Iron supplementation during malaria infection in pregnancy and childhood:A review

Malaria presents a significant global public health challenge,with severe malarial anaemia being a primary manifestation of the disease.The understanding of anaemia caused by malaria remains incomplete,making the treatment more complex.Iron is a crucial micronutrient essential for haemoglobin synthesis,oxygen delivery,and other vital metabolic functions in the body.It is indispensable for the growth of human beings,as well as bacteria,protozoa,and viruses in vitro and in vivo.Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life.Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis,leading to anaemia.Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy,infancy,and childhood.Dietary intake alone may not suffice to meet adequate iron requirements,thus highlighting the vital role of iron supplementation.While iron supplementation can alleviate iron deficiency,it can exacerbate malaria infection by providing additional iron for the parasites.However,in the context of pregnancy and childhood,iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development,respectively.This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.

Atherosclerosis originating from childhood:Specific features

Atherosclerosis is extremely widespread.Traditionally,it is considered a disease of older people,who most often experience problems with the heart and blood vessels.While much attention from the scientific community has been paid to studying the association between aging and atherosclerosis,as well as its consequences,there is evidence that atherosclerosis occurs at an early age.Atherosclerosis may form both during intrauterine development and in childhood.Nutrition plays an important role in childhood atherosclerosis,along with previous infectious diseases and excess weight of both the child and the mother.In the present review,we examined the development of atherosclerosis and the prerequisites in childhood.

Childhood Papillary Thyroid Carcinoma: A Case Report

Background: Thyroid cancer is a rare disease yet the most common endocrine malignancy in pediatrics. Unlike adult patients, children with thyroid nodules typically don’t complain of pain, soreness, or difficulty swallowing. Additionally, using the recommended therapy for adults to treat paediatrics is not appropriate. There is an unmet need for updated unique guidelines for the management of papillary thyroid carcinoma (PTC) in paediatrics and adolescents. Case Report: A 12-year-old girl had an atypical presentation of metastatic PTC in lymph nodes. She was treated initially with hemi-thyroidectomy, followed by total thyroidectomy. A multidisciplinary team followed her up till successful results were found. Conclusion: Due to the difference in pathophysiology between thyroid tumors in children and adults, a unique approach to PTC management is to be implemented. Further trials are required for a better understanding of risk factors, the likelihood of recurrence, and the long-term side effects of the chosen management plan.

Radiation Dose from CT-Scan of Childhood’s Head: Results of the First Ivorian Survey in a Single Study Site

Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDIvol) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDIvol and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDIvol and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.

Primary Multiple Cerebral Hydatid Cyst in 8 Year-Old Girl: A Rare Cause of Childhood Seizure

Background: Cystic echinococcosis is a zoonotic infection that occurs worldwide. Humans are infected through ingestion of parasite eggs in contaminated food, water or through direct contact with infected dogs, which are the definite host. Humans serve accidentally as intermediate host, and occurrences are common in children and young adults. Cystic echinococcosis is endemic in Mediterranean, South American, Middle Eastern, Central Asia, East Africa countries and Australia. Multiple cerebral hydatid cysts are very rare with only a few reports in the literature. Case Description: We present the case of an 8-year-old girl who presented with focal seizures, hemiparesis, headache, vomiting and bilateral optic atrophy. Diagnostic workup was performed, and magnetic resonance imaging revealed multiple intracranial cysts predominantly in the right frontal region with significant mass effect. A total of 11 intracranial cysts were removed surgically, and the child recovered uneventfully. Conclusion: Neurosurgeons should keep hydatidosis in the list of differentials when evaluating patients with cystic diseases of the brain. Although the removal of such cysts is challenging, outcomes are excellent when cysts are evacuated without rupture and patients show complete resolution of symptoms.

