Population Of Children Research Articles

Determinants of maternal adherence to child vaccination in jordan: A cross-sectional study

In the past few years, a significant decline in vaccination coverage has been noted, leading to measles outbreaks. Mothers’ adherence or reluctance to undergo childhood immunization is a major contributing factor to a substantial population of children who remain unvaccinated or inadequately vaccinated. This study aimed to investigate adherence to children’s vaccination by investigating mothers’ personal and contextual factors in addition to knowledge and attitudes scores. A cross-sectional analytical design was employed, and data were collected from a sample of 533 mothers in Jordan between May and July 2023. The statistical analysis included descriptive analysis, t-test, ANOVA, and Pearson r correlation. The results demonstrated that adherence to vaccination was associated with several factors, including knowledge score (r = 0.33, p < 0.01), the ability to access and understand health information (r = 0.16, p < 0.01), income level (F = 11.88, p < 0.01), education level (F = 5.71, p < 0.01), employment (t = 2.41, p < 0.05), and working in a medical field (t = 4.5, p < 0.01). Scheffe post hoc analysis was performed to evaluate adherence outcomes according to the different categories of education and income levels. Mothers’ adherence to vaccination needs improvement, with special attention given to contributing factors. Strategies should be developed to target mothers with low incomes and educational levels and limited ability to access and understand health information to enhance maternal knowledge and eventually adherence to children’s vaccination.

Enhancing daily life for children with cognitive developmental delay through insights into brain development.

Cognitive developmental delay, including severe intellectual disability (IQ below 70) and borderline intellectual functioning (IQ 70-85), poses significant challenges, including high costs and emotional burden. Early diagnosis and interventions might improve adaptive behavior and daily life functioning. High-risk groups include children with neonatal complications, congenital anomalies, genetic disorders, or metabolic errors, yet over 50% of cases have unknown causes. To provide timely diagnosis and intervention for children with cognitive developmental delay, it is important to increase our understanding and ability to prognosticate their level of functioning. The pivotal role of brain development in the first few years of life presents a window of opportunity for these goals. By detailed investigation of common patterns in structural brain development and connectivity by MRI in relation to cognitive and executive functioning, this review aims to identify potential factors that might improve understanding and prognostication of children with cognitive developmental delay. Exploring similarities among diverse patient groups with childhood cognitive developmental delay, this review intends to provide a nuanced perspective. IMPACT: This review identified several MRI brain developmental markers, especially in the white matter, that might hold potential to be a prognostic marker for intellectual and executive functioning in children with cognitive developmental delay. Bringing together information on aberrant brain developmental trajectories and connectivity across different patient childhood populations with cognitive developmental delay might improve our understanding and prognostication.

Mitochondrial DNA copy number and neurocognitive outcomes in children.

Low mitochondria DNA copy number (mtDNAcn) has been linked to cognitive decline. However, the role of mtDNAcn in healthy cognitive development is unclear. We hypothesized early-life mtDNAcn would be associated with children's learning and memory. We quantified mtDNAcn in umbilical cord blood and child blood at ages 5-7 from participants in a prospective birth cohort. We administered the Children's Memory Scale (CMS) at ages 9-14 (N = 342) and the Wechsler Intelligence Scale for Children (WISC-IV) at ages 7 and 9 (N = 457). Associations between mtDNAcn tertiles and CMS and WISC were evaluated with linear regression and linear mixed-effects models, respectively. We examined non-linear associations using generalized additive mixed models. Relative to the middle tertile of mtDNAcn, lower childhood mtDNAcn was associated with lower WISC Working Memory (β = -2.65, 95% CI [-5.24, -0.06]) and Full-Scale IQ (β = -3.71 [-6.42, -1.00]), and higher CMS Visual Memory (β = 4.70 [0.47, 8.93]). Higher childhood mtDNAcn was linked to higher CMS Verbal Memory (β = 7.75 [2.50, 13.01]). In non-linear models, higher childhood mtDNAcn was associated with lower WISC Verbal Comprehension. Our study provides novel evidence that mtDNAcn measured in childhood is associated with children's neurocognitive performance. mtDNAcn may be a marker of healthy child development. Mitochondrial DNA copy number (mtDNAcn) may serve as a biomarker for early-life neurocognitive performances in the children's population. Both low and high mtDNAcn may contribute to poorer neurocognition, reflected through learning and memory abilities. This research elucidated the importance of investigating mitochondrial biomarkers in healthy populations and facilitated advancements of future studies to better understand the associations between mitochondrial markers and adverse children's health outcomes.

