symptoms was found. This study provides evidence of cognitive impairment in PRS children and adolescents and shows a relationship between greater cognitive impairment in executive functions and attention tasks and severe attenuated positive symptoms. However, longitudinal studies are needed to clarify the nature of cognitive impairment as a possible vulnerability marker.

24) PMID: 31897855 DOI: 10.1007/s10803-019-04351-z
% 2020 Journal of autism and developmental disorders
* Mothers' Perspectives on the Inclusion of Young Autistic Children in Kuwait.
- There is a lack of information on early childhood inclusive education and the parental perspectives towards the inclusion of autistic children in Kuwait. The aim of this study was to explore the perspectives and experiences amongst mothers of young autistic children regarding the inclusion of their children in general education kindergarten settings. Focus group and individual semi-structured interviews were conducted with (n = 34) Kuwaiti mothers of children with (ASD). The study participants were of the opinion that the behaviours unique to (ASD) can only be managed in highly structured special education settings. The themes that emerged from the interviews demonstrate that the general view amongst the study participants is that the inclusive educational model will not meet the autistic children's needs.

25) PMID: 31899772 DOI: 10.1371/journal.pone.0227273
% 2020 PloS one
* Soil-Transmitted Helminth infections reduction in Bhutan: A report of 29 years of deworming.
- Soil Transmitted Helminth (STH) infections affect over 1.5 billion people worldwide. Although prevalent in all age groups, school aged children are a high-risk groups for STH infections. In Bhutan, epidemiological data on STH were collected from western Bhutan in 2003, which found a prevalence of 16.5%. However, little evidence is available on the prevalence of infection at national level. Therefore, this study was conducted with the aim to assess the prevalence and intensity of STH infections, and identify significant correlates of STH among students. A school-based survey was conducted in three regions of Bhutan. Two-stage cluster sampling was adopted to select a sample of 1500 students from 24 schools, in equal proportion from three regions of the country. A total of 1456 (97%) students were interviewed and their stool sample examined for the presence of parasites. Mini-FLOTAC technique was used to detect the parasite eggs/ova. The prevalence of any STH infection was 1.4%, with 0.8% Ascaris lumbricoides, 0.5% Trichuris trichiura and 0.2% hookworms. The eastern region had the highest prevalence at 2.3%. Except for one student who had moderate intensity of A. lumbricoides, the rest had light infection. Any STH presence was significantly associated with father's occupation, father's education level, type of house and the flooring of the house in which students reported to live. No significant associations were observed between water, sanitation and hygiene (WASH) variables measured and presence of any STH infection. The prevalence of STH was found to be very low with primarily light intensity in this study. Nonetheless, it was also found that the sanitation situation is not ideal in the country, with several students reporting constant or partial open defecation leading to environmental contamination. Based on this prevalence and in line with the WHO guideline, it is recommended that deworming be reduced to once a year in combination with concerted health education on proper hygiene and sanitation practice.

26) PMID: 31899958 DOI: 10.1080/02688697.2019.1708267
% 2020 British journal of neurosurgery
* Neurosurgical management of head injuries incurred during sports: a single centre experience.
- Introduction: Accidents during sporting activities are a common cause of head injury, particularly in children and young adults. Whilst most sporting head injuries are minor, there remains a proportion which is associated with high morbidity and mortality. The epidemiology of sports associated head injuries is variable based on geographical region so the aim of this study was to review the management and outcomes of sporting head injuries managed by a single neurosurgical unit in the South of England.Method: A retrospective review of the Trauma Audit and Research Network database was conducted for all patients admitted to a tertiary neurosurgical centre over a six-year period (January 2011-December 2016). Case notes were reviewed for demographics, mechanism of injury, injury severity score, intensive care admission, surgical interventions and Glasgow Outcome Score at discharge.Results: Seventy-six patients (mean age: 37.6 ± 18.4 years, male gender n = 43; 56.6%) were eligible for inclusion in this series. Horse riding accidents were identified as the most common cause of head injury (n = 31; 40.8%). Fifteen patients (19.7%) in this series had a severe head injury (GCS 3-8 on admission). Twenty-eight (36.8%) patients required admission to an intensive care unit and 26 (34.2%) patients underwent neurosurgical intervention. At discharge, 68 (89.5%) patients had a Glasgow Outcome Score 4-5.Conclusion: The majority of patients with head injuries admitted to a neurosurgical unit can expect a good functional outcome despite the need for intensive care or neurosurgical intervention. The range of sports resulting in head injury is likely influenced by geographic location; however, further national study is required for wider comparison.

27) PMID: 31901173 DOI: 10.1111/apa.15160
% 2020 Acta paediatrica (Oslo, Norway : 1992)
* Hypocalcaemia in children hospitalised for diarrhoea was associated with a higher death rate than those without hypocalcaemia.
- Diarrhoea is a common cause of death in children under five years old and it accounted for 437,000 deaths worldwide in this age group in 2018 (1). Calcium plays a key role in some vital physiological body functions, like vascular contraction and vasodilatation, muscle function, nerve transmission, intracellular signalling and hormonal secretion. However less than 1% of the body's total calcium supply is required to support these functions (2). Diarrhoeal diseases are often associated with hypocalcaemia, possibly due to malabsor ption (3) and sepsis (4). However, data are limited on any associations between hypocalcaemia and diarrhoea in children and their outcomes. The aim of our study was to address that knowledge gap.

28) PMID: 31901795 DOI: 10.1016/j.advms.2019.12.009
% 2020 Advances in medical sciences
* Metabolomic profiling in children with inflammatory bowel disease.
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29) PMID: 31902055 DOI: 10.1007/s10803-019-04356-8
% 2020 Journal of autism and developmental disorders
* Development of the Childhood Nonverbal Communication Scale.
- The aim of this study was to develop and validate the Childhood Nonverbal Communication Scale (CNCS) to assess nonverbal communication skills in children from birth to 18 months old. An extensive review of existing research provided evidence used to generate items representative of nonverbal communication behaviors. The final version of the CNCS includes 37 items divided in two dimensions (CNCS-1 and CNCS-2) showing high content validity (item-rated content validity index ≥ 0.75). The scale was administered to 428 Iranian Persian-speaking children 3 to 18 months old with normal development. According to the findings, the CNCS showed strong internal consistency (KR-20 = 0.965). Further, it had good convergent validity based on a significant correlation between total scores and the results of the Persian version of the Production of Infant Scale Evaluation (PRISE-P) (r = 0.5, P < 0.01). Therefore, the CNCS is a promising tool for measuring nonverbal communication in Iranian children from birth to 18 months of age.

30) PMID: 31902236 DOI: 10.1556/650.2020.31618
% 2020 Orvosi hetilap
* [Exudative tonsillitis in children. How can we reduce the unnecessary antibiotic consumption?]
- Introduction: Exudative tonsillitis is a common clinical picture during childhood. The majority of these cases are caused by viruses (Epstein-Barr virus [EBV], cytomegalovirus [CMV], influenza virus, parainfluenza virus, and adenovirus), and only some infections are caused by bacteria, mainly group A streptococci (GAS). On the basis of international guidelines, routine use of early antibiotic treatment is not recommended in these cases, because it seems not to prevent GAS-associated complications. Aim: Our aim was to determine those laboratory results which are useful to distinguish between bacterial and viral infections in children with exudative tonsillitis to reduce antibiotic overuse. Method: In our study, we evaluated 135 clinical data from 133 children with exudative tonsillitis. Patients were grouped according to the following criteria: the first group contained patients with acute CMV or EBV infections, while in the second group, CMV or EBV infections were not confirmed using serology. Results: On the basis of our results, EBV or CMV infections (66/135, 48.8%) were serologically confirmed in the majority of cases with exudative tonsillitis between 2016 and 2017, while the causative role of GAS was minimal in this patient group (3/65, 4.61%). In spite of this finding, the majority of patients (92%) were treated with antibiotics. Conclusion: Our retrospective findings confirmed that it is not possible to determine the causative agent of this clinical picture on the basis of symptoms, and physical findings, moreover laboratory results, such as high white blood cell count could not confirm bacterial infection. At the same time, elevated transaminase levels may refer to viral origin of infection, especially EBV or CMV with high predictive value; the use of extended laboratory tests may reduce the unnecessary antibiotic consumption. Orv Hetil. 2020; 161(2): 50-55.

31) PMID: 31902289 DOI: 10.1080/0167482X.2019.1708318
% 2020 Journal of psychosomatic obstetrics and gynaecology
* Factors associated with infertility distress of infertile women: a cross-sectional study.
- Background: Women undergoing infertility treatment may suffer infertility distress.Objective: The aim of this study was to determine factors associated with infertility distress in women with infertility problems.Materials and methods: Women (N = 368) who received infertility treatment and agreed to participate in the study constituted the sample of this cross-sectional descriptive study. The participants filled out the "Descriptive Information Form on Women with Infertility" and the "Infertility Distress Scale (IDS)". The data analysis of the study was performed using the Statistical Package for Social Sciences (SPSS-20.0). The statistical significance was accepted to be p < .05.Results: It was found out that the mean IDS score of women was 37.4 ± 9.96 (min: 21-max: 80). A significant difference was found between women's educational level, employment status, difficulty in taking time off work, economic situation, the person who paid for treatment expenses and cause of infertility and mean IDS scores (p < .05). No significant relationship was found between women's social security, family type, having children and previous infertility treatment and mean IDS scores (p > .05). A positive and statistically significant linear relationship was found between the IDS score and marriage duration, desiring time for a baby and duration of infertility treatment (p < .05).Conclusions: The study revealed that the infertility distress level increased as the marriage duration, desiring time for a baby and the duration of infertility treatment of women admitted to the infertility clinic increased. Infertile women should be provided with care and support by considering these variables.

32) PMID: 31902377 DOI: 10.1017/S0021932019000853
% 2020 Journal of biosocial science
* Changes in the prevalence of overweight/obesity and adiposity among pre-school children in Kraków, Poland, from 2008 to 2018.
- Socioeconomic changes occurring over time influence the lifestyle choices of a population, and these can significantly affect children's body weight and composition. The aim of this study was to assess the changes in prevalence of overweight, obesity and adiposity in pre-school children in Poland between 2008 and 2018. Body height, body weight and subscapular and triceps skinfolds were measured in 2167 children aged 3-7 years from Kraków. Body mass index and adiposity (percentage body fat, %BF) were calculated for the children, who were then categorized as underweight, normal weight, overweight or obese according to Cole's cut-off points. Adiposity was categorized according to the z-scores for %BF as low (<-1), normal (-1 to 1) or high (>1). Differences between cohorts were analysed using the chi-squared test. Only the decrease in the prevalence of obesity in 5-year-old girls was found to be statistically significant. However, some overall tendencies were noted. Decreases in the prevalence of underweight, overweight and obesity were observed for both sexes, as well as in the incidence of high adiposity in boys and low adiposity in girls. Increases in the prevalence of high adiposity in girls and low adiposity in boys were also noted. There was no significant change in the prevalence of overweight and obesity among pre-school children over the study decade, and the visible tendencies included decreases in the prevalence of excess body weight and adiposity as well as underweight and low body fat. Also, the visible trends in adiposity were mostly negative. Further studies should, however, also consider the levels of physical fitness and activity of children, as these have a crucial influence on the measured characteristics.

33) PMID: 31902382 DOI: 10.1017/S2040174419000850
% 2020 Journal of developmental origins of health and disease
* Cardiovascular risk factors in offspring exposed to gestational diabetes mellitus in utero: systematic review and meta-analysis.
- Gestational diabetes mellitus (GDM) is a pregnancy complication that affects one in seven pregnancies. Emerging evidence demonstrates that children born of pregnancies complicated by GDM may be at increased risk of cardiovascular disease (CVD) in adulthood. Therefore, the aim of this study was to determine cardiovascular risk factors in offspring exposed to GDM in utero. PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Information was extracted on established CVD risk factors including blood pressure, lipids, blood glucose, fasting insulin, body mass index (BMI), and endothelial/microvascular function. The review protocol is registered in PROSPERO (CRD42018094983). Prospective and retrospective studies comparing offspring exposed to GDM compared to controls (non-GDM pregnancies) were considered. We included studies that defined GDM based on the International Association of Diabetes and Pregnancy Study Groups (IADPSG) definition, or prior definitions. The PRISMA guidelines were followed in conducting this systematic review. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Study selection, data extraction, and quality assessment were done by two independent reviewers. The data were pooled using a random-effects model. Of 59 eligible studies, 24 were included in the meta-analysis. Offspring exposed to GDM had higher systolic blood pressure (mean difference (MD): 1.75 mmHg, 95% CI 0.57-2.94; eight studies, 7264 participants), BMI z-score (MD 0.11, 95% CI 0.02-0.20; nine studies, 8759 participants), and glucose (standard MD 0.43, 95% CI 0.08-0.77; 11 studies, 6423 participants) than control participants. In conclusion, offspring exposed to GDM have elevated systolic blood pressure, BMI, and glucose. Those exposed to GDM in utero may benefit from early childhood blood pressure measurements.

