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1.
Braz. j. biol ; 84: e257402, 2024. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1355856

ABSTRACT

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.


Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.


Subject(s)
Humains , Mâle , Femelle , Nouveau-né , Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Leishmaniose viscérale/diagnostic , Leishmaniose viscérale/épidémiologie , Saisons , Brésil/épidémiologie , Incidence , Modèles statistiques
2.
Emergencias (Sant Vicenç dels Horts) ; 35(1): 31-38, feb. 2023. ilus, tab, graf
Article in Spanish | IBECS | ID: ibc-213767

ABSTRACT

Objetivo. Evaluar el impacto de una iniciativa de mejora realizada en los servicios de urgencias (SU) de una comunidad autónoma para reducir el uso de fármacos no recomendados en lactantes con bronquiolitis aguda (BA).Método. Estudio cuasi-experimental analítico del tipo “antes y después de una intervención”. Se incluyeron de forma retrospectiva todas las BA en niños # 12 meses atendidas en los SU de 24 hospitales públicos durante el mes de diciembre de dos periodos epidémicos: 2018 (preintervención) y 2019 (postintervención). Se recogieron variables epidemiológicas, clínicas, asistenciales y evolutivas. La intervención consistió en difundir material informativo y realizar actividades formativas previas al periodo epidémico.Resultados. Se incluyeron 7.717 episodios (2018: 4.007 y 2019: 3.710). No existieron diferencias en las características epidemiológicas y clínicas. El empleo de salbutamol en los SU descendió del 29,4% [intervalo de confianza de 95% (IC 95%): 28,8-30,8] en 2018 al 10,6% (IC 95%: 9,6-11,6) en 2019 (p < 0,001), el de adrenalina del 6,0% (IC 95%: 5,3-6,8) al 0,9% (IC 95%: 0,7-1,3) y el de suero salino hipertónico del 8,2% (IC 95%: 7,3-9,1) al 2,1% (IC 95%: 1,7-2,6) (p < 0,001). La prescripción al alta de salbutamol se redujo del 38,7% (IC 95%: 36,9-40,4) al 10,6% (IC 95%: 9,6-11,6) (p < 0,001). La tasa de ingreso y la tasa de readmisión no cambiaron y la mediana de tiempo de estancia en los SU se redujo 81 minutos [rango intercuartil (RIC) 44-138] a 66 (RIQ: 37-127) (p < 0,001).Conclusiones. La iniciativa de mejora ha conseguido disminuir la tasa de intervenciones terapéuticas no indicadas en BA. Sin embargo, existe una gran variabilidad entre los diferentes SU por lo que la estrategia y la medición de su impacto deben mantenerse en el tiempo. (AU)


Objective. To evaluate the impact of a quality-of-care improvement program implemented in emergency departments (EDs) in a Spanish autonomous community with the aim of reducing the use of unrecommended drugs when treating infants for acute bronchiolitis. Methods. Before-after quasi-experimental intervention study. We retrospectively included infants aged 12 months or less who were treated for acute bronchiolitis in 24 Spanish national health system hospital EDs in December during 2 epidemic periods: in 2018, before implementing the program, and in 2019, after implementation. Data collected included epidemiologic information, clinical and care details, and clinical course. The program consisted of providing informative material and training sessions before the epidemic period started. Results. A total of 7717 episodes (4007 in 2018 and 2710 in 2019) were identified. Epidemiologic and clinical characteristics did not differ between the 2 periods. ED use of the following treatments decreased between the 2 periods: salbutamol, from 29.4% (95% CI, 28.8%-30.8%) in 2018 to 10.6% (95% CI, 9.6%-11.6%) in 2019; epinephrine from 6.0% (95% CI, 5.3%-6.8%) to 0.9% (95% CI, 0.7%-1.3%); and hypertonic saline solution fell from 8.2% (95% CI, 7.3%-9.1%) to 2.1% (95% CI, 1.7%-2.6%) (P<.001, all comparisons). Prescriptions for salbutamol on discharge fell from 38.7% (95% CI, 36.9%-40.4%) to 10.6% (95% CI, 9.6%-11.6%) (P<.001). Admissions and readmissions did not change, and the median time (interquartile range) spent in the ED fell from 81 (44-138) minutes to 66 (37-127) minutes (P<.001). Conclusions. The quality-of-care improvement initiative was able to decrease the number of unrecommended therapeutic interventions for acute bronchiolitis. However, we identified great variations between EDs, suggesting that training and assessment of impact should continue. (AU)


Subject(s)
Humains , Mâle , Femelle , Nourrisson , Bronchiolite/traitement médicamenteux , Services des urgences médicales , Amélioration de la qualité , Essais contrôlés non randomisés comme sujet , Guides de bonnes pratiques cliniques comme sujet
3.
Actas urol. esp ; 47(1): 22-26, jan.- feb. 2023. ilus, tab
Article in Spanish | IBECS | ID: ibc-214418

