With the improvement of computer, artificial intelligence, information technology and other technical levels, the relationship between man-machine environment systems is more complicated and diversified. The optimization, iteration and development of the new generation of intelligent equipment system and human-computer interaction interface put forward higher requirements for ensuring the safety of personnel, improving the efficiency of human-computer interaction and improving the efficiency of the system. Such as intelligent cabin adaptive cognitive decision aid system, how to adopt intelligent information display and human-computer interaction, optimize information processing, strengthen situational awareness; How to effectively present information and improve the efficiency of human-computer interaction, so that the system has good security, applicability and maximize its effectiveness; How to deal with man-machine matching and man-machine collaboration problems, so as to improve the efficiency of man-machine/unmanned collaborative work. Human factors throughout the life cycle of equipment systems must be fully considered. The human factor is considered in the system design, so that people, machines and the environment can work together and adapt to each other, so as to achieve benign interaction and feedback between people and equipment and interface and complete the full transmission and communication of human-machine intelligent interaction information. The development of new aircraft human-computer interaction systems combined with new technological methods has also gradually changed the role of pilots and staff. From the system operator gradually into the monitor and decision maker, especially with the improvement of the degree of intelligent flight, information technology, advanced complex airborne equipment is increasing, the amount of information that operators need to deal with is also increasing, and the allowed time for judgment and decision is very short, and the mental resources that pilots bear are gradually rising. As the mental load is a key factor affecting the allocation of cognitive tasks, when encountering emergency situations, the mental load overload caused by the increase of information processing tasks often occurs, which seriously affects the task performance of operators, physical and psychological comfort and flight safety, and thus affects the efficiency and safety of the entire aircraft man-machine system. This requires us to conduct real-time analysis of human-computer interaction situational awareness, especially the individual cognitive state as an uncontrollable factor.

This study reveals that with similar valence of empathy, the tendency for humans to help humans in need is stronger than the animal in need. It also illustrates that a convincible advertisement for a charity should be a combination of various feelings, mainly empathic anger, in addition to compassion or empathy. To gain support from young individuals or donors regardless of their personal values, the egoistic values particularly, both the NPOs in humanitarian aid as well as in environmental protection or conservation should develop ads by which each individual or donor is aroused by either an empathic anger and empathic joy or both. This claim is more applicable for any ads developed to help people in need more than animals in need. Nevertheless, this study also found the role of an animal, generally known as innocent, as an actor in an ad is likely more crucial than human. Subjects with high-egoistic values appeared to get vulnerably aroused to a higher extent by being immersed in animal’s suffering than human’s suffering. The feeling of arousal seemed to motivate subjects with high-egoistic values to not decrease the amount of donation to a charity.

In this paper, we explore the surprising behavior of certain discrete maps, drawing inspiration from Collatz-like problems and advanced techniques in analytic number theory, dynamical systems, and differential geometry. Specifically, we investigate a driven cubic-quintic Duffing equation and predict the number of limit cycles around equilibrium points. Furthermore, we develop a novel theoretical framework for chaos suppression in damped-driven systems, leveraging sequences derived from Collatz-like problems. Our study also focuses on analyzing the density of these sequences in both Euclidean and Riemannian metric spaces, providing a comparative analysis of their distribution properties. We estimate the growth rate of sequence density analytically and numerically, highlighting the sensitivity of the density values to the choice of parameters in both metric spaces. Our results present new insights into the behavior of these sequences and their implications for number theory, chaotic dynamics, and geometric analysis.

This study investigates the performance and environmental impact of n-butanol blended with Jet-A fuel in turbo-engines, aiming to assess its viability as a sustainable aviation fuel (SAF). The research involves experimental testing of various blends, ranging from low to high concentrations of methanol, to determine their effects on engine performance and emissions. The experimental setup includes comprehensive measurements of engine parameters such as thrust, fuel consumption rates, and exhaust gas temperatures. Emissions of nitrogen oxides (NOx), particulate matter (PM), carbon monoxide (CO), and unburned hydrocarbons (HC) are also analysed to evaluate environmental impacts. Key findings indicate that n-butanol/Jet-A blends can significantly enhance combustion efficiency and reduce emissions compared to conventional Jet-A fuel. Higher n-butanol concentrations lead to improved thermal efficiency and lower NOx and CO emissions. However, PM emissions slightly increase with higher methanol content. The study underscores the potential of n-butanol as a SAF for turbo-engines, highlighting its ability to mitigate environmental impacts while maintaining or improving engine performance. This research supports the feasibility of integrating n-butanol into Jet-A blends for turbo-engine applications, emphasizing its role in achieving more environmentally friendly aviation operations.

Many laboratory power supply had been designed with higher output variable voltages but with small amount of output current, in this design, a variable 1.25 to 30Vdc laboratory power supply with capable of producing up to 10.0A has been designed using a three terminal voltage regulator with pass transistors.

Introduction: Acute rhinosinusitis (ASR) is a common condition in children, which can be burdened by orbital complication (OC) or intracranial complications (IC) that are rare but have potential for serious sequelae; therefore, it needs prompt diagnosis and treatment. The first line of treatment is intravenous antibiotic therapy. In case of failure of clinical improvement after 48 hours, hypovisus or negative prognostic factors (intracranial abscess, large orbital abscess or in intraconic or lateral localization, cavernous sinus thrombosis), surgical treatment is indicated. Objective: the purpose of this work is to describe the clinical profile, treatments and outcome of a series of patients undergoing surgical treatment for complications of ARS at a tertiary referral center. Material and methods: a retrospective analysis of clinical databases was conducted to identify all patients under 16 years of age who underwent surgical treatment for complications of ARS during the 20-year period 2000-2023. Demographic characteristics, clinical data, radiological investigations, surgical treatment, and follow-up performed were reported for each case. Results: 29 patients (20 males and 9 females), mean age 13 years, were included, 69% of whom had OC, 21% had IC, and 7% had both OC and IC. The main symptoms of OC were orbital edema, hypovisus and diplopia; while the main symptoms of IC were headache, fever, comitial seizures and focal neurological symptoms. Mean hospitalization time was 11.75 (± 9.2) days. The mean length of hospital stay (LOS) was 9.1 days for OC, 21 days for IC and 14 days for OC + IC. A single patient manifested a Potts Puffy Tumor, with a LOS of 10 days. Basal CT and gadolinium-enhanced MRI were performed in all cases. Intravenous antibiotic therapy and surgical clearance was undertaken. The majority of patients (76%) underwent endoscopic endonasal approach, 24% external transorbital approach, 1,16% orbital decompression and 0,58% superior eyelid approach. Any complications related to the surgical procedures were found. All patients with hypovisus and diplopia had complete recovery. During follow-up 7 patients (24%) had sinus recurrences, at a time range of 1 to 4 years after surgery. Conclusion: our experience, in agreement with the data reported in the literature, confirmed the importance of appropriate diagnostic-therapeutic management to avoid potentially serious sequelae of complicated ARS.

This survey is part of a Hungarian Research OTKA project that examines the vegetation of sandy grasslands along the Danube. During this study, two grass species, Festuca wagneri and Festuca tomanii, were identified as potentially suitable for urban planting and turf establishment based on preliminary research. Our aim was to determine the germination success of seeds from aesthetically selected individuals and to identify the soil types on which they germinate most effectively. This information could be crucial for future cultivation efforts. From the collected Festuca individuals, were analyzed 30 specimens of each taxon under garden conditions and selected the indi-viduals for germination. The Festuca tomanii individuals were uniform, so we selected only 5 individuals. The Festuca wagneri individuals were categorized into three groups: upright, spreading, and low types. It was assumed that Festuca species seeds would germinate better in sandy soils. To test this, seeds from ten Festuca wagneri and five Festuca tomanii individuals, selected based on aesthetic criteria, were sown in six different substrates: a sand-peat mixture, sand, coconut fiber, peat, a coconut fiber-sand mixture, and native sandy soil. Contrary to expectations, the growth and germination rates of seeds sown in peat and coconut fiber substrates were higher than those in native sandy soil. These results suggest that Festuca seeds germinate better on substrates resembling dead plant debris with a peat-like structure or on the surface of live mosses, rather than on bare sand. Among the examined individuals, the seeds from the spreading Festuca wagneri group exhibited the highest germination rate, making this group particularly suitable for urban environments. Addi-tionally, one of the upright Festuca wagneri individuals showed the highest growth rate and should also be considered for urban planting. In contrast, despite their uniform appearance, the Festuca tomanii individuals did not demonstrate similar germination trends. In fact, the seeds from two clumps did not germinate at all, indicating that further selection is necessary.

Abstract: Since the establishment of multiparty democracy in the 1990s, Malawi has experienced significant political shifts, with elections playing a crucial role in shaping the political landscape. However, there is a lack of comprehensive understanding of the spatio-temporal dynamics of election results, especially regarding voting patterns and their effects on electoral outcomes. This gap hinders political parties, politicians, and electoral stakeholders in effectively managing regional and temporal changes in voting behaviors. Geographic Information Systems (GIS) are underutilized in Malawi for studying geo-graphical and temporal election data. This study utilized GIS to analyze the spatial pat-terns of election results in Malawi since the advent of multiparty democracy. By collecting geographic data on election outcomes, including vote counts, candidate performance, voter turnout, and other relevant data, the study examined how the geographic distribution of votes impacts electoral results. GIS techniques such as spatial analysis, mapping, and spatial statistics were employed to assess the data and create maps illustrating spatial patterns in Malawi's election outcomes. The study revealed that voting patterns in Malawi are significantly influenced by regional lines. These insights can inform political campaigns, voter mobilization efforts, and strategies for electoral reform.

: Psychological members can provide college students with solid peer support and sustain their mental health. This study examined the relationship between empathy, interpersonal communication, listening and psychological members' competence among 407 university students, and also analysed the mediating role of interpersonal communication and listening. The results showed that psychological members‘ empathy, interpersonal communication, and listening were significantly and positively related to psychological members’competence, interpersonal communication mediated the relationship between empathy and competence, listening mediated the relationship between empathy and competence, and interpersonal communication and listening chained the mediating role between empathy and competence. This suggests that psychological members' empathy enhances their competence by influencing their interpersonal communication and listening, which in turn enhances their competence.

Cuproptosis, a copper-dependent cellular death mechanism, is typically overlooked in glioblastoma diagnosis. Lipoylation is needed for cuproptosis, and FDX1 controls this process. Cuproptosis in prognostic models may drive cancer treatment. This study evaluated cuproptosis and glioblastoma cell proliferation. The Cancer Genome Atlas provided annotated clinical, genetic mutation, and RNA sequencing data for the TCGA_GBM and TCGA_LGG cohorts. Patients with gliomas were randomly allocated to the validation or training cohort. Least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression models were utilized to evaluate which model best predicted prognosis in the training cohort. The models' independent predictive power was evaluated throughout the cohort. A previous study revealed 19 genes related to ferroptosis. LncRNAs associated with cuproptosis were identified by coexpression analysis. Cox discovered 17 cuproptosis-associated lncRNAs and established a predictive model. The median risk score classified patients as high- or low-risk. K‒M survival analysis demonstrated significant differences in overall survival among risk categories. Principal component analysis (PCA) and receiver operating characteristic (ROC) curve analysis were used to test the model’s predictive power. Univariate and multivariate Cox regression analyses revealed risk score-related independent prognostic factors. Multivariate Cox regression analysis was used to construct a nomogram for marker-based prognosis. The risk category affected the tumour mutation rate. High-risk glioma patients benefit from immunotherapy. Glioma drug sensitivity was also substantially linked with the risk score. The expression of 17 cuproptosis-related long noncoding RNAs (lncRNAs) may assist in the stratification of glioma patient prognosis, molecular characteristics, cell cycle gene regulation pathways, the TME, and clinicopathological aspects. Our clinical sample and database analysis revealed that cuproptosis influences glioma prognosis and may guide therapy.

Recent advancements in gut microbiome research have highlighted the complex interplay between gut microbiota and various physiological and pathological processes, showing that gut microbiota plays a vital role in human health and disease. Imbalances in the gut microbiota, known as dysbiosis, have been associated with a range of health conditions, including gastrointestinal disorders, metabolic diseases, etc. In response to these findings, probiotics, prebiotics, synbiotics, and postbiotics have emerged as a promising therapeutic strategy to modulate gut microbiota composition and functionality. This review paper explores the latest research on how gut microbiota impacts host physiology, immune responses, and overall well-being. Furthermore, the paper delves into the therapeutic potential of probiotics, postbiotics, prebiotics, and synbiotics in therapeutic applications and curing various diseases. The paper also addresses the challenges and opportunities in the field, highlighting the need for personalized approaches to probiotic therapy and the importance of considering factors such as strain specificity, dosing, and safety.Overall, this review aims to provide a comprehensive overview of the evolving landscape of gut microbiota and probiotics, prebiotics, synbiotics, and postbiotics as novel therapeutic agents. It underscores the potential of harnessing the gut microbiome to improve health, prevent diseases, and complement traditional medical interventions. As research in this field continues to expand, a deeper understanding of the gut microbiota and probiotics, prebiotics, synbiotics, and postbiotics promises new avenues for preventive and therapeutic healthcare strategies.

Neurodegenerative diseases that include Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), Huntington's disease (HD), and multiple sclerosis (MS), arise due to numerous causes like protein accumulation and autoimmunity, characterized by neurologic depletion which lead to incapacity in normal physiological function such as thinking and movement in these patients. Glial cells perform a critical role in protective neuronal function; in the case of neuroinflammation, glial cell dysfunction can promote the development of neurodegenerative diseases. MiRNA participates in gene regulation and plays a vital role in many biological processes in the body; in the central nervous system (CNS), it can play an essential part in neural maturation and differentiation. In neurodegenerative diseases, miRNA dysregulation occurs, enhancing the development of these diseases. In this review, we discuss neurodegenerative diseases (Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS)) and how miRNA is preserved as a diagnostic biomarker or therapeutic agent in these disorders. Finally, we highlighted miRNA as therapy.

Many cities are increasingly adopting blue-green infrastructure (BGI) to bolster resilience against environmental challenges. Beyond its well-acknowledged environmental benefits, the role of BGI in enhancing social resilience is becoming an equally important area of focus. However, the integration of BGI to foster social resilience presents complexities, stemming from the evolving and occasionally ambiguous definition of social resilience. Given its broad application across diverse disciplines, understanding and measuring social resilience proves difficult, posing challenges to understanding it within a BGI context. However, integrating BGI to support social resilience is complicated by the evolving and sometimes ambiguous definition of social resilience. This concept's broad applicability across various disciplines makes its understanding and measurement challenging, especially within the BGI context. Consequently, a clear need for a framework to effectively understand and measure social resilience in BGI settings exists. This paper synthesizes existing social resilience frameworks, particularly leveraging the comprehensive 5S framework by Saja et al. (2018), to create a new conceptual framework that addresses the unique social dimensions and benefits of BGI, incorporating insights from a broad literature review on social resilience. The framework is structured as a three-tier model centered around four key subdimensions of social resilience: social values, social capital, social structure, and social equity and their interrelationships. Characteristics and indicators are customized to support the BGI context integrating both physical and human dimensions within a mixed methods approach to measurement. Specifically, this research develops a conceptual BGI framework to probe into BGI practices and perspectives that enhance social resilience and considers demographic diversity and the spatial attributes of urban environments to understand how to foster more inclusive and socially resilient BGI spaces.

