Turk J Pediatr. 2026 Jun 30;68(3):549-550. doi: 10.24953/turkjpediatr.2026.8711.
NO ABSTRACT
PMID:42497443 | DOI:10.24953/turkjpediatr.2026.8711
Tag: pubmed
Turk J Pediatr. 2026 Jun 30;68(3):547-548. doi: 10.24953/turkjpediatr.2026.7960.
NO ABSTRACT
PMID:42497441 | DOI:10.24953/turkjpediatr.2026.7960
Turk J Pediatr. 2026 Jun 30;68(3):439-449. doi: 10.24953/turkjpediatr.2026.7593.
ABSTRACT
BACKGROUND: Respiratory colonization with Pseudomonas aeruginosa is associated with increased morbidity and mortality in cystic fibrosis (CF) patients. This study aims to assess the clinical characteristics and associated factors of CF infants under two years of age with P. aeruginosa colonization in Türkiye.
METHOD: Of the 1637 patients registered in the Cystic Fibrosis Registry of Türkiye in 2019, 284 patients under two years of age were included in this retrospective cross-sectional study. Patients were classified into two groups: those with P. aeruginosa colonization (Group 1) and those without (Group 2). Cystic fibrosis transmembrane conductance regulator (CFTR) gene functions were categorized according to CFTR mutation functional class.
RESULTS: Twenty-three patients (8.1%) were categorized as Group 1 and 262 participants (91.9%) were classified as Group 2. Infants with P. aeruginosa colonization (Group 1) were more likely to have minimal CFTR function compared with those without colonization (87% vs. 39.8%, p = 0.017). In addition, both Staphylococcus aureus colonization (47.8% vs. 7.3%, p < 0.001) and methicillin-resistant S. aureus positivity (17.4% vs. 6.1%, p = 0.042) were observed more commonly in Group 1. There were no statistical differences between the groups in terms of age at diagnosis, gender, mean z-scores of weight and height, newborn screening test positivity, sweat chloride test results, and pancreatic insufficiency (p > 0.05). Univariate logistic regression analysis did not identify significant associated factors for P. aeruginosa colonization.
CONCLUSIONS: Our findings suggest that minimal CFTR function and S. aureus colonization are associated with P. aeruginosa colonization in CF patients under two years of age. Further studies are needed to investigate associated factors for early P. aeruginosa colonization, eradication treatment effectiveness, and longitudinal outcomes of in CF patients under two years of age.
PMID:42497434 | DOI:10.24953/turkjpediatr.2026.7593
Turk J Pediatr. 2026 Jun 30;68(3):369-380. doi: 10.24953/turkjpediatr.2026.6619.
ABSTRACT
BACKGROUND: Functional gastrointestinal disorders (FGIDs) significantly impact infant well- being and healthcare utilization, yet comprehensive data using updated Rome IV criteria in Turkish populations remains limited. Our objective was to determine the prevalence and characteristics of FGIDs in Turkish infants and examine associations with feeding patterns, sleep quality, and maternal depression.
METHODS: A cross-sectional study was conducted in a tertiary hospital between February and August 2020. A total of 459 infants aged 1-12 months were enrolled. FGIDs were diagnosed according to Rome IV criteria. Feeding characteristics, sleep quality assessed by the Brief Infant Sleep Questionnaire, and maternal depression measured using the Edinburgh Postnatal Depression Scale were recorded through face-to-face interviews. Comparisons were primarily performed between infants with and without FGIDs. Multivariable logistic regression adjusted for infant age was used to evaluate the association between feeding type and FGIDs.
RESULTS: At least one FGID was identified in 53.2% of infants (n=244). Co-occurrence of multiple FGIDs was observed in 92 infants. Infants with FGIDs were significantly younger than those without FGIDs with a median age of 3 months (interquartile range [IQR]: 2-5) vs 6 months (IQR: 3-9) (p<0.001). Poor sleep was markedly more prevalent among infants with FGIDs compared to those without (45.1% vs 22.3%, p<0.001). Mothers of infants with FGIDs had higher depression scores than mothers of infants without FGIDs (median: 7.0 [IQR: 4-11] vs 5.0 [3-10], p=0.030). In multivariable logistic regression analysis adjusted for infant age, the overall feeding model was not statistically significant (p=0.240); however, mixed breast milk and formula feeding was associated with increased FGID risk compared to exclusive breastfeeding (adjusted odds ratio: 2.16, 95% confidence interval: 1.17-3.98, p=0.014).
CONCLUSIONS: FGIDs affect over half of Turkish infants and are associated with sleep disturbances and maternal depressive symptoms. Mixed breast-formula feeding independently increased FGID risk after age adjustment. Integrated care approaches addressing feeding practices, sleep quality, and maternal mental health are warranted.
