Special Approach Research Articles

CHOICE OF ANESTHESIA TECHNIQUE FOR MINE-EXPLOSIVE OR GUNSHOT INJURIES TO THE LIMBS

Introduction. Despite the overall advancement of medicine, the issue of adequate pain management for patients with combat injuries remains relevant today at all stages of providing care to the wounded. Limb injuries dominate the structure of traumatic damage due to combat trauma, accounting for 44-52 % of cases. Adequate control of pain syndromes in the postoperative period allows reducing the incidence of complications, shortening the patient's stay in the hospital and intensive care unit, accelerating the start of rehabilitation for the injured. Regional pain management methods are becoming more widespread; however, they often require a more specialized approach and specific training for anesthesiologists to conduct multimodal analgesia effectively. At the same time, the use of regional pain management methods is associated with fewer anesthesia complications, significant economic advantages compared to general anesthesia. Objective. To improve the treatment outcomes of patients with blast and gunshot limb injuries by determining the optimal method of anesthesiological support. Materials and methods. This study includes data on 61 patients hospitalized at the Municipal Clinical Hospital № 17 in Kyiv with a diagnosis of blast and/or gunshot limb injuries and treated at the mentioned hospital from February 2022 to October 2023. Discussion of research results. The study results convincingly demonstrate the significant benefits of using regional anesthesia methods during primary and staged surgical interventions in patients with blast and gunshot limb injuries compared to the use of general anesthesia. Regarding anesthesiological support using regional anesthesia techniques, they have significant advantages over general anesthesia in patients with blast and gunshot limb injuries. Conclusion. The application of regional pain management methods enables better control of pain syndromes and a substantial reduction in the use of narcotic analgesics in the postoperative period for patients with blast and gunshot limb injuries, promoting faster recovery and early rehabilitation for this patient group.

Analysis of the Impact of Forces in Hanger Rods on Power Boiler Operation

Hanger rods intended for boiler suspensions on a metal structure require a special design approach that considers the total weight of the boiler structure that is to be carried. Unfortunately, a large reserve in the rods’ carrying capacity does not always guarantee the failure-free operation of a boiler. For this reason, it is very important to monitor the forces acting in the rods. Any negligence in this matter might cause a local excess of stresses in the boiler pressure part and result in periodic shutdowns of the boiler. Therefore, in order not to let this happen, adequate computational methods have to be developed. To date, the methods described in the literature and in design requirements have concentrated, first of all, on analyses of the boiler individual subassemblies or on small boiler units supported from the bottom at just a few points. The aim of this paper was to conduct a numerical analysis for a real high-capacity power boiler. The computations were performed based on experimentally measured forces in the hanger rods, and the results were verified by comparing the areas of stress concentration against the area where the boiler structure was regularly damaged.

Embracing Diversity: Implementing Inclusion-Based Islamic Education at SMALB Semarang to Meet Diverse Student Needs

Learning for children with disabilities necessitates specialized approaches to ensure the attainment of educational objectives. However, the heterogeneity of students with special needs within a single educational institution presents unique challenges in addressing their diverse educational requirements. This study aims to explore inclusion-based Islamic education at SMALB Semarang. Employing a qualitative research methodology with a case study approach, data was collected through interviews with the school principal, three teachers, ten students, and ten student guardians. Observations focused on the learning process and the interaction between students and teachers, while documentation provided insights into school records. Data analysis involved categorizing, coding, and identifying themes relevant to the research topic. The findings revealed that students at SMALB Semarang were classified into two categories: C (mentally retarded) and D (physically impaired). The learning process was tailored to the needs of students, who were grouped into several classes based on criteria such as religion and type of disability. Addressing the diversity in Islamic education involved curriculum adjustments and the formation of specific study groups. The Islamic learning process utilized various tools, including embossed media, visual aids, and hearing devices. For students with type C disabilities, the Islamic education process frequently involved repetition of learning materials. Embracing student diversity based on disability type and religion is crucial for effectively conveying and ensuring the acceptance of Islamic teachings among the appropriate student groups.