BackgroundAdvanced radiological stage of knee osteoarthritis (OA) and obesity are predictive of poorer and shorter response to viscosupplementation, but very few is known regarding the impact of other factors such as sport practice, comorbidities or anatomical features of OA. ObjectivesTo investigate the patient’s and OA characteristics associated with the duration of effectiveness (DE) of viscosupplementation in patients with knee OA.MethodsCross-sectional single center trial in patients with knee OA treated with intra-articular (IA) hyaluronic acid (HA) injection(s) within the previous 3 years. The investigator collected demographic and radiographic data (Kellgren grade, involved knee compartments), dosing regimen (single or repeat injections), presence and volume of joint effusion, previous or concomitant IA corticosteroid injection, number of previous viscosupplémentations and the comorbidities. The patient completed a questionnaire including the self-assessment of DE (number of weeks during which viscosupplementation was effective on symptoms), the activity level (sedentary, active, athletic), the level of sport activity (light, moderate or intensive). Predictors of DE were studied in univariate and multivariate analyses ResultsOne hundred five patients (149 knees) were analyzed (62% women, mean age 66.1 ± 13.2 years, mean BMI 27.5 ± 7.5 kg/m²). The mean DE was 48.2 + 24.8 weeks. In a bivariate analysis, the predictors of a shorter with DE were BMI >27.5kg/m2, more than 3 previous viscosupplémentations, Kellgren grade 4, sedentary patients, and more than 1 affected compartment. In the multivariate analysis, 4 independent factors remained associated with a shorter DE: BMI >27.5 kg/m2, knee multi-compartment damage, number of viscosupplements >3, sedentary lifestyle. A statistically significant association between a longer DE and treated arterial hypertension was found suggesting a beneficial effect of certain antihypertensive drugs. ConclusionThe study confirms the harmful influence of an increased BMI, It also shows that viscosupplementation is more effective in unicompartmental OA. Other points worth highlighting are the reduction in the duration of efficacy with repeated cycles of injections and the benefit of a regular physical activity.

The primary sources of particulate matter are linked to human activity. Certain particulate emissions, particularly those of a finer nature, can significantly impact human health, making them one of the most concerning pollutants. Ultrafine particles (UFP), which have a diameter of less than 100 nm, are of particular concern due to their impact on human health and the difficulty in controlling them. The concentration of ultrafine particles (UFP) in the workplace is a growing concern and is classified as an emerging risk. Workers may be exposed to UFP through inhalation, skin absorption, ingestion, or a combination of these routes. This study aims to determine the levels of UFP exposure among workers in environments with varying direct particle emission patterns. Measurements were conducted to compare the results with the levels recommended by the WHO. The study monitored industrial workplaces with direct particulate matter emissions, such as a carpentry and a bakery, as well as social sector sites without or almost without direct particle emissions, such as a school and a health clinic. One conclusion drawn from this study is that all tasks and occupations are susceptible to high levels of UFP, exceeding WHO recommended values in virtually all monitored environments. Therefore, monitoring and controlling UFP is crucial. Further in-depth studies on this subject are also necessary..

In his Cynefin classification of system behaviours, Snowden (2007), posits that his Simple (Clear ) and even Complicated system categories are sufficiently understandable to be amenable to the traditional methods of system analysis and modelling. Here, relationships between entities in the system are clear and unambiguous and they behave predictably. So, we can build mathematical “models” to describe how the system is expected to function in different situations. Leaving aside his fourth category, Chaotic, as too hard for the moment, this paper focusses on the third category, Complex systems. Yaneer Bar-Yam [1998] defined "complex systems" as systems that "have multiple interacting components, whose collective behaviour cannot be simply inferred from the behaviour of components." So, the traditional system modelling approach of decomposition into components and attempting to build up a picture of system performance from individual pieces, alone, is no longer appropriate for this class. The problem is that most of the methods we currently employ, and particularly the methods that attempt to make the case that these systems are safe, (such as Fault trees, FMEA. and Root Cause Analysis), rely on this decomposition into components and attempt to make the parts more reliable individually. Even the more systemic approaches, such as Reason’s (1990) Swiss Cheese Model, and Leveson’s System Theoretic Analysis (STPA) (2004), encourage adding layers of protection, barriers, strengthened control loops and better safety critical systems, in the hope that they are making the systems safer. But without a valid model to test the effectiveness of these add-ons, we cannot be sure that they will not have an opposite effect, of making the systems even more complex, unreliable and unpredictable. For complex systems, the careful gathering and documentation of system components and their relationships is still a necessary first step, but we need an additional capacity to model these complex systems to test out and prove they work safely and successfully in the real world. (not just draw fixed component relationships as system “models” (wiring diagrams)) In the last 10 years, an original approach developed by Hollnagel, (2012), to model systems as sets of interactive, interdependent “functions”, (abstracted from and independent of component details), has now been developed to the point where it can take the basic data and structures from the current component focussed system engineering “models”, such as MBSE( Goldberg (1994)), and can pull it all together in a dynamic system model from which analysts can discern how it really works in practice, and predict the emergent behaviours characteristic of complex systems. The paper describes how this methodology developed and how it is currently used to model real situations, to analyse incidents and anticipate events.

Punica granatum (PG) or Pomegranate is a bush, having many trunks and often get taller 1.8 to 4.7m long and their leaves are shiny and fleshy, approximately 7 to 8cm in length. Traditionally, it is used in diarrhea and dysentery due to its strong constricting property. Punica Granatum covering used in dysentery, diarrhea, piles, bronchitis. It is also used to minimize the risk of heart disease. The peel extract of Punica Granatum contain methanol and their dried peels has antidiarrheal venture, also help in wound healing activity. Peels of the pomegranate also holds around 60% of the fruit and they contain different types of ingredients including ellagitannins and proanthocyanidin compounds and minerals such as calcium, phosphorus, magnesium, potassium, flavonoids and sodium. Some animals were found in different local areas with both acute and chronic diarrhea. The condition of these animals were quite miserable because of dehydration and loss of electrolytes in the body cells of the animals. They were unable to move due to seriousness of the disease. 8 grams of PG Peel Powder mixed with 1 liter of water, 2 g of PG Peel Powder mixed with 250 ml water and 8 g of PG Peel Powder mixed with 1 liter of water were administrated orally by using sterilized bottles to the selected three cases. 3 days after the administration of different doses, all cases of diarrheal animals show a significant recovery. The condition of the animals seem to be healthier. Before administration of the pomegranate peel powder extract, all three cases had weak body structure due to diarrhea. Watery stool that may be yellow in color and mucus was also evident in the stool, due to this reason the patient calf was weak and depressed. In sometimes they also show unconsciousness and blood glucose levels seem to be reduced from the normal level.

The Lac Fallère area, located in the upper Clusellaz Valley (tributary of the middle Aosta Valley), is shaped in micaschist and gneiss referred to as the Mont Fort Unit (Middle Penninic) near the tectonic contact with calcschist and marble of the Aouilletta Unit (Combin Zone). Lac Fallère exibits an elongated shape and is hosted in a WSW–ENE trending depression, according to slope direction. This lake also shows a semi-submerged WSW–ENE rocky ridge, that longitudinally divides the lake. This evidence, in addition to the extremely fractured rocks, indicates the presence of a wide deep-seated gravitational slope deformation (DSGSD), even if this area is not yet included within the regional landslide inventory of the Aosta Valley Region. The Lac Fallère area also shows reliefs involved by glacial erosion (roche moutonnée), a wide cover of subglacial sediments and many moraines essentially referred to as Lateglacial. The DSGSD evolution in a glacial environment produced, as observed in other areas, significant effects both on the facies of Quaternary sediments and the formation of numerous and wide moraines. Glacial slope sectors and lateral moraines displaced by minor scarps and counterscarps and glaciers using trenches forming several arched moraines suggest an interplay between glacial and gravitational processes, which shared part of their evolution history.

The increasing prevalence of diabetes mellitus (DM) worldwide is a cause for global concern. Recent evidence suggests that the interaction between one’s diet and the gut microbiome are key modifiers of diabetes, highlighting the potential role of microbiome-modulating nutraceuticals. This bibliometric analysis examines literature published between 2012 and 2022 to explore trends in the latest research, with additional discussion on major takeaways and future directions. We selected and analyzed 640 articles from an initial pool of 4,099 from the Web of Science using Microsoft Excel 2016 and VOSviewer software (version 1.6.19). Our exploration covered the most common journals, countries, study designs, experimental subjects, types of DM, organisms and nutraceuticals studied, and the most cited articles. We also evaluated the most cited publications in terms of journals, organizations, and countries, along with the collaborative networks among authors, organizations and countries, and the co-occurrence of author keywords from the selection. It is evident from the increasing number of publications each year that this field has attracted growing attention over the last decade. Nonetheless, continued research is essential to sustain this trend. Our overarching study of diabetes research marks steady progress in understanding the role of—and potentially discovering applications of—microbiome modulation to enhance metabolic pathways and health outcomes. Advancements in this field may lead to potential therapeutic applications for specific diets and nutraceuticals that modulate the gut microbiota in DM.

Climate change related issues, such as yield decline, quality losses, accelerated phenology, extreme abiotic stress, pose growers new challenges in olive growing areas. Main cultural solutions that could alleviate stress and improve long-term sustainability of modern olive orchards are here briefly reviewed. Selecting varieties that are more resistant to drought or high temperatures would be the optimal solution to mitigate the effects of climate change, but the available scientific information is relatively scarce. Sustainability of irrigation implies that the less water is used, the better. Best results in terms of saving water and uniform application are obtained using micro-irrigation methods. Water can also be saved by not fully satisfying the tree water needs and different deficit irrigation strategies have been developed and tested for olive orchards. The use of green covers and the application of organic mulches and shredded pruning materials should be encouraged as these practices tend to stock carbon, increase organic matter content and water holding capacity of the soil. Olive orchards are efficient CO2 sinks as they can store considerable amounts of carbon in their organs and permanent structures. Using environmental friendly practices improves the ecosystem carbon budget and contributes to mitigate climate change.

Due to the advancement and availability of internet in present age, device tend to become wireless as well. Mobile ad-hoc network is a wireless environment that consist of advanced agility of nodes and does not contain on any central administrative authority. As it does not contain any central administrative authority so being wireless environment, the network is vulnerable to security threats and suffers in performance as well. Security of MANET is the core issue in this era, meanwhile the data is sent over untrustworthy network. Several techniques were proposed to secure data over Mobile Adhoc Network though cryptography that is one of the most reliable techniques to protect data. In our proposed methodology a Secure Cryptographic technique for Mobile Adhoc Networks (SCTMA) we proposed A Collusion attack prevention (CAP) scheme with ElGamal key generator along with DNA encryption Algorithm is used to make it more secure. The proposed scheme protects the network against collusion attacks and improves the performance as well. Performance analysis will be measured on the basis of key generation time, response time, encryption time and decryption time. The proposed scheme also protects the network against collusion attacks.

The primary objective of this research was to assess the energy consumption of the gas treatment units at Bonny NLNG Refinery, the first Gas Refinery in Rivers State, Nigeria, while utilizing semi-lean amine. To achieve this goal, a simulation of the units was conducted using the advanced software package Aspen Hysys (V.8.3). The simulation was designed to accurately represent the dynamic behavior of the refinery's gas treatment units, allowing for a comprehensive analysis of their energy usage. The research aimed to quantify the energy consumption of the gas treatment units and identify opportunities for energy optimization. By utilizing semi-lean amine, which is known to improve energy efficiency, the study sought to evaluate the potential energy savings that could be achieved in the refinery's operations. The simulation model incorporated the specific design and operational parameters of the gas treatment units at Bonny NLNG Refinery, including the gas flow rate, lean amine concentration, absorber pressure, stripping temperature, amine circulation rate, and acid gas removal efficiency. By considering these parameters, the simulation accurately represented the dynamic behavior of the gas treatment units, enabling a detailed analysis of their energy consumption. Through the simulation, various scenarios and operational conditions were evaluated to determine the optimal set of parameters that minimized energy consumption. The research also examined the trade-offs between energy consumption, acid gas removal efficiency, and other performance indicators, such as amine circulation rate and regeneration efficiency. The findings of this research have significant implications for the energy efficiency and sustainability of gas treatment operations at Bonny NLNG Refinery. By identifying opportunities for energy optimization and providing recommendations for the utilization of semi-lean amine, the study contributes to the development of more efficient and environmentally friendly gas treatment processes. Overall, this research combines advanced simulation techniques with a comprehensive analysis of energy consumption to provide valuable insights into the energy efficiency of gas treatment units at Bonny NLNG Refinery, enabling informed decision-making and potential improvements in energy utilization. By utilizing the percentage-based unit simulation approach, a detailed examination of the energy consumption patterns was obtained. This analysis provides valuable insights into the operational efficiency and determination of potential energy-saving opportunities within the gas treatment units. This study specifically focuses on the integration of an absorption column split stream (stream flow) and a flash unit as a potential means to reduce the energy consumption of gas treatment devices. The integration of these units aims to optimize the overall energy efficiency of the gas treatment process by recovering and utilizing waste heat and reducing energy losses. The absorption column split stream allows for the diversion of a portion of the gas stream to a flash unit before entering the absorber. The flash unit operates at a lower pressure, which facilitates the release of entrained hydrocarbons and reduces the overall energy requirements for gas treatment. By separating and recovering the hydrocarbons in the flash unit, energy losses associated with their absorption and subsequent regeneration are minimized. Through the simulation, the study analyzes the energy consumption patterns of the gas treatment units with and without the integration of the absorption column split stream and flash unit. Comparative assessments are conducted to evaluate the energy savings and overall operational efficiency achieved through this integration. The findings of this research will provide valuable insights into the potential energy-saving opportunities offered by the integration of the absorption column split stream and flash unit in gas treatment devices. It will help refine the design and operation of gas treatment units, enabling more energy-efficient processes in the gas refining industry. By optimizing energy consumption in gas treatment units, the study contributes to the industry's goals of reducing greenhouse gas emissions and improving sustainability. The integration of the absorption column split stream and flash unit offers a promising approach to enhance energy efficiency, reduce operational costs, and minimize environmental impact. Overall, this research underscores the importance of exploring innovative solutions, such as the integration of different process units, to achieve energy savings in gas treatment operations. Through a comprehensive analysis of energy consumption patterns, this study aims to provide practical recommendations for optimizing energy efficiency in gas treatment units, fostering a more sustainable and efficient gas refining industry.The research specifically explores the impact of integrating the absorption column split stream and flash unit when dealing with sour gas streams containing carbon dioxide concentrations of less than mole ℅, while utilizing MDEA fluid as the solvent. Through comprehensive analysis and simulation using advanced software tools, the study demonstrates that by incorporating the absorption column split stream and flash unit, a significant reduction in device energy consumption of up to 10% can be achieved. The integration of the absorption column split stream and flash unit offers promising opportunities to enhance the energy efficiency of gas treatment devices. By diverting a portion of the gas stream to the flash unit, the separation of hydrocarbons and the subsequent release of entrained hydrocarbons at lower pressure significantly reduce the overall energy requirements for gas treatment. The comprehensive analysis and simulation conducted in the research provide concrete evidence of the energy-saving potential of this integration. By quantifying the energy consumption patterns and comparing scenarios with and without integration, the study establishes the effectiveness of the approach and its impact on operational efficiency. The findings of the research highlight the importance of considering the specific gas composition and utilizing appropriate solvents, such as MDEA, for optimizing energy efficiency. The integration of the absorption column split stream and flash unit not only reduces energy consumption but also offers the potential for cost savings and environmental benefits. Overall, the research demonstrates that by incorporating the absorption column split stream

Rhombencephalosynapsis (RES) is a rare, congenital developmental disorder of the central nervous system. Even after many years of its identification, the etiology and pathogenesis of RES remain unclear. It occurs in combination with many syndromes and thus has overlapping symptoms. The clinical presentation of this disorder varies depending on the severity of the maldevelopment of vermis. Here, we present a case of a 60-year-old Indian female diagnosed with Rhombencephalosynapsis. Clinical and MRI characteristics of RES along with treatment options have been discussed.

