Control Children Research Articles

Peripheral Regional Anesthetic Techniques in Cardiac Surgery: A Systematic Review and Meta-Analysis

Objective(s)Aim of this systematic review was to investigate postoperative pain outcomes and adverse events following peripheral regional anesthesia (PRA) compared to no regional anesthesia (RA), placebo or neuraxial anesthesia in children and adults undergoing cardiac surgery. DesignSystematic review and meta-analysis with assessment of the risk of bias (Cochrane RoB 1) and certainty of evidence (GRADE). SettingRandomized controlled trials ParticipantsAdults and children undergoing heart surgery InterventionsAny kind of PRA compared to no RA or placebo or neuraxial anesthesia Measurements and Main resultsIn total 33 RCTs (2044 patients) – 24 of these had a high risk of bias and 28 were performed in adults - were included. PRA compared to no RA may reduce pain intensity at rest 24 h after surgery (MD -0.81 points, 95% CI -1.51 to -0.10; I2 = 92%; very low certainty evidence). PRA compared to placebo may reduce pain intensity at rest (MD -1.36 points, 95% CI -1.59 to -1.13; I2 = 54%; very low certainty evidence) and during movement (MD -1.00 points, 95% CI -1.34 to -0.67; I² = 72%; very low certainty evidence) 24 h after surgery. No data following pediatric cardiac surgery could be meta-analysed due to the low number of included trials. ConclusionsPRA compared to no RA or placebo may reduce pain intensity at rest and during movement. However, these results should be interpreted cautiously, because the certainty of evidence is only very low. Protocol registrationCRD42021223636

P006 The Impact of Growth Hormone Treatment on Cardiovascular Control in Children with Prader-Willi syndrome

Abstract Background Many children with Prader-Willi syndrome (PWS) are treated with growth hormone (GH), which may increase the risk of obstructive sleep apnoea. Children with PWS also have impaired cardiac autonomic control due to reduced parasympathetic activity, which may increase cardiovascular risk, however the impact of GH on autonomic control is yet to be elucidated. Methods Pre- and post-GH polysomnographic data in 38 children (aged 0-18 years) were retrospectively collected. Spectral analysis of heart rate variability (HRV) was used to determine total, low frequency (LF, sympathetic and parasympathetic activity), high frequency (HF, parasympathetic activity) power and LF/HF (sympathovagal balance). Data were compared with Wilcoxon Signed Rank Test and Spearman Rank Order Correlation analysis and are presented as median [interquartile range]. Results HRV data were significantly correlated with age so children were grouped into those <2 years (n=22) and >2 years (n=16). There were no significant differences in the obstructive or central apnoea-hypopnoea indexes between pre- and post-GH studies in either group. In children <2 years, there were no significant differences in total power, LF, HF and LF/HF between studies. In children >2 years, total power (1912.2 ms2, [920.2, 4916.1] vs 1010.2 ms2 [416.0, 2828.7), LF (434.0 ms2 [247.0, 1340.7] vs 278.9 ms2 [83.4, 676.0]) and HF (986.0 ms2 [321.8, 2400.6] vs 414.4 ms2 [146.2, 1152.7]) were lower (p< 0.01 for all) post-GH. Conclusions Our results demonstrate that GH decreases both sympathetic and parasympathetic activity during sleep in children >2 years, which could further increase cardiovascular risk.

O005 Deficits in learning and overnight memory consolidation in children with mild sleep disordered breathing

