Background: Exclusive breastfeeding (EBF) for the first 6 months of life improves the growth, health and survival status of newborns. Breastfeeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children. Objectives: The general objective was to identify the factors affecting exclusive breastfeeding among working class women in selected wards in Egbedore Local Government in Osun state, Nigeria. Methodology: This was descriptive cross-sectional study. Leslie Kish formula was used for sample size calculation and multistage sampling was used in selecting 316 working class women for the study. A structured, self-administered questionnaire was used for data collection. Data was analyzed using SPSS version 21.0 and level of significance was set at 5%. Results: 58% of the respondents were between the ages of 25-30. 72% demonstrated good understanding of exclusive breastfeeding based on the 6 months WHO recommendation for exclusive breast feeding, 25.9% had a fair knowledge and awareness of exclusive breastfeeding. 63.3% of the working class mother has a good practice of exclusive breast feeding, 19.6% of the women moderately practices exclusive breastfeeding while 17.1% poorly practices exclusive breastfeeding. Less than 3-months maternity leave for mothers, lack of crèche closer to place of work and lack of breastfeeding break were identified as barriers to exclusive breastfeeding practices among the working class women. The findings demonstrated a significant relationship between knowledge and practices of exclusively breastfeeding among working class women (P-value .009). Conclusion: This study demonstrated that working class women had good knowledge of exclusive breastfeeding and this influenced their breastfeeding practices. A good knowledge was associated with favorable attitudes to the practice of exclusive breast feeding. To derive long-term benefits from early childhood nutrition, interventions should focus on health education and community-based sensitization programs on the needs for mothers to engage in exclusive breast needing for global development.

The objective is to describe infant feeding practices and the nutritional status of infants under six months among Syrian refugees in Greater Beirut, Lebanon. A cross-sectional study was conducted among Syrian refugee mothers with children under five years (July-October 2018), mothers with infants under six months were included in the analysis (n=114). Additionally, eleven focus groups discussions were conducted to explore supportive factors and barriers associated with early breastfeeding practices. The prevalence of pre-lacteal feeding was high (62.5%), whereas early initiation of breastfeeding (EIBF) was low (31%), and exclusive breastfeeding (EBF) very low (24.6%). About one-fifth of the infants were suffering from anemia (20.5%) and 9.6% were wasted. Supporting factors of adequate infant feeding practices comprised knowledge on maternal nutrition and EBF, in addition to receiving support from healthcare professionals and family members. Identified barriers included preterm delivery, pre-lacteal feeding, an at-risk waist circumference and moderate to severe depression among mothers, bottle feeding, early introduction of food, maternal health reasons, breastmilk substitutes’ distribution, and misinformation offered by mothers-in-law. To address sub-optimal feeding practices documented among Syrian refugees in our study, existing infant and young child feeding policies and programs need to be strengthened and revised to tackle the identified gaps.

Background: Exclusive enteral nutrition (EEN) is the recommended first-line induction therapy for pediatric patients with active luminal Crohn’s disease (CD). The primary aim of this retrospective study was to ascertain the efficacy of EEN used as induction therapy for children with newly diagnosed CD resident in the South Island of NZ over a ten-year period (2010 – 2021). Secondary aims were to assess the clinical impact of EEN therapy on anthropometry, biochemistry, the progression to medical therapies over three time periods, and to identify positive predictors of response to EEN therapy. Methods: This retrospective clinical case review collected data from children diagnosed with CD at Christchurch Hospital, Christchurch, New Zealand, and prescribed EEN as induction therapy between the years January 1^st, 2010 – December 31^st, 2021. Descriptive statistics, Spearman’s correlation coefficient, multivariate logistic regression test and standard t-tests were used for analyses. Results: Data were collected for total of 161 children, 128 (80%) children were offered EEN as induction therapy and were included in this analysis. One hundred and twenty-one (94.5%) children successfully completed an eight-week course of EEN, and a decrease in PCDAI scores ≥ 15 points from baseline to the end of week 8 of EEN treatment was seen in 119 (98.3%). L1 and L4 disease location were positive predictors of response (p<0.05). One hundred and two (89.3%) children achieved disease remission defined as PCDAI <10 at the eight-week time-point. Conclusions: These children with newly diagnosed CD from the South Island of NZ achieved high rates of clinical remission using EEN as induction therapy. Moreover, these children also experienced significantly improved growth parameters and biochemical markers of disease consequent to their course of EEN.

Crohn’s disease is an inflammatory bowel disease whose prevalence is increasing worldwide. Among medical strategies, the dietary therapy with exclusive enteral nutrition is recommended as first line option, at least for children, because it induces clinical remission and mucosal healing. Modulen®, a polymeric TGF-β2 enriched formula, has a good palatability and is widely used. For the first time in the literature, this review outlines and discusses the clinical outcomes obtained with this therapy, as well as the potential mechanisms of action of its compounds. It can be explained by its TGF-β2 content but also by its protein and lipid composition. Further well-designed studies are required to improve our knowledge and to optimize therapeutic strategies.

