The strategy of any organization is based on the growth of its customer base, and one of 5 its principles is that selling a product to an existing customer is much more profitable than acquiring 6 a new customer. However, this approach has several opportunities for improvement, since it usu- 7 ally has a totally reactive approach, which does not give opportunity to the areas specialized in 8 customer experience and recovery, to give an effective response for that moment, since the customer 9 is gone at the time of the intervention. This happens because usually a diagnostic analysis of cus- 10 tomers who have stopped buying products or services in a defined period, commonly three (3) pe- 11 riods or months, is performed. This thesis work challenges the way to face this problem, and pro- 12 poses the development of a complete solution, which does not focus exclusively on the prediction 13 of churn, as is usually done in the state of the art research, but to intervene in different interactions 14 that can be carried out with customers. The above focused not only to prevent customer churn, but 15 to generate an added value of continuous improvement in sales processes, increase customer pene- 16 tration, leading to an improvement in customer experience and consequently, an increase in cus- 17 tomer loyalty.

The strategy of any organization is based on the growth of its customer base, and one of 5 its principles is that selling a product to an existing customer is much more profitable than acquiring 6 a new customer. However, this approach has several opportunities for improvement, since it usu- 7 ally has a totally reactive approach, which does not give opportunity to the areas specialized in 8 customer experience and recovery, to give an effective response for that moment, since the customer 9 is gone at the time of the intervention. This happens because usually a diagnostic analysis of cus- 10 tomers who have stopped buying products or services in a defined period, commonly three (3) pe- 11 riods or months, is performed. This paper challenges the way to face this problem, and proposes 12 the development of a complete solution, which does not focus exclusively on the prediction of 13 churn, as is usually done in the state of the art research, but to intervene in different interactions 14 that can be carried out with customers. The above focused not only to prevent customer churn, but 15 to generate an added value of continuous improvement in sales processes, increase customer pene- 16 tration, leading to an improvement in customer experience and consequently, an increase in cus- 17 tomer loyalty.

In Sub-Saharan African Countries such as Nigeria with high prevalence rate, Child HIV/AIDs acquired through Mother-to-Child transmission (MTCT) can be largely prevented by using a well-established prevention programme and scheme. This study examined factors that can enhanced Prevention of Mother-to-Child transmission (PMTCT) in Nasarawa State. To achieve this, structured questionnaire were used to collect data from one hundred and sixteen (116) women attending two (2) primary facilities and two (2) secondary facilities in the State. This study utilized methods of Poisson Regression, Negative Binomial Regression and Logistic Regression Analyses. Results revealed that women with at least a secondary school education, women with husband in military and women with perceived confidentiality of their HIV status significantly enhanced PMTCT of HIV in Nasarawa State while significant proportion of the women attest to the fact that drugs are available in the facilities (p-value=0.0000<0.05) . Other factors include mother income level, willingness to continue with PMTCT programme and women in support group can also enhanced PMTCT though they are not significant. This study recommends that the factors identified should be explored by NGOs, Ministry of Health and, Support groups and other relevant agencies since they have the capacity to enhanced PMTCT of HIV in Nasarawa State, Nigeria.

Background: Currently, a Dolutegravir (DTG)-based regimen is administered to women on option B plus to prevent mother-to-child transmission (MTCT) of the virus. However, its effect on reducing MTCT of human immunodeficiency virus (HIV) among exposed infants over the previously used Efavirenz (EFV)-based regimen is unknown. Objective: This study aimed to compare the effects of DTG-based and EFV-based regimens on the MTCT of HIV among exposed infants in southern Ethiopia. Methods: A retrospective before-after study design was employed from March to May 2023 among 958 mother-infant pairs (479 on EFV-based and 479 on DTG-based regimens) enrolled in the prevent mother-to-child transmission (PMTCT) care from September 2015 to February 2023. The outcome variable was the HIV infection status among the exposed infants. A log-binomial model was employed and the proportion was computed to compare the incidence of MTCT of HIV in both groups. The risk ratio (RR) with 95% confidence interval (CI) was calculated to assess the predictor variables. Results: Mothers on a DTG-based regimen were approximately 44% (adjusted risk ratio (aRR): 0.56; 95% CI: 0.44, 0.70) less likely to transmit HIV to their infants than those on an EFV-based regimen. In addition, poor/fair adherence to antiretroviral therapy (ART) (aRR: 5.82; 95% CI: 3.41, 9.93), home delivery (aRR: 3.61; 95% CI: 2.32, 5.62), mixed feeding practice (aRR: 1.83; 95% CI: 1.45, 2.3), and not receiving antiretroviral prophylaxis (aRR: 3.26; 95% CI: 1.6, 6.64) were found to increase the risk of MTCT of HIV infection, whereas older maternal age (aRR: 0.93; 95% CI: 0.9, 0.96) was a protective factor.Conclusion: The Dolutegravir-based regimen significantly reduced MTCT of HIV among exposed infants compared to the EFV-based regimen. Thus, DTG-based first-line ART regimen supplementation should be sustained to achieve global and national targets for zero new infections in HIV-exposed infants.

Children with severe acute malnutrition (SAM) are at high risk of impaired development. Contributing causes include inadequate intake of specific nutrients such as polyunsaturated fatty acids (PUFA) and lack of adequate stimulation. We conducted a pilot study assessing developmental and nutritional changes in children with SAM provided with a modified ready-to-use therapeutic food and a context-specific psychosocial intervention in Mwanza, Tanzania. We recruited 82 children with SAM (6-36 months) and 88 sex- and age-matched non-malnourished children. We measured child development, using the Malawi Development Assessment Tool (MDAT), measures of family and maternal care for children, and whole blood PUFA levels. At baseline, the mean total MDAT z-score of children with SAM was lower than non-malnourished children; -2.37 (95% confidence interval: -2.92; -1.82) as was their total n-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) levels. After 8 weeks’ intervention, MDAT z-scores improved in all domains, especially fine motor, among children with SAM. Total n-3, and EPA levels increased, total n-6 fatty acids decreased, and DHA remained unchanged. Family and maternal care also improved. The suggested benefits of the combined interventions on developmental and nutritional status of children with SAM will be tested in a future trial.

To gain new insights into the potential of mother-to-child transmission of Zika virus (ZIKV) through breast milk or breastfeeding practices, we systematically searched regional and international databases and screened 1,658 non-duplicate records describing women with suspected or confirmed ZIKV infection, intending to breastfeed or give breast milk to an infant. Fourteen studies met our inclusion criteria and inform this analysis. These studies reported on 97 mother-children pairs who provided breast milk for ZIKV assessment. Seventeen breast milk samples from different women were found positive for ZIKV via RT-PCR, and ZIKV replication was found in cell cultures from five out of seven breast milk samples from different women. Only three out of six infants who had ZIKV infection were breastfed, no evidence of clinical complications were found to be associated with ZIKV RNA in breast milk. This review updates our previous report by synthesizing the evidence from 12 new articles and we find no evidence of mother-to-child transmission through breast milk intake or breastfeeding. As the certainty of the present evidence is low, additional studies are still warranted to completely understand any potential of transmission of ZIKV through breastfeeding.

Atherosclerosis (AS) is a chronic progressive disease caused by various factors, and causes various cerebrovascular and cardiovascular diseases (CVDs). Reducing the plasma levels of low-density lipoprotein-cholesterol (LDL-C) is the primary goal in preventing and treating AS. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) plays a crucial role in regulating LDL-C metabolism. Panax notoginseng has potent lipid-reducing effects and protects against CVDs, and its saponins induce vascular dilatation, inhibit thrombus formation, and are used in treating CVDs. However, the anti-AS effect of the secondary metabolite, 20(S) -protopanaxatriol (20(S)-PPT), remains unclear. In this study, the anti-AS effect and molecular mechanism of 20(S)-PPT were investigated in vivo and in vitro by western blotting, real time-polymerase chain reaction (RT-PCR), Enzyme-linked Immunosorbent Assay (ELISA), immunofluorescence staining, and other assays. The in vitro experiments revealed that 20(S)-PPT reduced the levels of PCSK9 in the supernatant of HepG2 cells, upregulated low density lipoprotein receptor (LDLR) protein levels, promoted LDL uptake by HepG2 cells, and reduced PCSK9 mRNA transcription by upregulating the levels of FoxO3 protein and mRNA and decreasing the levels of HNF1α protein and mRNA. The in vivo experiments revealed that 20(S)-PPT upregulated aortic αSMA expression, increased the stability of atherosclerotic plaques, and reduced aortic plaque formation induced by a high-cholesterol fed in ApoE-/- mice (HCF group). Additionally, 20(S)-PPT reduced the aortic expression of CD68, reduced inflammation in the aortic root, and alleviated the hepatic lesions in the HCF group. The study revealed that 20(S)-PPT inhibited LDLR degradation via PCSK9 to alleviate AS.

According to official sources, the numbers of children-to-parent violence (CPV) in the most advanced countries have been on an increasing trend for more than a decade, which generates great social concern. This phenomenon has also aroused enormous interest among researchers, who have identified risk and protective factors related to adolescent CPV in numerous studies. To contribute to a better explanation of CPV, the aim of the present study was to analyze the relationship between family communication problems and CPV, through psychosocial adjustment variables -psychological distress and positive attitude toward the transgression of social norms- in schooled adolescents. The sample consisted of 8115 adolescents enrolled in schools in the State of Nuevo León (Mexico) (51.5% boys, 49.5% girls), whose ages ranged from 11 to 16 years (M = 13.34, SD = 1.04). Structural equation modeling was performed using Structural Equation Modeling Software (EQS). The results showed that family communication problems have a direct and signif-icant relationship with CPV. It was also observed that there is an indirect relationship between both variables, through the relationships of psychological distress and positive attitude towards the transgression of social norms. The multigroup analysis performed showed gender differences in some of these relationships. Finally, the results and their implications in the field of family intervention are discussed.

Given that evaluating suspected child maltreatment is a challenging task, we aimed to begin to explore how laboratory test results may assist in its detection. Hence, we have examined biomarker differences between 137 children entering out-of-home care and 126 children living in their own homes. Each child entering Majorcan institutionalized care was randomly matched for gender and age with children living in their homes and the same health area. Concerning basic hematological and biochemical values, children placed in out-of-home care differed significantly from children remaining at home in four distinct ways. Children at care entry had significantly higher eosinophil counts than children at home; and also had significantly lower levels of transaminase, thyroid-stimulating hormone, triglycerides and LDL-Cholesterol than children living at home. Oxidative stress linked to anxiety disorders and underweight are common features found in children at entry into the care system. The present study shows a relationship between some underweight or oxidative stress biomarkers and the risk of entry into out-of-home care. Medical diagnoses require physicians to select and assemble relevant data from all available information. Accordingly, we should consider the implementation of laboratory checkups in order to identify the abused from the non-abused child better.

Naturally fermented dairy products are an important component of the human diet. They are a valuable source of nutrients as well as vitamins and minerals. Their importance as a source of probiotic bacterial strains should not be overlooked. A number of studies highlights the positive effects of species of the Lactobacillacea on the intestinal microbiota, the overall homeostasis of the body, as well as a complementary treatment for some diseases. However, data on the effects on intestinal epithelial cells of postmetabolites released by bacteria are incomplete. This is likely due to the fact that these effects are species and strain specific. In the present study, we investigated the effects of postmetabolites produced by a pre-selected candidate probiotic strain Limosilactobacillus fermentum on HT-29 intestinal epithelial cells. Our data showed a pronounced proliferative effect, evaluated by flow cytometry, quantification of cell population, and determination of mitotic index. This was accompanied by stabilization of the cell monolayer, measured by increase of TEER (trans epithelial electric resistance) and reorganization of actin filaments. The data obtained are a clear indication of the positive effects, that the products secreted by L. fermentum strain 53 have on the intestinal epithelial cells.

Seeds from several Ribes taxa were surveyed for phenolic compounds and in vitro antiproliferative activity against HT-29 colorectal cancer cells. Total phenolic compounds were analysed through the Folin-Ciocalteu procedure, while phenolic profiles were analysed by LC coupled to a single mass spectrometer Orbitrap using an electrospray interface (ESI). Antitumor effects were established using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Total phenolics ranged from 11.4 in R. alpinum to 94.8 mg of caffeic acid equivalents (CAE)/g in R. nigrum 'Koksa'. Concerning phenolic compounds, four were hydroxylated benzoic acids, four cinnamic acid derivatives, eight flavonoids, and nine flavonoid glycosides. The growth inhibition against HT-29 cancer cells was exercised much better by R. nigrum 'Koksa' and Ribes 'Erkeeni' (GI50 37 and 42 µg/ml). All Ribes extracts, except R. nigrum 'Hara katarlik', showed higher activity than that of R. rubrum (GI50 at 72 h: 99 µg/ml). Interestingly, the highly bioactive extract from Ribes 'Erkeeni' contains all detected phenolics, while R. nigrum 'Koksa' lacks only populnin. Therefore, the high bioactivity found for such extracts could be due to a synergy due to all detected compounds. This work constitutes a comprehensive action for expanding knowledge on the phenolic profiles and antitumor activity of GLA-rich Ribes seeds.

