Birth order, sibship size, and risk of atopic dermatitis, food allergy, and atopy: A systematic review and meta-analysis

Anxiety and depression in only children versus children with siblings: A cross-sectional study among Chinese medical students

OBJECTIVES

This study aimed to explore the characteristics, overall anxiety and depression status, and influencing factors of only-child and non-only-child students by examining a medical student population in the post-COVID-19 era.

STUDY DESIGN

This study was a cross-sectional design.

METHODS

An online questionnaire survey was administered among medical students. The psychological problems related to depression and anxiety were measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively, which were scored via a Likert-4 scale. Statistical analysis was employed to explore the characteristics and overall differences between only-child and non-only-child students, along with the factors affecting their anxiety and depression.

RESULTS

A total of 1688 participants were enrolled. No significant differences were observed in the prevalence of anxiety (χ2 = 1.154, P = 0.283) and depression (χ2 = 0.313, P = 0.576) between only-child and non-only-child students. School level, single status, and desire for only child status are associated with anxiety and depression in the two groups. Region and loneliness are merely related to anxiety and depression among only-child students, while gender, willingness to apply for medical school, and equal treatment are associated with anxiety and depression among non-only-child students.

CONCLUSION

Our study found the factors that are associated with depression or anxiety inthe only-child and non-only-child medical students jointly and separately, which could provide a new theoretical basis for the psychological intervention of medical students, that is, to identify the high risk factors of depression and anxiety from the perspective of only child and non-only child.

Birth order, daycare attendance, and childhood socioeconomic status in relation to gingivitis: a cross-sectional study in Turkish young adults

AIM

Birth order, sibship size, breastfeeding, daycare attendance, and delivery method are known to influence the development of gut microbiota and the immune system, affecting the risk of many infectious diseases. This study aims to explore the impact of these factors, along with socioeconomic background and familial factors, on gingivitis and oral hygiene practices in early adulthood among the Turkish population.

MATERIALS AND METHODS

Patients were diagnosed using periodontal clinical and radiographic assessments, adhering to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The study included 18-year-old individuals diagnosed with either generalized gingivitis or clinical gingival health. Data collected included sociodemographic factors, birth order, sibship size, delivery methods, breastfeeding duration, daycare attendance, and oral hygiene behaviors. Binary logistic regression was employed to analyze the associations between these factors and the presence of generalized gingivitis.

RESULTS

A total of 178 individuals were evaluated, including 124 with generalized gingivitis and 54 with clinical gingival health. Daycare attendance was significantly associated with gingival health. Among those with gingival health, 55.6% had attended daycare, whereas only 29% of participants with generalized gingivitis had attended daycare. Conversely, 71% of those with generalized gingivitis did not attend daycare, compared to 44.4% in the gingival health group (p = 0.001). Univariate logistic regression identified a significant association between daycare attendance and a reduced risk of generalized gingivitis (Odds Ratio [OR] = 0.327, p = 0.001). Later birth order was associated with a reduced risk of gingivitis (OR = 0.470, p = 0.037). Sibship size, delivery methods, and breastfeeding duration showed no clear associations with gingivitis (p > 0.05).

CONCLUSIONS

The findings indicate a potential association between oral health status in adulthood and early childhood exposures, such as daycare attendance and birth order. Further research is necessary to confirm these associations and elucidate the mechanisms involved, even though these factors may contribute to gingival health in early adulthood. These insights may enhance our understanding of how early-life exposures relate to oral health outcomes and suggest that considering such factors could be beneficial in future oral health management strategies.

TRIAL REGISTRATION

Trial registration is also available at clinicaltrail.gov. Clinical Trials-ID: NCT06240247. Registration Date: 22.01.2024.

The clinical, mechanistic, and social impacts of air pollution on atopic dermatitis

Atopic dermatitis (AD) is a complex disease characterized by dry, pruritic skin and significant atopic and psychological sequelae. Although AD has always been viewed as multifactorial, early research was dominated by overlapping genetic determinist views of either innate barrier defects leading to inflammation or innate inflammation eroding skin barrier function. Since 1970, however, the incidence of AD in the United States has increased at a pace that far exceeds genetic drift, thus suggesting a modern, environmental etiology. Another implicated factor is Staphylococcus aureus; however, a highly contagious microorganism is unlikely to be the primary etiology of a noncommunicable disease. Recently, the roles of the skin and gut microbiomes have received greater attention as potentially targetable drivers of AD. Here too, however, dysbiosis on a population scale would require induction by an environmental factor. In this review, we describe the evidence supporting the environmental hypothesis of AD etiology and detail the molecular mechanisms of each of the AD-relevant toxins. We also outline how a pollution-focused paradigm demands earnest engagement with environmental injustice if the field is to meaningfully address racial and geographic disparities. Identifying specific toxins and their mechanisms can also inform in-home and national mitigation strategies.

Atopic dermatitis and cognitive function: a sibling comparison study among males in Sweden

A previous study indicated that atopic dermatitis (AD) was associated with better cognitive function in males during late adolescence. This association was examined among 2 021 369 males who had a medical examination and cognitive function testing during a military conscription assessment in late adolescence in Sweden. Sibling-comparison analysis to tackle confounding indicated that AD is associated with poorer cognitive function, suggesting AD in childhood is detrimental for the development of cognitive function.