ABSTRACT

Objetivo Este estudio investiga el impacto del uso de la cobertura de dartos para aumentar la neouretra en los resultados funcionales y cosméticos. Evaluar una técnica novedosa que demuestra cómo fijar la cobertura de dartos como cobertura de barrera de la neouretra en la corrección de hipospadias. Pacientes y métodos Este estudio se realizó en 204 pacientes varones, todos con diferentes grados de hipospadias (HPD: 132, hipospadias coronal: 46 y HPM: 26). Sus edades oscilaban entre 1-23 años (edad media: 2 años). Había incurvación ventral (chorda) en (HPD: 45, hipospadias coronal: 33 y HPM: 26). Todos los pacientes tenían un chorro urinario anormal dirigido hacia abajo. La corrección del hipospadias se realizó mediante la técnica TIP clásica, además de nuestra novedosa modificación con cobertura de dartos. El seguimiento se realizó durante 5 años mediante evaluaciones clínicas de los parámetros funcionales y cosméticos. Resultados Se registraron tasas de éxito en 200 pacientes, 3 pacientes tuvieron complicaciones con una fístula uretrocutánea subcoronal y un paciente presentó la pérdida completa de la reparación. Conclusión La fijación triple de dartos es una técnica sencilla con la que todos los hipospadiólogos pueden reducir la fístula uretrocutánea como complicación común de la corrección de hipospadias con unos buenos resultados funcionales y cosméticos (AU)


Objective This study investigates the impact of the use of dartos covering to augment the neourethra on functional and cosmetic results. To evaluate a novel technique demonstrating how to fix dartos flap to cover the neourethra as a barrier in hypospadias repair. Patients and methods This study comprised 204 male patients with different degree of hypospadias (DPH: 132, coronal hypospadias: 46, MPH: 26). Their ages ranged from 1-23 ys (mean age: 2ys). Penile chordee was in (DPH: 45, coronal hypospadias: 33, MPH: 26). All patients had abnormal downward directed urinary stream. Hypospadias repair was performed by the classic TIP technique in addition to our novel modification of dartos covering. Patients were submitted to 5 years of follow-up including clinical examination of the functional and cosmetic parameters. Results Success rates were reported in 200 patients, 3 patients had complications with subcoronal urethrocutaneous fistula and one patient with complete repair disruption. Conclusion Triple dartos fixation is a simple technique for all hypospadiologists to minimize urethrocutaneous fistula as common complication of hypospadias repair with good functional and cosmetic results (AU)


Subject(s)
Humains , Mâle , Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Jeune adulte , Hypospadias/chirurgie , Procédures de chirurgie urologique masculine/méthodes , Résultat thérapeutique , Études de suivi , Études prospectives , Urètre/chirurgie
4.
Sensors (Basel) ; 23(2)2023 Jan 06.
Article in English | MEDLINE | ID: mdl-36679449

ABSTRACT

Fetal brain tissue segmentation is essential for quantifying the presence of congenital disorders in the developing fetus. Manual segmentation of fetal brain tissue is cumbersome and time-consuming, so using an automatic segmentation method can greatly simplify the process. In addition, the fetal brain undergoes a variety of changes throughout pregnancy, such as increased brain volume, neuronal migration, and synaptogenesis. In this case, the contrast between tissues, especially between gray matter and white matter, constantly changes throughout pregnancy, increasing the complexity and difficulty of our segmentation. To reduce the burden of manual refinement of segmentation, we proposed a new deep learning-based segmentation method. Our approach utilized a novel attentional structural block, the contextual transformer block (CoT-Block), which was applied in the backbone network model of the encoder-decoder to guide the learning of dynamic attentional matrices and enhance image feature extraction. Additionally, in the last layer of the decoder, we introduced a hybrid dilated convolution module, which can expand the receptive field and retain detailed spatial information, effectively extracting the global contextual information in fetal brain MRI. We quantitatively evaluated our method according to several performance measures: dice, precision, sensitivity, and specificity. In 80 fetal brain MRI scans with gestational ages ranging from 20 to 35 weeks, we obtained an average Dice similarity coefficient (DSC) of 83.79%, an average Volume Similarity (VS) of 84.84%, and an average Hausdorff95 Distance (HD95) of 35.66 mm. We also used several advanced deep learning segmentation models for comparison under equivalent conditions, and the results showed that our method was superior to other methods and exhibited an excellent segmentation performance.