Use your imagination for better performance. Effects of analogy instruction in motor skills. A systematic review and meta-analysis

This systematic review and meta-analysis examined the effects of analogy instruction (ANA) on motor performance and knowledge declared (KD) compared with explicit learning (EXP) and control conditions. Five databases were included. The study analyzed 16 randomized controlled trials. Subsequent analysis was performed for moderators variables as age, skill, retention, stress situations number of rules, specificity and number of trials. The ANA instruction demonstrated greater efficacy than the control (ES = 0.32, p = 0.03) or EXP condition (ES = 0.29, p = 0.02) in motor tasks performance in general terms. ANA instructions also showed superiority in motor performance when compared to control conditions in retention (ES = 5.72, p = 0.004), and a trend towards significance was found under stress (ES = 1.18, p = 0.05). ANA also showed superiority in motor performance when compared to EXP instruction (ES = 0.29, p = 0.02). ANA demonstrated greater effects than EXP in retention (ES = 7.25, p = 0.01), but not under stress (ES = 0.62, p = 0.18). Sub-analyses demonstrated that children (all p < 0.01) and novices (all p < 0.01) are more likely to benefit from ANA instruction when compared to control or EXP. A subgroup analysis based on quantity of information comparing ANA versus EXP condition shows that ANA is more effective for enhancing motor performance than EXP when the number of rules are similar. Sub-analyses comparing ANA versus CNT shows that as the number of repetitions increases and the task becomes less specific, ANA instruction significantly improves performance. A comparison between ANA and EXP indicates no significant differences in performance regarding the number of repetitions and task specificity. A secondary analysis examined KD of different instructions. KD was greater in EXP instructions (ES = −1.48, p < 0.001) when compared to ANA. Findings suggest that analogy instruction may improve motor performance, especially in novice and child populations. However, caution is needed due to concerns when comparing with other instructional types and environments, as well as due to high heterogeneity in most of the comparisons and high risk of bias in included studies.

The Relationship Between Response Time and The Effect of Hospitalization on Preschoolers

Objective : Response time is the speed of health workers in treating patients starting from the time the patient comes to the emergency room until he gets health care . The indicator of success is the speed of officers in providing assistance to emergency patients ≤ 5 minutes. One of the first units to go to at the hospital is the emergency room. In children, not all treatments given are acceptable and even these treatments can have an impact or effect on the child's hospitalization. This study aims to analyze the correlation between response time and the effect of hospitalization on preschool children in the emergency room of the Muhammadiyah Gresik hospital. Methods : This type of research is analytic with a cross-sectional approach with a patient population of preschool children (3-6 years) who come to the emergency room of the Muhammadiyah Gresik hospital with a total of 132 children as respondents. And using purposive sampling method. Data analysis in this study used the Chi-Square test to determine the relationship between response time and the effect of hospitalization on preschool children with a significant p value = &lt;0.05. Results : Preschoolers children in the emergency room of Muhammadiyah Gresik hospital Most (54.5%) experienced the effects of anxious hospitalization, namely as many as 72 children. Response time of nurses to preschool children in the emergency room of the Muhammadiyah Gresik hospital, almost all of them were fast (89.4%), namely 118 children.. Conclusion : There is no correlation between response time and the effects of hospitalization in preschool children with a p-value = 0.056 Keywords: Hospitalization Effect, Response Time

Biomonitoring of Mercury and Lead Levels in the Blood of Children Living near a Tropical River Impacted by Artisanal and Small-Scale Gold Mining in Colombia.

