Although smartphone ownership among minors has become an important social phenomenon, its impact on children\'s and adolescents\' well-being, as well as the mechanisms by which this might take place are not yet sufficiently well-established. To date, no research has examined the effect of smartphone ownership on the well-being of minors through the consumption of influencer-generated content, nor has it explored the effectiveness of the main prevention strategies employed by parents in this context. To fill those gaps, 800 Spanish minors (50% female) aged from 8 to 16 years old (M = 12.33, SD = 2.38) participated in a correlational study in which the ownership of electronic devices, the consumption of influencer generated content, the parasocial relationship with the influencer, and the most common parental mediation strategies were considered. The results showed a positive association between electronic device ownership and psychological discomfort, problematic usage, and imitation of dangerous behaviors. This association was mediated by the consumption of influencer-generated content and the parasocial relationship established by the minor with the influencer. Regarding preventive strategies, only active mediation was inversely related to poorer well-being indicators, however this positive effect significantly decreased when a smartphone or a similar electronic device was owned by the minor (vs. no owned). These findings contribute to the understanding of how smartphone ownership can affect the well-being of children, emphasizing the need for thoughtful consideration when deciding whether to provide smartphones to minors.

It is well known that bacterial plaque is the main etiological factor that causes the appearance of periodontal diseases and carious disease. Periodontal diseases can affect children and adolescents and are manifested in the form of gingivitis, but also the early form of chronic periodontitis as well as aggressive marginal periodontitis associated with local or general factors. Early periodontitis is frequently undiagnosed by clinicians due to a lack of knowledge of the specific symptoms. Certain systemic diseases, such as cardiovascular diseases, can create favorable conditions for the appearance and progression of severe manifestations of periodontal disease; also, recent research highlights that individuals with periodontal disease present an increased risk of developing cardiovascular diseases. Children with congenital or acquired cardiovascular diseases are at increased risk for complications resulting from the growth of microorganisms in the oral cavity, presenting a risk of infective endocarditis. The specific aim was to highlight the existing differences between the periodontal health of children with cardiovascular diseases and that of children without these diseases. The analyzed group included 124 patients, represented by children and adolescents, aged between 7 and 17 years, who were divided into four subgroups depending on the presence or absence of cardiovascular diseases and periodontal disease. A specialized clinical examination was performed for each patient, and periodontal clinical parameters were quantified (plaque index, gingival bleeding index, gingival index, community periodontal index of treatment needs) and associated with the diagnosis of general condition. Patients diagnosed with periodontal disease underwent specialized treatment and were called to a control visit 3 months after treatment. Statistical analysis showed significant differences between subgroups with much higher values of clinical parameters for patients with cardiovascular disease. Also, the response to the treatment was better in the case of patients in the control subgroup without cardiovascular diseases. The present study highlighted the interaction of three factors in the progression of periodontal diseases: subgingival microbiota, immune system response and environmental factors.

Objective: To explore extrathyroidal extension (ETE) in children and adolescents with papillary thyroid carcinoma using a multiclassifier ultrasound radiomic model. Methods: In this study, data from 164 pediatric patients with papillary thyroid cancer (PTC) were retrospectively analyzed and patients were randomly divided into a training cohort (115) and a validation cohort (49) in a 7:3 ratio. To extract radiomics features from ultrasound images of the thyroid, areas of interest (ROIs) were delineated layer by layer along the edge of the tumor contour. The feature dimension was then reduced using the correlation coefficient screening method, and 16 features with a nonzero coefficient were chosen using Lasso. Then, in the training cohort, four supervised machine learning radiomics models (k-nearest neighbor, random forest, support vector machine [SVM], and LightGBM) were developed. ROC and decision-making curves were utilized to compare model performance, which was validated using validation cohorts. In addition, the SHapley Additive exPlanations (SHAP) framework was applied to explain the optimal model. Results: In the training cohort, the average area under the curve (AUC) was 0.880 (0.835-0.927), 0.873 (0.829-0.916), 0.999 (0.999-1.000), and 0.926 (0.892-0.926) for the SVM, KNN, random forest, and LightGBM, respectively. In the validation cohort, the AUC for the SVM was 0.784 (0.680-0.889), for the KNN, it was 0.720 (0.615-0.825), for the random forest, it was 0.728 (0.622-0.834), and for the LightGBM, it was 0.832 (0.742-0.921). Generally, the LightGBM model performed well in both the training and validation cohorts. From the SHAP results, original_shape_MinorAxisLength,original_shape_Maximum2DDiameterColumn, and wavelet-HHH_glszm_SmallAreaLowGrayLevelEmphasis have the most significant effect on the model. Conclusions: Our combined model based on machine learning and ultrasonic radiomics demonstrate the excellent predictive ability for extrathyroidal extension (ETE) in pediatric PTC.