34) PMID: 31903829 DOI: 10.1080/00325481.2019.1708147
% 2020 Postgraduate medicine
* THE EFFECT OF GENOTYPE ON MUSCULOSKELETAL COMPLAINTS IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER.
- Objectives: Familial Mediterranean fever (FMF) is an autosomal recessive disease, characterized by recurrent, self limited attacks of fever with serositis. The aim of this study was to describe the frequency of musculoskeletal complaints in children with FMF and to investigate the effect of genotype on these findings.Methods: Files of patients who had been seen in our department (during routine follow-up visits) were retrospectively evaluated. Comparisons regarding musculoskeletal findings were performed between patients with homozygous/compound heterozygous and heterozygous mutations. Thereafter, patients with two mutations were divided into three groups; M694V/M694V, M694V/other mutation and patients carrying two mutations other than M694V. Patients with single mutation were divided into two groups; M694V and non M694V carriers.Results: The study group comprised 317 FMF patients (170 females) with a mean age of 12.2 ± 5.7 years. Arthralgia (42.6%), leg pain (42.9%) and heel pain (35.6%) were the most common musculoskeletal complaints in children with FMF. Frequency of musculoskeletal findings of the patients who had two mutations did not differ from the patients with single mutations (p>0.05). Leg and heel pain were more frequently detected in patients with homozygous M694V mutation (p=0.001). Among patients with heterozygous mutations; children with M694V mutation had more frequently arthralgia, leg and heel pain (p<0.05).Conclusions: Musculoskeletal problems were commonly encountered in patients with FMF. Genotype seems to affect the frequency of these problems and M694V mutation is a predisposing factor for musculoskeletal complaints.

35) PMID: 31905003 DOI: 10.1089/bfm.2019.0262
% 2020 Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine
* Weaning Practices of Turkish Mothers: A Mixed-Model Research.
- Objectives: The aim of this study is to determine the weaning practices of mothers who have children between the ages of 2 and 5 years. Materials and Methods: This study was designed as a cross-sectional descriptive study, which was carried out between September 1, 2019 and October 1, 2019 in a pediatric clinic of a university hospital. For a better understanding, the traditional approaches, qualitative, and quantitative data were collected concurrently and analyzed together using Creswell's concurrent transformative mixed-model research design. Results: Of the 114 participants, the overall mean age was 29.2 ± 4.5 years. The mean breastfeeding duration was 15.3 ± 8.2 months. Sixty five (57.0%) of participants terminated breastfeeding themselves and 55 (85.9%) of them used traditional methods for weaning their children. The traditional methods used for termination of breastfeeding were staining the nipples to make baby startle (16.4%), applying nipples with a bad taste or smell to make baby disgust (40.0%), covering the nipples with various materials (18.2%), using a pacifier or feeding bottle (20.0%), and separation from mother (5.5%). Conclusions: In this study, it was found that most of the Turkish mothers use improper traditional methods for weaning. This study also demonstrated the urgent need to plan effective counseling services to implement natural weaning rather than traditional methods that are unsuitable for weaning.

36) PMID: 31906316 DOI: 10.3390/pharmaceutics12010033
% 2020 Pharmaceutics
* Stencil Printing-A Novel Manufacturing Platform for Orodispersible Discs.
- Stencil printing is a commonly used printing method, but it has not previously been used for production of pharmaceuticals. The aim of this study was to explore whether stencil printing of drug containing polymer inks could be used to manufacture flexible dosage forms with acceptable mass and content uniformity. Formulation development was supported by physicochemical characterization of the inks and final dosage forms. The printing of haloperidol (HAL) discs was performed using a prototype stencil printer. Ink development comprised of investigations of ink rheology in combination with printability assessment. The results show that stencil printing can be used to manufacture HAL doses in the therapeutic treatment range for 6-17 year-old children. The therapeutic HAL dose was achieved for the discs consisting of 16% of hydroxypropyl methylcellulose (HPMC) and 1% of lactic acid (LA). The formulation pH remained above pH 4 and the results imply that the drug was amorphous. Linear dose escalation was achieved by an increase in aperture area of the print pattern, while keeping the stencil thickness fixed. Disintegration times of the orodispersible discs printed with 250 and 500 µm thick stencils were below 30 s. In conclusion, stencil printing shows potential as a manufacturing method of pharmaceuticals.

37) PMID: 31906384 DOI: 10.3390/ijerph17010307
% 2020 International journal of environmental research and public health
* Does Daily Physical Activity Level Determine the Physical Efficiency of Children After Treatment of Leukemia?
- The aim of the study was to assess daily physical activity level and its influence on the physical efficiency of children after the treatment of leukemia. The study was comprised of 34 children (23 boys and 11 girls) after the treatment of acute lymphoblastic leukemia or myeloid leukemia (mean age of 11.29 ± 2.81 years, mean body height of 146.88 ± 16.11 cm, and mean body weight of 43.68 ± 13.93 kg). The mean time since treatment completion was 3.09 ± 1.80 years. The level of physical activity was assessed with the Health Behavior in School-Aged Children questionnaire (HBSC). Physical efficiency was assessed based on the palant ball throw (assessment of strength, coordination, and upper limb speed), the long jump (assessment of jumping ability, speed and coordination) and the 60 m run (assessment of speed). Measurements of motor skills were normalized, classified according to age and sex, and converted into grades. The mean values obtained in the run and the ball throw showed low pass grades in the study group. In the case of the long jump, satisfactory grades were obtained. A correlation of r = 0.512 was found between vigorous physical activity (HBSC 3) and the grade in the run. A correlation of r = -0.437 was observed between the duration of computer use in leisure time (HBSC 6) and the grade in the long jump, whereas correlations of r = -0.482 and -0.485 were noted between the number hours per week spent on games (HBSC 5) and the duration of computer use in leisure time (HBSC 6) and the grade obtained in the ball throw, respectively. In addition, different levels of physical activity and physical efficiency were demonstrated depending on the time elapsed since treatment completion. Supervised programs promoting daily physical activity should include children after the treatment of leukemia. These programs should also be aimed at improving their physical efficiency.

38) PMID: 31906728 DOI: 10.1080/09638288.2019.1709565
% 2020 Disability and rehabilitation
* Using Rasch and factor analysis to develop a Proxy-Reported health state classification (descriptive) system for Cerebral Palsy.
- Purpose: The Cerebral Palsy quality of life instrument is a well-known health-related quality of life measure for children with Cerebral Palsy. Due to its length it is not suitable as the basis of a preference-based instrument. The aim of this study is to develop a short version of the Cerebral Palsy quality of life instrument that can subsequently be scored as a multi-attribute utility instrument through assigning preference-based values.Methods: A sample of 473 participants who have a child with Cerebral Palsy completed the Cerebral Palsy quality of life instrument(proxy-version) instrument. After deleting questions related only to the proxy, the dimensional structure was obtained using exploratory factor analysis. Extended Rasch analysis was then undertaken to test the psychometric performance of items and select the best item to represent each dimension. Expert opinion was sought to confirm the dimensions and items.Results: A six-dimension classification system was identified, in which four domains were extracted from the factor analysis. Following expert opinion, two other domains were also added, as these were considered to have significant impact on health-related quality of life in children with Cerebral Palsy.Conclusions: The combination of Factor and Rasch analysis along with consultation with patients, clinicians and experts in health-related quality-of-life instrument development, has resulted in a short version of the Cerebral Palsy quality of life instrument.IMPLICATION FOR REHABILITATIONThis study provides the first classification system for children with Cerebral Palsy.The Cerebral Palsy-six dimension (CP-6D) survey, which is a short version of Cerebral Palsy Quality Of Life instrument, can be timesaving when measuring quality of life in children with Cerebral Palsy.The short version (CP-6D) can be used in preference based measurement and generate quality adjusted life years for children with Cerebral Palsy.

39) PMID: 31907526 DOI: 10.1093/dote/doz102
% 2020 Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
* Fixed the gap, solved the problem? Eating skills in esophageal atresia patients at 3 years.
- Although eating problems have been described as long-term morbidities of esophageal atresia (EA), there have been few studies exploring eating outcomes in children born with EA as primary aim. Parents of children operated on for EA in our Institution from January 2012 to January 2016, answered a telephone structured interview developed specifically to conduct the present study, assessing eating skills at 3 years of age. Clinical data were collected from children's medical records. Parents (45 mothers and 6 fathers) of 51 children (male = 34; female = 17) with a median age of 3.5 years form the object of the study. Considering eating problems, parents reported that 23 children (45%) still have episodes of choking during meals at 3 years of age, 9 (45%) of these have more than one episode a week, and 19 parents (39%) reported higher levels of anxiety during mealtimes. Forty-four children (86%) were described by their parents as able to eat alone, 32 (65%) accepted all food textures and 45 (90%) was described as curious about food (3 years). Forty-three (86%) parents let their children eat with other people. Correlations showed that weaning age was significantly associated with number of dilatations (rs = 0.35, P = 0.012), days of mechanical ventilation (rs = 0.40, P < 0.001), and presence of gastrostomy tube at discharge (rs = 0.45, P < 0.001). Chewing age resulted associated with number of dilatations (rs = 0.34, P < 0.01) and days of mechanical ventilation (rs = 0.38, P < 0.01). Presence of choking episodes was associated with curiosity about food (rs = 0.29, P < 0.05), while frequent choking episodes were associated with higher parental anxiety during mealtimes (rs = 0.45, P < 0.05). In order to prevent delay in the achievement of eating developmental milestones in children operated on of EA, we advocate a dedicated preventive intervention from birth to follow-up.

40) PMID: 31907637 DOI: 10.1007/s00431-019-03537-y
% 2020 European journal of pediatrics
* Age-specific occurrence of pathological fractures in patients with spina bifida.
- Pathological fractures (PFs) are common in patients with spina bifida. However, most previous studies refer to the overall fracture rate and largely neglecting putative age-dependent aspects. The aim of this retrospective study was to characterize patterns of fracture occurrence in childhood. In a retrospective study, we identified PF, all in the lower limbs, in 13% of 210 patients with spina bifida aperta. We further identified a bimodal frequency distribution of pathological fractures, with peaks at 1-5 and 10-12 years. We could thereby distinguish two groups of patients: (i) Children with a first fracture before an age of 6 years developed frequently multiple fractures within the following years, but fracture series typically stopped by 6 years-of-age. (ii) Children with a first fracture after the age of 6 years had fewer fractures, but these occurred also in adolescence. PF occurred rarely after the age of 13 years. The age at fracture correlated with the fracture site with 85% of the fractures occurring in the femur in the first five years of life and an increased frequency of tibia and foot fractures later in life. While, overall high lesion levels and preceding immobilizing events were risk factors for PF, femur fractures in children under 6 years-of-age occurred independent of their lesion level, and the age at verticalization did not correlate with PF rates.Conclusion: Based on these findings, standardized and effective preventive physiotherapeutic and/or pharmacological interventions to tackle PF in spina bifida need to consider age-specific differences in occurrence and reoccurrence of fractures.What is Known:• Pathological fractures are common in patients with spina bifida aperta, and associated risk factors include high lesion level, immobilization and low bone density.What is New:• We first report a bimodal frequency distribution of pathological fractures in childhood (first peak 1-5 years, second peak 10-12 years) and link early-onset fracture occurrence with the risk of multiple fractures arise in a short time period but a the chance of self-limitation of fracture series within a few years.• We show that femur fractures in children under 6 years-of-age occurred independent of their lesion level, and the age at verticalization did not correlate with PF rates.• We further link the age-dependent occurrence pattern with the risk of further fractures and with the chance of self-limitation of fracture series. The earlier a first fracture occurs, the more probable multiple fractures arise in a short time period. Nevertheless, early fracture series are often self-limiting within a few years.• Femur fractures in children under 6 years-of-age occurred independent of their lesion level, and the age at verticalization did not correlate with PF rates.• Based on these findings, physiotherapeutic and/or pharmaceutical concepts need to be developed in an age-adapted manner and in consideration of the potential self-limiting nature of fracture series.

41) PMID: 31907731 DOI: 10.1007/s10803-019-04344-y
% 2020 Journal of autism and developmental disorders
* Do Parental Interviews for ASD Converge with Clinical Diagnoses? An Empirical Comparison of the 3di and the DISCO in Children with ASD, a Clinically-Referred Group, and Typically Developing Children.
- Two semi-structured parental interviews are available with algorithms developed to measure DSM-5 criteria of ASD, namely the Developmental, Dimensional and Diagnostic Interview (3di) and the Diagnostic Interview for Social and Communication Disorders (DISCO-11). The main aim of this study was to examine the agreement between classification according to both interviews, and their convergence with the clinical diagnosis. Therefore, the 3di and DISCO-11 were administered from three groups of parents of a 4-18 year old. Results showed 75% agreement between both instruments, but in the ASD group only 16% of the children scored above threshold on both instruments. Exploratory analyses suggested that the 3di failed to detect rigid and repetitive behaviors, whereas the DISCO-11 was insufficiently sensitive in detecting socio-communicative problems.

