Hueng-Chuen Fan

Background: While attention deficit/hyperactivity disorder (ADHD) is characterized by neurodevelopmental heterogeneity, the influence of familial structural factors—particularly parental age and skipped-generation caregiving—on comorbidity patterns remains insufficiently studied. This study examined the associations between parent–child age gaps, skipped-generation family structures, and psychiatric comorbidities in children with ADHD. Methods: Data came from Taiwan’s NHIRD (2009–2013), including 79,163 ADHD cases and 395,815 matched controls. Key variables included maternal and paternal age at childbirth and grandparent-paid insurance premiums as a proxy for skipped-generation caregiving. Conditional logistic regression was used to estimate odds ratios (ORs) for 20 psychiatric and developmental comorbidities. Results: Children with ADHD exhibited significantly higher odds of various comorbidities, including oppositional defiant disorder (OR = 147.05, 95% CI = 101.0–214.1), somatoform disorder (OR = 25.78, 95% CI = 7.96–83.46), anxiety disorder (OR = 24.49, 95% CI = 17.9–33.5), emotional disturbances during childhood and adolescence (OR = 13.99, 95% CI = 9.15–21.4), and autism spectrum disorder (OR = 8.07, 95% CI = 6.63–9.82). Advanced maternal age (>35 years) was associated with increased odds of autism spectrum disorder (OR = 1.47, 95% CI: 1.29–1.67) and speech/language delay (OR = 1.33, 95% CI: 1.17–1.52), whereas younger maternal age (≤25 years) was linked to higher odds of anxiety disorder (OR = 1.23, 95% CI: 1.13–1.33) and adjustment reaction (OR = 1.41, 95% CI: 0.95–2.11). Maternal age under 20 years showed the highest odds for bipolar disorder (OR = 2.01, 95% CI: 1.04–3.88). For paternal age, older age (>35 years) was associated with increased odds of autism (OR = 1.14, 95% CI: 1.04–1.26) and speech/language delay (OR = 1.15, 95% CI: 1.04–1.27), whereas paternal age ≤20 years was strongly linked to bipolar disorder (OR = 3.58, 95% CI: 1.54–8.32) and anxiety (OR = 1.39, 95% CI: 1.01–1.93). Children from skipped-generation families—defined as grandparent-paid insurance premiums without parental cohabitation—had significantly higher odds of bipolar disorder (OR = 2.88, 95% CI: 1.36–6.11), personality disorder (OR = 9.23, 95% CI: 2.23–38.20), adjustment reaction (OR = 2.23, 95% CI: 1.39–3.59), and emotional disturbances during childhood/adolescence (OR = 1.69, 95% CI: 1.13–2.54). Conclusions: Both extremes of parental age and skipped-generation caregiving are linked to specific associations with certain psychiatric comorbidity patterns in children with ADHD. These findings highlight the importance of integrating family structure into diagnostic assessments and treatment planning and support the development of targeted early interventions.

Air pollution, particularly particulate matter (PM), poses a significant health risk worldwide, with rhinitis emerging as a prevalent respiratory condition. This review explores the association between air pollution and rhinitis, focusing on PM-induced inflammation and the potential preventive role of nutritional supplements. A comprehensive literature search was conducted using the PubMed and Scopus databases, covering studies from inception to 2024 that investigated air pollution, rhinitis, and nutritional interventions. This review synthesizes evidence linking PM exposure to increased prevalence and exacerbation of rhinitis through various inflammatory mechanisms. We further examine the potential of nutritional supplements, including kefir peptides, lactoferrin, vitamin D, polyunsaturated fatty acids, and probiotics, in mitigating PM-induced inflammation and rhinitis symptoms. However, the evidence regarding the role of these supplements in modulating immune responses and reducing inflammation related to PM-induced rhinitis is limited. This review highlights the potential efficacy of nutritional interventions in preventing and managing air pollution-associated rhinitis, offering a complementary approach to environmental regulations in addressing this public health challenge.

Epilepsy affects millions of people worldwide, necessitating effective and safe treatment options. Brivaracetam (BRV) and levetiracetam (LEV) are antiepileptic drugs that target the synaptic vesicle protein 2A (SV2A). Despite the similarities in their chemical structure, BRV and LEV exhibit distinct pharmacological profiles. This study provides a detailed comparative analysis of BRV and LEV, focusing on their mechanisms of action, preclinical profiles, and pharmacokinetic and pharmacodynamic properties. Clinical trial data highlight the efficacy and safety of both drugs, with BRV showing a higher affinity for SV2A and greater potency in certain seizure models. Additionally, emerging treatment strategies and future directions in epilepsy research are discussed, highlighting the potential for BRV and LEV in advancing epilepsy care.

