Association between childhood obesity and gut microbiota:16S rRNA gene sequencing-based cohort study

BACKGROUND This study aimed to identify characteristic gut genera in obese and normal-weight children(8-12 years old)using 16S rDNA sequencing.The research aimed to provide insights for mechanistic studies and prevention strategies for childhood obesity.Thirty normal-weight and thirty age-and sex-matched obese children were included.Questionnaires and body measurements were collected,and fecal samples underwent 16S rDNA sequencing.Significant differences in body mass index(BMI)and body-fat percentage were observed between the groups.Analysis of gut microbiota diversity revealed lowerα-diversity in obese children.Differences in gut microbiota composition were found between the two groups.Prevotella and Firmicutes were more abundant in the obese group,while Bacteroides and Sanguibacteroides were more prevalent in the control group.AIM To identify the characteristic gut genera in obese and normal-weight children(8-12-year-old)using 16S rDNA sequencing,and provide a basis for subsequent mechanistic studies and prevention strategies for childhood obesity.METHODS Thirty each normal-weight,1:1 matched for age and sex,and obese children,with an obese status from 2020 to 2022,were included in the control and obese groups,respectively.Basic information was collected through questionnaires and body measurements were obtained from both obese and normal-weight children.Fecal samples were collected from both groups and subjected to 16S rDNA sequencing using an Illumina MiSeq sequencing platform for gut microbiota diversity analysis.RESULTS Significant differences in BMI and body-fat percentage were observed between the two groups.The Ace and Chao1 indices were significantly lower in the obese group than those in the control group,whereas differences were not significant in the Shannon and Simpson indices.Kruskal-Wallis tests indicated significant differences in unweighted and weighted UniFrac distances between the gut microbiota of normal-weight and obese children(P<0.01),suggesting substantial disparities in both the species and quantity of gut microbiota between the two groups.Prevotella,Firmicutes,Bacteroides,and Sanguibacteroides were more abundant in the obese and control groups,respectively.Heatmap results demonstrated significant differences in the gut microbiota composition between obese and normal-weight children.CONCLUSION Obese children exhibited lowerα-diversity in their gut microbiota than did the normal-weight children.Significant differences were observed in the composition of gut microbiota between obese and normal-weight children.

Iron supplementation during malaria infection in pregnancy and childhood:A review

Malaria presents a significant global public health challenge,with severe malarial anaemia being a primary manifestation of the disease.The understanding of anaemia caused by malaria remains incomplete,making the treatment more complex.Iron is a crucial micronutrient essential for haemoglobin synthesis,oxygen delivery,and other vital metabolic functions in the body.It is indispensable for the growth of human beings,as well as bacteria,protozoa,and viruses in vitro and in vivo.Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life.Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis,leading to anaemia.Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy,infancy,and childhood.Dietary intake alone may not suffice to meet adequate iron requirements,thus highlighting the vital role of iron supplementation.While iron supplementation can alleviate iron deficiency,it can exacerbate malaria infection by providing additional iron for the parasites.However,in the context of pregnancy and childhood,iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development,respectively.This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.

Atherosclerosis originating from childhood:Specific features

Atherosclerosis is extremely widespread.Traditionally,it is considered a disease of older people,who most often experience problems with the heart and blood vessels.While much attention from the scientific community has been paid to studying the association between aging and atherosclerosis,as well as its consequences,there is evidence that atherosclerosis occurs at an early age.Atherosclerosis may form both during intrauterine development and in childhood.Nutrition plays an important role in childhood atherosclerosis,along with previous infectious diseases and excess weight of both the child and the mother.In the present review,we examined the development of atherosclerosis and the prerequisites in childhood.

Link between childhood obesity and gut microbiota

Childhood obesity is a critical global health concern with rising prevalence and significant long-term health implications.Recent studies have implicated gut microbiota in the development and progression of obesity.This editorial analyzes the research conducted by Li et al,who utilized 16S rRNA gene sequencing to compare the gut microbiome of overweight and healthy-weight children.The study found significant differences in microbial diversity and composition between the two groups,with potential implications for understanding and managing childhood obesity.We analyzed the study’s advantages and drawbacks,proposing potential areas for future research to better understand the connection between gut microbiota and obesity.