Abstract Objectives Sleep disordered breathing (SDB) is associated with sleep fragmentation that can compromise daytime learning and impact overnight memory consolidation. Yet, research into learning and overnight memory consolidation of children with SDB is very limited. The objective of the current study is to determine if school aged children with SDB show deficits in learning and overnight consolidation of declarative and non-declarative memories compared to healthy control (HC) children. Methods This study included 50 school aged (7-16 years) children (25 SDB, 25 HC) of comparable sex, parental SES, and BMI. Parents completed the paediatric sleep questionnaire (PSQ) for all children. Children with SDB underwent an overnight sleep study. All children completed a cognitive battery, including assessment of IQ and memory. We employed two declarative memory tasks, one verbal and one visual, and one non-declarative memory task. We measured learning and recall at two delays (30 minutes and overnight) on memory tasks. Results On the visual declarative memory task children with SDB performed more poorly in learning, and recalled significantly fewer pictures following a night of sleep, compared to HC. On the non-declarative task learning of children with SDB and HC children was comparable but following a night of sleep accuracy improved less in the SDB group compared to the HC group. Discussion This study provides, to our knowledge for the first time, evidence of impairment of overnight declarative and non-declarative memory consolidation concurrently in school aged children with mild SDB, whose declarative (but not non-declarative) learning was also impaired.

Assessing the Impact of Electrosuit Therapy on Cerebral Palsy: A Study on the Users' Satisfaction and Potential Efficacy.

The aim of this study is to evaluate the effectiveness of electrosuit therapy in the clinical treatment of children with Cerebral Palsy, focusing on the effect of the therapy on spasticity and trunk control. Moreover, the compliance of caregivers with respect to the use of the tool was investigated. During the period ranging from 2019 to 2022, a total of 26 children (18 M and 8 F), clinically stable and affected by CP and attending the Neurorehabilitation Unit of the "Padre Pio Foundation and Rehabilitation Centers", were enrolled in this study. A subset of 12 patients bought or rented the device; thus, they received the administration of the EMS-based therapy for one month, whereas the others received only one-hour training to evaluate the feasibility (by the caregivers) and short-term effects. The Gross Motor Function Classification System was utilized to evaluate gross motor functions and to classify the study sample, while the MAS and the LSS were employed to assess the outcomes of the EMS-based therapy. Moreover, between 80% and 90% of the study sample were satisfied with the safety, ease of use, comfort, adjustment, and after-sales service. Following a single session of electrical stimulation with EMS, patients exhibited a statistically significant enhancement in trunk control. For those who continued this study, the subscale of the QUEST with the best score was adaptability (0.74 ± 0.85), followed by competence (0.67 ± 0.70) and self-esteem (0.59 ± 0.60). This study investigates the impact of the employment of the EMS on CP children's ability to maintain trunk control. Specifically, after undergoing a single EMS session, LSS showed a discernible improvement in children's trunk control. In addition, the QUEST and the PIADS questionnaires demonstrated a good acceptability and satisfaction of the garment by the patients and the caregivers.

Book review: all through the town: the school bus as educational technology

Book review: all through the town: the school bus as educational technology

Alveolar nitric oxide concentration plays an important role in identifying cough variant asthma and assessing asthma control in children

Objective To study the value of alveolar nitric oxide concentration (CaNO) in the identification and disease control of cough variant asthma. Methods A retrospective study was conducted on cough variant asthma (CVA-Group), nonasthmatic cough (NAC-Group) and healthy control children (C-Group) aged 5–12 years. The exhaled nitric oxide and spirometry test results of the three groups were collected and compared. Results A total of 410 children were included in this study, including 190 in the CVA-Group, 183 in the NAC-Group, and 37 in the C-Group. The CaNO values of the CVA-Group [11.40 ppb (8.48–14.25)] were significantly higher than those of the NAC-Group and C-Group (all p values <.05). The MMEF %pred values of the CVA-Group [63.65 (56.28–73.58)] were significantly lower than those of the NAC-Group and C-Group (all p values <.05). FeNO50, JawNO and other spirometry indices (FVC %pred, FEV1%pred, FEV1/FVC %pred) showed no significant difference among the three groups. ROC curve analysis showed that the optimal cutoff point value of CaNO was 9.45 ppb, corresponding to 0.816 sensitivity and 0.736 specificity. Spearman correlation analysis showed a significant negative correlation between the CaNO measurement and CVA control score. Conclusions CaNO can not only help identify CVA early in children aged 5–12 years with chronic cough but is also significantly negatively correlated with the CVA control score.