Pengaruh Cedera Otak Kecil (Cerebellum) terhadap Perkembangan Bahasa Anak

The aim of this research is to understand the impact of cerebellar injury on children's language development. This study uses a library research approach. The findings indicate that injuries to the cerebellum have the potential to disrupt language development in children. The cerebellum, although small in size, plays a crucial role in coordinating movements and cognitive processes, including language. The effects of cerebellar injury include difficulties in articulation, disruptions in speech fluency, challenges in language comprehension and expression, and impairments in non-verbal communication. These issues arise due to disruptions in the fine motor coordination of the muscles needed for proper speech and language expression. The importance of appropriate intervention and treatment, such as physical therapy, speech therapy, and special educational approaches, is highlighted to help children overcome these difficulties and support their language development. In conclusion, a deeper understanding of the relationship between cerebellar injury and children's language development can aid in providing more effective interventions to improve outcomes for children affected by cerebellar injuries.

OPEN FOR DISCUSSION: РАЗВИТИЕ НАВЫКОВ РАЗГОВОРНОЙ РЕЧИ НА ЗАНЯТИЯХ ПО АНГЛИЙСКОМУ ЯЗЫКУ СО СТУДЕНТАМИ ХИМИЧЕСКОГО ФАКУЛЬТЕТА

In the context of studying foreign languages, speaking skills are generally viewed as the key criteria of success yet the most challenging aspect of language learning. This requires special approach and efforts on the side of the teacher who should be able to create proper conditions and apply certain methods to encourage students to speak. Open for Discussion is a language course specifically developed to support chemistry students in practising real-world speaking skills within the framework of problem-solving teaching strategy and provocation in teaching. The present article gives an overview of the course, its underlying concepts and practical application. At that, special focus is made on cooperative learning strategies and collaborative discussion as the most effective ways to enhance the communicative competence and boost English speaking skills. The described course may be used to strengthen methodological support for foreign-language teachers at nonlanguage faculties.

An Artificial Neural Network Model for a Comprehensive Assessment of the Production Performance of Multiple Fractured Unconventional Tight Gas Wells

The potential of unconventional hydrocarbon resources has been unlocked since the hydraulic fracturing technique in combination with long horizontal wells was applied to develop this type of reservoir economically. The design and optimization of the fracturing treatment and the stimulated reservoir volume and the forecasting of production performance are crucial for the development and management of such resources. However, the production performance of tight gas reservoirs is a complicated nonlinear problem, described by many parameters loaded with uncertainty. The complexity of the problem influences and inspires the sophistication of the solution to be used. This paper proposed an artificial network model that allows for fast, extended, and accurate analyses of the production performance of multiple fractured unconventional tight gas wells. In the comprehensive approach developed, the reservoir rock parameters, the drainage area, and the hydraulic fracture parameters are treated as a variable input to the model. The analysis is no longer constrained by fixed “shoes box” geometry, and the values of the parameters defining the reservoir and stimulated volume are not limited to a few discrete values. The numerical experiment used to construct a database for model development was designed using a genetically optimized Latin hypercube sampling technique. A special approach was used in the preparation of “blind data”, which are crucial for truly reliable model verification. In the result, a developed tool offers an extended rock-fluid description, flexible model, and stimulated reservoir volume dimensioning and parameterization, as well as a high degree of applicability in sensitivity analysis and/or optimization.