42) PMID: 31908188 DOI: 10.1177/1359104519897939
% 2020 Clinical child psychology and psychiatry
* Psychometric properties and factorial structure of the Spanish version of the parent-report Mood and Feelings Questionnaire (MFQ-P).
- The parent-report Mood and Feelings Questionnaire (MFQ-P) is one of the few well-established available measures specifically designed to assess childhood depression from the parent's perspective. However, to date, few studies have analyzed the factorial structure of the MFQ-P. The aim of this study was to examine for the first time the psychometric properties of the scores and factorial structure of the Spanish-adapted version of the MFQ-P in a community sample of Spanish-speaking children. Parents of 181 children (54.1% boys) aged 6-8 years participated in this study. The MFQ-P was translated into Spanish and administered along with the Strengths and Difficulties Questionnaire-parent version (SDQ-P) and the Spence Children's Anxiety Scale-parent version (SCAS-P). The scale showed high internal consistency (α = .92) and acceptable test-retest reliability, and factor analysis confirmed the original single-factor structure after removing one item. Convergent and divergent validity was supported. The findings provide initial support for the use of a 33-item version of the MFQ-P in the Spanish population, adding further international evidence for this promising scale.

43) PMID: 31909677 DOI: 10.1080/00016357.2019.1709891
% 2020 Acta odontologica Scandinavica
* Effect of body mass index percentile on skeletal maturation of cervical vertebrae and hand-wrist and dental maturation.
- Objective: The aim of this study was to evaluate the relationship between age- and gender-specific body mass index (BMI) percentile and skeletal and dental maturation in Turkish adolescents.Materials and methods: A sample of 429 patients (171 males, 258 females aged between 7 and 17 years) was selected. Skeletal maturation was identified in the hand-wrist radiography by Björk, Grave and Brown (BGB), and the cervical vertebrae maturation (CVM) method defined by Hassel and Farman in lateral cephalometric radiography. Dental maturation was determined by the Demirjian method. BMI was calculated by reference curves used for Turkish children. A regression model was used for the relationship between BMI percentile and skeletal and dental maturation.Results: There was no significant correlation between BMI and skeletal maturation of cervical vertebrae and dental maturation. A one-percentile increase in BMI percentile accelerates the increase of period (likelihood of being post-pubertal period) to 1.016 times (p < .05). Skeletal maturation of hand-wrist and cervical vertebrae and dental maturation were more prominent in females compared to males (p < .05). Males and females were not statistically significantly different in BMI percentile (p = .52).Conclusions: BMI may be considered before deciding to estimate the skeletal and dental maturation in an individual by the relevant methods.

44) PMID: 30652627 DOI: 10.1080/17483107.2018.1534997
% 2020 Disability and rehabilitation. Assistive technology
* Toward greater involvement of youth with complex communication needs in the selection of augmentative and alternative communication devices.
- Purpose: The study aim was to examine the measurement properties of the Youth Evaluation of Products Scale for Augmentative and Alternative Communication (YEP-AAC) as a means to understand the product attitudes of youth toward their AAC devices.Methods: In study 1, four males and two females between the ages of 8 and 17 years (median age = 14 years) participated in face-to-face interviews. A researcher administered the YEP-AAC and then asked youths to explain the rationale for their item ratings. Two researchers analyzed masked transcripts of the interviews to predict the valence of item ratings assigned by youths. In study 2, 18 families participated in a mailed survey to examine the reliability and validity of the scale domains. Seventeen mothers/one father and their children (9 male/9 female) between the ages of 10 and 20 years participated (median age = 16 years).Results: The level of chance-corrected agreement between valences converted from youth ratings on the YEP-AAC and those assigned by researchers was fair (weighted kappa = 0.38). Internal consistencies of the scale domains were acceptable. Youths who rated their AAC devices more favourably had higher functional communication as hypothesized.Conclusion: The two studies provide support for the face validity, internal consistency and convergent validity of the YEP-AAC as a measure of the product attitudes of youth with complex communication needs.Implications for rehabilitationDeveloping reliable ways to understand the product needs, preferences and values of youth with complex communication needs will help to support the selection, acquisition and use of augmentative and alternative communication (AAC) devices.Consumer socialization helps to explain how youth may acquire the skills, knowledge and experience relevant to their role as AAC consumers.Reliable youth-report questionnaires that are grounded in consumer socialization provide an expedient way to understand the product attitudes of young consumers with complex communication needs.

45) PMID: 31914077 DOI: 10.1097/MD.0000000000018707
% 2020 Medicine
* Validation of "urinary tract dilation" classification system: Correlation between fetal hydronephrosis and postnatal urological abnormalities.
- Aim to illuminate the correlation between fetal hydronephrosis and postnatal urological abnormalities by a new classification system-"urinary tract dilation (UTD)" grade.Of 659 pregnancies screened by ultrasound, 34 cases were found with isolated fetal hydronephrosis, and enrolled in our study from 2017 to 2019. These 34 infants had been prospectively followed up to 6 months after birth by 3 times of urinary tract ultrasound. Hydronephrosis was graded in accordance with the UTD classification system.Among 34 infants with isolated fetal hydronephrosis. Twenty-four (70.6%) were classified as UTD A1 grade (mild hydronephrosis), and the other 10 (29.4%) were UTD A2-3 grade (moderate to severe hydronephrosis) by antenatal evaluation. After birth, all of the 24 infants (70.6%) with UTD A1 grade had normal ultrasonic findings of urinary tract; while the other 10 cases with UTD A2-3 grade had persistent abnormalities of urinary tract by postnatal assessment, sorted as UTD P1 grade (mild hydronephrosis) in 6 cases (17.6%), UTD P2 grade (moderate hydronephrosis) in 2 cases (5.9%) and UTD P3 grade (severe hydronephrosis) in 2 cases (5.9%). The most common postnatal urological abnormality of isolated fetal hydronephrosis was vesicoureteral reflux. During the follow-up period, 7 infants (20.6%) had urinary tract infection episodes and very few obtained positive cultures of the urine. Only 2 infants (5.9%) with the diagnosis of ureterovesical junction obstruction required surgery intervention, who were both classified as UTD P3 grade. None of the children with UTD P1 and P2 grades needed operation.The UTD classification system described the urinary tract both antenatally and postnatally, which could point out the correlation between fetal hydronephrosis and postnatal urological abnormalities. This new classification system is expected to be a good prognostic marker for fetal hydronephrosis.

46) PMID: 31917774 DOI: 10.1097/j.pain.0000000000001797
% 2020 Pain
* Musculoskeletal pain in 6-year-old children: the Generation R Study.
- Musculoskeletal (MSK) pain is frequently reported among adolescents and children and a common reason for consultation in primary care. Our aim is to examine its prevalence in 6-year old children in a general population and to assess associations with physical and psychosocial factors. Data from the Generation R Study, a population based cohort, was used. Prevalence and characteristics of MSK pain were assessed with parent-reported questionnaires at 6-years of age (N=6200). Demographics and data on physical activity, sedentary behaviors, previous reported MSK pain and behavioral problems were extracted from questionnaires. The BMI SD score was calculated from objectively measured weight and height. A three-month prevalence of 10.0% was found for MSK pain in children, of which one third was chronic, and 44.6% experienced together with pain at other sites. Univariate analyses showed that boys and children with lower socioeconomic status (SES) reported MSK pain more frequent compared to other pain and no pain. While no associations were found between MSK pain and children's BMI and physical activity level, children with MSK pain were more likely to watch television ≥2 hours/day. Multivariable analysis showed significant associations for MSK pain at 3 years of age (OR 5.10, 95% CI 3.25 to 7.98) and behavioral problems (OR 2.10, 95% CI 1.19 to 3.72) with the presence of MSK pain. So, MSK pain is already common in young children and is often chronic or recurrent. Previous reported MSK pain and behavioral problems are independently associated with MSK pain in the studied population.

47) PMID: 31919732 DOI: 10.1007/s11096-019-00962-9
% 2020 International journal of clinical pharmacy
* Medication reconciliation upon admission in paediatric hospital setting: preliminary data.
- Background The benefits of medication reconciliation are well established in adult patients, but not in paediatric patients, being a population not included in the guidelines for medication reconciliation published so far. However, it is known that a significant number of children suffer from chronic illnesses leading to a complex pharmacological treatment. Moreover, there are a series of specific factors that cause a greater risk of medication errors in children. Aim The purpose of the present study was to determine whether patients from a paediatric hospital setting may benefit from medication reconciliation at hospital admission, in order to prevent and reduce prescribing errors on admission. Main outcome measures The primary outcome was the number of discrepancies between best possible medication history and prescribed treatment upon admission and, consequently, number of reconciliation errors. The secondary outcome was the main underlying disease with the highest number of reconciliation errors, and the main pharmacotherapeutic groups involved. Results The pharmacist reconciled the medication of 187 patients with an mean age of 6.6 ± 5.1 years. Sixty percent of patients had a base disease and 12.3% had polypharmacy, with an average of 6 drugs per patient. In a 42% of patients, at least one discrepancy was detected between their home treatment and the prescribed treatment upon admission, with 15% of patients having at least one reconciliation error (68% omissions). Neurological diseases were the main underlying disease with at least one reconciliation error (50%). The main pharmacotherapeutic groups involved in reconciliation errors were psychoanaleptic and psycholeptic, anti-acids, antiepileptic, and obstructive airway pharmacotherapy; each accounting for a 17.1%, 14.7%, 11.8% and 11.8% of the total, respectively. Conclusion Within our sample of paediatric patients, the rate of medication discrepancy and reconciliation errors at hospital admission was as relevant in terms of pharmacotherapy as has been reported in adults. The most frequent type of errors was omission of some home treatments. The main underlying disease with at least one error was neurological. As a whole, the detection of reconciliation errors in paediatrics by provision of medication reconciliation could be effective in reducing medication errors.

48) PMID: 31919734 DOI: 10.1007/s12031-019-01409-6
% 2020 Journal of molecular neuroscience : MN
* Clinical and Molecular Characteristics of Two Chinese Children with Infantile Sandhoff Disease and Review of the Literature.
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49) PMID: 31922454 DOI: 10.2217/cer-2019-0170
% 2020 Journal of comparative effectiveness research
* Real-world outcomes of long-term prednisone and deflazacort use in patients with Duchenne muscular dystrophy: experience at a single, large care center.
- Aim: To assess outcomes among patients with Duchenne muscular dystrophy receiving deflazacort or prednisone in real-world practice. Methods: Clinical data for 435 boys with Duchenne muscular dystrophy from Cincinnati Children's Hospital Medical Center were studied retrospectively using time-to-event and regression analyses. Results: Median ages at loss of ambulation were 15.6 and 13.5 years among deflazacort- and prednisone-initiated patients, respectively. Deflazacort was also associated with a lower risk of scoliosis and better ambulatory function, greater % lean body mass, shorter stature and lower weight, after adjusting for age and steroid duration. No differences were observed in whole body bone mineral density or left ventricular ejection fraction. Conclusion: This single center study adds to the real-world evidence associating deflazacort with improved clinical outcomes.

50) PMID: 31924421 DOI: 10.1016/j.ultrasmedbio.2019.12.011
% 2020 Ultrasound in medicine & biology
* Evolving Concepts in Ultrasonography of Pediatric Intussusceptions: Unequivocal Differentiation of Ileocolic, Obstructive and Transient Small-Bowel Intussusceptions.
- The main aim of the study was to elaborate on the various ultrasonographic parameters that can be used for definite differentiation of ileocolic, obstructive small-bowel and transient small-bowel intussusceptions (SBI). In this study, 90 children (63 boys and 27 girls) with suspected intussusception were evaluated. Of these, 54 cases were diagnosed as obstructive intussusceptions (33 ileocolic and 21 ileoileal), 15 cases were classified as transient SBIs and 21 cases were negative for intussusception. The mean fat core diameter was 1.45 ± 0.32 cm for ileocolic versus 0.37 ± 0.06 cm for obstructive SBI versus 0.29 ± 0.08 cm for transient SBI (p < 0.001). The mean lesion diameter was 3.23 ± 0.08 cm for ileocolic intussusceptions and 2.12 ± 0.038 cm for SBI (p < 0.001), and the ratio of inner fat core to outer wall thickness was greater than 1 for ileocolic intussusceptions and less than 1 for SBI. A statistically significant difference was found between segmental invagination of transient versus obstructive SBIs with mean values of 1.93 ± 0.39 cm and 3.17 ± 0.25 cm, respectively, and an "optimal" threshold at 2.5 cm.