PMID:42497431 | DOI:10.24953/turkjpediatr.2026.6619
Turk J Pediatr. 2026 Jun 30;68(3):471-484. doi: 10.24953/turkjpediatr.2026.7149.
ABSTRACT
BACKGROUND: In this study, we aimed to investigate peer bullying and its psychosocial consequences in children with celiac disease. We examined the relationship between adherence to diet and anxiety and depressive symptoms.
METHODS: The sample in this cross-sectional study consisted of 124 pediatric celiac patients on a gluten-free diet for one year or more. One hundred thirty-nine healthy children comparable in age and sex were enrolled as the control group. The Revised Olweus Bully Victim Questionnaire (OBVQ) was used to evaluate the peer victimization. The Revised Child Anxiety and Depression Scale and Strengths and Difficulties Questionnaire were used to assess children’s anxiety and depressive symptoms, and emotional and behavioral symptoms, respectively. Hierarchical logistic regression analysis was performed to identify independent predictors of dietary non-adherence.
RESULTS: The proportion of children classified as bullying victims based on the OBVQ was significantly higher in the celiac disease group than in the healthy controls. Children who did not comply with diet therapy experienced significantly higher rates of peer bullying than those who adhered to the diet (p=0.004). However, multivariate analysis indicated that depressive symptoms appeared to account for this relationship – while bullying initially predicted dietary non-adherence (odds ratio [OR]: 3.274, p=0.004), this effect became non-significant when depression was controlled (OR: 2.177, p=0.098), whereas depression remained a significant independent predictor (OR: 1.093, p=0.044). Significant positive correlations were observed between peer bullying and anxiety and depression symptom scores. Peer bullying also exhibited positive correlations with emotional and behavioral symptoms.
CONCLUSIONS: The study findings show that children with celiac disease experience higher rates of peer bullying than their healthy peers. More importantly, our results suggest that the association between bullying and dietary adherence may be largely explained by co-occurring depressive symptoms. We therefore recommend that depressive symptom screening and treatment should be integrated into the management of celiac disease in children, particularly for those experiencing peer victimization.
PMID:42497424 | DOI:10.24953/turkjpediatr.2026.7149
JMIR Med Inform. 2026 Jul 24;14:e79808. doi: 10.2196/79808.
ABSTRACT
BACKGROUND: The accurate documentation of medical treatments for combat-injured personnel has historically posed significant challenges for prehospital medical teams. During recent US Army conflicts in Afghanistan and Iraq, only 18%-25% of casualties had any form of prehospital documentation. In the Israel Defense Forces (IDF), traditional manual and paper-based documentation has proven inefficient. During the 2014 Israel-Hamas conflict in Gaza, the completion rate for full documentation was notably low; only 11% (82/704) of casualties had casualty cards from the field. The sudden outbreak of the 2023-2024 Israel-Hamas war required an immediate re-evaluation of battlefield medical documentation practices. The IDF identified an urgent need for an innovative documentation approach to address the challenges of managing and tracking casualties in high-pressure scenarios. The integration of this system underscores the importance of real-time, robust documentation in improving continuity of care, minimizing medical error, and enhancing operational efficiency.
OBJECTIVE: This study outlines the rapid development and deployment of the Digital Casualty Card System (DCCS), designed to enhance the accuracy and efficiency of field documentation by medical teams during the 2023-2024 Israel-Hamas war.
METHODS: The DCCS was designed to streamline real-time medical data capture, enhance information transfer along the evacuation chain, and improve battlefield casualty care. A strategic decision was made to prioritize rapid deployment by focusing on a user-friendly, digital application, deliberately excluding advanced features such as sensor integration and real-time data transfer between echelons. This system became operational within 2 weeks of the project’s initiation and comprises military-grade tablets embedded with a dedicated software application for documenting casualty status and plastic memory cards worn around the casualty’s neck for data transfer between medical teams. This study uses patient data from the IDF Trauma Registry, relying on data from point of injury casualty cards (DCCS), after-action reports, and data entry by on scene and en route providers.
IMPLEMENTATION (RESULTS): Overall, since the beginning of the distribution, over 700 DCCS kits were embedded in combat units, medical evacuation units, and training units. During the ground operation in Gaza, out of 2984 casualties, 1175 (39%) arrived with DCCS documentation.
CONCLUSIONS: The rapid development and deployment of DCCS during the ongoing war proved to be feasible and contributed to the substantial improvements in both documentation rates and the quality of data collected in the field compared to traditional paper-based casualty cards.
PMID:42497409 | DOI:10.2196/79808
JMIR AI. 2026 Jul 24;5:e82647. doi: 10.2196/82647.