Advancing Skin Cancer Prediction Using Ensemble Models

There are many different kinds of skin cancer, and an early and precise diagnosis is crucial because skin cancer is both frequent and deadly. The key to effective treatment is accurately classifying the various skin cancers, which have unique traits. Dermoscopy and other advanced imaging techniques have enhanced early detection by providing detailed images of lesions. However, accurately interpreting these images to distinguish between benign and malignant tumors remains a difficult task. Improved predictive modeling techniques are necessary due to the frequent occurrence of erroneous and inconsistent outcomes in the present diagnostic processes. Machine learning (ML) models have become essential in the field of dermatology for the automated identification and categorization of skin cancer lesions using image data. The aim of this work is to develop improved skin cancer predictions by using ensemble models, which combine numerous machine learning approaches to maximize their combined strengths and reduce their individual shortcomings. This paper proposes a fresh and special approach for ensemble model optimization for skin cancer classification: the Max Voting method. We trained and assessed five different ensemble models using the ISIC 2018 and HAM10000 datasets: AdaBoost, CatBoost, Random Forest, Gradient Boosting, and Extra Trees. Their combined predictions enhance the overall performance with the Max Voting method. Moreover, the ensemble models were fed with feature vectors that were optimally generated from the image data by a genetic algorithm (GA). We show that, with an accuracy of 95.80%, the Max Voting approach significantly improves the predictive performance when compared to the five ensemble models individually. Obtaining the best results for F1-measure, recall, and precision, the Max Voting method turned out to be the most dependable and robust. The novel aspect of this work is that skin cancer lesions are more robustly and reliably classified using the Max Voting technique. Several pre-trained machine learning models’ benefits are combined in this approach.

Towards a Methodological Basis the Study of the «Fourth Power» as an Institution of the Political System within Modern Society

Introduction. This article considers the mass media as the «Fourth Power» in the political system of modern society with the aim of illuminating the place of mass media in the latter. The authors had attempted to achieve this goal in terms of structural-functional, institutional and other explanatory concepts. From a theoretical point of view, the media attract the attention of both political scientists and sociologists, philosophers, historians, journalists and public relations specialists. Research in this direction requires a multiparadigmal methodological approach, since all theoretical and empirical resources for such analysis are available in modern science. Methodology and sources. In the framework of these methodological positions (multiparadigmal methodological approach) “The Fourth Power” appears in various aspects, which also allows to study the latter as an institution of the political system of society, in which the media are not only an indicator of the development of civil society, but also indicate the degree of openness of the political elite and the ruling political class. As methodological sources, this article uses the works of such founders of the concept of “Fourth Power” as J. S. Mill, J. Bentam, J. Habermas, F. Siebert, T. Peterson, W. Schram, etc. Results and discussion. The article studies the possibilities of applying the basic provisions of general scientific and specialized approaches to the study of the concept of «Fourth Branch of Power» as an explanatory methodological approach in modern political and sociological researches. The authors made an attempt to theoretical interpretation of the basic categories and to highlight their conceptual analogues in modern science.Conclusion. The results of the work show that the mass media (“The Fourth Power”) definitely play an ever-increasing role in terms of control over public power and are one of the institutions of civil-political society. Although it is known that the use of the term “The Fourth Power” to denote this political role of the media may cause objections and be a reason for discussion.

Introduction

Abstract Our special issue approaches knowledge as a product of intermingled sensory experiences in ways that confound neat divisions of body/mind, exterior/interior, subject/object, cognition, emotion, and imagination. Rejecting “cognitive ocularcentrism,” as well as approaches that focus on any single sense, we articulate an intersensorial framework premised on the entanglement of touch with other senses, particularly sight. Through this, we highlight hidden epistemic multiplicities, intersubjectivities, and literary strategies for the study of gender in the history of science, especially in reference to the gendering of personae and emotions. The putative rise of the visual in modern science was always already intersensorial, no matter how much cognitive ocularcentrism sought to tame this. By attending to seeming distractions within knowledge production, our issue seeks to reintegrate science back into the immersive flow of intersensorial experience and recover the sensuous webs that connect actors, geographies, fields, and time periods habitually separated.

"They look into our world" – A qualitative study of intensive support to adolescents with poorly regulated type 1 diabetes and their families

ObjectiveThis article is based on a qualitative evaluation of a project offering intensive support to Danish adolescents with poorly regulated type I diabetes and their families. The article explores 1) how the project allowed for another approach to the families than what is possible in usual care at the hospital, and 2) how the nurse involved other professionals in caring for the adolescents. MethodsThe study involved interviews with four participating adolescents, four parents, a social worker, and the nurse running the project, along with a reading of the nurse’s entries in the adolescents’ electronic patient records. Data was analyzed within the framework of realistic evaluation. ResultsThe findings showed that key mechanisms in the nurse’s work was her open and flexible approach to the families, the way she anchored conversations about diabetes in here and now situations, and her efforts at engaging teachers, social and health care professionals in helping the adolescents. ConclusionThe strengths of the project were the nurse’s special approach to the families and her ability to engage other professionals. Practice implicationsA care manager providing individualized and flexible help can have positive results on the treatment of adolescents with poorly regulated type 1 diabetes.

