The link between scoliotic deformity and bone metabolism in adolescent idiopathic scoliosis (AIS) has not been well researched. Moreover, the data concerning the cross-talk between fat tissue content/hormonal activity and bone markers in this group of patients are lacking. The objective of this study was to correlate the extent of scoliotic-curve severity with the bone turnover vs. leptin level and nutritional status in girls with AIS. The study encompassed 77 AIS girls, aged 14.7 ± 2.17 years. Scoliotic curve severity assessed by Cobb’s angle was categorized as mild (10-19o) moderate (20-39º) or severe (≥40º). Corrected height, weight, waist and hip circumferences were measured and body mass index (BMI), corrected height Z-score, BMI Z-score and waist/height ratio (WHtR) were calculated for the entire group. Body composition parameters: fat mass (FAT), fat-free mass (FFM) and predicted muscle mass (PMM) were determined using a bioelectrical impedance analyzer. Bone turnover markers (osteocalcin (OC) and amino terminal of collagen cross-links NTx) and leptin levels were assessed in serum. Multiple regression analysis showed that, OC, NTx (negatively with p<0.05) and leptin (positively with p<0.01) were significantly associated with curve severity in AIS girls. Moreover, Cobb’s angle was positively correlated with W/HtR (p<0.01)and FAT (p<0.05). One-way analysis of variance (ANOVA) revealed significant differences in leptin (p<0.05 vs. mild only), OC (p<0.05 vs. mild and moderate)) and W/HtR (p<0.01 and p<0.05 vs. mild and moderate respectively) between the three AIS severity subgroups. OC was significantly lower in the severe AIS subgroup, while leptin and W/HtR were significantly higher. Significant correlations between leptin and anthropometrical parameters as BMI z-score and W/HtR were shown. Leptin level correlated also significantly with BMI z score (p<0.001), W/HtR (p<0.0001) and body composition parameters (p<0.000001). Moreover, there was a significant negative correlation between NTx and leptin level (p<0.05). Bone metabolism in AIS girls seems to be altered and significantly related to the scoliotic curve severity. Leptin may be a crucial link in the cross-talk between bone turnover and body composition in this group of patients. Further studies concerning this topic are needed.

Understanding behavioral factors associated with obesity is of importance in addressing this issue. This study examined the association between cognitive restraint, uncontrolled eating, emotional eating and body mass index (BMI) and amount of food plated, consumed, leftovers, and leftover food thrown into the trash (food wasted) in early adolescent girls nine to 13 years in O’ahu, Hawai’i (n = 93). Food plated, consumed, leftovers, and food wasted were estimated using a three-day mobile food record (mFR). Weight and height were measured to compute BMI (kg/m2). The three-factor eating questionnaire provided a score from 0 to 100 for cognitive restraint, uncontrolled eating, and emotional eating. Higher scores are indicative of greater cognitive restraint, uncontrolled eating, and emotional eating. Pearson’s correlation and general linear models were computed to examine the relationship between three factor eating scores, BMI, and food plated, consumed, leftovers, and food wasted. There was no clinically significant association between cognitive restraint and amount of food wasted. Cognitive restraint was positively correlated with BMI (r=0.36, p<0.001) and with BMI z score (r=0.40, p<0.001). Uncontrolled eating and emotional eating were positively correlated with amount of leftover food at dinner (r=0.30, p=0.006; r=0.33, p=0.003, respectively). Emotional eating was positively associated with percentage of leftover food at dinner (r=0.24, p=0.30). Additional research should examine the specific roles of cognitive restraint, uncontrolled eating, emotional eating and food waste in the development of obesity in adolescents.

Despite several attempts by governments and non-governmental organizations to eliminate female genital mutilation or cutting, it is puzzling that this traditional procedure is widely practiced today in many parts of sub-Saharan Africa (SSA). Scholarly arguments on the influence of female genital mutilation on sexual behavior up until now remain inconclusive. The current study sought to examine the association between female genital mutilation and early sexual initiation among girls and young women (AGYW) in SSA. Data from Demographic and Health Surveys (DHS) of 12 SSA countries were combined. A total of 30,089 AGYW (15-24 years) who had ever had sex and had complete information on all the variables of interest were considered. The outcome variable for the study was early sexual initiation. The study employed multilevel logistic regression for the data analysis, with reported odds ratio and associated 95% confidence intervals (CIs). The overall prevalence of female genital mutilation among AGYW was 49.9%, with the highest and lowest prevalence in Guinea (95.8%) and Togo (3.3%) respectively. The prevalence of early sexual initiation was 42.4%, with the highest and lowest prevalence in Niger (59.9%) and Burkina Faso (30.6%) respectively. AGYW who had not experienced female genital mutilation were less likely to have early sexual initiation [OR= 0.74, CI= 0.70-0.78], compared to those who had experienced female genital mutilation, after controlling for significant covariates. The likelihood of early sexual initiation was high among AGYW aged 15-19 [OR=2.38, CI=2.26-2.51] but low among AGYW with secondary education [AOR=0.58, CI=0.54-0.63], those who had never married [OR=0.68, CI=0.60-0.78], those in households with richest wealth quintile [OR=0.64, CI=0.57-0.72], those who were exposed to mass media [OR=0.88, CI=0.83-0.93], and those working [OR=0.91, CI=0.87-0.96]. Not undergoing female genital mutilation in the midst of socio-economic factors (e.g., education level, household wealth) could limit AGYW from early sexual debut. These findings underscore the need for effective campaign and programs (e.g., educational programs, entrepreneurial training, micro-finance schemes) against the practice of female genital mutilation. Policy interventions (e.g., “schooling for the girl-child” initiatives) that might delay early sexual initiation among adolescent girls and young women in the midst of identified socio-economic factors should be developed.

Background: Autism spectrum disorder (ASD) is a persistent neurodevelopment disorder frequently co-occurring with Attention-Deficit/Hyperactivity Disorder (ADHD) and behavior-related disorders. While behavioral therapy is the first-line option to manage ASD core symptoms, pharmacological therapy is sometimes needed to treat acute problems, such as agitation and aggressive behaviors. Recent guidelines recommend neuroleptics to reduce psychomotor agitation in people with ASD. However, since children with ASD are often drug-resistant, alternative treatments are often justified. Reports from literature showed that intra-venous valproate (IV-VPA) can be effective in reducing agitation in psychiatric patients, with lower frequency of adverse events compared to convention-al treatments. However, since findings are occasionally inconsistent, IV-VPA is not an approved option in clinical psychiatry. We aim at improving the knowledge on the IV-VPA treatment option in emergency psychiatry in the pediatric age. Methods: We report the case of a 11-year-old boy suffering from a complex neurodevelopmental condition, who experienced a psychotic episode with severe aggressive and disruptive behaviors, successfully treated with IV-VPA. Besides, we conducted an up-dated literature review on this topic. Conclusion: In our case, first-line therapies proved to be ineffective. On the contrary, IV-VPA led to a safe and prompt clinical success, in line with other reports. Based on our literature review, IV-VPA can be highly effective and can reduce the risk of adverse events that frequently occur with the use of high-dose standard medications in emergency psychiatry.

Oral squamous cell carcinoma (OSCC) is a highly prevalent and aggressive malignancy, with mortality rates that reach 60%, mainly due to an excessive diagnostic delay. MiRNAs, a class of crucial epigenetic gene-expression regulators, have emerged as potential diagnostic biomarkers, with >200 molecules reported to be dysregulated in OSCC. We had previously established an in silico methodology for the identification of the most disease-specific molecules by bridging genetics and epigenetics. Here, we identified the stage-specific miRNAs that govern the asymptomatic early stages of oral tumorigenesis by exploiting the reverse interplay between miRNA-levels and their target-genes’ expression. Incorporating gene expression data from our group’s experimental hamster model of sequential oral oncogenesis, we bioinformatically detected the miRNAs that simultaneously target/regulate >75% of the genes that are characteristically upregulated or downregulated in the consecutive stages of hyperplasia, dysplasia and early-invasion OSCC, while exhibiting the opposite expressional dysregulation in OSCC-derived tissue and/or saliva specimens. We found that all stages share the downregulation of miR-34a-5p, miR124-3p, and miR-125b-5p, while miR-1-3p is underexpressed in dysplasia and early-invasion. Malignant early-invasion stage is distinguished by the downregulation of miR-147a and the overexpression of miR-155-5p, miR-423-3p and miR-34a-5p. The identification of stage-specific miRNA molecules may facilitate their utilization as biomarkers for presymptomatic OSCC diagnosis.

Sherubtse College under Royal University of Bhutan has a total of 1582 students, where 787 0f them are female. They suffer from menstrual and menstrual cramps every month and they use napkins to stay clean and healthy. As all the college girls are educated on the norms and use of sanitary napkins, the proper management of the waste generated is lacking. The disposal of used sanitary napkins and management is a challenge to the college management. This small research aims to investigate on how girls in college campus manage the menstural waste and the amount of sanitary napkins used. The lack of proper dumping areas leads to the improper sanitary waste management and sometimes the waste generated from the sanitary napkins are toxic and unhealthy. It is very important to initate some ways to dump the pads and its related problem should be seriously addressed by the college management. It is also important to come up with different soultion and management of these wastes for sustainable environment. Therefore, this research will be mainly mentioning about the suggestions and how the sanitary waste is being managed in Sherubtse College campus and the amount of sanitary pads used in a month or an year.

Psychological wellbeing can be impacted substantially by changes in body image during youth, which can be a predictive factor for positive or negative attitudes, such as for self-esteem and satisfaction. In this study, adherence to the thinness model and to healthy behaviours were analysed in terms of the emotional patterns and body management of the young female Italian population (N = 2287). Skinny girls fitting better with the thinness model tended to develop higher positive emotional patterns, but their body management was low. Findings suggest the urgent need for preventive programmes to enhance awareness of healthy behaviours against appearance models.

Despite soccer popularity, comparatively little scientific information is available concerning the assessment of youth players’ physiological characteristics. The use of medical software integrating wearable sensors to provide accurate and objective data is necessary. In the present study, the objective assessment of physical performance of 128 adolescent soccer players at two timepoints (pre-season and end-season) has been performed. Participants completed a comprehensive test battery including stability, countermovement jumps (CMJ), plyometric jumps (PJ), agility, and quick feet tests. A single Inertial Measurement Unit (IMU) sensor provided quantitative data on various performance metrics. Principal Component Analysis (PCA) reduced the dataset to four principal components (PCs) explaining over 80% of the variance: power (PC1), balance (PC2), speed/agility (PC3), and stiffness (PC4). Paired samples t-test between the two timepoints showed no significant differences in the PCs between the two timepoints, indicating that the training program did not significantly alter the assessed physical attributes. However, subtle individual changes may still inform personalized training adjustments. The study highlights the importance of continuous monitoring and individualized training strategies to optimize athlete performance and reduce injury risk.

This article objective was to identify a centenary trend in the growth and development of girls in the metropolis of Moscow. Material and methods — The physical development (body length and weight, chest circumference, right hand muscle strength, and menstrual function development) of Moscow girls was studied during the period from 1920 to 2020. The amount of own observations was 4581 girls aged 8-17 years. Results – A comparative analysis of the physical development of Moscow school girls of different decades revealed a statistically significant increase in body length by 3-5 cm and a significant increase in chest circumference in all age groups of girls of the beginning of the XXI century, compared with their peers in the 1960s and 1980s, which indicates the completion of the gracialization processes that have been observed since the 1980s. However, in all age groups, a decrease in the muscle strength of the right hand is still being noticed. Earlier terms of menarshe onset in modern Moscow school girls (12 years 9 months) and a shift in growth jumps to earlier terms were established. It is shown that the age of menstruation depends on the level of family wealth. Conclusions. In Moscow girls in the centenary dynamics, a tendency to increase the total body size and shift the terms of biological maturation to earlier terms was revealed.

Tennis is an individual sport characterised by high intensity action, including sprints and changes of direction (COD). There is a gap in the knowledge of limb asymmetries in adolescent tennis players and their association with performance. This study aimed to examine the relationship between asymmetry in vertical and horizontal jump tests (CMJ and HJ) and COD with lower limb performance variables in adolescent tennis players. Forty-five adolescent tennis players (age: 13.81 ± 1.08 years; height: 167.64 ± 9.9 cm; body mass: 57.48 ± 10.94 kg; body mass index: 20.27 ± 2.18 kg/m2) performed the CMJ test (unilateral and bilateral), horizontal jumps (unilateral and bilateral), 25 m sprint and 180º COD test. The single-leg countermovement jump showed the greatest asymmetries among the different tests (6.62 ± 9.35%). Significant negative relationships were found between CMJ asymmetry and COD asymmetry with unilateral horizontal jump variables (r = -0.30 to -0.53). In addition, CMJ asymmetry showed significant relationships with CMJR (r=0.49) and COD180R (r=0.29), whereas COD asymmetry showed a significant relationship with COD180L (r=0.40). On the other hand, HJ asymmetry showed no significant relationships with any variable. The main findings of this study indicate that greater imbalances in the CMJ and COD tests are associated with a reduced capacity to perform unilateral horizontal jumps. These results suggest the need to incorporate training protocols that reduce interlimb asymmetries in growing athletes to improve their performance.

GCTs are developmental tumors and likely to reflect ontogenetic and teratogenetic determinants. The objective was to identify syndromes with or without congenital anomalies and non-syndromic defects as potential risk factors. Patients with extracranial GCTs (eGCTs) registered in MAKEI 96/MAHO 98 between 1996 and 2017 were used. According to Teilum's holistic concept malignant and benign teratomas were registered. We used a case control study design with Orphanet as a reference group for syndromic defects and the Mainz birth registry (EUROCAT) for congenital anomalies at birth. Co-occurring genetic syndromes and/or congenital anomalies were assessed accordingly. Odds ratios and 95% confidence intervals were calculated and p-values for Fisher’s exact test with Bonferroni correction if needed. A strong association was confirmed for Swyer (OR 338.6, 95% CI 43.7-2623.6) and Currarino syndrome (OR 34.2, 95% CI 13.2-88.6). We additionally found 17 isolated cases of eGCT with a wide range of syndromes, however not significantly associated following Bonferroni correction. All these cases pertained to girls. Regarding non-syndromic defects, no association with eGCTs could be identified. In our study we confirmed a strong association for Swyer and Currarino syndromes with additional congenital anomalies.

