Children In General Population Research Articles

Impact of wheat sensitization on wheeze and T2 phenotypes in general population of children

BackgroundThe association between sensitization to specific aeroallergens and outcomes in patients with asthma is well-researched; however, the association between childhood-onset wheeze/asthma and sensitization to various aeroallergens and food allergens in the general pediatric population remains poorly understood. ObjectiveThe association between sensitization to common aeroallergens and food allergens with wheeze and type 2 (T2) inflammation in the general pediatric population was investigated. MethodsSpecific IgEs against nine aeroallergens and four food allergens were measured in the prospective Hokkaido birth cohort of 428 school-age children (approximately 10 years of age). Wheeze and other allergic symptoms were assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Blood eosinophil count and fractional exhaled nitric oxide level were assessed as T2 biomarkers. The Isle of Wight (IOW) birth cohort in UK was used for replication analysis (n=1032). ResultsThe prevalence of sensitization to at least one aeroallergen and food allergen was 70.5% and 22.3%, respectively. A significant association between wheeze and sensitization to aeroallergens such as ragweed, Japanese cedar, mugwort, and pet dander, were found. However, the association between wheeze and wheat sensitization was highly significant (Hokkaido birth cohort, odds ratio [OR]: 4.67; 95% confidence interval [CI]: 1.98–11.01; IOW birth cohort, OR: 4.01, 95% CI: 1.78–9.07). Sensitization to most aeroallergens, though not any food allergens, was associated with the T2high phenotype. ConclusionSensitization to wheat may be an important risk factor for wheeze/asthma development, especially the pathogenesis of T2-non/low asthma, independent of aeroallergens, in the general pediatric population.

Anthropometric Profile, Overweight/Obesity Prevalence, and Socioeconomic Impact in Moroccan Children Aged 6-12 Years Old with Autism Spectrum Disorder.

In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. A total of 258 children (boys = 195) aged 6 to 12 years old (mean = 9.4 ± 1.4) diagnosed with ASD participated in this study. Besides the body mass and height, four significant anthropometric markers for assessing obesity were examined: body mass index (BMI), body surface area (BSA), waist circumference (WC), and waist-to-height ratio (WHtR). Each anthropometric marker was categorized into one of three cardiometabolic risk levels based on the Z-scores and their corresponding percentiles. The distribution was as follows: low risk (≤84th percentile), high risk (85th-94th percentile), and very high risk (≥95th percentile). Subsequently, a multiple regression analysis was employed to develop an algorithm that generates a composite risk score. This score incorporates all the anthropometric variables simultaneously, while also weighting their individual contributions to the cardiometabolic risk. Children with ASD exhibit an anthropometric profile that markedly increases their susceptibility to cardiometabolic issues. While roughly 11% of the general Moroccan child population is overweight or obese, this figure soars to nearly 60% among children with ASD when considering the central adiposity markers. Furthermore, children from middle-class socioeconomic backgrounds display a more than threefold greater risk of developing overweight or obesity compared to their counterparts from lower socioeconomic backgrounds. This study has, for the first time, provided an up-to-date overview of the cardiometabolic risk in Moroccan children with ASD using traditional anthropometric measurements. The primary risk factor is clearly linked to central (abdominal) adiposity, which is recognized as the most deleterious. This study highlights the need to include general and central obesity markers. This study underscores the importance of incorporating both general and central adiposity markers for a more comprehensive assessment, and it emphasizes the need for closer monitoring within this high-risk population.

Ophthalmic Findings in Aboriginal Children with High Rates of Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder: The Lililwan Project

ABSTRACT Purpose To describe ophthalmic findings in an Indigenous paediatric population and the associations between fetal alcohol spectrum disorder (FASD), prenatal alcohol exposure (PAE), and eye anomalies. Methods Medical records were reviewed for eye problems, and eye assessments were conducted by an orthoptist or ophthalmologist in the Lililwan Project cohort, which comprised 108 (81%) of all children born between 2002 and 2003, and residing in the remote Fitzroy Valley, Western Australia in 2010. Values from ophthalmic assessments and prevalence of abnormalities were presented for the total cohort and stratified by group: FASD; PAE (no FASD); and No PAE. Results Of children, 55% had PAE and 19% FASD. Most (98%) had normal vision; 15.6% had keratometry cylinder values indicating astigmatism and potential for improved vision with glasses. Strabismus (22.3%), short palpebral fissure length (PFL; 21.3%), upslanting palpebral fissures (12.0%), follicular trachomatous inflammation (6.9%), abnormal slit lamp assessments (6.7%), retinal tortuosity (6.7%), and blepharoptosis (5.6%) were identified. Strabismus and trachoma rates were higher than in the general child population. Ophthalmic findings were similar between groups except for prevalence of short PFL (FASD > No PAE; p = 0.003); abnormal keratometry cylinder values (FASD [29.4%] and PAE (no FASD) [20.0%] > No PAE [5.3%]; p = 0.031) and blepharoptosis (FASD [9.5%] > other groups [0%]; p = 0.040). Conclusion Despite the small sample, some eye abnormalities were higher in children with PAE and/or FASD. Access to eye services or assessment of vision and structural eye anomalies is essential for Indigenous children, particularly those with PAE or FASD to allow early effective treatment.