Subject(s)
Apprentissage profond , Femelle , Grossesse , Humains , Nourrisson , Traitement d'image par ordinateur/méthodes , Encéphale/imagerie diagnostique , Foetus/imagerie diagnostique , Imagerie par résonance magnétique/méthodes
5.
Nutrients ; 15(2)2023 Jan 10.
Article in English | MEDLINE | ID: mdl-36678206

ABSTRACT

Aim: To determine if supplementation of infants born <33 weeks' gestation with higher dose docosahexaenoic acid (DHA) affects growth, body composition, and blood pressure at 7 y corrected age (CA) and if treatment effects differed by infant sex at birth and birth weight strata (<1250 and ≥1250 g). Methods: Seven-year follow-up of an Australian multicenter randomized controlled trial in which 657 infants were fed high-DHA (≈1% total fatty acids) enteral feeds or standard-DHA (≈0.3% total fatty acids) from age 2-4 d until term CA. Seven-year CA outcomes were growth (weight, height), body composition (lean body mass, fat mass, waist, and hip circumference), and blood pressure. Results: There was no effect of high-DHA enteral feeds compared with standard-DHA on growth, body composition, and blood pressure at 7-year CA either overall or in subgroup analysis by sex. There was a significant interaction between high-DHA and birthweight strata on height at 7-y CA (p = 0.03). However, the post-hoc analyses by birthweight strata did not reach significance (p > 0.1). High-DHA group infants were more likely to be classified as obese (relative risk 1.6 (95% CI 1.0, 2.6); p = 0.05). Conclusions: DHA supplementation of premature infants did not affect growth, body composition, or blood pressure at 7-year CA overall by sex and birthweight strata. The finding of a higher risk of obesity in children who receive high-DHA needs to be interpreted with caution due to the small number of children classified as obese.


Subject(s)
Prématuré , Obésité pédiatrique , Nourrisson , Enfant , Humains , Nouveau-né , Enfant d'âge préscolaire , Acide docosahexaénoïque/usage thérapeutique , Poids de naissance , Études de suivi , Pression sanguine , Obésité pédiatrique/traitement médicamenteux , Australie , Acides gras , Compléments alimentaires , Composition corporelle
6.
Nutrients ; 15(2)2023 Jan 14.
Article in English | MEDLINE | ID: mdl-36678317

ABSTRACT

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) plans to allow participants to redeem their food package benefits online, i.e., online ordering. As grocery shopping online has become more common, companies have developed strategies to market food products to customers using online (or mobile) grocery shopping platforms. There is a significant knowledge gap in how these strategies may influence WIC participants who choose to shop for WIC foods online. This review examines the relevant literature to (1) identify food marketing strategies used in online grocery shopping platforms, (2) understand how these strategies influence consumer behavior and consumer diet, and (3) consider the implications for WIC participants. A total of 1862 references were identified from a systematic database search, of which 83 were included for full-text screening and 18 were included for data extraction and evidence synthesis. The included studies provide policymakers and other stakeholders involved in developing WIC online order processes with valuable information about the factors that shape healthy food choices in the online food retail environment. Findings indicate that some marketing interventions, such as nutrition labeling and food swaps, may encourage healthier food choices in the online environment and could potentially be tailored to reinforce WIC messaging about a healthy diet.


Subject(s)
Assistance alimentaire , Nourrisson , Enfant , Humains , Femelle , Aliments , Marketing , Régime alimentaire , Préférences alimentaires , Comportement du consommateur , Approvisionnement en nourriture
7.
Sensors (Basel) ; 23(2)2023 Jan 14.
Article in English | MEDLINE | ID: mdl-36679775

ABSTRACT

Most well-established eye-tracking research paradigms adopt remote systems, which typically feature regular flat screens of limited width. Limitations of current eye-tracking methods over a wide area include calibration, the significant loss of data due to head movements, and the reduction of data quality over the course of an experimental session. Here, we introduced a novel method of tracking gaze and head movements that combines the possibility of investigating a wide field of view and an offline calibration procedure to enhance the accuracy of measurements. A 4-camera Smart Eye Pro system was adapted for infant research to detect gaze movements across 126° of the horizontal meridian. To accurately track this visual area, an online system calibration was combined with a new offline gaze calibration procedure. Results revealed that the proposed system successfully tracked infants' head and gaze beyond the average screen size. The implementation of an offline calibration procedure improved the validity and spatial accuracy of measures by correcting a systematic top-right error (1.38° mean horizontal error and 1.46° mean vertical error). This approach could be critical for deriving accurate physiological measures from the eye and represents a substantial methodological advance for tracking looking behaviour across both central and peripheral regions. The offline calibration is particularly useful for work with developing populations, such as infants, and for people who may have difficulties in following instructions.


Subject(s)
Mouvements oculaires , Champs visuels , Humains , Nourrisson , Fixation oculaire , Calibrage , Mouvements de la tête/physiologie
8.
BMC Pediatr ; 23(1): 31, 2023 Jan 19.
Article in English | MEDLINE | ID: mdl-36658521