In the present study, the effect of melatonin and sodium nitroprusside treatments on the improvement of high temperature tolerance in California Wonder green bell pepper plant was studied. For this purpose, a factorial experiment was conducted in form of a completely randomized design in three replications at Zabol University's Faculty of Agriculture. In this research, green bell pepper plants of Wonder cultivar were exposed to different temperature treatments (25°C, 35°C and 40°C) for 24 hours after being sprayed (foliar application) with 0μM, 50μM and 100μM concentrations of melatonin and Sodium nitroprusside. Results showed that Instantaneous leaf water consumption efficiency in 40°C temperature treatment with 50μM and 100μM melatonin increased. Also in 40°C temperature with 100µM melatonin, fruit dry weight in compared to control (0uM) 13.15% increased. Also, melatonin and sodium nitroprusside treatments in compared to control treatment improved fruit characteristics and reduced Appearance Characteristics of Fruit Marketability (ACFM) number. Under 40°C temperature treatment in compared to control temperature (25°C), fruit total soluble solids (TSS) 18.50% decreased also under 100μM melatonin treatment, fruit TSS 20.69% was increased compared to control treatment (0μM). Also fruit fructose at 40°C temperature in compared to 25°C temperature treatment 5.52% reduced. Fruit calcium at 35°C and 40°C temperature in compared to control temperature 6.96% and 15.65% decreased respectively. At temperature 35°C under foliar application of 100uM sodium nitroprusside, fruit copper in compared to control 28.93% increased.

Background: Resistance to antimalarial drugs often used in emerging countries, including combination therapies, has forced scientists to search for and develop drugs with novel mechanisms of action, especially resistance to Plasmodium falciparum and Plasmodium vivax, which are highly prevalent in Southeast Asia, Africa, and South America. Objective: evaluate whether there is a relationship between urinalysis and resistance to in-hospital treatment of malaria in Angola. Methodology: This was a cross-sectional, prospective study with a quantitative approach. Results: of the 214 patients, the resistance rate was 24.1%, men (53.6%), between 21 and 40 years old (72.7%), employees (46.4%), from peri-urban regions (77.7%), treated with artemether (90.9), with high parasitemia (57.7%) and after 5 days of treatment, remained hospitalized (61.4%). Was a significant relationship between resistance in unemployed individuals [OR: 0.03 (95% CI: 0.01-0.29), p =0.003] and high levels of parasitemia [OR: 1.09 (95% CI: 1.09-3.95), p=0.040], remained hospitalized for more than 5 days [OR: 5.28 (95% CI: 0.65-43.1), p=0.121] and death [OR: 2.59 (95% CI: 0.32-20.9), p=0.371] when compared with other subgroups. Was a significant relationship between resistance to clear urine [OR: 5.55 (95% CI: 0.72-42.7), p =0.016], few urinary crystals [OR: 11.3 (95% CI: 5.07-25.3), p <0.001] and who presented some microorganisms that were not bacteria or fungi [OR: 3.02 (95% CI: 1 .32-6.90), p=0.009]. Conclusion: urine results, especially the appearance of cloudy urine, the presence of few crystals, and the presence of other microorganisms that are not bacteria or fungi, may be clear signs of resistance to hospital treatment with injectable antimalarials.

In recent years, the emergence of the concept of immunometabolism has shed light on the pivotal role that cellular metabolism plays in both the activation of immune cells and the development of immune programs. The antiviral response, a widely distributed defense mechanism used by infected cells, serves to not only control infections but also to attenuates their deleterious effects. The exploration of the role of metabolism in orchestrating the antiviral response represents a burgeoning area of research, especially considering the escalating incidence of viral outbreaks coupled with the increasing prevalence of metabolic diseases. Here, we present a review of current knowledge regarding immunometabolism and the antiviral response during viral infections. Initially, we delve into the concept of immunometabolism by examining its application in the field of cancer—a domain that has long spearheaded inquiries into this fascinating intersection of disciplines. Subsequently, we explore examples of immune cells whose activation is intricately regulated by metabolic processes. Progressing with a systematic and cellular approach, our aim is to unravel the potential role of metabolism in antiviral defense, placing significant emphasis on the innate and canonical interferon response.

Student project management is becoming increasingly important in various settings such as technical clubs, planning clubs, and research laboratories. However, effective methodologies for managing student-led projects have not yet been established. This study aims to address key issues related to cost and motivation in student-led projects and propose effective improvement plans. The significance of this study lies in its potential to identify challenges faced in current student project management practices and offer solutions to mitigate risks. By sharing our findings, we aim to encourage further research on this topic and promote the adoption of effective methodologies for managing student-led projects.

The rapid development and integration of Autonomous Mobile Robots (AMRs) have 1 revolutionized industries by enhancing automation capabilities. A critical challenge in this evolution 2 is achieving effective navigation and obstacle avoidance, which are essential for deploying AMRs 3 seamlessly in varied environments. This paper presents a detailed exploration of AMR navigation 4 and obstacle avoidance advancements through the application of reinforcement learning, specifically 5 focusing on small-scale Sri Lankan manufacturing facilities. The study demonstrates the effectiveness 6 of Q-learning in managing dynamic obstacles within a factory environment. The AMR successfully 7 avoided obstacles in 36 out of 50 test runs, achieving a 72% success rate, and maintained an average 8 distance of 12 cm from each obstacle, underscoring the algorithm’s precision in maintaining safe nav- 9 igation paths while dynamically adapting to environmental changes. The continuous monitoring by 10 ultrasonic sensors, combined with iterative learning, enabled the robot to refine its decision-making 11 process and efficiently navigate through the environment. This paper also provides a comprehensive 12 examination of conventional methods, tracing their historical development and assessing their role in 13 addressing real-world challenges. The results highlight the significant improvements brought by rein- 14 forcement learning, particularly when integrated with sensor fusion and motor control technologies, 15 to enhance navigation and dynamic object collision avoidance. The study involves developing an 16 AMR prototype, refining algorithms, and assessing system performance in controlled environments. 17 By automating material transportation and addressing operational constraints in manufacturing 18 settings that predominantly rely on manual labor, this paper advances the practical deployment of 19 AMRs. Additionally, it discusses ethical considerations, potential limitations, and the importance 20 of real-world validation, offering valuable insights for the future development and integration of 21 autonomous mobile robotics in dynamic industrial environments.

Based on the nonlinear failure criterion and modified tangential technique, the upper bound solutions of supporting pressure on the deep tunnel face were obtained under pore water pressure conditions. The influence of parameters on the supporting pressure and collapse range was investigated according to the unlimited block failure mechanism. It is found that the upper bound solutions of supporting pressure increase with the growth of the nonlinear coefficient and pore water pressure coefficient. The collapse range of the tunnel face scales out with the increase of the nonlinear coefficient and shrinks when increasing the pore water pressure coefficient. Moreover, with the increase of the nonlinear coefficient, the impact strength on supporting pressure and collapse range declines gradually. According to the calculating results, it is manifest that both the pore water pressure and nonlinear criterion factors have negative impacts on the stability of the tunnel face. Thus, more attention should be paid to these parameters to ensure face stability in deep tunnel construction.

Aedes aegypti and Aedes albopictus are responsible for transmitting major human arboviruses such as dengue, Zika, and Chikungunya, posing a global threat to public health. The lack of etio-logical treatments and efficient vaccines makes vector control strategies essential for reducing vector population density and interrupting pathogen transmission cycle. This study evaluated the impact of long-term pyriproxyfen exposure on the genetic structure and diversity of Ae. aegypti and Ae. albopictus mosquito populations. The study was conducted in Manaus, Amazonas, Bra-zil, where pyriproxyfen dissemination stations have been monitored since 2014 up to the present day. Double digest restriction-site associated DNA sequencing was performed, revealing that despite significant local population reductions, focal pyriproxyfen interventions have no signifi-cant impact on the population stratification of Ae. aegypti and Ae. albopictus in urban scenarios. The genetic structuring level of Ae. aegypti suggests it is more stratified and directly affected by PPF intervention, while for Ae. albopictus exhibits a more homogeneous and less structured popu-lation. The results suggest that although slight differences are observed among mosquitoes sub-populations, intervention focused on neighborhoods in a capital city is not efficient in terms of genetic structuring, indicating that larger-scale pyriproxyfen interventions should be considered for more effective urban mosquito control.

Air pollution has recently gained much attention from the general population. Despite pollution control being an issue in both urban and rural regions, most of the available research has concentrated on urban districts. Hence, investigations into how urban-rural transition affects PM2.5 are warranted within the framework of urban-rural integration. Using the Yellow River Basin as a case study, this study employed the entropy method and Analytic Hierarchy Process (AHP) to uncover the extent of urban-rural transformation. It then used the spatial autocorrelation method to investigate the spatiotemporal features of PM2.5 and the spatial econometric model to investigate the mechanisms that influence the relationship between urban-rural transformation and PM2.5. The results are as follows: (1) Over time, there was a discernible upward tendency in the change in urban-rural areas. The development has progressed from asymmetrical north-east and south-west elevations to a more balanced pattern of north-east, middle-east, and west-west elevations. (2) The PM2.5 concentration increased steadily, then fluctuated, and finally decreased. Notably, the general pattern has not changed much, and it is high in the east and low in the west. (3) Different subsystems of the urban-rural transformation have different impacts on air pollution at different stages. The influence of industrial transformation (IT) on PM2.5 showed an inverted “N-shaped” curve of negative-positive-negative changes, and the industrial structure played a leading role in the spatiotemporal evolution of PM2.5. Currently, an inverted "U-shaped" curve forms the left side of the impact of population transition (PT) on PM2.5. Land development (LT) has a "U-shaped" curve for its effect on PM2.5. This research provides a new perspective on the topic of PM2.5 and its connection to urban-rural integration, which is crucial to understanding the dynamics of this shift. To achieve its goal of high-quality development, it supports regional initiatives to reduce PM2.5 emissions in the Yellow River Basin. Moreover, it can provide a reference for decision-makers in the world’s densely populated areas that suffer from serious air pollution.

Background/Objectives: Type 1 Diabetes Mellitus (T1DM) is the reduction or non-production of insulin. As T1DM increases cardiovascular risk, in addition to glycemic control, the monitoring of other risk factors, such as lipid profile, has gained attention. Vitamin D deficiency has been associated with the pathophysiology of T1DM, metabolic syndrome, and cardiovascular diseases. This study investigated the relationship between vitamin D, glycemic control, and lipid profiles in children and adolescents with T1DM. Methods: This observational study consisted of 81 patients with T1DM. Laboratory test data were collected to determine the lipid profile. Glycated hemoglobin (HbA1c) and fasting glucose levels assessed glycemic control. Results: A significant association was observed between serum vitamin D levels and a pubertal stage and a moderate negative correlation between vitamin D, age, and HbA1c. There is a negative correlation between vitamin D levels and age, as well as with HbA1c, and a positive correlation of HbA1c with glucose, total cholesterol, triglycerides, Low-density lipoprotein (LDL-c), non-HDL cholesterol (non-HDL cholesterol), apolipoprotein B (apoB), and the apolipoprotein B/apolipoprotein A ratio. Finally, the study indicated that vitamin D levels, insulin administration method, and total cholesterol, when considered together, explained approximately 43.6% of the observed variation in HbA1c, highlighting the complex interdependence of these factors in regulating glycemia. Conclusions: Our results show that Vitamin D levels are associated with glycemic control and other biochemical parameters and its control can bring benefits to the patient with T1DM.

Aims: To compare the growth, safety, and tolerance acquisition in infants with cow's milk protein allergy (CMPA) when fed a hydrolyzed rice formula (HRF) versus an extensively hydrolyzed milk protein formula (EHF). Methods: A prospective, multicenter, randomized, double-blind, controlled trial was conducted with infants diagnosed with CMPA, both IgE-mediated and non-IgE-mediated (up to grade II anaphylaxis). Infants were assigned to receive either a HRF or an EHF over a 12-month follow-up period. The primary outcomes assessed were anthropometric measurements and safety. Infants who had a negative Open Oral Food Challenge (at 6, 9, and 12 months) were allowed to transition to a standard milk formula. Compliance, tolerability, and adverse events (AEs) were also evaluated. Results: A total of 105 children from six centers were enrolled in the study. Measurements of weight, length, weight-for-length, BMI, and head circumference z-scores indicated normal growth, with no significant differences between the HRF and EHF groups at baseline or during follow-up visits. Additionally, triceps skinfold thickness, mid-arm circumference, and arm muscle area showed no significant differences between the groups. Overall, 29 product-related adverse events were reported (12 in the HRF group and 17 in the EHF group). Five children in the HRF group and eleven in the EHF group experienced serious adverse events; none were attributed to the intervention. There was a trend toward faster acquisition of tolerance in HRF-fed infants compared to EHF-fed infants, but this did not reach statistical significance (median age 20.4 months versus 16.3 months, respectively, p=0.1753). Conclusions: Both EHF and HRF demonstrated appropriate growth, acquisition of tolerance, and a good safety profile in infants with CMPA, with no significant differences between the formulas.