The role of the gut microbiota in the genesis of gallstone formation in childhood

Cholelithiasis has been and remains a frequent socially significant public health problem worldwide. The pathomorphosis of the disease has also undergone significant changes, which has significantly rejuvenated, occurring not only at a young age, but also in childhood. More than 175,000 cholecystectomies are performed annually for cholelithiasis. Cholelithiasis affects 10-20% of the adult population in our country. At the same time, cholecystectomy came in second place after appendectomy. There are no official statistics on the prevalence of GCD in the general population of children in Russia. In the Krasnodar Territory, the incidence of cholelithiasis in childhood, according to the data of circulation, is 1.8-3.3%. Over the past decade, a number of studies have been conducted confirming the role of the microbiota in various parts of the gastrointestinal tract as a new link in the etiopathogenesis of GI. Intestinal bacteria (Clostridium, Bifidobacterium, Peptostreptococcus, Bacteroides, Eubacterium, Escherichia coli), involved in the oxidation and epimerization of bile acids, can disrupt enterohepatic circulation and lead to the formation of gallstones. At the same time, cholecystectomy leads to further transformation of the microbiota composition in various parts of the gastrointestinal tract, increasing the risk of developing stomach cancer and colorectal cancer. Further research is needed to determine the possibility of using the assessment of the composition of the gastrointestinal microbiota as a marker for the early diagnosis of various gastroenterological diseases of cholelithiasis in particular. The purpose of the study: To determine the role of the intestinal microbiota in the development of metabolic disorders in children with cholelithiasis in order to predict the complicated course of the disease. Material and methods. The work was carried out on the basis of the children’s city polyclinic No. 122 Moscow`s Health Department (chief physician - A.I. Bragin), 194 children with housing and communal services were under supervision. The control group consisted of 78 practically healthy children of the I Health group. The study groups were comparable in gender and age. Criteria for inclusion in the study: children with an established diagnosis of cholelithiasis, asymptomatic course at the age of 3 to 15 years. Exclusion criteria from the study: refusal of the child’s legal representative from the study, the presence of diagnosed acute diseases in the child during the last month, chronic somatic diseases, taking antibiotics and probiotics in the last 6 months, catamnestic observation for less than 12 months. General clinical studies were conducted: questionnaires, health assessment, anthropometry, biochemical examination of blood serum, including lipidogram, ultrasound examination of the abdominal cavity and gallbladder. To assess the intestinal microbiome, the following methods were used: standard bacteriological analysis of feces (method of sowing feces on liquid agarized nutrient media); complex coprological examination with the determination of pancreatic elastase (ELISA method) and fecal carbohydrates (Benedict method); biochemical examination of feces with the determination of short-chain fatty acids (SCFCS) (gas-liquid chromatography method); The Shannon index was adopted as a measure of intestinal dysbiosis. Statistical analysis was performed using the software package Statistica8.0 and MS OfficeExcel 2010/ The results of the study and the conclusion. The biotransformation of the bile acid pool mediated by the gut microbiota regulates the metabolism of bile, glucose and lipids. In children with GI, the number of bacteria representing the indigenous microbiota is generally lower, the intensity of colonization of the intestinal mucosa by them is significantly less, the species diversity of opportunistic and pathogenic bacteria is significantly higher compared with those in practically healthy children. There is an unstable and poor-quality system of interrelation with the macroorganism, disparate metabolic pathways. MK is not able to qualitatively maintain homeostasis within its own consortium. All this creates conditions for disruption of bile acid metabolism and the formation of lithogenic bile. The presence of intestinal dysbiosis in children with GI can cause not only the formation of gallstones, but also negatively affect the further growth and development of children, including the formation of metabolic complications and inflammatory processes.

Oral killed cholera vaccines for preventing cholera.