Association between childhood obesity and gut microbiota:16S rRNA gene sequencing-based cohort study

BACKGROUND This study aimed to identify characteristic gut genera in obese and normal-weight children(8-12 years old)using 16S rDNA sequencing.The research aimed to provide insights for mechanistic studies and prevention strategies for childhood obesity.Thirty normal-weight and thirty age-and sex-matched obese children were included.Questionnaires and body measurements were collected,and fecal samples underwent 16S rDNA sequencing.Significant differences in body mass index(BMI)and body-fat percentage were observed between the groups.Analysis of gut microbiota diversity revealed lowerα-diversity in obese children.Differences in gut microbiota composition were found between the two groups.Prevotella and Firmicutes were more abundant in the obese group,while Bacteroides and Sanguibacteroides were more prevalent in the control group.AIM To identify the characteristic gut genera in obese and normal-weight children(8-12-year-old)using 16S rDNA sequencing,and provide a basis for subsequent mechanistic studies and prevention strategies for childhood obesity.METHODS Thirty each normal-weight,1:1 matched for age and sex,and obese children,with an obese status from 2020 to 2022,were included in the control and obese groups,respectively.Basic information was collected through questionnaires and body measurements were obtained from both obese and normal-weight children.Fecal samples were collected from both groups and subjected to 16S rDNA sequencing using an Illumina MiSeq sequencing platform for gut microbiota diversity analysis.RESULTS Significant differences in BMI and body-fat percentage were observed between the two groups.The Ace and Chao1 indices were significantly lower in the obese group than those in the control group,whereas differences were not significant in the Shannon and Simpson indices.Kruskal-Wallis tests indicated significant differences in unweighted and weighted UniFrac distances between the gut microbiota of normal-weight and obese children(P<0.01),suggesting substantial disparities in both the species and quantity of gut microbiota between the two groups.Prevotella,Firmicutes,Bacteroides,and Sanguibacteroides were more abundant in the obese and control groups,respectively.Heatmap results demonstrated significant differences in the gut microbiota composition between obese and normal-weight children.CONCLUSION Obese children exhibited lowerα-diversity in their gut microbiota than did the normal-weight children.Significant differences were observed in the composition of gut microbiota between obese and normal-weight children.

Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity:Implications for prevention and intervention

BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications.This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity.Despite the increasing prevalence of childhood obesity worldwide,this issue remains inadequately addressed in the Moroccan context.AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.METHODS The research encompasses a comprehensive survey of practicing physicians,revealing significant gaps in awareness and practices related to maternal obesity.RESULTS Notably,a significant portion of doctors do not provide adequate guidance to overweight pregnant women,highlighting the urgency for targeted educational programs.CONCLUSION In conclusion,this research illuminates critical areas for improvement in tackling childhood obesity in Morocco.By addressing these gaps,fostering awareness,and enhancing medical practices,the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.

Cost analysis of childhood glaucoma surgeries using the US Medicaire allowable costs

AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction($/mm Hg) at 1y postoperatively.RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.CONCLUSION: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.

Epidemiological and Diagnostic Aspects of Childhood Proptosis in Lome (Togo) from 2010 to 2020

Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and diagnostic aspects of childhood proptosis in Lome (Togo). Methods: Retrospective cross-sectional study conducted from June 2010 to May 2020, which is 10 years, in the ophthalmology department of CHU-campus of Lome. Files of patients between the age of 0 and 15 who presented a proptosis during the study period were taken into account in the study. Patients with a false proptosis or incomplete records during the study period were not taken into account in the study. Results: The study considered 42 children with an age average of 7.63 years ± 4.96 [4 days;15 years] and a sex-ratio of 1.33. The frequency of proptosis was 0.5% with an average progression of 383.7 days before the first consultation. The proptosis was unilateral in 80.95% of cases. The orbito-cerebral CT scan was done in 47.62% of cases. The proptosis in these patients was predominantly of grade 3 in 45% of cases. The tumor pathologies were at the forefront in 35.71%, dominated by retinoblastoma, and followed by infectious and inflammatory diseases in 14.29%. Conclusion: Childhood proptosis is rare and often indicative of infectious and tumor pathologies in our context. Its diagnosis is delayed, which shows the importance of an early and effective diagnosis. .