In some parts of Nigeria, many girls do not attend school, and among those sent to school, many still drop out early. This and other socio-cultural factors affect girls psychologically. There is no doubt that girls need consistent love and tutoring to guide them through the turbulent teen years and beyond. They need a mentor who acts as a friend and a role model. The Mobile-based Mentoring Platform seeks to leverage on mobile technology's affordances to focus on the needs of the girl-child, such as improvement in academic achievement, guidance in career choice, development of self-concept, and esteem. The girl-mentees comments revealed that using the platform provided them frequent access to mentors and access to learning opportunities. The challenges they faced include epileptic internet network, intrusions by parents, and others. Therefore, this paper examined the challenges and benefits of mentoring girls via a mentoring platform.

(1) Background: Since the pandemic, adolescent girls have increasingly faced mental health challenges. We examined prevalence trends and associated risk factors for depression among adolescent girls. 2) Methods: Data for girls aged 12 to 17 years (N=4346) from the 2021 cross-sectional National Survey on Drug Use and Health were analyzed. Factors associated with depression were examined using multiple regression analysis. (3) Results: Rates of severe depression were significantly higher (p&lt;.001) in older girls (adjusted odds ratio [AOR]: 1.63, 1.61, those who did not have authoritative parents (AOR: 3.40), and those with negative school experiences (AOR: 4.03). Black and Asian/Native Hawaiian or other Pacific Islanders were less likely to report severe depression than white girls. As previously reported, non-White girls were significantly less likely to receive treatment for depression (p&lt;.05). Parents’ characteristics and school experiences had no effect on the likelihood of receiving mental health treatment. (4) Conclusion: Depression has become increasingly common among American adolescent girls, who are now three times as likely as adolescent boys to have had recent experiences with depression. Our results show that family structure, parenting style, and negative school experiences significantly contribute to the rate of depression and that treatment disparities exist with regard to race and ethnicity.

This research ventures into the critical public health challenge of childhood obesity by exploring the dynamic interplay between psychological well-being and Body Mass Index (BMI) throughout various developmental stages of childhood. It delves into how emotional regulation, attachment dynamics, and social relationships correlate with obesity from early childhood to adolescence. Highlighting key findings, such as the negative correlation between psychological resilience and higher BMI in young children, the impact of social relationships on obesity risk during pre-adolescence, and the link between adaptive emotional strategies and higher BMI in adolescents, this study brings to the fore the nuanced relationship between psychological factors and obesity. Utilizing the interdisciplinary process of bioinformatics, this research synergizes psychometric and biomedical data to unearth psychological markers critical for crafting targeted, age-appropriate interventions. This study advocates for a holistic healthcare approach, emphasizing the integration of psychological support within obesity prevention and management strategies, thereby underscoring the indispensable role of psychological factors in the fight against childhood obesity. The application of bioinformatics methods to analyze complex datasets demonstrates how collaboration across medical specialties can enrich our understanding and response to childhood obesity, contributing significantly to the development of comprehensive, bioinformatics-enhanced healthcare solutions.

Background: Pediatric mallet finger injuries lack specific treatment guidelines, necessitating an exploration of effective techniques. Our aim was to evaluate the outcomes of the extension block technique in adolescent mallet finger management. Methods: A comprehensive retrospective analysis was conducted involving 36 adolescents who underwent surgery between 2014 and 2022. Ishiguro’s extension block pinning technique was the primary method employed. Treatment outcomes were evaluated using Crawford's criteria, and complications were also assessed. Results: Bone union was achieved in all cases with a mean union time of 42 days (range: 30-92 days). According to Crawford's criteria, 27 cases (75%) were classified as excellent, 5 cases (14%) as good, and 4 cases (11%) as fair. Minimal complications were observed, including three cases (8%) of superficial infections, one case (3%) of dermal necrosis, and another rare instance (3%) of osteomyelitis. No cases of poor outcomes or significant long-term complications were noted. The average follow-up period was 8.6 months (range: 2-42 months). Conclusions: Ishiguro’s extension block technique is a promising surgical option for adolescent mallet fingers. Its adoption could enhance pediatric orthopedic care, offering a valuable child-friendly treatment alternative.

Introduction Menstrual hygiene is a critical issue encountered by women and girls of the reproductive age, which negatively affects their health and empowerment. It is still deemed a taboo in several parts of the world and girls hesitate to discuss menstruation with their family members, friends, or schoolteachers, which creates hurdles when they attain their menarche. Girls residing in rural areas encounter more problems, since they lack proper resources, and knowledge to manage their menstruation in school as well as at home. Methods The descriptive cross-sectional design was used to assess the study questions. The consecutive sampling techniques was applied to recruit 300 female participants from remote area of Gilgit, Pakistan, who were 13- to 22-year-old. A pre-tested questionnaire was utilized to collect the data, and to analyze the data the SPSS version 21.0 was used. Results The study found that more than half of the participants had poor level of knowledge, practices, and negative attitude towards menstrual hygiene. This could be because of many cultural and social taboos attached to menstrual hygiene. Conclusions The study concluded that the study participants were not knowledgeable about menstrual hygiene. They had poor practices and attitude regarding menstrual hygiene. Hence, it is recommended that frequent sessions should be conducted by health care workers to enhance the knowledge of parents, teachers, and young girls, to increase the positive attitude and practices regarding menstrual hygiene. Keywords menstruation, knowledge, attitude, practices, Adolescents

The study aimed to analyze thoracic and lumbar erector spinae muscle activations during 3D elongation exercises in individuals with adolescent idiopathic scoliosis (AIS). Participants included 24 adolescents, meeting specific criteria such as a Cobb angle between 10° and 20°, and not having undergone surgical or brace treatments. EMG data were collected to evaluate muscle activations. The study found no significant interaction between exercise type and the side of the curve, but a significant main effect of exercise type on muscle activation, irrespective of Cobb angle. Different exercise types significantly affected muscle activity, with the highest activations in the TheraBand exercise, followed by manual and without equipment conditions. This suggests that exercise type significantly impacts muscle engagement in AIS patients, providing valuable insights for targeted exercise program design. The study, however, focused on short-term muscle activation, not long-term Cobb angle progression, pointing to the need for further research in this area.

This study aimed to evaluate the safety and tolerability of STP1, a combination of ibudilast and bumetanide, tailored for the treatment of a specific subgroup of patients with Autism Spectrum Disorder (ASD), namely ASD Phenotype 1 (ASD-Phen1). We conducted a randomized, double-blind, placebo-controlled, parallel-group phase 1b study with two 14-day treatment phases (registered at clinicaltrials.gov as NCT04644003). Nine ASD-Phen1 patients were administered STP1, while three received a placebo. We assessed safety and tolerability, along with electrophysiological markers, such as EEG, Auditory Habituation, and Auditory Chirp Synchronization, to better understand STP1's mechanism of action. Additionally, we used several clinical scales to measure treatment outcomes. The results showed that STP1 was safe and well-tolerated, with electrophysiological markers indicating a significant and dose-related reduction of gamma power in the whole brain and in brain areas associated with executive function and memory. Treatment with STP1 also increased alpha 2 power in frontal and occipital regions and improved habituation and neural synchronization to auditory chirps. Although numerical improvements were observed in several clinical scales, they did not reach statistical significance. Overall, this study suggests that STP1 is safe and well-tolerated in ASD-Phen1 patients and shows indirect target engagement in ASD brain regions of interest.

Background: Menarche as an important parameter in assessment of scoliosis progression in girls is proven to be dependent on geographical latitude. The aim of the study was to determine whether the age of menarche differs in scoliotic and non-scoliotic Balkan girls and the relation between menarche and laterality of scoliotic curves. Participants and methods: Retrospective study with three groups: scoliotic, non-scoliotic and control group. Patients data collection and analysis was approved by the Ethical committee of the Institute. Statistical analysis: Program SPSS 24 was used and included One-way ANOVA, Fisher’s and Chi-squared test to compare different groups. Statistical significance was defined as p&lt;0,05. Results: No statistically significant difference was found in age of menarche between the three groups (p=0,168). In scoliotic postmenarchal group, primary right curve was dominant in 54,80%, while in scoliotic premenarchal group primary left curve was dominant in 60,09% (p&lt;0,01). Conclusion: In Bosnia &amp; Herzegovina and Serbia Balkan girls, there was no significant difference in age of menarche between scoliotic and non-scoliotic girls. A significant difference was found in laterality of primary curve in premenarchal and postmenarchal scoliotic girls.

Adolescence is a central phase for the development of a person’s identity involving complex multidimensional changes and increasing vulnerability to distress. The aim of this study was to investigate the psychological well-being of adolescent students in Brescia (Northern Italy), two years after the beginning of the Covid-19 pandemic. An online survey investigated the extent and the reasons reported by high school students for their emotional distress (ED), also considering other factors such as physical activity, diet, sleep and smartphone overuse. The main reasons for ED were classified through a qualitative analysis of the freetext answers. 1686 students agreed to participate, 50% showed a presence of ED. According to a multiple logistic analysis, the main factors associated to ED were female gender (AdjOR 2.3, p<0.0001), age (AdjOR 1.6, p<0.0001), sleep duration <8 hours (AdjOR 1.5, p=0.0003), anxiety perception (AdjOR 3.4, p<0.0001), and certain eating behaviors, e.g. comfort food consumption (AdjOR 2.0, p<0.0001). According to free-text answers, the main reasons for ED were: “school pressure”, “ relationships with family and peers”, “negative emotional states” and “the pandemic”. The results show a high level of ED among adolescents and the reported reasons may help to better address their psychological needs after the pandemic.

The Cobb angle is critical in assessing adolescent idiopathic scoliosis (AIS) patients. This study aimed to evaluate the error in selecting the cranial and caudal limit vertebrae on AIS digital X-rays of experienced and novice observers and its correlation with the error in measuring the Cobb angle and determining the length of the scoliotic curves. Using the TraumaMeter v.873 software, eight raters (four experienced and four novices) independently evaluated 68 scoliotic curves on 42 AIS X-rays across three sessions one month apart according to Hopkins’ criteria of absolute reliability. Two spine specialist experts using the Cobb method established the gold standard measurements. The percentage of error in the selection of the cranial vertebrae (the most-tilted vertebra above the apex) is higher than in the caudal vertebrae (the most-tilted vertebrae below the apex) (44.7%, CI95% 41.05-48.3 compared to 35%, CI95% 29.7-40.4). The error in the choice of the most tilted vertebrae, in number of vertebrae per scoliotic curve, was MBE (mean bias error) =0.45, CI95% 0.38-0.52 in the cranial and MBE=0.35, CI% 0.69-0.91 in the caudal. The percentage of errors in the choice of boundary vertebrae is lower for the experienced than for the novices, both in cranial and caudal. The experienced chose at least one boundary vertebrae incorrectly in 52% of the meas-urements and the novices in 65.1%. The error in the Cobb angle did not depend on the number of boundary vertebrae chosen incorrectly (r=0.198, p=0.111). Of the 50% of Cobb angle measurements closest to the actual value, 55.4% (454) were obtained by incorrectly selecting at least one boundary vertebra. There was a positive correlation (r=0.673, p=0.000) between the error in selecting the boundary vertebrae and the error in determining the length of the scoliotic curves. The error in quantifying the length of scoliotic curves was MBE=0.43, CI95% 0.35-0.51 vertebrae per curve. We can conclude that errors in selecting boundary vertebrae are common among experienced and novice observers, with a greater frequency of error in the cranial vertebrae. There is no correlation between the error in selecting the boundary vertebrae and the error in measuring the Cobb angle. Contrary to the consensus, the accuracy of determining the length of the scoliotic curve is limited by the Cobb method’s reliance on the correct selection of boundary vertebrae. Inappropriate choice of boundary vertebrae leads to an estimated error in determining the length of the scoliotic curves of 0.805 vertebrae for each boundary vertebra chosen incorrectly.

Background: DICER1, cancer predisposition syndrome (CPS), seems to escape timely diagnosis in pediatric patients. Case report 1: A 16-year-old female patient was referred to the endocrinology ward due to a large goiter. Her medical history indicated normal sexual maturation, with menarche occurring at 13.5 years. Over the past 2.5 years, she developed pronounced androgenic symptoms, including a deepened male voice, facial, back and neckline acne, hirsutism, and menstrual irregularities leading to secondary amenorrhoea. A thyroid ultrasound identified a multinodular goiter with cystic-solid lesions containing calcifi-cations. An abdominal ultrasound identified a 5.7x6.9 cm solid mass in the right adnexal region, displacing the uterus to the left. Histopathological examination confirmed a Sertoli-Leydig cell tumor. The patient was subjected to total thyroidectomy. Histopathology revealed benign follicular cell-derived neoplasms. Thyroid follicular nodular disease was diagnosed bilaterally. DNA analysis using NGS, confirmed by the Sanger method, revealed a pathogenic heterozygotic variant c.2953>T [p.Gln985*] in exon 18 of DICER1 gene. Case report 2: A 12-year-old male patient was admitted to the pediatric surgery unit due to a 33 ml goiter. A month prior to admission, the patient discovered a palpable nodule in his neck, accompanied by hoarseness. An ultrasound revealed a multinodular goiter. Molecular analysis revealed a pathogenic heterozygotic variant c.2782C>T [p.Gln928Ter] in exon 17 of DICER1 gene. Subsequently, a total thyroidectomy was performed, and histopathological examination revealed thyroid follicular nodu-lar disease bilaterally. Conclusion: Multinodular goiter, although rare in pediatric population, when accompanied by characteristic ultrasound and histopathological features, and by additional features such as androgen excess, warrants exclusion of DICER1 syndrome.

Climate change is one of the widely acknowledged challenges faced by international communities in the 21^st century. It poses challenges to fundamental elements of our understanding of appropriate goals for socioeconomic policies, such as the connection of prosperity, growth, equity and sustainable development. Human activities-induced climatic changes have been widely perceived as threatening criteria for the long-term resilience of societies and communities throughout the world. The United Nations Intergovernmental Panel on Climate Change (UNIPCC) reported that greenhouse gas (GHG) emissions due to human activities, such as the burning of fossil fuels for energy generation, is changing the climate of Earth. Despite contributing less towards the causes, poor citizens of developing countries bear a lot of its impacts. In particular, women and girls face a major impact and finally, they migrate due to the social gender division and scarcity of food. Studies on gender and climate change-induced migration are scarce. This study provides an overview of the induced impact of climate change on the livelihood, health and migration of women and girls. The aim of this study would significantly advance our understanding of the current inter-linkages between migration, displacement patterns and climate change impacts.