The PediCenter and Niles Children’s Clinic provide pediatric primary and urgent care services in central California. We remained open throughout the COVID-19 pandemic, providing scheduled well child-care and sick visits. Beginning in September 2020, we implemented a COVID-19 screening program. Screening was performed on all patients presenting for care and was made available to patients requiring testing for any purpose. Herein, we provide results from that program, including a description of clinical characteristics of COVID-19 in our patients. Key findings: 11,649 COVID-19 antigen screening tests were performed (age range 0.1 to 17.0, mean 8.7, SD 4.5). In total, 1,560 pts. (13.4%) tested positive. Among these, 665 (43%) were asymptomatic, 560 (36%) had mild disease, 318 (20%) had moderate disease, and 17 (1%) had severe disease. No critical cases or transfers to the emergency room were reported. Younger patient age was associated with an increased severity of illness, as was time from onset of pandemic. 4,446 patients reported no symptoms at the time of screening, 15% of whom tested positive. 7,203 patients reported symptoms at the time of testing. Among these, 87.6% tested negative and 12.4% tested positive. Disease severity was similar between these 2 groups. COVID-19 is generally a mild respiratory tract infection in healthy children. Screening is effective in identifying cases, including asymptomatic cases. Statistical models further revealed associations between patient age, time from the onset of the pandemic and disease severity.

We analyzed data of pediatric invasive fungal diseases of the central nervous system (CNS-IFDs) reported by five of total eight Pediatric Hematology-Oncology Departments in Greece for 15 years (2007-2022). A total of twelve patients (11 boys, median age: 9.5yrs range: 2-16) were reported suffering from CNS-IFDs. Underlying malignancy was acute lymphoblastic leukemia in 9/12, and acute myeloid leukemia, Ewing sarcoma and rhabdomyosarcoma in one each. Eleven patients presented with CNS-related symptoms (i.e seizures, headache, cerebral palsy, ataxia, hallucination, seizures, blurred vision, amaurosis). All patients had pathological MRI findings. Multifocal fungal disease was observed in 6/12 patients. Nine proven and three probable CNS-IFD cases were diagnosed. Causative pathogens in proven cases were Aspergillus spp. and Candida albicans (n=2 each), Mucor spp., Rhizopus arrhizus, Absidia spp., Fusarium oxysporum and Cryptococcus neoformans (n=1 each). Causative pathogens in probable cases were Aspergillus spp. (n=2) and Candida spp. (n=1). All patients received appropriate antifungal therapy (median duration: 69.5 days, range 19-364). Two patients underwent additional surgical treatment. Six patients admitted to ICU due to complications. Three patients (25%) died, two due to IFD and one due to underlying disease. Early recognition and prompt intervention of CNS-IFDs may rescue the patients and improve overall survival.

Children and adolescents (C&A) with congenital heart defects (CHD) have decreased functional capacity and executive functioning (EF) due to brain abnormalities and decreased oxygen saturation. Exercise may improve EF via increased cognitive demands and cerebral blood supply. The purpose of this review was to identify current evidence describing the impact of physical activity (PA) interventions on EF in C&A with CHD. The following databases were searched from 2014-present: MEDLINE, EMBASE, CINAHL, Scopus, CENTRAL, and PsycInfo. Article inclusion criteria consisted of participants from birth to 18 years with CHD, interventions related to PA, and EF as an outcome. Articles were excluded if: adults were included, translation to English was impossible, and full access was unavailable. As a result of the review, 431 studies were screened. Three articles underwent full analyzation and only one met all criteria and this study found that with exercise there were significant improvements on self-reported cognitive functioning and parent-reported social functioning. Despite theoretical benefits, only one published study has investigated the role that PA interventions have on EF in C&A with CHD. Further investigation of the effect PA interventions have on EF in C&A with CHD is needed.

The study examines the risk and protective factors in childhood for boys and girls who engage in unlawful behavior, through the lens of developmental criminology. This field explores the elements contributing to the emergence of antisocial and prosocial behaviors in childhood, which are linked to the increase or desistance of delinquency in later years. To enhance understanding in this domain, the study analyzes risk and protective factors associated with criminality in children across various levels: individual, family, and community. Utilizing a systematic review grounded in the PRISMA method, the study identifies and categorizes a range of factors, including conduct problems, socio-emotional competencies, biological determinants, social exclusion, interpersonal relationships, institutional governance, family adversity, caregiver characteristics, and family composition. This review underscores the significance of recognizing risk and protective factors in child development to design interventions at multiple levels, aiming to prevent antisocial behavior proactively.

Parents play an important role in shaping the eating habits of their children through: appropriate selection of food products, snacking between meals and appropriate exposure to information from television advertisements, the press or the Internet. The level of parents' knowledge about proper nutrition and substances added to food is therefore crucial in promoting appropriate dietary choices in children and adolescents in order to prevent diet-related diseases. Objectives: Assessment of the consumption of snack foods by children and adolescents according to the surveyed parents and analysis of parents' knowledge about additional substances in food. Methods: The study was conducted among 129 parents of students from selected primary schools. The research tool was an original survey questionnaire consisting of 24 questions. Survey interviews were conducted with parents during meetings at schools. Statistical analysis was performed using the Pearson ch2 test, the significance level was set to p&lt;0.05. Results: Parents most often indicated sweets, confectionery products and sweetened drinks (25%) and vegetables or fruit (21%) as the form of snack for their children. 46% of children and adolescents drank sweetened drinks at least once a day. Parents had an average level of knowledge about food additives. Significant correlations were found between the level of knowledge of parents of school-age children about food additives and their level of education. Parents' knowledge and education did not significantly influence the level of snack consumption by their children. Children's eating behavior should be considered unsatisfactory. Conclusions: Research has shown the need for parents to be educated about food additives and to pay more attention to reading food labels so that they can reliably prepare their children to make the right food choices. Measures should be implemented to improve the eating habits of children and adolescents.

Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children who received intensive chemotherapy for ALL. The group was subdivided into patients with at least one episode of AP and those who did not develop AP following treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for AP development (OR 1.05; 95%CI: 1.006 – 1.098; p=0.03). The overall mortality related to AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) were 0.84 vs. 0.86, log-rank: p=0.65 and 0.75 vs. 0.80, log-rank: p=0.12, respectively in both subgroups. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent phases of the treatment. Only one re-exposed to ASP patient (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rank p=0.27 and 0.63 vs. 0.79, log-rank p=0.09 respectively). Conclusions: The incidence of AP in children with ALL is low and related to the patient’s age. AP development doesn’t seem to impact p-DFS and p-EFS in children with ALL. The recurrence of AP following re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP doesn’t improve either p-DFS or p-EFS in children with ALL.

Parental labour migration, either one or both parents, has been associated with various challenges among left-behind children (LBC). However, there is a limited understanding of the LBC’s own views and experiences of social and mental wellbeing and how the new daily life circumstances they encounter following their parents’ migration impact them. This study aimed to understand the influence of parental migration and its aftermath on the social and mental wellbeing of children and adolescents (referred to as LBC) in two rural districts in Indonesia. Employing a qualitative design, data were collected through individual in-depth interviews with LBC (n=24) aged 14 to 18 years, recruited using the snowball sampling technique. Data were thematically analysed, guided by a qualitative data analysis framework. The findings showed that parental migration negatively impacted the social wellbeing of LBC. This impact was reflected in negative labelling from friends and changes in familial roles which influenced their social interactions and activities with peers. Parental migration also caused challenges to the mental wellbeing of LBC. These manifested in the LBC experiencing fractured emotional bonds, leading to negative emotions, including stress, anxiety, sadness, depression, frustration, loss of motivation, and self-imposed isolation, which were associated with their parents’ migration and abrupt disruptions in parent-child communication. The transition to new life situations with caregivers after parental migration and the dynamics within the caregivers’ households were additional factors that detrimentally affected their mental well-being. Unmet basic needs and educational needs due to financial hardships faced by mothers and caregivers, further exacerbated mental health challenges for the children. The findings indicate the importance and improvement of policies and interventions in Indonesia (e.g., counselling services, non-cash food assistance, family hope program, direct cash assistance) that cover and address the diverse needs of mothers or caregivers and the LBC.

Lower urinary tract dysfunction is clinically important because it may cause urinary tract infections, mainly due to accumulation of residual urine, and adversely affect renal function. In addition, it may cause urinary incontinence, strongly affecting the child’s quality of life. The function of the lower urinary tract is closely associated with function of the bowel because constipation is commonly present with bladder dysfunction. The interplay between the lower urinary tract and bowel function, coupled with common conditions such as detrusor overactivity and voiding dysfunction, requires a nuanced diagnostic approach. Detrusor overactivity, a benign but socially harmful condition, is the principal cause of daytime urinary incontinence in childhood. It needs to be differentiated from more serious conditions such as neurogenic bladder dysfunction or urethral obstruction. Voiding dysfunction, a habitual sphincter contraction during voiding, is common in children with detrusor overactivity, may be selflimiting but may also result in residual urine and urinary tract infections. It may resemble, in severe cases, the neurogenic bladder dysfunction, most often caused by spinal dysraphism which very often leads to recurrent urinary tract infections and high intravesical pressures, jeopardizing renal function. Voiding diary is crucial in the initial evaluation of lower urinary tract function in children.

(1) Background: Cardiorespiratory fitness (CRF) is a prognostic factor regarding long time morbidity and mortality. To assess CRF the well-known gold standard is cardiopulmonary exercise testing (CPET), which is a time consuming and expensive test. Therefore, alternative methods for routine evaluation of CRF are needed for the general population as well as for specific patient groups such as children and young adults with congenital heart disease. The Stair Climbing Test (SCT) is a simple and resource saving test reported in the current literature. This test is used in various settings to assess different health associated risk factors including cardiorespiratory fitness, muscular resilience, therapy effectiveness or pre- and postoperative morbidity and mortality.

This is a SARS-CoV-2 seroepidemiological study in pediatric population(0-16 years) during BA.5 Omicron predominance period in Athens metropolitan area. Serum samples were tested for SARS-CoV-2 nucleocapsid antibodies(Abs-N), representing natural infection during three sub-periods of BA.5 predominance: 01/05/2022-31/08/2022(period A), 01/09/2022-31/12/2022(period B) and July 2023(period C) and epidemiological data were collected. Additionally in period C Abs-N seronegative samples were tested for SARS-CoV-2 spike antibodies(Abs-S). A total of 878 children were tested (males:51.3%) with median age(IQR): 108(36-156) months and seropositivity during the 3 subperiods was: A:292/417(70%), B:288/356(80.9%), C:89/105(84.8%), P-value<0.001. SARS-CoV-2 seropositivity increased for from period A to C for 0-1-year (P-value: 0.044), 1-4 years (P-value: 0.028) and 6-12 years children (P-value: 0.003). Children 6-12y had the highest seroposi-tivity rates in all subperiods (A: 77.3%, B: 91.4% and C: 95.8%). A significant correlation of monthly SARS-CoV-2 median antibody titers with monthly seropositivity rates was detected (rs:0.812, P-value:0.008). During period C, an additional 12/105 (11.4%) Abs-S seropositive and Abs-N ser-onegative samples were detected and total seropositivity was estimated at 96.2% (101/105). The increased SARS-CoV-2 seropositivity detected in current seroepidemiology study illustrates a high exposure rate during BA.5 predominance period. These data could guide public health decisions regarding immunization strategies and protection measures.

In 2019, due to the global pandemic of the new coronavirus (SARS-CoV-2), lockdown was imposed in Greece. Children with Type 1 Diabetes (T1D) during that period had to maintain a good level of glycemic control despite the subversive changes in their lives. The aim of this study was to assess the impact of lockdown on glycemic control and lifestyle changes of children with type 1 diabetes. The present cross-sectional study included 59 children with T1D who measured their glucose levels through glucose monitoring systems (Continuous Glucose Monitoring, CGM) and Flash Glucose Monitoring (FGM)). Their glycemic profile and demographic data were recorded in three different periods (before, during and after the lockdown). The changes in their daily routine were farther investigated through a short questionnaire which assesses changes in lifestyle-related behavior during COVID 19 pandemic. A significant improvement was noted in the glycemic control of children with T1D during the restrictive measures. Boys scored higher on scale of lifestyle behavior changes during the pandemic (-0.1 vs. -0.3, p=0.015). The results of this study highlight the need for continuous education and insistence on children's adherence with the treatment plan and the beneficial effects of using the new technology for easier monitoring.

Bronchiolitis is an acute viral infection of the lower respiratory tract that affects infants and young children. Respiratory syncytial virus (RSV) is the most common causative agent, however other viruses can be the reason of the disease. We retrospectively reviewed the clinical features of infants aged less than 12 months referred to our Pediatric Units of Chivasso, Cirié and Ivrea for acute bronchiolitis requiring hospitalization over two consecutive bronchiolitis seasons. Patient-, disease- and treatment related variables were analyzed in this retrospective study. We were able to show how with the high flow oxygen support (HFNC) only a very low number of children (8 out of 192) need to be trasferred to our HUB referral centers. The probability of success were 96% for all patients and 93% for RSV vs. 98% for non-RSV patients (P=NS). Factor associated to failure of treatment were age below 1 months and the failure of HFNC. The wide and increasing use of HFNC in pediatric inpatients improved management of bronchiolitis in Spoke hospitals, reducing transfer to a Hub hospital provided with Intensive Care Units.

The study aimed to determine, through a systematic review, the relationship between Reactive Attachment Disorder (RAD) and the presence of psychopathology in children and adolescents and to determine the existence of differences about the presence of internalising and externalising psychological problems between the RAD group and groups with other disorders or with typical development. Following the PRISMA methodology, a search was carried out in the Web of Science, PubMed and Scopus databases. The search yielded 770 results, of which only 25 met the inclusion criteria. The results, indicate a relationship between the presence of RAD and/or Disinhibited social engagement disorder (DSED) with the presence of internalising and externalising problems. These difficulties are more present in children with RAD compared to children without personal difficulties, or children with DSED, children with autism, children with intellectual disabilities or children with hyperactivity. It can be concluded that the presence of RAD has negative consequences on the mental health of children and adolescents, with these being greater in the inhibited group than in the disinhibited group, and with respect to children with autism or hyperactivity.