51) PMID: 31925500 DOI: 10.1007/s00431-019-03567-6
% 2020 European journal of pediatrics
* Diagnosis and management of Sandifer syndrome in children with intractable neurological symptoms.
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52) PMID: 31925800 DOI: 10.1111/cch.12739
% 2020 Child: care, health and development
* Parentally reported barriers to seeking help and advice for child sleep from healthcare professionals.
- Background Healthcare professionals (HCPs), largely doctors, paediatricians, health visitors, midwives and practice nurses are in a good position to provide information, help, advice or guidance to parents for child sleep. However, evidence suggests there is a gap between the number of parents who desire assistance from HCPs and those that make use of these sources, yet very little is known about the reason for this apparent disparity. The aim of this study was to understand the barriers reported by parents to consulting HCPs about child sleep. Methods In this study 266 UK based parents of children aged 6-36 months old completed an online questionnaire (between October 2015 to October 2016) about their help-seeking behaviours in relation to child sleep. This included reporting perceived barriers to consulting HCPs for child sleep information and advice about problems. Results Thematic analysis highlighted five themes, which parents reported acted as barriers to them consulting HCPs. Specifically, parents perceived HCPs to have a lack of knowledge or training around the topic of child sleep and that advice would be limited in terms of breadth of information or management options that would be offered. Parents were also concerned about wasting their own or HCPs time, perceived there was a lack of continuity in the information they received and held concerns about possible negative consequences for their family if they shared details about any child sleep difficulties. Conclusions Possible practical approaches to address the barriers reported by parents are highlighted. This includes improving training around the topic of child sleep for HCPs and adapting the content or manner in which the topic of child sleep and any associated issues are addressed with parents.

53) PMID: 31927523 DOI: 10.1515/jpem-2019-0469
% 2020 Journal of pediatric endocrinology & metabolism : JPEM
* Relative leptin deficiency in children with severe early-onset obesity (SEOO) - results of the Early-onset Obesity and Leptin - German-Polish Study (EOL-GPS).
- Background Severe early-onset obesity (SEOO) in children is a common feature of monogenic obesity. Gene defects of the leptin-melanocortin pathway can be analysed biochemically and genetically. The aim of this study was to search for children with leptin deficiency or biologically inactive leptin in a cohort of children with SEOO and to study associations between leptin parameters and anthropometric data. Methods The cohort included n = 50 children with SEOO (22 boys) who were recruited at one of four study centres (Germany: Ulm; Poland: Katowice, Szczecin, Rzeszow) between October 2015 and October 2017. Weight (kg) and height (m) were measured, Tanner stage was obtained and a fasting serum blood sample was taken. Serum levels of total leptin (LEP, ng/mL), biologically active leptin (bioLEP, ng/mL) and soluble leptin receptor (sLEPR, ng/mL) were measured. The body mass index (BMI [kg/m2]), BMI z-score (World Health Organization [WHO]), quotient of bioLEP/LEP and leptin-standard deviation score (LEP-SDS) (Tanner stage, BMI and sex-adjusted) were calculated. Results We did not find any child with leptin deficiency or biologically inactive leptin in our cohort. The serum LEP and bioLEP levels were strongly correlated with age (r = 0.50, p < 0.05) and BMI (r = 0.70; p < 0.0001). Girls had higher LEP and bioLEP levels (49.7 ± 35.9 vs. 37.1 ± 25.5 ng/mL, p > 0.05) as well as lower LEP-SDS than boys (-1.77 ± 2.61 vs. -1.40 ± 2.60, p > 0.05). sLEPR levels were negatively correlated with BMI values (r = -0.44; p < 0.05), LEP (r = -0.39; p < 0.05) and bioLEP levels (r = -0.37; p < 0.05). Interestingly, there was a strong inverse relationship between LEP-SDS and BMI (r = -0.72, p < 0.001). Conclusions In this cohort with SEOO, we identified no new cases of children with leptin deficiency or bioinactive leptin. A strong negative correlation between the LEP-SDS and BMI values could be interpreted as relative leptin deficiency in children with SEOO. In case this hypothesis can be confirmed, these children would benefit from a substitution therapy with methionyl human leptin (metreleptin™).

54) PMID: 31927735 DOI: 10.1007/s11356-020-07600-2
% 2020 Environmental science and pollution research international
* Cadmium and chromium levels in water and edible herbs in a risk assessment study of rural residents living in Eastern Iran.
- In arid and semi-arid regions of Iran, water is supplied by qanats, underground channels where pollution is suspected, but unestablished. The aim of this study was thus to run a risk assessment study regarding the levels of cadmium (Cd) and chromium (Cr) in qanat water and edible herbs (Adiantum capillus-verenis, Chara globularis and Plantago lanceolata) growing in qanats in 14 villages in South Khorasan Province in Iran between April and August 2018. Samples were collected in qanats from the same sampling points, and after mineralization in nitric and perchloric acids were analyzed for metal concentrations by means of atomic absorption spectrometry. Concentrations of Cd and Cr found in water were not high (0.028 and 1.091 μg L-1, respectively) and contamination parameters revealed no pollution. The ingestion rate of water and the exposure frequency to metals were the most relevant variables in the model of a sensitivity analysis, but the Hazard Quotient indicated no risk of non-carcinogenic health problems to consumers of the water. The Carcinogenic Risk parameter suggested, however, that there is a risk of these consumers' developing cancer. Concentrations found in herbs were higher than in water but remained below permissible thresholds. Hazard Quotient values of three species studied in the case of children and A. capillus-verenis in the case of adults indicated a potential non-carcinogenic health risk linked with eating them. The study reveals that further research to include many of the qanats across Iran should be carried out to verify the scale of the risk suggested. Graphical abstract.

55) PMID: 31928288 DOI: 10.1080/01942638.2020.1711844
% 2020 Physical & occupational therapy in pediatrics
* Participation in Everyday Activities of Children with and without Specific Learning Disorder.
- Aim: To evaluate the participation in everyday activities of school-aged children with and without Specific Learning Disorder (SLD) in two samples using two different standardized measures of participation.Methods: Study 1 comprised 60 children between 8 and 12 years (M = 10.2, SD = 1.2), 30 of them with and 30 without SLD. Participation was assessed by the LIFE-H questionnaire. Study 2 comprised 30 children between 8 and 12 years (M = 10.1, SD = 1.3), 14 of them had SLD, and 16 were typically developing children. Participation was assessed using the Child Participation Questionnaire.Results: As expected, the participation of children with SLD was significantly decreased in the learning domain compared with children without SLD as well as most other occupational domains. Parents of children with SLD reported lower child's enjoyment and lower parental satisfaction compared to parents of children without SLD.Conclusions: Participation and satisfaction of children and families was lower in children with SLD. We suggest measuring participation and addressing it in evaluations and interventions with this population in order to support their engagement in daily activities beyond school participation and to focus on additional needs of this population.

56) PMID: 31928369 DOI: 10.1089/bfm.2019.0236
% 2020 Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine
* The Possible Beneficial Effect of Breastfeeding on the Clinical Course of Urolithiasis Detected During Infancy.
- Aim: To evaluate the possible effect of breastfeeding duration on the clinical course and treatment of stones detected during infancy. Materials and Methods: Forty-eight infants with renal stones diagnosed between 0 and 23 months were included in this retrospective cohort study. The children were called for regular follow-up visits for the evaluation of physical examination findings, renal size and parenchymal thickness measured by ultrasonography, localization, size and number of stones, spot urine analysis data, metabolic evaluation findings, and duration of breastfeeding and formula use. The relationship between the disease course (progression or stability) and the duration of breastfeeding were assessed from different aspects by considering the original characteristics of the stones at the time of first diagnosis. Results: The mean follow-up period was 46.21 ± 23.22 months, and the most important metabolic risk factor was hypercalciuria with a rate of 29.2%. The mean duration of breast milk intake was longer in children with no disease progression and in those with a reduced size and/or number of stones. The children receiving only breast milk for the first 6 months of life required treatment less and had less growth retardation. Conclusions: Our findings suggest that breastfeeding has critical effects on infantile urolithiasis. Breastfeeding should be encouraged in children with stones particularly detected during infancy. Further studies with a larger case series are needed to reveal the positive effects of breast milk on the clinical course of urolithiasis in children.

57) PMID: 31928581 DOI: 10.21614/chirurgia.114.6.753
% 2020 Chirurgia (Bucharest, Romania : 1990)
* Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study.
- Background: Childhood obesity is becoming more frequent and the age of diagnosis has decreased. Although initially sceptic about bariatric surgery in children and adolescents the number of papers to advocate earlier bariatric interventions in this age group is now considerable. However, there are still a lot of controversies about bariatric surgery's indications and long-term results in these patients. Aim/Objective: To analyze the outcomes of bariatric surgery in a group of adolescents with obesity operated in our hospital. Methods: We analyzed retrospectively all the consecutive adolescent patients who underwent laparoscopic gastric sleeve or gastric bypass between 2013 and November 2019 in a Bariatric Center of Excellence, tracking the perioperative morbidity, the changes of BMI and comorbidities at 12 and 36 PO months. Results: Sixty-four adolescent patients were included in the study, 62 with sleeve gastrectomy (SG) and two with gastric bypass (GBP). Mean age at operation was 15 years and 5 months (SD 18 months). Mean BMI before operation was 39.45 kg/m2 (SD 6.9) and decreased to 24.92 kg/m2 and 22.7kg/m2 by 12 and 36 months respectively. There were no major perioperative complications, but early transitory postoperative dysphagia in one case. The mean length of hospital stay was 3.2 days. Mild, medically manageable complications were encountered in the first postoperative year: (anemia (6/61), folate deficiency (5/61), constipation (22/61), temporary hair loss (12/61). Conclusions: Bariatric surgery is safe and effective in treating adolescent obesity, when preformed in experienced centers.

58) PMID: 31929292 DOI: 10.4103/1319-2442.275489
% 2020 Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
* Women donate, men receive: gender disparity among renal donors.
- In living donor kidney transplantation, a predominance of female-to-male donations has been observed. This gender disparity is more so in developing countries and requires targeted counseling and research to understand whether the cause is medical or sociocultural obstacles. The aim of this study was to analyze all living donor kidney transplants performed at a tertiary care center catering to patients of varied socioeconomic backgrounds. This was a retrospective cohort study of all 600 kidney donors who underwent donor nephrectomy at a single transplant center, Mahatma Gandhi Hospital, Jaipur, between 2013 and November 2018. Patient characteristics including gender, age, and relationship between donors and recipients were obtained. There was a significant increase in the amount of voluntary renal donations, almost doubling every year. Majority (78%) of the donors were females, whereas males contributed to 22% of renal donations. We observed that mothers were the highest number of donors accounting for 181 donations (n = 600), followed by wives who contributed to 102 of the renal donors (n = 600), and 98 (16.3%) fathers donated to their children. Fifteen percent of the donors donated kidney to their siblings. We found gender disparity in living donor kidney transplant in a single center that caters to a population of varied cultures and socioeconomic backgrounds. We anticipate these results will guide clinicians and living donor coordinators and lead to appropriate counseling for patients and potential donors.

59) PMID: 31929463 DOI: 10.1097/NMD.0000000000001120
% 2020 The Journal of nervous and mental disease
* Sociodemographic Characteristics Associated With Speech and Language Delay and Disorders.
- The aim of this study was to identify major risk factors and sociodemographic characteristics responsible for speech and language delay/disorders. Two hundred twenty-eight children (aged 24-72 months) with speech and language delay/disorders participated in this study. The Ankara Developmental Screening Inventory and The Peabody Picture Vocabulary Test were used to assess language profiles and developmental stages of children. Low income, nonattendance in preschool education, low maternal education, having two or more siblings, later birth order (order of siblings), family history of speech and language delay/disorders, preterm birth, low birth weight, and birth complications or the need for intensive care support during neonatal period were identified as risk factors (all p < 0.005). Both sociodemographic and biologic factors were associated with speech and language delay/disorders. Awareness of these factors may provide a chance for earlier diagnosis and intervention. Identification of risk factors of these children would contribute to our knowledge in this field.

60) PMID: 31929584 DOI: 10.1371/journal.pone.0227413
% 2020 PloS one
* Seroepidemiological study of rubella in Vojvodina, Serbia: 24 years after the introduction of the MMR vaccine in the national immunization programme.
- Although rubella is usually a mild childhood disease, this infection in early pregnancy poses a serious problem due to its teratogenic effect. The goal of interrupted circulation and elimination of rubella virus was achieved in many countries in the world. The aim of this study was to determine the status of rubella immunity in Vojvodina and evaluate Serbia's progress toward this goal. A total of 3404 residual serum samples from patients of all ages (1 to 84 years) were included in the study. Samples were collected between May 2015 and December 2017 in Vojvodina. Rubella IgG antibodies were determined using an indirect chemiluminescent immunoassay. Percentage of participants seropositive for rubella antibodies was 92.9% in the entire sample. The highest number of seronegatives was in the youngest (1 year) age group (44.7%), followed by the group aged 24-49 (6.4%) and 2-11 years (6.2%). The absence of a higher percentage of children with protective anti-rubella antibodies in the group aged 2-11 can be explained by a lower immunization coverage during certain years. Participants in the group aged 24-49 were born during the pre-vaccination period with lower rubella incidence, leading to the conclusion that not all individuals of that age came into a contact with the virus. Comparing levels of anti-rubella IgG antibodies of seropositive males and females of different ages reveals that the immunity after a contact with the virus and a previously acquired infection is stronger than the immunity after the vaccination. Although the incidence rate of rubella in Vojvodina has been low for the last ten years, there is still a risk of an outbreak due to a decrease in immunization coverage. This study shows that the percentage of susceptible individuals is high, especially considering women aged 24-49, and that additional ("catch-up") immunization is required.

