Energy efficiency training's effect on fatigue scores of children with a cancer diagnosis

Objective:Fatigue is the most common complication of cancer treatment procedure during chemotherapy,leading to limited daily activities,mood swings,and ultimately impaired functional status.This study aimed to determine the effect of energy efficiency training on the fatigue scores of children with a cancer diagnosis.Methods:In the present clinical trial study,30 children with a cancer diagnosis were randomly assigned variously to the control and testing groups.The cancer-related fatigue questionnaire for children with cancer was employed as the data collection tool.The intervention of the testing group was conducted in 4 sessions of 45-60 min of face-to-face interaction,group sessions,and questionand-answer sessions.Meanwhile,routine interventions were employed in the control group.Quantitative variables were repor ted as mean and standard deviation,and qualitative variables as frequency and percentage.Stata 11 statistical software and a change score approach were used to analyze the data.Results:The mean fatigue score of the testing group increased from 72.12 to 77.53.There was a statistically significant difference between the mean fatigue scores of the testing group before and after the intervention(P=0.013),and the children’s fatigue score decreased.There was a statistically significant difference between the mean fatigue scores of the testing and control groups before and after the intervention(P=0.001),and the fatigue score of the children in the testing group had decreased compared to the control group.Conclusions:Energy efficiency techniques can be employed to increase energy and reduce fatigue during pediatric chemotherapy.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients:a clinical trial

Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.

Effectiveness of menstruation hygiene skills training for adolescents with autism

BACKGROUND Adolescents with autism spectrum disorder(ASD)may encounter many difficulties with their menstrual cycles.Potential challenges that adolescents with ASD may face include understanding physical changes,coping with symptoms,emotional sensitivity,communication,personal care,and hygiene.AIM To evaluate the effect of menstrual hygiene skills training given to adolescents with ASD on their menstrual hygiene skills.METHODS The study was conducted with 15 adolescents diagnosed with ASD by the single group pre-test and post-test model in three special education centers in Türkiye.Data were collected with the Adolescent and Parent Information Form and the Adolescent-Specific Menstrual Hygiene Skill Registration Form.RESULTS While the mean age of adolescents was 16.06±0.88 years,the mean age of individuals responsible for adolescent care was 43.66±5.56 years.While 60.0%of the adolescents noticed the onset of bleeding before training,this rate was 93.3%after training.The Adolescent-Specific Menstrual Hygiene Skill Registration Form showed a statistically significant increase in the application steps after the training.The difference between the menstrual hygiene skill scores of adolescents CONCLUSION The menstrual hygiene skills training given to adolescents with ASD was beneficial in increasing their menstrual hygiene skills.These individuals must take responsibility during menstruation and independently manage their continuous care activities.

Home-based health care model for caring of family in the prevention of COVID-19

Background In order to prevent the widespread spread of COVID-19,a physical distancing program has been implemented,where it is necessary to maintain a distance of at least 6 feet between individuals.COVID-19 spreads mainly among people who have been in close contact for a prolonged period.This study aims to make it easier for nurses to provide nursing care to families experiencing COVID-19.New health problems have made it difficult for nurses to provide care,and thus this model was developed to assist nurses in providing care[1].The effectiveness of family nursing care during the social distancing period will be analyzed using one-way analysis of variance for measurements I,II,III,and IV.The effectiveness of providing family nursing care with a focus on meeting the family’s basic needs and quality of life can be assessed by comparing measurements at the beginning and end of coaching every month using a paired t-test.To prepare a family health promotion model during the COVID-19 social distancing period,a factor analysis will be carried out using both explanatory factor analysis and confirmatory factor analysis through struqtural equation model testing.

Phagocytic and oxidative burst activity of neutrophils in the end stage of liver cirrhosis