This study aimed to verify the sex differences in early syntactic development among Cantonese-speaking children by Tse et al. (2002), with the same corpus design but a different Chinese language: Mandarin. The utterances produced during half-hour play activities by 192 Beijing children, ranging from 3 to 6 years, were collected in the Early Child Mandarin Corpus (Li &amp; Tse, 2011) and analyzed for this study. Their syntactic development was measured in terms of mean length of utterance (MLU), sentence type and structure, syntactic complexity, and verb pattern. The statistical analyses indicated significant age differences in MLU, sentence types and structures, and syntactic complexity. However, no sex or age-by-sex differences were found. This negative evidence indicates that sex difference is neither universal nor cross-language. The implications for early childhood education and future studies are discussed.

Increased motivation towards alcohol use and suboptimal behavioural control are suggested to predispose adolescents to Alcohol Use Disorders (AUDs). Paradoxically however, most adolescent AUDs resolve over time without any formal intervention, suggesting adolescent resilience to AUDs. Importantly, studies directly comparing adolescent and adult alcohol use are largely missing. We therefore aimed to unravel the moderating role of age in the relation between alcohol use and motivational and control-related cognitive processes in 45 adolescent drinkers compared to 45 adults. The results showed that enhancement drinking motives and impulsivity related positively to alcohol use. Although enhancement drinking motives and impulsivity were higher in adolescents, the strength of the relation between these measures and alcohol use did not differ between age groups. None of the alcohol use-related motivational measures (i.e., craving, attentional bias, approach bias) and behavioral control measures (i.e., interference control, risky decision making, working-memory) were associated with alcohol use or differed between age groups. These findings support the role of impulsivity and affective sensitivity in adolescent drinking, but question the moderating role of age therein. The current study contributes towards understanding the role of age in the relation between alcohol use and cognition.

Parental phubbing behavior is a significant factor in predicting adolescent smartphone dependence, but prior research has predominantly focused on a unidirectional perspective from the child's viewpoint, overlooking potential perceptual differences between parents and their children regarding parental phubbing. Therefore, are there differences in the perceptions of parental phubbing between parents and their children? Based on the "Discrepancy-Maladaptive" hypothesis, the presence of perceptual discrepancies in family factors can lead to adverse developmental outcomes in children. Does the parent-child perceptual discrepancy in parental phubbing influence adolescent smartphone dependence? And what role does parent-child relationship play in this context? This study selected 728 families from a middle school in Wuhan, and surveys were administered to both children and parents. The findings reveal: (1) There exist significant parent-child perceptual discrepancies in parental phubbing. (2) Parent-child perceptual discrepancies in parental phubbing significantly positively predict adolescent smartphone dependence and negatively predict parent-child relationships, while parent-child relationships significantly negatively predict adolescent smartphone dependence. (3) The parent-child relationship plays a mediating role between parent-child perceptual differences in parental phubbing behavior and adolescent smartphone dependence.

Introduction: The Elevation Training Mask 2.0 (ETM) has been introduced as a novel tool to allow for respiratory muscle training and altitude exposure during exercise that can improve performance and hematological markers in elite and well-trained athletes. Thus, the aim of the present study was to assess the effect of wearing ETM while training on erythropoietin (EPO), vascular endothelial growth factor (VEGF), peak oxygen consumption (VO2max), lactate, and 1000-m kayaking performance in elite Kayaking girls. Methods: Thirty elite Kayaking girls (14 to 18-year-old) were equally and randomly assigned into mask, no mask, and control groups. The mask and no-mask groups completed 8 weeks of repeated sprint training, while the control group performed their routine kayaking training programs. Pre- and post-training tests included EPO, VEGF, VO2max, lactate, and 1000-m kayaking performance. Results: 1000-m time trial significantly decreased for mask (p < 0.001) and control (p = 0.035) groups, and was significantly lower in mask group than control (p = 0.014) and no mask (p = 0.009) groups. EPO did not show any significant changes for all groups. VEGF was increased significantly for mask (p = 0.04) and no mask (p = 0.014) groups. Lactate was decreased significantly for mask group (p = 0.025). VO2max increased significantly for no mask group (p = 0.021). Conclusion: Wearing the ETM while participating in 8 weeks of repeated sprint training might improve specific blood markers and endurance performance, especially anaerobic pathways. Performing repeated sprint training while wearing ETM has the potential to enhance performance in Kayak racing.

This study reports results of focus groups with school nurses and teachers from elementary, middle, and high schools to explore their perceptions of child and adolescent oral health. Participants included 14 school nurses and 15 teachers (83% Female; 31% Hispanic, 21% White, 21% Asian, 14% African American, and 13% Others). Respondents were recruited from Los Angeles County schools and scheduled by school level for six one-hour focus groups, using Zoom. Audio recordings were transcribed, reviewed, and saved with anonymization of speaker identities. NVivo software was used to facilitate content analysis and identify key themes. The nurses’ rate of “Oral Health Education” comments statistically exceeded that of teachers, while teachers had higher rates for “Parental Involvement” and “Mutual Perception” “Need for Care” was perceived to be more prevalent in immigrants to the United States based on student behaviors and complaints. “Access to Care” was seen as primarily the nurse’s role. Strong relationships between community clinics and schools were viewed by some as integral to students achieving good oral health. The results suggest dimensions and questions important to item development for oral health surveys of children and parents to address screening, management, program assessment, and policy planning.

The management of shoulder instability in children and adolescents is a challenging field of orthopaedics. There are several complicating factors which originate from the variable underlying cause that is often a unique combination of traumatic factors, ligamentous laxity, and the pattern of muscle contractility. As the cause is often multifactorial, this makes interpretation of the literature difficult as nomenclature is variable. The purpose of this review is to shed light on the nuances of paediatric and adolescent shoulder instability.

Studies show that although female soccer players often have shorter change of direction (COD) deficits than males, indicating different biomechanical profiles, there is lack of research on the impact of physical metrics on COD performance in females. The aim of this study was to analyze whether performance metrics based on speed, and jumping could explain the variation in %CODD in young female soccer players. Thirty-three highly trained adolescent female soccer players (age: 16. ± 0.95 years; height: 160.4 ± 5.22 cm; body mass: 55.7 ± 7.22 kg) performed COD180 tests, 10-m and 30-m sprint test and single leg countermovement and horizontal jumps. Acceleration in the first 10 meters of a sprint was identified as a significant predictor of COD180 performance (R2 = 28%), (R2 = 50%), (p

Based on the traditional Chinese cultural belief of "male breadwinner, female homemaker," as well as the systemic and interactive characteristics of families, this study aims to explore the influence of maternal gatekeeping behavior on the quality and quantity of paternal parenting, as well as adolescent aggressive behavior. A total of 483 seventh-grade students completed questionnaires on maternal gatekeeping behavior, paternal involvement, parenting styles and aggressive behavior. Latent profile analysis identified four parenting combinations: positive, negative, mixed, and neglectful. Adolescents under negative parenting exhibited the highest aggression, while those under positive and neglectful parenting showed the least aggression. Maternal gatekeeping behavior correlated with paternal negative parenting and adolescent aggression. Paternal negative parenting mediated the relationship between maternal gatekeeping and aggression, while paternal involvement moderated this relationship. These findings highlight the role of parental interaction in adolescent behavior and support family-based interventions.

Optimal breastfeeding practices among mothers have been proven to have health and economic benefits, but evidence on breastfeeding practices among adolescent mothers in Bangladesh is limited. Hence, this study aims to estimate breastfeeding indicators and factors associated with selected feeding practices. The sample included 2554 children aged 0-23 months of adolescent mothers aged 12-19 years from four Bangladesh Demographic and Health Surveys collected between 2004 and 2014. Breastfeeding indicators were estimated using World Health Organization indicators. Selected feeding indicators were examined against potential confounding factors using univariate and multivariate analyses. Only 42.2% of adolescent mothers initiated breastfeeding within the first hour of birth, 53% exclusively breastfed their infants, predominant breastfeeding was 17.3%, and 15.7% bottle-fed their children. Parity (2-3 children), older infants and adolescent mothers who made postnatal check-up after two days were associated with increased exclusive breastfeeding (EBF) rates. Adolescent mothers aged 12-18 years and who watched television were less likely to delay breastfeeding initiation within the first hour of birth. Adolescent mothers who delivered at home (adjusted OR=2.63, 95% CI:1.86, 3.74) and made postnatal check-up after two days (adjusted OR=1.67, 95% CI: 1.21, 2.30) were significantly more likely to delay initiation breastfeeding within the first hour of birth. Younger infants, adolescent mothers living in Barisal region and who listened to radio reported increased odds of predominant breastfeeding and increased odds for bottle-feeding included male infants, an infant aged 0-5 months, Adolescent mothers who had eight or more antenatal clinic visits and richest wealth quintiles. In order for Bangladesh to meet the Sustainable Development Goals (SDGs) 2 and 3 by 2030, breastfeeding promotion programmes should discourage bottle-feeding among adolescent mothers from richest households and promote early initiation of breastfeeding especially among adolescent mothers who delivered at home and had late postnatal check-up after delivery

In Greece, as in most European countries, the heterogeneity of students leads to conflicts resulting in a general inability of the educational process to function. This review study is focused on modern issues affecting youth and school education procedures such as internet addiction, student behaviour expressed as bullying, and adolescent sexuality development. All sides agree that the most essential purposes of education are to emphasize the cultivation of interpersonal relationships, the development of sociability, and self-esteem, and the prevention. Teachers wanting to respond to the spirit of the times to rationalize the pedagogical process introduced the pedagogical contract as a school practice as a valuable tool in taking control of the class and gaining students' attendance. The teacher's positive attitude will create added value to their knowledge and experiences while helping them to integrate into society.

Introduction: Type 1 diabetes mellitus is a chronic disease of autoimmune etiology that is highly prevalent in childhood. In the last decade, the possibility of using the Bacillus Calmette-Guérin vaccine for the treatment of this disease has been studied thanks to its immunomodulatory action . Objectives: The objective of this work is to carry out a systematic review of the available scientific evidence on the relationship between the tuberculosis vaccine and the treatment of diabetes in childhood. Secondarily, the aim is to study the incidence of Type 1 Diabetes Mellitus in a cohort of children from the Basque Country according to whether or not they have received the vaccine. Methods: An exhaustive bibliographic search has been carried out on the evidence available to date. For the epidemiological study in Euskadi, a comparison of accumulated incidences between vaccinated and unvaccinated population groups was made. Results: According to the literature analyzed, There is more and more evidence about the possible use of the tuberculosis vaccine in Type 1 Diabetes Mellitus. The results of our study were not conclusive, but we believe that it is necessary to continue with long-term studies to eliminate biases. Conclusions: The Bacillus Calmette-Guérin vaccine could be used for the treatment of autoimmune, allergic, infectious or oncological processes, although more studies are still necessary in this regard.

Sarcomas are a heterogenous group of tumours that commonly carry poor prognosis with limited therapeutic options. Adolescents and young adults (AYA) with sarcoma are a unique and under-studied patient population that have only achieved modest survival gains compared to other groups. We present our institutional experience of AYA with sarcoma who underwent comprehensive molecular profiling (CMP) using either large-panel targeted DNA sequencing or whole genome and transcriptome sequencing and evaluated the feasibility and clinical impact of this approach. Genomic variants detected were determined to be clinically relevant and actionable following the Molecular Tumour Board evaluation. Clinicians provided feedback regarding the utility of testing three months after reporting. Twenty-five patients who were recruited for CMP are included in this analysis. The median time from consent to final molecular report was 45 days (interquartile range 37-57). Potentially actionable variants were detected for 14 patients (56%) and new treatment recommendations were identified for 12 patients (48%). Pathogenic germline variants were identified in three patients (12%), and one patient had a change of diagnosis. Implementation for CMP for AYA with sarcoma is clinically valuable, feasible and should be increasingly integrated into routine clinical practice as technologies and turnaround times continue to improve.

This research paper aimed to explore the impact of childhood and adolescent experiences on the leadership development of Emirati women in the United Arab Emirates (UAE). Using a qualitative research methodology, the study utilized in-depth narrative semi-structured interviews, document analysis, and diary writing to understand the complex issue of leadership development. Findings indicate that childhood and adolescent experiences, including family upbringing, education, culture, and societal expectations, have significant impacts on the leadership development of Emirati women. Specifically, family upbringing and cultural values shape Emirati women's leadership aspirations and behaviors, while education and societal expectations provide opportunities and barriers for women's leadership development. The implications of these findings for policymakers and practitioners seeking to promote women's leadership development in the UAE are discussed.

Adolescence is a crucial phase marked by significant physical, psychological, emotional and social changes. India having the world's largest adolescent population, understanding and addressing their health needs are vital for the nation's social, political, and economic progress. The primary aim of this study is to examine the impact of key health policies on adolescent health outcomes in India. To achieve this objective, the research adopts a mixed-method approach, combining qualitative and quantitative analysis of health policies, strategies, and programs implemented since 2005 was conducted. Additionally, data from the most recent three Demographic Health Surveys (DHS) were analyzed and compared to assess changes in adolescent health indicators after the implementation of these policies/strategies. Major adolescent health policies in India were assessed, namely the Adolescent Reproductive and Sexual Health Strategy (ARSH 2005), Rashtriya Kishor Swasthya Karyakram (RKSK 2014), and School Health Programme 2020. All the strategies and programs aim to provide a comprehensive framework for sexual and reproductive health services, expand the scope of adolescent health programming, and address various health aspects. The SWOT analysis findings, highlighted strengths in targeted interventions, monitoring, and promotion, but weaknesses in awareness, societal barriers, and healthcare worker participation. Opportunities include female-friendly clinics and education about early pregnancy, while addressing substance abuse and training volunteers remain challenges. Family planning has improved, with higher contraception usage and a decrease in unmet needs. Violence reduced, and positive health behaviors increased, such as condom use. However, challenges remain, including limited access to health services, concerns about female providers, and low health insurance coverage. Nutrition indicators show a slight increase in overweight/obesity and anemia rates. Overall, progress has been made, but certain health aspects still require attention. Therefore, conducting targeted awareness campaigns, strengthening health worker and NGOs engagement, combating the increasing prevalence of overweight and obesity among adolescents are highly recommended. Further efforts are needed to achieve universal health coverage and improve adolescent health outcomes globally.