Cholera causes acute watery diarrhoea and death if not properly treated. Outbreaks occur in areas with poor sanitation, including refugee camps. Several vaccines have been developed and tested over the last 50 years. This is an update of a Cochrane review, originally published in 1998, which explored the effects of all vaccines for preventing cholera. This review examines oral vaccines made from killed bacteria. To assess the effectiveness and safety of the available World Health Organization (WHO)-prequalified oral killed cholera vaccines among children and adults. We searched the Cochrane Infectious Diseases Group Specialized Register; CENTRAL, MEDLINE; Embase; LILACS; and two trials registers (February 2023). We included randomized controlled trials (RCTs), including cluster-RCTs. There were no restrictions on the age and sex of the participants or the setting of the study. We considered any available WHO-prequalified oral killed cholera vaccine as an intervention. The control group was given a placebo, another vaccine, or no vaccine. The outcomes were related to vaccine effectiveness and safety. We included articles published in English only. Two review authors independently applied the inclusion criteria and extracted data from included studies. We assessed the risk of bias using the Cochrane ROB 1 assessment tool. We used the generic inverse variance and a random-effects model meta-analysis to estimate the pooled effect of the interventions. We assessed the certainty of the evidence using the GRADE approach. For vaccine effectiveness (VE), we converted the overall risk ratio (RR) to vaccine effectiveness using the formula: VE = (1 - RR) x 100%. Five RCTs, reported in 12 records, with 462,754 participants, met the inclusion criteria. We identified trials on whole-cell plus recombinant vaccine (WC-rBS vaccine (Dukoral)) from Peru and trials on bivalent whole-cell vaccine (BivWC (Shanchol)) vaccine from India and Bangladesh. We did not identify any trials on other BivWC vaccines (Euvichol/Euvichol-Plus), or Hillchol. Two doses of Dukoral with or without a booster dose reduces cases of cholera at two-year follow-up in a general population of children and adults, and at five-month follow-up in an adult male population (overall VE 76%; RR 0.24, 95% confidence interval (CI) 0.08 to 0.65; 2 trials, 16,423 participants; high-certainty evidence). Two doses of Shanchol reduces cases of cholera at one-year follow-up (overall VE 37%; RR 0.63, 95% CI 0.47 to 0.85; 2 trials, 241,631 participants; high-certainty evidence), at two-year follow-up (overall VE 64%; RR 0.36, 95% CI 0.16 to 0.81; 2 trials, 168,540 participants; moderate-certainty evidence), and at five-year follow-up (overall VE 80%; RR 0.20, 95% CI 0.15 to 0.26; 1 trial, 54,519 participants; high-certainty evidence). A single dose of Shanchol reduces cases of cholera at six-month follow-up (overall VE 40%; RR 0.60, 95% CI 0.47 to 0.77; 1 trial, 204,700 participants; high-certainty evidence), and at two-year follow-up (overall VE 39%; RR 0.61, 95% CI 0.53 to 0.70; 1 trial, 204,700 participants; high-certainty evidence). A single dose of Shanchol also reduces cases of severe dehydrating cholera at six-month follow-up (overall VE 63%; RR 0.37, 95% CI 0.28 to 0.50; 1 trial, 204,700 participants; high-certainty evidence), and at two-year follow-up (overall VE 50%; RR 0.50, 95% CI 0.42 to 0.60; 1 trial, 204,700 participants; high-certainty evidence). We found no differences in the reporting of adverse events due to vaccination between the vaccine and control/placebo groups. Two doses of Dukoral reduces cases of cholera at two-year follow-up. Two doses of Shanchol reduces cases of cholera at five-year follow-up, and a single dose of Shanchol reduces cases of cholera at two-year follow-up. Overall, the vaccines were safe and well-tolerated. We found no trials on other BivWC vaccines (Euvichol/Euvichol-Plus). However, BivWC products (Shanchol, Euvichol/Euvichol-Plus) are considered to produce comparable vibriocidal responses. Therefore, it is reasonable to apply the results from Shanchol trials to the other BivWC products (Euvichol/Euvichol-Plus).