61) PMID: 31929679 DOI: 10.1007/s10560-019-00627-6
% 2020 Child & adolescent social work journal : C & A
* Psychometric Properties of a Comprehensive Parenting Practice Measure for Parents of Adolescents.
- Many measures exist that assess parenting skills and practices. Few comprehensive measures for parents of adolescents (13-17 years) exist. The aim of the current study was to develop a comprehensive assessment measure of parenting practices based on items from existing measures. Research and clinical settings can benefit from the advancement of a valid and more inclusive measure of parenting to assess youth behavior and functioning. This study utilized a sample that included 387 caregivers and youth (mean age of youth = 13.6, SD = .59) from a longitudinal study examining contextual influences on youths'substance use initiation. Exploratory factor analysis (EFA) was conducted on 12 parent-report measures of parenting. Confirmatory factor analysis (CFA) was conducted on a second sample, which included peers (N = 362, mean age of peers = 13.6, SD = 1.09) and peers' caregivers of the youth included in the original sample. The EFA results indicated a three-factor solution (i.e., parental knowledge and affective relationships, parental control, parental communication and involvement), which was supported in the CFA. The final measure demonstrated strong internal consistency and satisfactory convergent and discriminant validity. This study supported the sound psychometrical features of the Parenting Practice Measure (PPM), a comprehensive measure of parenting quality for adolescent samples. The PPM can serve as a tool for clinicians to design more targeted treatment plans and evaluate the effectiveness of treatments when working with parents with children in the early teenage years.

62) PMID: 31931660 DOI: 10.1177/1074840719898192
% 2020 Journal of family nursing
* Children's Self-Reports About Illness-Related Information and Family Communication When a Parent Has a Life-Threatening Illness.
- Children's experiences of information and family communication when a parent has a life-threatening illness have been sparsely studied, though such information is important for the child's wellbeing. The aim of this study was to explore children's reports of illness-related information and family communication when living with a parent with a life-threatening illness. Forty-eight children, aged 7 to 19 years, were recruited from four specialized palliative home care units in Stockholm, Sweden. All but one child reported that someone had told them about the parent's life-threatening illness; however, two thirds wanted more information. A quarter of the teenagers reported that they had questions about the illness that they did not dare to ask. Half of the children, aged 8 to 12, reported that they felt partially or completely unable to talk about how they felt or show their feelings to someone in the family. Interventions are needed that promote greater family communication and family-professional communication.

63) PMID: 31933412 DOI: 10.1080/13854046.2019.1711198
% 2020 The Clinical neuropsychologist
* Assessing prospective memory in children using the Memory for Intentions Screening Test for Youth (MISTY).
- Objective: Prospective memory (PM) is defined as the ability to remember to complete an intention in the future. The first aim of this study was to address the need for clinically useful measures of PM in children, by assessing the psychometric properties of a new measure of PM in children and adolescents, the Memory for Intentions Screening Test for Youth (MISTY). The second aim was to assess the relationship between prospective memory and age, particularly the relationships between age and the impact of different PM task demands. The third aim was to examine children's performance on different aspects of PM, such as time-based versus event-based cues.Method: One-hundred twenty-four children between the ages of 4 and 15 were given the MISTY.Results: Analyses revealed good internal consistency among the eight individual MISTY trials and among the six MISTY subscales which included two different cue types (event-based and time-based), two different time delays (2 minutes and 10 minutes), and two different response types (action and verbal). Results also revealed good split-half and inter-rater reliability. Findings highlighted significant correlations between age and the MISTY total score and all subscales, consistent with PM lifespan research. On the MISTY, children overall performed better on event-based cues than on time-based cues, and on shorter time delays than longer ones; there was no effect of response type (i.e. action vs. verbal response).Conclusions: The MISTY is a promising instrument with sound psychometric properties that could be useful in both clinical and research settings. Additionally, this study highlights the age-related process of PM development in children.

64) PMID: 31936487 DOI: 10.3390/nu12010182
% 2020 Nutrients
* The Effect of Donor Human Milk Fortification on The Adhesion of Probiotics In Vitro.
- Preterm delivery complications are the primary cause of death among children under the age of five. Preventive strategies include the use of pasteurized donor human milk (DHM), its fortification with human milk fortifiers (protein supplements), and supplementation with probiotics. Our aim was to examine the impact of DHM and fortified DHM (FDHM) on the mucus adhesion properties of two widely used probiotics. The study covered two forms of human milk fortifier, liquid and powdered, with or without probiotics and storage at 4 °C for 24 h. To test the adhesion properties of the probiotic strains, DHM+probiotics and FDHM+probiotics were prepared and added to immobilized mucus isolated from the stool of healthy Finnish infants. The probiotic adhesion was then measured by liquid scintillation. Our results suggest that addition of liquid or powdered human milk fortifier in donor human milk had no impact on probiotic adhesion. In addition, given the increased adhesion of probiotics suspended in buffer, other matrices should be further studied. These factors need to be considered when designing future intervention strategies using probiotics in preterm infants.

65) PMID: 31939337 DOI: 10.1080/01942638.2020.1711841
% 2020 Physical & occupational therapy in pediatrics
* A Solution-Focused Coaching Intervention with Children and Youth with Cerebral Palsy to Achieve Participation-Oriented Goals.
- Background: The ultimate goal of therapeutic intervention is meaningful participation in one's world. For people with Cerebral Palsy (CP), limitations can often become a focus of care.Aim: Our purpose was to investigate the impact of a Solution-Focused Coaching intervention designed for pediatric rehabilitation (SFC-peds) on the attainment of participation goals for children/youth with CP.Method: Twelve participants participated in a repeated measures quantitative study and in qualitative interviews. Children and youth (ages 6-19) and their families participated in three to five coaching sessions, including an initial baseline goal setting session, with one additional follow-up session as well as the qualitative interviews. The Canadian Occupational Performance Measure and Goal Attainment Scaling were incorporated into initial coaching sessions and then re-administered by a blind assessor within one month post-intervention. Qualitative interviews were conducted at this time.Results: Statistically significant improvements were found in goal performance, satisfaction, and attainment. Interview data included consideration of both the content of the intervention (what the practitioner is doing) and the unique SFC-peds process (how the client feels about the intervention).Conclusions: SFC-peds may present an effective approach for working with children/youth with CP to achieve self-selected participation-oriented goals in a relatively short time-period.

66) PMID: 31941135 DOI: 10.3390/nu12010208
% 2020 Nutrients
* Impact of a Three-Week in-Hospital Multidisciplinary Body Weight Reduction Program on Body Composition, Muscle Performance and Fatigue in a Pediatric Obese Population with or without Metabolic Syndrome.
- Metabolic syndrome is a combination of cardiometabolic risk factors, frequently detected in obese children and adolescents. To date, few clinical studies have evaluated the effectiveness of multidisciplinary body weight reduction programs on body mass index, body composition, muscle performance and fatigue in pediatric obese subjects suffering from metabolic syndrome, which might represent a sub-population that is more difficult to be treated and worthy of more intensive interventions than a population less metabolically complicated. The aim of the present study was to compare the impact of a three-week in-hospital multidisciplinary integrated body weight reduction program (BWRP) on body mass index (BMI), body composition (particularly, fat mass (FM) and fat-free mass (FFM)), motor control (evaluated by one-leg standing balance (OLSB) test), muscle performance (evaluated by the stair climbing test (SCT)) and fatigue (evaluated by fatigue severity scale (FSS)) in a pediatric obese population with or without metabolic syndrome. A pediatric population of 548 obese subjects without metabolic syndrome (F/M = 312/236; age range: 8-18 years; BMI: 36.3 ± 6.7 kg/m2) and 96 obese subjects with metabolic syndrome (F/M = 53/43; age range: 9-18 years; BMI: 38.3 ± 6.9 kg/m2) was recruited. The BWRP significantly reduced BMI, FM (expressed as %), SCT time and FSS score, and increased OLSB time in all subgroups of obese subjects, independent of sex and metabolic syndrome, with preservation of FFM. No significant differences in |ΔBMI|, |ΔFM|, |ΔOLSB| or |ΔSCT| times and |ΔFSS| score were found when comparing subjects (males and females) with or without metabolic syndrome, apart from obese females without metabolic syndrome, who exhibited a lower weight loss and FM (expressed as %) reduction when compared to the corresponding male counterpart. In conclusion, the beneficial effects of a three-week BWRP on BMI, body composition, muscle performance and fatigue in a pediatric obese population were not found to be different in patients with or without metabolic syndrome, thus indicating that the more metabolically compromised patient is as responsive to a short-term BWRP as the patient without metabolic syndrome. More prolonged follow-up studies are, however, necessary in order to verify whether the adherence to the multidisciplinary recommendations at home and the long-term maintenance of the positive effects in the two subgroups of patients will remain similar or not.

67) PMID: 31941385 DOI: 10.1080/10641963.2020.1714642
% 2020 Clinical and experimental hypertension (New York, N.Y. : 1993)
* Comparison of cuff-based and cuffless continuous blood pressure measurements in children and adolescents.
- Objective: In recent times, new methods of blood pressure measurements have been introduced, including cuffless blood pressure (BP) measurement device using pulse transit time (PTT) for calculation of BP values. However, it is still unknown how values obtained with a new cuffless device compare with standard ambulatory measurements in children. The main aim of the study was to investigate whether BP values measured by a cuffless PTT device are comparable with measurements by a standard upper arm cuff-based BP device.Methods: Thirty children were prospectively included. Blood pressure measurements using the cuffless device (Somnotouch-NIBP) and cuff-based standard device (Omron 907) were performed simultaneously on the left and right arm.Results: Mean systolic BP of the standard measurements was 123,47 ± 14,91 mmHg and 127,48 ± 15,98 mmHg (p < .001) measured by cuffless method. Mean diastolic BP of the standard ABPM measurements was 66,88 ± 11,86 mmHg and 68,52 ± 12,36 mmHg (p < .001). There were significant positive correlations between standard and cuffless measurements.Conclusion: The results show that the created PWV-BP function produces a significant correlation between BP derived from the PWV and the SBP measured by sphygmomanometry. When applying this device in clinical practice, one may keep in mind that the reported mean values over 24 hours, awake and asleep time are not directly interchangeable with cuff-based standard 24-hour BP values. The measured BP values were higher by the new technique. Although differences in SBP between both methods reached values up to 20 mmHg, we think that the development of a cuffless BP monitoring system will provide novel solutions in various medical situations.

68) PMID: 31941689 DOI: 10.1128/JCM.01611-19
% 2020 Journal of clinical microbiology
* Comparison of the ID NOWTM Influenza A & B 2, Cobas® Influenza A/B, and Xpert® Xpress Flu Point-of-Care Nucleic Acid Amplification Tests for Influenza A/B Detection in Children.
- Early diagnosis of influenza (Flu) virus is critical for patient management and infection control. The ID NOW™ Influenza A & B 2 assay (ID-NOW™; Abbott Laboratories), Cobas® Influenza A/B nucleic acid test (LIAT; Roche Molecular Systems Inc.), and Xpert® Xpress Flu (Xpert; Cepheid) are rapid, point-of-care molecular assays for Flu detection. The study aim was to compare the performance of these three commercially available Clinical Laboratory Improvement Amendments (CLIA) waived Flu assays. We prospectively enrolled 201 children <18 years old from January to April 2018 and collected nasopharyngeal swab specimens in viral media. Aliquots were frozen for testing on different diagnostic platforms per manufacturer's instructions. CDC Flu A/B PCR was used as a reference method to evaluate the performance of these three platforms. Among the 201 specimens tested, the CDC Flu A/B PCR assay detected Flu A/B in 107 samples (Flu A: 73, Flu B: 36; Dual Flu A/B positive: 2), while ID-NOW™ detected 102 samples (Flu A: 69, Flu B: 37; Dual Flu A/B positive: 4; Invalid rate: 1/201-0.5%), LIAT assay detected 112 samples (Flu A: 74, Flu B: 38; Invalid rate: 11/201-5.5%), and Xpert detected 112 samples (Flu A: 76, Flu B: 36; Invalid rate: 6/201-3.0%). The overall sensitivities for ID-NOW™/LIAT/Xpert for Flu A detection (93.2%/100%/100%) and Flu B detection (97.2%/94.4%/91.7%) were comparable. Specificity for Flu A and B detection by all methods was >97%. These molecular assays had higher sensitivity when compared to a historical standard-of-care test result from the BD Veritor™ antigen test (Flu A: 79.5%; Flu B: 66.7%).