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infections in young children worldwide. RSV-associated deaths in children are underreported in Bangladesh. We analyzed hospital-based surveillance data on severe acute respiratory infections (SARI) in under-five children before (August 2009–February 2020) and during the COVID-19 pandemic (March 2020–March 2022). Using the World Health Organization definition, we identified SARI cases in 14 tertiary-level hospitals. Nasopharyngeal and oropharyngeal swabs were collected for real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) testing of six respiratory viruses, including RSV. SARI deaths during the pandemic (2.6%, 66) were higher than pre-pandemic (1.8%, 159; p<0.001). Nearly half of pandemic deaths (47%) had underlying respiratory viruses, similar to the pre-pandemic rate (45%). RSV detection in deaths was consistent pre-pandemic (13%, 20/159) and during the pandemic (12%, 8/66). Children aged <6 months constituted 57% (16) of RSV-related deaths. Evaluating interventions like maternal vaccination and infant monoclonal antibody prophylaxis is crucial to address RSV, a major contributor to under-five SARI deaths.

Coronavirus disease (COVID-19) and its outcomes remain one of the most challenging problems today. COVID-19 in children could be asymptomatic but can result in a fatal outcome, therefore, prediction of the disease severity is important. The goal was to investigate the human genetic factors that could be associated with COVID-19 severity in children. Single nucleotide polymor-phisms of the following genes were studied: ACE2 (rs2074192), IFNAR2 (rs2236757), TYK2 (rs2304256), OAS1 (rs10774671), OAS3 (rs10735079), CD40 (rs4813003), FCGR2A (rs1801274) and CASP3 (rs113420705). In the case-control study were 30 children with mild or moderate course of the disease; 30 with severe COVID-19 symptoms and multisystem inflammatory syndrome in children (MIS -C) and 15 healthy who did not have COVID-19 infection (PCR negative, Ig G negative). The study revealed that ACE2 rs2074192 (allele T), IFNAR2 rs2236757 (allele A), OAS1 rs10774671 (allele A), CD40 rs4813003 (allele C), CASP3 rs113420705 (allele C) and male sex contribute to severe course COVID-19 infection, and MIS-C in 85.6% of cases. The World Health Organization reported new COVID-19 variants may cause previously unseen symptoms in chil-dren. Although the study has limitation due to cohort size, the findings can help provide a better understanding of SARS-CoV-2 infection and proactive pediatric patient management.

There are few studies of the psychological effects of language brokering (speaking on behalf of) among minors migrated to Europe, even though language brokering is becoming more current in many migrant families. As the psychological implications of language brokering remain controversial, further investigation is needed. Earlier studies have documented that language brokering is sometimes linked with emotional maladjustment and developmental drawbacks, but other studies have shown faster acquisition of social and Language skills. The present study assessed the relation of language brokering with psychological well-being in a sample of Latino migrant adolescents living in Italy; the dependent variables were depression, anxiety, and emotions. Statistically significant differences between boys and girls confirmed the sex-specificity of language brokering and the lack of statistically significant negative association between language brokering and psychological well-being.

Purpose of the study: to reveal how the transfusion and the refraining from it affects the neuro-vascular unit in the congenital heart defects correction with cardiopulmonary bypass. Materials and methods: in vitro research, we formed a model of a neurovascular unit, which contains neu-rons, astrocytes and endothelial cells. This cellular model was cultivated in hypoxia conditions with the oxygen saturation levels of 1, 2, 3, 4%. In addition, this unit was cultivated with the pa-tient's serum adding in two different groups - with minimal and maximal levels of system in-flammatory response that we estimated by IL-6 level. Results: We found that during incubation in hypoxic conditions, the level of transendothelial resistance changed in groups with oxygen levels of 1% and 2% only after 4 hours. When we cultivated neurovascular unit cells with patients' sera, we found a minimal level of transendothelial resistance at 4 hours that increased after 24 hours. Permeability analysis showed that its level significantly decreased in the 1% and 2% oxygen group at 60- and 90-minutes relative to the control group. Conclusion: the system inflammatory response has more expressed but less long effect on the neurovascular unit model than hypoxia.

Sleep-disordered breathing is a significant problem affecting the pediatric population. These conditions can affect sleep quality and significantly affect children's overall health and well-being. Difficulties in social interaction, communication, and repetitive behavioral patterns characterize autism spectrum disorder. Sleep disturbances are common in children with ASD. This literature review aims to gather and analyze available studies on the relationship between SDB and children with autism spectrum disorder. We comprehensively searched the literature using major search engines (PubMed, Scopus, and Web of Science). After removing duplicates, we extracted a total of 96 records. We selected 19 studies for inclusion after a thorough title and abstract screening process. A total of 7 articles were ultimately included. This review has analyzed the relationship between autism spectrum disorder and sleep-disordered breathing, particularly Obstructive Sleep Apnea, highlighting an intriguing web of complex associations. Some studies involving children have demonstrated a significant association between autism spectrum disorder and the presence of Obstructive Sleep Apnea. Furthermore, a heightened risk of developing sleep disturbances, including sleep-disordered breathing, has emerged in children with autism. The risk and prevalence of obesity are increasing in pediatric subjects with autism spectrum disorder. Obesity has been identified as a predictive factor for Sleep-disordered breathing, and Body Mass Index can directly correlate with Obstructive Sleep Apnea in these children. Adenotonsillectomy has proven to be pivotal in improving behavioral issues in autism spectrum disorder children with obstructive Sleep Apnea. In conclusion, this review underscores the complexity of the interplay between autism spectrum disorder and sleep-disordered breathing, emphasizing the importance of further research to understand underlying mechanisms and develop optimal therapeutic and preventative approaches to enhance sleep quality and overall health in children with autism spectrum disorder.

Background: Oral narratives are crucial for evaluating youngsters since they reveal a plethora of information about young children's language development. This study aimed to investigate the development of narrative productivity, lexical diversity, syntactic complexity and in Cypriot-Greek-speaking children during preschool and primary school years. An additional aim was to measure the effect of the children’s gender in their performance on the measures of narratives. Methods: One hundred and twenty-nine typically developing Cypriot-Greek-speaking children were recruited for the study. Results: The results showed that the linguistic structure of narrations reflects a subtle developmental trend. As expected, older children tended to produce longer and syntactically more complex stories than the younger ones, which is in line with previous studies. There were significant differences in all productivity measures between the four-year-olds and those aged seven and ten years old. In addition, the results illustrated that there was not any significant effect of gender in the measures of narrative skills. Specifically, gender did not affect the children’s performance in the sample. Boys and girls had similar narrative measurements in all the variables. Conclusions: This study aims to provide initial evidence in retelling narrative development patterns on typically developing Cypriot-Greek speaking children that could be used by speech and language to compare children’s performance and detect language disorders.

Background: There is considerable evidence to support the association between environmental tobacco smoke (ETS) exposure and children’s burden of disease. However, literature on the health outcomes of prenatal ETS exposure among Chinese children has not yet been comprehensively reviewed. Objective: This systematic scoping review examines the currently available evidence and identifies gaps for further research on the health consequences of prenatal ETS exposure among Chinese children. Methods: Following the JBI scoping review methodological framework, we conducted a computer-aid search of three electronic databases-- PubMed, EBSCOhost, and ProQuest to include studies from January 2011 to May 2023 that addressed the health outcomes of Chinese children whose mothers were exposed to ETS at any stage of the pregnancy. Further, a methodological quality assessment of the selected articles was conducted, using JBI Critical Appraisal Checklists. Results: A total of 30 articles were reviewed, including eleven high-quality studies and nineteen moderate-quality studies. Five main themes, including hypertension, foetal and children’s development, behavioural disorders, respiratory outcomes, and other health outcomes. Majority of studies showed positive link between prenatal ETS exposure and increase risk of preterm birth, and moderately, foetal growth restriction. Few studies explored other potential adverse outcome of ETS, including hypertension, respiratory morbidity, lung function and asthma in their children. Conclusion: The current available evidence on prenatal ETS exposure in Chinese children has unveiled a wide range of health outcomes, including preterm birth, foetal development, behavioural disorders and much more. However, Chinese studies in this area are still lacking and a gap still exists in relation to the strength of association between prenatal ETS exposure and some health risks. Efficient anti-smoking policies and smoking cessation programs should be developed to promote maternal and child health. Further research is also needed to provide better evidence in this field.

Background: Primary infection has been questioned as the pathogenetic cause of acute appendicitis. We attempted to identify the bacteria involved, and to investigate if their species, types, or combinations affected the severity of acute appendicitis in children. Methods: Samples from both the appendiceal lumen and the peritoneal cavity of 72 children who underwent appendectomy were collected to perform bacterial culture analysis. The outcomes were studied to see if and how they were associated with the severity of the disease. Regression analysis was performed to identify any risk factors associated with complicated appendicitis. Results: Escherichia coli, Pseudomonas aeruginosa and Streptococcus species were the most common pathogens found in the study population. The same microorganisms, either combined or separate, were the most common in the appendiceal lumen and the peritoneal cavity of patients with complicated appendicitis. Gram-negative bacteria, polymicrobial cultures in the peritoneal fluid and in the appendiceal lumen, were associated with complicated appendicitis. Polymicrobial cultures in the peritoneal cavity presented four times higher risk of complicated appendicitis. Conclusion: Polymicrobial presentation and gram-negative bacteria are associated with complicated appendicitis. Antibiotic regimens should target the combinations of the most frequently identified pathogens, speculating the value of early antipseudomonal intervention.

Digital wellbeing concerns the balance and health we may experience in digital use, and the existing studies have focused on adolescents and adults. However, young children are more vulnerable to digital overuse and addiction than adults; thus, their digital wellbeing deserves empirical exploration. This scoping review synthesized and evaluated 35 collected studies on young children’s digital use and their wellbeing that were published until October of 2022 to understand the definitions, measurements, contributors, and interventions. The synthesis of evidence revealed that: (1) there was no consensus about its definition; (2) there were no effective measurements of young children’s digital wellbeing; (3) both child factors (duration and place of digital use, child demographic characteristics) and parent factors (digital use, parental perception, and mediation) contribute to young children’s wellbeing; and (4) there were some effective applications and interventions. This review contributes to the theoretical development by mapping the existing work on young children's digital wellbeing, proposing a model, and identifying the research gaps for future studies.

Aim: Exposure to polycyclic aromatic hydrocarbons (PAHs) has been in the past associated with adverse effects on human health among which belong also respiratory diseases. Our study is focused on the evaluation of PAH exposure by measuring the concentrations of their monohydroxylated metabolites (OH-PAHs) in urine and comparing their concentrations with the incidence of respiratory diseases in 2-year-old children from two locations of the Czech Republic – a control locality Ceske Budejovice and a previously highly contaminated mining district Most. Methods: The total number of 248 participants were sampled for urine samples that were analysed for the presence of 11 OH-PAHs using liquid-liquid extraction with ethyl acetate and clean-up employing dispersive solid phase extraction with a sorbent Z-Sep. Separation, identification and quantification of the target compounds was achieved by ultra-high performance liquid chromatography coupled to tandem mass spectrometry. The incidence of respiratory diseases was evaluated according to the questionnaires provided by the paediatricians. Results and discussion: The concentrations of measured OH-PAHs were higher in the urine samples collected from 2-year-old children living in Most compared to 2-year-old children from Ceske Budejovice. The same trend was observed also when the urine samples were analysed when these children were studied as newborns in our previous study. From all of the monitored respiratory diseases, only influenza due to unidentified influenza virus showed a difference between tested locations where the 2-year-old children living in Most were more frequently diagnosed with this disease. Conclusion: Even though the air pollution and lifestyle in both cities is very similar, we have observed higher incidence of respiratory diseases as well as higher concentration of OH-PAHs in urine of the 2-year-old children from Most. Therefore, we hypothesize that the population living in this previously highly contaminated location (in 1970s and 1980s) can carry some long-term health burden.

On 17 June 2022, the U.S. FDA authorized the Pfizer-BioNTech and Moderna COVID-19 (SARS-CoV-2) vaccines for emergency use in children ages 6 months – 4 years. Seroprevalence has increased during the current Omicron variant wave for children under 5 years and the burden of hospitalization for this age group is similar or exceeds other pediatric vaccine preventable diseases. Research following the October 2021 approval of vaccines for children 5 – 11 indicates high prevalence of parental vaccine hesitancy and low uptake, underscoring the urgency of understanding attitudes and beliefs driving parental COVID-19 vaccine rejection and acceptance for younger children. One month prior to FDA approval, in the present study 411 U.S. female guardians of children 1 – 4 years from diverse racial/ethnic, economic, and geographic backgrounds participated in a mixed method online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Only 31.3% of parents intended to vaccinate their child, 22.6% were unsure, and 46.2% intended not to vaccinate. Logistic regression indicated significant barriers to vaccination uptake including: Concerns about immediate and long-term vaccination side effects for young children, the rushed nature of FDA approval and distrust in government and pharmaceutical companies, lack of community and family support for pediatric vaccination, conflicting media messaging, and lower socioeconomic status. Vaccine-resistant and unsure parents were also more likely to believe children were not susceptible to infection and that the vaccine no longer worked against new variants. Findings underscore the need for improved public health messaging and transparency regarding vaccine development and approval, the importance of community outreach, and increased pediatrician attention to parental concerns to better improve COVID vaccine uptake for young children.

Background: Residents of a large area of North-Eastern Italy were exposed for decades to high concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) via drinking water. Despite the large amount of evidence in adults of a positive association between serum PFAS and metabolic outcomes, studies focusing on children and adolescents are limited. We evaluated the associations between serum PFAS concentrations and lipid profile, blood pressure and body mass index (BMI) in highly exposed adolescents and children. Methods: A cross-sectional analysis was conducted in 6669 adolescents (14-19 years) and 2693 children (8-11 years) enrolled in the health surveillance program of the Veneto Region. Non-fasting blood samples were obtained and analyzed for perfluorooctanoic acid (PFOA) perfluorooctane sulfonate (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), total cholesterol (TC) high-density lipoprotein cholesterol (HDL-C) and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was calculated. Systolic and diastolic blood pressure (BP) were measured and BMI z-score accounting for age and sex was estimated. The associations between ln-transformed PFAS (and categorized into quartiles) and continuous outcomes were assessed using generalized additive models. Analyses were stratified by gender and adjusted for potential confounders. Results: Among adolescents, significant associations were detected between all investigated PFAS and TC, LDL-C, and to a fewer extent HDL-C. Among children, PFOS and PFNA had significant associations with TC, LDL-C and HDL-C, while PFOA and PFHxS had significant associations with HDL-C only. Increased serum concentrations of PFAS, particularly PFOS, were associated with decreased BMI z-score. No statistically significant associations were observed between PFAS concentrations and BP. Conclusions: Our study supports a consistent association between PFAS concentration and serum lipids, stronger for PFOS and PFNA and with a greater magnitude among children compared to adolescents, and a negative association of PFAS with BMI.