Prevalence of iron deficiency anaemia in congenital heart disease in children

Background: Congenital heart disease (CHD), out of all congenital anomalies, is the leading condition of mortality and morbidity in children under 5 years of age. Iron deficiency anaemia (IDA) has been clearly shown to be an important risk factor that increases morbidity and mortality in such patients. The present study is thus conducted to find out the prevalence of iron deficiency anaemia in children less than 15 years with congenital heart disease at a tertiary care centre and compare them with cases without CHD. Methods: Prospective study over a period of 2 years, included 60 cases of children below 15 years of age with echocardiographicaly confirmed CHD, investigated by serum ferritin to diagnosed IDA using cut off 12ng/ml. These cases compared with similar age controls. Results: 51cases (82%) were of acyanotic heart disease and 18% were of cyanotic heart disease. Iron deficiency or storage depletion was seen in 90% cases as compared to 75% controls. Iron deficiency anaemia was seen in 55% cases as compared to 30% controls, the difference was statistically significant. Conclusions: Present study observed higher prevalence of IDA among cases with CHD as compared to general population of children. The prevalence was found to be more in cases with cyanotic heart disease as compared to cases with acyanotic heart disease. We thus conclude that routine screening for iron deficiency should be done for these children and those found to be deficient should be treated.

Эссенциальная младенческая эзотропия

Relevance. Essential infantile esotropia (EIE) is the most common type of childhood strabismus. The incidence of EIE varies on average from 0.1 to 1.0% in the general population of children, which is significant for timely diagnosis and provision of appropriate assistance to this category of patients. The exact etiology of infantile essential esotropia remains unknown, but historically a number of conflicting theories have been proposed. Purpose. To summarize the accumulated experience in the field of studying EIE to determine the optimal path to achieving the main goal of treatment – achieving orthoposition with the subsequent formation of binocular vision in this category of patients. Material and methods. To complete the review, a search of literature sources was carried out in the PubMed and Scopus abstract databases for the period up to 2022 inclusive. A total of 32 articles relevant to the review topic were selected and analyzed. Results. Having analyzed the literature data, we can conclude that today there is no unified classification of infant essential esotropia, but a certain symptom complex of clinical manifestations has been identified that are pathognomonic for this type of strabismus. Usually, EIE manifests in the first 6 months of life, appears a large horizontal esodeviation, may be accompanied by latent nystagmus, compensatory head rotation, and cross-fixation syndrome. This type of strabismus occurs in infants with normal age-related refraction and normal neurological status. The clinical approach to tactics and methods of treatment of infantile esotropia varies widely in the strabismus world. There are conflicting opinions regarding the following issues: the optimal timing for the operation, the most effective type of operation, and what determines the favorable outcome of the treatment of essential congenital esotropia. Conclusion. Many aspects of EIE remain controversial and poorly defined. To optimally realize the main goal of EIE treatment – achieving orthoposition with the subsequent formation of binocular vision – is a feasible task, which will soon find a solution. Key words: essential infantile esotropia, latent nystagmus, cross fixation syndrome, binocular vision

Associations of diet quality and food consumption with serum biomarkers for lipid and amino acid metabolism in Finnish children: the PANIC study.

To investigate the associations of overall diet quality and dietary factors with serum biomarkers for lipid and amino acid metabolism in a general population of children. We studied 194 girls and 209 boys aged 6-8years participating in the Physical Activity and Nutrition in Children study. Food consumption was assessed by 4-day food records and diet quality was quantified by the Finnish Children Healthy Eating Index (FCHEI). Fasting serum fatty acids, amino acids, apolipoproteins, as well as lipoprotein particle sizes were analyzed with high-throughput nuclear magnetic resonance spectroscopy. Data were analyzed using linear regression adjusted for age, sex, and body fat percentage. FCHEI was directly associated with the ratio of polyunsaturated (PUFA) to saturated fatty acids (SFA) (PUFA/SFA), the ratio of PUFA to monounsaturated fatty acids (MUFA) (PUFA/MUFA), the ratio of PUFA to total fatty acids (FA) (PUFA%), the ratio of omega-3-fatty acids to total FA (omega-3 FA%), and inversely associated with the ratio of MUFA to total FA (MUFA%), alanine, glycine, histidine and very-low density lipoprotein (VLDL) particle size. Consumption of vegetable oils and vegetable-oil-based margarine (≥ 60% fat) was directly associated with PUFA/SFA, PUFA/MUFA, PUFA%, the ratio of omega-6 FA to total FA (omega-6 FA%), and inversely associated with SFA, MUFA, SFA to total FA (SFA%), MUFA%, alanine and VLDL particle size. Consumption of high-fiber grain products directly associated with PUFA/SFA, PUFA/MUFA, omega-3 FA%, omega-6 FA%, PUFA% and inversely associated with SFA and SFA%. Fish consumption directly related to omega-3 FA and omega-3 FA%. Consumption of sugary products was directly associated with histidine and VLDL particle size. Vegetable, fruit, and berry consumption had direct associations with VLDL particle size and the ratio of apolipoprotein B to apolipoprotein A1. Consumption of low fat (< 1%) milk was directly associated with phenylalanine. A higher consumption of high-fat (≥ 1%) milk was associated with lower serum MUFA/SFA and higher SFA%. Sausage consumption was directly related to SFA% and histidine. Red meat consumption was inversely associated with glycine. Better diet quality, higher in intake of dietary sources of unsaturated fat and fiber, and lower in sugary product intake were associated with more favorable levels of serum biomarkers for lipid and amino acid metabolism independent of adiposity. ClinicalTrials.gov: NCT01803776, registered March 3, 2013.

