Journal Description
Children
Children
is an international, peer-reviewed, open access journal on children’s health published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Pediatrics)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 13.8 days after submission; acceptance to publication is undertaken in 2.5 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.4 (2022);
5-Year Impact Factor:
2.6 (2022)
Latest Articles
Evaluation and Comparison of the Efficacy of Subcutaneous and Sublingual Immunotherapy for the Treatment of Allergic Asthma in Children
Children 2024, 11(6), 692; https://doi.org/10.3390/children11060692 - 5 Jun 2024
Abstract
Specific immunotherapy represents the only potentially curative treatment for allergic asthma. Allergens can be administered subcutaneously (SCIT) or sublingually (SLIT). The aim of the current study was to evaluate and compare the efficacy of SCIT and SLIT for the treatment of allergic asthma
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Specific immunotherapy represents the only potentially curative treatment for allergic asthma. Allergens can be administered subcutaneously (SCIT) or sublingually (SLIT). The aim of the current study was to evaluate and compare the efficacy of SCIT and SLIT for the treatment of allergic asthma in children. Our study included 69 children with allergic asthma who underwent immunotherapy for house dust mites or pollen for at least 3 consecutive years. After 3 years of SCIT and SLIT, the median number of asthma exacerbations in the last three months decreased from 2 to 0 (p < 0.01) and from 1 to 0 (p < 0.01), respectively. When comparing the efficacy of SCIT and SLIT, our study revealed a significantly better efficacy of SCIT only in terms of increasing lung function. The median increase in forced expiratory volume in one second (FEV1) after 3 years was 8% with SCIT and −1% with SLIT (p < 0.01). Daily controller therapy could be withdrawn or reduced in 9 out of 16 (56.3%) children who received it before SCIT (p < 0.01) and in 19 of 29 (65.6%) children who received it before SLIT (p < 0.01), but the difference in efficacy was not significant (p = 0.88). Both SCIT and SLIT are effective treatments for allergic asthma in children.
Full article
(This article belongs to the Special Issue Pediatric Respiratory Diseases: Diagnosis, Treatment, and Prevention)
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Open AccessArticle
Reconstructive Options for Pressure Ulcers in Pediatric Patients
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Dominika Krakowczyk, Jakub Opyrchał, Tomasz Koszutski, Krzysztof Dowgierd and Łukasz Krakowczyk
Children 2024, 11(6), 691; https://doi.org/10.3390/children11060691 - 5 Jun 2024
Abstract
Background: Pressure ulcers pose significant challenges in terms of treatment, often exhibiting a low success rate and a propensity for recurrence. Children with neurological impairments such as myelomeningocele and those with spinal injuries are particularly vulnerable to developing pressure ulcers. Despite advancements, achieving
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Background: Pressure ulcers pose significant challenges in terms of treatment, often exhibiting a low success rate and a propensity for recurrence. Children with neurological impairments such as myelomeningocele and those with spinal injuries are particularly vulnerable to developing pressure ulcers. Despite advancements, achieving successful reconstruction remains a formidable task. Common sites prone to pressure ulcer formation include the sacral and ischial regions, as well as areas over bony prominences. Additionally, pressure ulcers attributable to medical devices facilitating ambulation are observed. While many pressure sores resolve spontaneously, conservative management may prove ineffective for some, especially in cases of stage 3 and 4 ulcers, necessitating surgical intervention. Various surgical techniques are employed for the treatment of decubitus ulcers, yet there exists no universally accepted gold standard for their management. This paper presents our institutional experience in this domain, highlighting differences in surgical approaches, treatment outcomes, complication rates, and long-term follow-up. Methods: This study involved a retrospective analysis of medical records from 11 children, ranging in age from 10 to 17 years, who presented with extensive pressure ulcers that were unresponsive to conservative treatment measures. Data collection spanned from February 2017 to June 2022. The pressure ulcers affected various anatomical regions, including the ischial area (5/11 patients), sacral region (3/11 patients), lower limb (1/11 patients), elbow (1/11 patients), and perineal area (1/11 patients). Surgical intervention was the chosen approach for all cases, employing techniques such as reconstructive surgery utilizing perforator, pediculated flaps, and locoregional flaps. Results: Eleven patients with sore ulcers (stage 3 and 4) were treated surgically. We present our experience of using surgical methods, including pedicled anterolateral flaps, pedicled gracilis musculocutaneous flaps, propeller flaps and locoregional flaps. In some cases, surgery was performed after 60 days of hospitalization or ten years after ulcer occurrence. We reviewed the length of hospital stay, surgical management and patient satisfaction. Patients were followed up to 5 years post-surgery. All flaps survived except for one flap where partial necrosis was observed. The recurrence rate was 9.01% (1/11). One patient underwent another surgery. The general outcome was satisfactory. Conclusions: Conclusions: Our findings underscore the efficacy of flap reconstruction surgical techniques in the management of pressure ulcers among pediatric patients. Based on our experience and the outcomes observed, we advocate for considering reconstructive surgery as a viable therapeutic option early in the treatment course, particularly for stage 3 and 4 ulcers. This approach not only addresses the immediate needs of patients but also holds promise for long-term wound healing and prevention of recurrence.