69) PMID: 31941898 DOI: 10.1038/s41598-019-57031-4
% 2020 Scientific reports
* Comparison of laparoscopic and open pyloromyotomy: Concerns for omental herniation at port sites after the laparoscopic approach.
- Pyloromyotomy is a common surgical procedure in infants with hypertrophic pyloric stenosis and can be performed with a small laparotomy or laparoscopically. No specific complications have been documented about one of the approaches. We aim to study (severity of) complications of pyloromyotomy and to compare complications of both approaches. Children undergoing pyloromyotomy between 2007 and 2017 were analyzed retrospectively. Complication severity was classified using the Clavien-Dindo classification. We included 474 infants (236 open; 238 laparoscopic). 401 were male (85%) and median (IQR) age was 33 (19) days. There were 83 surgical complications in 71 patients (15.0%). In the open group 45 infants (19.1%) experienced a complication vs. 26 infants in the laparoscopic group (10.5%)(p = 0.013). Severity and quantity of postoperative complications were comparable between both groups. Serosal tears of the stomach (N = 19) and fascial dehiscence (N = 8) occurred only after open pyloromyotomy. Herniation of omentum through a port site occurred only after laparoscopy (N = 6) and required re-intervention in all cases. In conclusion, the surgical complication rate of pyloromyotomy was 15.0%. Serosal tear of the stomach and fascial dehiscence are only present after open pyloromyotomy and omental herniation after laparoscopy respectively. The latter complication is underestimated and requires attention.

70) PMID: 31945192 DOI: 10.1111/sjop.12611
% 2020 Scandinavian journal of psychology
* A Comparison of Attachment representations to Mother and Father using the MCAST.
- The aim of the current study was to examine the factorial structure of the Manchester Child Attachment Story Task (MCAST), using a father doll to address the child's attachment representation to father. While the MCAST, a doll story completion task measuring attachment representations in early childhood, has been validated for use with a mother doll, its use for assessing attachment to father is relatively unexplored. Thus, an additional aim was to compare the factorial structure of the child's attachment representation to father and mother, respectively. We analyzed data from 118 first-grade children who underwent counterbalanced administration of the MCAST with a mother and father doll, respectively, within a period of three months. Exploratory factorial analysis revealed similar, three-factor solutions for attachment to father and mother, with a first factor capturing the child's (scripted) knowledge of secure base/safe haven and a second factor reflecting intrusive and conflict behavior. The third factor was different in the father and mother representations, capturing self-care and role-reversal in attachment to father and disorganization in attachment to mother. Findings support the potential usefulness of the MCAST for exploring the father-child relationship and highlight a need for further research on early attachment representations to father.

71) PMID: 31947628 DOI: 10.3390/nu12010214
% 2020 Nutrients
* Policaptil Gel Retard Intake Reduces Postprandial Triglycerides, Ghrelin and Appetite in Obese Children: A Clinical Trial.
- The aim of this study is to test the hypothesis that the intake of Policaptil Gel Retard® (PGR) is able to affect appetite, metabolic and hormonal postprandial profile in obese children. 46 obese children were randomly assigned to treatment with PGR or placebo, in a double blind clinical trial. Two PGR tablets or placebo were given in fasting condition, before the ingestion of a mixed meal (15 kcal/kg lean body mass). Blood samples were taken at baseline and for 4 hours, for measuring blood lipids, glucose, insulin, ghrelin, and glucagon like peptide-1 (GLP-1). Appetite was quantified using a visual analog scale. Children assuming PGR had a significantly lower increase of postprandial triglycerides (area under the curve (AUC): 3021 (2879) vs. 5038 (3738) mg × 240 min/Dl) and appetite (-234 (274) vs. 36 (329)) than children assuming placebo. The AUC of ghrelin was significantly lower after PGR ingestion, than after placebo (-8179 (8073) vs. -2800 (7579) pg × 240 min/mL). Blood glucose, insulin, non-esterified fatty acids (NEFA) and GLP-1 profiles were not significantly different in the two groups. In conclusion, a single intake of two tablets of PGR was associated with a significant reduction of appetite, ghrelin, and triglycerides in the postprandial period in obese children. Further investigation will assess if a chronic intake of PGR may affect body weight and glucose metabolism.

72) PMID: 31947953 DOI: 10.3390/jcm9010141
% 2020 Journal of clinical medicine
* Randomised Clinical Trial: Calorie Restriction Regimen with Tomato Juice Supplementation Ameliorates Oxidative Stress and Preserves a Proper Immune Surveillance Modulating Mitochondrial Bioenergetics of T-Lymphocytes in Obese Children Affected by Non-Alcoholic Fatty Liver Disease (NAFLD).
- Fatty liver disease is a serious complication of childhood obesity. Calorie-restricted regimen (RCR) is one of the effective therapy for this condition. Aim of the study was to evaluate the effect of lycopene-rich tomato sauce with oregano and basil extracts in obese children with fatty liver on RCR. 61 obese children with fatty liver were enrolled, 52 completed the study. A randomized cross over clinical trial was performed. Participants were assigned to RCR alone or with a supplement of lycopene-rich tomato juice for 60 days; subsequently, the groups were switched to the alternative regimen for the next 60 days. Reduction in BMI, HOMA-IR, cholesterol, triglycerides, liver size, and steatosis was more profound in tomato-supplemented group. Leptin decreased in both groups whereas adiponectin raised only after tomato supplementation. RCR is associated with the impaired engagement of T-cells glycolysis and proliferation, tomato-supplementation resulted in glycolytic metabolic activation of T-cells. Tomato juice ameliorates glucose and lipid metabolism in obese children, improve oxidative and inflammatory state and modulates the mitochondrial metabolism of T-cells contributing to a maintenance of a proper immune surveillance in children, impaired by RCR. The addition of tomato to RCR could be considered a protective and preventive support to obese child.

73) PMID: 31947976 DOI: 10.3390/vaccines8010015
% 2020 Vaccines
* Epidemiology of Respiratory Syncytial Virus-Related Hospitalization Over a 5-Year Period in Italy: Evaluation of Seasonality and Age Distribution Before Vaccine Introduction.
- Respiratory Syncytial Virus (RSV) is associated with most of the acute viral respiratory tract infections causing hospitalization with a peak during the first months of life. Many clinical trials of RSV vaccine candidates are being carried out. The aim of this study was to obtain epidemiologic information to give suggestions on target populations and prevention strategies before the introduction of new vaccines or monoclonal antibodies. We retrospectively evaluated, over a 5-year period (September 2014-August 2019), a population of hospitalized Italian children aged 0-6 years with a laboratory confirmed diagnosis of RSV infection. Risk factors, seasonality of RSV infection, distribution according to age, cases of coinfections and reinfections and cases needing Intensive Care Unit were evaluated. Hospitalizations due to RSV were 624 in the period under study. The peak was found between November and April, with 80.4% of cases recorded between December and February. 62.5% of cases were found in children under three months of age and 41% in children under 30 days old. The need for intensive care was associated with younger ages, with 70.9% of cases in children below three months of age. Unless the incoming vaccines demonstrate a strong herd protection effect, preventive strategies should be aimed at newborns or at maternal immunization.

74) PMID: 31951638 DOI: 10.1371/journal.pone.0227314
% 2020 PloS one
* Functional characterization of NK cells in Mexican pediatric patients with acute lymphoblastic leukemia: Report from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia.
- Acute lymphoblastic leukemia (ALL) is the most common cancer in children around the globe. Mexico City has one of the highest incidence rates of childhood leukemia worldwide with 49.5 cases per million children under the age of 15 which is similar to that reported for Hispanic populations living in the United States. In addition, it has been noted a dismal prognosis in Mexican and Hispanic ALL pediatric population. Although ALL, like cancer in general, has its origins in endogenous, exogenous, and genetic factors, several studies have shown that the immune system also plays a deterministic role in cancer development. Among various elements of the immune system, T lymphocytes and NK cells seem to dominate the immune response against leukemia. The aim of the present study was to perform a phenotypic and functional characterization of NK cells in ALL Mexican children at the moment of diagnosis and before treatment initiation. A case-control study was conducted by the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL). 41 cases were incident ALL children younger than 17 years old and residents of Mexico City. 14 controls were children without leukemia, matched by age and sex with cases. NK cell function was evaluated by degranulation assays towards K562 cells and SLAM-associated protein (SAP) expression was measured by intracellular staining. All assays were performed using peripheral blood mononuclear cells from controls and patients. The results indicate that NK mediated cytotoxicity, measured by CD107a degranulation assays in response to K562 cells, was reduced in ALL patients compared to controls. Interestingly, an impaired NK cell killing of target cells was not equally distributed among ALL patients. In contrast to patients classified as high-risk, standard-risk patients did not display a significant reduction in NK cell-mediated cytotoxicity. Moreover, patients presenting a leukocyte count ≥ 50,000xmm3 displayed a reduction in NK-cell mediated cytotoxicity and a reduction in SAP expression, indicating a positive correlation between a reduced SAP expression and an impaired NK cell-mediated citotoxicity. In the present study it was observed that unlike patients with standard-risk, NK cells from children presenting high-risk ALL, harbor an impaired cytotoxicity towards K562 at diagnosis. In addition, NK cell function was observed to be compromised in patients with a leukocyte count ≥50,000xmm3, where also it was noticed a decreased expression of SAP compared to patients with a leukocyte count <50,000xmm3. These data indicate NK cell-mediated cytotoxicity is not equally affected in ALL patients, nevertheless a positive correlation between low SAP expression and decreased NK cell-mediated cytotoxicity was observed in ALL patients with a leukocyte count ≥50,000xmm3. Finally, an abnormal NK cell-mediated cytotoxicity may represent a prognostic factor for high-risk acute lymphoblastic leukemia.

75) PMID: 31952132 DOI: 10.3390/ijerph17020538
% 2020 International journal of environmental research and public health
* Preferences for Sweet and Fatty Taste in Children and Their Mothers in Association with Weight Status.
- Strong preferences for sweet and fat tastes (characters) are associated with the consumption of foods high in calories. The taste preferences, especially the sweet and fat tastes (characters), might be one of the factors predisposing children to become overweight and/or develop obesity. The aim of the study is to assess taste preferences in children and their mothers in association with their weight status. In the study, 150 children aged 8-15 were included; among them, 75 had overweight and/or obesity, and 150 mothers of whom 69 were overweight and/or obese. Body composition estimates were obtained using a bioelectrical impedance analysis-body height was measured using a stadiometerSeca 213. Sensory tests were carried out using apple juice of various sugar content and crackers of various fat content. Results show that children prefer a sweet taste more often than their mothers (50.0% vs. 35.3%, p = 0.009). In the group of children who preferred the high-sweet taste, there were twice as many obese children when compared to the group who preferred the low-sweet taste. Similar relationships applied to mothers. Preferences for fat taste (character) among mothers increased the risk of obesity among their children (39% vs. 20%; p = 0.039). Taste preferences, especially a sweet taste preference, seem to be one of the important factors determining overweight and obesity in children and adults. The fat taste(character) preferences in mothers correlate with the overweight and/or obesity of their children, while such preferences among children were not significantly different irrespective of body weight status.

76) PMID: 31953558 DOI: 10.1007/s00431-020-03577-9
% 2020 European journal of pediatrics
* Primary school children and nutrition: lifestyles and behavioral traits associated with a poor-to-moderate adherence to the Mediterranean diet. A cross-sectional study.
- The Mediterranean diet has consistently shown a beneficial influence on health and longevity. The aim of this cross-sectional study was to identify all the various factors-such as socio-demographics, lifestyles, and behavioral traits-associated with the risk of a poor adherence to the Mediterranean diet in a sample of Italian primary school children. The study sample included 267 children in their first year of primary school. Their mothers were asked to answer an anonymous, self-administered questionnaire that investigated their children's adherence to the Mediterranean diet (using the KidMed score) and variables related to their lifestyles, behavioral traits, and socio-economic factors. A multivariate logistic regression was performed to test the association between adherence to the Mediterranean diet and the other variables investigated. Most of the children involved in this study (73.9%) were classifiable as having a poor-to-moderate adherence to the Mediterranean diet. Higher odds of a poor adherence to the Mediterranean diet were associated with videogame playing for more than 1 h a day and lower levels of mothers' health consciousness. On the other hand, the odds were lower in association with more time spent practicing sport, higher levels of prosocial behavior, and with mothers having a high school education as opposed to fewer years of schooling.Conclusions: These results point to the need to consider the role of mothers' health consciousness and formal education in influencing their children's diets. Health promotion interventions should focus on the importance of a healthy overall lifestyle, which includes not only appropriate nutrition but also time spent on physical activity and leisure activities (such as playing videogames).What is Known:• Most of the children were classified as having a poor or moderate adherence to the Mediterranean diet. This result reflects a trend common to numerous countries of the Mediterranean area in recent years.• A mother's level of formal education influences her child's diet.What is New:• Higher levels of prosocial traits coincided with lower odds of a poor adherence to the Mediterranean diet.