Psychometric Evaluation of the PedsQL GCS and CHU9D in Australian Children and Adolescents with Common Chronic Health Conditions.

Generic instruments such as the Pediatric Quality of Life Inventory™ v4.0 Generic Core Scales (PedsQL GCS) and Child Health Utility 9D (CHU9D) are widely used to assess health-related quality of life (HRQOL) of the general childhood population, but there is a paucity of information about their psychometric properties in children with specific health conditions. This study assessed psychometric properties, including acceptability, reliability, validity, and responsiveness, of the PedsQL GCS and the CHU9D in children and adolescents with a range of common chronic health problems. We used data from the Longitudinal Study of Australian Children (LSAC), for children aged 10-17 years with at least one of the following six parent-reported health conditions: asthma, anxiety/depression, attention deficit hyperactivity disorder (ADHD), autism/Asperger's, epilepsy, and type 1 diabetes mellitus. The LSAC used parent proxy-reported PedsQL GCS and child self-reported CHU9D assessments. The performance of each instrument (PedsQL GCS and CHU9D) for each psychometric property (acceptability, reliability, validity, and responsiveness) was assessed against established criteria. The study sample included 7201 children and adolescents (mean age = 14 years; range 10.1-17.9 years; 49% female) with 15,568 longitudinal observations available for analyses. Across the six health conditions, acceptability of the PedsQL GCS was high, while acceptability for the CHU9D was mixed. Both the PedsQL GCS and CHU9D showed strong internal consistency (Cronbach's alpha range: PedsQL GCS = 0.70-0.95, CHU9D = 0.76-0.84; item-total correlations range: PedsQL GCS = 0.35-0.84, CHU9D = 0.32-0.70). However, convergent validity for both the PedsQL GCS and CHU9D was generally weak (Spearman's correlations ≤ 0.3). Known group validity was strong for the PedsQL GCS (HRQOL differences were detected for children with and without asthma, anxiety/depression, ADHD, autism/Asperger's, and epilepsy). CHU9D was only able to discriminate between children with and without anxiety/depression, ADHD, and autism/Asperger's. The responsiveness of both the PedsQL GCS and CHU9D was variable across the six conditions, and most of the estimated effect sizes were relatively small (<0.5). This study expands the evidence base of psychometric performance of the PedsQL GCS and CHU9D and can aid in appropriate HRQOL instrument selection for the required context by researchers and clinicians.

Outcomes for children and young people growing up in kinship care in Scotland: A population-level data linkage study

ObjectivesThe number of children and young people living in kinship care (living separately from their parents with a family friend/relative) in Scotland has increased consistently since 2010. This study aims to explore outcomes for children and young people in kinship care in terms of their health, education, and care journeys.&#x0D; MethodsThis population-wide data linkage study will utilise data on all children and young people who have been placed in formal kinship care from 2008 onwards. The datasets linked for this study are:&#x0D; &#x0D; Looked After Children&#x0D; Child Protection&#x0D; Health Visiting&#x0D; Educational attainment, attendances, absences and exclusion&#x0D; Children’s Hearings data&#x0D; &#x0D; Through descriptive analysis the study will provide insight into the experiences and outcomes of children and young people in kinship care. Where appropriate, comparisons will be drawn with the wider care population and the general population of children and young people in Scotland.&#x0D; ResultsData will be presented which highlight:&#x0D; &#x0D; Levels of kinship care usage in Scotland, and how this varies regionally and over time.&#x0D; The routes into kinship care in terms of child protection concerns and legal reasons data.&#x0D; How children fare while in kinship care – specifically in terms of their childhood development, placement stability and educational attainment/engagement.&#x0D; The pathways out of formal kinship care, and whether these differ over time.&#x0D; &#x0D; Full results will be available for publication at the 2023 ADR UK conference.&#x0D; Conclusion This is the first population-wide study on outcomes for children and young people living in kinship care within Scotland. It is hoped that insight arising from this work will aid local authorities, government and others in meeting the needs of the steadily increasing number of children living in formal kinship care.