(1) Background: Mercury and lead contamination resulting from various anthropogenic activities represents a global environmental problem and a considerable risk to the health of the human population. (2) Methods: The objective of this research was to evaluate the concentrations of mercury (Hg) and Lead (Pb) in the blood of the child population in the municipalities in the Atrato River basin using a direct Hg analyzer and graphite furnace atomic absorption spectrometry. (3) Results: In total, 171 children (5-14 years of age) were taken into account, and 18.71% (32) of the children had concentrations of Hg and Pb above the permissible values established by the WHO. In the municipality of UN, 19 children had blood Hg concentrations between 5.29 and 17.71 μg/L. In CA, two children had concentrations of 5.03 and 8.43 μg/L, separately. In the case of Pb, seven children showed concentrations between 3.60 and 4.83 μg/dL in the municipality of RQ, three in UN (3.59, 3.61, and 4.60 μg/dL), and one in Carmen de Atrato (5.47 μg/dL). (4) Conclusions: The levels of Hg and Pb in the blood of children living in the riparian areas of the Atrato River basin are related to gold mining activities in the basin and the consumption of contaminated fish.

Building the clinical workforce of pediatric infectious diseases in Bolivia for better care of children with cancer

Abstract Background Infections in children with cancer can be fatal if not appropriately managed. Access to trained and competent professionals in infection care and prevention (IC&amp;P) improve care outcomes. Bolivia expects about 1700 new pediatric cancer cases annually. In 2023, 2371 hematological neoplasms were reported in children, cared mainly at 4 public hospitals where, until 2016, 5 pediatric infectious disease (PID) specialists were working in 2 of these 4 hospitals. For better PID clinical workforce for critically ill children, we built a PID medical residency training. In 2017, the training accepted its first trainees at Hospital del Niño “Dr. Ovidio Aliaga Uría” (Hospital del Niño), a public hospital in La Paz. Here, we describe the program, how we built it, and its outcomes. Methods The PID training goal is to train leaders in PID for clinical observations, PID literature interpretation, and to transform them into concepts that can be applied to ID pathogenesis or treatment. At the end of the 2-year PID training program, we expect trainees will gain expertise in PID clinical practice and clinical or translational science research. Our PID program was based on other PID specialty training programs from Mexico, Spain, and the USA of which, we adapted standard topics and formats of training. The content has routine and prevalent PIDs of Bolivia and the region, including on immunocompromised patients. We expected that the trainee dedicate full time to the PID training program plus caring for assigned patients and those requested consultations in the wards and clinics of Hospital del Niño; review articles; participate in clinical discussions; attend the Infection Control Course of St. Jude Children’s Research Hospital; attend and / or present in the PID case-based learning international sessions; visit the virology, bacteriology, parasitology and immunology laboratories of the national reference laboratory; and attend international rotations at participating hospitals. Results Since 2017, 5 new PID pediatricians graduated from our program, 3 work in public hospitals that care for children with cancer and 2 work in government insurance hospitals. They are working in hospitals in La Paz (n=2), Cochabamba (n=1), Santa Cruz (n=1), and Tarija (n=1). These graduates are leaders in ICP, antimicrobial stewardships, and education of hospital staffs. As per December 2023, they produced 5 articles for local journals, 2 for international journals, 7 abstracts for scientific meetings. Currently, 2 pediatricians participate in the PID training program, and post-graduation, they plan to work in departments of Potosí and Sucre where there are no PID specialists. Challenges to establish PID specialists in Bolivia are lack of value attributed to PID and its role in care quality. Conclusion Creating local expertise in PID are essential to improve and sustain the optimum care for children with cancer in Bolivia especially in places where these personnel did not exist before. However, for best investment return of PID trained professionals, having PID job descriptions and paid positions in hospitals will absorb PID specialists to benefit the largest population of children with cancer in Bolivia.

Family-Centered Treatment Program for Problematic Gaming and Excessive Screen Use in a Clinical Child and Youth Population (FAME): Protocol for a Feasibility Pilot Mixed Method Study.