OBJECTIVE: To investigate the impact of single-vision spectacle use on myopia progression in children with low myopia.
METHODS: MYOSOTIS is a prospective myopia screening survey including all 46 primary and junior high schools in two districts of Hangzhou, China. After 1-to-1 propensity score matching (PSM), 1,685 pairs of students with low myopia were included. Group 1 was composed of 1,685 non-spectacle users at baseline, and group 2 consisted of 1,685 spectacle wearers at both survey rounds. Refraction was examined by noncycloplegic autorefraction and mean spherical equivalent refraction (SER) of both eyes was analyzed. Myopia progression was measured by average rate of change in SER (r∆SER) between two survey rounds and compared between the two groups.
RESULTS: After PSM, no significant difference in age, sex ratio, SER, and uncorrected visual acuity (VA) between the two groups was found at baseline. For myopic progression, r∆SER showed no significant difference between the two groups (- 0.67 ± 0.97 versus - 0.69 ± 0.81 diopter/year, P = 0.448). After adjusting for age, sex, SER, and VA, the difference in r∆SER between the two groups was not significant (- 0.031, 95% CI - 0.089 ~ 0.028 diopter/year, P = 0.302). In the subgroup analyses stratified by age and SER, and in the sensitivity analyses by eye side, there was still no significant difference in myopia progression between the two groups.
CONCLUSIONS: Our study indicates that single-vision spectacle use has no impact on myopia progression in children with low myopia. Spectacles are recommended in children with low myopia if their visual acuity has interfered with the daily life.

暂无摘要。

OBJECTIVE: To explore the long-term joint outcomes of low-dose prophylaxis in Chinese children with severe haemophilia A and to analyse their related factors.
METHODS: We retrospectively analysed follow-up data from 21 severe haemophilia A children on regular low-dose prophylaxis for 6-10 years. We used International Prophylaxis Study Group magnetic resonance imaging score (IPSG MRI score), Hemophilia Joint Health Score (HJHS), number of target joints, and Hemophilia-Specific Quality of Life Index (Haemo-QoL) to evaluate joint outcomes. Factors associated with these outcomes were evaluated by statistical analysis.
RESULTS: (1) The children were 1.75 to 17 years age at prophylaxis initiation. Median prophylactic factor VIII dose was 22.9 IU/kg per week. (2) At the end of follow-up: (a) The total IPSG MRI scores were 2-24 with 90.5% children exhibiting moderate to severe joint involvement (score 7-24); (b) The HJHS ranged 2-27, with 0-10 for 46.7% children and >10 for 53.3% children. There was a positive correlation between the MRI score and HJHS (p < .05); (c) Compared to their on-demand treatment period before prophylaxis, target joints numbers decreased, and no child needed auxiliary devices to walk; (d) Joint outcomes were positively correlated with the age at initiation of low-dose prophylaxis (p < .05) and negatively correlated with the treatment dose.
CONCLUSIONS: Long-term low-dose prophylaxis had positive effect on joint outcomes compared with on-demand treatment. However, a certain degree of joint damage remained in all children indicating the need for improving the current strategy of low-dose prophylaxis.

OBJECTIVE: To assess the intake of caffeine from snacks among children and adolescents aged 6-17 years in Beijing City.
METHODS: A multi-stage stratified cluster random sampling method was adopted to obtain the consumption status of caffeine-containing snacks among 881 school-age children and adolescents in Chaoyang, Changping and Yanqing Districts through a 3 d 24 h continuous questionnaire survey between October 2016 and February 2017, and the caffeine content in snacks was obtained through literature retrieval and laboratory detection.
RESULTS: The proportion of caffeinated snacks consumers among children and adolescents aged 6-17 years in Beijing was 42. 45%(374/881). The average daily caffeine intake of the whole population was 9. 19 mg, with a median of 0 and a P95 of 41. 38 mg. The average daily caffeine intake of consumers was 21. 66 mg, with a median of 11. 03 mg and 76. 99 mg of P95. About 1. 60%(6/374) of individuals exceeded the daily safe intake level and there were statistically significant differences in caffeine intake between different ages, genders, grades and groups with and without tea drinking habits after weight was taken into account. Among the top three contributors, 12. 13 mg of caffeine was derived from tea, milk tea and tea beverages(including solid drinks), with a contribution rate which reached 56. 01%, 4. 35 mg of caffeine was derived from coffee, with a contribution rate of 20. 09%, and 3. 31 mg of caffeine was derived from cola and energy drinks, with a contribution rate of 15. 30%, and there existed slightly difference of the top three contribution foods among 6-11 and 12-17 years old children and adolescents.
CONCLUSIONS: Children and adolescents aged 6-17 years in Beijing City had low caffeine intake levels from snacks and there was little risk of overconsumption. Tea, milk tea and tea beverages(including solid drinks) was the major contributor to its caffeine exposure.