Mediating Effect of Mindfulness,Self-Esteem and Psychological Resilience in the Relation between Childhood Maltreatment and Life Satisfaction

Childhood maltreatment,as a typical early adverse environment,is known to have a negative impact on one’s life satisfaction.Mindfulness,on the other hand,may serve as a protective factor.This study explored the mediating role of mindfulness and its related variables–positive thoughts,psychological resilience and self-esteem.In order to testify the mechanism,we administered Childhood Trauma Questionnaire(CTQ),Satisfaction with Life Scale(SWLS),Mindful Attention Awareness Scale(MAAS),Connor–Davidson Resilience Scale(CD-RISC)and Rosenberg Self-Esteem Scale(RSES)to a non-clinical sample of Chinese university students(N=1021).The results indicated that positive thoughts did not mediate the relationship between childhood maltreatment and life satisfaction,but self-esteem(β=−0.194,95%CI=[−0.090,−0.040])and psychological resilience(β=−0.063,95%CI=[−0.059,−0.020])mediated the relationship,as well as the“mindfulness-selfesteem”(β=−0.061,95%CI=[−0.287,−0.126])and“mindfulness-psychological resilience”(β=−0.035,95%CI=[−0.115,−0.034]).The results of this study were helpful to understand the relationship between childhood maltreatment and life satisfaction and provided a theoretical basis for the development of mindfulness intervention programs from the perspective of positive psychology.

The Effects of Childhood Trauma on College Students’Depressive Symptoms:The Mediation Role of Subjective Well-Being and the Moderation Role of Resilience

Background:The enduring and detrimental impact of childhood trauma on later health and well-being is now well established.However,research on the relationship between childhood trauma and depressive symptoms,along with the potential risk and protective factors,is insufficient in the context of Chinese college student population.Methods:Data on childhood trauma,depressive symptoms,resilience,and subjective well-being were collected through surveys conducted with 367 Chinese university students.The data collected in this study were analyzed using SPSS 26.0 and PROCESS 3.5.Results:The results revealed that subjective well-being mediated the relationship between childhood trauma and depressive symptoms among college students,with direct and indirect effects accounting for 59.46%and 40.54%of the total effect,respectively.The pathway process between subjective well-being and depressive symptoms was moderated by resilience,whereby an increase in resilience levels corresponded to a gradual escalation in the predictive power of subjective well-being on depressive symptoms.Conclusion:The study indicates that childhood trauma significantly and positively predicts depressive symptoms among college students,and it can also directly predict depressive symptoms through the mediating effect of subjective well-being.Elevating levels of psychological resilience and subjective well-being among college students can mitigate depression and promote psychological well-being.From the perspective of positive psychology,the present study provides a new perspective for the prevention and intervention of depressive symptoms among college students.

Total hip arthroplasty for sequelae of childhood hip disorders:Current review of management to achieve hip centre restoration

Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.

Diagnosis and Management of Childhood Tuberculosis: A Cross-Sectional Study of Practices in Gilgit Baltistan, Pakistan

Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary Tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood Tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no post graduate qualification in medicine or pediatrics. The deviations from the guidelines for TB control cannot be negated in the region.

Indian perspective on childhood malnutrition:Prevalence,pathophysiology,risk factors,and prevention

BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world,predominantly in South-Asian and sub-Saharan countries.AIM To summarize the childhood malnutrition epidemiology along with the comorbid factors associated with it and its management within the community.METHODS The data collection process involved conducting a comprehensive search using specific keywords such as child nutrition disorders and India with Boolean operators.The search was conducted in the Scopus and PubMed electronic databases.RESULTS Inadequate energy consumption initiates pathological alterations in the form of growth retardation,fat,visceral,and muscle loss,a reduction in basal metabolic rate,and a significant reduction in total energy expenditure.It has become evident that malnutrition shows an increased prevalence and incidence rate,despite available guidelines for the management of malnutrition.CONCLUSION Malnutrition can be a major player in the establishment of severe infections that result in significant post discharge mortalities in children.Future trials are required to fill the prime gaps in knowledge regarding the identification of other contributory factors in the pathogenesis of malnutrition and postdischarge infection.New biomarkers for early detection of malnutrition should be the priority of the scientific community for the early management of malnutrition.

Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity:Implications for prevention and intervention

BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications.This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity.Despite the increasing prevalence of childhood obesity worldwide,this issue remains inadequately addressed in the Moroccan context.AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.METHODS The research encompasses a comprehensive survey of practicing physicians,revealing significant gaps in awareness and practices related to maternal obesity.RESULTS Notably,a significant portion of doctors do not provide adequate guidance to overweight pregnant women,highlighting the urgency for targeted educational programs.CONCLUSION In conclusion,this research illuminates critical areas for improvement in tackling childhood obesity in Morocco.By addressing these gaps,fostering awareness,and enhancing medical practices,the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.

Impact of COVID-19 pandemic on routine childhood vaccinations

Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.

Childhood Papillary Thyroid Carcinoma: A Case Report

Background: Thyroid cancer is a rare disease yet the most common endocrine malignancy in pediatrics. Unlike adult patients, children with thyroid nodules typically don’t complain of pain, soreness, or difficulty swallowing. Additionally, using the recommended therapy for adults to treat paediatrics is not appropriate. There is an unmet need for updated unique guidelines for the management of papillary thyroid carcinoma (PTC) in paediatrics and adolescents. Case Report: A 12-year-old girl had an atypical presentation of metastatic PTC in lymph nodes. She was treated initially with hemi-thyroidectomy, followed by total thyroidectomy. A multidisciplinary team followed her up till successful results were found. Conclusion: Due to the difference in pathophysiology between thyroid tumors in children and adults, a unique approach to PTC management is to be implemented. Further trials are required for a better understanding of risk factors, the likelihood of recurrence, and the long-term side effects of the chosen management plan.

Radiation Dose from CT-Scan of Childhood’s Head: Results of the First Ivorian Survey in a Single Study Site

Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDIvol) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDIvol and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDIvol and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.

Primary Multiple Cerebral Hydatid Cyst in 8 Year-Old Girl: A Rare Cause of Childhood Seizure

Background: Cystic echinococcosis is a zoonotic infection that occurs worldwide. Humans are infected through ingestion of parasite eggs in contaminated food, water or through direct contact with infected dogs, which are the definite host. Humans serve accidentally as intermediate host, and occurrences are common in children and young adults. Cystic echinococcosis is endemic in Mediterranean, South American, Middle Eastern, Central Asia, East Africa countries and Australia. Multiple cerebral hydatid cysts are very rare with only a few reports in the literature. Case Description: We present the case of an 8-year-old girl who presented with focal seizures, hemiparesis, headache, vomiting and bilateral optic atrophy. Diagnostic workup was performed, and magnetic resonance imaging revealed multiple intracranial cysts predominantly in the right frontal region with significant mass effect. A total of 11 intracranial cysts were removed surgically, and the child recovered uneventfully. Conclusion: Neurosurgeons should keep hydatidosis in the list of differentials when evaluating patients with cystic diseases of the brain. Although the removal of such cysts is challenging, outcomes are excellent when cysts are evacuated without rupture and patients show complete resolution of symptoms.

Cost analysis of childhood glaucoma surgeries using the US Medicaire allowable costs

AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction($/mm Hg) at 1y postoperatively.RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.CONCLUSION: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.

Childhood Sexual Abuse and Quality of Life in Chinese Undergraduates: the Mediating Role of Resilience

Childhood sexual abuse(CSA)is a widespread and serious public health concern,with long-term impacts on overall health in adulthood.According to a systematic review published in 2018,the prevalence of CSA in China ranges from 11.6%to 20.2%[1].A longitudinal study from New Zealand demonstrated that CSA negatively influences a broad range of adult developmental outcomes,including mental disorders,psychological wellbeing,sexual risk-taking,physical health,and socioeconomic wellbeing[2].Therefore,CSA is considered a longterm hazard to the overall health of adults and is associated with poor quality of life(QoL).