PROBLEMS OF ESTABLISHING KEEPING ONE FROM MARRIAGE IN THE CONDITIONS OF MARITAL STATE IN UKRAINE

The study highlights the difficulties associated with establishing spousal support under martial law in Ukraine. A comprehensive analysis reveals the problems that individuals may face when exercising their right to receive material support from the other spouse who is a member of the Armed Forces of Ukraine. The purpose of the article is to highlight the current challenges and peculiarities associated with establishing spousal support under martial law in Ukraine. The article states that the obligation to pay alimony is one of the most important institutions of modern family law in Ukraine. Its importance is due to its fundamental role in ensuring the protection and stability of family relations. Alimony obligations to support spouses, based on both legal and moral values, serve as a cornerstone for maintaining social equality in society. It is established that family law establishes moral standards for material support of spouses, while recognising the limited scope of state provision of such needs. This dual approach reflects the balance between legal obligations and practical aspects of family relations. Family law recognises the importance of mutual support and care among family members, but also acknowledges the reality that public funds may not be sufficient to meet their needs. It is substantiated that spousal support in a marriage relationship is mutual, where the financial well-being of each partner is intertwined with their financial situation. Recognising the vulnerability that can arise when one of the spouses is unable to earn an income, the law seeks to ensure that persons in such circumstances are not left without the necessary financial assistance. It is established that the conditions of martial law in Ukraine pose significant challenges in the field of family law, in particular with regard to spousal support, especially when one of the family members, in particular a husband, is mobilised to the Armed Forces of Ukraine. In particular, there are problems with the payment of state financial support to such persons, which may have a negative impact on the timeliness of receiving financial assistance by the person in need of support. The author gives an opinion as to whether a person who has failed to pay spousal maintenance in a timely manner should be held liable, given that such a person, being a military officer, was not provided with a timely allowance for military service. It is noted that there are certain aspects of the judicial process in cases of establishing maintenance for one of the spouses when the other is mobilised and serves in the Armed Forces of Ukraine. This study highlights the urgent need for a special approach to the consideration of cases on the establishment of spousal maintenance under martial law. Although the fundamental principles of equality and justice remain unchanged, the realities of wartime require individual approaches that take into account the unique challenges faced by both payers and recipients of spousal maintenance. Therefore, the problems described above underline the need for further scientific research into the theory and practice of establishing spousal maintenance under martial law in Ukraine.

Pain in Dementia: An Empirical Test of a Common Assumption

Numerous, and often largely overlapping, observational pain assessment tools have been developed specifically to assess pain in older adults with dementia under the assumption that a specialized approach is necessary to evaluate pain in this population. However, this assumption has never been tested empirically. As an empirical test of this implicit assumption, our goal was to compare existing tools for people living with dementia (with respect to psychometric properties), not only against each other, but also against a tool developed for a different population with cognitive impairments. Videos of older adults with severe dementia recorded in long-term care settings were coded for pain behaviors in the laboratory. Trained coders coded pain behaviors in video segments of older adults with dementia during a quiet baseline condition as well as during a physical examination (designed to identify painful areas), using various observational pain assessment tools. An observational measure of agitation was employed to facilitate the assessment of discriminant validity. Consistent with our expectations, all pain tools (including the tool developed for younger people with cognitive impairments) successfully differentiated between painful and nonpainful states, with large effect sizes. This was the first study to compare tools specifically developed to assess pain in people living with dementia to a tool developed for a different population. Given that all tools under study showed satisfactory psychometric properties when tested on persons with dementia, this study suggests that the assumption that different tools are necessary for different populations with cognitive impairments cannot be taken for granted. PerspectiveThis article challenges an implicitly held assumption that specialized tools are needed to assess pain in different populations with cognitive impairments. Given commonalities in pain expression across populations, further research is needed to determine whether population-specific tools are needed.