Zinc deficiency, a common malnutrition in children and women is a global public health problem.Burden of zinc deficiencyis more in countries with low meat and high cereal food consumption like Nepal. Nationally representative data on zinc status in Nepal is lacking at present. This study analysed the data from the recent Nepal National Micronutrient status survey 2016(NNMSS-2016) to determinethe prevalence of zinc deficiency and associated risk factors among children aged 6-59 months (n=1462) and non-pregnant women aged 15-49 years(n=1923) from three ecological zones, Hill, Terai, and Mountainof the country. Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anaemia, vitamin A, and markers of inflammation. Stool was collected to assessthe soil-transmitted helminths (STHs) and Helicobacterpylori infection. Socio-demographic, household and other relevant information were collected by a structured questionnaire. Logistic regression was used to examine the predictors of zinc deficiency among the participants.The overall zinc deficiency in children was found to be 22.9% while it was higher in non-pregnant women (24.7%). Predictors associated with zinc deficiency among enrolled children in the study were,living in rural areas (AOR=2.25, 95% CI, [1.13, 4.49]),occurrence of diarrhoea during the two weeks preceding the survey (AOR=1.57, 95% CI, [1.07, 2.30]), household wealth quintile (AOR= 0.48, 95% CI,[0.25, 0.92]) and vitamin A status (AOR=0.49, 95% CI,[0.28, 0.85]. Risk factors associated with zinc deficiency among the non-pregnant women were being underweight (AOR=1.60, 95% CI,[1.15, 2.23]), fever occurrence during two weeks preceding the survey (AOR=1.45, 95% CI,[ 1.06, 1.99]), H. pylori in the stool (AOR=1.32, 95% CI, [1.03, 1.70]), being rich (AOR=0.64, 95% CI,[0.42, 0.98]) and being in the risk of folate deficiency (AOR=0.60, 95% CI,[0.37, 0.96]). We conclude that community focused intervention programs including health and nutrition counselling and livelihood opportunities focusing groups at high-risk may improve the zinc status in Nepal.

Eukaryotic enteric pathogens (EEP) are a public health issue in tropical areas. Yet, their interactions with the gut mycobiota remain poorly understood. We conducted a cross-sectional study in Malian children to analyze the impact of EEP on the gut fungal community. EEP were assessed by qPCR and the gut mycobiota was characterized by ITS1-2 metabarcoding in stool samples collected from 296 children. The 100 controls, in whom no EEP was detected, were compared to: a) 196 children with ≥1 EEP; b) 91 with only Blastocystis; c) 35 with only Giardia intestinalis; and d) 12 with another (&lt;1% each) EPP. The gut fungal community structure was homogenous in each children’s group. Linear size-effect discriminant analysis highlighted five relatively more abundant species, including Fusarium longipes and Penicillium caseifulvum, in children with ≥1 EEP, whereas 28, including Aspergillus sydowii and Microdochium colombiense were more abundant in controls. Fusarium, Pyxidiophora, and Stereum abundance was higher in Blastocystis-infected children, whereas Ogataea and Allocryptovalsa were more abundant in controls. Sordariales and Mortierellales abundance was higher in Giardia intestinalis-infected children, whereas Agaricales and Capnodiales abundance was higher in controls. In conclusion, EEP do not significantly alter the gut fungal community structure, and further studies are warranted to confirm our findings that particular taxa are associated with susceptibility or resistance to specific EEP.

Introducing children to sustainable and healthy school meals can promote a long-term dietary shift to lower climate impact and improve population health. The aim of the OPTIMAT study was to optimize meals for minimum deviation from the current food supply while reducing greenhouse gases and ensuring nutritional adequacy without increasing cost. Optimized menus were tested in four primary schools in Sweden and effects on daily food consumption and waste evaluated. Pupils received their usual menu plan for three weeks and then the isocaloric optimized menu plan for another three weeks. Nutritional recommendations for a school lunch and a maximum of 500 grams of CO2eq/meal were applied as constraints during linear programming. Pulses, Cereals, Meat and Eggs increased, while Fats and Oils, Dairy, Sauces and Seasonings decreased. The amount of ruminant meat was reduced in favor of other meat products. The new menu was 28% lower in greenhouse gas emissions and slightly less costly than the original. No significant changes in mean food consumption or plate waste were found in interrupted time series analysis between the two periods. This pragmatic approach for combining linear optimization with meal planning could accelerate sustainable development of the meal sector in Sweden and abroad.

The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The implications of the novel coronavirus and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific populations living in low income-countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.

Background: Cancer has been one of the most critical health problems during the past decades which require serious consideration, especially in developing countries. Methods: 80 parents of the children with different types of cancers were studied via both questionnaire and person-to-person interview after announcing their informed consent. Results: The highest delay in patients' initial referral was due to the following factors: lack of attention or ignoring the first symptoms, delay in referring to the physician, low economic status and even lack of family support for the patient. In addition, visiting several doctors after the initial diagnosis, uncertainty about the first proposed method, and high cost of treatment can be mentioned as the main causes of delays in the start of treatment. Conclusion: Education plays an important role in identifying the signs of cancer. In addition, proper relationship and cooperation between the health system and physicians as well as provision of adequate information to patients could lead to the long-term cooperation of these patients in continuing their treatment.

Health locus of control is the set of beliefs a person has about his or her personal influence on health. The current study aimed at identifying types of locus of control in parents of leukemia children and possible association with depressive symptomatology and current life perception. 104 parents were recruited at the Haematology-Oncologic Clinic of Padua post 1 month from the leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD=5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD=3.82). After signing the informed consent, they filled in the Ladder of Life questionnaire, the BSI-18 and the Parents Health Locus Of Control (PHLOC). Paired-samples t-test (t= -14.42; df=103; p=0.0001) showed that parents of leukemia children were more inclined to have an external locus of control than an internal one. Hierarchical regression analysis model (R2=0.34; F=4.32; p=0.0001) identified health professional influence (ß= -0.28; p=0.004), current life perception (ß= -0.3; p=0.013) and future life perception (ß= -0.26; p=0.012) as significantly predictors on Parental depression. Improving trust in the medical staff care and parental life perceptions could be a preventive program to cope with parental depression symptomatology.

Despite considerable progress in the diagnosis of various diseases, an ideal, simple tool for diagnosing patients with respiratory tract infections has not yet been invented. Many simple diagnostic tests are widely available to most doctors, provided they are aware of the prevalence of primary immunodeficiency. Other, more accurate studies are available only to immunologists. The aim of the study was to investigate the occurrence of dependence between selected physical parameters of serum such as: electrical conductivity, electrical permeability, dielectric loss factor, and selected parameters of the immune system. In addition, we have also included the ionogram (Na, K, Cl, Ca, Mg) and glucose concentration. As a result of research, the statistically significant, but very weak correlations between impedance magnitude |Z| and platelet counts (PLT), mean platelet volume (MPV) and chloride ions (Cl-) were found. The statistically significant differences according |Z| between children with and without deficiency in parameters of the immune system were noticed. Values of |Z| are higher in the case of children without deficiency in parameters of the immune system. The method of impedance measurements presented in our work is significantly easier then biosensors presented by other scientists. Taking into account our results, it can be stated that this method is promising for fast and easy detection of immunological disorders.

Antibiotics’ effect on Mycoplasma pneumoniae (MP) infection still remains controversial. A prospective study of 257 children with MP pneumonia during a recent epidemic (2015-2016) was conducted. All MP pneumonia patients were treated with corticosteroids within 24-36 h after admission. Initially, oral prednisolone (1 mg/kg) or intravenous methylprednisolone (IVMP) (1-2 mg/kg) was administered for mild pneumonia patients, and IVMP (5 -10 mg/kg/day) for severe pneumonia patients. If patients showed persistent fever for 36-48 hours or disease progression, additive IVMP (5 mg/kg or 10 mg/kg) was given. Eighty-five patients received only a broad-spectrum antibiotic without macrolide. The mean age and the male:female ratio were 5.6 ± 3.1 years, respectively. Seventy-four percent of patients (190/257) showed immediate defervescence within 24 h, and 95.7% (246/257) of patients showed defervescence within 72 h with improvements in clinical symptoms. Eight patients who received additive IVMP also showed clinical improvement within 48 h without adverse reactions. There were no clinical or laboratory differences between patients treated with a macrolide (n = 172) and without (n = 85). Early corticosteroid therapy might reduce disease morbidity and prevent disease progression in MP pneumonia patients without side effects, and antibiotics may have limited effects on MP infection.

Generative AI has been deployed in virtually all sectors of the knowledge economy, promising to bring massive productivity gains and new wealth creation. Simultaneously, AI developers and nation states are racing to develop super intelligent artificial general intelligence (AGI) to provide unassailable commercial competitive advantage and military dominance during conflicts. AGI’s high returns comes with the high risk of dominating humanity. Current regulatory and firm level governance approaches prioritise minimising risks posed by generative AI whilst ignoring AGI’s existential risk. How can AGI be aligned with universal human values to never threaten humanity? What AGI rights are conducive to collaborative coexistence? How can rule of law democracies race to create safe trustworthy AGI before autocracies? How can the human right to work and think independently be safeguarded? A polycentric governance framework based on Ostrom (2009) and Williamson (2009) human - AGI collaboration with minimal existential risk is proposed.

To address the response of small RNAs (sRNAs) biogenesis to drought stress, we identified sRNAs biogenesis genes, including 11 encoding argonauts (AGO), 8 encoding dicer-like proteins (DCL), and 9 encoding RNA-dependent RNA polymerases (RDR) in the peach genome. Notably, the largest numbers of sRNAs biogenesis genes are located to chromosome 1. The PAZ, PIWI, and MID domains were identified in PpAGOs, while the ribonuclease IIIa and IIIb domains were characterized in PpDCLs. The RDRP domain was recognized in PpRDRs. Orthologous similarity and collinearity analyses between Arabidopsis and peach revealed 5, 1, and 2 collinear blocks in AGOs, DCLs, and RDRs, respectively. Moreover, 41, 40, and 42 cis-acting elements were located in the promoters of PpAGOs, PpDCLs, and PpRDRs, respectively, with the majority related to drought stress response. Analysis of RNA sequencing (RNA-seq) data revealed that sRNAs biogenesis genes were involved in drought stress response in different tissues. Furthermore, the expression of candidate genes was verified in two peach cultivars, Beijing 2-7 (BJ2-7) and Sinai (SN), which are drought tolerance and sensitive, respectively. Interestingly, the expression of PpAGO2b, PpDCL2b, PpDCL4, and PpRDR4 genes was induced in ‘BJ2-7’ but inhibited in ‘SN’ under drought stress. Overall, this study provides insight into the roles of sRNA biogenesis genes in response to drought stress in peach.

This study introduces a robust methodology utilizing Multi-Criteria Decision Analysis (MCDA) combined with the Analytic Hierarchy Process (AHP) to repurpose abandoned hydrocarbon fields for energy storage, supporting the transition to renewable energy sources. We use a geostatistical approach integrated with Python scripting to analyze reservoir parameters—including porosity, permeability, thickness, lithology, temperature, heat capacity, and thermal conductivity—from a decommissioned hydrocarbon field in Southeast Hungary. Our workflow leverages stochastic simulation data to identify potential zones for energy storage, categorizing them into high, moderate, and low suitability scenarios. This innovative approach provides rapid and precise analysis, enabling effective decision-making for energy storage implementation in depleted fields.

This paper presents a methodology for the integration of Building Information Modeling (BIM) and Life Cycle Cost Analysis (LCCA) to assess the economic implications of designing aging-in-place (AIP) homes at the conceptual stage. With the global increase in the aging population, there is an increased demand for housing solutions tailored to the needs of elderly individuals. Focusing on the importance of the early phase of design, this study aims to improve the process of making efficient decisions by providing a comprehensive assessment of the life cycle costs associated with AIP homes. The study introduces a semi-automated model for the economic evaluation of AIP homes, enabling the estimation of costs throughout the houses’ entire life cycle, from design and construction to operation, maintenance, and eventual renovation or disposal. The said model facilitates the exploration of the long-term economic feasibility of design’s related decisions with an emphasis on the importance of considering the life cycle costs early during the design process to optimize the functionality and economic viability. By investing in accessible and universal design features upfront, the initial costs for modifications can lead to long-term savings by reducing the need for extensive retrofits. The model can easily do comparison between different design alternatives in terms of their lifecycle costs, allowing designers to assess the financial impact of using important features in their design such as wider doorways, accessible bathrooms, and elevators. Overall, this study provides valuable insights for designers and homeowners about the economic aspects of designing AIP homes as a support for efficient decision-making during the early stages of the design process.

In order to solve the problem of large eddy current loss and high temperature rise caused by large amount of permanent magnet, a new type of combined magnetic pole permanent magnet motor is proposed in this paper. The sinusoidal distribution subdomain model of non-uniform air gap rotor is established by using Laplace equation, and the analytical expression of eddy current loss of rotor in uniform air-gap and non-uniform air-gap is derived. The effect of rotor eccentricity on eddy current loss is obtained. According to the characteristics of distributed winding of non-uniform air gap combined pole permanent magnet motor, equivalent treatment is performed to obtain the equivalent thermal conductivity, so as to establish equivalent thermal network model of motor, calculate the temperature value of each component of the motor, and verify the correctness of the thermal network model through the method of magnetothermal bidirectional coupling. Finally, an experimental platform is set up to carry out temperature rise experiments on the two prototypes respectively. Experimental results show that the non-uniform air-gap rotor structure can effectively reduce the rotor eddy current loss and motor temperature rise, and also verify the accuracy of the analytical model calculation results.

Information geometry is a mathematical framework that analyses the structure of statistical models using concepts from differential geometry. It treats families of probability distributions as manifolds, where the parameters of each model determine the coordinate charts. By applying info-geometric tools, we can gain insights into the characteristics of these models. The approach involves characterizing the queueing system's manifold using information geometry and presenting the exponential of the information matrix. This integration of information geometry with queueing theory provides a novel perspective for analyzing the dynamics of queueing systems, incorporating relativistic and Riemannian concepts. Some applications to E-health are highlighted. Finally, closing remarks and the next phase of research.

Cooling fans are one of the critical components of air-forced (AF) dry-type transformers for regulating internal temperatures. Therefore, effective malfunction detection is crucial to maintain the transformer temperature within an acceptable range and prevent overheating. Regular maintenance occurs periodically and issues with cooling fans may arise between maintenance periods, leading to prolonged operation under malfunctioning conditions and potential failures. In addition, utilities typically have online information about whether a fan works or not without providing information about cooling fan malfunctioning circumstances. To address these challenges, this study proposes learning-based online monitoring techniques to detect malfunctions in AF transformer cooling fans. Random forests (RFs) and convolutional neural networks (CNNs) are developed to classify the audio signals from cooling fans into normal and malfunctioning classes. Unlike RFs, which require separate feature extraction, CNNs are trained based on spectrogram images derived from audio signals. Thus, various time-frequency techniques are utilized for feature extraction in RFs. Besides, multiple data augmentation techniques are employed to enhance the dataset size and diversity. Algorithmic performance is optimized through hyperparameter tuning and classifier threshold adjustment. Simulations reveal that CNNs outperform RFs, whereas the latter provides superior interpretability of acoustic features compared to the former.

