Children-Basel最新文献

{"title":"Automatic Movement Recognition for Evaluating the Gross Motor Development of Infants.","authors":"Yin-Zhang Yang, Jia-An Tsai, Ya-Lan Yu, Mary Hsin-Ju Ko, Hung-Yi Chiou, Tun-Wen Pai, Hui-Ju Chen","doi":"10.3390/children12030310","DOIUrl":"10.3390/children12030310","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to early-detect gross motor abnormalities through video detection in Taiwanese infants aged 2-6 months.</p><p><strong>Background: </strong>The current diagnosis of infant developmental delays primarily relies on clinical examinations. However, during clinical visits, infants may show atypical behaviors due to unfamiliar environments, which might not truly reflect their true developmental status.</p><p><strong>Methods: </strong>This study utilized videos of infants recorded in their home environments. Two pediatric neurologists manually annotated these clips to identify whether an infant possessed the characteristics of gross motor delays through an assessment of his/her gross motor movements. Using transfer learning techniques, four pose recognition models, including ViTPose, HRNet, DARK, and UDP, were applied to the infant gross motor dataset. Four machine learning classification models, including random forest, support vector machine, logistic regression, and XGBoost, were used to predict the developmental status of infants.</p><p><strong>Results: </strong>The experimental results of pose estimation and tracking indicate that the ViTPose model provided the best performance for pose recognition. A total of 227 features related to kinematics, motions, and postures were extracted and calculated. A one-way ANOVA analysis revealed 106 significant features that were retained for constructing prediction models. The results show that a random forest model achieved the best performance with an average F1-score of 0.94, a weighted average AUC of 0.98, and an average accuracy of 94%.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Maternal HbA1c Levels for Fetal Hypertrophic Cardiomyopathy in Pregestational Diabetic Pregnancies.","authors":"Angel Chimenea, Ana María Calderón, Guillermo Antiñolo, Eduardo Moreno-Reina, Lutgardo García-Díaz","doi":"10.3390/children12030312","DOIUrl":"10.3390/children12030312","url":null,"abstract":"<p><p>(1) Background: This study investigated the utility of first-visit HbA1c levels as a predictor of fetal hypertrophic cardiomyopathy (FHCM) in women with pregestational diabetes mellitus (PGDM). (2) Methods: A retrospective observational cohort study was conducted among all pregnant women with PGDM between 2012 and 2019. (3) Results: Of 329 participants, 5.8% had fetuses diagnosed with FHCM. These women exhibited significantly higher pregestational HbA1c (8.2% vs. 7.3%, <i>p</i> = 0.003) and higher first-visit HbA1c (7.6% vs. 6.9%, <i>p</i> = 0.001) and were less likely to have planned their pregnancies (<i>p</i> = 0.035). Fetuses with FHCM demonstrated a higher incidence of macrosomia (63.2% vs. 17.7%, <i>p</i> < 0.001; OR 9.20, 95% CI 3.31-25.58). Receiver-operating characteristic (ROC) analysis indicated an adequate predictive capacity for FHCM using first-visit HbA1c (AUC 0.75). An HbA1c threshold of 7.15% provided the best discriminative power, encompassing 38.9% of the cohort. (4) Conclusions: These findings underscore the value of assessing first-visit HbA1c levels for predicting FHCM in women with PGDM. The significant association between glycemic status and FHCM highlights the importance of optimizing glycemic control before and during pregnancy. Establishing optimal HbA1c cutoffs enables effective risk stratification and supports targeted clinical interventions.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Link Between Special Educational Needs and Mental Health of Schoolchildren and Their Parents.","authors":"Juan Manuel Núñez, Marián Pérez-Marín, Ana Soto-Rubio","doi":"10.3390/children12030314","DOIUrl":"10.3390/children12030314","url":null,"abstract":"<p><strong>Background/objectives: </strong>The relationship between executive functions, special educational needs (SEN), and psychopathology in school-aged children is critical to the design of effective educational and therapeutic interventions. This study examines the connection between executive functions, SEN, schoolchildren's psychopathology, and parental mental health. The objectives were to describe the psychopathological profiles of schoolchildren, to analyze the psychopathological differences between students with and without SEN, and to know the mental health status of parents of children with SEN.</p><p><strong>Methods: </strong>A total of 123 schoolchildren with and without SEN, together with their parents, participated in the study. Validated instruments were used to assess executive functions and child psychopathology, and an ad hoc register was used to assess parental mental health. In addition, sociodemographic and clinical data were collected.