Sleep Stage Transitions and Sleep-Dependent Memory Consolidation in Children with Narcolepsy-Cataplexy.

Electroencephalographic sleep stage transitions and altered first REM sleep period transitions have been identified as biomarkers of type 1 narcolepsy in adults, but not in children. Studies on memory complaints in narcolepsy have not yet investigated sleep-dependent memory consolidation. We aimed to explore stage transitions; more specifically altered REM sleep transition and its relationship with sleep-dependent memory consolidation in children with narcolepsy. Twenty-one children with narcolepsy-cataplexy and twenty-three healthy control children completed overnight polysomnography and sleep-dependent memory consolidation tests. Overnight transition rates (number of transitions per hour), global relative transition frequencies (number of transitions between a stage and all other stages/total number of transitions × 100), overnight transitions to REM sleep (transition from a given stage to REM/total REM transitions × 100), and altered first REM sleep period transitions (transitions from wake or N1 to the first REM period) were computed. Narcoleptic children had a significantly higher overnight transition rate with a higher global relative transition frequencies to wake. A lower sleep-dependent memory consolidation score found in children with narcolepsy was associated with a higher overnight transition frequency. As observed in narcoleptic adults, 90.48% of narcoleptic children exhibited an altered first REM sleep transition. As in adults, the altered sleep stage transition is also present in children with narcolepsy-cataplexy, and a higher transition rate could have an impact on sleep-dependent memory consolidation. These potential biomarkers could help diagnose type 1 narcolepsy in children more quickly; however, further studies with larger cohorts, including of those with type 2 narcolepsy and hypersomnia, are needed.

Relationship between gut microbiota dysbiosis and immune indicator in children with sepsis

Sepsis is a life-threatening multiple-organ injury caused by disordered host immune response to microbial infection. However, the correlation between gut microbiota dysbiosis and immune indicators remains unexplored. To address this gap in knowledge, we carried out 16 S rDNA sequencing, analyzed clinical fecal samples from children with sepsis (n = 30) and control children (n = 25), and obtained immune indicators, including T cell subtypes (CD3+, CD3+CD4+, CD3+CD8+, and CD4/CD8), NK cells, cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ), and immunoglobulin indices (IgA, IgE, IgM and IgG). In addition, we analyzed the correlation between gut microbiota dysbiosis and immune indicators, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. We found that children with sepsis exhibited gut bacterial dysbiosis and low alpha diversity. The Spearman’s rank correlation coefficient suggested that Rhodococcus erythropolis had a significantly positive correlation with IFN-γ and CD3+ T cells. Klebsiella pneumoniae and Streptococcus mitis were significantly correlated with NK cells. Bacteroides uniformis was significantly positively correlated with IgM and erythrocyte sedimentation rate, and Eubacterium eligens was significantly positively correlated with IL-4 and CD3+CD8+ T cells. The biomarkers discovered in this study had strong discriminatory power. These changes in the gut microbiome may be closely related to immunologic dysfunction and to the development or exacerbation of sepsis. However, a large sample size is required for verification.

Cascade of atopic dermatitis comorbidities in children after birth for 15 years.

Individuals with atopic dermatitis often develop other conditions. This study aimed to determine how atopic dermatitis comorbidities develop in children over time. This population-based administrative cohort study used national health insurance data. We traced individuals born in Korea between 2002 and 2003 to 2018. The date of initial atopic dermatitis diagnosis was set as the index date. Fifty-three childhood comorbidities of atopic dermatitis were identified as outcomes of interest by performing a comprehensive literature search and comparing the prevalence of diagnostic codes in children with and without atopic dermatitis. Four control children per individual in the atopic dermatitis group were randomly matched based on sex and index date. The association between atopic dermatitis and the development of each specified disease was assessed using proportional hazard assumption, followed by mapping of the temporal sequences of interconnected comorbidities. The atopic dermatitis and control groups contained 67,632 and 270,528 individuals, respectively. The median age at the index date was 10 months, whereas the median follow-up period was 15 years. Twenty diseases that were associated with a higher risk of atopic dermatitis were identified and a chain of interconnected conditions created. The progression began in childhood with febrile seizures, constipation, and asthma, and was later associated with the emergence of food allergy, allergic rhinitis, psychiatric disorders, and autoimmune diseases. Our study highlights the temporal nature of atopic dermatitis comorbidities in children, and indicates that an understanding of the comorbidities may inform its clinical management and treatment.