Introduction: The present study investigated the relationship between air pollution, specifically PM_2.5 and PM₁₀, and childhood and adolescent obesity in northern and central Taiwan. Previous research has shown a positive correlation between air pollution and pediatric obesity, but no study has been conducted in Taiwan. We used data from the K-12 Education Administration, Ministry of Education, and the Taiwan Air Quality Monitoring Network to analyze the association between PM_2.5 and PM₁₀ exposures and obesity rates among elementary and junior high school students. Methods: Data on students’ height and weight were combined with air pollution data obtained from monitoring stations to assess exposure. A multivariable model estimated the relative risk and 95% confidence intervals of obesity linked to PM_2.5 and PM₁₀ exposures. Cities were categorized into quartiles (Q1–Q4) based on pollutant accumulation to compare the obesity rates. Results: Students living in areas with higher PM_2.5 and PM₁₀ exposures (Q4) had a significantly higher risk of obesity than those living in areas with lower exposures (Q1). The effect was more pronounced in girls and older students, with PM_2.5 exhibiting a stronger relationship than PM₁₀. Conclusions: PM_2.5 and PM₁₀ exposures are significantly associated with an increased obesity risk in children and adolescents, particularly in girls and older students. Further research is needed to explore the underlying mechanisms and to control for socioeconomic and demographic factors.

* Provides a clear summary of the case * Introduction: provides necessary background * Case Presentation: Thorough timeline of the patient’s clinical course. * Discussion: The discussion is comprehensive but lacks a clear structure. *...

Background: Echovirus 11 (EV-11) is a notable enterovirus linked to severe infections in neonates, often resulting in significant morbidity and mortality. In April 2019, an EV-11 outbreak occurred in the sick neonate room at a teaching hospital in Taichung, Taiwan, posing a serious threat to the vulnerable infants in this setting. Objectives: This study aimed to identify the source and transmission dynamics of the EV-11 outbreak in the neonatal unit and evaluate the effectiveness of the infection control measures implemented to contain the outbreak. Methods: Patient records, epidemiological data, and laboratory findings were reviewed. For all cases, confirmatory tests were performed using virus isolated from cerebrospinal fluid. Rapid quarantine measures were employed. The hospital’s nosocomial infection surveillance system was used to track confirmed cases and exposed individuals to facilitate effective management and monitoring; Results: Five neonates were confirmed to have EV-11 during the outbreak. Surveillance of 10 contacts and 11 newly admitted cases yielded negative results. All infected infants eventually recovered. The cohort comprised three males and two females, with a birth weight range of 2472–4224 grams. Their gestational ages range of 34 3/7 weeks to 39 weeks; including two premature and three full-term infants. Symptoms began between 6 and 27 days of life, with fever being the consistent clinical manifestation. Strict infection control measures, including isolation of infected cases, suspension of rooming-in, and rigorous disinfection protocols, successfully halted viral spread. The outbreak was contained within 39 days, with no additional cases reported post-intervention; Conclusions: The prompt and effective response, including robust infection control protocols, was crucial for managing and containing the EV-11 outbreak in the neonatal unit. These cases underscore the significance of immediate action, stringent infection control measures, and ongoing monitoring for addressing enterovirus outbreaks in neonatal care settings.

Adolescent patients frequently experience hematomas after injury, which usually resolve spontaneously in healthy individuals. Hematomas can present with a spectrum of clinical manifestations, from being asymptomatic to causing visible swelling. We describe the case of a 17-year-old female who developed an isolated pretibial hematoma on her left leg, which became infected with Streptococcus dysgalactiae. The large lesion was initially misdiagnosed as cellulitis. Close observation of her leg’s status and antibiotic response, prompt surgical intervention, and proper wound management likely contributed to her full recovery.

Children with attention-deficit hyperactivity disorder (ADHD) have difficulties in social interactions. Studying brain activity during social interactions is difficult with conventional artificial stimuli. This pioneering study examined the neural correlates of social perception in children with ADHD and matched controls using naturalistic stimuli. We presented 20 children with ADHD and 20 age-and-sex-matched controls with tailored movies featuring high- or low-level social interactions while recording electroencephalographic signals. Both groups exhibited synchronized gamma-band oscillations, but controls demonstrated greater inter-subject correlations. Additionally, the difference in inter-subject correlations between high- and low-interaction movies was significantly larger in controls compared to ADHD patients. Between 55 and 75 Hz comparing viewing high interaction movies with low interaction moves, controls had a significantly larger weighting in the right parietal lobe, while ADHD patients had a significantly smaller weighting in the left occipital lobe. These findings reveal distinct spatiotemporal neural signatures in social interaction processing among children with ADHD and controls using naturalistic stimuli. These neural markers offer potential for group differentiation and assessing intervention efficacy, advancing our understanding ADHD-related social interaction mechanisms.

Background: This study evaluated early childhood comorbidities of cerebral palsy (CP) in low birth weight (LBW) children and assessed the impact of maternal bio-psychosocial factors on CP risk in preterm infants of varying birth weights (BWs). Methods: Data from 15,181 preterm infants (2009–2013) and 151,810 controls were analyzed using Taiwan’s National Health Insurance Research Database. CP prevalence and LBW-associated comorbidities were examined, and odds ratios (ORs) were calculated. Results: This study confirmed increasing prematurity and LBW rates in Taiwan, with LBW infants showing higher CP prevalence. Significant maternal risk factors included age extremes (40 years). LBW infants exhibited higher risks for respiratory, circulatory, nervous system, and psycho-developmental comorbidities compared with controls, with the lowest BW having even higher ORs. Maternal factors such as family income, the number of hospital admissions, and length of hospital stay were remarkably correlated with BW and subsequent complications. Each additional gestational week crucially reduced the risk of complications in premature infants. Conclusions: LBW infants are at a higher risk for CP and various comorbidities, with maternal bio-psychosocial factors playing a critical role. Addressing these factors in prenatal care and interventions is essential to improve outcomes for premature infants.