</p><p><strong>Results: </strong>The results revealed that children with SEN showed a significantly more affected psychopathological profile compared to their peers without SEN in all areas assessed. In addition, parents of children with SEN reported higher levels of emotional overburden (<b>r = 0.39, <i>p</i> < 0.01</b>). Deficits in executive functions, such as inhibition (<b>r = 0.41, <i>p</i> < 0.01</b>), working memory (<b>r = 0.37, <i>p</i> < 0.01</b>), and cognitive flexibility (<b>r = 0.33, <i>p</i> < 0.05</b>), were also found to be related to greater psychopathological problems in children.</p><p><strong>Conclusions: </strong>These findings underscore the importance of considering both executive functions and psychopathological profiles in designing educational and therapeutic interventions for children with SEN. It is recommended that intervention programs should comprehensively address the educational and emotional needs of children, as well as the well-being of their parents, with a specific focus on improving executive functions and reducing psychopathological disorders.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Circulatory Support in Congenital Heart Disease.","authors":"Áine Lynch, Aamir Jeewa","doi":"10.3390/children12030306","DOIUrl":"10.3390/children12030306","url":null,"abstract":"<p><p>As early survival outcomes have improved, heart failure in children with congenital heart disease (CHD) has become a growing problem. Primary care providers and pediatricians are thus encountering increasing numbers of children with or at-risk for heart failure. Despite medication, many of these children progress to end-stage heart failure and require heart transplant for long-term survival. Mechanical circulatory support (MCS) is increasingly utilized to support this cohort both acutely when recovery is anticipated, and as a bridge to transplant. Early referral to tertiary heart failure and MCS teams is key to facilitate timely institution of MCS and preserve end-organ function. MCS in children with CHD presents unique challenges due to patient size and complex intra- and extra-cardiac anatomy. Evaluations for MCS should take into account patient size, anatomy, end-organ function, and psychosocial supports. The form of MCS utilized is dependent on clinical urgency, patient size, and anatomy. We describe the evolving landscape of MCS in pediatric patients with CHD.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Evaluate a Regional Telemedical Care Network Focusing on Critically Ill Children? Results from the Consensus-Based Development of an Evaluation Design.","authors":"Josephine Mathiebe, Gabriele Müller, Jochen Schmitt, Sebastian Brenner, Stefan Winkler, Anne Schawohl, Franziska Waurig, Madlen Scheibe","doi":"10.3390/children12030313","DOIUrl":"10.3390/children12030313","url":null,"abstract":"<p><p><b>Background:</b> The medical care of critically ill children requires special expertise in pediatric emergency and intensive care medicine. In Germany, this expertise is mainly available in specialized centers at maximum-care hospitals due to the small number of cases of critically ill children. Telemedical care networks, such as the Pediatric-Tele-Intensive-Care Network Saxony, offer a solution for networking these centers with regional hospitals providing basic or standard care. However, the evaluation of these networks represents a major challenge, especially because it involves a heterogeneous target group of patients with various diseases. This article reports on the evaluation design development process for such a network, under equal participation of all relevant stakeholders, and presents the resulting evaluation design. <b>Methods:</b> The methods used were a literature review, two workshops, and a survey of all relevant stakeholders (representatives of 17 partner clinics, 4 external experts in pediatric intensive care, and 2 patient representatives). <b>Results:</b> The evaluation design contained proposals for a care objective, outcomes, and the corresponding databases (project database, clinic database, and survey database) to investigate these. <b>Conclusions:</b> Our study can offer other researchers and stakeholders a methodological approach and template for their evaluation design. It is the first published, consented evaluation design for a telemedical care network in pediatric intensive care. When developing and realizing an evaluation design for (tele)medical interventions, including the perspectives of relevant stakeholders, from the outset, it is essential to achieve a high level of commitment to the implementation of the evaluation.