Gender-Related Violence: What Can a Concept Do?

This paper explains the logic for using the concept of gender-related violence (GRV) as a broad category that problematises homophobia, transphobia and the policing of gender norms and the gender binary, as well as gender-based violence—understood as primarily violence against women and girls (VAWG). It then evaluates the utility of this concept and its capacity to introduce theoretical refinement to the study of gendered violence, by reviewing its reception within a large international feminist project on gendered violence in the lives of children and young people. The aim of this study was to improve knowledge and understanding of forms of violence and discrimination among practitioners who have everyday contact with general populations of children and young people. It sought to improve their ability to identify and challenge sexist, sexualising, homophobic or transphobic language or behaviour, and their knowledge of how and when to refer children and young people to appropriate support. The paper reports my view of the contribution that the concept of gender-related violence made in each of the four project sites: Ireland, Italy, Spain and the UK. The findings are mixed: in Spain and the UK the concept seemed helpful, but in Italy and Ireland it was initially expected to be helpful but, in practice, a conceptualisation closer to gender-based violence plus homophobia was employed. It is tentatively concluded that where LGBTQIA+ rights were well-established as well as the problematisation of VAWG, this framework was successful, but that it was less successful in more heteronormative sites where homophobia was less problematised. It is suggested that, as a concept, GRV can make a valuable intervention in sites like the former.

Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children.

Understanding the normal range of laboratory values as pertained to different age groups and males or females is paramount in health care delivery. We aimed to assess the distribution of morning fasting serum glucose levels by age and sex in the general population of children using a large-scale population-based cohort. A retrospective study with real-world de-identified data from a large, state mandated health fund in Israel among children aged 2-18 years old between 2006 and 2019. Age, sex, and BMI differences in mean glucose levels were evaluated. Study included 130,170 venous blood samples from 117,411 children, 53.3 % were female. After adjusting for age boys had higher fasting serum glucose levels than girls, with a mean of 89.21±8.66 mg/dL vs. 87.59±8.35 (p<0.001) [4.95±0.48 mmol/L vs. 4.86±0.46]. Compared to the 15 to 18 year-olds (88.49±7.63 mg/dL) [4.92±0.42 mmol/L], 2 to 5 year-olds had lower glucose levels (84.19±10.65, [4.68±0.59] (p<0.001)), 11 to 14 year-olds had higher glucose (90.40±7.42 [5.02±0.41], (p<0.001)) and 6 to 10 year-olds showed no difference (88.45±8.25) [4.91±0.46]. 33.0 % (n=42,991) had a BMI percentile record the same year as their glucose test result. There was a weak yet significant positive association between blood glucose levels and BMI. Our large cohort indicates that boys have slightly higher fasting serum glucose levels than girls, as do adolescents compared to younger children. This finding is important for the delivery of adequate health care, screening for illness and avoiding unnecessary investigations and tests.

Pediatric Optic Pathway Gliomas Resource Utilization and Prevalence in the OptumLabs Data Warehouse.

Although significant progress has been made in improving the rate of survival for pediatric optic pathway gliomas (OPGs), data describing the methods of diagnosis and treatment for OPGs are limited in the modern era. This retrospective study aims to provide an epidemiological overview in the pediatric population and an update on eye care resource utilization in OPG patients using big data analysis. Using the OptumLabs Data Warehouse, 9-11 million children from 2016 to 2021 assessed the presence of an OPG claim. This data set was analyzed for demographic distribution data and clinical data including average ages for computed tomography (CT), MRI, strabismus, and related treatment (surgery, chemotherapy, and radiation), as well as yearly rates for optical coherence tomography (OCT) and visual field (VF) examinations. Five hundred fifty-one unique patients ranging in age from 0 to 17 years had an OPG claim, with an estimated prevalence of 4.6-6.1 per 100k. Among the 476 OPG patients with at least 6 months of follow-up, 88.9% had at least one MRI and 15.3% had at least one CT. Annual rates for OCT and VF testing were similar (1.26 vs 1.35 per year), although OCT was ordered for younger patients (mean age = 9.2 vs 11.7 years, respectively). During the study period, 14.1% of OPG patients had chemotherapy, 6.1% had either surgery or radiation, and 81.7% had no treatment. This study updates OPG demographics for the modern era and characterizes the burden of the treatment course for pediatric OPG patients using big data analysis of a commercial claims database. OPGs had a prevalence of about 0.005% occurring equally in boys and girls. Most did not receive treatment, and the average child had at least one claim for OCT or VF per year for clinical monitoring. This study is limited to only commercially insured children, who represent approximately half of the general child population.