This study focuses on the potential medicinal properties of Campsis radicans L. extracts and its aim is to investigate the antioxidant and antiproliferative effects of these extracts on the human colon adenocarcinoma cell line (HT-29). Cytotoxic activity in the HT-29 cell line was evaluated, and the 3-dimensional structures of phenolic compounds were obtained using the GC-MS method. Docking simulations were performed with AutoDock Vina, targeting proteins that are crucial in the apoptotic pathway (Bax, Bcl-2, and Caspase-3). Drug similarities and ADMET estimates of the phenolic compounds were obtained from databases. The highest antioxidant activity of Campsis radicans L. plant was observed in ethanol and water extracts, with notable inhibition capacities. While the total phenolic content was highest in ethanol, water, and ether extracts respectively the total flavonoid content was highest in ethanol, then ether, and water extracts. Certain elements were undetectable in mineral determination, and others exceeded the toxic doses for plants. The water extract exhibited dose-dependent cytotoxic activity in the HT-29 cell line, with an IC50 value of 4.47 mg/mL. Molecular docking results revealed the binding of phenolic molecules to the active sites of apoptotic pathway proteins. The findings suggest that Campsis radicans L. plant possesses cytotoxic properties, significant phenolic and flavonoid content, and a high antioxidant capacity. These properties make it a potential candidate for treatment use, emphasizing its potential therapeutic value in the HT-29 cell line. Further research and exploration on the identified phenolic compounds could contribute to the development of novel therapeutic agents.

Objective: To determine demographic predictors and comorbidities in hospitalized children with conduct disorder. Methods: A retrospective analysis was performed using Nationwide Inpatient Sample (2012–2014). All patients were ≤18 years and cases with primary diagnosis of conduct disorder (N = 32345) and a comparison group with another psychiatric diagnosis (N = 410,479) were identified using ICD-9-CM diagnosis codes. A logistic regression model was used to generate the Odds Ratio (OR) between both groups. Results: Children <11 years old have five times greater chances of admission for conduct disorder than adolescent (OR 5.339). African American males are more likely to be admitted for conduct disorder. Children with conduct disorder from low-income families have a 1.5 times higher likelihood for inpatient admission compared to high-income families. These children have about eleven times higher odds of comorbid psychosis (OR 11.810) and seven times for depression (OR 7.093) compared to the comparison group. Conclusion: Conduct disorders are more debilitating for children and families than many providers realize. African American male under 11 years is at the highest risk for inpatient management for conduct disorder. These patients have a higher risk of comorbid psychosis and depression which may further deteriorate the severity of illness and require acute inpatient care.

We sought to calculate the extra social costs resulting from child abuse in residential care facilities (RCFs) for children with disabilities (CWD) in Japan. We distributed a survey to 260 residential facilities for CWD in 2020 and obtained responses from 91 facilities. Among the children admitted to these facilities, 23–67% were affected by child abuse. We estimated the extra costs to be an average of USD 647.7 million. This study is meaningful in that there are no existing official statistics or research findings on the extra costs of residential care due to child abuse in Japan.

Background: Producing, distributing or discussing child sexual abuse materials (CSAM) is often committed through the dark web in order to remain hidden from search engines and regular users. Additionally, on the dark web, the CSAM creators employ various techniques to avoid detection and conceal their activities. The large volume of CSAM on the dark web presents a global social problem and poses a significant challenge for helplines, hotlines and law enforcement agencies. Objective: Identifying CSAM discussions on the dark web and uncovering associated metadata insights into characteristics, behaviours and motivation of CSAM creators. Participants and Setting: We have conducted an analysis of more than 353,000 posts generated by 35,400 distinct users and written in 118 different languages across eight dark web forums in 2022. Out of these, approximately 221,000 posts were written in English and contributed by around 29,500 unique users. Method: We propose a CSAM detection intelligence system. The system uses a manually labelled dataset to train, evaluate and select an efficient CSAM classification model. Once we identify CSAM creators and victims through CSAM posts on the dark web, we proceed to analyze, visualize and uncover information concerning the behaviors of CSAM creators and victims. Result: The CSAM classifier, based on Support Vector Machine model, exhibited good performance, achieving the highest precision of 92.3\%, accuracy of 87.6\% and recall of 84.2\%. Its prediction time is fast, taking only 0.3 milliseconds to process a single post on our laptop. While, the Naive Bayes combination is the best in term of recall, achieving 89\%, and its prediction time is just 0.1 microseconds per post. Across the eight forums in 2022, our Support Vector Machine model detected around 63,000 English CSAM posts and identified near 10,500 English CSAM creators. The analysis of metadata of CSAM posts revealed meaningful information about CSAM creators and their victims, such as: (1) the ages and nationalities of the victims typically mentioned by CSAM creators, (2) forum topics where the CSAM creators assign their posts, and (3) online platforms preferred by CSAM creators for sharing or uploading CSAM. Conclusion: Our CSAM detection system exhibits high performance in precision, recall, and accuracy in real-time when classifying CSAM and non-CSAM posts. Additionally, it can extract and visualize valuable and unique insights about CSAM creators and victims by employing advanced statistical methods. These insights prove beneficial to our partners, i.e. national hotlines and child agencies.

Children’s right to participation in child protection decision-making is supported by moral imperatives and international conventions. The fragmented implementation of this right reflects an already-conflicted discursive terrain that attempts to incorporate both children’s agency and their need for protection. This article uses two key theoretical lenses to further examine this terrain: child welfare inequalities and cultural capital. These theories draw attention to how social inequities and cultural capital relating to culture and class affect how participation plays out. An unintended consequence of constructing children within a traditional liberal account of rights, within neoliberal and ‘child focussed’ policy paradigms, is the reduction of an acknowledgment of the culturally contested nature of an individualistic construction of children, excising children from their social backgrounds and promoting the notion of a ‘universal child’. With a particular focus on class, culture and professional paradigms, I argue that the ways children’s views are elicited, the content of those views and how they are interpreted, become subject to a set of professional assumptions that tend to take little cognisance of the social backround of children, including norms relating to class, ethinicity and the oppressive structural relations relating to those two factors. This process is shored up with concepts such as attachment theory, the ‘adultification’ of children of colour, the diminishing of Indigenous concepts of children and childhood, and the pre-eminence of the ‘concerted cultivation’ middle class parenting style. The child’s cultural worldview and manner of expressing it may clash with professional cultures that emphasise an ability for verbal expression, independence, and entitlement when negotiating preferences with representatives of powerful social institutions such as child protection systems. Many children may not comply with this expectation due to both cultural and class socialisation processes, and the histories of the oppressive functions of child protection systems. The unspoken power of child protection organisations that must engage in constant translation of children’s cultural capital to ensure participation, may instead better serve children’s participation aims by devolving authority to affected communities. Communities reflecting children’s own, may be better able to offer recognition to children and enable their participation more effectively.

Since the origin of COVID-19, everyone is getting accustomed to the new rules and regulations, travel restrictions and new lifestyle. Constant changes in the government advisories and the COVID-19 guidelines poses a real challenge for children to adapt to causing stress, anxiety and other mental health issues. Therefore, it is imperative to raise awareness about the challenges that Indian children are dealing with to help them better cope with this stressful and frantic time. The focus of this review is on various child-related problems that the Indian government is trying to tackle such as stress, depression, malnutrition, school closures, digital divide, child labor, child trafficking in context of mental health issues caused by them during COVID-19. Highlights:The reader will come to appreciate that: Digital-divide caused by shifting offline learning to online mode. Strategies implemented by Indian government to combat malnutrition Effect of COVID-19 lockdown on children suffering from mental disorders Child labor and trafficking and the strategies that aim to decrease child labor during the pandemic Educating the children appropriately regarding COVID protocols

In this paper we take China’s one child policy as an example and investigate its environmental impact. We develop a model for an economy using a standard overlapping generation model extended with human capital, endogenous fertility, and changing life expectancy. To model the environmental impact of economic activities, we use a modified IPAT model. We show that China’s one child has a very strong positive impact on the environment, particularly if we consider the whole human legacy.

Child-friendly tourism is a tourism concept that focuses on the welfare and needs of children as tourism actors. This concept is an important part of developing a sustainable tourism city because children are the future generation who will continue their role in maintaining the sustainability of the tourism industry. This article discusses the importance of child-friendly tourism in the development of a sustainable tourist city and provides some examples of best practices in creating a safe, comfortable and educational tourism environment for children. This article also discusses some of the challenges and opportunities in implementing the concept of child-friendly tourism, including how to involve children in decision-making and increase community participation in creating a better tourism environment for children. By adopting the concept of child-friendly tourism, tourist cities can build a sustainable tourism environment and preserve natural resources and local culture, while also providing positive and memorable tourism experiences for children and their families.

Objectives: to assess the knowledge level of parents from the central region of Saudi Arabia about oral health and care of preschool children and its relation with sociodemographic variables, parents‟ self-perception toward their dental health, importance of teeth and frequency of dental visits. Methods: a random sample of 754 parents participated in this cross-sectional study and completed an internationally accepted questionnaire. Chi square test and logistic regression analysis were used to analyze the data (p<0.05). Results: mean knowledge score of the parents was 4.8 (out of 11). Less than 20% of the parents were knowledgeable about the best position for tooth brushing, the concentration of fluoride in a child‟s toothpaste, timing of first dental check-up, and best time to give a sugary snack. Mothers, parents with high educational level and family income, parents with positive attitude towards teeth and excellent self-perception of their dental health were significantly more likely to score higher (p<0.05). Conclusions: knowledge of parents about oral health and care of preschool children in the central region of Saudi Arabia was deficient. Gender, education level of parents, family income, attitude about teeth and self-perception of parents‟ own dental health were factors which influenced their knowledge. To improve parents‟ knowledge, role of health professionals should be improved and TV commercials directed toward the areas which had gaps in knowledge.

Parental phubbing behavior is a significant factor in predicting adolescent smartphone dependence, but prior research has predominantly focused on a unidirectional perspective from the child's viewpoint, overlooking potential perceptual differences between parents and their children regarding parental phubbing. Therefore, are there differences in the perceptions of parental phubbing between parents and their children? Based on the "Discrepancy-Maladaptive" hypothesis, the presence of perceptual discrepancies in family factors can lead to adverse developmental outcomes in children. Does the parent-child perceptual discrepancy in parental phubbing influence adolescent smartphone dependence? And what role does parent-child relationship play in this context? This study selected 728 families from a middle school in Wuhan, and surveys were administered to both children and parents. The findings reveal: (1) There exist significant parent-child perceptual discrepancies in parental phubbing. (2) Parent-child perceptual discrepancies in parental phubbing significantly positively predict adolescent smartphone dependence and negatively predict parent-child relationships, while parent-child relationships significantly negatively predict adolescent smartphone dependence. (3) The parent-child relationship plays a mediating role between parent-child perceptual differences in parental phubbing behavior and adolescent smartphone dependence.

Background: After the increasingly common anterior cruciate ligament reconstruction (ACLR) procedure in competitive athletes, rehabilitation is crucial for facilitating a timely return to sports (RTS) and preventing re-injury. This pilot study investigates the biomechanical and psychological outcomes of postoperative rehabilitation in competitive athletes, comparing supervised rehabilita-tion (SVR) and home-based rehabilitation (HBR). Methods: After ACLR, 60 (out of 74 screened) athletes were recruited and equally divided into 2 groups using non-probability convenience sam-pling: 30 HBR and 30 SVR (each group comprising 15 males and 15 females). Rehabilitation out-comes in respective groups were evaluated at 8 months using measures (Tegner-Activity-Scale [TAS], International Knee Documentation Committee subjective knee form [IKDC-SKF], ACL Return to Sport after Injury [ACL-RSI]) and objective parameters (isometric muscle strength, hamstring/quadriceps asymmetry). RTS was evaluated at 9 months; with ACL re-injury rates rec-orded approximately 6 months post-RTS. Results: Both groups exhibited decreased TAS scores (HBR: 8 to 6, SVR: 8 to 7), with the SVR group demonstrating superior post-operative IKDC-SKF scores (81.82 vs. 68.43) and lower ACL-RSI scores (49.46 vs. 55.25). Isometric and isokinetic mus-cle strength, along with asymmetry values, favored the SVR group 8 months post-ACLR (p

Background: As a result of the pandemic, families and children have faced physical, emotional, and mental challenges. However, there has been little attention given to the relationship between the COVID-19 pandemic and child development. This systematic review aims to identify the impact of the pandemic on child development, globally. Methods: This study follows the PRISMA guidelines for the systematic review of 16 quantitative and qualitative studies conducted between 2020-2023. Results: This systematic review suggest that the COVID-19 pandemic played a crucial role in hindering child development in early childhood. Conclusion: Therefore, it is important to promote and implement the use of policies and strategies to overcome these obstacles.