Impact of Symbolic Modeling on Developing the Emotional Intelligence and Ability to Solve Life Problems of the Children at Early Childhood Stage

This present study aimed to the know impact of symbolic modeling on developing emotional intelligence skills and the ability to solve the life problems of children. The study used the semi-experimental method, the study population consisted of all elementary classes at Al-Hussein Ben Talal University school in Ma'an Governorate, and children were distributed in a random way to two groups: the control group and the experimental group. A group of results has been reached, the most prominent: the promises of differences with statistical significance at level (&lt;0.05) between means degrees of the control and experimental groups children in the post-application in favor of the experimental group in emotional an intelligence test, also the presence of differences with statistical significance between the pre and post measures for the experimental group in favor of the post measure in problems solving test of the children. In light of these results, a group of recommendations was introduced, the most important assuring the importance of using the symbolic modeling strategy by the female teachers with the children due to its positive impact on developing emotional intelligence skills and the ability of the children to solve life problems, and the necessity for engaging the kindergartens' female teachers in development courses about how to prepare and use this strategy, and conducting studies focusing on the effective role of the family in training their children on how to be characterized by the emotional intelligence and problems solving skills.

Parenting style and child asthma control in families of school-age children with asthma: The mediating effects of children's general self-efficacy and medication adherence

PurposeParenting style plays a pivotal role in children's chronic disease control. However, the relationship and underlying mechanism between parenting style and asthma control remain unclear. This study investigated the effects of parenting style on children's general self-efficacy, medication adherence and asthma control and the mediating effects of general self-efficacy and medication adherence among school-age children with asthma. Design and methodsA cross-sectional study with a convenience sampling approach was conducted. This study followed the STROBE guidelines. School-age children with asthma and their parents (N = 211) from pediatric respiratory clinics in China completed the General Questionnaire, Short-Egna Minnen av. Barndoms Uppfostran-Chinese, General Self-Efficacy Scale, Medication Adherence Questionnaire and Childhood Asthma Control Test. Structural equation modeling was used to examine the mediation models. ResultsPositive parenting style was positively correlated with child general self-efficacy, medication adherence and asthma control (r = 0.602, 0.572, 0.613, p < 0.001). Negative parenting style was negatively correlated with child general self-efficacy, medication adherence and asthma control (r = −0.535, −0.598, −0.586, p < 0.001). Structure Equation Modle (SEM) results indicated that the relationships between positive parenting style, negative parenting style and child asthma control were mediated by general self-efficacy (Effect Size [ES]: 0.209, 95%CI [0.075, 0.372]; and ES: -0.229, 95%CI [−0.387, −0.103], respectively) and medication adherence (ES: 0.128, 95%CI [0.032, 0.322]; and ES: -0.190, 95%CI [−0.432, −0.071], respectively) and together in serial (ES: 0.177, 95%CI [0.076, 0.295]; and ES: -0.118, 95%CI [−0.235, −0.020], respectively). ConclusionsParenting style may impact child asthma through both child general self-efficacy and medication adherence. The study may provide useful intervention targets for improving asthma control. Practice implicationsNurses should encourage parents to increase positive parenting style while decreasing negative parenting style. Family interventions focusing on general self-efficacy and medication adherence may be advantageous to improve asthma control.

Examining the effects of prenatal alcohol exposure on performance of the sustained attention to response task in children with an FASD.

