The limited predictive effect of genotype on familial Mediterranean fever (FMF) phenotype suggests that epigenetic factors and alternative mechanisms that may cause IL-1β release could contribute to phenotypic heterogeneity. The objective of this study was to examine the role of IL-1β levels and miR-21-5p, cathepsin B and pyrin levels, which were identified as potential factors causing IL-1β release through the use of bioinformatics tools, in the pathogenesis of FMF and their relationship with disease severity.

Street-connected young people (SCYP) in Tanzania face intersecting challenges, including economic vulnerability, social marginalisation and limited access to supportive networks. This study examines the impact of the Youth Association (YA) model, implemented by Railway Children Africa, and does so through the lens of the relational well-being approach, which emphasises the interplay of material, relational and subjective dimensions of well-being, as well as personal, societal and environmental drivers of well-being. Using a mixed methods design, this study tracked 116 SCYP in Mwanza and Dar es Salaam, Tanzania, through four stages of the YA model. Quantitative data revealed gains: 71% transitioned into stable housing, 84% reported increased pride and self-worth and 58% initiated income-generating projects. Qualitative insights provided deeper context, capturing participants' reflections on how peer networks and leadership opportunities, and vocational training fostered self-confidence, economic independence and community integration. Participants' recommendations included expanding educational opportunities, enhancing health services and addressing logistical barriers to increase the model's accessibility and impact. This study demonstrates the transformative potential of relationally driven interventions for vulnerable young people. By leveraging existing networks and prioritising relational support, the YA model offers an effective pathway for SCYP to transition from precarity to stability. The findings underscore the importance of participatory approaches and call for further research into the invisible networks of care supporting SCYP, ensuring that future interventions are responsive to their lived experiences and evolving needs.

Early child development sets the course for optimal outcomes across life. Increasing numbers of children worldwide are exposed to opioids in pregnancy and frequently live in environments associated with adverse developmental outcomes. Although multiple systematic reviews have been published in this area, they use different exposures and different types of outcomes. This umbrella review aims to bring together these systematic reviews to provide a comprehensive overview of the evidence around the association between prenatal opioid exposure and preschool developmental outcomes.

Human milk, especially the mother's own milk (MOM), is highly recommended for preterm babies considering its numerous benefits. Prioritising the use of exclusive MOM in enteral feeding plans is essential for maximising the health and development of preterm babies. This study evaluated the effect of early establishment of full enteral feed (FEF) with exclusive MOM on feeding rate and neonatal nutritional outcomes at discharge among preterm babies.

Neurodevelopmental disability is a common long-term concern following surgery for congenital heart disease (CHD). Little information is available from low-resource environments where the majority of children with CHD are born. Several challenges in the CHD care continuum exist in such environments.

The current study aims to give an overview of transition-to-home services provided by perinatal centres in Austria and Switzerland and to evaluate parental satisfaction with the care provided.

Urban health challenges, particularly for street and slum-dwelling children and families, have emerged as one of the most significant health concerns in India. While there is little published on effective healthcare delivery to these populations, mobile health vans (MHV) have been proposed as a proactive pathway to providing outreach healthcare. Our aims were to evaluate the impact of Bal Umang Drishya Sanstha (BUDS) MHV in providing health and support services to the urban slum populations in Delhi National Capital Region (NCR), focusing on benefits to children.

Ambulatory care sensitive conditions (ACSCs) are those for which hospital admission could be prevented by interventions in primary care. Children living in socioeconomic disadvantage have higher rates of emergency admissions for ACSCs than their more affluent counterparts. Emergency admissions for ACSCs have been increasing, but few studies have assessed how changing socioeconomic conditions (SECs) have impacted this. This study investigates the association between local SECs and emergency ACS hospital admissions in children in England.

Studies have shown a high rate of mortality among adults despite the introduction of highly active antiretroviral therapy (HAART). However, long-term outcomes of HAART among children remain poorly documented in Ethiopia. This study aimed to estimate the survival rate and identify associated factors among HIV-infected children on antiretroviral therapy.

To explore whether parents' attendance at a commercial adult weight management programme (WMP) offers an opportunity to identify and signpost families to child weight management support, if appropriate to a child's weight status.