77) PMID: 31953852 DOI: 10.1002/cne.24858
% 2020 The Journal of comparative neurology
* Structural brain network development in children following prenatal methamphetamine exposure.
- Brain imaging studies in children with prenatal methamphetamine exposure (PME) suggest structural and functional alterations of striatal, frontal, parietal and limbic regions. However, no longitudinal studies have investigated changes in structural connectivity during the first two years of formal schooling. The aim of this study was to explore the effects of PME on structural connectivity of brain networks in children over the critical first two years of formal schooling when foundational learning takes place. Networks are expected to gradually increase in global connectedness while segregating into defined systems. Graph theoretical analysis was used to investigate changes in structural connectivity at age 6 and 8 years in children with (n = 17) and without PME (n = 16). While healthy control children showed increased connectivity in frontal and limbic hubs over time, children with PME showed increased connectivity in the superior parietal cortex and striatum in their global network. Furthermore, compared to control children, those with PME were characterized by less change in segregation of structural networks over time. These findings are consistent with previous work on regions implicated in children with PME, but they additionally demonstrate alterations in structural connectivity between regions that underlie primary cognitive, behavioral and emotional development. Understanding patterns of network development during critical periods in at-risk children may inform strategies for supporting this group of children in these developmental tasks important for lifelong brain health and development. This article is protected by copyright. All rights reserved.

78) PMID: 31954134 DOI: 10.1016/j.actatropica.2020.105341
% 2020 Acta tropica
* Identification of potential 'hot spots' of cystic echinococcosis transmission in the province of Río Negro, Argentina.
- Cystic echinococcosis (CE) is a parasitic zoonosis caused by Echinococcus granulosus. The control program of CE of Rio Negro province, Argentina, involves annual surveillance using ultrasound (US) screening in school children, and five-year cross-sectional surveys to detect livestock farms with parasitized dogs by coproELISA with confirmation tests (Western Blot or PCR). Control program is based on deworming of dogs with praziquantel and the aim is to identify areas at risk of Cystic echinococcosis transmission to humans, using all available data sources. The information was spatially distributed in 13 program areas and, at a smaller geographical scale, in 80 Primary Health Care Centers. CoproELISA surveys involved three randomized sampling periods (2003-05, 2009-10, 2017-18), with 1790 canine fecal samples. The US surveys were conducted in 2003-08, 2009-16 and 2017-18 in 34515 children. Heat maps were created at the smallest geographic scale with QGIS 3.4.6. For the consecutive sampling periods, prevalence of positive canine fecal samples from livestock farms were 14.7, 12.1 and 7.8%, respectively, and children prevalence was 0.4, 0.2 and 0.1%, respectively. The study has been developed on a scale according to which the temporal-spatial distribution of CE allows to adjust control strategies in those areas of potential transmission of the zoonosis to humans.

79) PMID: 31954140 DOI: 10.1016/j.ypmed.2020.105993
% 2020 Preventive medicine
* Childhood predictors of adult obesity in the Chicago Longitudinal Study.
- Despite obesity being a major concern for both children and adults in the United States today, there are few successful childhood interventions that curb obesity later in life. The objective of the current study is to identify childhood predictors of adult obesity at multiple levels in a large longitudinal sample of participants from an economically disadvantaged childhood cohort. 1065 participants (93% Black) from the Chicago Longitudinal Study were interviewed as part of a 30-year follow-up between 2012 and 2017. Parent involvement, school quality, neighborhood human capital, socioemotional learning skills, and achievement motivation assessed before age 12 years were examined as predictors of Body Mass Index (BMI) at age 35 years. Child neighborhood human capital and socioemotional learning skills predicted a lower BMI in adulthood and a decreased likelihood of being classified as obese; when separately analyzed by sex, both neighborhood human capital and higher socioemotional learning skills predicted a decreased likelihood of obesity for males and females. Being female and higher birthweight were associated with larger adult BMI. Socioemotional learning and neighborhood human capital in childhood consistently predict a decreased likelihood of being obese at age 35 in this predominately Black sample. Future obesity intervention/prevention programs should aim to bolster childhood socioemotional learning resources and neighborhood capital.

80) PMID: 31954142 DOI: 10.1016/j.ypmed.2020.105988
% 2020 Preventive medicine
* The impact of computer use on myopia development in childhood: The Generation R study.
- Environmental factors are important in the development of myopia. There is still limited evidence as to whether computer use is a risk factor. The aim of this study is to investigate the association between computer use and myopia in the context of other near work activities. Within the birth cohort study Generation R, we studied 5074 children born in Rotterdam between 2002 and 2006. Refractive error and axial length was measured at ages 6 and 9. Information on computer use and outdoor exposure was obtained at age 3, 6 and 9 years using a questionnaire, and reading time and reading distance were assessed at age 9 years. Myopia prevalence (spherical equivalent ≤-0.5 dioptre) was 11.5% at 9 years. Mean computer use was associated with myopia at age 9 (OR = 1.005, 95% CI = 1.001-1.009), as was reading time and reading distance (OR = 1.031; 95% CI = 1.007-1.055 (5-10 h/wk); OR = 1.113; 95% CI = 1.073-1.155 (>10 h/wk) and OR = 1.072; 95% CI = 1.048-1.097 respectively). The combined effect of near work (computer use, reading time and reading distance) showed an increased odd ratio for myopia at age 9 (OR = 1.072; 95% CI = 1.047-1.098), while outdoor exposure showed a decreased odd ratio (OR = 0.996; 95% CI = 0.994-0.999) and the interaction term was significant (P = 0.036). From our results, we can conclude that within our sample of children, increased computer use is associated with myopia development. The effect of combined near work was decreased by outdoor exposure. The risks of digital devices on myopia and the protection by outdoor exposure should become widely known. Public campaigns are warranted.

81) PMID: 31955342 DOI: 10.1007/s10943-020-00980-2
% 2020 Journal of religion and health
* Trauma and Post-traumatic Growth: Spirituality and Self-compassion as Mediators Among Parents Who Lost Their Young Children in a Protracted Conflict.
- The purpose of the present study was to expand the knowledge on trauma and post-traumatic growth (PTG) by exploring this relationship in parents who lost their children in Kashmir (India). The main aim of the present study was to examine whether spirituality and self-compassion mediate the relationship between trauma and PTG. Data were collected from 80 parents in the age range of 35-80 years (Mean Age = 52.09). Traumatic Grief scale Prigerson et al. (in Am J Psychiatry 154:616-623, 1997), Daily Spirituality Scale (Underwood and Teresi, Ann Behav Med 24(1):22-33, 2002), Self-Compassion Scale (Raes et al., Clin Psychol Psychoth 18:250-255, 2011), and PTG Inventory (Tedeschi and Calhoun, J Trauma Stress 9(3):455-471, 1996) scales were used to measure trauma, spirituality, self-compassion, and PTG, respectively. Results of the study indicated the presence of average amount of spirituality and high amount of trauma among the participants. High level of self-compassion and post-traumatic growth was also found among the participants. The results showed that there is no significant direct relationship between trauma and PTG; however, both the indirect paths (trauma, spirituality, and PTG as well as trauma, self-compassion, and PTG) were found to be significant. The results of the present study supported serial mediation model of Trauma and PTG through spirituality and self-compassion. It implies that trauma would lead to spirituality which in turn would lead to self-compassion and which would finally result in PTG. The result provided another lens to see the relationship between trauma and PTG.

82) PMID: 31955583 DOI: 10.1556/650.2020.31543
% 2020 Orvosi hetilap
* [Prevalence of hypertension in overweight and obese Hungarian children and adolescents].
- Introduction: The prevalence of overweight and obesity is increasing worldwide, which affects not only adults, but children and adolescents as well. Moreover, this condition may lead to several comorbidities, such as elevated or even high blood pressure. Aim: Aim of this study was to assess the prevalence of overweight- and obesity-related elevated and high blood pressure in a population aged 3-18 years in Hungary. Method: Between 2005 and 2018, altogether 8624 (boys = 4719) individuals were enrolled to this study. Normal weight, overweight and obese groups were created on the basis of body mass index. The diagnosis of elevated (systolic and/or diastolic blood pressure is between 90th and 95th percentile) and high blood pressure (systolic and/or diastolic blood pressure is over 95th percentile) was based on detailed examination (laboratory tests, abdominal ultrasonography, paediatric cardiology and 24-hours ambulatory blood pressure monitoring). Results: In this study, the prevalence of overweight and obesity was 23.5% overall, 26.4% in boys and 20% in girls. The prevalence of elevated blood pressure was 9.8% in overweight patients, while it was 4.6% in the obese group. The prevalence of high blood pressure was 8.3% (odds ratio: 1.1%, 95% CI) among overweight subjects, while it was 26.7% (odds ratio: 3.6, 95% CI) in the obese group. Conclusion: To the best of our knowledge, this is the first Hungarian population-based study on the prevalence of overweight- and obesity-related elevated and high blood pressure assessed in a large contemporary cohort of children and adolescents. The cardiovascular risk is increased in this patient group. Hence, it is essential to set up a proper primary prevention strategy. Orv Hetil. 2020; 161(4): 151-160.

83) PMID: 31956939 DOI: 10.1007/s11239-020-02036-4
% 2020 Journal of thrombosis and thrombolysis
* Silent bleeding in children and adolescents with immune thrombocytopenia: relation to laboratory parameters and health related quality of life.
- Occult hemorrhage can occur in any internal organ in ITP patients. Four sites of occult hemorrhage require attention including microscopic hematuria, fecal occult blood loss, retinal hemorrhage, and silent intracranial hemorrhage. The aim of this study was to investigate the frequency of subclinical bleeding in children with ITP and its relation to clinical and laboratory disease parameters including bleeding score and health related quality of life. This cross-sectional study included 40 ITP patients recruited from the Pediatric Hematology/Oncology unit, Children's Hospital, Ain Shams University, Cairo, Egypt. Inclusion criteria were patients with ITP (acute, persistent or chronic) having platelet count of 20,000/cmm or less at diagnosis/relapse, patients with overt bleeding and patients with secondary ITP were excluded. Occult blood in stools and urine analysis, fundus examination, and non-contrast brain MRI for microbleeds were done. Out of the forty included patients, 24 had chronic, 11 had acute and 5 had persistent ITP. Eleven patients had occult bleeds. Two patients had occult blood in stools, five had microscopic hematuria, one had retinal bleeds and three patients had brain microbleeds. Their mean age was 10.23 ± 4.18 years and their mean initial bleeding score was 2.55 ± 0.82. Nine patients with occult bleeding were chronic, one persistent and one acute ITP patients. There were no significant differences between patients with occult bleeding and those without as regards the initial bleeding score, platelet counts and hemoglobin level, as well as the mean platelet counts and mean hemoglobin level over the disease duration (p > 0.5). The scoring of the parent's life, Child and parents' quality of life was low in 3 out of 11 patients with occult bleeding. There was no significant difference between patients with occult bleeding and those without as regards the ITP child and parents' quality of life items (p = 0.850 and 0.511 respectively). Our results suggest that subclinical bleeding is a potential risk in children with ITP, more commonly chronic ITP patients. We could not demonstrate a significant relation of occult bleeding to the laboratory findings, bleeding score, and the ITP health quality of life; nevertheless, the significance of the routine assessment of occult bleeding in ITP and the identification of high-risk patients require additional studies.

84) PMID: 30714507 DOI: 10.1080/20469047.2019.1570443
% 2020 Paediatrics and international child health
* Outcomes of in-hospital paediatric cardiac arrest from a tertiary hospital in a low-income African country.
- Background: There are scarce data on outcomes of in-hospital paediatric cardiac arrest (CA) in resource-poor settings and none for World Bank-defined low-income countries.Aim: To report the outcomes of in-hospital paediatric CA from a university-affiliated referral hospital in Malawi.Methods: Data were collected prospectively on patients aged 30 days to 13 years who experienced CA and underwent cardiopulmonary resuscitation (CPR) at Kamuzu Central Hospital in Lilongwe, Malawi from January through June 2017. Utstein-style reporting guidelines for CAs were used to define outcomes; the primary outcome was survival to hospital discharge. A data collection form was used to record patient, arrest and resuscitation characteristics.Results: A total of 135 patients fulfilled the criteria for inclusion in the study. Resuscitation outcomes are presented in Figure 1 using a modified Utstein template. In-hospital CA was associated with 100% mortality. Return of spontaneous circulation (ROSC) was obtained in 6% of patients and sustained ROSC in 4%; 24-h survival was zero. The most common admission diagnosis was malaria (51%). Most arrests occurred on the paediatric ward (90%) rather than critical care units. Most resuscitations were led by trainees and mid-level providers (58%) rather than paediatricians (23%).Conclusion: Survival following in-hospital paediatric CA was zero, suggesting that CPR may have no benefit in this tertiary hospital. Future efforts to improve outcomes should focus on advocating better pre-arrest care and research interventions aimed to identify and treat children at risk of CA within the resource constraints of this setting.