Screen time among children and adolescents has increased dramatically, raising concerns about its impact on development and mental health. While research highlights both potential benefits and risks, excessive use has been linked to issues like anxiety, depression, and gaming addiction. Despite growing concern, effective interventions are scarce. Recognizing the importance of family dynamics in child development, we propose a family-centered program to address problematic gaming and excessive screen use in a clinical population. By involving both children and parents, we aim to create a more comprehensive approach to prevention and treatment. This study aims to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical child and adolescent psychiatry (CAP) population. We will monitor the recruitment rate; track the retention and attendance rates of both parents and children; and assess whether each session's objectives are met, the content is delivered within the allotted time, and the necessary resources (eg, facilitators and materials) are available. Additionally, we will gather qualitative and quantitative feedback from participants through postprogram surveys and individual interviews with both children and parents. A total of 10 families with ongoing contact with CAP in Skåne, Sweden, will be recruited and offered participation in a family-centered group program targeting children aged 10-18 years with reported difficulties regarding screen gaming or screen use. The intervention to be tested is a newly developed, family-centered, psychoeducational, cognitive behavioral therapy-based intervention addressing both positive and negative aspects of screen use; setting boundaries; the connection between thoughts, feelings, and behaviors; conflict triggers; and sleep hygiene. The primary goal of the pilot study is to test the feasibility of the program, as well as recruitment and the analysis of participants' experiences with the program. A total of 11 children and their parents were enrolled during first quarter of 2024. A 4-session pilot was delivered in first quarter of 2024, and the first results are expected in the third quarter of 2024. The overarching goal of this pilot study is to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical CAP population. The insights gained from this study will guide our future research, which will focus on conducting a larger-scale evaluation of the intervention's impact on family screen time conflicts and inform future strategies for the implementation of family-centered interventions in child and youth clinics. ClinicalTrials.gov NCT06098807; https://clinicaltrials.gov/study/NCT06098807. DERR1-10.2196/56387.

Macrophage MAPK7/AhR/STAT3 Signaling Mediates Mitochondrial ROS Burst and Enterohepatic Inflammatory Responses Induced by Deoxynivalenol Relevant to Low-Dose Exposure in Children.

Deoxynivalenol (DON) can induce endoplasmic reticulum (ER) stress, mitochondrial ROS burst, and macrophage polarization. Here, we investigated the mechanism linking the above three aspects with the dose range relevant to low-level exposure in children. At 0.5 μg/kg bw/day, we found remarkable liver and gut inflammatory responses after 6-week exposure in mice age comparable to humans 7-12 years old. Through antioxidant intervention, we found that ROS played a driver role in macrophage polarization and inflammatory responses induced by DON in the liver and gut. Further bioinformatics analysis uncovered that ER stress-associated protein MAPK7 (ERK5) may bind with AhR to initiate a mitochondrial ROS burst and macrophage M1 polarization. The downstream cellular events of MAPK7-AhR interaction may be mediated by the AhR/STAT3/p-STAT(Ser727) pathway. This mechanism was further supported by DON toxicity mitigation using cyanidin-3-glucoside (C-3-G), which docks to MAPK7 oligomerization region 200-400 aa and disrupts MAPK7-AhR interaction. Overall, our study provides novel evidence and mechanism for DON-induced inflammatory responses in the liver and gut system. Our findings call attention to the health risks associated with low-level DON exposure in the prepuberty children population.

Association between provegetarian food patterns and micronutrient adequacy in preschoolers: the SENDO project

This study aims to examine the association between different versions of a provegetarian food pattern and micronutrient adequacy in a population of children from the SENDO Project. Children aged 4–5 years old were recruited and baseline information on diet, lifestyle and socio-demographic characteristics was collected through self-administered online questionnaires completed by their parents. Scores were calculated for overall, healthful, and unhealthful provegetarian food patterns (FP) using an a priori approach. Participants were categorized into tertiles according to their scores. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off point. Multivariate analyses were performed to evaluate the relationship between tertiles of each provegetarian FP and the risk of inadequate micronutrient intake (failing to meet ≥ 3 requirements). Despite lower intakes of certain micronutrients, children with higher scores in the healthful provegetarian FP did not exhibit a higher prevalence of inadequacy. Children in the highest tertile of this index had 0.47-fold lower odds (95%CI 0.23–0.95) of having ≥ 3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. In contrast, children in the highest tertile of the unhealthful provegetarian FP had 20.06-fold higher odds (95%CI 9.19–43.79) of having ≥ 3 inadequate micronutrient intakes compared to children in the lowest tertile. Conclusions: Adherence to a healthful provegetarian food pattern is associated with improved nutritional adequacy in preschoolers, while following an unhealthful pattern is detrimental to micronutrient adequacy. These results suggest that moderate reductions in animal food consumption within a healthy diet may not compromise micronutrient adequacy in young children. Further research is needed to explore the impact of diets reduced in animal food intake on the health of children.What is Known:• There's a notable trend towards plant-based diets due to health and sustainability concerns.• Research links plant-based diets in adults with lower risks of obesity, cardiovascular disease, and cancer.What is New:• A new study examines how different versions of a provegetarian food pattern affect micronutrient adequacy in children, using a moderate and stepwise approach.• Following a healthful provegetarian food pattern enhances nutritional adequacy in preschoolers, whereas an unhealthful pattern negatively impacts micronutrient adequacy.