Childhood Sexual Abuse and Quality of Life in Chinese Undergraduates: the Mediating Role of Resilience

Childhood sexual abuse(CSA)is a widespread and serious public health concern,with long-term impacts on overall health in adulthood.According to a systematic review published in 2018,the prevalence of CSA in China ranges from 11.6%to 20.2%[1].A longitudinal study from New Zealand demonstrated that CSA negatively influences a broad range of adult developmental outcomes,including mental disorders,psychological wellbeing,sexual risk-taking,physical health,and socioeconomic wellbeing[2].Therefore,CSA is considered a longterm hazard to the overall health of adults and is associated with poor quality of life(QoL).

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 o019 children(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was defined using Chinese national body mass index cut-points.Principal component analysis was used to convert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive variable.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8%,and was higher in boys than in girls(17.8%vs.7.6%,P<0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95%CI:1.09 to 1.40,P<O.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's selfperceived weight status mediated 70.0%of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Deep Learning Framework for the Prediction of Childhood Medulloblastoma

This research work develops new and better prognostic markers for predicting Childhood MedulloBlastoma(CMB)using a well-defined deep learning architecture.A deep learning architecture could be designed using ideas from image processing and neural networks to predict CMB using histopathological images.First,a convolution process transforms the histopathological image into deep features that uniquely describe it using different two-dimensional filters of various sizes.A 10-layer deep learning architecture is designed to extract deep features.The introduction of pooling layers in the architecture reduces the feature dimension.The extracted and dimension-reduced deep features from the arrangement of convolution layers and pooling layers are used to classify histopathological images using a neural network classifier.The performance of the CMB classification system is evaluated using 1414(10×magnification)and 1071(100×magnification)augmented histopathological images with five classes of CMB such as desmoplastic,nodular,large cell,classic,and normal.Experimental results show that the average classification accuracy of 99.38%(10×)and 99.07%(100×)is attained by the proposed CNB classification system.

The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries: A Systematic Review

Thefirst years of life and the family context are key to the promotion and protection of children’s health and well-being,emphasizing the need for interventions aimed to support families with young children.This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries.Six electronic databases were systematically searched,and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria.The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention.Outcomes of interest encompassed mental health,related risk and protective factors among the parents and/or the children,or child-parent interaction.The results from studies applying statistical methods show significant improvements in parents’self-efficacy,self-esteem,and parental satisfaction,while few improvements in parents’social support or parental relationship were identified.Improvements in social support and parental relationships were however reported in qualitative studies.Most quantitative studies reporting on parents’mental health problems and stress found a significant decrease,and qualitative studies highlighted experienced positive effects on mental health and well-being.The majority of stu-dies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development.No significant changes were however found for existing behavioral problems.The majority of studies examining parenting strategies and/or parent-child interaction found signifi-cant positive changes after the interventions.In sum,althoughfindings are heterogeneous,early childhood inter-ventions show various positive effects on the parenting and mental health of both children and their parents.The fact that different types of initiatives have been developed and implemented can be seen as an advantage,con-sidering the varying needs and expectations of different families.

Associations between Mental Health Outcomes and Adverse Childhood Experiences and Character Strengths among University Students in Southern China

Adverse childhood experiences(ACEs)can negatively affect mental health,whereas character strengths seem to be positively correlated with mental health.Detailed information on the history of ACEs among university students in China and the extent which mental health is associated with ACEs and character strengths can contribute to the needed empirical evidence for relevant stakeholders.Objectives of this study are 1)to estimate the prevalence of ACEs among undergraduate students in Southern China;and 2)to assess the extent which mental health outcomes(positive growth,well-being,and depression)are associated with ACEs and character strengths among undergraduate students in Southern China.We conducted a self-administered survey amongfirst and second-year students at a university in Southern China and analyzed data using descriptive statistics and linear regression analyses.Among the 779 students who completed the questionnaire,283 were males,439 were females,and 57 did not indicate their gender.The prevalence of ACEs among the participants was 32.1%.History of ACEs was associated with lower positive growth score(Adjusted Beta=-0.20;95%CI=-0.37,-0.02;p=0.030)and lower well-being score(Adjusted Beta=-1.13;95%CI=-2.04,-0.23;p=0.014).Vitality domain of character strength was associated with all three mental health outcomes after adjusting for covariables(all p-values<0.001).Our studyfindings provide empirical evidence for stakeholders in university mental health.However,caveats regarding lack of temporality,selection bias,social desirability bias,and lack of generalizability should be considered in the interpretation of the studyfindings.