Full article
(This article belongs to the Section Pediatric Surgery)
Open AccessArticle
A Deep Learning Approach to Automatic Tooth Caries Segmentation in Panoramic Radiographs of Children in Primary Dentition, Mixed Dentition, and Permanent Dentition
by
Esra Asci, Munevver Kilic, Ozer Celik, Kenan Cantekin, Hasan Basri Bircan, İbrahim Sevki Bayrakdar and Kaan Orhan
Children 2024, 11(6), 690; https://doi.org/10.3390/children11060690 - 5 Jun 2024
Abstract
Objectives: The purpose of this study was to evaluate the effectiveness of dental caries segmentation on the panoramic radiographs taken from children in primary dentition, mixed dentition, and permanent dentition with Artificial Intelligence (AI) models developed using the deep learning method. Methods: This
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Objectives: The purpose of this study was to evaluate the effectiveness of dental caries segmentation on the panoramic radiographs taken from children in primary dentition, mixed dentition, and permanent dentition with Artificial Intelligence (AI) models developed using the deep learning method. Methods: This study used 6075 panoramic radiographs taken from children aged between 4 and 14 to develop the AI model. The radiographs included in the study were divided into three groups: primary dentition (n: 1857), mixed dentition (n: 1406), and permanent dentition (n: 2812). The U-Net model implemented with PyTorch library was used for the segmentation of caries lesions. A confusion matrix was used to evaluate model performance. Results: In the primary dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8525, 0.9128, and 0.8816, respectively. In the mixed dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.7377, 0.9192, and 0.8185, respectively. In the permanent dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8271, 0.9125, and 0.8677, respectively. In the total group including primary, mixed, and permanent dentition, the sensitivity, precision, and F1 scores calculated using the confusion matrix were 0.8269, 0.9123, and 0.8675, respectively. Conclusions: Deep learning-based AI models are promising tools for the detection and diagnosis of caries in panoramic radiographs taken from children with different dentition.
Full article
(This article belongs to the Section Pediatric Dentistry)
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Open AccessArticle
A Qualitative Investigation of Parent Perceptions of Home Exercises for Congenital Muscular Torticollis
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Audrey Stitt and Rebecca Operacz
Children 2024, 11(6), 689; https://doi.org/10.3390/children11060689 - 5 Jun 2024
Abstract
The purpose of this qualitative study was to describe parent perceptions of the home exercise program (HEP) for infants with congenital muscular torticollis (CMT), and how these perceptions evolved over a physical therapy (PT) plan of care. Twelve participants were recruited from a
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The purpose of this qualitative study was to describe parent perceptions of the home exercise program (HEP) for infants with congenital muscular torticollis (CMT), and how these perceptions evolved over a physical therapy (PT) plan of care. Twelve participants were recruited from a pediatric PT clinic, and nine completed interviews at three time points. Qualitative description and an iterative approach for thematic analysis of 27 interviews yielded three themes that corresponded to the research questions. The participants’ responses were categorized into three main themes: (1) parents’ perceptions of three key exercises within the HEP, (2) internal and external sources of stress, and (3) sources of empowerment and disempowerment. Regarding the HEP, parents articulated common sentiments for three frequently prescribed exercises for the management of CMT: (1) tummy time was the fast favorite, (2) ipsilateral cervical rotation was perceived as stressful, and (3) contralateral cervical lateral flexion felt uncomfortable. Additionally, participants disclosed internal and external sources of stress (guilt, uncertainty, and the demands of returning to work) and sources of disempowerment (inconsistent messaging frompractitioners, feeling overwhelmed) and empowerment (being able to see the bigger picture and clear communication and education about the diagnosis) with respect to managing their infant’s CMT. These themes provide insight into the evolution of parent perceptions over a PT plan of care for CMT. Participants’ insights suggest a need for consistent messaging regarding the diagnosis and evidence-based management of CMT, addressing parent stress, and modifying how exercises are taught. This study contributes updated research on parents’ experiences with physical therapy and the HEP for their infant’s CMT.
Full article
(This article belongs to the Special Issue New Trends in Physical Therapy for Children)
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Open AccessArticle
Unveiling Child Sexual Abuse Disclosure in China: An Ecological Exploration of Survivors’ Experiences
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Tian Tian, Ilan Katz and Xiaoyuan Shang
Children 2024, 11(6), 688; https://doi.org/10.3390/children11060688 - 4 Jun 2024
Abstract
Through a thematic analysis of firsthand posts from 258 abuse survivors in online forums from 2016 to 2023, this research examines the barriers that Chinese children encounter when disclosing sexual abuse. The anonymous narratives shed light on the motives behind survivors’ reluctance to
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Through a thematic analysis of firsthand posts from 258 abuse survivors in online forums from 2016 to 2023, this research examines the barriers that Chinese children encounter when disclosing sexual abuse. The anonymous narratives shed light on the motives behind survivors’ reluctance to reveal abuse, the outcomes following disclosure, and the wider implications for survivors and their families under culture. The findings underscore the need for early intervention upon disclosure, aiming to safeguard children from further harm and foster the development of an effective child protection framework.