ABSTRACT
BACKGROUND: Relaxation techniques, such as the “safe place” imagery exercise, are simple and accessible strategies to cope with the negative effects of stress. While virtual reality (VR) has been applied in relaxation research, it is still unclear whether it enhances the relaxing effect of such exercises or is merely an alternative and similarly effective form of delivery.
OBJECTIVE: This study aimed to evaluate whether the use of VR enhances the relaxing effect of the safe place imagery exercise by generating an individualized virtual environment representing each participant’s personal safe place with AI. Additionally, the roles of imagery vividness, presence, and satisfaction with the AI-generated safe place were examined.
METHODS: This randomized controlled trial involved a single laboratory session with 4 measurement points followed by a 5-day online follow-up period involving daily self-report questionnaires. A total of 60 adults were randomly assigned to the experimental condition or the control condition. In the experimental condition, participants engaged in the safe place imagery exercise in which they imagined a place where they feel completely safe and comfortable, followed by a stress induction task. Then, participants completed a 3-minute relaxation period within an AI-generated virtual environment representing their personal safe place, which was created based on their individual descriptions. In the control condition, the same procedures were implemented; however, in the 3-minute relaxation period, participants imagined their safe place with their eyes closed. The primary outcome was self-reported relaxation, assessed with the Relaxation State Questionnaire. Secondary outcomes included imagery vividness (assessed with the Vividness of Visual Imagery Questionnaire), presence (assessed with the Igroup Presence Questionnaire), satisfaction with the AI-generated safe place, and use of the safe place in everyday life.
RESULTS: The 3-minute relaxation period of both conditions enhanced self-reported relaxation levels with no statistically significant differences between conditions, indicating that relaxation in VR did not outperform traditional mental imagery. Relaxation levels during the 5-day online follow-up period likewise did not differ significantly between conditions, and there were no significant differences in the frequency with which participants used their safe place during the follow-up period. Imagery vividness was positively associated with postintervention relaxation in both conditions, whereas satisfaction with the AI-generated safe place and presence in the virtual environment did not predict outcomes.
CONCLUSIONS: While relaxation in the AI-generated safe place in VR was effective in promoting relaxation, it did not demonstrate a benefit compared to traditional mental imagery, either immediately after the intervention or during the follow-up period. These findings suggest that VR may represent an effective alternative form of delivery, but not a superior enhancement, for brief relaxation interventions. Future developments might increase the potential of AI and VR as effective tool for promoting relaxation.
TRIAL REGISTRATION: Open Science Framework 10.17605/OSF.IO/BP53A; https://osf.io/bp53a/overview.
PMID:42497407 | DOI:10.2196/82647
JMIR Public Health Surveill. 2026 Jul 24;12:e82079. doi: 10.2196/82079.
ABSTRACT
BACKGROUND: Injuries are a major cause of death and disability, but cities often lack surveillance systems that can monitor injury burden across mechanisms, severity levels, and population groups. In Spain, no comprehensive city-level injury surveillance system routinely captures the full spectrum of injuries. The Barcelona Injury Surveillance System (BISS) was developed to address this gap by integrating routine health and police data.
OBJECTIVE: This study aims to describe the BISS, including its scope, data sources, and public health rationale, and illustrate its utility through the analysis of recent injury data in Barcelona.
METHODS: We conducted a descriptive study using routinely collected emergency department, hospital discharge, mortality, and police data integrated into the BISS. We analyzed nonfatal injuries in 2024, fatal injuries in 2023, and trends from 2018 onward. Injury indicators were examined by sex, age, mechanism, type, and severity. Crude and age-adjusted rates per 100,000 residents were calculated.
RESULTS: In 2024, BISS recorded 123,420 emergency department injury episodes and 18,749 injury-related hospitalizations; among residents, these figures were 99,379 and 14,319, respectively. In 2023, 695 injury-related deaths were recorded among residents. Nonfatal injuries were slightly more frequent in females, especially at older ages, whereas injury-related mortality was higher in males. Falls were the leading specified mechanism and were concentrated among older females, particularly those aged ≥75 years. Self-harm hospitalization rates were highest among females aged 15 years to 24 years, whereas self-harm mortality was higher in males. Road traffic injury and overall mortality rates were also higher in males. From 2018 to 2024, most nonfatal injury indicators increased after the decline observed in 2020, while road traffic injuries declined overall.
CONCLUSIONS: BISS demonstrates the value of integrating routine health and police data to generate actionable urban injury intelligence. The findings highlight priorities for prevention, particularly falls in older females, self-harm in young females, and the persistently higher fatal injury burden among males. Integrated city-level surveillance systems such as BISS can support monitoring, equity-oriented prevention, and data-informed public health policy.
PMID:42497404 | DOI:10.2196/82079
JMIR Med Inform. 2026 Jul 24;14:e86145. doi: 10.2196/86145.
