When breastfeeding is not possible, goat milk-based infant formula (GMF) provides an alternative to cow's milk-based formula. This narrative review evaluates clinical, observational, and mechanistic evidence on the nutritional suitability of GMF and its potential relevance to infant gut health. Randomized trials and meta-analytic evidence support the safety and nutritional adequacy of GMF. Its distinct composition, including a higher β-casein-to-αs1-casein ratio and differences in the profile and concentrations of oligosaccharides and bioactive proteins compared with cow's milk, provides biological plausibility for differences in curd formation, protein digestion kinetics, and microbial fermentation. However, these mechanistic findings do not establish clinical benefit. Controlled evidence does not currently demonstrate that GMF prevents or treats feeding-related gastrointestinal symptoms, including infant colic and functional constipation, although observational studies suggest possible symptom differences in some infants. Well-designed randomized trials in symptomatic infants are needed to evaluate gastrointestinal outcomes, microbiota development, immune effects, and the potential value of emerging formula innovations. Future GMF development may combine the goat milk matrix with recombinant human milk proteins or microbiome-targeted ingredients to complement components that are absent, present at low concentrations, or altered during processing; however, their application and clinical benefits in GMF remain to be established.
IntroductionThe efforts towards an HIV-free generation could be undermined by the burden of vertical transmission (VT) in sub-Saharan Africa, compounded by dwindling donor support, erratic availability of early infant diagnosis supplies, and a fragile health system. Our study evaluated the time to seroreversion and identified associated factors among perinatally HIV exposed infants (HEIs) in Lagos, Nigeria.Methods and materialsA prospective cohort involving HEIs and their mothers attending the PMTCT clinic at the Nigerian Institute of Medical Research, Yaba, Lagos. Demographic and clinical characteristics of mother-infant pair, including the infant's age at enrolment, gender, birth weight, place of delivery, mode of delivery, gestational age at delivery, duration of rupture of membrane, ART prophylaxis, mode of feeding, and maternal characteristics (educational status, occupation, type of ART, and recent HIV RNA viral load and CD4 counts) were collected. Infant HIV serology was done at 6–8 weeks, 3 months, 6 months, 9 months, 12 months, 15 months, and 18 months. A rapid test for infants is discontinued on at least two consecutive visits with a negative result. Time to seroreversion was estimated with Kaplan–Meier methods. Associated factors were assessed with a single multivariable Cox proportional hazards model over the full 18-month follow-up, with an interval-censored proportional hazards model as a check and Benjamini-Hochberg correction for multiple testing.ResultsOf 130 mother-infant pairs screened, 111 were enrolled; 103 infants seroreverted and 8 were censored (7 lost to follow-up, 1 death). The median age at seroreversion was 24 weeks (95% CI 24–32), and the cumulative probability of seroreversion was 20.0% by 12 weeks, 54.6% by 24 weeks and 87.8% by 36 weeks. Mean ( ± SD) age at seroreversion was 21.7 ( ± 11.5) weeks and 27.7 ( ± 11.9) weeks among infants on breast milk substitutes (BMS) and exclusively breastfed infants, respectively (p = 0.013). In the single multivariable Cox model, BMS feeding was associated with earlier seroreversion (adjusted HR 2.77, 95% CI 1.67–4.61; Benjamini-Hochberg adjusted p < 0.001), and the interval-censored model gave a consistent estimate (adjusted HR 2.22, 95% CI 1.34–3.68). The association did not differ across age periods (p for heterogeneity = 0.53).ConclusionThis study provides valuable insight into the time to seroreversion among HEIs in the era of test-and-treat. The finding can help strengthen diagnostic algorithms, ensure sustainable early detection, and improve paediatric HIV outcomes in Nigeria.
ObjectiveTo identify the factors associated with residual symptoms after adenotonsillectomy in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) using LASSO-logistic regression, and to construct a nomogram prediction model.MethodsA total of 324 children with OSAHS treated at our hospital from January 2023 to March 2024 were enrolled and randomly divided into a training cohort (n = 227) and an internal validation cohort (n = 97) at a ratio of 7:3. According to the 1-year follow-up results, the training cohort was further divided into a recovery group and a residual symptom group. In addition, 175 children with OSAHS treated at our hospital from April 2024 to January 2025 were included as an external validation cohort. LASSO-logistic regression was used to identify independent predictors of postoperative residual symptoms. A nomogram model was then established and evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).ResultsCompared with the recovery group, children in the residual symptom group were younger and had higher proportions of males, BMI > the 95th percentile, family history of OSAHS, asthma, rhinitis, >8 spontaneous awakenings per hour before surgery, AHI > 18 events/h before surgery, as well as higher preoperative mYPAS scores and postoperative Wong-Baker scores (all P < 0.05). LASSO-logistic regression identified sex, BMI, asthma, rhinitis, number of spontaneous awakenings before surgery, and preoperative AHI as independent predictors (all P < 0.05). The AUC values of the nomogram in the training, internal validation, and external validation cohorts were 0.874, 0.851, and 0.850, respectively. Calibration curves showed good agreement between predicted and observed outcomes, and DCA demonstrated favorable clinical utility.ConclusionThe nomogram showed good predictive performance and may help assess the risk of residual symptoms after adenotonsillectomy in children with OSAHS.