Full article
(This article belongs to the Special Issue Growing Up Unequal: Family Complexity, Child Maltreatment and Child Well-Being)
Open AccessReview
Impact of Parental Cancer on Children: Differences by Child’s Age and Parent’s Disease Stage
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Gessica Migliaccio, Michela Petrillo, Valentina Abate, Ornella Mazzoni, Daria Di Bonito and Daniela Barberio
Children 2024, 11(6), 687; https://doi.org/10.3390/children11060687 - 4 Jun 2024
Abstract
(1) Receiving an oncological diagnosis involves countless physical and mental challenges for those who become ill. In addition to this, developmental activities are put on hold when a parent becomes ill, significantly impairing children’s normal growth and development. The purpose of this review
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(1) Receiving an oncological diagnosis involves countless physical and mental challenges for those who become ill. In addition to this, developmental activities are put on hold when a parent becomes ill, significantly impairing children’s normal growth and development. The purpose of this review is to highlight the psychological impact of cancer on children, with particular attention to differences based on the age of the child and the stage of the parent’s disease. (2) Articles published on PubMed up until October 2023 were searched. Qualitative and quantitative studies were included in this review after an evaluation of the full text. The study selection process was undertaken by two researchers, and articles for which there was unanimous agreement between researchers were included in the review. (3) Children’s psycho-emotional responses differ based on their age and the disease stage. In general, good communication and a supportive family environment that understands everyone’s needs seem to constitute important protective factors that favor the adaptation of the entire family to the disease. (4) The family, as an evolutionary system, finds itself facing phases typical of development. Knowing the variables that intervene in the process of adaptation to the disease will allow us to design specific and differentiated clinical interventions based on the needs of not only the patient but also the entire family.
Full article
Open AccessArticle
The Impact of Time to Initiate Therapeutic Hypothermia on Short-Term Neurological Outcomes in Neonates with Hypoxic–Ischemic Encephalopathy
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Till Dresbach, Viktoria Rigoni, Anne Groteklaes, Thomas Hoehn, Anja Stein, Ursula Felderhoff-Mueser, Andreas Mueller and Hemmen Sabir
Children 2024, 11(6), 686; https://doi.org/10.3390/children11060686 - 4 Jun 2024
Abstract
Background: Therapeutic hypothermia is the standard treatment for neonates with hypoxic–ischemic encephalopathy. Preclinical evidence indicates that the time to initiate therapeutic hypothermia correlates with its therapeutic success. This study aims to explore whether there is a correlation between the early initiation of therapeutic
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Background: Therapeutic hypothermia is the standard treatment for neonates with hypoxic–ischemic encephalopathy. Preclinical evidence indicates that the time to initiate therapeutic hypothermia correlates with its therapeutic success. This study aims to explore whether there is a correlation between the early initiation of therapeutic hypothermia and improved short-term neurological outcomes in cooled asphyxiated newborns. Methods: A retrospective analysis was conducted, involving 68 neonates from two different neonatal intensive care units. The impact of time to initiate treatment, time to reach the target temperature, and time between initiation and target temperature was correlated with short-term outcomes on MRI. Results: We did not find a significant difference between outcomes regarding the time to start treatment and the time to achieve the target temperature. Interestingly, neonates with a poor outcome were treated on average earlier than neonates with a favorable outcome but required more time to reach the target temperature. Additionally, the study results did not support the hypothesis that a shorter time to initiate treatment would lead to shorter times to achieve the target temperature. Conclusion: Based on our findings, it is recommended to prioritize a thorough evaluation of neonatal encephalopathy before initiating therapeutic hypothermia. Early initiation of treatment should be balanced with the time required for precise assessment to ensure better outcomes.