多区正向设计离焦框架眼镜与角膜塑形镜对儿童近视的延缓效果比较

目的比较配戴多区正向设计离焦(DIMS)框架眼镜和角膜塑形镜对儿童近视进展的延缓效果。方法采用非随机对照临床研究方法,纳入2018年1月至2020年12月于郑州大学第一附属医院就诊的近视儿童390例390眼,等效球镜度(SER)为-0.75~-6.00 D。依据患儿及其监护人意愿将受试者分为DIMS框架眼镜组、角膜塑形镜组和单光框架眼镜组,每组130例130眼,分别给予配戴DIMS框架眼镜、标准型或带散光设计角膜塑形镜及非球面设计的普通单光足矫框架眼镜,分别在戴镜前及戴镜后1年采用全自动电脑验光仪联合主觉验光测定受试眼SER;采用IOLMaster测量眼轴长度(AL)。最终符合纳入及排除标准的随访者共327例327眼,其中DIMS框架眼镜组107例107眼、角膜塑形镜组112例112眼、单光框架眼镜组104例104眼,均取右眼数据纳入分析。比较3个组受试眼戴镜前及戴镜后1年SER和AL及其变化量。DIMS框架眼镜组受试眼AL和SER变化量与基线资料的关系评估采用Pearson线性相关分析。结果DIMS框架眼镜组、角膜塑形镜组、单光框架眼镜组不同时间点SER和AL总体比较差异均有统计学意义(SER:F_(组别)=7.065,P=0.009;F_(时间)=183.730,P<0.001.AL:F_(组别)=6.151,P=0.014;F_(时间)=175.290,P<0.001),戴镜后1年3个组受试眼SER和AL变化量总体比较差异均有统计学意义(F=7.065,P=0.009;F=6.151,P=0.014),其中各组1年后SER和AL均大于基线时,角膜塑形镜组和DIMS框架眼镜组SER和AL及其变化量均明显小于单光框架眼镜组,DIMS框架眼镜组SER和AL及其变化量均大于角膜塑形镜组,差异均有统计学意义(均P<0.05)。与单光框架眼镜相比,配戴角膜塑形镜1年能分别抑制SER和AL进展58.3%和59.0%,配戴DIMS框架眼镜1年能分别抑制SER和AL进展46.9%和43.6%。戴镜1年单光框架眼镜组、角膜塑形镜组和DIMS框架眼镜组SER无变化的眼数占比分别为5.77%(6/104)、24.11%(27/112)和17.76%(19/107),AL无变化的眼数占比分别为0.00%(0/104)、8.93%(10/112)和7.48%(8/107),总体比较差异均有统计学意义(χ2=9.316、8.676,均P<0.001)。DIMS框架眼镜组AL变化量与年龄呈弱负相关(r=-0.252,P=0.006)。结论配戴DIMS框架眼镜对儿童近视的延缓效果不及角膜塑形镜,但明显优于配戴普通单光框架眼镜。