ABSTRACT

BACKGROUND: Sudden Unexpected Infant Deaths (SUID) can occur between 1 month and 1 year of age and are inequitably distributed with a greater burden in populations with numerous health disparities. Modifying the infant sleep environment to promote safe sleep is the most effective risk reduction strategy to reduce SUID. The provision of baby boxes with a mattress and infant supplies has been part of a larger anti-poverty social justice maternity package for decades in Finland. While infant mortality rates have generally improved after the maternity package was introduced, little is known about whether the provision of the baby box increased safe sleep practices. The purpose of the study was to evaluate whether the provision of a Finnish-style baby box reinforced safe infant sleep practice in the home in a low-resource community in Ecuador. METHODS: In this longitudinal randomized controlled trial all participants received the same safe sleep education in their third trimester of pregnancy (n = 100). This was followed by randomization into two groups; the control received a diaper bag and newborn gifts, and the intervention group received a baby box and the same gifts at each timepoint. Four infant sleep practices (room sharing, bed sharing/co-sleeping, position, and soft items in the sleep environment) were assessed at 1 month and 1 months post-delivery during a home visit where safe sleep education was also reinforced with both groups. RESULTS: Those in the baby box group were 2.5 times more likely to report safe sleep practices compared with mothers in the diaper bag group at 1 month (odds ratio [OR] = 2.45 and 95% confidence interval [CI]: 1.03-5.86; χ2 = 4.1, p = .043). The group difference was also present at 6-months post-birth: those in the baby box group were 2.9 times more likely to report safe sleep practices compared with those in the diaper bag group (OR = 2.86 and 95% CI: 1.16-7.05; χ2 = 5.2, p = .022). CONCLUSIONS: While not all participants used the box regularly, the mothers who received the box were more likely to practice safe sleep at 1 month and 6 months. This suggests the baby box may have served as an important prompt towards safer infant sleep practice. TRIAL REGISTRATION: (Clinical Trial Registry, per clinicaltrials.gov : not applicable under 42 CFR 11.22(b) as the study Facility Location was not in the United States (took place in Ecuador), does not involve FDA IND or IDE, and does not involve a drug, biological or device product that is manufactured in and exported from the US for study in another country. The University of San Francisco Quito, Research Ethics Committee in Human Beings approved the study, #2017- 127 M. The University of Kentucky Office of Research Integrity also approved the study, IRB # 42965).


Subject(s)
Mort subite du nourrisson , Nourrisson , Nouveau-né , Enfant , Humains , Femelle , États-Unis , Grossesse , Équateur , Mort subite du nourrisson/prévention et contrôle , Mères , Sommeil , Mortalité infantile , Soins du nourrisson
9.
Int Breastfeed J ; 18(1): 8, 2023 Jan 19.
Article in English | MEDLINE | ID: mdl-36658629

ABSTRACT

BACKGROUND: Exclusive breastfeeding to six months of age is a major global public health priority. Several characteristics are known to be associated with early cessation of breastfeeding, however, limited evidence exists regarding whether women's reported reasons for cessation are associated with maternal, pregnancy and infant characteristics. The aims of this study were to: i) describe women's reported intention to breastfeed and their subsequent breastfeeding practices; ii) describe women's reported reasons for breastfeeding cessation prior to the infant being five months of age; and iii) examine associations between these factors and maternal, pregnancy and infant characteristics. METHODS: Telephone and online surveys were conducted between October 2019 and April 2020 with 536 women who had given birth in the previous eight to 21 weeks at four public maternity services in Australia. RESULTS: The majority of women intended to (94%), and did, initiate (95%) breastfeeding. At the time the survey was conducted, 57% of women were exclusively breastfeeding. Women who: had less than University level education, had a pre-pregnancy BMI in the overweight or obese category, and who smoked tobacco at the time of the survey had lower odds of exclusively breastfeeding. The most common self-reported reasons for breastfeeding cessation were breastfeeding challenges (47%) and low milk supply (40%). Women aged 26-35 years and 36 + years had greater odds of reporting breastfeeding cessation due to low milk supply (OR = 2.92, 95% CI: 1.11, 7.66; OR = 5.57, 95% CI: 1.70, 18.29) compared to women aged 18-25 years. While women who had completed a TAFE certificate or diploma had lower odds of reporting this as a reason for breastfeeding cessation (OR = 0.28; 95% CI: 0.11, 0.73) compared to women who had University level education. There were no other significant associations found between characteristics and reasons for ceasing breastfeeding. CONCLUSIONS: The most common reasons for breastfeeding cessation may be modifiable through the provision of breastfeeding support in the early postpartum period, with such support being tailored to women's age and level of education. Such support should aim to increase women's self-efficacy in breastfeeding, and be provided from the antenatal period and throughout the first six months postpartum.


Subject(s)
Allaitement naturel , Obésité , Nourrisson , Femelle , Grossesse , Humains , Adolescent , Jeune adulte , Adulte , Études transversales , Australie , Parturition
10.
J Health Popul Nutr ; 42(1): 4, 2023 Jan 19.
Article in English | MEDLINE | ID: mdl-36658658