Full article
(This article belongs to the Special Issue New Advances and Perspectives for Neonatal Brain Hypoxia)
Open AccessArticle
Electronic Heart (ECG) Monitoring at Birth and Newborn Resuscitation
by
Sarah Mende, Syed Ahmed, Lise DeShea, Edgardo Szyld and Birju A. Shah
Children 2024, 11(6), 685; https://doi.org/10.3390/children11060685 - 4 Jun 2024
Abstract
Background: Approximately 10% of newborns require assistance at delivery, and heart rate (HR) is the primary vital sign providers use to guide resuscitation methods. In 2016, the American Heart Association (AHA) suggested electrocardiogram in the delivery room (DR-ECG) to measure heart rate during
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Background: Approximately 10% of newborns require assistance at delivery, and heart rate (HR) is the primary vital sign providers use to guide resuscitation methods. In 2016, the American Heart Association (AHA) suggested electrocardiogram in the delivery room (DR-ECG) to measure heart rate during resuscitation. This study aimed to compare the frequency of resuscitation methods used before and after implementation of the AHA recommendations. Methods: This longitudinal retrospective cohort study compared a pre-implementation (2015) cohort with two post-implementation cohorts (2017, 2021) at our Level IV neonatal intensive care unit. Results: An initial increase in chest compressions at birth associated with the introduction of DR-ECG monitoring was mitigated by focused educational interventions on effective ventilation. Implementation was accompanied by no changes in neonatal mortality. Conclusions: Investigation of neonatal outcomes during the ongoing incorporation of DR-ECG may help our understanding of human and system factors, identify ways to optimize resuscitation team performance, and assess the impact of targeted training initiatives on clinical outcomes.
Full article
(This article belongs to the Special Issue New Insights in Neonatal Resuscitation)
Open AccessReview
Voice as a Biomarker of Pediatric Health: A Scoping Review
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Hannah Paige Rogers, Anne Hseu, Jung Kim, Elizabeth Silberholz, Stacy Jo, Anna Dorste and Kathy Jenkins
Children 2024, 11(6), 684; https://doi.org/10.3390/children11060684 - 4 Jun 2024
Abstract
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The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of artificial intelligence (AI) in analyzing pediatric voice as a biomarker
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The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of artificial intelligence (AI) in analyzing pediatric voice as a biomarker for health. The included studies featured voice recordings from pediatric populations aged 0–17 years, utilized feature extraction methods, and analyzed pathological biomarkers using AI models. Data from 62 studies were extracted, encompassing study and participant characteristics, recording sources, feature extraction methods, and AI models. Data from 39 models across 35 studies were evaluated for accuracy, sensitivity, and specificity. The review showed a global representation of pediatric voice studies, with a focus on developmental, respiratory, speech, and language conditions. The most frequently studied conditions were autism spectrum disorder, intellectual disabilities, asphyxia, and asthma. Mel-Frequency Cepstral Coefficients were the most utilized feature extraction method, while Support Vector Machines were the predominant AI model. The analysis of pediatric voice using AI demonstrates promise as a non-invasive, cost-effective biomarker for a broad spectrum of pediatric conditions. Further research is necessary to standardize the feature extraction methods and AI models utilized for the evaluation of pediatric voice as a biomarker for health. Standardization has significant potential to enhance the accuracy and applicability of these tools in clinical settings across a variety of conditions and voice recording types. Further development of this field has enormous potential for the creation of innovative diagnostic tools and interventions for pediatric populations globally.
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Open AccessArticle
Leveraging User-Friendly Mobile Medical Devices to Facilitate Early Hospital Discharges in a Pediatric Setting: A Randomized Trial Study Protocol
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Gianvincenzo Zuccotti, Marta Marsilio, Laura Fiori, Paola Erba, Francesca Destro, Costantino Zamana, Laura Folgori, Anna Mandelli, Davide Braghieri, Chiara Guglielmetti, Martina Pisarra, Letizia Magnani, Gabriele Infante, Dario Dilillo, Valentina Fabiano, Patrizia Carlucci, Elena Zoia, Gloria Pelizzo and Valeria Calcaterra
Children 2024, 11(6), 683; https://doi.org/10.3390/children11060683 - 4 Jun 2024
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Background: Mobile technology is increasingly prevalent in healthcare, serving various purposes, including remote health monitoring and patient self-management, which could prove beneficial to early hospital discharges. Aims: This study investigates the transitional care program experience facilitating early discharges in a pediatric setting through
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Background: Mobile technology is increasingly prevalent in healthcare, serving various purposes, including remote health monitoring and patient self-management, which could prove beneficial to early hospital discharges. Aims: This study investigates the transitional care program experience facilitating early discharges in a pediatric setting through the use of an easy-to-use mobile medical device (TytoCare™, TytoCare Ltd., Natanya, Israel). Outcomes: This study aims to assess the effectiveness of telehomecare in achieving complete resolution of diseases without readmission, compare the length of stay between intervention and standard care groups, and gather user and professional experiences. Methods: A randomized open-label, controlled pilot study enrolled 102 children, randomly assigned to the telehomecare (TELE) group (n = 51, adopting early hospital discharge with continued home monitoring) or the standard-of-care (STAND) group (n = 51). Primary outcomes include complete disease resolution without readmission. Secondary objectives include recording a shorter length of stay in the intervention group. Surveys on user and professional experiences were conducted. A group of 51 children declining telemedicine services (NO-TELE) was also included. Results: In the TELE group, 100% of children achieved complete disease resolution without readmission, with a median duration of stay of 4 days, significantly shorter than the 7 days in the STAND group (p = 0.01). The telemedicine system demonstrated efficient performance and high satisfaction levels. The NO-TELE group showed no significant differences in demographics or digital technology competence. Perceived benefits of telemedicine included time and cost savings, reduced hospital stays, and technology utility and usability. Conclusions: This study demonstrates that user-friendly mobile medical devices effectively facilitate early hospital discharges in a pediatric setting. These devices serve as a bridge between home and hospital, optimizing care pathways.