Prenatal alcohol exposure (PAE), the leading known cause of childhood developmental disability, has long-lasting effects extending throughout the lifespan. It is well documented that children prenatally exposed to alcohol have difficulties inhibiting behavior and sustaining attention. Thus, the Sustained Attention to Response Task (SART), a Go/No-go paradigm, is especially well suited to assess the behavioral and neural functioning characteristics of children with PAE. In this study, we utilized neuropsychological assessment, parent/guardian questionnaires, and magnetoencephalography during SART random and fixed orders to assess characteristics of children 8-12 years old prenatally exposed to alcohol compared to typically developing children. Compared to neurotypical control children, children with a Fetal Alcohol Spectrum Disorder (FASD) diagnosis had significantly decreased performance on neuropsychological measures, had deficiencies in task-based performance, were rated as having increased Attention-Deficit/Hyperactivity Disorder (ADHD) behaviors and as having lower cognitive functioning by their caretakers, and had decreased peak amplitudes in Broadmann's Area 44 (BA44) during SART. Further, MEG peak amplitude in BA44 was found to be significantly associated with neuropsychological test results, parent/guardian questionnaires, and task-based performance such that decreased amplitude was associated with poorer performance. In exploratory analyses, we also found significant correlations between total cortical volume and MEG peak amplitude indicating that the reduced amplitude is likely related in part to reduced overall brain volume often reported in children with PAE. These findings show that children 8-12 years old with an FASD diagnosis have decreased amplitudes in BA44 during SART random order, and that these deficits are associated with multiple behavioral measures.

The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial.

To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss. We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks. In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except "eyes closed firm surface" of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, "overall" stability index in postural stability test, "overall," "left," and "backward left" of limits of stability test, all parameters of the mCTSIB, and BESS total. Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.

Inhibitory Control in Children With Tourette’s Disorder Is Impaired in Everyday Life But Intact During a Stop Signal Task

Inhibitory Control in Children With Tourette’s Disorder Is Impaired in Everyday Life But Intact During a Stop Signal Task

Investigation of LncRNA PVT1 and MiR-21-5p Expression as Promising Novel Biomarkers for Autism Spectrum Disorder.

The characteristics of ncRNA in children with autism spectrum disorder (ASD) were observed to disclose a theoretical basis for further research on molecular markers for early warning of ASD. Children with ASD and normal control children were recruited to collect peripheral blood RNA samples. The concentration of PVT1 and miR-21-5p was quantitatively analyzed by qRT-PCR. Pearson correlation coefficient method was used to evaluate the link between PVT1 level and miR-21-5p level of the children. Receiver operating characteristic (ROC) curves were applied to reckon the predictive value of PVT1, miR-21-5p, and their combination in ASD. The interconnection of PVT1 with miR-21-5p was represented by luciferase reporter assay. The targeted genes of miR-21-5p were predicted. The enrichment and protein interaction analysis of these genes was carried out to find the important core genes and analyze their value in ASD. In the disease group, the level of PVT1 was downregulated, while the content of miR-21-5p was upregulated. The expression level of serum miR-21-5p was negatively correlated with the level of PVT1. Luciferase reporter gene assay documented that PVT1 directly targeted miR-21-5p. ROC curve showed that PVT1, miR-21-5p, and their combination showed clinical value for disease diagnosis. The functional enrichment analysis showed that the targets of miR-21-5p participated in ASD by regulating related functions and pathways. Reduced expression of PVT1 and raised miR-21-5p were good diagnostic markers for ASD, which would provide a basis for effective prevention, early diagnosis, and early intervention of ASD.

Evaluation of maxillary sinus volumes and pathologies in children with and without cleft lip and palate using cone beam computed tomography.