ABSTRACT

BACKGROUND: Inequalities in child feeding practices are evident in urban slums in developing nations. Our study identified the determinants of complementary feeding (CF) practices in the informal settings of Pune, India, a district close to the business capital of India. METHODS: Employing a cross-sectional study design, 1066 mother-children dyads were surveyed. Five indicators defined by the WHO were used to study complementary feeding practices. Determinants of complementary feeding practices were identified using multivariate analyses. RESULTS: Timely initiation of CF was reported by 42%. Minimum acceptable diet (MAD), minimum meal frequency (MMF), and Diet Diversity Score > 4 were achieved by 14.9%, 76.5%, and 16.4%, respectively. Continued breastfeeding (CBF) at 2 years, and feeding processed foods were practiced by 94% and 50%, respectively. Among the maternal characteristics, a mother's age > 30 years at pregnancy was less likely to achieve DD [AOR: 0.195 (CI 0.047-0.809)] and MAD [AOR: 0.231 (CI 0.056-0.960)]. Mothers with lower education were less likely to meet MMF [AOR: 0.302 (0.113-0.807)], MAD [AOR: 0.505 (CI 0.295-0.867)] and to introduce formula feeds (FF) [AOR: 0.417 (0.193- 0.899)]. Among obstetric characteristics, birth spacing < 33 months was less likely to achieve DD [AOR: 0.594 (CI 0.365-0.965)] and CBF [AOR: 0.562 (CI: 0.322-0.982)]. Receiving IYCF counseling only during postnatal care hindered the timely initiation of CF [AOR: 0.638 (0.415-0.981)]. Very Low Birth Weight increased the odds of achieving DD [AOR: 2.384 (1.007-5.644)] and MAD [AOR: 2.588(CI: 1.054-6.352)], while low birth weight increased the odds of children being introduced to processed foods [AOR: 1.370 (CI: 1.056-1.776)]. Concerning socio-economic status, being above the poverty line increased the odds of achieving MMF, [AOR: 1.851 (1.005-3.407)]. Other backward castes showed higher odds of achieving MAD [AOR: 2.191 (1.208-3.973)] and undisclosed caste in our study setting decreased the odds of FF [AOR: 0.339 (0.170-0.677)]. Bottle feeding interfered with MMF [AOR: 0.440 (0.317-0.611)] and CBF [AOR: 0.153 (0.105-0.224)]. CONCLUSION: Investing in maternal education and IYCF counseling during both ANC and PNC to provide nutritious complementary foods alongside addressing poverty should be a national priority to prevent the double burden of undernutrition at an early age in informal settings.


Subject(s)
Comportement alimentaire , Zones de pauvreté , Nourrisson , Femelle , Grossesse , Humains , Études transversales , Inde , Phénomènes physiologiques nutritionnels chez le nourrisson , Allaitement naturel , Mères/psychologie , Régime alimentaire
11.
Pediatr Surg Int ; 39(1): 85, 2023 Jan 20.
Article in English | MEDLINE | ID: mdl-36662290

ABSTRACT

INTRODUCTION: A non-functional kidney (NFK) has been defined as one having paper-thin parenchyma, and split renal function (SRF) of < 10% on a nuclear scan. There are differences of opinion about nephrectomy or pyeloplasty in these patients. The present study was conducted to assess our management strategy of renal salvage for NFK. MATERIALS AND METHODS: It was a retrospective cohort study from January 2015 to July 2022, patients having SRF < 10% were included. These patients underwent ultrasound-guided percutaneous nephrostomy (PCN). A repeat nuclear scan was performed after 3 months. If SRF increased to > 10%, pyeloplasty was performed. RESULTS: Fifteen patients were managed. The mean age was 24.67 ± 23.61 months. Male to female ratio was 4:1. The initial mean SRF was 6.67 ± 2.85, which improved to 16.80 ± 4.69 after 3 months of placing the PCN (p < 0.001). The corresponding changes in the mean effective renal plasma flow (ERPF) were 60.13 ± 24.08 to 106.53 ± 24.61 (p < 0.001). There was no complaint after the placement of PCN. All patients underwent dismembered pyeloplasty. CONCLUSION: In NFK due to PUJO, expectant treatment in form of PCN followed by pyeloplasty appears to be the primary treatment modality, and nephrectomy may not be needed in any of them.


Subject(s)
Hydronéphrose , Obstruction urétérale , Enfant , Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Pelvis rénal/imagerie diagnostique , Pelvis rénal/chirurgie , Études rétrospectives , Obstruction urétérale/imagerie diagnostique , Obstruction urétérale/chirurgie , Rein/imagerie diagnostique , Rein/chirurgie , Hydronéphrose/chirurgie , Résultat thérapeutique , Procédures de chirurgie urologique
12.
Article in English | MEDLINE | ID: mdl-36674065