Problem-based learning innovation through realism and culture: Impact on mathematical problem solving and self-efficacy in primary school students

Background: Elementary school students in Aceh Tamiang often struggle with problem-solving which negatively impacts their confidence. To address this issue, a new teaching approach called PBL-Reathnomath was developed, combining problem-based learning with real-world math examples and cultural references.Aim: This study aimed to determine the effectiveness of the PBL-Reathnomath model at improving students' problem-solving skills and self-confidence.Method: A study was conducted involving randomly selecting participants and dividing them into two groups. One group learned using the new PBL-Reathnomath model while the other group learned using traditional methods. Data were collected through tests and surveys and the results were analyzed using statistical methods.Results: The findings showed that the PBL-Reathnomath model significantly improved both the problem-solving abilities and self-efficacy of the students. The group that used this new model performed better on average than the group that used traditional methods. Further analysis confirmed that the PBL-Reathnomath model simultaneously affected problem-solving and self-efficacy, explaining a substantial portion of the variation in these outcomes.Conclusion: While the effect size was smaller compared to conventional learning, the study concluded that PBL-Reathnomath is a valuable and specialized approach for improving problem-solving skills and boosting self-confidence among elementary school students.

Smart specialization of industrial regions of Ukraine: organizational and economic support

Industrial regions of Ukraine, especially near-front territories (Donetsk, Luhansk, Kharkiv and Zaporizhzhia regions), suffered the greatest damage and losses as a result of the full-scale war. The needs for their recovery, according to the joint assessment of international institutions and the Ukrainian government, constitute half (50.46% or $207.2 billion USD) of the reconstruction needs for Ukraine. Considering the structural lag of the economy in industrial regions, dominated by sectors with weak innovation activity and low technological intensity, the continuation of pre-war development trajectories is absolutely unacceptable and non-competitive in the context of the Industry 4.0-5.0 which gains traction globally. In the conditions of a significant change in the profiles of industrial regions due to the war, there is an opportunity to revive their economy but on fundamentally new, innovative principles. Smart specialization can be utilized for this purpose, aiming at the structural transformation of the economy and the development of new competitive advantages for regions and countries. Emphasis is placed on the necessity of conducting a critical analysis and rethinking the implementation directions of smart specialization in the industrial regions of Ukraine. This is due to the varying degrees of consideration of its fundamental principles in the regional development strategies for 2021-2027 and the need for the structural transformation of their economies to overcome the consequences of the war for the local population. The purpose of the article is to identify key problems in the field of organizational and economic support for the implementation of the smart specialization approach in the industrial regions of Ukraine and to determine ways to solve them, taking into account purely Ukrainian challenges and EU experience. The role of organizational and economic support for the implementation of the smart specialization approach in national conditions has been substantiated. The scientific understanding of the main organizational and economic problems and shortcomings of the implementation of the smart specialization approach in the industrial regions of Ukraine has been deepened. It is highlighted that freezing these problems and the absence of appropriate actions to address them will prevent structural and innovation transformations in the economies of regions based on the principles of sustainable development, thereby excluding the possibility of overcoming their structural backwardness. Proposals on ways to solve existing organizational and economic problems are substantiated, taking into account purely Ukrainian challenges, and the knowledge obtained in the EU member states during the implementation of this approach over the last ten years. The practical implementation of these proposals will make it possible to adjust the smart-oriented goals and sectoral focuses of regional development strategies, to direct them to the transformation of the economy of industrial regions through the support of sectors and industries that have the potential to develop new competitive advantages.