The aim of this study is to evaluate the maxillary sinus (MS) volume and pathologies, nasal septum (NS) deviation, and MS septa formation in children with and without cleft lip and palate (CLP); also to investigate the possible causes of MS pathologies. Cone Beam Computed Tomography (CBCT) images of 200 (100 CLP, 100 control) children (5-18 years old) were evaluated from the computer database of Marmara University Faculty of Dentistry. Children with a history of maxillofacial trauma, diseases that affect bone metabolism, orthognathic surgery, extrinsic pathologies of the MS, and accompanying syndromes were excluded. NS deviation, MS septa formation, volume, and pathologies evaluated using Mimics® software. In statistical evaluations; Student t test, paired sample t test, Chi-Square test, Fisher's Exact Chi-Square test, Continuity Correction, Chi-square analysis in one-eyed layout, McNemar test, and logistic regression analysis were used. Total MS volume was smaller in the CLP group (21 232 mm3) than in control children (23 763 mm3) (P:0.026). NS deviation and MS pathology were more frequent in the CLP. In logistic regression analysis, there was no significant relation between the presence of NS deviation and pathology in MS. The presence of CLP increased the risk of MS pathology by 2.6 times. We found that children with CLP have less MS volume and an increased rate of NS deviation and MS pathology compared to the control group. Further radiological and clinical studies are needed to explain the predisposing factors of MS pathology in children with CLP.

Effects of the BalanCI on Working Memory and Balance in Children and Young Adults With Cochleovestibular Dysfunction.

This study aimed to: (1) determine the interaction between cognitive load and balance in children and young adults with bilateral cochleovestibular dysfunction who use bilateral cochlear implants (CIs) and (2) determine the effect of an auditory balance prosthesis (the BalanCI) on this interaction. Many (20 to 70%) children with sensorineural hearing loss experience some degree of vestibular loss, leading to poorer balance. Poor balance could have effects on cognitive resource allocation which might be alleviated by the BalanCI as it translates head-referenced cues into electrical pulses delivered through the CI. It is hypothesized that children and young adults with cochleovestibular dysfunction will demonstrate greater dual-task costs than typically-developing children during dual balance-cognition tasks, and that BalanCI use will improve performance on these tasks. Study participants were 15 typically-developing children (control group: mean age ± SD = 13.6 ± 2.75 years, 6 females) and 10 children and young adults who use bilateral CIs and have vestibular dysfunction (CI-V group: mean age ± SD=20.6 ± 5.36 years, 7 females). Participants completed two working memory tasks (backward auditory verbal digit span task and backward visuospatial dot matrix task) during three balance conditions: seated, standing in tandem stance with the BalanCI off, and standing in tandem stance with the BalanCI on. Working memory performance was quantified as total number of correct trials achieved. Postural stability was quantified as translational and rotational path length of motion capture markers worn on the head, upper body, pelvis, and feet, normalized by trial time. Relative to the control group, children and young adults in the CI-V group exhibited poorer overall working memory across all balance conditions ( p = 0.03), poorer translational postural stability (larger translational path length) during both verbal and visuospatial working memory tasks ( p < 0.001), and poorer rotational stability (larger rotational path length) during the verbal working memory task ( p = 0.026). The CI-V group also exhibited poorer translational ( p = 0.004) and rotational ( p < 0.001) postural stability during the backward verbal digit span task than backward visuospatial dot matrix task; BalanCI use reduced this stability difference between verbal and visuospatial working memory tasks for translational stability overall ( p > 0.9), as well as for rotational stability during the maximum working memory span (highest load) participants achieved in each task ( p = 0.91). Balance and working memory were impaired in the CI-V group compared with the control group. The BalanCI offered subtle improvements in stability in the CI-V group during a backward verbal working memory task, without producing a negative effect on working memory outcomes. This study supports the feasibility of the BalanCI as a balance prosthesis for individuals with cochleovestibular impairments.

Executive Control and Associated Brain Activity in Children With Familial High-Risk of Schizophrenia or Bipolar Disorder: A Danish Register-based Study.