儿童复发性眩晕伴单侧前庭功能障碍临床特点及预后相关因素分析

目的了解儿童复发性眩晕伴单侧外周前庭功能障碍患儿临床特点及预后相关因素。方法回顾性分析2022年1月~2023年1月北京儿童医院耳鼻咽喉头颈外科就诊的儿童复发性眩晕伴单侧外周前庭功能障碍患儿临床资料,对数据进行统计学分析。结果42例患儿纳入研究,年龄4~13(7.95±0.415)岁。病程平均6.01±1.618周,合并非偏头痛性头痛23.8%,合并晕车26.2%,1个月内有呼吸道感染病史者占23.8%。进行前庭康复训练者有61.9%(26/42)。治疗1个月时,前庭症状治愈率为66.67%,双温试验恢复率为73.80%。治疗1个月时两组比较,儿童前庭症状问卷差异有统计学意义(P=0.001)。前庭康复训练治疗与前庭症状治愈率相关(P=0.004),与双温试验恢复率无关(P=0.148)。结论儿童复发性眩晕伴单侧外周前庭功能障碍,除药物对症治疗外,建议进行前庭康复训练,达到更高临床症状缓解率。

儿童期精神分裂症的遗传特点研究进展

本文综述了儿童期精神分裂症(COS)的遗传特点,COS遗传度>80%,主要表现为(1)相关风险基因与成年期精神分裂症有很多重叠;(2)很多风险基因也关联孤独症谱系障碍等更早发的神经发育性障碍;(3)COS的风险基因结构中含有更多的常见和罕见变异体,包括拷贝数变异体(CNVs)。

儿童急性坏死性脑病26例临床特征及预后分析

目的总结儿童急性坏死性脑病(ANEC)的临床特征、治疗过程和预后。方法回顾性分析2016年6月至2022年12月确诊ANEC患儿的临床资料。对存活患儿进行电话随访,应用儿童整体表现分类量表(POPC)评估患儿生存质量。结果共纳入26例ANEC患儿,男女比例为1.6∶1,中位年龄36.0(23.0~69.0)个月。发病季节以夏季常见(42.3%),其次为冬季(34.6%);前驱感染以流感病毒感染多见(34.6%),其次为人类疱疹病毒6B型及新型冠状病毒。所有患儿均有发热伴不同程度意识障碍,24例出现惊厥。神经影像学以对称性丘脑受累(100%)为典型改变,多伴有基底节区(50.0%)、脑干(61.5%)、小脑(26.9%)等部位受累。23例患儿接受甲基泼尼松龙激素冲击治疗,住院病死率为23.1%(6/26),出院6个月后累积病死率为30.7%(8/26)。6个月后随访到14例存活患儿,11例接受康复治疗,其中POPC评估2分1例,3分4例,4分6例,5分1例,6分2例。3例新型冠状病毒感染后ANEC患儿3个月随访POPC评估结果为2分2例,6分1例。结论华南地区ANEC于夏季和冬季高发,新型冠状病毒感染可诱发ANEC;临床表现为发热、抽搐、意识障碍三联征,典型影像学改变为双侧丘脑受累。早期免疫治疗及综合康复训练有助于减少神经系统后遗症的严重程度。

学前教育结构特征与过程质量关系的实证研究述评

当前我国学前教育正处于数量发展转向质量提高的关键节点,通过改善结构质量可以提高过程质量,进而推动学前教育高质量发展。梳理近30年国内外有关学前教育结构特征与过程质量关系的实证研究成果可以发现:学前教育质量评价与改进制度有助于提高过程质量;机构环境中的机构规模与类型、物质环境与材料、组织氛围与管理质量、工作条件等变量均对过程质量有显著预测作用;班级环境中的班级规模与师幼比、班级结构等变量有较强预测作用;教师的受教育水平、在职培训、个体特征等能够影响过程质量。我国学前教育结构特征与过程质量关系研究应进一步拓宽广度,丰富结构特征的研究内容;拓展深度,实施跨区域的追踪性研究,为学前教育政策制定提供循证依据。

Analysis of the Writing Characteristics of the Title Music,Using“Scenes of Childhood”and“Children’s Garden”as Examples

In European thought and culture,there exists a group of passionate artists who are fascinated by the intention,passion,and richness of artistic expression.They strive to establish connections between different art forms.Musicians not only attempt to represent masterpieces through the language of music but also aim to convey subjective experiences of emotions and personal imagination to listeners by adding titles to their musical works.This study examines two pieces,“Scenes of Childhood”and“Children’s Garden”,and analyzes the different approaches employed by the composers in portraying similar content.