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Interrupting Oral Prevention on Dental Health of 7- to 8-Year-Old Children Due to COVID-19.","authors":"Julia Winter, Thea Hartmann, Constanze Schul, Esther Hörschgen, Miriam Thöne-Mühling, Birgit Wollenberg, Stefanie Amend, Roland Frankenberger","doi":"10.3390/children12030315","DOIUrl":"10.3390/children12030315","url":null,"abstract":"<p><p><b>Background/Objectives</b>: In Marburg (Hesse, Germany), the selective intensive preventive program (SIP) with fluoride varnish applications had to be interrupted due to the COVID-19 pandemic. The aim of this retrospective anonymized evaluation was to investigate possible effects of SIP interruption on oral health in socially vulnerable 7- and 8-year-olds. <b>Methods</b>: The caries increment in 7- and 8-year-olds for the test group (N = 180) between last dental check-up before the interruption of SIP (02/2019-02/2020) and the first check-up after restart (01/2022-07/2022) were calculated from dental public health service data. The test group was compared to a control group of children (N = 215; same age and schools, with SIP, data collected between the school year 2017/18 and 2019/20). One dentist conducted the dental examinations. The University of Marburg ethics committee approved the study. The Mann-Whitney U test and Pearson's chi-square test were used for statistical analysis. <b>Results</b>: There was no significant difference in the caries increment in the first dentition between the test and the control group for both age groups. In the different groups, a maximum of 61% of the children with caries experience were completely treated. There was no significant difference between the test and control groups in either the percentage of sealed first permanent molars or the degree of restoration. <b>Conclusions</b>: The interruption of SIP had no negative impact on caries increment. It is possible that the children examined went through the pandemic without a significant increase in tooth decay because the children were well-trained in tooth brushing since kindergarten.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Pediatric Displaced Intraarticular Olecranon Fractures with Resorbable Poly-L-Lactic-Co-Glycolic Acid (PLGA) Pins and Polydioxanone (PDS) Loops.","authors":"Zoltán Tóth, Tamás Kassai, Marcell Varga, Tibor Molnár, Eszter Antal, Anna Gabriella Lamberti, Hermann Nudelman, Aba Lőrincz, Gergő Józsa","doi":"10.3390/children12030316","DOIUrl":"10.3390/children12030316","url":null,"abstract":"<p><strong>Background: </strong>Pediatric olecranon fractures, though rare, can be serious. Treatment varies by type and severity; displaced, intraarticular fractures usually need surgery, where biodegradable implants are emerging as an encouraging option to metal hardware.</p><p><strong>Methods: </strong>Our prospective, single-center, single-arm case series evaluates three pediatric olecranon fracture patients treated by resorbable poly-L-lactic-co-glycolic acid (PLGA) pins and polydioxanone (PDS) loops between Jan 2022 and January 2023 at the Department of Pediatrics, University of Pécs, Clinical Complex.</p><p><strong>Results: </strong>All patients achieved complete radiological healing with excellent functional recovery and no implant-related complications at one-year follow-up.</p><p><strong>Conclusions: </strong>Resorbable PLGA pins and PDS loops provide a promising alternative to conventional metallic fixation in pediatric olecranon fractures, abolishing the need for a second implant-removal surgery while maintaining stability and biocompatibility. Our findings support the child-friendly nature and growing role of biodegradable materials in pediatric fracture management.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Pediatric Growth Assessment with Machine Learning: Overcoming Challenges in Early Diagnosis and Monitoring.","authors":"Mauro Rodriguez-Marin, Luis Gustavo Orozco-Alatorre","doi":"10.3390/children12030317","DOIUrl":"10.3390/children12030317","url":null,"abstract":"<p><strong>Background: </strong>Pediatric growth assessment is crucial for early diagnosis and intervention in growth disorders. Traditional methods often lack accuracy and real-time decision-making capabilities This study explores the application of machine learning (ML), particularly logistic regression, to improve diagnostic precision and timeliness in pediatric growth assessment. Logistic regression is a reliable and easily interpretable model for detecting growth abnormalities in children. Unlike complex machine learning models, it offers parsimony in transparency, efficiency, and reproducibility, making it ideal for clinical settings where explainable, data-driven decisions are essential.