AIM: To evaluate the phagocytic activity and neutrophil oxidative burst in liver cirrhosis.METHODS: In 45 patients with advanced postalcoholic liver cirrhosis (aged 45±14 years) and in 25 healthy volunteers (aged 38±5 years), the percentage of phagocytizing cells after in vitro incubation with E. coli (Phagotest Kit), phagocytic activity (mean intensity of fluorescence, MIF) and the percentage of neutrophil oxidative burst (Bursttest Kit), and the level of free oxygen radical production (MIF of Rodamine 123)were analyzed by flow cytometry. The levels of soluble sICAM-1, sVCAM-1, sP-selectin, sE-selectin, sL-selectin,and TNF-α were determined in blood serum.RESULTS: The percentage of E. coli phagocytizing neutrophils in liver cirrhosis patients was comparable to that in healthy subjects. MIF of neutrophil - ingested E. coli was higher in patients with liver cirrhosis. The oxidative burst in E. coli phagocytizing neutrophils generated less amount of active oxygen compounds in liver cirrhosis patients (MIF of R123:24.7±7.1 and 29.7±6.6 in healthy,P＜0.01). Phorbol myristate acetate (PMA) - stimulated neutrophilsproduced less reactive oxidants in liver cirrhosis patients than in healthy subjects (MIF of R123: 42.7±14.6 vs 50.2±13.3, P＜0.01). A negative correlation was observed between oxidative burst MIF of PMA-stimulated neutrophils and ALT and AST levels (r -0.35, P＜0.05;r-0.4, P＜0.03). sVCAM-1, sICAM-1, sE-selectin concentrations correlated negatively with the oxygen free radical production (MIF of R123) in neutrophils after PMA stimulation in liver cirrhosis patients (r-0.45, P＜0.05;r-0.41, P＜0.05; r-0.39, P＜0.05, respectively).CONCLUSION: Neutrophil metabolic activity diminishes together with the intensification of liver failure. The metabolic potential of phagocytizing neutrophils is significantly lower in liver cirrhosis patients, which can be one of the causes of immune mechanism damage. The evaluation of oxygen metabolism of E. coli-stimulated neutrophils reveals that the amount of released oxygen metabolites is smaller in liver cirrhosis patients than in healthy subjects.

Expression of β2-integrin on leukocytes in liver cirrhosis

AIM: To analyze β2-integrin expression on blood leukocytes in liver cirrhosis. METHODS: In 40 patients with liver cirrhosis and 20 healthy individuals, the evaluation of expression of CD11a (LFA-1α), CD11b (Mac-1α), CD11c (αX) and CD49d (VLA-4α) on peripheral blood leukocytes was performed using flow cytometry. The analysis was carried out in groups of patients divided into B and C according to Child-Pugh’s classification. RESULTS: An increased CD11a, CD11b, CD11c and CD49d integrin expression was observed on peripheral blood leukocytes in liver cirrhosis. The integrin levels were elevated as the advancement of liver failure progressed. The highest expression of integrins occurred predominantly on monocytes. A slight expression of VLA-4 was found on lymphocytes and granulocytes and it increased together with liver failure. A positive correlation was noted between median intensity of fluorescence (MIF) expression on polymorphonuclear cells of CD11a and CD11c and CD49d (r = 0.42, P < 0.01; r = 053, P < 0.01, respectively) in liver cirrhosis stage C. However, no correlation was observed between integrin expression on leukocytes. The concentrations of sICAM-1, sVCAM-1, and TNFα, were significantly elevated in liver cirrhosis. CONCLUSION: β2-integrin expression on leukocytes increases in liver cirrhosis decompensated as the stage of liver failure increases, which is a result of permanent activation of leukocytes circulating through the inflamed liver environment. β2-integrin expression on circulating leukocytes can intensify liver cirrhosis.

Mental health of parents of children with autism spectrum disorder during COVID-19 pandemic: A systematic review

BACKGROUND Children diagnosed with autism spectrum disorder(ASD)may have great difficulties when their routines change,and this may affect the psychological wellbeing of their parents.For this reason,it is important to examine studies that address the mental health of parents in order to adapt to the coronavirus disease 2019(COVID-19)pandemic.AIM To determine the mental health status of parents with children diagnosed with ASD in the COVID-19 pandemic.METHODS The study,which is a systematic review,was conducted between December 15,2020 and December 30,2020 by scanning articles in English.The Scopus,Science Direct,PubMed,Cochrane,Web of Science,and Google Scholar databases were used for scanning.The keywords COVID-19 AND(“autism”OR“autistic”OR“autism spectrum disorder”)AND parent AND(“mental health”OR“anxiety”OR“stress”)were used in the search process.The inclusion criteria in the study were findings regarding the mental health of parents with children diagnosed with ASD in the COVID-19 pandemic,addressing their anxiety and stress situations,being a research article,and accessing the full text of the article.RESULTS In the study,a total of 6389 articles were reached,and the full texts of 173 articles were evaluated for eligibility.After the articles excluded by the full-text search were eliminated,12 studies involving 7105 parents were included in the analysis.The findings obtained from the articles containing data on mental health in the COVID-19 pandemic of parents with children with autism spectrum disorder were discussed in three groups.These were findings on the experiences of parents with children with ASD in the COVID-19 pandemic regarding the areas where parents with children with ASD need support in the COVID-19 pandemic and methods of coping with the COVID-19 pandemic for parents with children with ASD.In the systematic review,it was determined that the anxiety and stress of the parents increased,they needed more support compared to the pre-pandemic period,and they had difficulty coping.CONCLUSION In this systematic review,it was concluded that the COVID-19 pandemic negatively affected the mental health of the parents of children with ASD.