ABSTRACT

BACKGROUND: Air pollution is a major risk factor for public health worldwide, but evidence linking this environmental problem with the mortality of children in Central Europe is limited. OBJECTIVE: To investigate the relationship between air pollution due to the emission of industry-related particulate matter and mortality due to respiratory diseases under one year of age. METHODS: A retrospective birth cohort analysis of the dataset including 2,277,585 children from all Polish counties was conducted, and the dataset was matched with 248 deaths from respiratory diseases under one year of age. Time to death during the first 365 days of life was used as a dependent variable. Harmful emission was described as total particle pollution (TPP) from industries. The survival analysis was performed using the Cox proportional hazards model for the emission of TPP at the place of residence of the mother and child, adjusted individual characteristics, demographic factors, and socioeconomic status related to the contextual level. RESULTS: Infants born in areas with extremely high emission of TPP had a significantly higher risk of mortality due to respiratory diseases: hazard ratio (HR) = 1.781 [95% confidence interval (CI): 1.175, 2.697], p = 0.006, compared with those born in areas with the lowest emission levels. This effect was persistent when significant factors were adjusted at individual and contextual levels (HR = 1.959 [95% CI: 1.058, 3.628], p = 0.032). The increased risk of mortality was marked between the 50th and 150th days of life, coinciding with the highest exposure to TPP. CONCLUSIONS: The emission of TPP from industries is associated with mortality due to respiratory diseases under one year of age. A considerable proportion of children's deaths could be prevented in Poland, especially in urban areas, if air pollution due to the emission of particle pollution is reduced.


Subject(s)
Polluants atmosphériques , Pollution de l'air , Troubles respiratoires , Maladies de l'appareil respiratoire , Nourrisson , Enfant , Humains , Études de cohortes , Pologne/épidémiologie , Polluants atmosphériques/analyse , Études rétrospectives , Exposition environnementale/analyse , Pollution de l'air/effets indésirables , Pollution de l'air/analyse , Troubles respiratoires/induit chimiquement , Matière particulaire/analyse
13.
Article in English | MEDLINE | ID: mdl-36674072

ABSTRACT

Low Birth weight (LBW) infants pose a serious public health concern worldwide in both the short and long term for infants and their mothers. Infant weight prediction prior to birth can help to identify risk factors and reduce the risk of infant morbidity and mortality. Although many Machine Learning (ML) algorithms have been proposed for LBW prediction using maternal features and produced considerable model performance, their performance needs to be improved so that they can be adapted in real-world clinical settings. Existing algorithms used for LBW classification often fail to capture structural information from the tabular dataset of patients with different complications. Therefore, to improve the LBW classification performance, we propose a solution by transforming the tabular data into a knowledge graph with the aim that patients from the same class (normal or LBW) exhibit similar patterns in the graphs. To achieve this, several features related to each node are extracted such as node embedding using node2vec algorithm, node degree, node similarity, nearest neighbors, etc. Our method is evaluated on a real-life dataset obtained from a large cohort study in the United Arab Emirates which contains data from 3453 patients. Multiple experiments were performed using the seven most commonly used ML models on the original dataset, graph features, and a combination of features, respectively. Experimental results show that our proposed method achieved the best performance with an area under the curve of 0.834 which is over 6% improvement compared to using the original risk factors without transforming them into knowledge graphs. Furthermore, we provide the clinical relevance of the proposed model that are important for the model to be adapted in clinical settings.


Subject(s)
Nourrisson à faible poids de naissance , Mères , Nouveau-né , Grossesse , Femelle , Humains , Nourrisson , Études de cohortes , Poids de naissance , Parturition
14.
Article in English | MEDLINE | ID: mdl-36674268

ABSTRACT

Exclusive breastfeeding (EBF) is not a norm in many communities in South Africa despite the World Health Organizations' recommendations for EBF in the first six months of infant's life. Thus, South Africa continues to observe suboptimal and poor practices of EBF. The purpose of the study was to explore the experiences of mothers who are HIV-positive and negative on EBF and examine the extent to which initiation and sustenance of EBF is influenced by cultural beliefs, societal norms, and family norms and practices in Mpumalanga Province. Three focus group discussions and twelve in-depth interviews were conducted among thirty mothers who were purposively selected during their visits to the facilities for childcare services. Interviews were audiotaped, transcribed verbatim, and transcripts were analysed through thematic analysis using NVivo version 10. Mothers were aged between 18 and 42 years, most were unemployed and were living in poor sociodemographic backgrounds in extended family households. We found evidence of factors that influence the decision to EBF and mix feed infants among mothers. Traditional and cultural beliefs and norms that exist within their communities informed decisions mothers took to EBF. These beliefs existed alongside mothers' opinions on breastfeeding (BF) and HIV infection, as well as the fears of harming the baby through HIV infection, leading to early cessation of BF. Mothers were also advised by family members, friends, and even some healthcare workers to use traditional medicines while BF. The association of EBF with sagging breasts and weight loss as well as discomfort with public BF are personal beliefs that influenced initiation and early cessation of EBF. Breastfeeding messages ought to be context specific to improve the knowledge, understanding, acceptance and practice of EBF among HIV-positive and negative mothers. Culturally appropriate counselling messages that address the known cultural practices of the populations affected are essential to changing the beliefs and norms of the communities including extended families of EBF mothers.