Rates of Viral Non-Suppression and Acquired HIV-1 Drug Resistance Emergence among Children during the Sociopolitical Crisis in the Northwest Region of Cameroon: A Call for Improved Monitoring Strategies.

Virological failure (VF) among children remains concerning, with high risks of HIV drug resistance (HIVDR) emergence and increased disease progression. Therefore, monitoring of viral non-suppression and emerging HIVDR is crucial, especially in the frame of sociopolitical unrest. The study sought to determine the prevalence of VF and evaluate the acquired HIVDR and viral genetic diversity among children in the northwest region of Cameroon during the ongoing sociopolitical crisis. A cross-sectional facility-based study was conducted among HIV-infected children aged ≤18 years, receiving antiretroviral therapy (ART) in urban and rural settings of Northwest Cameroon, from November 2017 through May 2018. Viral load (VL) was done using the Abbott m2000RealTime. Unsuppressed VL was defined as viral load ≥1,000 copies/ml. HIVDR testing was performed by sequencing of HIV-1 protease-reverse transcriptase at the Chantal Biya International Reference Center (CIRCB) using an in-house protocol. Drug resistance mutations (DRM) were interpreted using Stanford HIVdbv8.5 and phylogeny using MEGAv.6. Data were compared between urban and rural areas with p<0.05 considered statistically significant. A total of 363 children were recruited, average age of 12 years (urban) and 8 years (rural). VL coverage was 100% in the urban setting and 77% in the rural setting. Overall, VF was 40.5% (39% [130/332] in the urban setting and 41% (13/31) in the rural setting; p=0.45). Overall, viral undetectability (defined as VL<40 copies/ml) was 45.5% (46% (urban) and 45% (rural); p=0.47). Among those experiencing confirmed virological failure and who were successfully sequenced (n=35), the overall rate of HIVDR was 100% (35/35). By drug class, HIVDR rates were 97.1% (34/35) for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 97.1% (34/35) for NRTIs and 17.1% (6/35) for protease inhibitors (22.7% (5/22) in the urban setting and 7.7% [1/13] in the rural setting). CRF02_AG was the most prevalent viral clade (75%), followed by other recombinants (09_cpx, 11_cpx, 13_cpx, 22_01A1, 37_cpx) and pure subtypes (A1, F2, G, H). In this population of children and adolescents living with HIV in a context of socio-political instability in the North-West region of Cameroon, rates of viral non-suppression are high, and accompanied by HIVDR selection. Our suggests the need for a more differentiated care of these CAHIV, especially those in these regions faced with significant socio-economic and health impacts due to the ongoing crisis.

Nutrition support in children with medical complexity and chronic critical illness: A narrative review.

Children with medical complexity (CMC) and children with chronic critical illness (CCI) represent growing populations with high healthcare use and dependence on specialized care, both in the hospital and community setting. Nutrition assessment and delivery represent critical components of addressing the short-term and long-term health needs for these populations across the care continuum. This article provides a framework and reviews existing literature for the assessment of nutrition status and subsequent delivery of nutrition prescriptions in CMC and children with CCI. The specific aims are to (1) describe the epidemiology of health services experience for CMC and children with CCI, with a focus on their nutrition outcomes; (2) detail how to assess their nutrition status and energy requirements; (3) review methods of delivery of the nutrient prescription; (4) introduce perioperative considerations; (5) highlight examples of special populations of CMC and children with CCI; and (6) propose future research initiatives to improve nutrition and overall outcomes for these populations.