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Open AccessArticle
The Relationship between Cyber Violence and Cyber Sex Crimes: Understanding the Perception of Cyber Sex Crimes as Systemic Issues
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Eugene Lee and Hye Eun Lee
Children 2024, 11(6), 682; https://doi.org/10.3390/children11060682 - 4 Jun 2024
Abstract
This study examines the relationship between cyber violence and cyber sex crimes, specifically focusing on these crimes as systemic issues among adolescents. The research highlights the severe impact of cyber sex crimes, characterized by the non-consensual sharing of sexually explicit content. It examines
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This study examines the relationship between cyber violence and cyber sex crimes, specifically focusing on these crimes as systemic issues among adolescents. The research highlights the severe impact of cyber sex crimes, characterized by the non-consensual sharing of sexually explicit content. It examines various factors that may contribute to witnessing cyber sex crimes, including exposure to violent online content, personal experiences of cyber violence (either as a victim or perpetrator), and the role of parental and teacher interventions. Utilizing data from a nationwide survey conducted by the Korea Communications Commission, the study analyzes responses from 9016 adolescents in 2021 and 9693 in 2022. This analysis reveals significant predictors of witnessing cyber sex crimes and examines how perceptions of cyber violence and interventions of authoritative figures may influence adolescents’ perception of cyber sex crimes as either systemic or individual issues. With females disproportionately affected, the findings underscore a gendered aspect of cyber violence. Furthermore, these insights suggest that perceiving cyber violence as a serious issue leads to viewing cyber sex crimes as systemic problems necessitating societal intervention. The study advocates for enhanced digital literacy education and systemic changes to protect adolescents from the widespread threats of cyber violence and sex crimes.
Full article
(This article belongs to the Special Issue Screen Time, Adverse Childhood Experiences and Childhood Mental Health on Child and Adolescent Development: Current Research and Future Directions)
Open AccessArticle
Positive Youth Development, Mental Stress and Life Satisfaction in Middle School and High School Students in Portugal: Outcomes on Stress, Anxiety and Depression
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Marina Carvalho, Cátia Branquinho, Barbara Moraes, Ana Cerqueira, Gina Tomé, Catarina Noronha, Tânia Gaspar, Nuno Rodrigues and Margarida Gaspar de Matos
Children 2024, 11(6), 681; https://doi.org/10.3390/children11060681 (registering DOI) - 3 Jun 2024
Abstract
The relation between positive youth development and stress, anxiety and depression was studied considering the mediator role of psychological symptoms and life satisfaction. A total of 3109 students included in the “Psychological Health and Well-being” study of the School Observatory participated, including 1618
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The relation between positive youth development and stress, anxiety and depression was studied considering the mediator role of psychological symptoms and life satisfaction. A total of 3109 students included in the “Psychological Health and Well-being” study of the School Observatory participated, including 1618 females and 1491 males aged between 11 and 18 years old (M = 14.45; SD = 1.88), belonging to different school groups in different regions of the country. Adolescents with higher stress, depression and anxiety levels reported lower levels of competence, confidence and connection, as well as more psychological symptoms and lower life satisfaction. The results also showed that adolescents with higher levels of competence, confidence and connection reported less psychological symptoms and more life satisfaction. Two separate mediation analyses were performed to analyse the role of mental distress and life satisfaction on the relationship between positive youth development indicators and stress, anxiety and depression. These analyses confirmed the predicted relationships and partial mediations between mental distress and life satisfaction. These results should be taken into account in public policies concerning young people’s health and education that should involve both targeted and indicated prevention strategies, including school and community-based interventions, in order to be effective.
Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents: 2nd Edition)
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Open AccessArticle
Association of Antenatal Corticosteroids with Neonatal Outcomes among Very Preterm Infants Born to Mothers with Clinical Chorioamnionitis: A Multicenter Cohort Study
by
Qingqing Lin, Yanchen Wang, Ying Huang, Wei Zhu, Siyuan Jiang, Xinyue Gu, Jianhua Sun, Shoo K. Lee, Wenhao Zhou, Deyi Zhuang, Yun Cao and on behalf of Chinese Neonatal Network
Children 2024, 11(6), 680; https://doi.org/10.3390/children11060680 - 3 Jun 2024
Abstract
The objective of this study was to assess the relationship of ACS with neonatal outcomes among very preterm infants born to mothers with clinical chorioamnionitis in China. This was a multicenter retrospective cohort study. Study participants included infants born at <32 weeks’ gestation
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The objective of this study was to assess the relationship of ACS with neonatal outcomes among very preterm infants born to mothers with clinical chorioamnionitis in China. This was a multicenter retrospective cohort study. Study participants included infants born at <32 weeks’ gestation with clinical chorioamnionitis and registered in the Chinese Neonatal Network from 1 January 2019 to 31 December 2020. Infants were divided into two groups: any amount of ACS or no administration of ACS. Multivariable generalized linear models using generalized estimating equations were used to assess the association between ACS and neonatal outcomes among the study population. We identified 2193 infants eligible for this study; 1966 (89.6%) infants had received ACS therapy, and 227 (10.4%) had not received any ACS therapy. Among very preterm infants born to mothers with clinical chorioamnionitis, any ACS usage was significantly associated with decreased risks of early death (aRR 0.56, 95% CI 0.32, 0.99) and severe ROP (aRR 0.51, 95% CI 0.28, 0.93) after adjustment for maternal hypertension, gestational age at birth, Caesarean section, being inborn, and administration of systemic antibiotics to the mother within 24 h before birth. In addition, out of the 2193 infants, the placentas of 1931 infants underwent pathological examination with recorded results. Subsequently, 1490 of these cases (77.2%) were diagnosed with histological chorioamnionitis. In 1490 cases of histologic chorioamnionitis, any ACS usage was significantly related to decreased risks of overall mortality (aRR 0.52, 95% CI 0.31, 0.87), severe ROP (aRR 0.47, 95% CI 0.25, 0.97), and respiratory distress syndrome (aRR 0.52, 95% CI 0.31, 0.87). We concluded that any ACS was associated with reduced risks for neonatal early death and severe ROP among very preterm infants born to mothers with clinical chorioamnionitis.
Full article
(This article belongs to the Section Pediatric Neonatology)
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Open AccessOpinion
Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures
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Gloria Pelizzo, Francesca Destro, Ugo Maria Pierucci, Sara Costanzo, Anna Camporesi, Veronica Diotto, Valeria Calcaterra and Amulya K. Saxena
Children 2024, 11(6), 679; https://doi.org/10.3390/children11060679 - 3 Jun 2024
Abstract
Surgical techniques are evolving in Pediatric Surgery, especially in the area of minimal access surgery (MAS) where indications for applications are expanding. Miniaturization of instruments, using natural orifices, single incisions, or remotely controlled robot-assisted procedures, promises to increase the benefits of MAS procedures
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Surgical techniques are evolving in Pediatric Surgery, especially in the area of minimal access surgery (MAS) where indications for applications are expanding. Miniaturization of instruments, using natural orifices, single incisions, or remotely controlled robot-assisted procedures, promises to increase the benefits of MAS procedures in pediatrics. Many pediatric pathologies are rare, and specialized surgical and anesthesiologic instruments are necessary to manage them, defined as “orphan devices”, for which development and dissemination on the market are slowed down or sometimes hindered by regulatory standards and limiting financial conflicts of interest. In pediatric surgery, it is of utmost importance to work in a multidisciplinary way to offer a surgical path that is safe and supported by technological advances. For this reason, optimizing pediatric anesthesia is also a crucial factor where technological advances have made monitoring more precise, thereby enhancing safety in the operative room. The development of customized instruments and technologies should be supported by pediatric research and should be adapted to the individualities of the small patient. This overview outlines the importance of dedicated instruments developed for the safe completion of MAS procedures in pediatrics.
Full article
(This article belongs to the Special Issue Advances and Future Challenges of Minimally Invasive Surgery in Children: 2nd Edition)
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Open AccessArticle
The Ripple Effect: Quality of Life and Mental Health of Parents of Children with Attention Deficit Hyperactivity Disorder in Saudi Arabia: A Cross-Sectional Study
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Shuliweeh Alenezi, Samah H. Alkhawashki, Muneera Alkhorayef, Sarah Alarifi, Shahad Alsahil, Renad Alhaqbani and Nouf Alhussaini
Children 2024, 11(6), 678; https://doi.org/10.3390/children11060678 - 3 Jun 2024
Abstract
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition in children in Saudi Arabia. ADHD significantly impacts children and their families, particularly by increasing parental stress and diminishing quality of life. In Saudi Arabia, there is a research gap regarding the
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Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition in children in Saudi Arabia. ADHD significantly impacts children and their families, particularly by increasing parental stress and diminishing quality of life. In Saudi Arabia, there is a research gap regarding the quality of life and coping mechanisms of parents managing children with ADHD. This study assesses levels of depression and anxiety, quality of life, and coping strategies among parents of children diagnosed with ADHD. Methods: We conducted a cross-sectional online survey with 151 parents of ADHD-diagnosed children, utilizing the WHOQOL-Brief for life quality, the Brief-COPE for coping strategies, and the Patient Health Questionnaire (PHQ) for depression (PHQ9-9 items) and generalized anxiety (GAD7-7 items) modules. Results: Among the parents surveyed, 36% reported moderate to severe depression, while 39.1% experienced moderate to high anxiety levels. Quality of life was significantly positively correlated with higher household monthly income (HHI), employment status, sibling count, and effective coping strategies. Conversely, a parent’s age, educational level, and, in particular, maternal status were inversely related to anxiety levels, with fathers displaying higher maladaptive coping scores. Conclusion: This study sheds light on the considerable anxiety and depression experienced by parents of children with ADHD, significantly affecting their quality of life. Lower quality of life among parents is associated with high levels of depression, anxiety, and ineffective coping strategies. These insights highlight the critical need for interventions to aid parental mental health, thereby improving their overall quality of life amidst ADHD challenges.