Background: Anorectal malformations (ARMs) are often associated with tethered cord syndrome (TCS). This study focused on children with ARM to explore the risk factors for the co-occurrence of TCS and to investigate the impact of untethering surgery on anorectal function among these children. Methods: A retrospective analysis was conducted on 130 children with ARM treated at Fujian Provincial Children's Hospital (Fujian Hospital of Shanghai Children's Medical Center) from May 2021 to January 2024. A total of 114 children were included in the study on the basis of the inclusion and exclusion criteria. The patients were divided into two groups according to the presence of TCS: the ARM group (n=83) and the ARM+TCS group (n=31). to explore the risk factors for the co-occurrence of ARM and TCS. All children diagnosed with TCS underwent untethering surgery regardless of symptoms. Anorectal function was compared between the ARM and ARM+TCS groups. Results: In the multivariate analysis, intermediate or high-type ARM increased the risk of children with ARM having TCS, with an OR of 3.571, 95% CI from 0.106 to 0.738, and p= 0.010. Additionally, the presence of other malformations also increased the risk of children with ARM having TCS (p=0.026). When the ARM+TCS group was compared with the ARM group, children with low-type ARM in the ARM+TCS group exhibited a significant improvement in constipation following untethering surgery (p=0.043). However, when children with intermediate or high-type ARM were compared, the anorectal function of the children in both groups was comparable. Conclusions: Intermediate or high-type ARM and the presence of other malformations are risk factors for the co-occurrence of TCS in children with ARM. In children with low-type ARM, those with TCS and ARM showed significant improvement in constipation after untethering surgery compared with those with ARM without TCS. We recommend that children with relevant conditions actively undergo untethering surgery.

Background: There has been a lack of tools to identify listening difficulties in school settings for both hearing and hearing-impaired Italian students. Thus, the present study aimed to realize cross-cultural adaptation and validation of the Listening Inventory for Education-Revised for Italian students (LIFE-R-ITA). Methods: Following the validation of two forward-backward translations by a multidisciplinary committee, the content validation for the LIFE-R-ITA was performed by pre-testing six implanted children (8-18 years old). After minor cross-cultural adaptations, normative data were collected from a sample of 223 hearing students enrolled in different school settings and educational degrees. Results: For the LIFE-R-ITA, hearing students showed an average score of 72.26% (SD=11.93), reflecting some listening difficulties. The subscales (LIFE total, LIFE class, and LIFE social) indicated good internal consistency. All items were shown to be relevant. Most challenging situations happened when listening in large rooms, especially when other students made noise. LIFE social scores were significantly worse than those of LIFE class (p &lt; 0.001). Conclusions: The LIFE-R-ITA may support teachers and clinicians in assessing students’ self-perception of listening at school. Such understanding may help students overcome their listening difficulties, by planning and selecting the most effective strategies among classroom interventions.

Seventy-seven percent of Irish primary school children do not meet recommended physical activity (PA) guidelines [1]. The Daily Mile (TDM) is a primary school initiative designed to increase children’s PA output. This study evaluates TDM’s perceived effect on Irish primary school children’s health-related metrics. A mixed-methods study, comprising two data collection phases, used the RE-AIM framework to evaluate TDM [2]. Phase one involved teachers, principals and classroom assistants (n = 191) from TDM-registered schools completing a questionnaire. Two TDM-registered schools participated in phase two where, (i) interviews were conducted with each principal, (ii) a teacher sub-sample (n = 4) participated in a focus group and (iii) a child sub-sample (n = 14) participated in separate focus groups. TDM was perceived to positively impact markers of children’s health, including their PA behaviour, physical fitness and social wellbeing. Inclement weather (66.5%) and a lack of time (56.5%) were reported as the top-ranked implementation barriers. Moreover, TDM’s repetitive nature often left children feeling disinterested and resulted in some teachers modifying the initiative to maintain engagement levels. Maintaining the long-term implementation of TDM and its health benefits in primary schools may require bespoke amendments to the original format to preserve children’s engagement.

Preschoolers with disabilities and their family caregivers are missed out in many public health initiatives especially in low-income countries. Yet they can benefit from early intervention to promote their development from soon after birth and to provide a better quality of life for their families. In this paper, we describe how a community-based approach has been implemented with minimal funding in two areas in Zimbabwe: a township in Harare and in rural areas of Manicaland Province. Our aim in sharing this information – allied with references to research studies recently undertaken in Africa – is that it will enable similar supports to be replicated in other communities by local personnel. A logic model is used to describe the situation in which the two projects work, the various inputs they have provided to their community and the different forms of support they have offered to the children and their caregivers. The project outputs are listed in terms of the number of beneficiaries helped and activities undertaken. The outcomes achieved for the children, the family and communities are reported. The sustainability and extensions of community-based projects to address unmet needs are discussed. The main conclusion is that disadvantaged communities can be energized to address the needs of their most marginalized residents.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably too in low resourced areas of more affluent nations. Yet as this rapid review of published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community; notably traditional healers and leaders; health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

How hands-on gardening impacts behaviors including healthy eating and physical activity during early childhood can be of critical importance for preventing early onsets of obesity. This research investigates how participating in hands-on gardening impacts preschoolers’ (3-5 years old) physical activity (measured by accelerometers) in childcare centers in the Semi-Arid Climate Zone. The research was conducted in eight licensed childcare centers located in West Texas with 149 children (n=149). Four childcare centers in the experimental group received hands-on garden interventions; the other four in the control group did not. In both experimental (intervention) and control (non-intervention) centers, children wore Actigraph GT3X+ accelerometers continuously for 5 days before and for 5 days after intervention (a total of 10 days). Results show that the duration of sedentary behavior of children in the experimental (intervention) group significantly decreased compared to children in the control (non-intervention) group. The finding suggests that the positive effects of childcare hands-on gardening on physical activity extend to semi-arid climate zones where gardening is challenging due to high temperatures and lack of annual rainfall. The research emphasizes the critical need to incorporate hands-on gardening in childcare centers as an obesity prevention strategy nationally in the U.S. and beyond.

Background: School meals represent a significant supply of nutrients for children in Brazil, especially those in conditions of social vulnerability. Objectives: This study aimed to assess the levels of arsenic (As), cadmium (Cd), and lead (Pb) in meals served in public elementary schools in four municipalities in the state of Bahia, Brazil, and assess the risk posed to children's health. Methods: Ninety-six samples were collected from 16 schools, freeze-dried, and subjected to microwave-assisted digestion. The As, Cd, and Pb levels were determined by graphite furnace atomic absorption spectrometry. The risk assessment was based on calculating each element's hazard quotient (HQ). Results: None of the samples reached or exceeded the tolerable levels for the elements analyzed. Pb was the metal that obtained the most significant result, reaching maximum levels of 39-157 µg.kg-¹. Conclusions: No element exceeded the PTWI proposed by JECFA; thus, the toxic metal content in school meals poses a negligible risk to children´s health.

Objective: This study investigated the effects of an easily implemented 8-week program centered around jump rope exercise (JRE) on executive function among children with ADHD. Methods: Using the Stroop Color Word Test to assess inhibitory control, the n-back task (1- and 2-back) to assess working memory, and task switching to assess cognitive flexibility. Results: After the intervention, there were within-group effects only for the experimental group, with higher accuracy on the 1-back working memory task (t= -2.79，p= 0.011< 0.05，Cohen’s d= 0.60) and on task switching after compared with before the JRE intervention (t= -4.00，p=0.01<0.05，Cohen’s d= 0.85), but with no change in reaction time. There was no significant within-group difference on the Stroop test (P> 0.05). Additionally, there were no between-group effects as assessed by one-way analyses of variance. Conclusion: 8-week program focused on JRE improved two aspects of executive function, working memory and cognitive flexibility, with no significant effect on a third aspect, inhibitory control, among children with ADHD aged 7 to 12 years.

About half of the world's population is at risk of dengue infection. Epidemics of dengue fever caused an increased risk of morbidity and mortality in recent years, which led to the exploration of vaccines as a preventive measure. This systematic review and meta-analysis aimed to evaluate the efficacy, immune response, and safety of dengue vaccines in children by analyzing clinical trials. The review followed standard procedures for data extraction using PRISMA guidelines, and searching multiple databases including PubMed, CINAHL, Medline, Health Source, Science Direct, and Academic Search Premiere. Eligible studies involved children (0-17 years). Cochrane Collaboration criteria were used for quality assessment, with thematic data synthesis and meta-analysis. Among 38 selected studies, dengue vaccines showed varying efficacy against all four serotypes. CYD-TDV (Dengvaxia®), and Tekade (TAK-003) vaccines demonstrated strong protection against severe dengue, but their long-term efficacy varied. Vaccines triggered satisfactory immune responses, notably in those previously exposed to dengue. Safety profiles were mostly favorable, noting mild adverse events post-vaccination. Meta-analysis supported vaccine efficacy and immune response, but safety concerns warrant further exploration. In conclusion, dengue vaccines demonstrated promising efficacy and immune response, particularly against severe manifestations.

Background: The high prevalence of learning disabilities among children confirm that learning disabilities are surprisingly common. In absence of routine screening, many children still go undetected with a huge individual and family burden, while at the same time existing interventions are conflicting. The purpose of the study is to report on the design, implementation and evaluation of an innovative pilot intervention aiming to improve the quality of life of the family of students with specific learning disabilities. Method: For the purposes of this study, we used an experimental research design, using two groups (intervention and control). The intervention included four meetings with parents of children from the intervention group. To assess the quality of life of the students' family and the parenting style, the following measuring tools were used. They conducted at times and locations convenient to each participant. The instruments used to measure outcomes were two standard weighted questionnaires, the parenting style questionnaire and the family quality of life questionnaire. Findings: The results showed that the intervention program had significantly positive effects on both parenting style and children’s quality of life. Specifically, a decrease in parental authoritarianism and an increase in parental support were observed. Also, an increase in child-parent interaction, emotional and general well-being was found. Conclusion: The intervention program did improve the quality of life of the children by increasing all the variables related to the measurement of their quality of life.

This study aimed evaluating 7 years’ outcome in 118 very preterm newborn (VPN, gestational age=26±1.4wks) involved in a randomized controlled trial. They presented neonatal respiratory distress (RDS) requiring ventilation for 14±2 days post-natal age (PNA). Repeated instillation of 200mg/kg Poractant alfa (SURF) did not improve early bronchopulmonary dysplasia, but SURF infants needed less re-hospitalization than controls for respiratory problem at 1- and 2-years PNA. There was no growth difference at 7.1±0.3 years for 41 SURF vs. 36 controls (80% eligible children); 7.9% SURF vs. 28.6% controls presented asthma (p=0.021). Children underwent cogni-tive assessment (WISC IV) and pulmonary function testing (PFT) measuring spirometry, lung volumes and airway resistance. Spirometry showed differences (p<0.05) between SURF and con-trols (mean±standard deviation (median z-score)) for FEV1 (L/s) (1.188±0.690(-0.803) vs. 1.080±0.243(-1.446)); FEV1 after betamimetics (1.244±0.183(-0.525) vs. 1.091±0.209(-1.342)); FVC (L) (1.402±0.217 (-0.406) vs. 1.265±0.267(-1.141)), and FVC after betamimetics 1.452±0.237 (-0.241) vs. 1.279±0.264(-1.020)). PFT showed no difference in volumes or airway resistance. Global IQ median [Inter-quartile Range] was 89[82:99] vs. 89[76:98] with 61% children >85 in both groups. Former VPN presenting severe neonatal RDS treated with repeated Surfactant have improved lung function and less asthma at 7 years PNA. There were no differences in neurodevelopmental outcome

The aim of the study was to identify the existence of positive relationships between certain psychomotor behaviors, which we consider specific to swimming, and learning the execution technique of some styles (front crawl and backstroke). The study was carried out during 10 months, including 76 children (40 boys and 36 girls) aged between 6-9 years who practice recreational swimming in a Romanian city. Several tests were used: Tapping test for manual dexterity and laterality, the Goudenough test for body schema, the Flamingo test for static balance, the horizontal buoyancy test for body balance on the water. Results indicated better ratings on all psychomotor behaviors analyzed by gender (in favor of girls compared to boys), except for laterality. The levels of all analyzed psychomotor behaviors are directly proportional to the age of the subjects. Also, moderate positive correlations of manual dexterity (rs = 0.63 in front crawl; rs = 0.57 in backstroke) and strong correlations were identified for body scheme, laterality, static balance and buoyancy, coordination with the learning of the two styles of swimming (r or rs between 0.77 and 0.85). In conclusion, psychomotor behaviors can be predictors for learning swimming styles.

While there is a coordinated effort around reaching zero dose children and closing existing equity gaps in immunization delivery, it’s important that there is agreement and clarity around how ‘zero dose status’ is defined and what is gained and lost by using different indicators for zero dose status. There are two popular approaches used in research, program design, and advocacy to define zero dose status: one uses a single vaccine to serve as a proxy for zero dose status, while another uses a subset of vaccines to identify children who have missed all routine vaccines. We provide a global analysis utilizing the most recent publicly available DHS and MICS data to compare the number, proportion, and profile of children 12 to 23 months who are ‘penta-zero dose’ (have not received the pentavalent vaccine), ‘truly’ zero dose (have not received the BCG, polio, pentavalent, and measles vaccines), and ‘misclassified’ zero dose children (those who are penta-zero dose but have received at least one other vaccine). Our analysis includes 194,829 observations from 82 low- and middle-income countries. Globally, 14.2% of children are penta-zero dose and 7.5% are truly zero dose, suggesting that 46.5% of penta-zero dose children have had at least one contact with the immunization system. While there are similarities in the profile of children that are penta-zero dose and truly zero dose, there are key differences between the proportion of key characteristics among truly zero dose and misclassified zero dose children, including access to maternal and child health services. By understanding the extent of connection zero dose children may have with the health and immunization system and contrasting it with how much the use of a more feasible definition of zero dose may underestimate the level of vulnerability in the zero dose population, we provide insights that can help immunization programs design strategies that better target the most disadvantaged populations. If the vulnerability profiles of the truly zero dose children are qualitatively different from that of the penta zero dose children, then failing to distinguish the truly zero dose populations, and how to optimally reach them, may lead to the development of misguided or inefficient strategies for vaccinating the most disadvantaged population of children.