Toxic Metal Injustice? Socioeconomic status at birth and exposure to airborne pollution

We combine administrative data on socioeconomic status (SES) with high-resolution data on residential locations, local pollution levels, industrial facilities, as well as land cover information to investigate whether exposure to airborne toxic metals (arsenic, lead, and mercury) is unequally distributed within the population of newborn children in Sweden. We find that the spatial distribution of SES among newborns weakly correlates with the distribution of toxic metals at the national level and in the largest cities, indicating negligible sorting in this dimension. If anything, high SES children are disproportionately more exposed, residing in urban areas with higher levels of traffic and industrial activities. This leads us to conclude that environmental injustice regarding airborne arsenic, lead, and mercury exposure is not a major concern in Sweden.

The continuous rise in orbital subperiosteal abscess incidence in the Iranian pediatric population

In this study, we aimed to follow up on the surprising increase in the incidence of orbital subperiosteal abscesses (SPA) reported in the Iranian pediatric population in the post-COVID era. Pediatric patients (≤ 18 years old) diagnosed with orbital SPA following acute sinusitis who were hospitalized between October 1st, 2023, and March 31st, 2024 in Farabi Eye Hospital, Tehran, Iran, were included. Demographic, clinical, microbiologic, and radiological characteristics of patients were reviewed. During the 6-month study period, 39 patients were admitted to our tertiary referral hospital. The average age of patients was 7.29 ± 4.13 years and 30 patients (76.92%) were male. The ethmoid sinus was involved in 100% of patients, and SPA involvement was in the medial wall in 27 patients (69.23%). The mean volume of SPA was 1.45 ± 1.77 cm3. Nineteen patients (48.72%) underwent surgical interventions, however, 20 patients (51.28%) received only medical treatment. The best corrected visual acuity of patients increased from 0.63 (0.20 LogMAR) on the first day of admission to 0.84 (0.07 LogMAR) according to the Snellen chart in the first month after treatment. It seems that the outbreak of orbital SPA in the Iranian children population in the post-COVID era is an increasing trend.

Implementing an Adverse Childhood Experiences Screening Tool With Migrant Children: A Quality Improvement Project Using the PEARLS Screening Tool

BackgroundImmigrants, asylum seekers, and refugees live with extreme stress, consistent vulnerability, and life-long health consequences. Children in these populations face increased risk of poor mental health due to adverse childhood experiences (ACEs) and related healthcare barriers, such as lack of screening, that limit their ability to receive appropriate mental health care. AimTo implement an ACEs screening questionnaire for all migrant children 19 and under in a community shelter. MethodsThe Model for Improvement. InterventionThe Pediatric ACES and Related Life Events Screener (PEARLS) was implemented over a 10-week period in a community shelter. ResultsAll children screened had at least 1 ACE. Initiation of PEARLS screening led to recognition of adverse experiences thus allowing for mental health support and referrals to mental health specialists. ConclusionsThis QI project supports implementation of screening for adverse childhood experiences within populations of migrant children in order to uncover potential mental health concerns and provide targeted support, recognizing the long-term effects of trauma on their wellbeing.

A-310 Neurodevelopmental disorders and hyperlipidemia in HIV-exposed uninfected children in the Bronx, New York