Marine species are declining at an unprecedented rate, catalyzing many nations to adopt conservation and management targets within their jurisdictions. However, marine species and the biophysical processes that sustain them are naive to international borders. An understanding of the prevalence of cross-border species distributions is important for informing high-level conservation strategies, such as bilateral or regional agreements. Here, we examined 28,252 distribution maps to determine the number and locations of transboundary marine plants and animals. Over 90% of species have ranges spanning at least two jurisdictions, with 58% covering more than ten jurisdictions. All jurisdictions have at least one transboundary species, with the highest concentrations of transboundary species in the USA, Australia, Indonesia, and the Areas Beyond National Jurisdiction. Distributions of mapped biodiversity indicate that overcoming the challenges of multinational governance is critical for a much wider suite of species than migratory megavertebrates and commercially exploited fish stocks—the groups that have received the vast majority of multinational management attention. To effectively protect marine biodiversity, international governance mechanisms (particularly those related to the Convention on Biological Diversity, the Convention on Migratory Species, and Regional Seas Organizations) must be expanded to promote multinational conservation planning, and complimented by a holistic governance framework for biodiversity beyond national jurisdiction.

Tuna species are an important resource to the people of the Pacific, particularly small island countries like Tonga, that have few alternative natural resources. These countries are dependent on this fishery for their nutrition, recreation, government revenue, employment, welfare and culture. Threatening these benefits, however, are global warming and climate uncertainties that affect the presence and distribution of tuna in the Pacific islands countries and territories. There-fore, one of the most important development goals for Tonga involves managing its tuna fish-eries in order to optimize these benefits within the context of climatic impacts. This paper has two main goals. Firstly, we discuss Tonga’s commitment to implement the existing tuna man-agement policies. This commitment permeates through a range of activities to monitoring catch regulations and regulate locally based foreign vessels to fish in the Economic Exclusive Zone of Tonga. This reflects the implementation of an information-based management framework namely, the Tonga National Tuna Fishery Management and Development Plan that is revised every five years. Secondly, the paper identifies key scientific research programs, which form the basis to design more informed future policies towards tuna management. These researches include : i) examining of the bathymetric features of the island nation’s fishing ground, ii) model-ling the spatio-temporal distribution of tuna and, iii) characterizing tuna habitats within an oceanic environment using biophysical oceanographic data within Geographic Information Sys-tem, and iv) impacts of climate change on tuna

Background: Breastfeeding is essential for optimal infant health, offering numerous benefits such as infection prevention and enhanced bonding. Despite its importance, challenges exist, particularly for mothers of preterm and very low birth weight (VLBW) infants, necessitating effective lactation support strategies. Initiatives like the Baby Friendly Hospital Initiative (BFHI) and Kangaroo Mother Care (KMC) aim to promote breastfeeding success, while donor human milk (DHM) serves as an alternative bridge while the mother is supported to build up her supply. Adequate lactation support, counseling, and education are vital antenatally, during NICU stays and after discharge to improve breastfeeding rates and infant health outcomes, ultimately contributing to global efforts to reduce neonatal mortality and achieve sustainable development goals. This study explores existing research on factors influencing mothers’ ability to produce breast milk and sustain breastfeeding, with the aim of enhancing lactation support and improving infant health outcomes.Methods/Design: A systematic review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Searches will be performed in the following databases: PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE Ovid via EBSCOhost, Google Scholar, and WILEY online Library) to identify and incorporate primary research articles related to the topic published between 2014 and 2024. Authors will search peer-reviewed articles, gray literature sources, and reference lists to identify eligible studies. Independent abstract and full-text screening by two reviewers will follow the title screening. The analysis of data will be carried out using Review Manager software (version 5.3.5). The I² test will be used to quantify the amount of unexplained heterogeneity. Potential biases related to study size (such as publication bias) will be examined through the application of several techniques, including funnel plots, Egger’s test, Begg’s test, and Trim and Fill analysis.Discussion: Our review represents a singular exploration into exclusive breastfeeding among very low birth weight (VLBW) infants in low- and middle-income countries (LMICs), focusing on breastfeeding assistance methods. With VLBW defined as less than 1500 g, and most low birth weight (LBW) babies born in LMICs, there is a critical need to address feeding challenges and promote optimal nutrition. Despite updated WHO guidelines in 2022, there is still a lack of comprehensive advice for this vulnerable population. Peer support interventions and health worker counseling have shown promise in increasing breastfeeding continuation rates in LMICs, but challenges persist due to workforce shortages and inadequate documentation. Promoting early postpartum milk expression is crucial for milk production and infant health. Our review aims to fill the gap in understanding VLBW mothers’ breastfeeding experiences in LMICs, shedding light on the effectiveness of breastfeeding support methods and identifying areas for further research. Systematic review registration: CRD42024547864

The urban transportation network design problem involving exclusive bus lanes (XBLs) has been widely discussed and analyzed in recent years. An improved and more flexible transit lane management strategy—intermittent bus lanes (IBLs)—prove to be potentially more efficient and car-friendly than XBLs. The common benefit of XBLs and IBLs arises from the fact that they separate the bus and car traffic and hence can eliminate the impacts of slowly moving buses on the car traffic. This paper proposes a cell transmission model for separate car and bus traffic (CTM-SCB) in a network with some dedicated roadway segments reserved for buses. By encapsulating the CTM-SCB model, an XBL-based network design problem and an IBL-based network design problem are then formulated and solved, respectively, where the former model statically sets bus lanes while the later one allows a dynamic allocation of bus lanes. A synthetic freeway-arterial network and a real-world urban street network (where the latter was extracted from the Harbin South New Industrial City) are used as test networks for evaluating the proposed models and methods. The numerical results show that both XBLs and IBLs enjoy significant operational efficiency benefits compared to the situation of no protected bus lanes. However, we believe that the expected improvement from XBLs to IBLs need further tests and validations.