ABSTRACT
BACKGROUND: Accurate assessment of pulpal status is essential for achieving successful endodontic outcomes. However, direct evaluation remains inherently challenging because the pulp is surrounded by calcified tissue, necessitating reliance on clinical and radiographic examinations for diagnostic and prognostic decision-making. These procedures demand substantial clinical expertise and time, and less-experienced clinicians often face challenges that may lead to errors in diagnosis and treatment planning. Recent advancements in large language models (LLMs) offer promising opportunities to enhance clinical reasoning by facilitating the integration of evidence and supporting methodical diagnostic decision-making.
OBJECTIVE: This study aimed to evaluate the clinical applicability of LLMs by comparing their text-based clinical screening performance and the clinical validity of their treatment plan responses with those of human evaluators.
METHODS: Between January 2011 and December 2022, 100 clinical cases involving primary endodontic disease were randomly selected from the clinical records of outpatients who visited the Department of Conservative Dentistry or Advanced General Dentistry (AGD) at Yonsei University Dental Hospital. Four prompt types, combining 2 variables (language and role), were used as input for 4 LLMs. Both LLMs and human evaluators (AGD specialists, AGD residents, endodontic residents, and senior dental students) assessed the cases using text-based clinical records. Radiographic images were not directly provided. Screening performance was evaluated using a 0-to-2-point concordance scale, and treatment plan validity and relevance were assessed using a 5-point Likert scale.
RESULTS: Among the 4 LLMs evaluated, ChatGPT achieved the highest mean concordance score on Korean-doctor prompts (mean 0.98, SD 0.82). However, this score did not reach the partially correct criterion of 1 on the 0 to 2-point scale. Clova X recorded the lowest mean score on English-patient prompts (mean 0.23, SD 0.63). Across both diagnostic categories, AGD specialists demonstrated the highest diagnostic accuracy (pulpal: 0.70; periapical: 0.65), with higher sensitivity but lower specificity than those exhibited by the other groups. ChatGPT also showed favorable performance among the LLMs, with accuracies of 0.65 (95% CI 0.55-0.74) for pulpal disease and 0.57 (95% CI 0.47-0.69) for periapical disease, which were comparable to those of AGD and endodontic residents.
CONCLUSIONS: Under image-free clinical record review conditions, ChatGPT 4.0 showed relatively higher and more consistent performance in symptom screening and treatment planning compared to the other LLMs evaluated. However, its highest mean score of 0.98 (SD 0.82) did not reach the partially correct criterion of 1 on the 0 to 2-point scale. Hallucinations generated by LLMs and experience-dependent interpretation biases among human evaluators remain key challenges that require attention. Therefore, continuous clinical supervision and comprehensive user training are necessary for the safe and effective clinical application.
PMID:42497401 | DOI:10.2196/86145
Nutr Rev. 2026 Jul 24:nuag105. doi: 10.1093/nutrit/nuag105. Online ahead of print.
ABSTRACT
CONTEXT: Omega-3 polyunsaturated fatty acids (PUFAs) have demonstrated metabolic benefits in several populations; however, their efficacy in type 1 diabetes mellitus (T1D) is not well established.
OBJECTIVE: The aim of this systematic review and meta-analysis was to assess the efficacy of omega-3 PUFAs supplementation on the lipid and glycemic profile in T1D.
DATA SOURCES: A systematic search was conducted in Medline, Scopus, Web of Science, and the Cochrane Library, from inception to June 2026.
DATA EXTRACTION: Studies evaluating the effect of omega-3 PUFA supplementation on total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDL-C and HDL-C), triglycerides, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) were included. Random-effects meta-analyses of randomized clinical trials (RCTs) and of the pre-post effect of a single intervention arm were performed separately. Heterogeneity was assessed using the I2 statistic.
DATA ANALYSIS: Eighteen studies were included. In the RCTs, omega-3 PUFA supplementation increased HDL-C by 4.47 mg/dL (95% CI, 0.07 to 8.86) with an I2 of 64.87%, and decreased triglycerides by 9.49 mg/dL (95% CI, 16.60 to -2.38) with an I2 of 29.83%. There was no effect on the other outcomes, including TC, LDL-C, FPG, and HbA1c. Finally, the effect on the meta-analyses of pre-post studies was similar to that found in the RCTs.
CONCLUSIONS: Although omega-3 supplementation has been associated with modest improvements in lipid levels in people with T1D, the results are statistically fragile. No glycemic benefits were observed. Future RCTs focusing on hard cardiovascular outcomes and standardized protocols are necessary to determine the clinical efficacy of omega-3 supplementation beyond surrogate metabolic markers.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. [CRD420261297164].
PMID:42497400 | DOI:10.1093/nutrit/nuag105