Full article
(This article belongs to the Special Issue Children with Specific Neurodevelopmental Disorders: Assessment and Intervention)
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Open AccessArticle
Risk Factors Associated with Children’s Behavior in Dental Clinics: A Cross-Sectional Study
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Rana Abdullah Alamoudi, Nada Bamashmous, Nuha Hamdi Albeladi and Heba Jafar Sabbagh
Children 2024, 11(6), 677; https://doi.org/10.3390/children11060677 - 3 Jun 2024
Abstract
One of the most crucial tasks of pediatric dentists is to control children’s negative behaviors. This study aimed to assess dental behavior and the associated risk factors among children aged 4–12. This cross-sectional study recruited healthy, unaffected children aged 4 to 12 years.
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One of the most crucial tasks of pediatric dentists is to control children’s negative behaviors. This study aimed to assess dental behavior and the associated risk factors among children aged 4–12. This cross-sectional study recruited healthy, unaffected children aged 4 to 12 years. Parents were interviewed regarding the sociodemographic details and characteristics of their children’s dental visits. Two collaborative dentists examined the children for dental caries (DMFT/DMFT) and behavioral status (Frankl’s behavior rating scale). This study included 439 children: 27.3% exhibited uncooperative behavior, and the mean DMFT/dmft was 8.46 ± 3.530. Uncooperative behavior significantly increased when the dental visit was scheduled as an emergency treatment (p = 0.134; Adjusted Odds Ratio (AOR): 1.530) and when there was an elevated DMFT/DMFT ratio (p < 0.001; AOR: 1.308). This study revealed a significant association between children’s uncooperative behavior and their first dental visit, emphasizing the need for tailored strategies to address behavioral challenges when scheduling pediatric dental care. The proactive measures included controlling caries and avoiding emergencies.
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Evaluation of the Relationship between Pain Exposure and Somatosensory Evoked Potentials in Preterm Infants: A Prospective Cohort Study
by
Caterina Coviello, Silvia Lori, Giovanna Bertini, Simona Montano, Simonetta Gabbanini, Maria Bastianelli, Cesarina Cossu, Sara Cavaliere, Clara Lunardi and Carlo Dani
Children 2024, 11(6), 676; https://doi.org/10.3390/children11060676 - 3 Jun 2024
Abstract
Background and aim: First, to compare somatosensory evoked potentials (SEPs) in preterm newborns without major brain injury studied at term equivalent age (TEA) with a term historical control group. Second, to investigate the impact of pain exposure during the first 28 days after
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Background and aim: First, to compare somatosensory evoked potentials (SEPs) in preterm newborns without major brain injury studied at term equivalent age (TEA) with a term historical control group. Second, to investigate the impact of pain exposure during the first 28 days after birth on SEPs. Third, to evaluate the association between SEPs and Bayley-III at 2 years corrected age (CA). Methods: Infants born at <32 weeks’ gestational age (GA) were studied with continuous-SEPs. First, SEP differences between preterm and term infants were analyzed. Second, regression analyses were conducted to explore the association between SEPs and painful procedures, and then between SEPs and neurodevelopment. Results: 86 preterm infants were prospectively enrolled. Preterm infants exhibited prolonged N1 latencies, central conduction time (CCT), lower N1-P1 amplitudes, and more recurrently abnormal SEPs compared to term infants. Higher pain exposure predicted longer N1 latency and slower CCT (all p < 0.005), adjusting for clinical risk factors. Younger GA and postmenstrual age (PMA) at SEP recording were associated with longer N1 latency and lower N1-P1 amplitude (all p < 0.005). A normal SEP at TEA positively predicted cognitive outcome at 2 years CA (p < 0.005). Conclusion: Pain exposure and prematurity were risk factors for altered SEP parameters at TEA. SEPs predicted cognitive outcome.