This study was carried out in a qualitative research type and phenomenological design since it was aimed to determine the life experiences of the parents of deaf children. The study sample consisted of 20 parents of deaf children registered in a special education and rehabilitation center who spoke Turkish and were literate and did not have hearing loss. The data were collected through in-depth interviews in Istanbul between December and January 2022. Colaizzi's phenomenological interpretation method was used in qualitative data analysis. It was determined that parents of deaf children experienced anxiety, sadness, and happiness during diagnosis. They lacked information at first, but then they gained knowledge in the process, and it was not easy to accept this process. They stated that having a deaf child requires more time, responsibility, and effort than other children, this situation affects their social life, and they experience interpersonal conflicts. When parents were asked how they coped, they said they did it through prayer, social support, or time to themselves. It can be recommended to apply psychosocial intervention programs to the parents of deaf children, especially their mothers, from the first diagnosis process.

The juvenile criminal justice system is an important part of maintaining justice and protecting children's rights in criminal cases. Through literature study techniques, this paper aims to evaluate the juvenile justice system in Indonesia from the perspective of children in conflict with the law. The results of the study show that there are still some deficiencies in the juvenile justice system, such as the low quality of legal services and the minimal participation of children in the judicial process. Some efforts that can be made to improve the juvenile justice system include improving the quality of legal services, providing greater opportunities for children to be involved in the judicial process, and increasing alternative dispute resolution outside of juvenile justice. It is hoped that the results of this research can make a positive contribution to improving the juvenile justice system in the future.

Background: Although widely believed to be safe for use in infants and children when used as directed, increasing evidence indicates that early life exposure to paracetamol (acetaminophen) may cause long-term neurodevelopmental problems. Further, recent studies in animal models demonstrate that cognitive development is exquisitely sensitive to paracetamol exposure during early development. In this study, evidence for the claim that paracetamol is safe was evaluated using a systematic literature search. Methods: Publications on PubMed between 1974 and 2017 that contained the keywords “infant” and either “paracetamol” or “acetaminophen” were considered. Of those initial 3096 papers, 218 were identified that made claims that paracetamol was safe for use with infants or children. From these 218, a total of 103 papers were identified as sources of authority for the safety claim. Results and Conclusions: A total of 52 papers contained actual experiments designed to test safety, and had a median follow-up time of 48 hours. None monitored neurodevelopment. Further, no trial considered total exposure to drug since birth, eliminating the possibility that the effects of drug exposure on long-term neurodevelopment could be accurately assessed. On the other hand, abundant and sufficient evidence was found to conclude that paracetamol does not induce acute liver damage in babies or children when used as directed.

Early childhood is important for future cognitive and educational outcomes. Programs overcoming barriers to engagement in early education for Indigenous children must address family cultural needs and target developmental delays. This systematic review identifies culturally adapted programs to improve cognitive, emotional and developmental delays among young children, in response to an identified priority of a remote Indigenous community. Five databases (the Cochrane Library, Embase, Medline, Scopus and CINAHL) were searched for English language papers in January 2018. Study quality was assessed and findings analysed thematically. Findings were presented to the community at an event with key stakeholders, to determine their inclusion and face validity. Seven relevant studies, published between 1997-2013, were identified by the researchers and each study was supported by the community for inclusion. Two studies focused on Native American children and five studies included children from non-Indigenous disadvantaged backgrounds. Findings were reported narratively across four themes: Storytelling to improve educational outcomes; Family involvement improved development; Culturally adapted Cognitive Behavioral Therapy to reduce trauma; Rewards-based teaching to improve child attention. Limited published research on culturally adapted and safe interventions for children with cognitive, emotional and developmental delay exists but these four themes from seven studies identify useful components.

To support the development of research evidence and behavioral health policy that aligns with the priorities of youth and families serviced in child and youth mental health systems, this project documents the service outcomes that caregivers value most. A diverse group of caregivers, representing six regions of the United States, participated in two rounds of virtual one-hour focus groups. In round 1, participants identified what they hoped to gain from using behavioral health services for themselves, their families, and their child and discussed what made services a positive experience for them. They then reported their top three most hoped for outcomes. In round 2, groups validated and refined summary findings from round 1. Caregivers prioritize service quality outcomes, primarily. They expressed a desire for an accessible, respectful, and supportive treatment environment underpinned by well-trained and culturally responsive professionals. Caregivers also desire seamless cross-sector provider collaboration and care transitions which integrate the insights and preferences of families and children themselves to craft a customized care plan. Priority outcomes not related to service quality included hoping to gain increased knowledge, resources, and tools and techniques to support the mental health needs of their children, help them improve their daily functioning, and develop more effective interpersonal communication skills. Caregivers also reported hoping to experience less stigma related to the mental health needs of their children and to achieve personal fulfillment for themselves and their children. Research and policies should prioritize and be designed to address the outcomes that matter to youth and families.

Endotoxins are toxic substances that widely exist in the environment and can enter the intestine with food and other substances. Intestinal epithelial cells are protected by a mucus layer that contains MUC2 as its main structural component. However, a detailed understanding of the mechanisms involved in the function of the mucus barrier in endotoxin penetration is lacking. Here, we established the most suitable proportion of Caco-2/HT-29 co-culture cells as a powerful tool to evaluate the intestinal mucus layer. Our findings significantly advance current knowledge as focal adhesion and ECM-receptor interaction were identified as the two most significantly implicated pathways in MUC2 small interfering RNA (siRNA)-transfected Caco-2/HT-29 co-culture cells after 24 h of LPS stimulation. When the mucus layer was not intact, LPS was found to damage the tight junctions of Caco-2/HT29 co-cultured cells. Furthermore, LPS was demonstrated to inhibit the integrin-mediated focal adhesion structure and damage the matrix network structure of the extracellular and actin microfilament skeletons. Ultimately, LPS inhibited the interactive communication between the extracellular matrix and the cytoskeleton for 24 h in the siMUC2 group compared with the LPS(+) and LPS(-) groups. Overall, we recognized the potential of MUC2 as a tool for barrier function in several intestinal bacterial diseases.

Primary and secondary cardiovascular prevention is less effective than expected due to the concern about polymedication by professionals and the lack of patient adherence to medications prescribed in the medium and long term. Polypills have been presented as a possible solution. A comprehensive bibliographic review is presented about polypills as mechanisms for facilitating adherence and a proposed guide for the use of polypills for the prevention of cardiovascular risk. 41 articles were included, showing options for the polypill as a method of primary and secondary cardiovascular prevention.The polypill increases therapeutic adherence in the medium and long term, also increasing the therapeutic results compared to the administration of the various drugs separately. Based on the evidence, a flow diagram is proposed for the prescription of a polypill.Polypills increase the effectiveness and adherence of patients to primary and secondary cardiovascular prevention programs, without increasing the cost of the intervention. The use of a polypill in cardiovascular prevention can be effective as a prescription tool.

With this study, we aimed to evaluate the effect of digital game addiction tendencies of preschoolers (36-72 months) on children's depressive symptoms.We conducted the research in a virtual environment with mothers who have 747 preschool children. Predictive evaluation was performed using simple regression analysis between the mean scores of (DGATS) and (CDSAS). In the regression analysis, it was determined that there was a strong positive correlation between the (DGATS) total score average and the (CDSAS) total score average (R=0.52,R2=0.27,p<0.05). Accordingly, digital game addiction tendency explains 27% of children's depressive symptoms. When the standardized beta coefficient and t values are examined, it can be said that digital game addiction tendency is a significant predictor of children's depressive symptoms.

Wound healing in the pediatric population is known to be a challenge and poorly studied. Split-thickness skin grafts, full-thickness skin grafts and flaps overlap their applications with the growing field of cellular and tissue-based therapies. However, their role in pediatric reconstruction has yet to be defined. The Kerecis® Omega3 wound patch, derived from decellularized codfish skin, has garnered attention due to its preserved microscopic architecture resembling the human extracellular matrix. This acellular dermal matrix acts as a scaffold, fostering dermal cell and capillary adhesion while harnessing omega-3 polyunsaturated fatty acids for granulation acceleration and antimicrobial effects. This study presents a comprehensive review and surgical protocol for utilizing Kerecis® fish skin in pediatric wound care. The research embraces a case series involving five patients with diverse wound locations. The Kerecis® Omega3 wound patch underwent meticulous application and careful monitoring. The results highlight an average time of 48.6 days for complete epithelialization, yielding favorable outcomes with no hypertrophic scarring and mild retraction. Notably, this innovative approach may eliminate donor site morbidity and improve pain control, promising a novel avenue for pediatric wound management.

Artificial Intelligence (AI) has become a hopeful tool for helping parents with different parts of raising children by giving them personalized tips, evidence-based methods, and timely solutions. This paper talks about the difficulties and possibilities of using AI to help parents. It also talks about the possible benefits and its impact on child psychology. There are a lot of ways that AI can help parents, from giving personalized advice that fits the needs of each family to intervening quickly when it spots early signs of developmental problems or parenting stress. AI makes it easier for parents to find tools, workshops, and interactive modules that are based on research. This gives parents the knowledge and trust they need to make choices about their child's growth that are based on facts. Also, AI-powered support can connect parents with similar problems, creating a sense of community and making it less embarrassing to ask for help with parenting or mental health. But there are a few problems that need to be carefully dealt with before AI can be used to help parents in a responsible and effective way. Data privacy and security are very important to protect families' safety and well-being. Important things to think about are the ethical use of data, transparency, and educated permission. Also, the accuracy and dependability of AI programs are very important when it comes to giving good advise and suggestions. To make sure everyone gets fair and equal help, efforts must be made to find and get rid of flaws. Also, AI shouldn't replace human sense and experience; it should add to them. When parents rely too much on AI, they might forget how important human contact and mental support are. To accommodate different parenting styles and views, it is important to be sensitive to culture and circumstances. In conclusion, AI-powered parenting support has a lot of promise to help parents be better parents and help children grow and learn. AI can be a useful tool for helping parents if it can solve problems related to data privacy, ethics, reducing bias, and working together with humans. Finding a balance between technology progress and human connection is important if AI is to be used to its fullest potential to give parents more power and help children grow in the best way possible.

Family-Centered Care (FCC) as a philosophy is defined as a care provider that emphasizes and involves the important role of the family. However, there are several obstacles in implementing family center care for children where parents have different perceptions from health workers. Parents are angry when they are involved in a job they consider to be a nurse's job and the attitude of nurses prevents parents from participating. This difference in perception causes the implementation of Family Center Care (FCC) has not been carried out optimally, this has an impact on discomfort during treatment. Along with the not yet optimal implementation of family center care when providing care to children, further discussion is needed regarding the philosophy of child nursing with a family center care approach. The reasons for the importance of implementing family center care include building a collaborative system, focusing on family strengths and resources.

Parenting has been robustly associated with offspring psychosocial development, and these effects are likely reflected in brain development. However, the claim that parenting influences offspring brain development in humans, as measured by structural and functional Magnetic Resonance Imaging (MRI), is subject to numerous methodological limitations. To interpret the state of the parenting and brain development literature, we review these limitations. Four limitations are common. First, most literature has been cross-sectional. Where longitudinal, studies rarely included multiple assessments of brain structure or function, precluding measurement of actual brain development. Second, parenting has largely been measured via selfor parent-report, as opposed to observational assessment. Third, there has been a focus on extreme forms of developmental adversity which do not necessarily lie on a continuum with normative parenting. Fourth, although not a limitation per se, studies have generally focused on negative as opposed to positive parenting behaviours. While not all studies are subject to all these limitations, the study of parenting in relation to offspring brain development is in its infancy.