The paper aims in assessing risks of mandible fractures consequent to impacts or sport accidents. The role of the structural stiffness of mandible, related to disocclusion state, is evaluated through numerical simulations using the finite element method (FEM). It has been assumed that the quasi-static stress field, due to distributed forces developed during accidents, could explain the common types of mandibular fractures. Geometric model of adolescent mandible was built, upon the basis of medical imaging, in CAD software with distinction between cortical layer and inner spongy bone. The finite element model of disoccluded mandible was next created. Mandibular condyles were supposed jammed in the maxillary fossae. The total force of 700 N, simulating an impact on mandible, has been sequentially applied in three distinct areas: centrally, at canine zone and at the mandibular angle. Clinically most frequent fractures of mandible were recognized through the analysis of maximal principal stress and maximal principal strain fields. Mandibular fracture during accidents can be analyzed at satisfactory level using linear quasi-static FE models for designing protections in sport and transport. The proposed approach can be improved by introducing more realistic interactions between condylar processes and fossae.

The ratio of males to females with ASD is generally quoted as 4:1 though it is believed that there are biases preventing females being diagnosed and that the true ratio is lower. These biases have not been clearly identified or quantified. Starting with a clinical dataset of 1711 children <18 years old four different methods were employed in an inductive study to identify and quantify the biases and calculate the proportion of females missed. A mathematical model was constructed to compare the findings with current published data. The true male to female ratio appears to be 3:4. Eighty per cent of females remain undiagnosed at age 18 which has serious consequences for the mental health of young women.

Until recently, no disease-specific health-related quality of life (HRQoL) instrument existed for pediatric traumatic brain injury (TBI). In this revalidation study, the psychometric properties and the validity of the final German version of the 35-item QOLIBRI-KID/ADO questionnaire were examined in 300 children and adolescents. It is the first self-reported TBI-specific instrument for measuring pediatric HRQoL in individuals aged 8–17 years. The six-factor model fits the data adequately. Internal consistencies were excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability. Construct validity was supported by overlaps between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. Discriminant validity indicated that HRQoL was significantly lower in older children and girls, and in those with anxiety, depression, and post-concussion symptoms than in comparison groups, replicating the results of the questionnaire’s first development study. Our results suggest that the QOLIBRI-KID/ADO is a valid and reliable multidimensional instrument for assessing disease-specific HRQoL after pediatric TBI in clinical and research settings, which can additionally be used across the lifespan in combination with the adult version. This may help to improve care, treatment, daily functioning and HRQoL after TBI.

Background: Poor menstrual health literacy impacts adolescents’ quality of life and health outcomes across the world. The aim of this systematic review was to identify concerns about menstrual health literacy in low/middle (LMIC) and high-income (HIC) countries. Methods: Relevant social science and medical databases were searched for peer-reviewed papers from January 2008 to January 2020 identifying 61 relevant studies. Results: A thematic analysis of the data revealed that LMICs report detrimental impacts on adolescents in relation to menstrual hygiene and cultural issues, while in HICs, issues related to pain management and long term health outcomes were reported more frequently. Conclusions: In order to improve overall menstrual health literacy in LMICs and HICs, appropriate policies need to be developed, drawing on input from multiple stakeholders to ensure evidence-based and cost-effective practical interventions.

Background/Objectives: The aim of the project is a longitudinal assessment of body image and mental health in scoliosis females pre-, postoperatively and in a follow-up, and implementation (one group-CBT scoliosis sample, CBTSS) or not (second group-control scoliosis sample, CSS) of CBT interventions. A healthy female sample (HFS) was also selected for comparative purposes. Methods. 36 in total AIS patients participated in the 1st and 2nd study phases, whereas 23 were eligible in the follow-up. Regarding HFS, 18 participants were included in the study. The CBT intervention took place pre- and postoperatively, during the patients' stay in hospital. Participants completed the Spinal Appearance Questionnaire (SAQ), Body Esteem Scale (BES) and Strengths and Difficulties Questionnaire-25 (SDQ-25). Body image was also assessed using a virtual reality-based application “Avatar Scoliosis 3D”. Results: The difference between the desired and objective, actual body shape is significant preoperatively both in the CBTSS and CSS at p

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to under-stand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included par-ent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4,525 valid responses, 1,831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-report tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities high-light the need for a public health approach. This should include accessible support services, resili-ence building, targeted support for vulnerable families and gender-specific interventions.

Tourette syndrome is a complex neuropsychiatric condition that manifests in childhood and is often associated with other psychiatric comorbidities. This case describes a young male with Tourette syndrome with major depressive disorder and attention deficit hyperactivity disorder (ADHD), who experienced troublesome side-effects due to his existing medications (escitalopram, risperidone and methylphenidate). In order to control his tics, ameliorate depressive symptoms, and eliminate side-effects of stiffness and sedation, risperidone was switched to cariprazine, a third-generation antipsychotic medication with D3-D2 partial agonism. In addition, the antidepressant dose was also increased. With the new combination, the patient reported good control of his tics, together with significant improvement in depressive symptoms and no side-effects. Based on this case and the reviewed literature, cariprazine might be a viable option for patients with Tourette syndrome with other comorbid illnesses, whom are prone to side effects of medication.

Mild traumatic brain injury (mTBI) is the most common brain injury, seen in sports, falls, vehicle, or workplace injuries. Concussion is the most common type of mTBI. Assessment of impairments from concussion are evolving, with oculomotor testing suggested as a key component in a multi-modality diagnostic protocol. The aim of this study was to evaluate the reliability of one eye-tracking system, the EyeGuide Focus. Seventy-five healthy adolescent and adult participants (adolescents: n=28; female=11, male=17, mean age 16.5 ± 1.4 years; adults n=47; female=22; male=25, mean age 26.7 ± 7.0 years) completed three repetitions of the EyeGuide Focus within the one session. Intraclass correlation coefficient (ICC) analysis showed the EyeGuide Focus had overall good reliability (ICC 0.79, 95%CI: 0.70, 0.86). However, a familiarization effect showing improvements in subsequent trials was noticeable in both cohorts (p<0.001) with adolescent participants showing greater familiarisation effects than adults. No differences were observed between sexes (p=0.69). Overall, the EyeGuide Focus was found to be reliable, but the observation of familiarization effects suggests that a standardized protocol of a minimum of three trials be employed, similar to other eye-movement testing applications.

This is a retrospective chart review of outcomes of maxillofacial microvascular free flap reconstructions in pediatric and adolescent patients. A single head and neck surgical team performed all the included 136 procedures. Demographic and surgical patient data were recorded. Type of transfer performed in each recipient site and major complications were analyzed. Relevant influencing factors, such as age, gender and etiology of defect were determined using the ANOVA test and χ² test of independence. Results indicate a 90% success rate. No significant relation was found between the incidence of total flap loss and patient age, etiology or graft source. The maxillary reconstructions showed a higher incidence of total flap loss compared to mandibular ones (11 vs. 3 cases). Despite the high success rate, the findings underline the necessity for further research to validate these observations and enhance surgical methods for pediatric and adolescent patients.

The feeling of emotional self-efficacy helps people understand how to handle positive and negative emotions. Emotion regulation indicates the process that helps modulate emotions, to adapt suitably to the demands of the environment. This study has a two-fold aim. Firstly, it analyses the relationships among emotion regulation; the personality traits of extraversion and emotional stability; and the feeling of efficacy of positive and negative emotions in an adolescent population. Secondly, it analyses the mediating role of personality traits (extraversion and emotional stability) in the relationship between emotion regulation and self-efficacy for positive and negative emotions. There were 703 adolescents who took part (49.9% male and 50.1% female) aged between 15 and 18 years (M=15.86, TD=0.30). The results observe the significant relationships among emotion regulation; the personality traits of extraversion and emotional stability; and self-efficacy for positive and negative emotions. The structural equation model confirms that the link between emotion regulation and self-efficacy is direct and is also mediated by the personality traits of extraversion and emotional stability. The study confirms that emotional self-efficacy beliefs are connected to the emotional regulation strategies used. Effective emotional regulation favours self-perception and emotional coping. There is a discussion about the results, which are connected to previous research.

Assessment of health-related quality of life (HRQoL) after pediatric traumatic brain injury (TBI) has been limited in children and adolescents due to a lack of disease-specific instruments. To fill this gap, the Quality of Life after Traumatic Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) was developed for the German-speaking population. Reference values from a comparable general population are essential for comprehending the impact of TBI on health and well-being. This study examines the validity of the German QOLIBRI-KID/ADO in a general pediatric population in Germany and provides reference values for use in clinical practice. Overall, 1997 children and adolescents aged 8-17 years from the general population and 300 from the TBI population participated in the study. The questionnaire was tested for reliability and validity. A measurement invariance (MI) approach was used to assess the comparability of the HRQoL construct between both samples. Reference values were determined by percentile-based stratification according to factors that significantly influenced HRQoL in regression analyses. The QOLIBRI-KID/ADO demonstrated strong psychometric properties. The HRQoL construct was measured largely equivalently in both samples, and reference values could be provided. The QOLIBRI-KID/ADO was considered reliable and valid for assessing HRQoL in a general German-speaking pediatric population, allowing for clinically meaningful comparisons between general and TBI populations.

The current study aimed to examine the relationship between demographic variables within the family context and parenting behaviors among adolescent mothers (including affection, responsiveness, encouragement, and teaching). These factors were correlated with communication, problem-solving abilities, and personal-social development in typically developing infants. The study included a sample of 79 Chilean adolescent mother-child dyads with children aged 10 to 24 months. Communication, problem-solving, and personal-social development were assessed using the Ages and Stages Questionnaire-3, along with a demographic information questionnaire. Parenting behaviors (affection, responsiveness, encouragement, and teaching) were observed using the Spanish version of Parenting Interactions with Children: Checklist of Observations Linked to Outcomes. The findings indicated that employed mothers and those who had not dropped out of school had children with better problem-solving skills. Additionally, children residing with their fathers and female children exhibited superior performance in communication, problem-solving, and personal-social development. Maternal responsiveness was associated with communication and problem-solving, while maternal encouragement was linked to improved problem-solving skills. Maternal teaching was connected to communication, problem-solving, and personal-social development. The study emphasized the significance of parenting and sociodemographic factors among adolescent mothers in influencing their children's development.

Incobotulinumtoxin A and Yoga-like Isometric Exercise in Adolescent Idiopathic Lumbar Scoliosis – a randomized pilot study Abstract: Background: Approximately 90% of scoliosis is adolescent idiopathic (AIS). From its first appearance at 10-14 until age 18 it is most vulnerable to deterioration; young people are most susceptible to the condition worsening. An effective non-surgical means of remediation would be welcome. Design: Randomized control two-arm study, assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant healthy 12 – 18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), given the side plank (Vasisthasana) done thrice daily with placebo injection (control sub-group 2) or given the thrice-daily side-plank with botulinum injection (Intervention group 3). Injection: 33 IU of incobotulinum toxin type A (Xeomin) injected into concave-side lumbar paraspinals and quadratus lumborum at L2-3 and the psoas muscle at L3-4, or injected similarly with placebo. Randomization by Random.com. Objective: Assess whether muscular asymmetry treated with botulinum toxin injection and the side-plank are safe and effective in AIS.Results: Outcome: Twelve intervention and 12 placebo patients (Groups 1 + 2), 12 -18 years old completed the three-month study period. Mean daily side-plank time = 165 seconds. Mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p<0.0001); mean curvature at 3 weeks was 29.5 degrees. (SD 14.23) (p<0.0001); mean curvature at 3 months was 26.0 degrees (SD 12.81) Onset vs 3-month value: p<0.0001. Two patients in Group 3 complained of shoulder pain, and 2 of wrist pain that resolved when the side-plank was done on the elbow. Conclusion: Muscle asymmetry appears relevant to AIS treatment. Incobotulinum injections combined with the side-plank done with the convex side downward may be safe and helpful in adolescent idiopathic lumbar scoliosis.

Incobotulinumtoxin A and Yoga-like Isometric Exercise in Adolescent Idiopathic Lumbar Scoliosis – a randomized pilot study Abstract: Background: Approximately 90% of scoliosis is adolescent idiopathic (AIS). From its first appearance at 10-14 until age 18 it is most vulnerable to deterioration; young people are most susceptible to the condition worsening. An effective non-surgical means of remediation would be welcome. Design: Randomized control two-arm study, assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant healthy 12 – 18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), given the side plank (Vasisthasana) done thrice daily with placebo injection (control sub-group 2) or given the thrice-daily side-plank with botulinum injection (Intervention group 3). Injection: 33 IU of incobotulinum toxin type A (Xeomin) injected into concave-side lumbar paraspinals and quadratus lumborum at L2-3 and the psoas muscle at L3-4, or injected similarly with placebo. Randomization by Random.com. Objective: Assess whether muscular asymmetry treated with botulinum toxin injection and the side-plank are safe and effective in AIS. Results: Outcome: Twelve intervention and 12 placebo patients (Groups 1 + 2), 12 -18 years old completed the three-month study period. Mean daily side-plank time = 165 seconds. Mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p<0.0001); mean curvature at 3 weeks was 29.5 degrees. (SD 14.23) (p<0.0001); mean curvature at 3 months was 26.0 degrees (SD 12.81) Onset vs 3-month value: p<0.0001. Two patients in Group 3 complained of shoulder pain, and 2 of wrist pain that resolved when the side-plank was done on the elbow. Conclusion: Muscle asymmetry appears relevant to AIS treatment. Incobotulinum injections combined with the side-plank done with the convex side downward may be safe and helpful in adolescent idiopathic lumbar scoliosis.