Challenge of limb care after violence and war with aspecial focus on imaging procedures

Injury patterns in the area of the extremities following violence and war harbor many special features and require special attention. Destructive and complex defect injuries are often present, which necessitate elaborate and special reconstruction approaches, predominantly as part of astaged and multistaged procedure. In this context, special attention must be paid to the diagnostic options as an essential aspect, as aclear diagnosis means that targeted treatment steps can be planned and implemented. The authors' experience in this field from military operations in Afghanistan, Iraq, the Republic of Mali, Kosovo and Georgia, as well as the core content of the Terror and Disaster Surgical Care (TDSC®) course on this topic, have been contextualized and incorporated. In addition, aspects of interdisciplinary cooperation with radiological and, in particular, nuclear medicine disciplines are taken into account in the daily routine. Extremity injuries in the context of violence and war are accompanied by complex bone and surrounding soft tissue defects due to the high energy impact. The principles of reconstruction familiar from everyday life can only be transferred one-to-one to alimited extent. The treatment pathways are often very long and complex and the questions of infection and tissue vitality must be answered again and again in stages. Interdisciplinary collaboration with the disciplines specialized in imaging procedures, particularly in the field of nuclear medicine, is one of the key building blocks for a successful treatment pathway.

QUALITY CONTROL METHODS AND MODELS OF POLYMER COMPOSITE MATERIALS

This article analyzes the traditional and modern methods of demolition control applied to structures made of polymer composite materials. Polymer composite materials are designed to ensure the strength of structures with a minimum mass, not subject to corrosion, etc. as there are advantages. But such materials require a special approach in the preparation and creation and the application of new methods, tools and solutions. This is due to the fact that there are many different types of polymer composite materials. Therefore, the development of criteria for the analysis of quality control methods and models, reliability forecasting in the technology of manufacturing products from polymer composite materials is an urgent issue. The authors give recommendations for the selection of methods for a complete assessment of the quality of compositional materials. The analysis of effective methods of quality control and forecasting of reliability of polymer composite materials was carried out. For this purpose, factors for the choice of the method and reliability prediction have been identified, taking into account its complexity for controlling polymer composite materials. Models for controlling polymer composite materials and products made on its basis were selected and on their basis the effectiveness of the application of low-frequency ultrasonic devices at the separation boundaries of controlled environments was determined.

Analysis of the mutability of the legal framework for migration policy in Russia (1990-2023) in the context of the effectiveness of migration governance

The article analyzes the dynamics of changes in the institutional and legal framework of Russian migration policy from 1990 to 2023. Based on legal statistics, the authors investigate the frequency of amendments to key laws in the field of migration regulation in the Russian Federation. By comparing the series of events in political, legal, and institutional changes to migration governance, the authors identify external factors that influence the changes in legislation. Through comparative legal methods and an analysis of relevant literature, we discuss issues related to the differences between adaptive governance and agile management, as well as the impact of rapidly changing laws on the stability of the legal system. The analysis of the data revealed a high frequency of changes to migration laws, with an average of up to 5-6 amendments per year, and in some cases, up to 15-17 amendments per year. Acts of federal and regional authorities are also frequently amended. During the pandemic, a decision of the Moscow government was in effect for a little over a week. There is a significant excess in the number of secondary legal acts compared to the number of primary ones. The constant amendment of migration regulations reflects the state's response to diverse and sometimes unforeseen challenges in modern society, and demonstrates the adaptive nature of Russia's migration policy. This increase in adaptability raises questions about where the line is between improving the efficiency of legal regulations and their instability. Additionally, a special multidisciplinary approach is required to assess how changes in migration policies affect socio-economic development. The relevance of this study is linked to the fact that improving the efficiency of migration governance is a challenging task. Migration is both a source of economic development and potential risk to socio-political stability.