85) PMID: 31138037 DOI: 10.1177/1087054719851575
% 2020 Journal of attention disorders
* Effects of Sleep Extension on Inhibitory Control in Children With ADHD: A Pilot Study.
- Objective: Children with ADHD often have sleep complaints and cognitive deficits. The aim of this pilot study was to determine whether sleep extension improves inhibitory control, a primary cognitive deficit in ADHD. Method: Children with (n = 11) and without (n = 15) ADHD participated in a within-subject sleep extension intervention that targeted nocturnal sleep duration. Sleep was assessed with actigraphy and polysomnography. Inhibitory control was assessed with a Go/No-Go task. Results: For children without ADHD, there was a significant main effect of time, such that morning inhibitory control was 10% greater than evening inhibitory control. However, inhibitory control did not differ between the baseline and extension conditions in this group. For children with ADHD, although morning inhibitory control did not differ from evening inhibitory control, sleep extension improved inhibitory control by 13% overall. Conclusion: These results suggest that a sleep extension intervention improves inhibitory control in children with ADHD.

86) PMID: 31959781 DOI: 10.1038/s41598-020-57457-1
% 2020 Scientific reports
* Sampling and processing blood samples within the South American Youth/Child cARdiovascular and Environmental (SAYCARE) Study.
- Obesity and overweight in children and adolescents is increasing rapidly worldwide; however, scarce data have been reported from South America countries. With the purpose of assessing hyperlipidemia, insulin resistance and chronic inflammation, the evaluation of blood biomarkers such as glucose, lipoproteins and chronic inflammation proteins is required. In the context of the SAYCARE study, in children and adolescents (3 to 18 years) from seven South American cities, our aim was to assess the impact of pre analytical conditions on different biomarkers evaluated in 474 fresh serum samples, in different country centers. We also evaluated the stability according to time and frozen storage within this study across the concordance of the results obtained from the 49 blood samples measured in three different centers. Significant correlations as well as concordance were observed in TG, Total-C, HDL-C and glucose between Buenos Aires and São Paulo. The samples evaluated in Teresina and São Paulo presented similar results, with exception of total cholesterol. We observed acceptable concordance between Buenos Aires vs São Paulo and Teresina vs São Paulo, suggesting that samples could be processed in each of these centers. This concordance is a consequence of the strict pre analytical conditions previously established in the SAYCARE study.

87) PMID: 31961193 DOI: 10.1037/dev0000883
% 2020 Developmental psychology
* Is poverty on young minds? Stereotype endorsement, disadvantage awareness, and social-emotional challenges in socioeconomically disadvantaged children.
- Socioeconomic disadvantage is associated with social-emotional difficulties, including internalizing and externalizing problems, as early as toddlerhood. The aim of the current study was to understand whether economically disadvantaged children's beliefs about the consequences and correlates of poverty (poverty stereotypes) and their beliefs about their personal economic disadvantage contribute to their social-emotional functioning. Interviews were conducted with 94 socioeconomically diverse 4- to 9-year-old children, whose parents reported on their social-emotional functioning and family socioeconomic disadvantage. As hypothesized, among relatively socioeconomically disadvantaged children, perceived disadvantage was associated with social-emotional functioning. The same relation was not found for relatively socioeconomically advantaged children. Socioeconomically disadvantaged children who endorsed higher levels of personal disadvantage had more attention problems and more anxious-depressive symptoms than socioeconomically disadvantaged children who endorsed lower levels of personal disadvantage. In addition, only among socioeconomically disadvantaged children (and not among relatively advantaged children) was negative stereotyping associated with attention problems. Socioeconomically disadvantaged children who endorsed more negative stereotypes had higher levels of attention problems. There was no evidence of an association between negative stereotyping and anxious-depressive symptoms and no moderation of this relation by socioeconomic status. Implications and directions for future research are discussed in light of several relevant theoretical frameworks, including stigma consciousness, status anxiety, and critical consciousness. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

88) PMID: 31961702 DOI: 10.1044/2019_AJSLP-19-00103
% 2020 American journal of speech-language pathology
* Preliminary Investigation of the Perspectives of Parents of Children With Cerebral Palsy on the Supports, Challenges, and Realities of Integrating Augmentative and Alternative Communication Into Everyday Life.
- Purpose To ensure long-term adoption and use of augmentative and alternative communication (AAC) technologies, they must be designed to support children to participate within everyday activities and routines that are prioritized by families. The aim of this study was to gain parent perspectives on how AAC technologies were integrated into everyday life. Method Nine parents of children with cerebral palsy who used AAC technologies participated in semistructured interviews to provide their perspectives on how AAC technologies were integrated into the functional contexts of everyday life. Results Five major themes emerged from the discussions: (a) integrating AAC into life, (b) AAC technologies, (c) child needs and skills, (d) parent responsibilities and priorities, and (e) AAC process and decision making. Children were able to use AAC technologies within a variety of everyday contexts with various partners; however, challenges included access to technologies within care routines and outdoor activities as well as partners who lacked knowledge regarding operational competencies and effective interaction strategies. To integrate AAC technologies into life, parents prioritized technology features including ease of programming, improved physical design, features to enhance efficiency and ease of access, and availability of multiple functions and features (e.g., games and leisure activities, environmental controls). Conclusion AAC manufacturers and mainstream technology developers should work to ensure that technologies are responsive to the supports, limitations, and ideal features identified by parents. Future research should seek input from a larger group of stakeholders and use longitudinal methods to examine perceptions of AAC technologies over time. Supplemental Material https://doi.org/10.23641/asha.11625543.

89) PMID: 31963185 DOI: 10.3390/nu12010229
% 2020 Nutrients
* Sharing is Caring: A Study of Food-Sharing Practices in Australian Early Childhood Education and Care Services.
- Food connects people, and can significantly impact the physical, social and emotional development of young children. Food sharing and family-style mealtimes can support healthy eating practices and psychological well-being among young children, and carersother than family members, such as Early Childhood Education and Care staff, play an important role in the provision of these practices. Despite increasing numbers of Australian children attending Early Childhood Education and Care services, there is often reluctance among staff to promote such mealtime practices, to the detriment of children's social and emotional development. The aim of this paper was to focus on the potential role of Early Childhood Education and Care services in facilitating food sharing and family-style mealtime practices in the earliest stages of the lifespan. A qualitative, netnographic approach was used, and data was collected as part of the broader 'Supporting Nutrition for Australian Childcare' (SNAC) study, via online conversation threads, observations and qualitative interviews. Findings demonstrated that whilst many Early Childhood Education and Care services are committed to supporting food sharing and family-style mealtime practices, a number of barriers were reported. These included the perception that babies and toddlers could not participate in these practices, concerns about food hygiene and cross contamination of allergens, and negative parental influences on food sharing. In conclusion, this paper supports the practice of food sharing in Early Childhood Education and Care settings and calls for them to become embedded in everyday operations to support the physical, social and emotional development of Australia's future generations.

90) PMID: 31963189 DOI: 10.3390/ijerph17020577
% 2020 International journal of environmental research and public health
* Intestinal Parasites, Anemia and Nutritional Status in Young Children from Transitioning Western Amazon.
- Young children are particularly vulnerable to the chronic sequelae of anemia, including poor nutritional status. The aim of this study was to assess intestinal parasitic-infections and nutritional status (anemia and linear growth) in preschool children living in contemporary Amazonian communities. A cross-sectional study measured children's intestinal parasites and hair-Hg (HHg)-biomarkers of fish consumption, hemoglobin levels, and growth (anthropometric Z-scores). Children came from traditional-living families (Itapuã), and tin-mining settlements (Bom Futuro) representing current transitioning populations. It covered 937 pre-school children (from 1 to 59 months of age) from traditional (247) and immigrant tin-mining families (688). There was a high prevalence of intestinal polyparasitic-infection in children from both communities, but mild anemia (hemoglobin concentrations) and moderate (chronic) malnutrition were more frequent in children from traditional families than in children from tin-mining settlers. Children from traditional families ate significantly more fish (HHg mean of 4.3 µg/g) than children from tin-mining families (HHg mean of 2.3 µg/g). Among traditional villagers, children showed a significant correlation (r = 0.2318; p = 0.0005) between hemoglobin concentrations and HHg concentrations. High rates of parasitic infection underlie the poverty and attendant health issues of young children in the Brazilian Amazon. The intestinal parasite burden affecting poor Amazonian children resulting from unsafe water, lack of sanitation and poor hygiene is the most urgent environmental health issue.

91) PMID: 31963706 DOI: 10.3390/ijerph17020625
% 2020 International journal of environmental research and public health
* "Not Only Adults Can Make Good Decisions, We as Children Can Do That as Well" Evaluating the Process of the Youth-Led Participatory Action Research 'Kids in Action'.
- In Youth-led Participatory Action Research (YPAR), youth collaborate with academic researchers to study a problem, develop actions that align with their needs and interests, and become empowered. 'Kids in Action' aimed to develop actions targeting healthy physical activity and dietary behavior among, and together with, 9-12-year-old children as co-researchers. This paper presents the process evaluation of 'Kids in Action' based on eight focus groups with children (N = 40) and eight interviews with community partners (N = 11). Interview guides were based on empowerment theory and the RE-AIM framework, in order to evaluate the study on: empowerment, collaborations, reach, effectiveness, adoption, implementation, and maintenance. Transcripts were analyzed using evaluation and provisional coding. Both children and community partners perceived an increased awareness of healthy behaviors and an improvement in confidence, critical awareness, leadership and collaboration skills, which contributed to increased feelings of empowerment. Community partners valued child participation and the co-created actions. Actions were also well-perceived by children and they liked being involved in action development. The strong relationship of researchers with both children and relevant community partners proved an important facilitator of co-creation. Future studies are recommended to attempt closer collaboration with schools and parents to gain even more support for co-created actions and increase their effectiveness.

92) PMID: 31963752 DOI: 10.3390/nu12010252
% 2020 Nutrients
* Small-Scale Livestock Production in Nepal Is Directly Associated with Children's Increased Intakes of Eggs and Dairy, But Not Meat.
- Animal source foods (ASF) provide nutrients essential to child growth and development yet remain infrequently consumed in rural Nepal. Agriculture and nutrition programs aim to increase ASF intake among children through small-scale animal husbandry projects. The relationship between livestock ownership and children's consumption of ASF, however, is not well established. This study examined associations between livestock ownership and the frequency with which Nepali children consume eggs, dairy, and meat. We analyzed longitudinal 7-day food frequency data from sentinel surveillance sites of the Policy and Science of Health, Agriculture and Nutrition (PoSHAN) study. Data consisted of surveys from 485 Nepali farming households conducted twice per year for two years (a total of 1449 surveys). We used negative binomial regression analysis to examine the association between the number of cattle, poultry, and meat animals (small livestock) owned and children's weekly dairy, egg, and meat intakes, respectively, adjusting for household expenditure on each food type, mother's education level, caste/ethnicity, agroecological region, season, and child age and sex. We calculated predicted marginal values based on model estimates. Children consumed dairy 1.4 (95% CI 1.1-2.0), 2.3 (1.7-3.0) and 3.0 (2.1-4.2) more times per week in households owning 1, 2-4 and >4 cattle, respectively, compared to children in households without cattle. Children consumed eggs 2.8 (2.1-3.7) more times per week in households owning 1 or 2 chickens compared to children in households without chickens. Child intake of meat was higher only in households owning more than seven meat animals. Children's intakes of dairy, eggs, and meat rose with household expenditure on these foods. Small-scale animal production may be an effective strategy for increasing children's consumption of eggs and dairy, but not meat. Increasing household ability to access ASF via purchasing appears to be an important approach for raising children's intakes of all three food types.

93) PMID: 31963781 DOI: 10.3390/dj8010012
% 2020 Dentistry journal
* Use of an Oral Device in the Stabilization of Facial Advancement after Early Removal of the Osteodistraction Device for Postoperative Sequelae.
- The aim of this study is to present an oral device that improves splanchnocranium stability after osteodistraction in children treated for correction of craniofacial malformations. When removal of the distraction device before the end of the treatment is necessary, the reposition of a new fixation system might not be possible. In these cases, regrown bone is immature, and relapse of malformation occurs frequently. We have been treating these cases by the application of an oral device named Maxillary Advancement Contention (MAC). MAC is used in every patient when any complication interrupts the protocol of osteodistraction before the end of the stabilization time. The device is placed immediately after the removal of the distraction device and left in place for at least three months. We used MAC in six children surgically treated for correction of craniosynostosis with facial or craniofacial advancement. To establish the relapse of malformation we analyzed relations Sella-Nasion-Orbitale (SNOr) and Sella-Nasion-A point (SNA) angles before application of the MAC and after one year. The analysis of stability was excellent in every patient. This device might help, with a minimally invasive procedure, to maintain the obtained advancement allowing stabilization of the regrown bone.

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