(1) Background: Sleep disordered breathing represent a growing public health concern, especially among children and adolescents. Full-night polysomnography is considered the gold standard for diagnosing obstructive sleep apnea. Our goals are to identify personal and environmental risk factors for the onset and persistence of sleep respiratory disorders. We also want to investigate the differences in neuropsychological profiles; (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) are questionnaires used for screening sleep respiratory disorders in children. The data were statistically analyzed it using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL); (3) Results: The study involved 138 patients, but only 100 parents participated. A higher percentage of patients with sleep disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep disordered breathing had a habit of using a pacifier. A rise in physical results is associated with a reduction in the PSQ at follow-up (p=0.051). An increase of overall academic achievement is associated with an average decrease in the PSQ at follow-up (p&lt;0.0001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth (4) Conclusions: These results provide essential information on the effectiveness and effects of adenotonsillectomy intervention compared to adenoidectomy intervention and the factors associated with SDB in children undergoing these interventions.

Proximal Junctional Kyphosis (PJK) as one of the most discussed problems after corrective surgery in adolescent idiopathic scoliosis (AIS), is still not fully clarified and seems to be multifactorial. Biome-chanical and few clinical studies have shown the influence of destruction of posterior ligaments by re-section of spinous processes and some parameters concerning rod contouring as risk factors for PJK. To verify these results 192 patients with AIS and corrective surgery via posterior approach between 2009 and 2017 were included. Radiographic parameters were analyzed preoperatively (preOP), postoperatively (postOP), and with a mean follow up (FU) of 27 months. The participants were divided into two groups (PJK group and non-PJK group). The incidence of PJK was 15.6%. Contrary to the results of biomechanical studies, we could not find any significant influence of the spinous process resection. However, the PJK group had significantly larger preOP T4-T12 kyphosis (31.1°±13.93° vs. 23.3°±14.93°, p=.016). Furthermore, the PJK group showed a significantly larger rod contour angle (RCA) (8.0°±4.44° vs. 5.9°±3.28°, p=.003) and mismatch of postOP proximal junctional angle (PJA) and RCA (3.5°±5.72° vs. 0.9°±4.86°, p=.010) compared to the non-PJK group. An increase of the mismatch of postOP PJA and RCA (OR=1.14, p=.008) and a high RCA are risk factors for PJK and need to be focused on by surgeons.

Prosocial behavior is vital for positive social development among adolescents, contributing to improved peer relationships, emotional well-being, and social competence. Gratitude, a positive emotion arising from recognizing and appreciating benefits received from others, has been identified as a potential contributor to adolescent prosocial behavior. This study aimed to investigate the mediating roles of social support and basic psychological needs in the relationship between gratitude and prosocial behavior among adolescents. A total of 390 middle school students participated in a longitudinal study, completing questionnaires assessing gratitude, social support, basic psychological needs, and prosocial behavior at two time points with a six-month interval. The results indicated that gratitude positively correlated with social support, basic psychological needs, and prosocial behavior. Structural equation modeling revealed that social support and basic psychological needs partially mediated the relationship between gratitude and adolescent prosocial behavior. Moreover, a chain-like mediation effect was observed, wherein social support influenced basic psychological needs, which in turn predicted prosocial behavior. These findings emphasize the importance of gratitude in fostering prosocial behavior among adolescents and highlight the mediating roles of social support and basic psychological needs in this relationship.

Sport has the potential to support psychosocial development in young people. However, extant studies have tended to evaluate purpose-built interventions, leaving regular organised sport relatively overlooked. Moreover, previous work has tended to concentrated on a narrow range of outcomes. To address these gaps, we conducted a season-long ethnography of a youth performance sport club based on a novel Realist Evaluation approach [1]. We construed the club as a social intervention within a complex system of agents and structures. In this - Part 1 - account we detail the perceptions of former and current club parents, players and coaches, using them to build a set of programme theories. The resulting network of outcomes (i.e. self, emotional, social, moral and cognitive) and generative mechanisms (i.e., the attention factory, the greenhouse for growth, the personal boost, and the real-life simulator) spanning across multiple contextual layers provides a nuanced understanding of stakeholders’ views and experiences. This textured perspective of the multi-faceted process of development provides new insights for administrators, coaches and parents to maximise the developmental properties of youth sport, and signposts new avenues for research in this area.

The use of alcohol and tobacco is related to several variables which act as risk or protective factors, depending on the circumstances. The objectives of this study were to analyze the relationship between emotional intelligence, resilience and family functioning in adolescent use of alcohol and tobacco and to find emotional profiles for their use considering self-concept. The sample was made up of 317 high school students aged 13 to 18 who filled out the Brief Emotional Intelligence Inventory, the Resilience Scale for Adolescents, the APGAR Scale, the Alcohol Expectancy Questionnaire - Adolescents and the Five-Factor Self-Concept Questionnaire. The results revealed that emotional intelligence and resilience, specifically, stress management and family cohesion were significant in the group of nonusers. Family functioning acts as a predictor factor for onset of use of tobacco and alcohol. Positive expectancies about drinking alcohol were found to be a risk factor and the intrapersonal factor to be protective. Both stress management and family cohesion were protective factors against smoking. Furthermore, cluster analysis revealed emotional profiles for users of both substances based on self-concept. Finally, the importance of the direction of the relationship between the variables studied for intervention in this problem should be mentioned. Responsible use by improving adolescent decision-making is one of the results expected from this type of intervention.

There is still little research on psychological wellbeing and reported problems in preadolescents and adolescents under therapy for leukemia, also comparing them with their healthy peers. The present study aims to analyze the life perceptions, psychological well-being and problems’ intensity in these patients during the first year of therapy and to compare these reports with those of matched healthy peers adopting a battery of self-report questionnaires. Mann-Whitney tests identified the younger patients more at risk than older ones in their problems’ intensity and psychological symptoms. Older patients resulted instead more vulnerable regarding past life perceptions. Wilcoxon test with 2 dependent samples analyses showed that: healthy peers have a better perception of current life and lower percentage of somatization symptoms than patients after 6-months post-diagnosis. On the other hand, healthy peers reported more problems dealing with impulsivity, mood, disorganization, concentration and memory than patients both at 6-months and 1-year from diagnosis. Healthy peers reported also more anxiety and depression symptoms than patients and worse past and future life perceptions than patients at 1-year from diagnosis. The clinical aim is to perform a psychological screening of preadolescents and adolescents in order to prepare ad hoc psychological interventions.

Reelin depletion and stress seem to affect similar pathways including GABAergic and glutamatergic signaling and both are implicated in psychiatric disorders in late adolescence/early adulthood. The interaction between reelin depletion and stress, however, remains unclear. To investigate this, male and female heterozygous reelin mice (HRM) and wildtype (WT) controls were treated with the stress hormone, corticosterone (CORT), during late adolescence to simulate chronic stress. Glucocorticoid receptors (GR), N-methyl-D-aspartate receptor (NMDAr) subunits, glutamic acid decarboxylase (GAD67) and parvalbumin (PV) were measured in the hippocampus and the prefrontal cortex (PFC) in adulthood. While no changes were seen in male mice, female HRM showed a significant reduction in GR expression in the dorsal hippocampus. In addition, CORT reduced GR levels as well as GluN2B and GluN2C subunits of NMDAr in the dorsal hippocampus in female mice only. CORT furthermore reduced GluN1 levels in the PFC of female mice. The combined effect of HRM and CORT treatment appeared to be additive in terms of GR expression in the dorsal hippocampus. Female-specific CORT-induced changes were associated with overall higher circulating CORT levels in female compared to male mice. This study shows differential effects of reelin depletion and CORT treatment on GR and NMDAr protein expression in male and female mice, suggesting that females are more susceptible to reelin haploinsufficiency as well as late-adolescent stress. These findings shed more light on female-specific vulnerability to stress and have implications for stress-associated mental illnesses with a female bias including anxiety and major depression.

Introduction: The application of the concept of self-regulation that has an impact on the psychological well-being of adolescent social media users as self-regulation in a core aspect of human functioning that helps facilitate the successful pursuit of personal goals and adaptability to changes in the environment. This literature aims to determine the study of the psychological well-being philosophy of adolescent social media users based on self-regulation.Methods: This literature study was conducted through a search for scientific publications ranging from 2018-2022. The databases used are PubMed, Science Direct, and ProQuest. The literature search was carried out according to topics with four groups of keywords based on Medical Subject Heading (MeSH) and combined with Boolean operators AND, OR and NOT, keywords Self-regulation AND mental wellbeing AND social media AND adolescence.Results: A study of the psychological well-being of adolescent social media users based on self-regulation based on ontology, epistemology, and axiology studies. Self-regulation is a philosophy that emphasizes the dynamic process that directs the behavior of a teenager towards the desired final state and adapts to changes that occur in the surrounding environment. The adaptation process is carried out as a form of self-regulation of the positive and negative impacts of using social media on adolescents with a motivational approach and avoidance system. The approach motivation system is carried out if it provides positive aspects in social media. While avoidance motivation is carried out if it has a negative impact in the form of low self-esteem, depression, and body image disturbances as a result of social comparisons made by teenagers when they see other people's posts.Conclusion: The concept of psychological well-being of adolescent social media users based on self-regulation is beneficial for parents to improve the parenting pattern of adolescent children. Good parenting is needed in understanding the positive and negative impacts of using social media and reducing externalization problems in adolescents.

This study investigated the relationship between functional movement (FM) and adiposity in adolescents (16-17 years). This research is a part of the CRO-PALS study conducted in a random sample of adolescents (n=652, mean age±SD: 16.6±0.4). Body mass index (BMI), a sum of four skinfolds (S4S), waist and hip circumference were measured, and FM was assessed via Functional Movement Screen™ (FMSTM). Multilevel analysis were employed to determine the relationship between different predictors and total FMS score. After controlling for age, moderate-to-vigorous physical activity, and socioeconomic status, relationship between variables of adiposity and total FMS score was significant and negative among boys (BMI:β=-0.18, p<0.0001; S4S:β=-0.04, p<0.0001; waist circumference:β=-0.08, p<0.0001; hip circumference:β=-0.09, p<0.0001). However, among girls, in adjusted models, only S4S showed a significant and negative effect on total FMS score (β=-0.03, p<0.0001), while other coefficients failed to reach significance (BMI:β=-0.05, p=0.23; waist circumference:β=-0.04, p=0.06; hip circumference:β=-0.01, p=0.70). Results showed that the effect of adiposity on FM in adolescence is sex-specific, suggesting that boys with overweight and obesity could be more prone to develop dysfunctional movement patterns. Therefore, exercise interventions directed toward correcting dysfunctional patterns should be sex-specific, targeting more boys with overweight and obesity rather than adolescent girls with overweight and obesity.

Brain physiology and morphology are vulnerable to chronic stress, affecting cognitive performance and behavior. However, functional compounds found in food may alleviate these alterations. White quinoa (Chenopodium quinoa, Wild) seeds have high content of n-3 fatty acids, including alpha-linolenic acid. This work aimed to evaluate the possible neuroprotective role of a quinoa-based functional food (QFF) in rats. Prepubertal male Sprague-Dawley rats were fed with rat chow or QFF (50% rat chow + 50% dehydrated quinoa seeds) and exposed or not to restraint stress protocol (2 hours/day; 15 days). Four experimental groups were used: Non-stressed (rat chow), Non-stressed + QFF, Stressed (rat chow) and Stressed + QFF. Weight gain, locomotor activity (open field), anxiety (elevated plus maze, light-dark box), spatial memory (Y-maze), and dendritic length in the hippocampus were measured in all animals. QFF intake did not affect anxiety-like behaviors, while the memory of stressed rats fed with QFF improved compared to those fed with rat chow. In addition, QFF intake countered the stress-induced dendritic atrophy in pyramidal neurons located in CA3 area of the hippocampus. The results suggest that a quinoa-supplemented diet could have a protective role on the memory of chronically stressed rats.

Part 1 of this 2-paper series identified a wide and deep network of context, generative mechanisms and outcomes responsible for psychosocial development in a performance basketball club. In this – part 2 – study, the stakeholder’s programme theories were tested during a full-season ethnography of the same club. The findings confirm the highly individualised nature of each young person’s journey. Methodologically, immersion in the day-to-day environment generated a fine-grain analysis of the processes involved, including: i) sustained attentional focus; ii) structured and unstructured skill building activities; iii) deliberate and incidental support; and iv) feelings indicating personal growth. Personal development in and through sport is thus shown to be conditional, multi-faceted, time-sensitive and idiosyncratic. The findings of this two-part study are considered to propose a model of psychosocial development in and through sport. This heuristic tool is presented to support sport psychologists, coaches, club administrators and parents to deliberately create and optimise developmental environments.

Obesity in adolescents combined with the increased exposure time to electronic devices, enhances a sedentary lifestyle and is linked to the risk of developing musculoskeletal injuries. The aim of this study was to identify possible correlations between anthropometric characteristics, body composition, exposure time to electronic devices or screen time (ST) and physical activity (PA) level along with muscle power and dynamic knee valgus (DKV) in young athletes to avoid future injuries. A total of 125 adolescent basketball athletes (66.4% boys), 12 to 17 years old (13.94±1.58 years) participated. Anthropometric and demographic characteristics were recorded. PA level was assessed through IPAQ and ST through a single question from the HELENA study. The Counter Movement Jump test was used for the evaluation of the lower limb muscle power, while the Single Leg Drop Jump test was used for the evaluation of the dynamic knee valgus via two-dimensional (2D) kinematic analysis. The Pearson index showed a statistically significant positive correlation between muscle power and height (r=0.788, p<0.001), while the Spearman index showed a smaller but equally statistically significant positive correlation with BMI (rs =0.651, p<0.001) and age (rs=0.579, p<0.001). The ST (rs= -0.194, p=0.03) showed a weak negative correlation with DKV, while PA (r=0.85, p<0.001) showed a high, statistically significant, positive correlation. The anthropometric characteristics of adolescent athletes can determine their ability to produce muscle power. A high level of physical activity could play a key role in compensating and thus reducing the negative effects of high exposure to screen time on the dynamic knee valgus

Background: Adolescent Idiopathic Scoliosis (AIS) patients have been found to exhibit cortical asymmetry. This study aimed to examine the impact of conservative treatments on perceptual and cognitive asymmetry in the auditory system of AIS patients with thoracic major curve. Method: The study involved 30 AIS patients and 21 healthy subjects. The intervention group used a Cheneau brace and performed 18 Schroth Best Practice (SBP) exercise sessions. Auditory lateralization was assessed with a Dichotic Listening Paradigm (DLP) in both groups before and after the intervention. Results: The six-week intervention resulted in a significant increase in left ear responses in the force-left condition in the AIS (p<0.05). Left ear responses were lower in AIS at baseline (p<0.05). Sixth-week results were similar in all conditions (p>0.05). Conclusion: The results of this study demonstrated that SBP exercises and Cheneau brace treatment can improve perceptual and cognitive asymmetry in the auditory system in AIS patients with thoracic major curve. Scoliosis-associated changes in the spine and postural control may affect auditory perception by causing adaptations in sensory and motor networks. Future studies are needed to examine the connectivity in brain regions related to motor control and auditory processing after conservative treatment.