Jurisdiction of a State Party under Article 2(1) of the ICCPR: A Comment on A.S. and Others v. Italy

Abstract In A.S. and others v. Italy, the question of the jurisdiction of a State party under Article 2(1) of the ICCPR is formulated as “whether the alleged victims could be considered to have been within the power or effective control of the State party”. Per HRC’s earlier views, one form of “within the power or effective control” of a State party may be identified by the impact on the enjoyment of rights caused by a State party’s action. This can be considered as the “functional impact model”. Apparently this is what the HRC applied in this case. But a State party’s inaction cannot cause any impact unless it owes prior positive obligations towards the allegedly impacted person. As the applicable instruments allow considerable discretion to a State party to decide whether to rescue the persons in distress at sea, Italy’s “obligations” to rescue and to cooperate do not necessarily trigger Italy’s positive obligations towards the relevant persons. Taking Italy’s jurisdiction as a consequence of the causal link between the sinking of the vessel and the resulting sufferings (and deaths in some cases) of the persons on the vessel and Italy’s decisions (inaction) is the result of an expansive and improper application of the special approach adopted in other cases. To be non-arbitrary, one may find that affected persons are “within the power or effective control” of a State party: (1) where harm is caused by affirmative acts of a State party, the impact can be deemed as a manifestation that the person impacted is “within the power or effective control” of the State party; or (2) where harm is caused by an omission of a State party, there must be a prior specific legal relationship between the allegedly impacted person and the State party.

Emergency Department Evaluation of Young Infants With Head Injury.

We compared the emergency department (ED) evaluation and outcomes of young head-injured infants to older children. Using the Pediatric Health Information Systems database, we performed a retrospective, cross-sectional analysis of children <2 years old with isolated head injuries (International Classification of Diseases, 10th Revision, diagnoses) at one of 47 EDs from 2015 to 2019. Our primary outcome was utilization of diagnostic cranial imaging. Secondary outcomes were diagnosis of traumatic brain injury (TBI), clinically important TBI, and mortality. We compared outcomes between the youngest infants (<3 months old) and children 3 to 24 months old. We identified 112 885 ED visits for children <2 years old with isolated head injuries. A total of 62 129 (55%) were by males, and 10 325 (9.1%) were by infants <3 months of age. Compared with older children (12-23 months old), the youngest infants were more likely to: Undergo any diagnostic cranial imaging (50.3% vs 18.3%; difference 31.9%, 95% confidence interval [CI] 35.0-28.9%), be diagnosed with a TBI (17.5% vs 2.7%; difference 14.8%, 95% CI 16.4%-13.2%) or clinically important TBI (4.6% vs 0.5%; difference 4.1%, 95% CI 3.8%-4.5%), and to die (0.3% vs 0.1%; difference 0.2%, 95% CI 0.3%-0.1%). Among those undergoing computed tomography or MRI, TBIs were significantly more common in the youngest infants (26.4% vs 8.8%, difference 17.6%, 95% CI 16.3%-19.0%). The youngest infants with head injuries are significantly more likely to undergo cranial imaging, be diagnosed with brain injuries, and die, highlighting the need for a specialized approach for this vulnerable population.

Decoding Innocence: Advancing Forensic Facial Discrimination through Comparative Analysis of Conventional CNN and Advanced Architectures

The field of Digital Image Forensics (DIF) faces a critical issue in accurately identifying children in digital images, notably in cases involving the proliferation of child sexual abuse content. Existing techniques face hurdles due to model architecture limitations, dataset suitability concerns, and classification imbalance, impeding their ability to recognize children to deter pornographic images. Addressing this challenge, this study introduces Implicit Feature Extraction (IFE), a specialized approach for distinguishing child and adult images in object detection. Leveraging Convolutional Neural Networks (CNNs), the IFE method automates the extraction of discriminative facial features, surpassing the constraints of Explicit Feature Extraction (EFE) methods, which achieve an accuracy of around 70%. The research focuses on three core objectives introducing IFE for detailed face feature detection in DIF's child and adult image identification, implementing IFE with CNNs to enhance image classification, and conducting a thorough evaluation of the proposed technique's performance using key metrics like accuracy and balanced classification results and comparing the result with a basic CNN model’s performance. This research's significance lies in its notable contributions to digital image forensics, particularly in combatting child exploitation. The fusion of IFE with CNNs showcases 92% accuracy in distinguishing child and adult images, promising advancements with practical implications in child protection and forensic investigations. The comprehensive evaluation using the UTKFace dataset underscores the proposed technique's efficacy, marking a substantial improvement in child image identification within digital image forensics.