</p><p><strong>Methods: </strong>A logistic regression model was developed using R to analyze biometric and demographic data from a cross-sectional dataset, including real-world data from public institucions. The study employed a bibliometric analysis to identify key trends and incorporated data preprocessing techniques such as cleaning, imputation, and feature selection to enhance model performance. Performance metrics, including accuracy, sensitivity, and the Receiver Operating Characteristic (ROC) curve, were utilized for evaluation.</p><p><strong>Results: </strong>The logistic regression model demonstrated an accuracy of 94.65% and a sensitivity of 91.03%, significantly improving the identification of growth anomalies compared to conventional assessment methods. The model's ROC curve showed an area under the curve (AUC) of 0.96, indicating excellent predictive capability. Findings highlight ML's potential in automating pediatric growth monitoring and supporting clinical decision-making, as it can be very simple and highly interpretable in clinical practice.</p><p><strong>Conclusions: </strong>ML, particularly logistic regression, offers a promising tool for pediatric healthcare by enhancing diagnostic precision and operational efficiency. Despite these advancements, challenges remain regarding data quality, clinical integration, and privacy concerns. Future research should focus on expanding dataset diversity, improving model interpretability, and conducting external validation to facilitate broader clinical adoption.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oro-Functional Conditions in a 6-to-14-Year-Old School Children Population in Rome: An Epidemiological Study.","authors":"Giuseppina Laganà, Roberta Lione, Arianna Malara, Silvia Fanelli, Francesco Fabi, Paola Cozza","doi":"10.3390/children12030305","DOIUrl":"10.3390/children12030305","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present cross-sectional study was to assess oral and functional conditions, the prevalence of malocclusions, and oral habits in a population of schoolchildren in Rome (Italy).</p><p><strong>Methods: </strong>The study sample included n. 1033 subjects, between 6 and 14 years of age, attending public schools in Rome. Oral health condition, occlusal relationship, and functional analysis were charted for all subjects. The rate of prevalence for the dental health element was calculated. To evaluate the relationship between the variables examined, Pearson's Chi-square test was used to assess the significative findings of this association.</p><p><strong>Results: </strong>More than half of the students had a low level of oral hygiene (654 subjects). Class I malocclusion was the most common occlusal condition (573 subjects). Oral habits were present in most of the subjects and more than one habit was observed.</p><p><strong>Conclusions: </strong>The results of the current investigation highlight the necessity of improving public health programs for orthodontic prevention, and future screenings need to be planned to organize resources in Rome.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Multidimensional Dynamic Feedback Model: A Comprehensive Framework for Understanding and Managing Attention-Deficit/Hyperactivity Disorder.","authors":"Yuying Wang, Yuan Zhao, Luming Hu, Xuemin Zhang","doi":"10.3390/children12030303","DOIUrl":"10.3390/children12030303","url":null,"abstract":"<p><p>Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. These symptoms can significantly impact academic performance, social interactions, and daily activities, often creating cycles that worsen long-term challenges. This review introduces the <i>Multidimensional Dynamic Feedback Model</i> (MDFM), which aids in understanding ADHD's development and guiding intervention strategies. The model emphasizes the dynamic interactions among genetic, environmental, cognitive, and behavioral factors. The MDFM consists of three key aspects: (1) the interplay between genetic and environmental factors in shaping ADHD's biological basis, (2) the role of cognitive and neural processes in driving core symptoms, and (3) the influence of behavioral feedback loops that reinforce negative behaviors and hinder adaptation. The model highlights the importance of personalized interventions and effective feedback systems, including early prevention, supportive family and school environments, and the impact of social and cultural backgrounds on treatment outcomes. As a comprehensive framework, the MDFM offers a holistic perspective for clinicians, aiming to enhance long-term outcomes and promote the health and well-being of individuals with ADHD across the lifespan. By addressing implementation challenges, the model seeks to improve ADHD prevention and management, ultimately supporting individuals and their communities.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}