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(This article belongs to the Special Issue Adverse Neonatal Outcomes in Perinatal Periods: Risk Factors, Screening and Treatment)
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Open AccessArticle
The Usefulness of a Revised Version of the Material Values Scale—Short Form in Italian Adolescents: Psychometric Evidence from Two Studies
by
Carola Beccari, Maria Anna Donati, Giuseppe Iraci Sareri and Caterina Primi
Children 2024, 11(6), 675; https://doi.org/10.3390/children11060675 - 2 Jun 2024
Abstract
Background: Materialism is an attitude that considers material goods to be central in life. Nowadays, adolescents appear to have a high level of materialism, which is related to risky behaviors. Nevertheless, there is a lack of measurement tools with adequate psychometric properties to
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Background: Materialism is an attitude that considers material goods to be central in life. Nowadays, adolescents appear to have a high level of materialism, which is related to risky behaviors. Nevertheless, there is a lack of measurement tools with adequate psychometric properties to assess materialism in this age group. For this reason, two studies were conducted to investigate the psychometric properties of the original and short Material Values Scale (MVS) in adolescents. Methods: In Study 1, participants were randomly split into two subsamples to compare psychometric properties of the original version of MVS with those of the short one. The first subsample consisted of 1054 adolescents (58% male; Mage = 16.34; SD = 1.15), and the second one of 1058 adolescents (57% male; Mage = 16.26; SD = 1.04). In Study 2, the psychometric properties of a revised version of the short MVS (without item 8) were investigated to confirm its adequacy with a new sample composed of 1896 adolescents (60% male; Mage = 16.40; SD = 2.76). Results: Results of Study 1 showed that the short version appeared to be a better measuring tool with respect to the long form to investigate materialism in adolescents. Nevertheless, problems with item 8 emerged. Results of Study 2 attested to the adequacy of the psychometric properties of the revised version of the short MVS (by excluding item 8) in this age group, in terms of dimensionality, reliability, and validity. Conclusions: Findings show that the revised short version of the MVS could be a valid and reliable tool for measuring the multidimensional construct of materialism in Italian adolescents.
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(This article belongs to the Special Issue Psychological Health of Children and Adolescents in Times of Crises)
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Open AccessReview
Exploring Cardiovascular Involvement in Tuberous Sclerosis: Insights for Pediatric Clinicians
by
Cecilia Lazea, Ioana Țaranu and Sorana D. Bolboacă
Children 2024, 11(6), 674; https://doi.org/10.3390/children11060674 - 2 Jun 2024
Abstract
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Tuberous sclerosis is a rare genetic disorder involving mainly the nervous and cardiovascular systems. The early recognition of the cardiovascular manifestations by the pediatrician allows an appropriate management and therefore enhances the quality of life of the affected children. Cardiac rhabdomyomas and the
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Tuberous sclerosis is a rare genetic disorder involving mainly the nervous and cardiovascular systems. The early recognition of the cardiovascular manifestations by the pediatrician allows an appropriate management and therefore enhances the quality of life of the affected children. Cardiac rhabdomyomas and the associated arrhythmias are the first cardiac features and they might represent a diagnosis challenge given their wide spectrum of clinical manifestations. We aimed to provide the paediatric practitioners with current knowledge regarding the cardiovascular complications in children with tuberous sclerosis. We overviewed the antenatal and postnatal evolution of cardiovascular manifestations, the systematic screening and long-term follow-up strategy of cardiac rhabdomyomas and arrhythmias in children with tuberous sclerosis.
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Open AccessReview
Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension?
by
Deepika Sankaran, Jessa Rose A. Li and Satyan Lakshminrusimha
Children 2024, 11(6), 673; https://doi.org/10.3390/children11060673 - 1 Jun 2024
Abstract
Hypoxic-ischemic encephalopathy (HIE) is the leading cause of mortality among term newborns globally. Infants born through meconium-stained amniotic fluid are at risk of developing meconium aspiration syndrome (MAS) and HIE. Simultaneous occurrence of MAS and HIE is a perilous combination for newborns due
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Hypoxic-ischemic encephalopathy (HIE) is the leading cause of mortality among term newborns globally. Infants born through meconium-stained amniotic fluid are at risk of developing meconium aspiration syndrome (MAS) and HIE. Simultaneous occurrence of MAS and HIE is a perilous combination for newborns due to the risk of persistent pulmonary hypertension of the newborn (PPHN). Moreover, therapeutic hypothermia (TH), which is the current standard of care for the management of HIE, may increase pulmonary vascular resistance (PVR) and worsen PPHN. Infants with MAS and HIE require close cardiorespiratory and hemodynamic monitoring for PPHN. Therapeutic strategies, including oxygen supplementation, ventilation, use of surfactant, inhaled nitric oxide and other pulmonary vasodilators, and systemic vasopressors, play a critical role in the management of PPHN in MAS, HIE, and TH. While TH reduces death or disability in infants with HIE, infants with MAS and HIE undergoing TH need close hemodynamic monitoring for PPHN.
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(This article belongs to the Special Issue The Management of Pulmonary Hypertension in Infants and Children)
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