BackgroundChildhood overweight and obesity are associated with impaired motor competence, yet evidence on how weight status relates to structured aquatic motor skill learning in preschoolers—and whether sex moderates this relationship—remains scarce. This study compared changes in aquatic motor competence between overweight/obese and healthy-weight 4–5-year-old preschoolers following a common 8-week structured aquatic programme, and examined sex differences.MethodsSixty 4–5-year-old children (30 overweight/obese, 30 healthy-weight; 15 boys and 15 girls per group) without prior systematic aquatic exposure were recruited from two kindergartens in Taiyuan, China. Weight status was classified using the Chinese Growth Standard for Children Under 7 Years (WS/T 423–2022) and WHO criteria. All children completed a 16-session, 8-week structured aquatic motor skill programme (45 min/session, 2 sessions/week, 1:5 instructor-to-child ratio). Aquatic motor competence was assessed pre- and post-intervention using the Actual Aquatic Skills Test (AAST; 17 items, range 17–51). The primary analysis examined differential change over time using a 2 (Group) × 2 (Sex) × 2 (Time) mixed-design ANOVA; estimated mean differences are reported with 95% confidence intervals (CIs), and effect sizes as Cohen's d and partial η2. A 2 × 2 factorial ANOVA on post-intervention scores was retained as a secondary analysis.ResultsPre-intervention AAST scores did not differ between weight-status groups (t = −0.76, p = 0.448) or between boys and girls (t = −0.94, p = 0.353). The Group×Time interaction was significant (F(1,58) = 31.88, p < 0.001, partial η2 = 0.355): healthy-weight children showed greater mean improvement than overweight/obese children (mean Δ 27.50 vs. 23.40 points; mean difference 4.10, 95% CI 2.65–5.55; Cohen's d = 1.46, 95% CI 0.89–2.03). The Sex×Time interaction was also significant (F(1,58) = 5.15, p = 0.027, partial η2 = 0.082): girls showed greater mean improvement than boys (mean Δ 26.43 vs. 24.47; mean difference 1.96, 95% CI 0.23–3.70; Cohen's d = 0.59, 95% CI 0.07–1.11). The Group×Sex interaction on post-intervention scores was not significant (F(1,56) = 0.22, p = 0.645, partial η2 = 0.004; interaction contrast on change scores 0.34 points, 95% CI −1.10 to 1.78).ConclusionIn this convenience sample of Chinese preschoolers, healthy-weight children and girls showed greater mean improvement in aquatic motor competence than overweight/obese children and boys, respectively, following a common structured aquatic programme. Because the design lacked a non-intervention control group, these findings are associative and do not establish that weight status caused the differential response. Longer and more individualised aquatic curricula, potentially combined with nutritional and psychological support, warrant prospective evaluation in randomised trials for overweight/obese preschoolers.
ObjectivesPrevious research on emotional socialization has primarily relied on mothers, limiting insight into paternal roles and cross-spousal association. To address this knowledge gap, we employed the actor–partner interdependence model to simultaneously examine maternal and paternal burnout and associations with child socioemotional competence (SEC) incorporating parental meta-emotion philosophy (PMEP).MethodsIn this study, we analyzed 390 family triads (father–mother–child). Fathers and mothers independently reported Parental Burnout Assessment (PBA) and PMEP, and children reported SEC. An actor–partner interdependence mediation model (APIMeM) was employed to investigate actor indirect mediation and partner indirect mediation of parents on the SEC of their children.ResultsThere was a significant indirect association between paternal burnout and child SEC in the model incorporating paternal emotion coaching [indirect effect = −0.043, 95% CI (–0.086, −0.005)]. Maternal burnout and the SEC of children demonstrated significant indirect associations in models incorporating maternal emotion-dismissing [indirect effect = −0.034, 95% CI (–0.073, −0.006)] and emotion dysfunction [indirect effect = −0.043, 95% CI (–0.090, −0.011)]. Although emotion non-involvement correlated positively with parental burnout, its indirect effect on the SEC of children was not statistically significant, as it did not represent a significant indirect association between burnout and child SEC. Significant partner effects suggested that burnout in one parent was associated with maladaptive PMEP of the other parent.ConclusionIn our cross-sectional APIMeM framework, parental burnout demonstrated indirect associations with SEC of children involving maternal and paternal meta-emotion dimensions. Notably, the indirect effect involving emotion non-involvement was not significant, indicating that non-involvement does not exhibit a statistically significant indirect association within the model.