Abstract Background The implementation of combination antiretroviral therapy (cART) for treating human immunodeficiency virus (HIV) has significantly reduced the rates of vertical HIV transmission. With increasing cART coverage, the number of HIV-positive infants has declined, while the number of HIV-exposed uninfected (HEU) infants has risen. This group now comprises a rapidly expanding cohort of HIV-affected individuals, currently totaling 16 million and increasing by 1.6 million annually. However, our understanding of the potential in-utero toxicity of cART remains limited. Numerous studies, primarily from Africa, suggest that HEU children may face heightened risks of adverse health outcomes, including growth restriction, increased susceptibility to infections, and neurobehavioral disorders. It is widely recognized that infants with growth restriction are at a greater risk of developing chronic diseases such as cardiometabolic and neurological disorders later in life, which is accentuated by low socioeconomic status. The objective of this study was to assess the prevalence of neurodevelopmental disorders and hyperlipidemia in HIV-negative children born to HIV-infected mothers in the Bronx, New York, utilizing retrospective medical records information. Methods We conducted a retrospective chart review of HEU and age-matched control (HIV-unexposed and uninfected; HUU) children (age 0-15 years) using clinical data obtained from the electronic medical record (EMR) at the Montefiore Medical Center in the Bronx, New York, between 2015 and 2023. Demographic data and documented diagnostic data were collected. Lipid panel results were also obtained from the EMR and stratified by age and testing date. Neurodevelopmental outcome measures were compared between HEU and HUU children using Chi-square and Student’s t-test was used for continuous variables. Results A total of 127 HEU (46% females, 54% males) children and 157 HUU (46% females, 54% males) children were analyzed. Among the HEU children, 12 (9.5%) were diagnosed with attention-deficit/hyperactivity disorder (ADHD), while only 1 out of 157 (0.6%) HUU children had this diagnosis (p=0.0004). Similarly, a significant number of HEU children were found to have autism spectrum disorder, with 11 (8.7%) affected compared to 2 (1.3%) in the control group (p=0.0036). HEU children also exhibited a higher prevalence of unspecified developmental delay compared to HUU children (14.2% vs 5.1%; p=0.012). However, no significant differences were observed between the two groups regarding speech and language delay or learning difficulties. Abnormal cholesterol levels were detected in 33% of HEU children, while 54.5% had abnormal triglyceride levels. These percentages surpass the prevalence of pediatric hypercholesterolemia (7%) and hypertriglyceridemia (10.2%) in the United States. Conclusions Our findings indicate that HEU children born in areas designated as medically underserved and socioeconomically disadvantaged, such as the Bronx in the United States, face significant risks of neurodevelopmental disorders and hyperlipidemia. Considering the increasing population of HEU children, even minor rises in adverse health effects could lead to significant public health challenges. To support HEU children in achieving their utmost potential, further studies must be encouraged to understand these children's needs. Moreover, it is imperative to enact policies that facilitate equitable distribution of resources, ensuring timely screening and intervention in underprivileged communities.

Prevalence of and factors associated with Na + /K + imbalances in a population of children hospitalized with febrile urinary tract infection

We aimed to assess the prevalence of and factors associated with Na + /K + imbalances in children hospitalized for febrile urinary tract infection (fUTI). This retrospective Italian multicenter study included children aged 18 years or younger (median age = 0.5 years) who were discharged with a primary diagnosis of fUTI. Na + /K + imbalances were classified as hyponatremia (sodium < 135 mEq/L), hypernatremia (sodium > 145 mEq/L), hypokalemia (potassium < 3.5 mEq/L), hyperkalemia (potassium > 5.5 mEq/L), and concurrent hyponatremia and hyperkalemia, in the absence of evidence of hemolyzed blood samples. Among the 849 enrolled children, 23% had hyponatremia, 6.4% had hyperkalemia, 2.9% had concurrent hyponatremia and hyperkalemia, 0.7% had hypokalemia, and 0.4% had hypernatremia. In the multiple logistic regression analysis, after applying the Bonferroni correction, only C-reactive protein (C-RP) levels were significantly associated with hyponatremia (OR = 1.04; 95% CI: 1.02–1.06; p < 0.001), only age was significantly associated with hyperkalemia (OR = 1.7; 95% CI: 1.1–2.7; p = 0.01), and only CAKUT was significantly associated with concurrent hyponatremia and hyperkalemia (OR = 4.3; 95% CI: 1.7–10.8; p = 0.002). Even after adjusting for the presence of kidney hypoplasia, abnormal renal echogenicity, pelvi-caliceal dilation, ureteral dilation, uroepithelial thickening of the renal pelvis, bladder abnormalities, pathogen other than E. coli, concurrent hyponatremia and hyperkalemia persisted significantly associated with CAKUT (OR = 3.6; 95% CI: 1.2–10.9; p = 0.02).Conclusion: Hyponatremia was the most common Na + /K + imbalance in children hospitalized for fUTI, followed by hyperkalemia and concurrent hyponatremia and hyperkalemia. C-RP levels were most strongly associated with hyponatremia, age with hyperkalemia, and CAKUT with concurrent hyponatremia and hyperkalemia (suggestive of transient secondary pseudo-hypoaldosteronism). Therefore, in children who develop concurrent hyponatremia and hyperkalemia during the course of a fUTI, an underlying CAKUT could be suspected.What is known:• Na+ and K+ abnormalities can occur in patients hospitalized for febrile urinary tract infection (fUTI).• Concurrent hyponatremia and hyperkalemia during fUTI may suggest transient secondary pseudo-hypoaldosteronism (TPHA), for which limited data on prevalence are available.What is new:• The most common Na+/K+ imbalance in children hospitalized with fUTI was hyponatremia (23%), followed by hyperkalemia (6.4%), concurrent hyponatremia and hyperkalemia (2.9%), hypokalemia (0.7%), and hypernatremia (0.4%).• Concurrent hyponatremia and hyperkalemia were mainly associated with CAKUT, while hyponatremia alone correlated with high C-reactive protein and hyperkalemia alone with younger age. In cases of concurrent hyponatremia and hyperkalemia during fUTI, an underlying CAKUT should be suspected.