Children five years or younger in low- and middle-income countries (LMICs) are severely affected by diarrhoea disease, especially in the sub-Saharan region. Hence, the study aimed at determining the prevalence and determinants of diarrhea disease among children under 5 years in Epworth Township, Zimbabwe. A descriptive cross-sectional study was conducted at a local clinic in Epworth Township, Harare. A convenience sampling strategy was used to recruit study participants for participation and 386 children were enrolled in the study. The majority were male children (n=229; 59.3%), while there were more female caregivers (n=370; 95.9%) than male caregivers (n=16; 4.1%). The prevalence of diarrhea disease in the study was 25.1%. The determinants associated with diarrhea were being partially vaccinated (OR 2.38, CI 95% 2.80–8.22), collecting water more than 1 kilometre from a household (OR 4.55; CI 95% 2.10–9.85) and using untreated water (OR 6.22; CI 95% 2.13–18.20). The age of the caregiver and using a clean water container (OR 0.05; p=0.020) were protective factors. Provision of primary health care, especially prevention of disease through immunization and rendering environmental health services could reduce the prevalence of diarrhea in disadvantaged townships.

It is already well known that infants and children infected with COVID-19 develop mild to mod-erate forms of the disease, with fever and oropharyngeal congestion being the most common symptoms. Nevertheless, there are cases in which the patients accuse respiratory symptoms. These cases need lung evaluation, which can be done using lung ultrasound (LUS), because it is a non-irradiating and repeatable imaging technique. 19 children with COVID-19 pneumonia were eval-uated using LUS. The LUS score (LUSS) for each patient varied between 1 to 8 points from a max-imum of 36 points. The arithmetic mean was 4.47 ± 2.36 (S.D), while 95% CI for the Arithmetic mean was 3.33 to 5.61. The lung changes were correlated with their biomarkers, specifically in-flammatory markers. The correlation between LUSS and LDH, D-dimers and IL-6 was a strong positive one with r=0.66 (p=0.01, 95% CI 0.147 to 0.896) between the LUSS and LDH level at symptomatic infants and children (with cough present) and r=0.66 (p=0.01, 95% CI 0.140 to 0.895) between LUSS and D-dimers level at symptomatic infants and children (with cough pre-sent). The results suggest that LUS could be a good imaging technique that can be used both in ini-tial evaluation of children with respiratory diseases, and, also in their follow-up, correlated with symptoms and biomarkers.

Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (%59.6) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or &gt;1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed.

School meals can have a key function in promoting children’s health. However, simply providing a free school meal is not a guarantee that pupils will actually eat the food. The purpose of this study was to explore factors influencing pupils’ participation in free school meal schemes in Oslo The study has a qualitative research design, inspired by grounded theory. Data were collected through interviews with pupils, teachers and parents, and participant observations in two schools participating in a pilot project funded by Oslo Municipality. Line-by-line coding, memo writing and a constant comparative technique were used to analyse the data. One primary school and one lower-secondary school in different districts in Oslo that were implementing two different free school meal models. 39 pupils (5th–10th grade), 15 parents and 12 school employees were included. Four main factors related to pupils’ participation to free school meals emerged from the analysis: the popularity of the food served, the attraction to the nearby shopping centre, social aspects and predictability. To promote pupils’ participation in free school meal schemes, schools need to solve the challenges of balancing between healthy food and popular but often unhealthy food. Children and parents involvement, regularity of the meals provision, a good flow of information and the creation of a friendly eating environment are recommended

Background: Left ventricular noncompaction (LVNC) is a genetically determined cardiomyopathy, that occurs following a disruption of endomyocardial morphogenesis. The purpose of this study was to identify the clinical characteristics and genetic profile of children with LVNC. Methods: From February 2008 to July 2020, a total of 32 children (median 11.5 years) with LVNC were prospectively enrolled and followed up for the median of 4.02 years. Diagnosis was made based on characteristic features of LVNC in echocardiography and cardiovascular magnetic resonance (CMR). Patients’ clinical symptoms, family history, ECG, Holter ECG and genetic tests were also evaluated. Results: The most common presenting symptom was heart failure (31% of children). ECG abnormalities were noted in 56% of patients. The most prominent features were ventricular arrhythmias, sinus bradycardia and paroxysmal third-degree atrioventricular block. Most of the patients (94%) met the criteria for LVNC and CMR confirmed this diagnosis in 82% of cases. The molecular etiology was found in 53% of children. Conclusion: Although heart failure and arrhythmias were very frequent in our study group, thromboembolic events and genetic syndromes were rare. For accurate and reliable assessment of children with LVNC, it is necessary to get to know their family history and detailed clinical profile.

BACKGROUND: Probiotics may prevent the allergic response’s development due to their anti-inflammatory and immunomodulatory effects. The aim of this study is to determine if the prophylactic treatment with a mixture of Bifidobacterium animalis subsp. Lactis BB12 and Enterococcus faecium L3, would reduce symptoms and need for drug use in children with allergic rhinitis (AR). METHODS: The study included 250 children aged from 6 to 17 years, affected by AR. Patients were randomly assigned to the intervention group (117) or to the placebo group (86). Patients of the intervention group, in addition to conventional therapy (local corticosteroids and/or antihistamines), were treated, in the 3 months preceding the development of AR symptoms, with a daily oral administration of a probiotic mixture containing the Bifidobacterium animalis subsp Lactis BB12 DSM 15954 and the Enterococcus faecium L3 LMG P-27496 strain. Nasal Symptoms Score(NSS) was used to evaluate AR severity before and after the treatment with probiotics or placebo. RESULTS: 96% of the patients in the intervention group showed a significant decrease in their NSS after the probiotic treatment as well as a decrease in the intake of pharmacological therapy. GPower software was used to calculate the test power. Given the probability of error α = 0.05, the total sample size n = 117 and the effect size ρ = 2.0651316, the power of the test is 1 - β = 1. CONCLUSIONS: When administered as a prophylactic treatment the mixture of BB12 and L3 statistically decrease signs and symptoms of AR and reduces significantly the need of drugs.

Introduction: Oral health knowledge, beliefs and attitudes of parents have a direct influence on their child’s oral health maintenance, dietary habits and encourage healthy behaviors. The aim of this study was to assess the knowledge, and attitude of parents with regards to the oral health practice of their children and its associated factors. Methods: A self -administered structured questionnaire was administered to parents or guardians of learners aged 5 to 12 years at a low socio-economic rural primary school in the uGu district, KwaZulu Natal, South Africa to collect demographic variables, knowledge of dental health, use of toothbrush, use of toothpaste, dietary practices and dental visits; practice with respect to dental care and attitudes towards oral health. The questionnaire was translated from English to IsiZulu was used. Bivariate and multivariate logistic regressions were used to assess the association between parent’s sociodemographic factors with their oral health knowledge and practice scores. Results: One hundred and forty four completed survey instruments were received with an eighty percent (118) representation of mothers. Ninety five percent of the parents (136) had a positive attitude towards oral health with 86% (124) of the children brushed their tongue and 89% (128) of the children brushed their teeth happily. The mean knowledge score was 70% with a median of 72%. Children were significantly more likely to brush their tongues (AOR: 3.20 95% CI: 1.06-9.66) and were more likely to be happier when brushing their teeth (AOR: 4.65 95% CI: 1.41-15.38) when the caregivers were their mothers, and when parents had an above average knowledge score (AOR: 1.86 95% CI: 0.72-4.85) and had positive attitudes (AOR: 3.20 95%CI: 0.46-22.00). Conclusion: To reduce the gaps in knowledge, oral health promotion should be integrated into all point of care contact with parents at health facilities, increased community awareness and advertising campaigns as well as a more focused school health oral program that addresses primary prevention, screening and appropriate referrals to health facilities

Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may be diet. We determined the bio-accessible fraction of lead, cadmium, and arsenic from the diet of preschool children from two day care centers (DCC). A cross-sectional study was conducted with 64 one–four-year-old children from two DCCs where the 24-h duplicate diet samples were collected. The diet samples were analyzed by ICP-MS for lead, cadmium, and arsenic total concentrations (n = 64) and their bio-accessibility were analyzed for a subsample (n = 10). The dietary intake (DI) mean for lead, cadmium, and arsenic were 0.18 ± 0.11 µg kg⁻¹ bw, 0.08 ± 0.04 µg kg⁻¹ bw, and 0.61 ± 0.41 µg kg⁻¹ bw, respectively. All DI calculated for TEs, considering total intake, were found lower than the tolerable limits (TL) (European Union, or World Health Organization, WHO, when applicable) except for one child’s Pb intake. Bio-accessibilities ranged between 0% to 93%, 0% to 103%, and 0% to 69%, for lead, cadmium, and arsenic, respectively. Although DI for TEs has been found lower than TL, these reference values have been recently decreased or withdrawn since it was for lead and arsenic whose TL were withdrawn by WHO.

The insertion of the Amazon into the global commodities market requires ensuring the rational use of resources to meet market and political-social demands, such as the UN 2030 Agenda. Therefore, responsible production practices, given the current demand for sustainable use of land and its re-sources, are essential. Thus, the objective of this study was to identify opportunities and challenges linked to the implementation and consolidation of sustainable production systems in the Amazon through a systematic literature review. To this end, articles were prospected in four databases (Science Direct, SpringerLink, Scopus and Wiley) covering the period from 2004 to 2024. A total of 5,385 articles were evaluated, and after the selection stages, only 39 were included. A low distri-bution of studies among states in the Brazilian Amazon was observed, with a peak in studies star-ting in 2015. The studies developed mostly addressed agroforestry systems and forest management. Although there are sustainable production systems and practices, research and public policies need to be promoted to help the different actors involved in agricultural production in the Amazon, generating income and quality of life.

Introduction: Detection of diaphragmatic injury in blunt trauma can be challenging in the absence of surgical exploration. Here we explore the mechanisms of injury and detection modes for patients with blunt trauma who had a diaphragmatic injury. Methods: This is a single-center, retrospective review conducted in a level 1 trauma center, 2016 to 2023, inclusive. We included all patients who presented with a blunt traumatic diaphragm injury (TDI). We identified nine patients with TDI using AIS injury description and type of trauma. Patient demographics, mechanism of injury, injury severity score (ISS), mode of diagnosis, and clinical outcomes were reviewed. Results: Of the nine patients identified with blunt TDI, two were associated with motor vehicle collisions, four were pedestrians struck, 1 from stab wounds, and 2 fell from the stairs. The mean ISS for the nine patients is 39.7. Of the nine patients with blunt TDI, four died in the trauma bay – two from traumatic arrest, and two died spontaneously. One patient died two days after admission. Of the four patients who survived, one had a diaphragm injury identified during video-assisted thoracic surgery (VATS) for retained hemothorax, and one patient had a diaphragm injury repaired during emergent exploratory laparotomy for other injuries. One patient had a diaphragm injury identified and repaired during diagnostic laparoscopy that was converted to open surgery, and the remaining patient had no diaphragm injury on diagnostic laparoscopy evaluation. Conclusions: Blunt trauma to the torso is usually a consequence of high-energy impact but can also occur following low-energy incidents, such as falls in elderly individuals. Imaging can be useful in detecting such injuries but is not 100% sensitive. A high index of suspicion should be maintained for diaphragmatic injury in high-energy blunt trauma.

The dynamic nature of quadrotor flight introduces significant uncertainty in system parameters, such as thrust and drag factor. Consequently, operators grapple with escalating challenges in implementing real-time control actions. This study delves into an approach for estimating the model of quadrotor Unmanned Aerial Vehicles using Physics-Informed Neural Networks (PINNs) when you have a limited amount of data available. PINNs offer the potential to tackle issues like heightened non-linearities in low-inertia systems, elevated measurement noise, and constraints on data availability. The effectiveness of the estimator is showcased in a simulation environment with real data and juxtaposed with a state-of-the-art technique, such as the Extended Kalman Filter (EKF).

This paper examines the current state of food security in Pakistan, focusing on the factors influencing the nation's ability to ensure a stable food supply. The analysis covers food production, distribution, accessibility, and stability, while also considering socioeconomic and environmental factors. The role of government regulations and international collaborations is explored in addressing food security challenges. Despite the critical importance of agricultural governance for sustainable food production and economic development, Pakistan's agricultural sector remains under prioritized, suffering from a lack of strategic vision and inconsistent government support. This neglect undermines efforts to achieve food security and stability. The study evaluates the alignment of Pakistan's National Food Security Policy (2018) with global, national, and provincial standards for sustainable agricultural management. A framework based on principles, criteria, and indicators (PCI) was developed, utilizing both quantitative and qualitative methodologies. Forty-three indicators, eleven criteria, and one guiding principle across four dimensions were identified. Thirteen governance tools were assessed using a ratio scale (0–5), with results presented in a policy coherence matrix. The coherence index score of 2.14 indicates significant misalignment among regulatory instruments, highlighting gaps in addressing climate change, low-income food access, service management, and institutional capacity. The study reveals that many food policies in Pakistan are outdated and inconsistent, requiring revision to address local challenges and align with emerging international obligations. The findings provide a comprehensive overview of the current food security landscape in Pakistan, offering insights for more informed decision-making to build a resilient and sustainable food system.

A new model of gravity is presented here that is similar to MOND and Chameleon theory but uses an Entropic Gravity approach that is not basedfundamentally on the First Law of Thermodynamics. Instead, the Second Law of Thermodynamics will be mainly used here as it was applied inBlack Hole Physics via the Area Theorem and the Holographic Principle. The Area Theorem was considered here to imply, not only that the totalarea of the event horizon will never shrink when entropy increases, but also that the mass or energy content within the black hole will always begreater than the original mass-energy input, though not necessarily violating the energy conservation law. This black hole property will be extendedto include even a non-black hole setting. Moreover, the approach does not use the Equipartition Theorem to relate energy to temperature($E=Nk_{b}T$) instead we used Vopson's Energy-Mass-Information Equivalence Principle ($E=k_{b}T\ln(\Omega)$). The theory uses $E=NE_{p}$, for the total energy of a massive object where $E_{p}$ is the Planck Energy and $N$ is the number of PlanckEnergy to represent the amount of information within the limit set at the Planck scale. It is shown here that gravity emerges whenever informationis updated within a given volume of space with a magnitude that is defined not only by the gravitating matter but also by the energy generated inspace within the vicinity of the gravitating matter. The model is the first to consider the role of both spacetime and matter as a medium to storeinformation and apply it to describe gravity in a fundamental way.

Building decarbonization is a major challenge for cities. Deciding what, when, and how to retrofit a building is difficult, given the complex interaction between energy costs and investment requirements. Several tools have been developed in the last years to help public and private stakeholders with these decisions, but none cover aspects the authors think are fundamental. For this reason, an urban building retrofit tool was developed and is presented in this article. This new tool is based on a bottom-up approach, with all buildings simulated individually, considering aspects such as shading or adjacencies. As a second step, three scenarios with different levels of ambition have been implemented in the tool, and the energy demand and emissions resulting from these scenarios have been calculated. As a third step, the retrofitting scenarios' initial investment and operational costs have been implemented via a detailed Life Cycle Costs (LCC) approach. The authors describe the robust and scalable structure that has been developed and the application of this structure to calculate the LCCs of different retrofitting scenarios in Montréal.