Association Between Adverse Childhood Experiences and Academic Performance Among Children and Adolescents: A Global Meta-Analysis.

This study was conducted to quantify the association of adverse childhood experiences (ACEs) and the academic performance of children and adolescents. The literature was systematically searched in six electronic databases, and a meta-analysis was conducted. Twenty studies with a total of 1,196,631 children and adolescents from five countries were included. Meta-analysis showed that ACE score was positively associated with poor academic achievement, grade repetition, and special education support. Compared with children and adolescents without any ACE, those with one or more ACE had a significantly higher risk of poor academic achievement (pooled odds ratio [OR]: 1.45, 95% confidence interval [CI] [1.13, 1.85], I2 = 82.6%) and grade repetition (pooled OR: 1.36, 95% CI [1.29, 1.43], I2 = 71.0%). Moreover, all types of ACEs were positively associated with poor academic achievement and grade repetition. In addition, there was a significant dose-response relationship between the ACE score and the risk of poor academic achievement. This study supported that ACE had a significant impact on the academic performance of children and adolescents. Based on these findings, we recommend that early screening of ACEs for children and adolescent is critical and appropriate support and prevention in education should be developed for those with ACEs. Further studies are needed to further explore the long-term effect of ACEs on education and its gender differences.

Caesarean section and offspring's emotional development: Sex differences and the role of key neurotransmitters.

Increasing caesarean section (CS) rates are of global concern not only for health care providers but also from a more general public health point of view. Growing concern on the association between CS and offspring's neurodevelopmental outcomes have been raised in recent years, but the effect of CS on offspring's emotional development is rarely reported. By using mice models, we have set up two groups, ie. offspring born via CS and in-fostered by dams with vaginal delivery (VD), and offspring born via VD and in-fostered by their non-biological mothers. Depression-like behavioral was evaluated by sucrose preference test and forced swimming test, and anxiety-like behavioral was evaluated by open-field test and elevated plus maze test, respectively during offspring's adolescence and adulthood. Offspring's prefrontal cortex was collected for HE staining and assessment for DA, HVA, 5-HT, 5-HIAA. It was found that offspring born of CS have anxiety-like and depression-like behaviors in adolescence and adulthood. Male offspring was sensitive to be depressive and female offspring tended to be anxious. Although no significant sex difference was observed, there existed edema and nuclear retraction of neurons in the prefrontal cortex in offspring via CS during adolescence and adulthood. Compared with offspring born via VD, offspring through CS had shown higher DA and HVA levels while lower 5-HT and 5-HIAA levels in adolescence and adulthood, and this difference was observed in female offspring. The findings highlight the sex-specific effect of CS on offspring's emotional development. Variations in key neurotransmitters in the prefrontal cortex may partly explain the association between CS and offspring's emotional symptoms.

Suicide ideation, suicide plan, and suicide attempt among left-behind children and adolescents: A systematic review and meta-analysis.

OBJECTIVE: There are an increasing number of studies that discussed suicide ideation (SI), suicide plan (SP), and suicide attempt (SA) among left-behind children (LBC). However, the prevalence of these indicators of LBC has not been synthesized and the true correlation between these indicators and left-behind status remains unclear. METHODS: Electronic databases were comprehensively searched, and eligible observational studies were selected to extract useful data. We pooled the rates and their 95% confidence intervals (95% CIs) to determine the prevalence of SI, SP, and SA among LBC. The odds ratios (ORs) and 95% CIs were calculated to reflect the association between left-behind status and risk of SI, SP, and SA. RESULTS: Among LBC, the pooled prevalence was 18.7% (95% CI: 15.4-21.9) for SI, 6.4% (95% CI: 4.7-8.1) for SP, and 3.1% (95% CI: 2.6-3.6) for SA. Compared to non-LBC, LBC was at higher risk of SI (OR = 1.26), SP (OR = 1.20), and SA (OR = 1.14), but only the effect for SI achieved statistical significance. CONCLUSION: Overall, the prevalence of SI, SP, and SA is common among LBC, and parental migration has a significant impact on the SI of LBC. Intervention plans and programs are urgently needed to prevent suicidality of this vulnerable group.

Is antibiotics use really associated with increased risk of colorectal cancer? An updated systematic review and meta-analysis of observational studies.

PURPOSE: The association between antibiotics and colorectal cancer (CRC) risk has drawn increasing attention but remains controversial. This study was performed to clarify the association. METHODS: A systematic review and meta-analysis was performed on seven electronic databases. The pooled odds ratios (OR) with a 95% confidence interval (CI) were calculated to estimate the association using the fixed-effects model or the random-effects model. RESULTS: Ten studies that contained 4,853,289 participants were included in our study. We found that antibiotics use was associated with a higher risk of CRC (OR 1.09, 95%CI 1.02-1.17, I2 = 92.8%). More than 60 days of antibiotics use and 5 prescriptions of antibiotics were significantly associated with a higher risk of CRC. Sub-analysis on different types of antibiotics found that anti-anaerobic antibiotics, penicillins, and quinolones use led to increased risk of CRC (OR 1.22, 95% CI 1.04-1.44, I2 = 89.1%; OR 1.09, 95% CI 1.04-1.13, I2 = 69.2%; OR 1.15, 95% CI 1.03-1.35, I2 = 88.2%; respectively) and colon cancer (OR 1.28, 95% CI 1.04-1.58, I2 = 98.5%; OR 1.09, 95% CI 1.05-1.12, I2 = 0; OR 1.09, 95% CI 1.04-1.15, I2 = 0; respectively). However, antibiotics use was not significantly associated with rectal cancer (OR 1.03, 95% CI 0.92-1.16, I2 = 77.6%). CONCLUSION: It needs attention that antibiotics use is associated with a higher risk of CRC, especially for colon cancer. Clinicians should be aware of the potential risk of CRC when prescribing anti-anaerobic antibiotics, penicillins, and quinolones in the future. Further studies are needed to assess any potential differences by tumor sites and class of antibiotics.

Effect of vitamin D supplementation on blood pressure parameters in patients with vitamin D deficiency: a systematic review and meta-analysis.

Evidence suggests that supplementation of vitamin D cannot decrease blood pressure in normal populations. However, in randomized controlled trials (RCTs) with vitamin D deficient participants (defined as baseline serum 25[OH]D levels <30 ng/mL or 50 nmol/L), this effect is inconsistent and under debate. Thus, we performed this systematic review and meta-analysis to evaluate whether vitamin D supplementation could affect blood pressure parameters in vitamin D-deficient subjects. The PubMed, Web of Science, ScienceDirect, and Cochrane library databases were searched. Extracted data were pooled as weighted mean differences with 95% confidence intervals to evaluate the effects. Subgroup analysis was further conducted according to the characteristics of included studies. Seven RCTs that contained 560 participants were included in our meta-analysis. The pooled weighted mean difference of peripheral diastolic blood pressure was -1.65 mm Hg (95% confidence interval: -3.05 to -0.25, I2 = 30.3%). No significant effect of vitamin D supplementation was found on other parameters. Subgroup analysis showed a significant decrease in peripheral systolic blood pressure and diastolic blood pressure in Asia, 8 weeks of intervention, and more than 5000 IU of daily vitamin D supplementation subgroups. For vitamin D-deficient patients, there is a small but significant fall in peripheral blood pressure but no significant fall in other blood pressure parameters with vitamin D supplementation. Further RCTs with large numbers of participants is still warranted to confirm these effects.