To date, radiation adaptation response has been reported as a low-dose related phenomenon and has been associated with radiation hormesis. Well-known cancers are caused by non-radiation active reactants, in addition to radiation. A model of suppression for radiation-specific cancers was previously reported, but the model did not target radiation-nonspecific cancers. In this paper, we describe kinetic models of radiation-induced suppressors for general radiation non-specific cancers, estimating the dose that induces the maximum hormesis effect while satisfying the condition that the risk is approximately proportional to dose above 100 mSv. It was found that the radiation hormesis effect is maximal at about 20 mSv when the rate constant for generation is the same as the rate constant for decomposition. When the two rate constants are different, the dose at which the radiation hormesis effect is maximized depends on both rate constants, but the dose increases as the two rate constants approach each other, reaching a maximum of about 20 mSv. This conclusion may lead to the discovery of unknown cancer suppressors at low doses and the development of cancer suppression methods in the future.

SUDEP is a sudden death in a person with epilepsy, without evidence of a seizure before death. While its cause is still unclear, various factors have been linked to seizure onset and cardiopulmonary function. Studies have shown that although 91.3% of epilepsy patients want information on premature death, only 31% of them receive it. The numbers emphasize the need for open and sensitive communication by medical professionals. It is important to choose the appropriate moment for the conversation, avoiding periods of stress and ensuring emotional stability in the patient, as well as clear, appropriate and easy to comprehend information about SUDEP. To facilitate this, knowing the patient's level of knowledge is essential. Education on the warning signs of seizures and SUDEP can help take precautions and can decrease the incidence of the phenomenon itself. Effective epilepsy care requires a comprehensive plan, including medication adherence and lifestyle changes. Regular communication and collaboration between the patient, caregiver and health professionals are essential for the effective management of epilepsy, so just as epilepsy has a fluid, changeable course of disease and follow-up appointments are very important, the topic of SUDEP is not a one-time conversation either.

Nephrolithiasis affects around 10% of the population and is frequently associated with impaired dietary factors. The first one is insufficient fluid intake inducing reduced urine volume, urine supersaturation, and subsequently urinary lithiasis. Kidneys regulate 24-hour urine volume, which, under physiological conditions, approximately reflect daily fluid intake. Increasing fluid intake has a preventive effect on the risk of developing a first kidney stone (primary prevention) but also decreases the risk of stone recurrence (secondary prevention). Current guidelines recommend increasing fluid intake at least at 2.5L /day to prevent stone formation, and even at 3.5-4L in some severe forms of nephrolithiasis (primary or enteric hyperoxaluria or cystinuria). Fluid intake must also be balanced between day and night, to avoid urinary supersaturation during the night. Patients should be informed and supported in this difficult process of increasing urine dilution, with practical ways and daily routines to increase their fluid intake. The liquid of choice is water, which should be chosen depending on its composition (such as calcium, bicarbonate or magnesium content). Finally, some additional advices have to be given to avoid some beverages such as those containing fructose or phosphoric acid, which are susceptible to increase the risk of nephrolithiasis.

Keywords: Wall-like RC columns; Strengthening; FRP; NSM rebars; Steel plates; Testing; FE modeling; Preloading.

The current clinical model for genetic-testing is based on clinical-criteria/family-history(FH) and a pre-defined mutation probability threshold. It requires people to develop cancer before identifying unaffected individuals in the family to target prevention. This process is inefficient, resource intense and misses >50% of individuals/mutation carriers at risk. Population genetic-testing can overcome these limitations. It is technically feasible to test populations on a large scale; genetic-testing costs are falling and the acceptability/awareness is rising. MEDLINE/EMBASE/Pubmed/CINAHL/PsychINFO databases were searched using a free-text and MeSH terms; reference lists of publications retrieved screened; additionally web-based platforms, Google, and clinical-trial registries were searched. Quality of studies were evaluated using appropriate check-lists. A number of studies have evaluated population-based BRCA-testing in the Jewish-population. This has been found to be acceptable, feasible, clinically-effective, safe, associated with high satisfaction rates and extremely cost-effective. Data support change in guidelines to population-based BRCA-testing in the Jewish-population. Population panel-testing for BRCA1/BRCA2/RAD51C/RAD51D/BRIP1/PALB2 gene mutations is the most cost-effective genetic-testing strategy in general-population women and can prevent thousands more breast/ovarian cancers than current clinical-criteria based approaches. A few ongoing studies are evaluating population-based genetic-testing for multiple cancer susceptibility genes in the general-population but more implementation studies are needed. A future population-testing programme could also target other chronic diseases.

This study investigated the relationship between aluminum adjuvant vaccines and the prevalence of 4 childhood diseases (Autism, Allergies, Asthma, ADD/ADHD) using data from the 2020-2021 National Survey of Children's Health (NSCH) [1] and the Centers for Disease Control National Immunization Survey (CDC NIS) [2]. The study found an association with aluminum adjuvant dosage and the prevalence of each disease studied (Autism, Allergies, Asthma, ADD/ADHD) through a weighted regression analysis of disease prevalence against the summed likelihood of aluminum adjuvant vaccine uptake.

BACKGROUND: Functional constipation can lead to painful defecations, fecal incontinence, and abdominal pain, significantly affecting a child's quality of life. Treatment options include non-pharmacological and pharmacological approaches, but some cases are intractable and require alternative interventions like neuromodulation. A subtype of neuromodulation, called Transcutaneous Posterior Tibial Nerve Stimulation (TPTNS), comprises electrical stimulation at the ankle level, by means of electrodes fixed to the skin. TPTNS is a minimally invasive, easy-to-apply technique that can potentially improve constipation symptoms in the pediatric population by stimulating the sacral nerves. AIM: To evaluate the clinical results and applicability of TPTNS as an adjuvant treatment for children and adolescents with functional constipation. METHODS: Between April 2019 and October 2021, 38 patients diagnosed with functional constipation according to the Rome IV Criteria were invited to participate in the study. The study followed a single-center, uncontrolled, prospective cohort design. Patients received TPTNS for 4 or 8 weeks, with assessments conducted immediately after the periods of TPTNS and 4 weeks after the end of the intervention period. The data normality distribution was determined by the Shapiro-Wilk test. Wilcoxon test and Student's t-test for paired samples were used to compare quantitative variables, and the McNemar test was used to compare categorical variables. RESULTS: Of the 38 enrolled patients, 28 children and adolescents with intractable function constipation completed the study, receiving TPTNS for 4 weeks. Sixteen patients (57.1%) extended the intervention period for 4 extra weeks, receiving 8 weeks of intervention. TPTNS led to significant improvements in stool consistency, frequency of defecation, and bowel function scores, with a reduction in abdominal pain. Quality of life across physical and psychosocial domains showed substantial enhancements. The quality of life-related to bowel habits also improved significantly, particularly in lifestyle, behavior, and embarrassment domains. The positive effects of this intervention are seen relatively early, detected after 4 weeks of intervention, and even 4 weeks after the end of the intervention. TPTNS was well-tolerated, with an adherence rate of approximately 78%, and no adverse effects were reported. CONCLUSION: TPTNS is an adjuvant treatment for intractable functional constipation, improving bowel function and quality of life. The effects of TPTNS were observed relatively early and sustained even after treatment cessation.

This research mapped significant social networks of victims of childhood sexual abuse, identifying relationships between childhood trauma and social bonds in adult life. Ten adult women, aged between 20 and 40 years, in psychiatric care for the consequences of trauma suffered in childhood participated in the research. For data collection, the map of significant social networks was used and analyzed through the structure, functions and attributes of the bonds. The network is composed of people from the Friendship, Family, Community, Work/Study and Health Teams group. The networks of friendships, family, co-workers or studies play a predominant role of emotional support, while the Health Teams also offer emotional support, but primarily provide clinical support in overcoming trauma and its consequences. The network of relationships has specific functions that maintain psychosocial integrity and help women to overcome the abuse suffered.

Purpose: To explore parents’ perceptions of the educational intervention programme regarding their children’s postoperative pain management. Design and Methods: A qualitative descriptive study was conducted. Thirty-two parents whose children underwent inpatient elective surgery were recruited from the two intervention groups (received an educational booklet and a video, with or without an hour of face-to-face teaching session) for this qualitative evaluation of the intervention. Participants were asked to comment on the content and delivery methods of the intervention via individual face-to-face semi-structured interviews. Thematic analysis was used to identify themes from the data. Results: Three themes were generated from 32 participants’ interview data: current pain management practices, experiences and benefits of the educational intervention, and suggestions to improve pain management. Conclusions: Our findings suggested that the educational intervention in children’s postoperative pain management was helpful for parents and their children. However, it is necessary to improve educational materials and equip healthcare professionals with non-pharmacological pain relief methods. Practice Implications: Our findings reveal the current challenges in extensively adopting non-pharmacological pain relief methods. Healthcare professionals can do more to routinely integrate pharmacological and non-pharmacological pain management strategies in relieving pain effectively. Future research could develop technology-based programmes to increase ease of access. Trial Registration Number: ISRCTN24910957.

The study proposes planning independent children's mobility through geoinformation technologies for listening to children. This research assumes that children’s values and expectations must be considered in city planning. A bibliographic review identifies 15 indicators which make spaces safe and attractive for children to circulate and play. Thematic maps of the indicators are prepared, integrated by Multicriteria Analysis by Weights of Evidence, according to the hierarchical importance of each variable. The definition of weights considers the opinion of children and technicians. Consultation with children is carried out by Mapping Volunteers (VGI), Consultation on Hierarchy, Geodesign of Ideas for the area and Artistic Workshop. In the technical study, the query applies the Delphi method. It uses the VGI – Volunteered Geographic Information – web-based platform, where children record places of topophilia and topophobia, while technicians map the presence of 15 indicators. The set of information is made available on a web-based platform of SDI – Spatial Data Infrastructure, in which there are resources for a Geodesign workshop when ideas for the area are elaborated through negotiation and co-creation. The product is a transformation design for the area through urban design and parameterisation of uses.

2003 it is shown that after the Chernobyl accident, childhood leukemia by single age and year of birth in the 0-4y cohort increased significantly in Wales and Scotland combined in the period 1986-1990 compared with controls born 1970-1985 and 1991-1994. Relative risk RR = 1.41; 95% CI 1.20<RR<1.65; p = 0.00004. These exposure periods were chosen because whole body Caesium-137 monitoring had demonstrated that internal exposures persisted for more than 4 years. The dose-response exhibits saturation and reversal, interpreted as biological censoring effects in the developing individual.

Background: The respiratory syncytial virus infection (RSV) spread has been unusually high during 2022 and increasing trends have been documented We aimed to assess the survival experience of children hospitalized due bronchiolitis by laboratory-confirmed RSV. Methods: A nationwide and retrospective cohort was conducted in Mexico and data from 436 children aged 5 years and younger, with symptoms onset from August 2021 to November 2022, were analyzed. Survivor functions and 95% confidence intervals (CI) were computed by using the Kaplan-Meier method. Results: The survival rates were high, particularly within the first three weeks of admission. The 3-day survival was 99.8% (CI 95% 98.4-99.9%) and went to 98.9% (CI 95% 96.5-99.7%), 97.5% (CI 95% 91.9-99.3%), 86.7% (95% CI 48.2-97.2%), and 69.4% (95% CI 24.2-91.0%) on days 7, 14, 21 and 28 of hospital stay, respectively. We documented 5 fatal outcomes, and the mortality rate was 2.1 per 1,000 person-days. Conclusions: We analyzed a large set of pediatric patients with bronchiolitis by RSV and the presented results contribute to achieving a better understanding of the in-hospital evolution of this disease.

1) Background: A significant proportion of child laborers are compelled to work in exploitative environments, experience both deteriorating health and financial loss. The present study sought to determine the factors affecting child labour and the characteristics of their working environment. 2) Methods: A questionnaire survey was conducted with 80 child labourers aged 5 to 17 years. Alongside descriptive statistics, a newly devised technique known as Influencing Causes Index (ICI) was administered and tested. 3) Results: The startling demographic findings reveal that peak share of child labourers are young children (12-14 years) and 32.5% child laborers had never attended school. The thorough assessment of determinants reflects that not only poverty, but schooling expenses and lack of access opportunity to primary schools are also the top-ranked push factors to trigger children towards labour. Around 72.5% of children work for over 8 hours a day. A significant proportion of participants received no leave, training, or access to hygiene facilities. The existing pattern of employment and working conditions resulted in musculoskeletal pain and dermatological infections among child labourers (p&lt;0.05). 4) Conclusion: This research suggests that income measures for households, and an education programme for both children and parents would expedite the abolition of child labour.

Infant obesity has become one of the most serious global health challenges of our time. The combined prevalence of overweight and obesity has rapidly increased worldwide during the last two decades, especially in some developing countries where obesity is reaching levels on a par with some industrialized countries, or even higher. This fast growth has occurred especially in countries in the midst of rapid social-economic transitions. Most international comparisons focus on the adult population while analyses focusing on the child population are more limited. Using the methodology developed by Phillips and Sul [1], this paper studies the worldwide evolution of infant body mass index (BMI), overweight and obesity prevalence for a large sample of countries during the period 1975-2016. Our results indicate that the figures for BMI or the prevalence of obesity in different countries do not converge, while the opposite is the case for overweight prevalence in children. Furthermore, there is a non-linear relationship between obesity and income or human capital, indicating that low and middle-income countries require a strong initiative for health policies targeting obesity prevention.