The prevalence of back pain (BP) among children and adolescents has increased over recent years. Some authors advocate promoting back-health education in the school setting. It is therefore important to adopt a uniform suite of assessment instruments to measure the various constructs. The present study aimed to perform a cultural adaptation of a validated measurement instrument (BackPEI), beginning with a translation and cultural adaptation phase, followed by a second phase to test reliability using a test-retest design. The translation and cross-cultural adaptation were performed based on the guidelines. Reliability was tested by applying the questionnaire to 224 secondary school students, at two different times with a 7-day interval between the tests. In general, the Spanish version presented adequate agreement for questions 1–20, with only question 9 achieving a low Kappa range of .312 [-.152- .189]. The question about pain intensity did not show differences between the averages for the test (4.72 ± 2.33) and re-test (4.58 ± 2.37) (p = .333), and the responses for these two tests were highly correlated (ICC= .951 [.928- .966]; p= .0001). Psychometric testing indicated that the Spanish version of the BackPEI is well-adapted and reliable, based on the test-retest design, providing similar results to the original Brazilian version.

Thrombosis after severe acute respiratory syndrome coronavirus 2 vaccination is a serious complication in patients who have a thrombophilic predisposition. In this case, a female patient with no family history of thrombophilia who had pediatric antiphospholipid syndrome (APS) developed deep vein thrombosis (DVT) when she was 6 years old; 6 months after receiving a second dose of the BNT162b2 vaccine, DVT reoccurred. The original thrombi were found in the right common iliac vein and the inferior vena cava, with concomitant left pulmonary infarction. The patient was treated with anticoagulants for 6 years after DVT onset, with subsequent treatment cessation for 5 years without recurrence. She received the BNT162b2 vaccine at 17 years of age, 1 week before a routine outpatient visit. Platelet factor 4 elevation was detected 14 days after the first vaccination, persisting for 5 months without thrombotic symptoms. Six months after the second vaccine dose, the DVT recurred and was treated with a direct oral anticoagulant. The vaccine exacerbated the patient’s APS by activating coagulation, causing thrombosis recurrence. Platelet factor 4 levels may indicate coagulation status. When patients predisposed to thrombosis are vaccinated, coagulation status and platelet activation markers should be monitored to prevent DVT development.

Background. Pose estimation based on deep learning has been expected to be a breakthrough method to increase the accuracy of clinical photographic evaluation and to decrease interobserver errors. The purpose is to quantify pose estimation from photography of patients with adolescent idiopathic scoliosis (AIS) using open-source software packages and determine correlations between parameters obtained by radiography and photography. Methods. We included 12 consecutive patients with AIS treated with spinal correction surgery. Photographs were taken preoperatively using a tripod-mounted camera (iPhone 13Pro) on an X-ray tube head. To assess photographic parameters obtained by photography, we defined 17 points to analyze posture and define parameters. Results. In the sagittal plane, there was a significant correlation between the radiographic trunk tilt angle and the photographic sagittal trunk tilt angle of the shoulder–hip and ear–hip. In the coronal plane, there was a significant correlation between the radiographic clavicle angle and the photographic shoulder height angle, and the radiographic C7–CSVL and the photographic coronal trunk tilt angle. Conclusions. Posture analysis by photography using popular mobile devices has clinical utility for improving and promoting the screening and early detection of AIS because it is simple, without patient exposure to X-ray radiation.

It is widely acknowledged that adolescent females are particularly at risk of low body-esteem. Low body-esteem is associated with poor mental health and other negative outcomes. Interventions to help raise body-image could have considerable impact, especially if the intervention is low-cost, easy to implement and scalable. We investigated the efficacy of an intervention where participnants could chose their own clothes to wear during a Physical Education (PE lesson) on changes in body-esteem. We hypothesized that body-esteem would improve with choice. To show that body-esteem is not a transient construct, we tested its stability when assessed in a test-retest design when completed in a classroom setting, hypothesizing body-esteem would be stable. Participants (N =110; Mage =14.9; SDage = 0.68) females completed a 14-item body-esteem scale 4 times; a) wearing school uniform in an assembly, b) during a PE lesson separated by a 2-week gap. The intervention was implemented where students got a choice of PE kit and could wear their own clothes. Findings indicate that body-esteem was stable in the classroom setting where clothes and context were stable, but improved significantly when participants were given a free choice of kit to wear during PE. We argue that this low-cost and scalable intervention represents a useful start point for helping support low body-esteem among a potentially vulnerable population.

This paper, which is one of the few in the world dealing with this topic, presented the psychologist's work based on the concepts of mentalization and internal working models (IWMs) of attachment, with an adolescent girl who was prone to nonsuicidal self-injury. Gaga, a student in the first grade of high school, had visible scars from cutting her hands on the inner sides of both forearms. Gaga told the psychologist that her mother believes that this is an attempt to draw attention to her problems, and even a suicide attempt. Together with Gaga, the psychologist made a formulation of her mental difficulties. The main aim of the psychologist's work with Gaga was to control unpleasant impulses and emotions, so as to eliminate self-injury. This aim has been achieved through three global tasks: 1) that Gaga, in the relationship with the psychologist, builds her IWMs as positive, so that she can see herself as a person who is worthy of the love and support of close people; 2) to develop a stable capacity for mentalization; 3) to apply this acquired skills in the interpretation of her affective experiences. The mentalizing approach in working with Gaga was based on an attitude of emotional warmth, acceptance and authentic interest in her inner world. The psychologist's work with Gaga led to her better self-control, which resulted in the cessation of her self-injury. In her work with a psychologist, Gaga acquired positive IWMs, which she transferred into other significant interpersonal relationships.

The serious impact of Adolescent’s Free Sex Behavior will affect their developmental task. Having proper education and having optimal sex counseling are related to sexual behavior in adolescents. The alternative for this phenomenon recently has involved adolescents participating as peer counselors because they are more susceptible to peer influence. Online peer counselor programs may promote progression into depth understanding of sexual behavior among adolescents. This paper provides an overview of the effect of peer counselors on reproductive health among adolescents. It describes many conceptual frameworks about free sex behaviors, risk factors among adolescents, and the role of peer counselors in improving health reproductive behavior among adolescents.

This research delved into exploring the impact of ladder training on improving the athletic performance of adolescent students, particularly focusing on boosting explosive power and speed. The study involved thirty boys aged 15-17, selected randomly from an Indian school in Doha, Qatar. The variables measured were Explosive Power (EP) and speed (S). EP was assessed using the Standing Broad Jump (SBJ), while Speed (S) was gauged through the 50-yard dash. Divided into two groups - the Experimental Group (EG) and the Control Group (CG), each consisting of fifteen students - the EG underwent dedicated ladder training for 12 weeks while the CG continued their routine. Analysis of pre-test and post-test results indicated significant enhancements in EP and speed within the EG, with notable shifts from 2.15±.27 to 2.40±.24and 7.52±.54to 6.97±.66, respectively, exhibiting significant 't' values (EP: -2.39; speed: 2.23) at P˂.05. Conversely, the CG showed minimal changes in EP (pre: 2.22±.22; post: 2.2±.21) and speed (pre: 7.51±.43; post: 7.58±.72), with 't' values of 0.295 and 0.842, respectively, failing to reach significance at P˂.05. These outcomes highlight the efficacy of ladder training in improving explosive power and speed among adolescent students, suggesting its potential as a safe and advantageous component in athletic training programs.

The purpose of this research was two-fold: (a) to observe whether highly trained adolescent swimmers abide to vitamin D supplement recommendations; and (b) to monitor changes in circulating 25-hydroxyvitamin D (25(OH)D) that occur between the autumn and winter months. Twenty swimmers (age: 17 ± 2 years) from a UK high-performance swimming club volunteered to complete two blood spot cards to determine 25(OH)D concentration: the first in an autumn training phase (October) and the second during winter training (January). All swimmers were advised to consume vitamin D3 supplements across the assessment period; however, only 50% of swimmers adhered to this recommendation. Resultantly, a winter decline in 25(OH)D was observed in non-supplementing swimmers (79.6 ± 25.2 to 52.6 ± 15.1 nmol·L-1, p = 0.005), with swimmers either displaying an ‘insufficient’ (60%) or ‘deficient’ (40%) vitamin D status. In comparison, greater maintenance of 25(OH)D occurred in supplementing swimmers (92.0 ± 25.5 to 97.2 ± 38.3 nmol·L-1, p = 0.544), although variable outcomes occurred at the individual level (four increased, three maintained, three declined). These findings highlight possible risks of vitamin D insufficiency during the winter for swimmers in the UK, possibly requiring standardised supplement practices. Moreover, alternative educational strategies may be required for swimmers to transfer knowledge to practice in order to improve supplement adherence in future.

Isolated fallopian tube torsions presenting to the emergency department are a very rare cause of childhood acute abdominal pain. Since the diagnosis to be made in the early period is of importance in terms of affecting tubal damage and fertility, it was aimed to evaluate the cases in the light of literature. Materials and Methods: This study included 10 patients under 18 years of age presented to the emergency department with abdominal pain between January 2003 and December 2018. The mean age was 14.5±1.43 years (range: 12-17years). The demographic characteristics, surgical findings, and methods, concomitant pathology results of these patients were retrospectively evaluated. Results: The reason for admitting to the emergency department of 10 patients included in the study was abdominal pain. The mean duration of hospital admission with pain was 4.97 days. The onset of pain was less than 24 hours in 7 patients (70%) and was more than 24 hours in three patients (30%). Of the patients, 9 (90%) had tenderness in the lower abdominal quadrant, 5 (5%) had the defense, and 3 (30%) had a rebound. Nausea, vomiting, and leucocytosis were present in 50% of the cases. Right and left tubal involvement of the cases was equal. Seven (70%) of the isolated tubal torsions were accompanied by paraovarian cysts. Of the patients, 8 (80%) underwent open surgery and 2 (20%) underwent laparoscopic intervention. Detorsion was performed in 5 (50%) and salpingectomy was performed in 5 (50%) cases. Conclusion: Isolated tubal torsion should be considered in children presenting with acute abdominal pain in early adolescence. Early diagnosis is important for the maintenance of fertility.

Abstract: (1) Background: The occurrence of youth aggression has aroused widespread concern, and we would like to explore the reasons for it from both the family and individual sides of the youth. This study constructed a chain mediation model based on Bandura's Social Learning Theory to explore the mechanism of internet gaming disorder and avatar identification in it; (2) Methods: We conducted a randomized survey involving 973 adolescents from various middle schools in China. We used the Harsh Parenting Scale, the Online Gaming Disorder Scale, the Incarnate Identity Scale, and the Buss-Perry Aggression Scale to conduct a randomized survey. Empirical analyses were conducted using SPSS 25.0 and Amos 24.0 software to examine the mediating role of online gaming barriers and avatar identity; (3) Results: There was a two-by-two significant positive correlation between harsh parenting, internet gaming disorder, avatar identification and aggression. The me-diation model between harsh parenting, internet gaming disorder, avatar identification and ag-gression was well fitted ( χ2/df=7.268, GFI=0.961, AGFI=0.923, IFI=0.970, CFI=0.970, TLI=0.951, RMSEA=0.080).; (4) Conclusions: Parental harsh parenting affects adolescent aggression not only through the separate mediating roles of internet gaming disorder and avatar identification, but also through the chain mediating roles of internet gaming disorder and avatar identification.

One of the greatest COVID-19 related challenges for children and their families was managing distance learning due to school closures. We also know from previous research that families with a child with a neurodevelopmental disorder such as ADHD or ASD were struggling more than others, but also experiences some positive effects. However, few qualitative studies have been conducted. The present study therefore aimed to investigate parental experiences of negative and positive effects of distance learning during the COVID-19 pandemic in a large sample of families with an adolescent with ADHD and/or ASD and a matched comparison group (n = 682). Data was collected through open-ended questions as part of a larger survey study. Five main themes, with different sub-themes were identified for both negative and positive effects: 1) Teaching, 2) Social, 3) Support, 4) Child factors, and 5) Home environment. In addiction, the main themes “Technical problems” were identified for negative effects. Families with a child with ADHD/ASD reported negative effects related to “Child factors” and “Support” more frequently than the controls, as well as negative effects related to some aspects of “Teaching” and “Technical problems”. Regarding positive effects, significant group differences were primarily found for the theme “Child factors”. These findings are discussed botn in terms of how to best prepare for possible future pandemics, but also how to best provide educational support for children with ADHD and/or ASD when schools are open.

Single parenting is a social phenomenon that has always been in existence and is as old as mankind, and today the number of single-parent families has been rampantly increasing. As a result, the researcher conducted a study in the Gambella region of Ethiopia to investigate the economic and educational implications of single parenting on female adolescent students. The study employed a qualitative research approach with a case study research design. The researchers used the purposive sampling technique to select the research area and research participants for in-depth interviews and focus group discussions, and eleven interviewees, seventeen participants in focus group discussions within two groups, and seven key informants participated. Interviews were audio-recorded, transcribed, translated, and thematically analyzed. Interviews with research participants revealed that adolescent girl students from single-parent homes experience financial difficulties. The study also explored that students with single parents are more likely to be absent from school, to come late to school, to score low marks, and to drop out of school. Therefore, having an understanding of the benefits of having intact parents for the well-being of adolescents and raising children together should be advocated.