A determination of the quality of life of children and adolescents with type 1 diabetes and their parents

Objective: Type 1 diabetes is a chronic illness which can have a negative effect on the health care and development of children and can put their lives in danger. This descriptive study aimed to determine the quality of life and the factors affecting it of children and adolescents with type 1 diabetes using the Pediatric Quality of Life Inventory (PedsQL).Methods: The study was conducted in the Child Endocrinology Unit of a University Hospital in Bursa, Turkey. Totally 64 children eight-12 years and 85 adolescents aged 13-18 with type 1 diabetes and their parents were recruited. HbA1c measurements were obtained from the records of the endocrinology clinicare, which were made once every three months, and the average of the last three measurements was taken in the study. The PedsQL was used to measure quality of life of the children and adolescents. The data was analyzed using SPSS version 20.0 and P<0.05 was considered significant. The demographic data of the children and parents were analyzed using means and percentiles. Pearson's correlation analysis was used to assess the relationship between two averages. Results: Of the sub-groups on the scale, affective and school function scores were somewhat low, and social function scores were high. The quality of life scores of the children and adolescents were found to correlate with those of their parents. A negative correlation was found between HbA1c levels and adolescent quality of life, a positive correlation was found between the child's age and the quality of life of the child and parents, and a negative correlation was found between the number of children in the family and the quality of life of the child and parents. Conclusions: An evaluation of the quality of life after a diagnosis of diabetes can be used to assess the problems which may be faced by children and adolescents and to combat these problems.

Concentrations of gastric mucosal cytokines in children with food allergy and Helicobacterpylori infection

AIM: To measure the concentrations of chosen cytokines in the antrum mucosa depending on the kind of harmful pathogenic factors and to compare the concentrations with the values of controls without allergy and coexisting Helicobacter pylori (H pylori) infection.METHODS: The patients (97 children) were divided into three groups according to the data obtained from the case history, to the main cause of the disease and to the dominant clinical symptoms. Group Ⅰ: children with food allergy (Fa); group Ⅱ: children infected with H pylori; group Ⅲ (control group): children with functional disorders of the alimentary tract (without Fa and Hp infection). H pylori infection was determined by the presence of anti-Hp antibodies in serum (ELISA method) and urease test performed during endoscopic examination. Cytokine concentration in homogenates of gastric mucosa was detected by ELISA method.RESULTS: The IL-2 concentration in gastric mucosa bioptates was the highest in children with Hp infection (116.5±179.5 pg/mg of the protein) and Fa and Hp infection (98.1±101.0 pg/mg), while decreased in children with Fa (44.8±50.3 pg/mg) and controls (45.7±23.5 pg/mg). The lowest mean concentration of IFN-y was observed in children with Hp infection (18.9±16.4 pg/mg), with Fa and Hp infection (25.5±27.7 pg/mg), with Fa (40.6±39.7 pg/mg)and controls (49.9±33.4 pg/mg). The highest IL-4concentrations were observed in children with Hp infection (35.3±52.8 pg/mg) and in children with Fa and Hp infection (37.2±51.7 pg/mg), while lower IL-4concentration (23.6±35.8 pg/mg) was found in children with Fa compared to the controls (22.7±13.8 pg/mg).The analysis of IL-4 concentrations in children with Hp infection regarding the intensity of gastritis showed the highest value (62.2±61.2 pg/mg) in mild and moderate gastritis. The concentrations of IL-5 in the gastric mucosa of children with or without Fa did not differ significantly and were comparable to the control group. The highest mean IL-8 value was observed in Hp-infected children with or without Fa. The highest concentration of mucosal IL-10 was detected in children with Hp infection (79.3±41.2 pg/mg) and decreased in children with Fa and Hp infection (50.1±18.8 pg/mg)and in children with Fa (39.9±35.5 pg/mg). The intensity and activity of the inflammation did not affect IL-10concentrations in the gastric mucosa. In children with Hp infection, TNF-a concentration was the highest (45.9±49.3 pg/mg) and in children with Fa and Hp infection was low (45.3±32.6 pg/mg), whereas decreased in children with Fa (21.7±34.2 pg/mg) and in controls (31.6±14.5 pg/mg).CONCLUSION: The morphological changes of the gastric mucosa in children with Hp infection are comparable to those in children with Fa and coexisting Hpinfection. Cytokine concentration in children with Fa and Hp infection is significantly different in IFN-γ, IL-2,IL-8, and TNF-α.