Impaired executive control is a potential prognostic and endophenotypic marker of schizophrenia (SZ) and bipolar disorder (BP). Assessing children with familial high-risk (FHR) of SZ or BP enables characterization of early risk markers and we hypothesize that they express impaired executive control as well as aberrant brain activation compared to population-based control (PBC) children. Using a flanker task, we examined executive control together with functional magnetic resonance imaging (fMRI) in 11- to 12-year-old children with FHR of SZ (FHR-SZ) or FHR of BP (FHR-BP) and PBC children as part of a register-based, prospective cohort-study; The Danish High Risk and Resilience study-VIA 11. We included 85 (44% female) FHR-SZ, 63 (52% female) FHR-BP and 98 (50% female) PBC in the analyses. Executive control effects, caused by the spatial visuomotor conflict, showed no differences between groups. Bayesian ANOVA of reaction time (RT) variability, quantified by the coefficient of variation (CVRT), revealed a group effect with similarly higher CVRT in FHR-BP and FHR-SZ compared to PBC (BF10 = 6.82). The fMRI analyses revealed no evidence for between-group differences in task-related brain activation. Post hoc analyses excluding children with psychiatric illness yielded same results. FHR-SZ and FHR-BP at age 11-12 show intact ability to resolve a spatial visuomotor conflict and neural efficacy. The increased variability in RT may reflect difficulties in maintaining sustained attention. Since variability in RT was independent of existing psychiatric illness, it may reflect a potential endophenotypic marker of risk.

The impact of illicit and licit drugs on the incidence of gastroschisis in a developing country

BackgroundGastroschisis is a congenital malformation of unknown cause. Publications from developed countries associate its incidence with illicit and licit drug use. Our objective was to analyze the impact of illicit and licit drugs on the incidence of gastroschisis in a developing country. MethodsThis case–control study (1:4), was conducted in a public hospital in Xalapa, Veracruz, Mexico. We prospectively collected data on 91 children with gastroschisis and retrospectively collected 364 randomized control children without congenital malformations. Variables included maternal consumption of illicit and licit drugs, age, body mass index (BMI), parity, socioeconomic level, education, marital status, and residence. The Mann–Whitney U, chi-square, and Fisher tests were conducted, and the odds ratio (OR), adjusted odds ratio (aOR), and 95 % confidence intervals (CIs) were calculated. ResultsConsumption of illicit drugs in the case (1.1 %) vs. control (0.3 %) groups was not a significant risk factor for gastroschisis (aOR: 3.55; 95 % CI: 0.21–57.70). Tobacco consumption was not a determinative factor for gastroschisis (case (2.2 %) vs. control (0 %); p = 0.005). Alcohol consumption in the case (4.4 %) vs. control (0.3 %) groups was a risk factor for gastroschisis (aOR 14.02; 95 % CI: 1.43–136.68). Young maternal age, low socioeconomic background, rural residence, and primiparity were significant risk factors for gastroschisis; high BMI had a protective effect. ConclusionIllicit drugs and tobacco use were not associated with the incidence of gastroschisis in a developing country. Alcohol was a risk factor, despite the small number of subjects consuming it. Level of evidenceIII.

Sociodemographic factors affecting glycaemic control in Finnish paediatric patients with type 1 diabetes.

Socioeconomic problems may present significant challenges when trying to reach optimal glycaemic control in paediatric patients with type 1 diabetes. We examined sociodemographic factors affecting metabolic control in patients in one of the biggest paediatric diabetes clinics in Finland. One hundred ninety-one children (age 2-15 years; median 11 years; 47% female) with type 1 diabetes and their families were recruited during outpatient visits in the paediatric diabetes clinic of Tampere University Hospital, Finland. The participants completed a questionnaire on the family's sociodemographic background. The child's glycaemic control was assessed by both glycosylated haemoglobin (HbA1c) and time in range (TIR). Risk factors for poor (HbA1c ≥75 mmol/mol; TIR <40%) and optimal (HbA1c <53 mmol/mol; TIR ≥70%) metabolic control were searched using logistic regression analyses. Living in a nuclear family, male gender, younger age and a school assistant for diabetes management were associated with the simultaneous presence of both indicators of optimal metabolic control. Poor glycaemic control, as estimated by HbA1c, was associated with lower parental education and the child's older age. Parental smoking and the child's older age were associated with poor TIR. This study confirms the importance of sociodemographic factors in care of Finnish paediatric patients with type 1 diabetes. Sociodemographic status markers of the family could be used as triggers to alert paediatric diabetes teams to offer more tailored care to families with new-onset type 1 diabetes mellitus.