Injury to the optic nerve, termed, traumatic optic neuropathy (TON) is a known comorbidity of traumatic brain injury (TBI) and is now known to cause chronic and progressive retinal thinning up to 35 years after injury. Although animal models of TBI have described the presence of optic nerve degeneration and research exploring acute mechanisms is underway, few studies in humans or animals have examined chronic TON pathophysiology outside the retina. We used a closed-head weight-drop model of TBI/TON in 6-week-old male C57BL/6 mice. Mice were euthanized 7-, 14-, 30-, 90-, and 150-days post injury (DPI) to assess histological changes in the visual system of the brain spanning a total of 12 regions. We show chronic elevation of FluoroJade-C, indicative of neurodegeneration, throughout the time course. Intriguingly, FJ-C staining revealed a bimodal distribution of mice indicating the possibility of subpopulations that may be more or less sus-ceptible to injury outcomes. Additionally, we show that microglia and astrocytes react to optic nerve damage in both temporally and regionally different ways. Despite these differences, as-trogliosis and microglial changes were alleviated between 14-30 DPI in all regions examined, perhaps indicating a potential critical period for intervention/recovery that may determine chronic outcomes.

Many researches have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate associations of 13 common types of ACEs with NSSI, suicidal ideation (SI) and suicide attempt (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 students aged 11-16 years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included for the analysis. ACEs, SI, SA, depressive and anxiety symptoms were recorded by standard questionnaire. Of included participants, 92.0% reported one or more category of ACEs. Smoking, parent-child separation, emotional abuse, physical abuse and being bullied were positively associated with NSSI, with the adjusted odds ratio (aOR) of 2.41(95%CI, 1.01-5.75), 1.80(1.28-2.54), 1.69(1.21-2.37), 2.08(1.44-3.01) and 1.87(1.35-2.59), respectively; smoking (4.03, 1.66-9.81), parent-child separation (1.42, 1.07-1.90), emotional abuse (1.91, 1.41-2.59), physical abuse (1.80, 1.27-2.57), emotional neglect (1.78, 1.28-2.49) and being bullied (2.08, 1.54-2.81) were positively associated with SI; smoking(4.30, 1.67-11.10), emotional abuse (2.42, 1.58-3.72) and being bullied (1.75, 1.17-2.60) were positively associated with SA. The associations of ACEs with NSSI, SI and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms.

To investigate effects of probiotics on cognitive function and regulation of cortisol and IL-1β in adolescents with depression. All 180 participants were randomly assigned into study group(treated by probiotics combined with sertraline hydrochloride) and control group(treated by sertraline hydrochloride). The repetitive Neuropsychological State Test (RBANS) and Hamilton Depression Scale (HAMD) were administered in MDD patients. The levels of serum cortisol and IL-1β were detected by ELISA kit. Except speech function, immediate memory, visual span, attention function, delayed memory and RBANS in the study group were significantly higher than those in the control group. The cortisol and interleukin1β in the study group were significantly downregulated than those in the control group. Except speech function, cortisol level was negatively correlated with RBANS total score and other factors in the study group. Interleukin-1β was negatively correlated with the total score of RBANS and each factor score. Cortisol and interleukin-1β were predictors of RBANS total score, which explained 46.80% of the variance. Cortisol had significant predictive effects on attention function and delayed memory, and interleukin-1β had significant predictive effects on visual span and speech function. It could concluded that probiotics can improve cognitive function in adolescents with depression by regulating cortisol and IL-1β levels.

Introduction:The high interest in sports among young people has contributed to the growing importance of the phenomenon of sports specialization in recent years. It refers to players who train a particular sport for more than 80h per month. This is particularly noticeable in the group of young soccer players, in whom such a high training volume, is an important factor predisposing to the development of injuries. An important risk factor is the common lower limb muscle imbalance in the soccer player population between the extensors and flexors of the knee joint, showing a maximum isometric force ratio as low as 1:2. To compensate for this imbalance, it is important that eccentric exercises have a positive effect by improving the strength of the knee joint flexor muscles, especially the well-studied Nordic hamstring exercise(NHE). However, many studies only evaluate the effect of modified NHE exercise training volume, without isolating the effects of performing a single exercise session. It is worth noting that, there are warm-up protocols that incorporate the aforementioned exercise and enjoy high utility and effectiveness for sports injury prevention. Objective: Given the emerging imbalance in the strength of the knee stabilizing muscles, the aim of the study was to determine whether performing a single NHE intervention would alter the isometric strength of the knee flexor muscles (HAM). Methods: A group of 56 players of a youth soccer team (age range 13-16), were recruited for the pilot study. In doing so, the players constituted a group of healthy, training soccer players at the central junior level. After meeting the inclusion criteria, 32 players were entered into the study. Participants were randomly assigned to a study group (A) and a control group (B). In the study group, the intervention consisted of a single NHE exercise in the form of two series of trunk slumps in a kneeling position, eight repetitions each. The control group performed one series of forward trunk bends, five repetitions each. Participants (group A and B) were tested on the ` platform before the experimental procedure and immediately after the intervention. Maximum isometric strength of the knee joint extensors (QUAD) and knee joint flexors (HAM) were measured. Results: Statistical analysis of the obtained results indicated that the maximum muscle strength of the HAM increased after the performed, single intervention NHE (p=0.04) relative to the control group. At the same time, no increase in the strength of the quadriceps muscles of the thigh (extensors of the knee joint) was shown after the intervention, relative to the control group. Conclusions:The results obtained indicate that a single performance of the NHE exercise has an effect on increasing the maximum isometric strength of the HAM muscles. This increase, although not statistically significant, correlated with no change in quadriceps muscle strength. The work is a pilot study and further research may benefit in maintaining the balance between the two muscle groups, namely HAM and QAD, which contributes to the prevention of joint-muscle injuries. At the same time, the study supports the previously stated thesis that a single performed Nordic Eccentric Exercise is an important element in the prevention of muscle injuries in the lower limb, thus confirming the effectiveness of its use in football warm-ups. Nonetheless, implementation of the exercise into long-term training is necessary to achieve significant effects of muscle balance compensation in the lower limb, as confirmed by numerous training protocols.

Background: Cefazolin is typically used to minimize the risk of surgical site infection (SSI) following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Cefazolin dosing recommendations vary and there is limited evidence of the tissue concentrations achieved throughout surgery. Methods: We performed a randomized, controlled, prospective pharmacokinetic pilot study of 12 patients given cefazolin by either intermittent bolus (30mg/kg every 3 hours) or continuous infusion (30 mg/kg bolus followed by 10/mg/kg per hour throughout the surgery) during PSF for AIS. We measured plasma cefazolin concentrations and used a clinical microdialysis technique to measure skeletal muscle and subcutaneous adipose tissue concentrations. Results: Patients were well matched for demographic and perioperative variables. As expected, patients in the infusion group received more cefazolin. While global drug exposure measured as area under the curve was similar in plasma for bolus and infusion dosing, infusion dosing achieved greater cefazolin exposure in subcutaneous and muscle tissue. Using the pharmacodynamic metric of time spent below minimal inhibitory concentration both bolus and infusion dosing performed well. However, when targeting a bactericidal concentration of 32 µg/mL for the typical 6 hour operative time, patients in the bolus group spent a median of 1/5 and 1/3 of below that target in subcutaneous and muscle tissue, respectively. Conclusions: Intraoperative determination of cefazolin tissue concentrations is feasible in PSF for AIS. Both, bolus and infusion dosing of cefazolin achieve concentrations in excess of typical minimal inhibitory concentrations. Infusion dosing appears to more consistently achieve bactericidal concentrations in subcutaneous and muscle tissues.

Basketball is a highly anaerobic game, that consists of high-intensity efforts followed by lower-intensity efforts. Postural deformities can be a limiting factor in achieving maximal performances in basketball. Flat feet are one of the most common deformities and they can lead to poorer performances, discomfort and pain. In this research we made an attempt to link the degree of feet flatness with sports performances among Icelandic adolescent basketball players. A sample of 100 basketball players was tested on a podoscope to establish the degree of feet flatness and all participants performed countermovement jump, 20m sprint and pushups in 30 seconds. No significant correlation was observed between feet status and sports performances. No differences were found between groups with and without flat feet, which indicates that feet flatness was not a limiting factor in achieving better results. However, we state that only strong and healthy feet might lead to excellent performance.

Early childhood may be a stressful period for families with a significant impact on parents’ mental health and the child’s healthy development. The goal of the SKKIPPI cohort study was to assess the occurrence and determinants of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. Based on random samples from three residents' registration offices, parents with infants up to 12 months of age at the time of sampling, were invited to participate in the study. A screening online questionnaire was newly developed, available in four languages, to assess common psy-chosocial stressors and mental health problems of parents with small children. The study enrolled 4,984 mothers and 962 fathers. The most common potential psychosocial stressors at baseline were professional problems (mothers 22%, fathers 33%), lack of social sup-port (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obses-sive-compulsive thoughts (21%, 16%), depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory prob-lems of the child were reported by between 1.5% and 5.1% of parents. The SKKIPPI study showed that a substantial proportion of parents are burdened by psychoso-cial problems and suffer from mental health problems in the first years after birth. Early pre-ventive and low-threshold support measures should be available in the health and social care system. The newly developed questionnaire can be used to screen in the relevant populations in order to avoid disturbances in the mother-child attachment.

The Sustainable Development Goals (SDGs) 4, 5 and 9 are related to the quality of education, gender equality and the use of new technologies. It is important to bear in mind that a major part of the success of education has to do with students' motivation, which is closely connected to the use of technologies in the classroom. For this reason, a study was carried out with 131 students aged 12 and 13, 58 girls and 73 boys, who use a tablet in their Science classes. The purpose of the study was to determine, based on the Self Determination Theory, the level of intrinsic motivation of those adolescents towards the use of tablets in the classroom. The study measured the interest they have in the tasks and the value they assign to said tasks, as well as their perception of their competence in using tablets. The results reveal that students' motivation is high without significant differences between girls and boys when technological resources are included in teaching-learning processes. This is reflected by the improvement of their academic performance. It is thus possible to state that SDGs 4, 5 and 9 can be achieved.

The tobacco epidemic is one of the leading public health threats the world has ever faced and public health policy that seeks to limit the problem may not only have to target the price of tobacco but also the initiation stage in a smoker’s life – the adolescent stage. This research contributes to the health economics literature by using a Bayesian hierarchical logistic model, estimated using Hamiltonian Monte Carlo (HMC) methods to empirically identify what drives the intentions to quit smoking among adolescent smokers in Zambia. Results suggest that among the junior secondary school-going adolescent smokers in Zambia, about 63% have plans to quit smoking. We find socio-demographic characteristics and several tobacco-smoking-related factors as the main drivers of adolescent smokers’ plans to quit smoking. Most importantly, we provide insights that could be useful to help adolescent smokers realize their quitting plans.

For monitoring of chimeric antigen receptor (CAR) T-cell therapies antigen-based CAR detection methods are usually applied. However, for each target-antigen a separate detection system is required. Furthermore, when monitoring CAR T-cells in the blood of patients treated with bispecific antibodies or T-cell engagers (bsAbs/BiTEs) recognize the same antigen, these methods producing false-positive results in clinical diagnostics. Anti-CAR-linker monoclonal antibodies (mAbs) targeting the linker sequence between the variable domains of the antigen binding CAR fragment, promise an universal and unbiased CAR detection. To test this, we analyzed clinical specimens of all BCMA- and CD19 targeting CAR T-cell products currently approved for clinical use. We found a highly specific and sensitive CAR detection by using anti-CAR-linker mAb in blood cells from patients treated with Ide-cel, Tisa-cel, Axi-cel, Brexu-cel, and Liso-cel. For Ide-cel and Tisa-cel the sensitivity was significant lower compared to antigen-based CAR detection assays. Strikingly, the specificity of anti-CAR linker mAb was not affected by the simultaneous presence of bispecific blinatumomab or teclistamab for Axi-cel, Brexu-cel, Liso-cel or Ide-cel, respectively. Cilta-cel (containing an monomeric G4S-CAR linker) could not be detected by anti-CAR linker mAb. In conclusion, anti-CAR-linker mAbs are highly specific and useful for CAR T-cell monitoring but not universal applicable.

(1) Context: Cancer triggers significant changes in family dynamics. It is noteworthy that coping and problem-solving skills, particularly in situations involving cancer in children and adolescents, have not been adequately explored in the context of family adaptation. This study aims to analyze the effectiveness of family interventions in coping to improve problem-solving skills in parents and/or caregivers of children and adolescents during and after oncological treatment. (2) Methods: This is a scoping review following the recommendations of the Joanna Briggs Institute and the Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), from 2014 to 2024, in the databases LILACS, CINAHL, SCOPUS, Web of Science, and PUBMED. (3) Results: Forty-five studies were eligible. Coping strategies were categorized as follows: (1) positive attitudes (including a sense of courage and hope, family support to enhance resilience, and future planning), (2) caregiver empowerment (involving acceptance of diagnosis, emotional distancing, and coping through religiosity), and (3) communication skills (encompassing professional communication, horizontal dialogue with healthcare teams, and sincere communication with friends and family). (4) Conclusions: Over time, families develop coping and problem-solving strategies that influence changes in family functioning patterns, aiding them in accepting, reinterpreting, and reframing ideas and feelings associated with neoplasia.

Objective: Mechanical bowel preparation is essential for the visualisation of the colon during colonoscopy, and previous studies have identified changes in gut microbiota composition after bowel preparation and colonoscopy. Considering the gut microbiota is increasingly implicated in mood, we aimed to explore the potential impact of this intervention on mood and the microbiota-gut-brain axis. Methods: We conducted a pre-post intervention study, with timepoints of one week before and one month after bowel preparation and colonoscopy, in community-dwelling adults referred for colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores using generalised estimating equations. We also examined changes in average anxiety, stress, and quality of life scores, and faecal microbiota composition and potential function using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and the gut microbiota and conducted post-hoc analyses to explore potential effect modifiers. Key Results: 59 participants were included in the analyses. Depressive symptoms decreased one-month post-procedure compared to baseline (adjusted β=−0.64; 95%CI: −1.18, −0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (1.78; 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Changes in gut microbiome composition included reduced alpha diversity, modest effects on beta-diversity, and increases in genera associated with potential health benefits, one-month post-procedure compared to baseline. Increases in the CLR-transformed abundance of Ruminococcaceae UCG-009 were associated with improvements in depressive symptoms. Conclusions: There is preliminary evidence of a potential mental health effect of bowel preparation and colonoscopy, which may be associated with changes to the gut microbiota. There may also be a differential mental health impact of this procedure for those with and without IBS. Considering the limitations of our study, further research is required to confirm these findings and their clinical relevance.