In Europe, disparities exist in having access to optimal neonatal care. With the European Standards of Care for Newborn Health (ESCNH), evidence-based reference standards are available which provide guidance to improve the care for preterm and ill newborns. To support healthcare professionals (HCPs) and hospital/clinic management in identifying the extent of ESCNH implementation, a feasible assessment tool is required. Such a tool should help identify areas in need of improvement and provide clear recommendations for action. We aim to develop a digital self-assessment tool for HCPs to detect the local level of ESCNH fulfilment and identify areas in need of improvement, and thus provide recommendations for action.

Greenhouse gas (GHG) emissions are creating unprecedented climate-driven extreme weather, with levels of heat and humidity surpassing human physiological tolerance for heat stress. These conditions create a risk of mass casualties, with some populations particularly vulnerable due to physiological, behavioural and socioeconomic conditions (eg, lack of adequate shelter, limited healthcare infrastructure, sparse air conditioning access and electrical grid vulnerabilities). Children, especially young children, are uniquely vulnerable to extreme heat-related morbidity and mortality due to factors including low body mass, high metabolism, suboptimal thermoregulatory mechanisms and behavioural vulnerabilities. Children are also uniquely vulnerable to non-fatal heat-related morbidities, including malnutrition due to agricultural disruptions and cardiometabolic, respiratory and mental illnesses from heat exposure and/or confinement during heat avoidance. Climate mitigation through GHG reductions is central to reducing harms to children and preventing the loss of a generation to climate change. In regions most predisposed to extreme heat-driven mass casualties under various GHG emission scenarios-particularly South Asian and Southwest Asian and North African regions-adaptation tools specific to children's needs are the most urgently needed. Existing public health interventions (eg, cooling infrastructure and preventative educational campaigns) to reduce acute heat mortality, and medical infrastructure capacity to treat heat-related illnesses are currently inadequate to meet children's growing heat resiliency needs. Paediatricians and other clinical and community child healthcare providers in these regions lack education about children's heat risks and adaptation tools. Paediatricians and other child healthcare providers have a crucial role in research, education, clinical practice and advocacy to protect children during extreme heat events. Paediatricians, other child healthcare providers and stakeholders of children's well-being are urged to act on young children's behalf and to elevate youth leadership in GHG mitigation and extreme heat adaptation policy-making.

Pregestational diabetes mellitus (PGDM) occurs when a woman becomes pregnant after having diabetes mellitus. The presence of diabetes during the entire pregnancy can have an adverse impact on fetal and neonatal outcomes. The objective of this study is to examine the association between PGDM and neonatal outcomes at birth.

Febrile infants often have self-limiting conditions. Differentiating them from infants with serious bacterial infections can be challenging. We aimed to understand how febrile infants are managed across London, by analysing the management steps from local clinical practical guidelines (CPGs) and comparing them to the national guideline 143 (NG143). The ten hospitals using local CPGs recommended doing blood tests for febrile infants and often had more cautious advice about performing lumbar punctures and starting antibiotics. All CPGs scored lower on quality, as per AGREE-II tool, when compared with NG143. CPGs giving more cautious advice, exposes more infants to invasive investigations and treatments.

Antibiotic use for early-onset neonatal sepsis (EONS) is common, but prolonged exposure can lead to poor outcomes. Laboratory capacity and infection prevention initiatives may impact antibiotic use for EONS in neonatal intensive care units. The objective of this study was to examine the influence of institutional capacity on antibiotic prescribing for EONS in India.

Criticism of mainstream approaches to child labour is widespread and well-established. The Child Labour Action Research in South and Southeast Asia (CLARISSA) Cash Plus pilot sought to address these critiques through an innovative programme that prioritised the development of household resilience and well-being, and through increasing household capacity to make alternative choices around children's work.

SARS-CoV-2 infection during pregnancy can adversely affect maternal and neonatal health, although risks vary depending on the variant of concern (VOC). Omicron, although highly infectious, causes fewer maternal and neonatal complications than earlier VOC, so vaccination may be considered unnecessary in planned pregnancy. Using data from the CRONOS registry, we compared pregnancy outcomes according to VOC and vaccination status. We found that vaccination during pregnancy reduced preterm birth rates compared with unvaccinated or vaccinated women with Omicron infection, without increasing severe neonatal outcomes. Given the risks associated with preterm birth, the study consistently supports vaccination recommendations for women planning pregnancy.

Diarrhoea remains a leading cause of death in children. An intestinal adsorbent may reduce diarrhoea duration and severity.