This article sets out to deconstruct and challenge the psychologised and pathologising approach that has come to dominate child protection practice in Aotearoa-New Zealand and comparable societies in neoliberal times. Within a risk and protection focused paradigm circumstances and behaviours associated with material deprivation are construed as indicators of heightened danger and harm as opposed to a means of better understanding family life. In this way, although poverty may be classified as an issue that is worthy of attention in the realm of broader economic and social policy, structural inequality is rendered largely irrelevant to the practice of statutory child protection. This article sets out to trouble this construction. It will be argued that understandings of how the effects of material inequality are played out in the lives of children and their families are critical to the development of more effective child protection social work. This ‘life-world’ is generally populated by young women parenting in poverty. Poverty exacerbates the everyday struggle of parenting - it shames and dis-empowers; reducing confidence and perceptions of competence (Gupta, 2015). A paradigm shift is needed. Child protection policy and practice needs to re-engage with the every-day struggles that accompany the lives of socially marginalised families in increasingly stratified late capitalist society. The future of social work in child protection depends on it.

Background: Facebook represents a new dimension for global information sharing. Suicidal behaviours and attempts are growingly reported on Facebook. This scoping review explores the various aspects of suicidal behaviours associated with Facebook, discussing the challenges and preventive measures. Methods: PubMed, Google Scholar, and Scopus were searched for related articles published in English up to October 2021, using different combinations of "Facebook" and "suicide". A group of consultant psychiatrists screened the records and read the full-text articles to extract relevant data. Results: Facebook impacts suicidal behaviours in different aspects. Announcing suicides through sharing notes or personal information, which can be helpful in prediction of suicide, and harmful since negatively affects audience. Live-streaming videos of suicide is another aspect, which questions the ability of Facebook to monitor shared contents that can negatively affect the audience. Helping bereaved families to share feelings and seek support online, commemorating the lost person by sharing their photos is another positive impact. Moreover, it can provide real-world details of everyday user behaviours, which are helpful to predict suicide risk, primarily through novel machine-learning techniques, and provide early warning and valuable help to prevent it. It can also provide a timeline of the user's activities and state of mind before suicide. Conclusions: Social media can detect suicidal tendencies, provide support for those seeking help, comfort family and friends with their grief, and provide insights via timelining the users' activities leading to their suicide. The lack of quantitative studies on evaluating preventative efforts on Facebook was one of the limitations. The creators' commitment and the users' social responsibility will be required to create a mentally healthy Facebook environment.

Monkeypox virus was named so because of its detection in monkeys in 1958. It belongs to the same family as smallpox and chickenpox viruses. There had been numerous outbreaks of this malady initially in the African continent and other parts of the world. The simultaneous spread in nineteen countries in 2022 has raised some serious concerns.Monkeypox is no more a rare disease and has the potential for bioweapon use. We discuss the various ways to prevent its spread, treatment options available, diagnosis, and differentiation from other closely related diseases. We also discuss if the present outbreak could be a bioattack or if this disease is here to stay.The literature suggests that we can effectively manage Monkeypox because of the availability of drugs and vaccination against smallpox. There is also a need for active surveillance against the new resistant recombinant viral strains. The possibility of this outbreak being a bioattack seems remote, although there are questions about the transmission which still need to be answered.

Kinesio tape is considered one of the most common techniques which using recently, where it is used as a therapeutic technique for pain relief, correction of joint position, prevention of oedema and injuries, improve range of motion and muscular activity for the individual. This study is a descriptive research design and aims to identify the effect of using Kinesio tape on the neuromuscular activity of quadriceps muscle after the rehabilitation program of the knee joint. The study sample consists of (10) players from different sports (football, basketball …etc.) and suffering from knee joint injuries. This sample was taken from Kafr-El sheikh and Kaleen club. Results showed that Kinesio tape doesn’t have any explicit effect on the neuromuscular activity of muscle but acts as a catalyst for muscle and promote a person’s feeling of psychological wellbeing and reassurance.When comparing results of using Kinesio tape during performing leg squatting and balance test with not using tape, founded that when performing leg squatting and balance test with using Kinesio tape, there were significant effects on muscle activity compared to not using it.

Tripping is the largest cause of falls and low swing foot ground clearance during the mid-swing phase, particularly at the critical gait event known as Minimum Foot Clearance (MFC) is the major risk factor for tripping-related falls. Intervention strategies to increase MFC height can be effective if applied in real-time based on feed-forward prediction. The current study investigated the capability of machine learning models to classify the MFC into various categories using toe-off kinematics data. Specifically, three MFC sub-categories (less than 1.5cm, between 1.5-2.0cm and higher than 2.0cm) were predicted applying machine learning approaches. A total of 18,490 swing phase gait cycles’ data were extracted from six healthy young adults, each walking for 5-minutes at a constant speed of 4km/h on a motorised treadmill. Both K-Nearest Neighbour (KNN) and Random-Forest were utilised for prediction based on the data from toe-off for five consecutive frames (0.025s duration). Foot kinematics data were obtained from inertial measurement unit attached to the mid-foot, recording tri-axial linear accelerations and angular velocities of the local coordinate. KNN and Random-Forest achieved 84% and 86% accuracy, respectively, in classifying MFC into the three sub-categories with run time of 0.39 seconds and 13.98 seconds respectively. The KNN-based model was found to be more effective if incorporated into an active exoskeleton as the intelligent system to control MFC based on the preceding gait event, toe-off due to its quicker computation time. The machine learning based prediction model shows promise for the prediction of critical MFC data indicating higher tripping risk.

Abstract: This study aimed to evaluate the long-term impact of paediatric dentistry programmes on children and adolescents to reduce oral health inequalities. It measures and assesses the improvement effects of paediatric dentistry programmes on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and paediatric dentistry programmes between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. Frequency analysis was conducted for demographic characteristics, and binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. Data were analysed using PASW Statistics with the statistical significance level set at α=0.05. Regarding oral health indicators based on the frequency of participation in paediatric dentistry programmes for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health indicators in paediatric dentistry programmes between primary and adolescent age groups, individuals under continuous management showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, binary logistic regression analysis revealed significant influences (p

Sleep is of vital necessity for health, it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose was to identify the scientific production on sleep patterns in children and adolescents with chronic conditions and their families. This integrative review was developed in March and June 2022, of the MEDLINE, Web of Science, CINAHL and PSYCInfo. The articles included were original papers published be-tween January 2007 and mid-2022. Excluded were review studies that did not evaluate sleep and whose participants did not have chronic conditions or were not children, adolescents and/or their families. The searches returned 814 abstracts. After exclusions, 47 studies were selected to be read in full; of these, 29 were selected and were grouped empirically into four categories: major alterations in sleep patterns of children and adolescents with chronic conditions; the relationship between sleep disorders and symptoms in children and adolescents with chronic conditions; impaired sleep patterns of families of children and adolescents with chronic conditions; sleep alterations and their relationship with other problems in families of children and adolescents with chronic conditions. All studies showed sleep pattern impairment in children and adolescents with chronic conditions and their families.

This study investigated how positive (e.g., incentives) and negative (e.g., restrictions) reinforcement used in vaccination promotional messages and trust in government impact parental vaccine perceptions and decisions on vaccinating their children during a large-scale infectious disease crisis. Two hundred and eighty-six parents of unvaccinated teens participated in a 2 (reinforcement: positive vs. negative) × 2 (trust in government: high vs. low) between-subjects experimental survey. Positive reinforcement (e.g., gift cards for the vaccinated) was more effective for parents with low trust in the government to improve their attitudes and intentions toward child vaccination, while parents with high trust in the government were unaffected by reinforcement types. To the best of our knowledge, this study is among the first to examine the effects of both positive and negative reinforcement on vaccination perceptions and behavioral intentions through a controlled experiment and is the first study to do so in a large-scale infectious disease crisis setting. This research is expected to help public health professionals better prepare for and manage virus-induced public health crises in the future.

The relationship between child psychology and the widespread usage of mobile devices in the modern day is examined in "The Mobile Dilemma: Child Psychology and the Era of Technological Dependence." The abstract serves as a brief synopsis of the work, highlighting its important ideas and arguments. Concerns concerning the effects of excessive time spent on mobile devices on children's mental health and development have arisen in this age of technology dependency. The essay opens by pointing out the importance of investigating the psychological effects of kids' exposure to mobile gadgets. The effects of mobile phone addiction on learning, memory, and social and emotional health are investigated. The neurodevelopmental implications are explored further in the abstract, with a focus on the impact of mobile technology on brain plasticity and the formation of the developing brain. It offers advice on how to establish appropriate limits for children's screen time, encourages the development of digital literacy, and promotes responsible behavior.The pros and cons of using mobile devices in the classroom are also examined, along with their effects on students' ability to study and the risks and difficulties that could arise from implementing such a strategy. The emotional and social impacts of mobile device addiction are discussed in the abstract. This includes the impact on one's social life, empathy, ability to communicate, and sense of self-worth. The abstract also stresses the importance of interdisciplinary efforts involving parents, teachers, psychologists, and legislators to combat mobile device addiction through intervention and preventative techniques. Future directions are highlighted, with a focus on topics such as mobile technology development, digital well-being, privacy protection, mental health implications, screen time limits, digital literacy, and the impact of cultural and socioeconomic variables.

It is difficult to obtain necessary information accurately from Social Networking Service (SNS) while raising children, and it is thought that there is a certain demand for the development of a system that presents appropriate information to users according to the child's developmental stage. There are still few examples of research on knowledge extraction that focuses on childcare. This research aims to develop a system that extracts and presents useful knowledge for people who are actually raising children, using texts about childcare posted on Twitter. In many systems numbers in text data are just strings like words and are normalized to zero or simply ignored. In this paper, we created a set of tweet texts and a set of profiles created according to the developmental stages of infants from "0-year-old child" to "6-year-old child". For each set, we used ML algorithms such as NB (Naive Bayes), LR (Logistic Regression), ANN (Approximate Nearest Neighbor algorithms search), XGboost, RF (random forest), decision trees, and SVM (Support Vector Machine) to compare with BERT, a neural language model, to construct a classification model that predicts numbers from "0" to "6" from sentences. The accuracy rate predicted by the BERT (Bidirectional Encoder Representations from Transformers) classifier was slightly higher than that of the NB, LR, ANN, XGboost, RF, decision trees, and SVM classifiers, indicating that the BERT classification method was better.

Benefits of baby swimming have been established, but there is limited knowledge about the methodologies used by practitioners. To address this knowledge gap, this study aimed to categorize and classify the equipment and environmental used in baby swimming programs worldwide. A descriptive categorical content analysis approach was employed to analyse videos of baby swimming programs obtained from YouTube. The framework created was validated for interrater reliability, and a pilot study was conducted to classify videos from different countries based on the equipment and environment used. Results indicated that the physical environments observed were pool tanks and swimming pools with and without depth reduction zones, while the equipment used included assistive devices, toys, and clothes. This study represents a significant first step in the development of a comprehensive tool to systematize and characterize the methodologies used in baby swimming programs globally.

It is difficult to obtain necessary information accurately from Social Networking Service (SNS) while raising children, and it is thought that there is a certain demand for the development of a system that presents appropriate information to users according to the child's developmental stage. There are still few examples of research on knowledge extraction that focuses on childcare. This research aims to develop a system that extracts and presents useful knowledge for people who are actually raising children, using texts about childcare posted on Twitter. In many systems numbers in text data are just strings like words and are normalized to zero or simply ignored. In this paper, we created a set of tweet texts and a set of profiles created according to the developmental stages of infants from "0-year-old child" to "6-year-old child". For each set, we used Support Vector Machine (SVM), and Bidirectional Encoder Representations from Transformers (BERT), a neural language model, to construct a classification model that predicts numbers from "0" to "6" from sentences. The accuracy rate predicted by the BERT classifier was slightly higher than that of the SVM classifier, indicating that the BERT classification method was better.