The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries: A Systematic Review

Thefirst years of life and the family context are key to the promotion and protection of children’s health and well-being,emphasizing the need for interventions aimed to support families with young children.This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries.Six electronic databases were systematically searched,and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria.The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention.Outcomes of interest encompassed mental health,related risk and protective factors among the parents and/or the children,or child-parent interaction.The results from studies applying statistical methods show significant improvements in parents’self-efficacy,self-esteem,and parental satisfaction,while few improvements in parents’social support or parental relationship were identified.Improvements in social support and parental relationships were however reported in qualitative studies.Most quantitative studies reporting on parents’mental health problems and stress found a significant decrease,and qualitative studies highlighted experienced positive effects on mental health and well-being.The majority of stu-dies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development.No significant changes were however found for existing behavioral problems.The majority of studies examining parenting strategies and/or parent-child interaction found signifi-cant positive changes after the interventions.In sum,althoughfindings are heterogeneous,early childhood inter-ventions show various positive effects on the parenting and mental health of both children and their parents.The fact that different types of initiatives have been developed and implemented can be seen as an advantage,con-sidering the varying needs and expectations of different families.

Deep Learning Framework for the Prediction of Childhood Medulloblastoma

This research work develops new and better prognostic markers for predicting Childhood MedulloBlastoma(CMB)using a well-defined deep learning architecture.A deep learning architecture could be designed using ideas from image processing and neural networks to predict CMB using histopathological images.First,a convolution process transforms the histopathological image into deep features that uniquely describe it using different two-dimensional filters of various sizes.A 10-layer deep learning architecture is designed to extract deep features.The introduction of pooling layers in the architecture reduces the feature dimension.The extracted and dimension-reduced deep features from the arrangement of convolution layers and pooling layers are used to classify histopathological images using a neural network classifier.The performance of the CMB classification system is evaluated using 1414(10×magnification)and 1071(100×magnification)augmented histopathological images with five classes of CMB such as desmoplastic,nodular,large cell,classic,and normal.Experimental results show that the average classification accuracy of 99.38%(10×)and 99.07%(100×)is attained by the proposed CNB classification system.

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 o019 children(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was defined using Chinese national body mass index cut-points.Principal component analysis was used to convert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive variable.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8%,and was higher in boys than in girls(17.8%vs.7.6%,P<0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95%CI:1.09 to 1.40,P<O.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's selfperceived weight status mediated 70.0%of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Associations between Mental Health Outcomes and Adverse Childhood Experiences and Character Strengths among University Students in Southern China

Adverse childhood experiences(ACEs)can negatively affect mental health,whereas character strengths seem to be positively correlated with mental health.Detailed information on the history of ACEs among university students in China and the extent which mental health is associated with ACEs and character strengths can contribute to the needed empirical evidence for relevant stakeholders.Objectives of this study are 1)to estimate the prevalence of ACEs among undergraduate students in Southern China;and 2)to assess the extent which mental health outcomes(positive growth,well-being,and depression)are associated with ACEs and character strengths among undergraduate students in Southern China.We conducted a self-administered survey amongfirst and second-year students at a university in Southern China and analyzed data using descriptive statistics and linear regression analyses.Among the 779 students who completed the questionnaire,283 were males,439 were females,and 57 did not indicate their gender.The prevalence of ACEs among the participants was 32.1%.History of ACEs was associated with lower positive growth score(Adjusted Beta=-0.20;95%CI=-0.37,-0.02;p=0.030)and lower well-being score(Adjusted Beta=-1.13;95%CI=-2.04,-0.23;p=0.014).Vitality domain of character strength was associated with all three mental health outcomes after adjusting for covariables(all p-values<0.001).Our studyfindings provide empirical evidence for stakeholders in university mental health.However,caveats regarding lack of temporality,selection bias,social desirability bias,and lack of generalizability should be considered in the interpretation of the studyfindings.