Subject(s)
Infections à VIH , Séropositivité VIH , Nourrisson , Femelle , Humains , Adolescent , Jeune adulte , Adulte , Allaitement naturel , République d'Afrique du Sud , Mères , Connaissances, attitudes et pratiques en santé , , Soins de santé primaires
15.
Article in English | MEDLINE | ID: mdl-36674312

ABSTRACT

Excess free sugars intake contributes to dental caries and obesity in children. Food frequency questionnaires (FFQ) that assess free sugars intake in young children are limited. This study evaluated the utility of a 68-item FFQ to assess free sugars intake in Australian young children against three 24-h recalls at ages 1.5, 3.5, and 5.0 years. Free sugars intakes estimated from two methods were compared using group- and individual-level validation tests. Group-level tests revealed that mean free sugars intakes estimated from two methods were similar and Bland-Altman tests revealed no presence of proportional bias at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ underestimated the free sugars intake compared to the recalls, and Bland-Altman tests revealed proportional bias. For individual-level tests, the deattenuated correlation (R) between free sugars intakes estimated from two methods exhibited good agreement across three time-points (R: 0.54-0.62), as were the percentage agreement (68.5-73.6%) and weighted kappa (Kw: 0.26-0.39). The FFQ showed good validity at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ showed good validity for individual-level tests only. The FFQ provided stronger validity in the ranking of individuals according to free sugars intake than comparing absolute free sugars intake at group level.


Subject(s)
Caries dentaires , Obésité pédiatrique , Humains , Enfant , Nourrisson , Enfant d'âge préscolaire , Régime alimentaire , Caries dentaires/épidémiologie , Australie , Reproductibilité des résultats , Enquêtes et questionnaires , Sucres , Ration calorique , Enquêtes sur le régime alimentaire , Journaux alimentaires
16.
Article in English | MEDLINE | ID: mdl-36674364

ABSTRACT

Preterm birth (PTB) identifies infants prematurely born <37 weeks/gestation and is one of the main causes of infant mortality. PTB has been linked to air pollution exposure, but its timing is still unclear and neglects the acute nature of delivery and its association with short-term effects. We analyzed 3 years of birth data (2015-2017) in Turin (Italy) and the relationships with proinflammatory chemicals (PM2.5, O3, and NO2) and biological (aeroallergens) pollutants on PTB vs. at-term birth, in the narrow window of a week before delivery. A tailored non-stationary Poisson model correcting for seasonality and possible confounding variables was applied. Relative risk associated with each pollutant was assessed at any time lag between 0 and 7 days prior to delivery. PTB risk was significantly associated with increased levels of both chemical (PM2.5, RR = 1.023 (1.003-1.043), O3, 1.025 (1.001-1.048)) and biological (aeroallergens, RR ~ 1.01 (1.0002-1.016)) pollutants in the week prior to delivery. None of these, except for NO2 (RR = 1.01 (1.002-1.021)), appeared to play any role on at-term delivery. Pollutant-induced acute inflammation eliciting delivery in at-risk pregnancies may represent the pathophysiological link between air pollution and PTB, as testified by the different effects played on PTB revealed. Further studies are needed to better elucidate a possible exposure threshold to prevent PTB.


Subject(s)
Polluants atmosphériques , Pollution de l'air , Polluants environnementaux , Naissance prématurée , Grossesse , Nourrisson , Femelle , Nouveau-né , Humains , Naissance prématurée/épidémiologie , Polluants atmosphériques/toxicité , Polluants atmosphériques/analyse , Dioxyde d'azote , Pollution de l'air/effets indésirables , Pollution de l'air/analyse , Matière particulaire/effets indésirables , Matière particulaire/analyse , Exposition maternelle
17.
Article in English | MEDLINE | ID: mdl-36674391

ABSTRACT

In East Nusa Tenggara Province, Indonesia, 42.6% of children under five had stunted growth in 2018, which affects both individual and communal levels. The first step in creating effective interventions is identifying the risk factors for stunting. This study aims to pinpoint the stunting risk factors in East Nusa Tenggara Province, Indonesia, by incorporating secondary data from the 2018 Indonesia Basic Health Research (RISKESDAS). This study implemented a cross-sectional design by utilizing the data of individuals who were successfully visited during the survey. Initial data screening in East Nusa Tenggara Province based on the criteria for children aged 0-59 months and stunting showed as many as 1643. Multivariate logistic regression analysis was performed to evaluate the relationship between children's characteristics and stunting. There was a significant relationship between age group variables for younger children (aged 12-23, 24-35, and 36-47 months), mothers with low education, and children living in rural areas with the incidence of stunting in children (p-value < 0.05). The dominant factors that caused stunting in this study were the children's age of 24-35 months (OR = 2.08, 95% CI: 1.12-3.86), mothers with low education (OR = 1.57, 95% CI: 1.18-2.08), and children living in rural areas (OR = 1.39, 95% CI: 1.01-1.91). The highest prevalence of stunting was in the group of children aged 12-23 months (45.2%). To prevent child stunting, the government must intervene for mothers with low education and those living in rural areas. Intervention includes intensive socialization about improving nutritional status during pregnancy and practicing complementary feeding and breastfeeding habits until the child is 24 months old.