In this study, we analyse if in-utero exposure to Ramadan fasting period is negatively associated with child nutrition? The data for the analyses come from a retrospective assessment of 924,198 children from 103 demographic and health surveys (DHS) across 56 countries during the period 2003-2020. Considering the month-long Ramadan exposure as a natural experiment, we implement an intent-to-treat framework, comparing outcomes among individuals who were exposed to Ramadan at any time in-utero to those who were not exposed. Our findings do not show significant evidence to conclude that in-utero exposure to Ramadan fasting period is negatively associated with child nutrition. On the contrary, except for stunting in children who had in-utero exposure to Ramadan during the first trimester, among Muslims, we find slightly better nutritional outcomes among children exposed in-utero to Ramadan period. The better nutritional outcomes among children exposed in-utero can be attributed to high nutritious food intake and better hygienic practices during holy months of Ramadan compared to usual months. Our main results are robust to multiple robustness checks.

The MLL gene is a site of frequent rearrangement in acute leukemia with multiple fusion partners, but MLL-SEPT6 rearrangement is rare in clinical leukemia practice, and only 13 cases have been reported. We describe the case of an acute myelogenous leukemia child with MLL-SEPT6 rearrangement whose age of onset and accompanying gene mutations differs from previous reports. Considering the poor prognosis of leukemia children with MLL-SEPT6 rearrangement and the unsatisfactory results of existing treatments, the study of this case may provide new theories for diagnosis and treatment of MLL-SEPT6-associated childhood acute leukemia.

In some parts of Nigeria, many girls do not attend school, and among those sent to school, many still drop out early. This and other socio-cultural factors affect girls psychologically. There is no doubt that girls need consistent love and tutoring to guide them through the turbulent teen years and beyond. They need a mentor who acts as a friend and a role model. The Mobile-based Mentoring Platform seeks to leverage on mobile technology's affordances to focus on the needs of the girl-child, such as improvement in academic achievement, guidance in career choice, development of self-concept, and esteem. The girl-mentees comments revealed that using the platform provided them frequent access to mentors and access to learning opportunities. The challenges they faced include epileptic internet network, intrusions by parents, and others. Therefore, this paper examined the challenges and benefits of mentoring girls via a mentoring platform.

(1) Background: There is robust evidence of an attention bias-anxiety relationship in children, but lack of appropriate methods has limited the number of studies with children younger than 8 years old. This study used eye-tracking as a measure of overt attention in young children. The aim of this study was to assess anxiety related attention bias in children aged 4 to 8 years. Age was considered as a moderator and the influence of effortful control was investigated. (2) Method: A community sample of 104 children were shown pairs of happy-neutral and angry-neutral faces. Growth curve analyses were used to examine patterns of gaze over time. (3) Results: Analyses revealed moderation by age and anxiety, with distinct patterns of anxiety-related biases seen in different age groups in the angry-neutral face trials. Effortful control did not account for age related effects. (4) Conclusions: Results support a moderation model of the development of anxiety in children.

The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparity populations. The objective of our study was to evaluate the efficacy and scalability of the Healthy Eating Lifestyle Program (HELP) – a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino pediatric obesity patients and their families. Our evaluation methods included: 1) a quasi-experimental, one group, longitudinal study to measures changes in BMI at 0, 6, and 18 weeks of follow-up, and 2) A stakeholder analysis consisting of six key informant interviews of HELP program staff. We found a significant decrease in body mass index across all adults (-0.2 kg/m² p=0.0047), that was much stronger in men. For children ages 5-12 years, there was also a significant decrease in BMI Z score from pre- to post- intervention (p=0.04). Program strengths were the cultural tailoring of the plant-based diet choices, and allowing a tiered approached that did not require adherence to strict vegetarianism. Our pilot study findings from HELP raise the possibility that incorporating plant-based diet choices into the treatment of pediatric obesity patients and their families can be an effective addition to a culturally responsive care model.

Assessment of cardiac function is the leading parameter when evaluating the state of the cardiovascular system of patients undergoing chronic hemodialysis. The aim of the paper: to assess the state of the cardiovascular system of these patients using new sensitive echocardiography and Doppler techniques and thus advance the prevention of cardiovascular disease.Method: Twenty children with end-stage renal insufficiency on chronic hemodialysis and twenty healthy controls underwent echocardiographic monitoring using standard Doppler and tissue Doppler imaging. Structural and functional changes in the left ventricle were evaluated.Results: Patients on hemodialysis had significantly greater left ventricular mass indices compared to the controls (p<0.001). The patients on hemodialysis had preserved systolic function – their fractional shortening, ejection fraction and Sm (systolic myocardial velocity) did not differ significantly compared to the controls (p>0.05). Early diastolic function in children on hemodialysis was also preserved: the E/A and Em/Am ratio did not differ significantly from the control group (p>0.05). Children on hemodialysis exhibited impaired late diastolic function (compliance index), that is, considerably higher E/Em compared to controls (p<0.00). Myocardial Performance Index values showed statistically significant elevation in children on hemodialysis compared to the control group (p<0.001).Conclusion: Tissue Doppler in tandem with conventional Pulsed Doppler can provide additional information on left ventricular filling pressures (E/Em) in children on hemodialysis. It is therefore recommended to perform routine measuring of Em waves and the E/Em ratio, not only in order to evaluate myocardial relaxation and ventricular filling pressures, but primarily to stratify risk and provide a prognosis.

In recent years, more attention has been paid to behavioral problems in children. However, for the most part, risk factors for these problems have yet to be determined. The current prebirth cohort study investigated the relationship between maternal calcium consumption during pregnancy and behavioral problems in five-year-old Japanese children. Subjects were 1199 mother-child pairs. Dietary intake was assessed using a diet history questionnaire. Emotional problems, conduct problems, hyperactivity problems, and peer problems were assessed using the Strengths and Difficulties Questionnaire. Logistic regression analysis was conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for four behavioral problems under study according to the quartile of calcium intake, with the lowest quartile as the reference. Adjustment was made for maternal age, gestation at baseline, region of residence at baseline, number of children at baseline, maternal and paternal education, household income, maternal depressive symptoms during pregnancy, maternal alcohol intake during pregnancy, maternal smoking during pregnancy, child's age, child's birth weight, postnatal secondhand smoke exposure at home during the first year of life, and breastfeeding duration. Higher maternal calcium intake during pregnancy was independently associated with a decreased risk of childhood emotional and hyperactivity problems; the adjusted ORs between extreme quartiles (95% CIs, P for trend) were 0.46 (0.27–0.79, 0.01) and 0.60 (0.37–0.97, 0.046). No such inverse associations were observed for childhood conduct problems or peer problems. Maternal calcium intake during pregnancy may decrease the risk of childhood emotional and hyperactivity problems.

The aim of this study was to evaluate the usefulness of cystoscopic injection of Botulinum-A toxin (BTX) in the detrusor wall in the treatment of children with decreased bladder capacity due to neurogenic bladder. The prospective, randomized non placebo controlled trial is conducted in our institution since year 2006 with the approval of the local Ethics Committee. 556 cystoscopic injections of BTX were performed in 141 children with neurogenic bladder in age 1 to 18 years. In all cases decreased bladder capacity and bladder overactivity with urine incontinence were estimated. The pre-and post-treatment evaluations included determination of urinary continence status, bladder function in frequency/volume chart of catheterized urine and in urodynamic studies. Parameters measured in urodynamic investigations included maximal cystometric capacity, detrusor reflex volume, maximal detrusor pressure. Parameters were analyzed before the cystoscopy and during the follow-up examinations in 5 age groups. Values of all measured parameters improved significantly and equally after therapy in every from 5 age groups. The results obtained from the study confirmed that endoscopic administration of BTX improves function of urinary bladder in children with neurogenic bladder, and the method represents an alternative approach to conservative treatment and surgical augmentation.

Many emotionally disturbed children who have been maltreated and are legally separated from their parents or primary caregivers live in group homes and receive compulsory education. Such institutions provide various special intervention programs. Taiko, a Japanese style of group drumming, is one such program because playing drums in a group may improve children’s emotional well-being. However, evidence for its efficacy has not been well established at the biological level. In this study, we measured salivary levels of oxytocin (OT), a neuropeptide associated with social memory and communication, in three conditions (recital, practice, and free sessions) in four classes of school-aged children. Following the sessions, OT concentrations showed changes in various degrees and directions (no change, increases, or decreases). However, the mean OT concentration changes after each session increased, ranging from 112% to 165%. Plasma OT concentrations were equally sensitive to drum playing in school-aged boys and girls. However, the difference between practice and free play sessions was only significant among elementary school boys aged 8-12 years. The results suggest that younger boys are most responsive to this type of educational music intervention.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

Rabies persists as a longstanding issue in Zambia, despite being preventable. The current control measures, including dog vaccination, population control, and movement restriction, guided by ‘The Control of Dogs Act Chapter 247 of the Laws of Zambia’, have not yielded the desired impact in many areas of the country including Manyinga and Mwansabombwe districts. These two districts continue to report low dog vaccination rates, unrestricted dog movements, and escalating cases of animal and human rabies, along with dog bites. Aligned with global aspirations to achieve zero human rabies cases by 2030, this study scrutinizes the determinants and obstacles hampering the execution of rabies control initiatives in Manyinga and Mwansabombwe. Spanning approximately 11 months, this cross-sectional study gathered pre- and post-vaccination data from 301 households in Manyinga and 100 households in Mwansabombwe. Questionnaires probed knowledge, attitudes, and practices related to rabies prevention and control. A transect survey, key informant interviews, and assessment of rabies vaccination and dog bite records complemented the data collection. Findings revealed that 88% of respondents from both districts possessed knowledge about rabies, confirming affected species and transmission. Moreover, 76.8% in Manyinga and 88.6% in Mwansabombwe were acquainted with rabies prevention and control methods. Concerning dog owners, 89% were aware of rabies, 66% understood its prevention and control, and the majority identified bites as the primary mode of transmission. Vaccination coverage stood at 64% in Manyinga and 21% in Mwansabombwe. Notably, education and occupation exhibited a positive significant association with rabies knowledge. In terms of dog bite cases, Manyinga recorded 538 dog bite cases from 2017 to June 2022 while Mwansabombwe recorded 81 dog bite and 23 jackal bite cases from 2021 to June 2022. The study underscores critical knowledge gaps in rural areas and emphasizes the imperative for enhanced public education and awareness programs, improved rabies surveillance, free mass vaccination campaigns, and community engagement to augment vaccination coverage and knowledge about rabies.

Chikungunya virus (CHIKV), a single-stranded RNA virus transmitted by Aedes mosquitoes, poses a significant global health threat, with severe complications observed in vulnerable populations. The only licensed vaccine, IXCHIQ, approved by the USFDA, is insufficient to address the growing disease burden, particularly in endemic regions lacking herd immunity. Monoclonal antibodies (mAbs), explicitly targeting structural proteins E1/E2, demonstrate promise in passive transfer studies, with mouse and human-derived mAbs showing protective efficacy. The article explores various vaccine candidates, including live attenuated, killed, nucleic-acid-based (DNA/RNA), virus-like particle, chimeric, subunit, and adenovirus vectored vaccines. RNA vaccines emerge as promising candidates due to their rapid response capabilities and enhanced safety profile. The review underscores the importance of E1 and E2 proteins as immunogens, emphasising their antigenic potential. Several vaccine candidates, such as CHIKV/IRES, measles vector (MV-CHIK), synthetic DNA-encoded antibodies, and mRNA-lipid nanoparticle vaccines, demonstrate encouraging preclinical and clinical study results. In addition to identifying potential molecular targets for antiviral therapy, the study looks into the roles played by Toll-like receptors, RIG-I, and NOD-like receptors in the immune response to CHIKV. It also offers insights into novel tactics and promising vaccine candidates.

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country with high mortality and strict lockdown. This study explored the emotions and challenges of pregnant and post-partum women during the pandemic, using AI-based mixed-methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 post-partum. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and tried to cultivate gratitude and hope. The study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic, and also highlights women’s resilience and coping strategies.

Background: Studies addressing diet quality and mental health have shown a strong association. There is limited evidence of specific vitamins essential for treating depression. This study aims to understand the impact of diet quality through supplementation of vitamins D, B6, and magnesium on depressive symptoms. Methods: Multiple datasets from the National Health and Nutrition Examination Survey 2017-March 2020 investigated the associations between vitamin D, B6, and magnesium on depression symptoms. A cross-sectional sample of adults over 20 was extracted (n=9,232). Chi-square tests and logistic regression analyses were used to investigate the associations. Results: Individuals with low doses of vitamin D were more likely to report symptoms of depression relative to those with low doses of vitamin B6 (χ²=3.9063, p=0.0481 vs. χ²=5.2071, p=0.0225). These results remained significant among those with high magnesium proportionate to high vitamin B6 (χ²=6.1272, p=0.0133 vs. χ²=5.2071, p=0.0225). Logistic regression results provided associations for all models except unadjusted vitamin D and adjusted vitamin D. Conclusions: Preventive measures could be addressed by identifying the risks of vitamin deficiencies. Further epidemiological research is needed for the individual effects of vitamin supplementation and depression symptoms.