Changes in anxiety and depression among public health workers during the COVID-19 pandemic response.

The COVID-19 pandemic has negatively impacted mental health indicators, leading to an increase in symptoms of anxiety and depression in both the general population of adults and children and many occupational groups. This study aims to examine changes in anxiety and depression among a cohort of public health workers in the U.S. during the first year of the COVID-19 pandemic and identify potential risk factors. Longitudinal data were collected from a sub-sample (N = 85) of public health workers in 23 U.S. states who completed two surveys in 2020 and 2021. Information on background characteristics, personal well-being, and work environment as well as validated scales to assess generalized anxiety disorder (GAD), depressive disorder, and burnout was collected. Data were analyzed using Stata Version 17, and significant differences were determined using Pearson's Chi2 and Fisher's Exact tests. The proportion of those reporting GAD (46.3% to 23.2%) or depression (37.8% to 26.8%) improved from Survey 1 to Survey 2 overall; symptoms of anxiety saw the largest improvement. Persistent depression was associated with sustained burnout, changes in social support, and days worked per week. Public health workers experienced elevated levels of anxiety and depression during the initial pandemic response, but a reduction in these symptoms was observed in the subsequent year after vaccines had become widely available. However, unmet needs remain for ongoing workplace mental health supports to address burnout, as well as for additional emotional supports outside of work for public health professionals.

Association Between Intellectual Functioning and Autistic Traits in the General Population of Children.

Autistic traits are continuously distributed in the general population. The associations between autistic traits and intellectual functioning and/or behavioural difficulties, and the impact of intellectual functioning on behavioural difficulties are unclear. The study aims to describe the distribution of autistic traits in a population-based cross-sectional sample of children. Further aims are to examine the association between intellectual functioning and autistic traits, and between autistic traits and behavioural difficulties. Wechsler scales and ratings of autistic traits and behavioural problems in 874 children aged 7-9 years in the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study were assessed. We found a continuous distribution of autistic traits. Intellectual functioning was negatively associated with autistic traits but not with behavioural difficulties. Behavioural difficulties were associated with autistic traits.

Effects of 2-Year Physical Activity and Dietary Intervention on Adrenarchal and Pubertal Development: The PANIC Study.

Childhood overweight has been linked to earlier development of adrenarche and puberty, but it remains unknown if lifestyle interventions influence sexual maturation in general populations. To investigate if a 2-year lifestyle intervention influences circulating androgen concentrations and sexual maturation in a general population of children. We conducted a 2-year physical activity and dietary intervention study in which 421 prepubertal and mostly normal-weight 6- to 9-year-old children were allocated either to a lifestyle intervention group (119 girls, 132 boys) or a control group (84 girls, 86 boys). The main outcome measures were serum dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A4), and testosterone concentrations, and clinical adrenarchal and pubertal signs. The intervention and control groups had no differences in body size and composition, clinical signs of androgen action, and serum androgens at baseline. The intervention attenuated the increase of DHEA (P = .032), DHEAS (P = .001), A4 (P = .003), and testosterone (P = .007) and delayed pubarche (P = .038) in boys but it only attenuated the increase of DHEA (P = .013) and DHEAS (P = .003) in girls. These effects of lifestyle intervention on androgens and the development of pubarche were independent of changes in body size and composition, but the effects of intervention on androgens were partly explained by changes in fasting serum insulin. A combined physical activity and dietary intervention attenuates the increase of serum androgen concentrations and sexual maturation in a general population of prepubertal and mostly normal-weight children, independently of changes in body size and composition.

8th ABM/EABM European Regional Conference May 11–13, 2023 Split, Croatia

8^th ABM/EABM European Regional Conference May 11–13, 2023 Split, Croatia

Reference intervals for cd, hg, Mn and Pb in the general children population (3–14 years) of Kinshasa, Democratic Republic of Congo (DRC) between June 2019 and June 2020