Subject(s)
Allaitement naturel , Troubles de la croissance , Nourrisson , Grossesse , Femelle , Humains , Enfant , Enfant d'âge préscolaire , Indonésie/épidémiologie , Études transversales , Facteurs de risque , Troubles de la croissance/épidémiologie , Troubles de la croissance/étiologie , Prévalence
18.
Nutrients ; 15(1)2023 Jan 02.
Article in English | MEDLINE | ID: mdl-36615889

ABSTRACT

Stunting remains a public health concern in developing countries. Factors related to stunting have been categorized using various frameworks. Family plays an important role in providing nutrients for children; however, no review specifies this aspect for identifying family characteristics related to stunting. This study aimed to identify family household characteristics related to stunting among children aged less than 5 years. A scoping review was undertaken with sources from PubMed, CINAHL, and Scopus, using the keywords "family characteristics" AND "growth". Inclusion criteria were (1) correlational study; (2) published between 2018 and 31 July 2022; (3) families with children under the age of 5 years; and (4) independent variable any measure of stunting factors from family and household factors. Of 376 articles, only 20 met the inclusion criteria of the study. The family household characteristics included individual factors (sex age, history of diarrhea, and birthplace), family factors (family headship, primary caregiver/mother, social-cultural orientation, and family system factors), and environmental factors. Various child variables, family factors, and environmental factors (the type of home, floor type, water access, source of drinking water, and household electricity) were identified as being associated with stunting. Therefore, these factors should be evaluated to prevent and control stunting, and they should be incorporated into health programs targeting stunting.


Subject(s)
Troubles de la croissance , Mères , Enfant , Femelle , Humains , Nourrisson , Troubles de la croissance/épidémiologie , Troubles de la croissance/étiologie , Troubles de la croissance/prévention et contrôle , Caractéristiques familiales , Nutriments , Santé publique
19.
Nutrients ; 15(1)2023 Jan 03.
Article in English | MEDLINE | ID: mdl-36615900

ABSTRACT

There is rising concern about population mental health. Personality and mental health traits manifest early. Sufficient nutrition is fundamental to early development. However, little is known about early life dietary impact on later mental health. The aim of this study was to investigate associations of exposure to a healthy and sustainable antenatal and early childhood diet with personality traits and symptoms of depression and anxiety measured at 8 years of age. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN) including 40,566 participants. Mental health measures and personality traits were assessed at 8 years. Dietary data from pregnancy, child age 6 and 18 months and 3 and 7 years were used. With few exceptions, inverse associations were observed between healthier diet at all time points and depression and anxiety symptom scores at age 8. We found positive associations between diet scores at almost all time points and extraversion, benevolence, conscientiousness and imagination. Inverse associations were observed between diet scores and neuroticism. Combined, these findings underpin a probable impact of both maternal pregnancy diet and early childhood diet on several aspects of child mental health.


Subject(s)
Santé mentale , Mères , Humains , Enfant , Femelle , Enfant d'âge préscolaire , Grossesse , Nourrisson , Mâle , Études de cohortes , Mères/psychologie , Régime alimentaire , Personnalité , Pères , Norvège/épidémiologie
20.
Biochem Med (Zagreb) ; 33(1): 010706, 2023 Feb 15.
Article in English | MEDLINE | ID: mdl-36627976

ABSTRACT

Introduction: The aim of research was to assess the melatonin concentrations in the early neonatal period as a predictor of adverse outcomes of late neonatal period in preterm infants and to estimate its optimal predictive cut-off values. Materials and methods: A total of 115 preterm infants admitted to the neonatal intensive care unit were screened for eligibility, five did not meet the criteria, six parents declined the participation. So, a total of 104 preterm infants with gestational age 25-34 weeks were included in research. The concentration of melatonin in urine was determined by the Enzyme Immunoassay method (Human Melatonin Sulfate ELISA kit, Elabscience, China). The Mann-Whitney U-test and analysis of the receiver operating characteristic (ROC) curve were used in statistical analysis. Results: Analysis of the ROC curves has revealed optimal cut-off values for urinary melatonin concentration to predict late outcomes. Melatonin concentration below 3.58 ng/ml with sensitivity of 72% can predict development of retinopathy of prematurity (ROP) (AUC = 0.73; 95% confidence intervals (CI) 0.61-0.86). Good diagnostic accuracy (AUC = 0.80; 95% CI 0.67-0.93) has been shown for bronchopulmonary dysplasia (BPD). The optimal cut-off value for melatonin concentration in BPD prediction is 3.71 ng/ml (sensitivity 80%, specificity 64%). Urinary melatonin concentration below 3.79 ng/ml can be associated with late-onset sepsis (AUC = 0.76; 95% CI 0.64-0.87; sensitivity 72%; specificity 62%). There were no significant associations between melatonin concentration and necrotizing enterocolitis (P = 0.912). Conclusion: Urinary melatonin concentration below the certain cut-off values in the early neonatal period may serve as one of the predictors of adverse outcomes such as BPD, ROP, and late-onset sepsis in the late neonatal period in preterm infants.


Subject(s)
Dysplasie bronchopulmonaire , Mélatonine , Rétinopathie du prématuré , Sepsie , Nourrisson , Nouveau-né , Humains , Prématuré
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