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy that involves the continuous administration of antiretroviral drugs to HIV-negative individuals wit a substantial risk of contracting an HIV infection. The use of PrEP has shown a reduction in the risk of HIV acquisition through sexual intercourse by up to 99%. Despite its effectiveness, PrEP uptake remains low among populations at high risk of HIV infection. This highlights the need for further research in stratetegies to enhance awareness and uptake of PrEP amongst these specific populations

This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in UOs with more than five confirmed cases of scabies, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases of at high scabies risk underwent a dermatological examination and the infested HCWs were suspended from work until definitive healing. Mass prophylactic treatment was established for all HCWs working in UOs with more than five confirmed cases of scabies. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. We obtain a prevalence of scabies of 2.6% (21/800) and a duration of the outbreak of 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and have an allergy to dust mites. We obtained a low prevalence of scabies infection, limiting the duration of the outbreak and the related economic burden.

INTRODUCTION: Radiation dermatitis is a common sequela of radiotherapy (RT) that can affect up to 95% of patients, developing moderate to severe skin reactions in up to 30% of them. Variation in fractionation or administration methods may reduce the incidence and severity of radiation dermatitis. It is considered that topical use of preparations holding certain preservatives, surfactants, additives, oils, and impurities should be avoided in cancer patients. In clinical practice, creams of different compositions are used, with and without Epidermal Growth Factor (EFG). OBJECTIVE: To analyze the effectiveness of three creams of different compositions for the control of symptoms and skin side effects of RT.METHODS: A pilot study comparing three treatment groups (HR, HU, and RS creams) during the RT program and with a follow-up of 2 weeks thereafter. Study variables: fractionation, Patient-Observer scale, Maxidex (elasticity, hydration, melanin, erythema).RESULTS: The pilot study sample included 15 patients (5 for each group), so the results were not statistically significant. There were no undesirable side effects to the application of the creams under study and compliance and tolerance were excellent.Regardless of fractionation, RS cream appears to be more effective in controlling symptoms during RT, while HU cream may control them more effectively after the RT regimen is completed.During RT, in hypofractionated therapies, the RS cream seems to preserve elasticity, hydration, and hyperpigmentation allowing erythema that could increase skin repair processes. After the RT is finished, the HR cream further improves elasticity and allows the appearance of erythema.In normofractionated therapies during RT all creams seem to have comparable results in the four cutaneous components analyzed; after completion of RT, HR cream appears to better control hydration and hyperpigmentation.CONCLUSIONS: All the creams analyzed have good control of symptoms and the appearance of the skin during and after RT. The prescription of one or another composition should be done individually according to the cutaneous and clinical particularities of each patient. A study with experimental design is needed to analyze the statistical significance of the differences between the creams analyzed.

(1) Background: This study identifies and analyzes those variables that may influence sick leave due to mental illness, based on a retrospective descriptive study of a mutual insurance company in the industrialized region of southern Europe (Catalonia). (2) Methods: All workers who were on sick leave due to mental illness during the period 2009-2019 were included in the study. The relationships between sick leave due to mental illness and social/employment-related and economical and demographic factors were analyzed using multivariate logistic regression and Cox regression model. (3) Results: The period studied included 34,764 workers. Anxious-depressive disorders account for 83.3% of the diagnosed mental disorders. The age cohorts between 30 and 50 years represent 60% of the affected workers. Highest income and high population density regions are the most affected. The levels of mental illness are higher in spring and summer. Professions related to manufacturing industry, automobile mechanics companies, the hospitality industry, education and healthcare and social service companies was more heavily affected. (4) Conclusions: Population density and GDP per capita, the age cohort, the season of the year, the type of payment, the type of contract, and the worker’s business and profession can predict the appearance of sick leave due to mental illness. Mutual insurance companies should plan interventions to minimize these factors and avoid the socioeconomic consequences.

Background: General Practitioners (GP) have an important role in the prevention of suicidal behavior. The purpose of this study was to explore their views and experiences of identifying and assessing suicidal ideation. Methods: Ten GPs were recruited through convenience sampling, based on accessibility, interest and willingness to participate. In-depth interviews were carried out and results transcribed ver-batim. Aspects of experiences with suicidal patients emerged through the thematic analyses process. Results: The GPs described the varied clinical picture when patients presented in their office. How they identified depressive symptoms apart from originally somatic complaints, formed a trusting relationship and addressed suicide ideation. They described customized interventions as well as obstacles and factors that facilitated communication: time, own personal traits, pa-tient’s disclosure and organizational barriers. Conclusions: The levels of the suicidal process among patients in general practice vary greatly. GPs adjust their appraisals to profundity understand and intervene in order to prevent a crisis to escalate into subsequent suicidal behavior.

Background The high incidence of diverticulitis and hemorrhoidal proctitis episodes in the population imposes an important healthcare and economic burden. Aim To determine the association between intake of certain plant foods and diverticulitis and hemorrhoidal proctitis episodes. Methods Case-control study with quantitative food frequency questionnaire focusing on selected plant foods and derived products. These were grouped by main chemical components into: ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods like curcumin. We quantified intake according to 24-h recall, either on a 1-4 scale (no intake, low, moderate, high intake) or as the number of units consumed (e.g. cups of tea/coffee, n of oranges or lemons); this value was multiplied by the number of reported intake days per week (1-7). Overall intake was expressed as a continuous variable obtained by successively multiplying the score for each food category, and the result was transformed into a common logarithm (range 0.3 to 27.7). Cases and controls were compared using the chi-squared test, student’s t test, odds ratio (OR) and 95% confidence interval (CI), and predictive analysis (multiple logistic regression). Results The sample included 410 cases and 401 controls, who were similar in mean age and gender distribution. The mean score for overall intake of included plant foods was 6.3 points (standard deviation [SD] 4.5), and this was significantly higher in cases (8.5 points, SD 5.3) than in controls (4.1 points, SD 1.2; p < 0.001). Overall intake was similar in cases presenting diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (> 7 points) compared to controls (OR 13.2, 95% CI 8.3 to 20.8, p < 0.001). Predictive logistic regression models showed that the chemical food group most closely associated with diverticulitis and hemorrhoidal proctitis was capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. The OR for age was near the null value. Neither alliin nor miscellaneous food groups showed any association. Conclusions High, frequent consumption of some plant foods and derived products increases the risk of presenting symptoms of diverticulitis and hemorrhoidal proctitis.

To evaluate the efficacy of fish oil for protection against coronary heart disease (CHD), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the use of fish oil for protection against CHD. We retrieved relevant articles published from January 1966 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. RCTs of fish oil in preventing CHD were selected. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. The first selection involved 350 citations. After screening and evaluation of suitability, 19 RCTs adjusted for clustering were included in the meta-analysis. All selected manuscripts considered that fish oil was effective in preventing CHD, secondary outcome measures included angina, sepsis and death. Compared with the control group, fish oil may confer significant protection against CHD (odds ratio = 0.84; 95% confidence interval: 0.72–0.98). There was no significant difference in the incidence of secondary outcomes between the observation group and the control group (P > 0.05). The above results show that fish oil plays an important role in reducing CHD and cardiovascular events. However, because of the suboptimal quality of the studies included into the meta-analysis, these results do not justify adding fish oils systematically to the heavy pharmaceutical assortment already recommended in CHD patients.

There are many types of coronavirus on the bases of important hosts including human, rat, turkey, rabbit, etc. The virus looks like a crown or corona of the sun with its round projection, spike. Now a day, newly emerged coronavirus disease (COVID 19) was first detected at Wuhan, China in December 2019 and it became a public health emergency international concern. Although a couple of researches has been conducting, much secretes of the virus and disease is still not understood and not reached a common understanding yet. However, sharing basic information is crucial based on the existing published research articles and updated information. Therefore, this review aimed to draw attention to the COVID 19 pandemic facts, opportunities, and challenges based on up to date information on cases in Ethiopia. Accordingly, the coronavirus is a single-stranded, non-segmented RNA genome virus. Two third of the genome (5'end) consists of two genes that code nonstructural proteins and the other 2-7 genes (3' end) code structural proteins including spike, envelope, membrane, and nucleocapsid. The virus transmits from animal to human and suggested as it might be originated from a bat and/or seafood. Coronavirus transmit human to human by direct contact and droplets during coughing and sneezing and common symptoms like fever, dry cough, and tiredness, short breathing, etc. can be seen from the patient. So that stay at home and social distancing are the most practicing pre-prevention methods. The disease causes high economic loss, face to face education closure, community cultural practice, and mass gathering activities are prohibited. However, various charity associations and creativities found increase than before. To this end, peoples should accept and follow governmental advice and instructions to escape from the pandemic.

The primary purpose of this investigation was to identify safety-oriented bicycling practices commonly used by adult riders in an urban setting (Brooklyn, New York), and to explore whether there are any differences between the safety-oriented practices of men and women riders. Methods: 24 adult riders (14 men, 10 women) in Brooklyn were interviewed concerning their perceptions of bicycling hazards and their safety-oriented practices. Interviews were recorded, transcribed, and analyzed through thematic analysis. Fisher’s Exact Test was employed to test for gender differences. Results: Participants identified a variety of hazards, mainly due to motor vehicles but also pedestrians and roadway conditions. The analysis distilled twenty-one bicycling practices to summarize prevalent views of the participants about safe riding practices. Related items were grouped under broader categories, generating seven safety-oriented bicycling strategies. Few differences based on gender were found in the analysis; however, women in this study were more likely than men to say that they felt disrespected by other road users. Conclusion: Seven strategies may be important for safe urban bicycling: minimizing exposure to other road users (especially motor vehicles) while riding, being vigilant and anticipating what others might do, riding in a predictable fashion, making one’s presence known to other road users, making sure it is safe before proceeding, obeying traffic rules, and riding at a safe speed. Future studies could develop these concepts further and test whether they are associated with involvement in traffic crashes.

Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behaviour change interventions. Despite the rapid growth in digital health interventions, effective engagement with adolescents remains a pertinent issue. Key strategies for effective engagement include co-designing interventions with adolescents, personalisation of interventions, and just-in-time adaptation using data from wearable devices. The aim of this paper is to appraise these strategies, which may be used to improve effective engagement and thereby improve the dietary behaviours of adolescents now and in the future.

Thin people who undergo implant insertion into the chest wall face a high risk of implant exposure to the external environment. Five months after an 8-year-old boy underwent implantable cardioverter-defibrillator (ICD) implantation in a subcutaneous pocket in the left anterolateral chest wall to manage long QT syndrome, ICD replacement became necessary owing to exposure risk from distal and lateral thinning of the ICD pocket. Pocket rupture and exposure would increase the risk of infection; therefore, we performed ICD removal and primary pocket closure. Two weeks later, a new suprafascial pocket was created, acellular dermal matrix (ADM) was attached to the inner wall to prevent ICD protrusion, and a new ICD was inserted. One year postoperatively, the ADM was engrafted, and no complications were observed. A thin subcutaneous layer increases the risk of ICD implantation complications. Inner wall strengthening with ADM can help prevent pocket rupture.

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine: 1) What constitutes the concept of child-centred care in healthcare? 2) How has the concept of child-centred care developed? 3) What is the applicability of child-centred care and what are its limitations? and 4) How does the concept of child-centred care benefit and inform children’s healthcare? In total, 2984 papers were imported for screening, following removal of duplicates and screening, 21 papers were included in the scoping review.The findings suggest that child-centred care is an emerging, ambiguous, poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact of, and benefit from, child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care it needs to establish robust evidence of its effectiveness, impact on children and their families as well as the wider impacts on the healthcare system.

The current study aimed to examine the relationship between demographic variables within the family context and parenting behaviors among adolescent mothers (including affection, responsiveness, encouragement, and teaching). These factors were correlated with communication, problem-solving abilities, and personal-social development in typically developing infants. The study included a sample of 79 Chilean adolescent mother-child dyads with children aged 10 to 24 months. Communication, problem-solving, and personal-social development were assessed using the Ages and Stages Questionnaire-3, along with a demographic information questionnaire. Parenting behaviors (affection, responsiveness, encouragement, and teaching) were observed using the Spanish version of Parenting Interactions with Children: Checklist of Observations Linked to Outcomes. The findings indicated that employed mothers and those who had not dropped out of school had children with better problem-solving skills. Additionally, children residing with their fathers and female children exhibited superior performance in communication, problem-solving, and personal-social development. Maternal responsiveness was associated with communication and problem-solving, while maternal encouragement was linked to improved problem-solving skills. Maternal teaching was connected to communication, problem-solving, and personal-social development. The study emphasized the significance of parenting and sociodemographic factors among adolescent mothers in influencing their children's development.