The reference intervals (RIs), proposed by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the International Union of Pure and Applied Chemistry (IUPAC), were derived for Cd, Hg, Mn and Pb in the blood and urine of the children population living in Kinshasa (n = 200, aged 3–14 years with 97 girls). Levels of metals were measured using coupled plasma mass (ICP-MS). In blood, the proposed RIs [P5-P95 (GM)] were 0.022–1.112 μg/L (0.074), 35.69–144.50 μg/L (71.43), 0.060 to 1.161 μg/L (0.208) and 6.597–15.740 μg/L (9.882) for Cd, Pb, Hg and Mn, respectively. Urinary levels [(P5-P95 (GM)] were 0.082–1.530 μg/L (0.366) for Cd, 1.827–18.500 μg/L (5.458) for Pb, 0.323–1.953 μg/L (0.709) for Hg and 0.070 to 1.703 μg/L (0.186) for Mn. As compared to the CDC updated blood Pb reference value (35 μg/L), Pb levels remain higher of public health concern. Cd and Mn levels were similar to those found in the same city in 2015 and databases involving non-occupationally exposed populations from other countries. Hg levels significantly lower than those found in the same city in 2015, probably due to exclusion criteria of metal exposure applying in the present survey (occupationally exposed to the studied metals, smoking habits, amalgam tooth fillings, fish consumption habit more than one time per week, etc.). These background metal exposures will be useful for future occupational and/or environmental surveys as well as undertaking a reliable regulation of chemical exposure in Kinshasa via a national HBM program.

Clinical improvement of teens participating in a dbt skills training

IntroductionDialectical behavioural therapy (DBT) developed by Linehan has been shown to be widely effective in improving emotional regulation capacity in patients diagnosed with borderline personality disorder in adults and adolescents, but also for other profiles of emotional dysregulation, even in the general non-clinical population through emotional regulation skills training programs in schools.ObjectivesThe objective was to describe psychopathological characteristics and to evaluate clinical outcome variables (self-harm, suicide attempts, admissions and emotional regulation difficulties) in young patients who participated in the DBT skills training group carried out by the child and adolescent psychiatry team of Hospital del Mar (Barcelona) between February 2020 and April 2022.MethodsProspective longitudinal study with two evaluations (before starting the group and after finishing it). The clinical variables were evaluated by reviewing the medical records, and the improvement in emotional regulation difficulties was evaluated through the Difficulties in Emotion Regulation Scale (DERS) adaptation to adolescents before and after the intervention.ResultsA total of 36 participants have been referred and assessed to participate in the previously mentioned emotional regulation program. The mean age was 15.6 years (14-17 years old). 100% of the participants were female. All of them met criteria for BPD according to the SCID-II questionnaire; but only 23 patients (63.9%) had BPD as their main diagnosis. 63.9% (n=23) presented psychiatric comorbidities, being 27.8% (n= 10) ADHD, 30.6% (n= 11) substance use disorder and 47.2% (n= 17) eating disorders,77.8% (n=28) had presented self-injurious behaviour, 52% (n=18) had committed a suicide attempt, requiring hospital admission in 36.2% (n=13) at some point in their lives before the therapy group. In the three months after the end of the group, admissions were reduced to 17% (n=6), suicide attempts to 14.8% (n=5) and non-suicidal self-injurious behaviours to 27.8% (n=10).The mean score of all participants on the DERS scale was 129.91 points before participating in the DBT skills group and 105 points right after the group finished. Higher scores translate into greater emotional regulation difficulties.ConclusionsThe reduction in DERS scores, self-injurious behaviours, suicide attempts, and admissions was notable for all participants. It remains to add the results of the groups currently in operation and perform the statistical analysis of all the results. It is necessary to continue studying and testing the benefits of DBT both in the clinical adolescent population and in the general child and adolescent population in order to generalize the promising results observed in our sample. At Hospital del Mar, we will continue to expand the DBT program so that more children and adolescents with emotional dysregulation can benefit.Disclosure of InterestNone Declared

Functional neurological disorder in children and young people: Incidence, clinical features, and prognosis.

To report incidence, demographic and clinical characteristics, and symptom outcome of functional neurological disorder (FND) in children. Children diagnosed with FND at a regional children's hospital were prospectively recruited by weekly active surveillance for 36 months. Demographic, clinical, and follow-up data were retrospectively extracted by review of electronic records. Descriptive statistical analyses were used. Ninety-seven children (age range 5-15 years) met the case definition of FND (annual incidence 18.3 per 100 000 children). Children with FND were likely to be female (n =68 [70%]) and older (median 13 years) with no difference in the Scottish Index of Multiple Deprivation (marker of socioeconomic status) compared with the general childhood population. Functional motor (41%) and sensory (41%) symptoms were most common; other somatic symptoms such as headache (31%) and pain (27%) were frequent. Self-reported psychiatric symptoms and infection/inflammation were the most common predisposing and precipitating factors respectively. At a median of 15 months follow-up, 49% of 75 children reported improvement or resolution of FND symptoms with no prognostic factors found. At this regional centre, FND in children had a higher incidence than previously reported and a less optimistic outcome than in some other studies.