Intensive care outcomes of refugee patients in Turkey between 2013 and 2019: A retrospective descriptive study

Objectives:To assess the outcomes of the intensive care of Syrian refugees under temporary protection (SRUTP). Methods: The sample of the study was composed of 110 SRUTP patients who were treated at a tertiary intensive care unit (ICU) between 2013 and 2019 in Istanbul, Turkey. Baseline information and clinical data of the patients were collected by scanning the hospital's electronic database and clinical decision support system. Results:The mean length of ICU stay was 97.6 (36.3-187.8) h. Among the patients, 71 (64.5%) had comorbid diseases, and ICU mortality was 40%. The median cost of health care for each patient was 2144 (1060-4471) USD, and the total health care cost of all patients was 534012USD. Conclusions: Use of vasoactive drug, hemodialysis application, and low Glasgow Coma Scale scores are independent risk factors of the mortality. More researches are needed to clearly reveal the health and cost consequences of war.

Code blue applications as an indicator of clinical quality

Objective:To investigate the code blue application at a training and research hospital in Turkey.Methods:The code blue declaration forms and the hospital database with 238 complete records between January 2016 and July 2017 were collected.The form involved individual characteristics,the reason for issuing the code blue call,the unit and block where the code was given,time and location related properties such as working time and arrival duration,properties regarding the intervention process such as its type,duration or result.The 24-hour and 30-day long survival data of the patients to whom cardiopulmonary resuscitation was implemented were obtained from the hospital database,or from their relatives.The influencing factors of arrival duration were analyzed.Results:The median duration of arrival was 2.14(2.00-3.02)min.Code blue applications were performed more frequently in Departments of General Surgery,Internal Medicine,Orthopaedics,and Cardiology Clinics.Half of the code blue calls were due to cardiac arrest;the other half was due to shortness of breath or respiratory distress,syncope,and respiratory arrest.Three-out-of four code blue calls were treated with orotracheal intubation and cardiopulmonary resuscitation,or only orotracheal intubation or only medical treatment;one-fourth of the calls were not intervened.Altogether,72.36%of the code blue calls patients were intervened;69.35%of them were made both orotracheal intubation and cardiopulmonary resuscitation,and 20.5%of them were made only orotracheal intubation and 10.55%of them made only medical treatment.It was found that giving the code blue day or night had no effect on the time to reach the area where the code was given.Similarly,it was found that giving the code blue within daytime or night shift had no effect on the time to reach the area where the code was given.(P>0.05).The survival rates were 39.1%within the first 24 h and 18.1%within the first 30 d.Conclusions:Applications of code blue should be analyzed at regular intervals as clinical quality indicators.Reasons for wrong calls should be determined.The duration of reaching locations where calls are made should also be decreased.

Repeated measurements of depression and outcomes in patients receiving hemodialysis

Objective:Depression appears to be common among the patients with end-stage renal disease(ESRD).Therefore,how to comprehensively analyze the changes in depression and its impact on patient outcomes is an impor tant research direction.The objectives of this study were to assess changes in depression and whether depression can be used to predict outcomes in patients receiving hemodialysis.Methods:In a longitudinal study,317 patients receiving hemodialysis from two hospitals were investigated.Depression was assessed using the Hamilton Depression Scale(HAMDS)at baseline.Outcomes data(survival and mor tality)were collected from baseline to the end of follow-up 2 years later.Mor tality was assessed using Cox propor tional hazards analysis.Results:The HAMDS score and percentage of high scores increased at three time points.Moreover,the changes were statistically significant.Surviving patients had significantly lower HAMDS scores.Through multivariate Cox regression analysis,age and depression can be used to predict mor tality(P<0.05),and the relative risks(RRs)were 1.032 and 1.069,respectively.Conclusions:Depression in patients receiving hemodialysis is worse.Moreover,baseline depression is an independent predictor of outcomes.Patients receiving hemodialysis should be focused on improving their psychological complications.A systematic and individual psychological health promotion plan must also be incorporated into the health education plan for patients receiving hemodialysis.