Prevalence of chronic urticaria: A study in the pediatric population of a general hospital.

Introduction. Chronic urticaria is an inflammatory skin condition characterized by the presence of evanescent wheals or angioedema that last for ≥ 6 weeks. Objective. To determine the prevalence of urticaria and describe its clinical characteristics in children and adolescents under 19 years of age in a general hospital. Population and methods. This was a cross-sectional study carried out between 2015 and 2020 in a population of children and adolescents seen at a private healthcare facility. Results. A total of 1567 medical records of patients with urticaria seen during the study period were reviewed. Thirty-six patients with chronic urticaria were identified; the prevalence was 0.16% (95% CI: 0.11-0.22). Conclusion. The prevalence of chronic urticaria in children and adolescents was 0.16%. A higher frequency was observed among girls and adolescents.

Chemical Characterization and Assessment of Public Health Risk due to Inhalation of PM2.5 in the City of Salamanca, Guanajuato.

In this study, we conducted an analysis of health risks faced by residents of Salamanca, Mexico, who were exposed to fine particulate matter with a diameter of 2.5μm (PM2.5) through inhalation. The characterization and analysis of these particulate matter samples were undertaken. A total of 131 samples were collected from two different sites: 65 from the Red Cross site (RC) and 66 from the Integral Family Development site (DIF) in 2014-2015. These samples were analyzed for a set of chemical components, including metals and ions. Non-cancerous health risk levels associated with PM2.5 exposure through the human respiratory system, as per the WHO benchmark (assigned a value of 1), revealed notable risk values for two elements: Manganese (Mn) with a range of 1.19-2.12 in the adult population and 1.59-2.84 in the child population, and Nickel (Ni) with a uniform risk value of 1.39 for both evaluated population groups. However, concerns arose regarding potential non-cancerous effects as the cumulative risk levels for various assessed elements showed elevated indices. These ranged from 3.81 to 4.4 in adults and 4.48-5.24 in children. This study provided comprehensive data on composition and its potential impact on human health, offering valuable insights for the implementation of mitigation measures aimed at reducing inhalation-related exposure.

A Child-Friendly Wearable Device for Quantifying Environmental Risk Factors for Myopia.

In the past few decades, the prevalence of myopia, where the eye grows too long, has increased dramatically. The visual environment appears to be critical to regulating the eye growth. Thus, it is very important to determine the properties of the environment that put children at risk for myopia. Researchers have suggested that the intensity of illumination and range of distances to which a child's eyes are exposed are important, but this has not been confirmed. We designed, built, and tested an inexpensive, child-friendly, head-mounted device that can measure the intensity and spectral content of illumination approaching the eyes and can also measure the distances to which the central visual field of the eyes are exposed. The device is mounted on a child's bicycle helmet. It includes a camera that measures distances over a substantial range and a six-channel spectral sensor. The sensors are hosted by a light-weight, battery-powered microcomputer. We acquired pilot data from children while they were engaged in various indoor and outdoor activities. The device proved to be comfortable, easy, and safe to wear, and able to collect very useful data on the statistics of illumination and distances. The designed device is an ideal tool to be used in a population of young children, some of whom will later develop myopia and some of whom will not. Such data would be critical for determining the properties of the visual environment that put children at risk for becoming myopic.