The study follows the interaction between the individual and the social context regarding the development of adolescents protected in residential houses from the child protection system in Iasi County, Romania. Starting from the evidence that in situations of providing relatively identical material and social resources, the results obtained by these children vary greatly, we examine how the meaning (understood mainly as purpose and mattering) can constitute a developmental resource. Considering theoretical models and previous research, the study aims to describe, through a qualitative approach, how these young people see themselves and the external environment (family and residential care), how they project their future (their purpose and objectives), and how these constructions and perceptions can influence their quality of life and social integration. We conducted three focus groups with 35 adolescents and young people (the ages 13-21) protected in and for different periods in residential houses (period 1-20 years). The results highlighted that a specific meaning is reconfigured as compensatory when affected by a trauma or adverse external event and thus can be a resource for resilience. On the other hand, the research highlighted that only the existence of goals alone is insufficient to generate action, and the unrealistic meanings given to own persons, experiences, and resources can be dangerous.

SCARED-C instrument (the child version, 41 items) is used for screening anxiety in children between 8 to 18 years old and has been first introduced by Birmaher & collab. in 1995, with good psychometric data - internal consistency from α =.74 to .93 - and good discriminative validity indices in the original versions (1997, 1999). Since then, many countries have adopted the scale, for its utility in identifying five subsets of anxiety disorders (subscales): somatic/panic disorder, generalized anxiety, separation anxiety, social phobia, and school avoidance. The present study contains the first Romanian translated and adapted version of the SCARED-C instrument on a community sample of 477 children (8-18 years old) from Mureș county schools. The instrument showed moderate to good internal consistency (α Cronbach from to .63 to .91 for the total scale) and good test-retest reliability (.70) on a subset of 85 children sample. A confirmatory factorial analysis (CFA) was conducted to test the factor structure of the Romanian version of SCARED-C; results showed that SCARED-C has good psychometric properties to be used for screening anxiety in Romanian children and adolescents. The implications for using SCARED-C in dental practice are discussed. Future studies need to be conducted for exploring convergent and discriminative validity of the instrument and the sensitivity to current DSM-V criteria. Application on a dental pediatric sample is also required.

This prospective observational study aimed to describe voriconazole administrations and trough concentrations in patients with Child-pugh class C clinically, and to investigate the variability of trough concentration. A total of 144 voriconazole trough concentrations from 43 Child-pugh class C patients were analyzed. The majority of patients (62.8%) received adjustments. The repeated measured trough concentration was higher than the first and final ones generally (median, 4.33 vs. 2.99, 3.90 mg/L). Eight patients with ideal initial concentration later got supratherapeutic with no adjusted daily dose, implying accumulation. There was a significant difference in concentrations among the six groups by daily dose (P=0.006). The bivariate correlation analysis showed that sex, CYP2C19 genotyping, daily dose, prothrombin time activity, international normalized ratio, platelet, and Model for end-stage liver disease score were significant factors for concentration. Subsequently, the first four factors mentioned above entered into a stepwise multiple linear regression model (variance inflation factor &lt; 5), implying that CYP2C19 testing makes sense for precision medicine of Child-pugh class C cirrhosis patients. The equation fits well and explains the 34.8% variety of concentrations (R^2 = 0.348). In conclusion, it needs more cautious administration clinically due to no recommendation for Child-pugh class C patients in the medication label. The adjustment of the administration regimen should be mainly based on the results of repeated therapeutic drug monitoring.

Adventurous play, defined as exciting, thrilling play where children are able to take age-appropriate risks has been associated with a wide range of positive outcomes. Despite this, it remains unclear what factors might aid or hinder schools in offering adventurous play opportu-nities. The purpose of this systematic review is to synthesise findings from qualitative studies on the perceived barriers and facilitators of adventurous play in schools. A total of nine studies were included in the final synthesis. The review used two synthesis strategies: a meta-aggregative syn-thesis and narrative synthesis. Findings were similar across the two syntheses, highlighting that key barriers and facilitators were: adults’ perceptions of children; adults’ attitudes and beliefs about adventurous play and concerns pertaining to health; and, safety and concerns about legis-lation. Based on the findings of the review, recommendations for policy and practice as provided to support adventurous play in schools.

When participants in a statistical learning paradigm are asked to learn from two incompatible or competing inputs, they often fail to learn from one or both inputs. This study presents the results of two experiments that were both completed by one group of typically developing four-year-old children. One experiment targeted word-medial consonant patterns (phonotactics), whereas the other targeted strong-weak and weak-strong stress patterns (prosody). The order of the experiments was critical for learning outcomes in the phonotactics experiment: When children learned phonotactics first, their production accuracy increased following exposure to a high frequency input. When children learned phonotactics second, however, their production accuracy dropped when they were exposed to the high frequency input. Results from the prosody experiment were inconclusive, with limited evidence of any learning effect. Overall, the results suggest that children may conflate learning experiences, and patterns learned from an initial experimental input compete with patterns in a subsequent experiment. When considering natural language acquisition, the results suggest that an isolated episode of learning may lead to generalizations that are incompatible with later input, and possibly, with larger patterns in the language.

This study analysed trends of first-time patients visiting the paediatric psychiatry clinic in a university hospital. The medical records from 2009 to 2016 of first-time patients visiting the Kyung Hee university hospital were reviewed, focusing on children in grades 1–12. We analysed the prevalence rate of psychiatric disorders per 100,000 general populations by gender and grade, and the characteristics of patients who sought outpatient care more than three times. The study included 1,467 participants, of which 931 were males (63.5%). The number of male patients per 100,000 populations significantly decreased from 4.14 in 2009 to 2.03 in 2016. While hyperkinetic disorders had the highest prevalence in males, neurotic disorders were most frequent in females. Prevalence of disruptive behaviour disorders in males and mental retardations in females decreased significantly during the study period. The factors affecting continuity were being female, studying in grades 7–12, and diagnosis of depressive, hyperkinetic, and tic disorders. Physicians should consider the new paediatric patients’ gender, grade, and expected diagnosis from their first visit to improve treatment compliance.

The study presents a comparison of the common Child Restraint Systems (CRS) which reduces the value of dynamic loads affecting the child's body during car accidents. The analyzed systems were: child seats, Combi Booster Seats, and straps adjusting vehicle seat belts to children's sizes. The effectiveness of the analyzed devices was assessed on the basis of experimental tests carried out in the accredited laboratory approving the Child Restraint Systems. The tests were carried out accordingly to the new Regulation No. 129 UN / ECE. Whether the tested devices meet the guidelines of the new Regulations No. 129 despite approval in accordance with Regulation No. 44. Based on the research result, better safety parameters of some new solutions dedicated to children’s safety could be observed. The final results show that there is still space for improving the safety of young vehicle passengers.

The study presents a comparison of the common Child Restraint Systems (CRS) which reduces the value of dynamic loads affecting the child's body during car accidents. The analyzed systems were: child seats, Combi Booster Seats, and straps adjusting vehicle seat belts to children's sizes. The effectiveness of the analyzed devices was assessed on the basis of experimental tests carried out in the accredited laboratory approving the Child Restraint Systems. The tests were carried out accordingly to the new Regulation No. 129 UN / ECE. Whether the tested devices meet the guidelines of the new Regulations No. 129 despite approval in accordance with Regulation No. 44. Based on the research result, better safety parameters of some new solutions dedicated to children's safety could be observed. The final results show that there is still space for improving the safety of young vehicle passengers.

Objectives: The aim of this study was to describe potential factors contributing to neonatal mortality in Takeo, Cambodia through assessment of verbal autopsies collected following newborn deaths in the community. The mortality review was nested within a trial of a behavioral intervention to improve newborn survival, and was conducted after the close of the trial, within the study setting. The World Health Organization standardized definition of neonatal mortality was employed, and two pediatricians independently reviewed data collected from each event to assign a cause of death. Results: Thirteen newborn deaths of infants born in health facilities participating in a community based, behavioral intervention were reported during February 2015–November 2016. Ten deaths (76.92%) were early neonatal deaths, two (15.38%) were late neonatal deaths, and one was a stillbirth. Five out of 13 deaths (38.46%) occurred within the first day of life. The largest single contributor to mortality was neonatal sepsis; six of 13 deaths (46.15%) were attributed to some form of sepsis. Twenty-three percent of deaths were attributed to asphyxia. The study highlights the continuing need to improve quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.: The study highlights the continuing need to improve both intrapartum and postnatal quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.

Obesity has been identified as an emerging health concern for Chinese American children; however, very little is known about diets in Asian American children. The objective of our paper was to describe the dietary intakes of urban Chinese American schoolchildren using a state-of-the-art approach for dietary assessment. Data for this analysis come from the Food Journal Project 2017, a pilot and feasibility study conducted by a multi-sector collaboration. Children aged 8-12 (n=83) completed two dietary assessments using a food diary from January-June 2017. Children were then interviewed using the food diary as a guide and dietary data were entered into the online ASA24 system by study staff. Chinese American children were identified using surname, and were compared to non-Chinese peers with respect to nutrient intake and the Healthy Eating Index 2010 (HEI-2010). Chinese American children consumed more sodium dense diets, more protein, and less sugar compared to non-Chinese children. With regards to the HEI-2010, Chinese American children had less favorable whole grains and sodium scores; and more favorable seafood protein and empty calories scores compared to non-Chinese children. Sodium reduction and increasing whole grain intakes may be warranted in this group, but should be verified with additional studies.

Background: Detection of small proportion of serious bacterial infections (SBI) with potentially life threating course in a large group of children with fever admitted to emergency department (ED) is still complicated. Measurement of immature granulocytes (IG) percentage may be used as a marker of bacterial infections. The aim of the study was to evaluate whether the IG percentage is a useful additional predictive marker of SBI. Methods: This study included 258 children with febrile infections admitted to the ED. Clinical follow-up, microbiological and radiological tests were used as reference standards for the definition of SBI. Study population was categorized into two groups: (i) infected patients with no suspicion of SBI (n = 75); (ii) patients with suspicion of SBI (n = 183). IG percentage, white blood cell count (WBC) and C-reactive protein (CRP) levels were analyzed from the first routine blood samples at hospital admission. Results: A statistically significant difference in IG percentage levels was observed in children with SBI and those without - the mean IG percentage was 1.2% for the SBI group, 0.3% for those without SBI. The cutoff level of IG percentage to predict SBI was 0.45 (84% specificity, 66% sensitivity, 90% positive predictive value). We combine variables and evaluate their additive values. The sensitivity of WBC to detected SBI improved from 74% to 85% when IG percentage was added to the prediction models. When CRP, WBC and IG percentage were combined, the sensitivity to predict SBI increased to 93%, the specificity to 86%. (95% CI 77–93%). Receiver operator characteristic analysis to predict SBI showed an area under the curve (AUC) of 0.80 for IG percentage. Conclusion: Addition of IG percentage to traditionally used markers of SBI as WBC and CRP may help to identify children with serious bacterial infections. Furthermore IG percentage can be rapidly obtained from the traditional full blood count without any extra sampling and costs.

Запропонована методика спрямована на визначення та прогнозування технічного стану елементів мосту, що може слугувати прогресивним інженерним інструментом для оцінки надійності та довговічності. Розроблено на основі фундаментальних досліджень, які узагальнюють досвід вивчення фізико-механічних і фізико-хімічних властивостей матеріалів мостових конструкцій, що експлуатуються в реальних умовах. Теоретичною основою методики є модель надійності та прогнозування залишкового ресурсу елементів мосту на основі теорії Маркова. Розроблена методика призначена для оцінки технічного стану окремих елементів мосту з подальшою комплексною оцінкою всієї конструкції. За показник технічного стану прийнята надійність при експлуатації. Цей кількісний показник надійності в моделі є критерієм для: оцінки рівня безпеки елементів мосту; ранжування елементів мосту за необхідністю для конкретних видів ремонту, реконструкції або заміни; стратегічне планування витрат на ремонт або реконструкцію в умовах обмеженого фінансування; прогнозування залишкового ресурсу елементів. Для застосування розробленої методики запропоновано алгоритм оцінки та прогнозування технічного стану мостів. Було проведено математичний експеримент розробленої методики, який підтвердив адекватність висунутої гіпотези, тобто використання моделі надійності та прогнозування залишкового ресурсу елементів мосту. По-перше, запропоновано триступеневий механізм уточнення технічного стану мосту, суттєво підвищення точності розрахунків. Тому розроблена методика має практичне значення і може слугувати основою для інформаційно-аналітичних систем управління станом мостів.