Dietary interventions for functional abdominal pain disorders in children: a systematic review and meta-analysis

Background Functional abdominal pain disorders (FAPDs) are common among children and are associated with decreased quality of life and school attendance. Several dietary interventions have been suggested to improve symptoms of FAPDs. This systematic review assessed the efficacy and safety of dietary interventions for pediatric FAPDs. Design and methods Electronic databases were searched (inception–October 2021). Systematic reviews or RCTs were included if children (4–18 years) with FAPDs were treated with dietary interventions and compared to placebo, no diet or any other diet. Data extraction and assessment of quality of evidence based on GRADE system was independently performed by two review authors. Outcomes were treatment success, pain intensity and frequency, and withdrawal due to adverse events. Results Twelve articles were included, representing data of 819 pediatric FAPD patients. Trials investigating fibers, FODMAP diet, fructans, fructose-restricted diet, prebiotic (inulin), serum-derived bovine immunoglobulin, and vitamin D supplementation were included. We found very low-certainty evidence that the use of fibers leads to higher treatment success (NNT = 5). Conclusion Based on current evidence, the use of fibers can be discussed in daily practice. High-quality intervention trials are highly needed to investigate if other dietary interventions are effective in the treatment of pediatric FAPD

Nanofiltration of hormone mimicking trace organic contaminants

The removal mechanisms of three hormone mimicking organic compounds by nanofiltration (NF) membranes have been examined. Two NF membranes having different pore size were used in laboratory-scale nanofiltration experiments with feed solutions spiked with a hormone mimicking compound ¾ nonylphenol, tert-butyl phenol, or bisphenol A. Retention of the compounds was determined at various solution chemistries, namely aqueous solution pH, ionic strength, and presence of natural organic matter. The nanofiltration behavior of the selected hormone mimicking compounds appears similar to that of natural hormones as reported in our previous work. While the solution pH can dramatically influence the retention of hormone mimicking compounds by a loose NF membrane, ionic strength does not affect the nanofiltration of such contaminants. However, in the presence of natural organic matter in the feed solution, ionic strength appears to play a significant role in solute-solute and solute-membrane interactions, resulting in increased retention due to partitioning of the hormone mimicking compounds onto organic matter at a higher ionic strength

Mindful with your baby: Feasibility, acceptability, and effects of a Mindful Parenting group training for mothers and their babies in a mental health context

Many mothers experience difficulties after the birth of a baby. Mindful parenting may have benefits for mothers and babies, because it can help mothers regulate stress, and be more attentive towards themselves and their babies, which may have positive effects on their responsivity. This study examined the effectiveness of Mindful with your baby, an 8-week mindful parenting group training for mothers with their babies. The presence of the babies provides on-the-spot practicing opportunities and facilitates generalization of what is learned. Forty-four mothers with their babies (0–18 months), who were referred to a mental health clinic because of elevated stress or mental health problems of the mother, infant (regulation) problems, or mother-infant interaction problems, participated in 10 groups, each comprising of three to six mother-baby dyads. Questionnaires were administered at pretest, posttest, 8-week follow-up, and 1-year follow-up. Dropout rate was 7%. At posttest, 8-week follow-up, and 1-year follow-up, a significant improvement was seen in mindfulness, self-compassion, mindful parenting, (medium to large effects), as well as in well-being, psychopathology, parental confidence, responsivity, and hostility (small to large effects). Parental stress and parental affection only improved at the first and second follow-ups, respectively (small to medium effects), and maternal attention and rejection did not change. The infants improved in their positive affectivity (medium effect) but not in other aspects of their temperament. Mindful with your baby is a promising intervention for mothers with babies who are referred to mental health care because of elevated stress or mental health problems, infant (regulation) problems, or mother-infant interaction problems

Flexible Power & Biomass-to-Methanol plants: Design optimization and economic viability of the electrolysis integration

This paper assesses the optimal design criteria of a flexible power and biomass to methanol (PBtM) plant, conceived to operate both without green hydrogen addition (baseline mode) and with hydrogen addition (enhanced mode), following an intermittent use of the electrolysis system, which is turned on when the electricity price allows an economically viable hydrogen production. The assessed plant includes a gasification section, syngas cleaning and compression, methanol synthesis and purification and heat recovery steam cycle, to be flexibly operated. A sorption-enhanced gasification technology allows to produce a tailored syngas for the downstream synthesis in both the baseline and enhanced operating conditions, by controlling the in-situ CO2 separation rate. Two designs are assessed for the methanol synthesis unit, with two different reactor sizes: (i) a larger reactor, designed on the enhanced operation mode (enhanced reactor design – ERD) and (ii) a smaller reactor, designed on the baseline operation mode (baseline reactor design – BRD). The ERD design resulted to be preferable from the techno economic perspectives, resulting in 20% lower cost of the e-MeOH (30.80 vs. 37.76 €/GJLHV) with the baseline assumptions (i.e. 80% of electrolyzer capacity factor and 2019 Denmark day-ahead market electricity price). Other important outcomes are: (i) high electrolysis capacity factor is needed to obtain competitive cost of e-MeOH and (ii) advantages of flexibly operated PBtM plants with respect to inflexible PBtM plants are significant in scenarios with high penetration of intermittent renewables, leading to low average prices of electricity but also longer periods of high peak prices

A therapeutic guide on pediatric irritable bowel syndrome and functional abdominal pain-not otherwise specified

Disorders of the gut-brain interaction negatively impact quality of life and carry a substantial socioeconomic burden. Irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) are common functional abdominal pain disorders in childhood. The pathophysiology is not fully understood, and high-quality intervention trials and international guidelines are missing. Therefore, the management of these disorders remains challenging. This review aims to provide an up-to-date overview of therapeutic possibilities for pediatric IBS or FAP-NOS and recommends management strategies. To prevent unnecessary referrals and extensive costs, it is fundamental to make a positive diagnosis of IBS or FAP-NOS in children with chronic abdominal pain with only minimal investigations. A tailor-made approach for each patient, based on the accompanying physical and psychological symptoms, is proposed to date. Conclusion: Shared decision-making including non-pharmacological and pharmacological interventions should be considered and discussed with the family.What is Known:• Irritable bowel syndrome and functional abdominal pain-not otherwise specified are common in childhood.• Although the number of treatment options has grown recently, managing these disorders can be challenging and unsatisfactory, and no evidence-based international management guidelines are available.What is New:• We suggest using a stepwise individualized approach to management, where after first-line management, both non-pharmacological and pharmacological interventions should be discussed