Background: Patient satisfaction is a principal indicator in the evaluation of the stay of pediatric patients in hospitals, since its consequences can emotionally interfere with health treatment. The aim of this study was to obtain a valid scale to assess children\'s satisfaction with their time spent as a patient in an Andalusian hospital. Method: The Children\'s Satisfaction with Hospitalization Questionnaire (CSHQ) was applied to 623 pediatric patients hospitalized in Andalusia. An exploratory factor analysis (EFA) showed one dimension underlying the children\'s satisfaction with their hospitalization. After that, we developed a depuration analysis process to achieve a valid and unidimensional scale to assess children\'s satisfaction. Results: The eleven-item one-dimension solution showed suitable consistency and goodness-of-fit indices. The final scale addresses hosting aspects as the main dimension of a minor\'s satisfaction in Andalusian hospitals. Conclusion: A unidimensional scale has been determined for the assessment of children\'s satisfaction with their stay in Andalusian hospitals based on hosting aspects. Nonetheless, other dimensions underlying the satisfaction of patients should also be considered.

The rational for the study was the high prevalence of myopia in the world. According to the World Health Organization (WHO), myopia is one of the five leading causes of blindness and low vision. Of recent reports on conservative measures for the stabilization of myopia, two areas of investigation deserve attention: methods of optical correction that affect peripheral refraction, orthokeratology lenses (OKL) in particular, and pharmacotherapy. The aim of the study was to evaluate the effectiveness and safety of myopia control in pediatric patients by combining two methods - OKL wearing and instillation of extra low doses of atropine (0.01%).
METHODS: Within a prospective cohort study, 31 patients (62 eyes) aged 8 to 14 years with acquired myopia of low 14 (28), medium 11 (22), or high 6 (12) degree, were examined before and 6 months after adding 0.01% atropine instillations to OKL wearing. Refraction (Huvitz MRK 3100P), axial eye length (IOL-Master, \'CarlZeiss\', Germany), absolute accommodation (Grand Seiko WRK-5100K), accommodative reserves, and pseudoaccommodation were assessed.
RESULTS: The most significant effect on reducing the rate of disease progression was observed in patients with low and moderate myopia (1.5 and 1.7 times, correspondingly, p<0.05). In high myopia no reliable changes were noticed. Obviously, the inhibitory effect of OKL, which is conditioned by optical factors (peripheral myopic defocus in particular), even in combination with atropine, is not able to stop the progression of high myopia, which is based on structural and biomechanical changes of the sclera.
CONCLUSIONS: Judging from these preliminary results, one should not claim 100% effectiveness of prolonged minute-concentration atropine use, however, the positive effect exists and the study continues.
Обоснование исследования - распространенность миопии в мире. По данным ВОЗ, миопия - одна из пяти ведущих причин слепоты и слабовидения. Среди имеющихся сообщений об использовании консервативных методов лечения для стабилизации миопии в последние годы заслуживают внимание два направления: это применение оптических методов коррекции (в частности, ортокератологической коррекции) с воздействием на периферическую рефракцию и фармакологических средств. Цель исследования - оценка эффективности и безопасности контроля миопии у пациентов детского возраста при использовании сочетания двух методов - ортокератологической коррекции и инстилляций сверхмалых доз атропина (0,01%). Материал и методы. В проспективное когортное исследование включен 31 пациент (62 глаза) в возрасте от 8 до 14 лет с приобретенной миопией слабой 14 (28), средней 11 (22) и высокой 6 (12) степени. Пациентов обследовали до и через 6 мес после присоединения 0,01% раствора атропина к ношению ортокератологических линз (ОКЛ) при продолжающемся процессе прогрессирования миопии. Измеряли рефракцию (Huvitz MRK 3100P), переднезаднюю ось (IOL-Master, \'CarlZeiss\', Германия), объективный аккомодационный ответ (Grand Seiko WRK-5100K), запасы относительной аккомодации, псевдоаккомодацию. Результаты. Наиболее заметная эффективность снижения темпов прогрессирования наблюдалась при миопии слабой (в 1,5 раза, р<0,05) и средней (в 1,7 раза, р<0,05) степени, при высокой миопии достоверных изменений не отмечено. Очевидно, тормозящий эффект ОКЛ, обусловленный оптическими факторами (а именно - периферическим миопическим дефокусом), даже в сочетании с атропином не может остановить прогрессирование высокой миопии, в основе которого лежит нарушение структурных и биомеханических свойств склеральной капсулы. Заключение. На сегодняшний день предварительные результаты не позволяют говорить о 100% эффективности длительной атропинизации сверхмалыми концентрациями, тем не менее положительный результат наблюдался, исследование продолжается.