A causal model of job stress among Thai nurse-midwives

Objective: To test a causal model of job stress among nurse-midwives working in labor and delivery units in Thailand.Methods: Random and convenience sampling was used to recruit 282 nurse-midwives with at least 6 months of work experience from 16 regional ter tiary hospitals in Thailand. Data were collected from May to December 2020. Research instruments with good internal consistency reliability ranged from 0.83 to 0.91 including the Job Stress Scale and the Thai version of the Job Content Questionnaire(TJCQ). Descriptive statistics and a structural equation model were used for data analysis.Results: Job demands were the strongest predictor of job stress. At the theoretical level, high job control plays a crucial role in directly reducing job stress. However, the present research provides contrary evidence to the theoretical predictions. When nurse-midwives perceive high job control, they perceive pressure to meet the expectations of their supervisors and colleagues. Therefore, high job control can contribute to job stress. Likewise, job suppor t had an indirect effect on job stress among nurse-midwives through job control. The modified model fitted the empirical data(χ^(2) = 57.76, df = 22, CMIN/df = 2.62, goodness of fit(GFI) =0.96, adjusted goodness of fit(AGFI) =0.91, comparative fit index(CFI) = 0.95, and root mean square error of approximation(RMSEA) = 0.07). The effects of job demands, job control, and job suppor t on job stress among Thai nurse-midwives can explain 67% of the model’s total variance for job stress.Conclusions: Nurse-midwives who encounter high job demands and less control over their work control suffer from job stress. Job support does not directly affect nurse-midwives’ job stress but influences it through perceived job control. Strategies to decrease job stress among Thai nurse-midwives should focus on how to balance job demands, and enhance job control, and job suppor t.

Prevalence and predictive factors of elder mistreatment in Chinese migrant families

Objectives:To examine the prevalence of and identify the predictive factors for elder mistreatment(EM)in Chinese migrant families.Methods:This was a cross-sectional study.A total of 489 rural migrant elderly were recruited using multistage sampling technique from communities in Wenzhou city between June 2020 and October 2020.All par ticipants completed the Mini-Cog,and then data were collected in a survey using the 12-Item Shor t-Form Health Survey Questionnaire,Abuser’s Dependency Scale,the Friendship Scale(FS),Intergenerational Ambivalence Scale,Filial Piety Index,the Assessment Tool of Domestic Elder Abuse,and a demographic questionnaire.Descriptive statistics and multiple regression were carried out to analyze the data.Results:The prevalences of physical mistreatment,psychological mistreatment,neglect,economic mistreatment,and social mistreatment among the migrant elderly were 1.23%,20.65%,22.50%,0.61%,and 9.41%,respectively.Significant predictive factors were migrant elderlies’mental health status(β=–0.118,P<0.01),adult children’s filial piety(FP)(β=–0.245,P<0.001),and intergene rational ambivalence(β=0.365,P<0.001).Conclusions:EM was common among the migrant elderly.Predictive factors for EM in Chinese migrant families were identified.The findings could be useful in developing nursing interventions to promote migrant elderlies’mental health,uphold their children’s FP,and harmonize intergenerational relationship to avoid EM.

Soluble adhesion molecules ICAM-1,VCAM-1,P-selectin in children with Helicobacter pylori infection