During summer 2016 in the District of Palermo, Italy, the rapid succession of four cases of invasive meningococcal disease among young adults, with one death, have had an extraordinary emphasis by Local and National mass media. The resultant “epidemic of panic” among general population overloaded vaccination Units of the Palermo District during following months. Strategies implemented by Sicilian and Local Public Health Authorities to counteract “meningitis fear” were: a) extension of active and free of charge anti-meningococcal tetravalent vaccination from age class 12–18 to 12–30 years old; b) implementation of vaccination units usual opening hours and rooms tailored for vaccine administration; c) development of informative institutional tools and timely communications throughout local mass media to reassure general population. In 2016, was observed an increase of anti-meningococcal coverage in Palermo District (+18% for 16th y.o. and + 14% for 18th y.o. cohorts) and at Regional Level (+11.2% and +13.5% respectively). Concurrent catch-up of other recommended vaccination for age (diphtheria-tetanus-pertussis-poliomyelitis and papillomavirus), resulted in further increase of doses administered. The fear for meningitis, managed by Sicilian Public Health Authorities, had positive reverberations in terms of prevention. In particular, informative strategies adopted sensibly contributed to get Sicilian young adults closer to vaccination issues.

Background: Although many studies analyse gender differences in the clinical expression of Attention Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls with ADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls with ADHD. Objective: The objective of this study is to develop a self-report early detection instrument for ADHD for boys and girls aged 7 to 16, which includes the gender perspective and is sensitive to the detection of girls with ADHD. Methods: The development of the scale and the items that comprise it were created from the thematic analysis of ADHD and its evaluation in children, based on the diagnostic criteria of the DSM-5-TR. A modified e-Delphi method involving a three-round web survey was used to reach a consensus on the content of the scale. Ten experts were recruited into a professional panel. The panel members were asked to assess the differential symptomatology of ADHD in boys and girls, the dimensions to be evaluated, and the importance of the scale items to evaluate the content. Results: Consensus was reached regarding 13 total items distributed in three dimensions: Inattention, Hyperactivity/Impulsivity, and a third dimension, Internalisation, which includes symptoms most present in the expression of ADHD in girls. Conclusions: To the best of our knowledge, the development of this scale using the Delphi method is the first specific scale for identifying ADHD that addresses the gender perspective and the differential symptomatology between boys and girls. Although we must proceed to the analysis of the psychometric properties, we can anticipate that this scale will provide relevant and reliable information for the identification of ADHD in both boys and girls.

Improving HIV testing efficiency saves financial and material resources for health. We conducted a retrospective secondary data analysis of routinely collected HIV risk screening program data in Uganda, from October to November 2019, to determine the performance characteristics of the adolescent and adult HIV risk screening tool in public health facility settings. A total of 19,854 clients had been screened for HIV testing eligibility and tested for HIV. The overall positivity rate (cluster weighted prevalence of HIV) among those screened was 4.5% (95% CI: 4.1%-4.8%) versus 3.71% (95% CI: 3.06-4.50) among those not screened. The sensitivity and specificity of the risk screening tool were 90.7% (95% CI: 88.4%, 92.7%) and 75.8%, (75.2-76.4) respectively. With screening, the number needed to test to identify one PLHIV was reduced from 27 to 22. Although risk screening would have led to a 24.5% (4,825/19,704) reduction in testing volume, 9.3% (68/732) of PLHIV would have been missed, being misclassified as not eligible for testing. The cost per PLHIV identified fell by 3% from $69 without screening to $66.9 with screening. We recommend the use of scientifically validated HIV risk screening tools, and a need to explore the use of HIV self-testing as a test for tirage.

The diagnosis and management of cow's milk allergy (CMA) is a topic of debate and controversy. We aimed to compare the opinions of expert groups from the Middle East (n=14) and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) (n=13). These Expert groups voted on statements developed by the ESPGHAN group and published in a recent position paper. The voting outcome was compared. Overall, there was consensus amongst both groups of experts. Most experts agreed that symptoms of crying, irritability and colic, as single manifestations, do not suggest CMA. They agreed that amino-acid-based formula (AAF) should be reserved for severe cases (e.g. malnutrition and anaphylaxis) and that there is insufficient evidence to recommend a step-down approach. There was no consensus on the statement that a cow’s milk-based extensively hydrolysed formula (eHF) should be the first choice as a diagnostic elimination diet in mild/moderate cases. Although the statements regarding the role of hydrolysed rice formula as a diagnostic and therapeutic elimination diet were accepted, 3/27 disagreed. The votes regarding soy formula highlight the differences in opinion in the role of soy protein in CMA dietary treatment. Generally, soy-based formula is seldom available in the Middle East region. All ESPGHAN experts agreed that there was no added value of probiotics, prebiotics, and synbiotics to the efficacy of elimination diets, whereas 3/14 of the Middle East group thought there was sufficient evidence. Therefore, there is not a consensus on the optimal diagnostic and therapeutic elimination diet for CMA, but the first-choice elimination diet and the stepwise management approach reveal some differences.

Milk serves as a crucial source of natural bioactive compounds essential for human nutrition and health. The gastrointestinal digestion of milk proteins releases various biologically active peptides that positively impact human health and enhance physiological performance. With the growing production of cheese, Greek yogurt, and other dairy products, the volume of unutilized acid whey is significantly increasing. Acid whey, containing almost all whey proteins and approximately one-quarter of casein, presents a valuable raw material for generating peptides with potential health benefits. These peptides exhibit properties such as antioxidant, antimicrobial, anti-inflammatory, anticarcinogenic, antihypertensive, antithrombotic, opioid, mineral-binding, and growth-stimulating activities, contributing to improved human immunity and the treatment of chronic diseases. Enzymatic hydrolysis of milk proteins has been developed as a method to produce these peptides, facilitating their use in food fortification. To incorporate whey into functional beverages, it undergoes fermentation by lactic acid bacteria with proteolytic activity. To specifically enrich these beverages with peptides exhibiting targeted bioactivities, it is essential to select lactic acid bacteria strains possessing the requisite protease profiles. Additionally, the sensory properties of the final product can be enhanced using starter cultures with diverse metabolic capabilities, even in the absence of added flavoring agents. Given the imperative to develop waste-free technologies and enhance the profitability of the dairy industry, there is a growing need to efficiently utilize and transform acid whey into a broad spectrum of valuable products and food additives. This approach is justified not only by the nutritional benefits of the bioactive components in whey but also by the commercial potential of safe and health-enhancing products.

The paper focuses on the application of a multilevel, integrative and territorial approach to the protection of cultural heritage through planning instruments in Serbia. It points out the problems of the sectoral approach and discusses international recommendations that can be integrated into the planning methodology. The case study is the area of Djerdap National Park, which has an already established international and national importance. The research suggests that the cultural heritage in the area, with the exception of the Roman limes, is still recognized at the level of individual localities. The study emphasizes the importance of aligning all levels of governance to safeguard the whole spatial entity rather than focusing solely on its particular areas. The interna-tional and national importance of the planning area contributes to the strengthening of awareness of heritage and its institutional protection. However, the vitality of the area, which is key to its sustainable development, comes from the local level. Planning documents contribute to the inte-gration of local values and local communities into development programs and projects.

In order to shorten the detection time and improve the average precision on embedded devices, A lightweight and high accuracy model is proposed for passion fruit in complex environments (backlight, occlusion, overlap, sunny, cloudy, rainy). Firstly, replacing the backbone network of YOLOv5 with a lightweight GhostNet model reduces the number of parameters and computation while improving detection speed. Secondly, a new feature branch is added to the GhostNet network, and the feature fusion layer in the neck network is reconstructed to effectively combine the lower-level and higher-level features, which not only improves the accuracy of the model but also maintains its lightweight. Finally, the knowledge distillation methods are used to transfer the knowledge from the more capable teacher model to the less capable student model, which significantly improving the detection accuracy. The improved model is denoted as G-YOLO-NK. The average accuracy of the G-YOLO-NK network is 96.00%, which is 1.00% higher than the original YOLOv5s model. Furthermore, the improved model size is 7.14MB, reduced to half of the original model, and the real-time detection frame rate is 11.25 FPS on the Jetson Nano. Compared to the state-of-the-art model, the proposed model outperforms them in terms of average precision and detection performance. The present work provides an effective model for real-time detection of passion fruits in complex orchard scenes, which can provide valuable technical support for the development of orchard picking robots and greatly improve the intelligence level of orchards.

The impact of interaction SS with MJO on rainfall along Java Island to East Nusa Tenggara has been studied using daily rainfall observation data from 2140 weather observation stations, which are also equipped with GSMaP, OLR, and ERA5 data. There were 61 SS events found, 17 during active MJO and 44 in inactive MJO. Rainfall increases more in the western study area when the active MJO and more in the eastern study area when the inactive MJO is due to SS. SS reduces rainfall in the Jakarta region, regardless of the activity or inactivity of the MJO. SS causes extreme rainfall to only occur in a small part of certain areas, so it tends to significantly reduce the possibility of extreme rainfall. In the southern part of the IMC, SS predominates over MJO in supporting increased water vapor transport. Large-scale synoptic circulations like the monsoon, SS, and MJO can interact with local land-sea wind circulation to produce spatiotemporal variability in rainfall on Java Island. Rainfall mostly increases in the afternoon and decreases in the morning when SS occurs, whether there is MJO or not. Convective instability analysis indicates that SS increases precipitation, most likely by lowering CIN and raising VIMFC.

The Simultaneous Localization And Mapping (SLAM) scanner is an easy and portable Light Detection And Ranging (LiDAR) data acquisition device. Its main output is a 3D point cloud covering the scanned scene. Regarding the importance of accuracy in the survey domain, this paper aims to assess the accuracy of two SLAM scanners: the NavVis VLX and the BLK2GO Scanner. This assessment is conducted for both outdoor and indoor environments. In this context, two types of reference data are used: the Total Station (TS) and the static scanner Z+F Imager 5016. To carry out the assessment, four comparisons are tested: cloud to cloud, cloud to mesh, mesh to mesh, and edge detection board assessment. However, the results of the assessments confirm that the accuracy of indoor SLAM scanner measurements (5 mm) is greater than that of outdoor ones (between 10 mm and 60 mm). Moreover, the comparison of cloud to cloud provides the best accuracy regarding direct accuracy measurement without manipulations. Finally, based on the high accuracy, scanning speed, flexibility, and the accuracy differences between tested cases, it is confirmed that SLAM scanners are effective tools for data acquisition.

Glycosidic linkage analysis was conducted on the unfractionated polysaccharides in the alcohol-insoluble residues (AIRs) prepared from six red seaweeds (Gracilariopsis sp., Prionitis sp., Mastocarpus papillatus, Callophyllis sp., Mazzaella splendens, and Palmaria palmata) using GC-MS/FID analysis of partially methylated alditol acetates (PMAAs). The cell walls of P. palmata primarily contained mixed-linkage xylans and small amounts of sulfated galactans and cellulose. In contrast, the unfractionated polysaccharides of the other five species were rich in galactans displaying diverse 3,6-anhydro-galactose and galactose linkages with varied sulfation patterns. Different levels of cellulose were also observed. This glycosidic linkage method offers advantages for cellulose analysis over traditional monosaccharide analysis that is known for underrepresenting glucose in crystalline cellulose. Relative linkage compositions calculated from GC-MS and GC-FID measurements showed that anhydro sugar linkages generated more response in the latter detection method. This improved linkage workflow presents a useful tool for studying polysaccharide structural variations across red seaweed species. Furthermore, for the first time, relative linkage compositions from GC-MS and GC-FID measurements, along with normalized FID and total ion current (TIC) chromatograms without peak assignments, were analyzed using principal component analysis (PCA) as a proof-of-concept demonstration of the technique's potential to differentiate various red seaweed species.

Background: Educating college students about the importance of good sleep habits could lead to the adoption of healthier sleep routines, including sufficient sleep duration and sleep quality. The current pre-post study examines the impact of completing a sleep education program called “Sleep 101” on (1) sleep hygiene practices, (2) sleep quality, and (3) weekday and weekend sleep behaviors among college students. “Sleep 101” is an interactive online course developed to educate college students about the importance of sleep by addressing basic sleep physiology, the impact of sleep on mood, academic and physical performance, the interactions between sleep and various substances, and common sleep disorders. Methods: 338 college students were recruited from a midsized public university in the US and invited to participate in “Sleep 101”, of which 25 participants completed the baseline and post-intervention questionnaire. The Sleep Hygiene Index (SHI) was utilized to evaluate sleep hygiene practices, while standard questions were employed to assess weekday and weekend sleep behaviors and overall sleep quality. Results: Those who completed the study demonstrated a significant increase in weekday sleep duration and were less likely to engage in negative prior bedtime activities. In addition, 40% of those who completed baseline and post-intervention assessments noticed improvements in their sleep quality. Conclusion: These findings suggest that a brief online program is beneficial in improving sleep behaviors among college and could be a scalable approach to addressing current sleep issues and preventing future sleep problems in college students.

The profile of secondary metabolites occurring in apple cuticular layer is not only characteristic for particular apple cultivar, but also dynamically reflects various external factors in growing environment. In this study, the possibility to authenticate apple samples based on analysis of their cuticular layer extracts was investigated. Ultra-high-performance liquid chromatography coupled to high resolution tandem mass spectrometry (UHPLC-HRMS/MS) was employed for obtaining metabolomic fingerprints. In total, 274 authentic apple samples, four cultivars harvested within the seasons 2020 to 2022 in the Czech Republic and Poland were analysed. The generated complex data processed by univariate and multivariate statistical methods enabled to build classification models for discrimination of apple cultivars as well as their geographical origin. The models showed very good performance in differentiation of Czech and Polish samples for three of four cultivars: ‘Gala’, ‘Golden Delicious’ and ‘Idared’, moreover, the validity of the models was verified over harvest seasons. The diagnostic markers, besides metabolites of triterpene biosynthetic pathway, mainly represented wax esters. ‘Jonagold’, which is known to be susceptible to mutations, was the only cultivar for which the unambiguous classification of geographical origin was not possible.