AIM: To assess the sICAM-1, sVCAM-1, and sP-selectin levels in children withHelicobacter pylori(H pylori)infection and to evaluate their significance for the morphological changes found in gastric mucosa.METHODS: The study included 106 children: 59children (55.7%) with chronic gastritis and positive IgG against H pylori, 29 children (27.3%) after previous H pylori infection without the bacterium colonization but with positive IgG against H pylori, and 18 children (17%) with functional disorders of the gastrointestinal system but with normal IgG against H pylori. Endoscopic and histopathological evaluation of gastric mucosa was performed based on the Sydney System classification.The evaluation of sP-selectin, sIC AM-1, sVCAM-1 levels in the sera of children was carried out using ELISA test.RESULTS: The assessment of gastritis activity degrees indicated statistically significant values in the antrum and corpus (P＜0.001) of children examined. Serum sVCAM-1 levels were higher in group with gastritis due to H pylori infection than in group without infection and differed statistically (P＜0.05). Serum sVCAM-1 levels proved to be the highest among other adhesive molecules in infected children and decreased after eradication of H pylori. Serum sICAM-1 levels were similar in all examined groups. Serum sP-selectin levels were similar in children with and without H pylori infection.CONCLUSION: Assessment of adhesive molecules (sPselectin, sICAM-1, sVCAM-1) in the sera of children with active H pylori infection can show the participation of sVCAM-1 in the pathogenesis of gastric mucosal inflammation, sP-selectin and sICAM-1 concentrations in the sera of children with H pylori infection after eradication cannot reveal any significant differences as compared to healthy children.

Moving from fear to realization: Family engagement in tuberculosis prevention in children living in tuberculosis Sundanese households in Indonesia

Objective: Children living in tuberculosis households need protection.However,families need to be engaged to prevent tuberculosis transmission to children.This study aimed to analyze the details of "moving from fear to realization," which is one category of a substantive theory of family engagement in tuberculosis prevention in children.Methods: Fourteen family caregivers participated as key informants after their families met the criteria.The participants were recruited at a lung clinic in West Java,Indonesia and followed up at their homes.The data were gathered using in-depth interviews and analyzed following the coding procedures of the Straussian grounded theory.Findings: "Moving from fear to realization" was the main category that emerged from the experiences of the Sundanese families to begin engaging in tuberculosis prevention in children living in tuberculosis households.It was composed of four sub-categories,namely,fear of tuberculosis,seeking information,following God's will,and awareness of tuberculosis transmission risks.Conclusions: This study showed how a family moves from fear to the realization of tuberculosis transmission risks.Its findings are useful for nurses to provide optimum care in order to prevent tuberculosis transmission to children with household contact by providing both education and counseling for families.

Prevalence of depression and anxiety among children with type 1 and type 2 diabetes:a systematic review and meta-analysis

Background Evaluation of psychiatric disorders in children is essential in timely treatment.Despite individual studies,there is no information on the exact status of psychiatric disorders in children.The present study was conducted to determine the prevalence of depression among children with type 1 and type 2 diabetes.Methods This meta-analysis is registered with PROSPERO(CRD42021231491).Several databases(Web of Science,Scopus,and PubMed)were searched from January 1,2000 to December 15,2020.The key words included:depression,anxiety,children,and diabetes.The steps of search,comprising screening,risk of bias,and extraction of study data,were performed separately by two researchers.Results It was found that a total of 109 studies had been conducted involving 52,493 children with type 1 and type 2 diabetes.These studies were included in the present review study.The prevalence of depression,anxiety among children with type 1 diabetes were 22.2%[95%confidence interval(CI)19.2–25.2],and 17.7%(95%CI 15.2–20.1),respectively.The prevalence of depression was higher among girls(29.7%)than boys(19.7%).The prevalence of depression was higher in lower-middle-income countries at 29.3%(95%CI 18.6–40.0).The prevalence of depression among children with type 2 diabetes was 22.7%(95%CI 17.3–28.0).Conclusion The results of the present study indicate the importance of paying attention to extensive periodic screening and appropriate activities to reduce pediatric depression.

The Hippo signalling pathway and its implications in human health and diseases

As an evolutionarily conserved signalling network,the Hippo pathway plays a crucial role in the regulation of numerous biological processes.Thus,substantial efforts have been made to understand the upstream signals that influence the activity of the Hippo pathway,as well as its physiological functions,such as cell proliferation and differentiation,organ growth,embryogenesis,and tissue regeneration/wound healing.However,dysregulation of the Hippo pathway can cause a variety of diseases,including cancer,eye diseases,cardiac diseases,pulmonary diseases,renal diseases,hepatic diseases,and immune dysfunction.Therefore,therapeutic strategies that target dysregulated Hippo components might be promising approaches for the treatment of a wide spectrum of diseases.Here,we review the key components and upstream signals of the Hippo pathway,as well as the critical physiological functions controlled by the Hippo pathway.Additionally,diseases associated with alterations in the Hippo pathway and potential therapies targeting Hippo components will be discussed.