Surfaces In Children Research Articles

Environmental risk estimation of potentially toxic metal(loid)s (PTMs) in fine particulate dust on the surface of children's playgrounds in parks

To determine the priority control factors for risk control and management of potentially toxic metal(loid)s (PTMs) in fine particulate dust (FPD) on the surface of children's playgrounds in parks, a comprehensive study was conducted on the pollution, risks, and sources of 12 PTMs in the FPD, taking Xi’an, China as a case. The pollution, ecological and health risks of PTMs were assessed using Nemerow integrated enrichment factor, modified Nemerow integrated eco–risk index, and health risk evaluation model, combined with Monte Carlo simulation. The sources of PTMs in the FPD were quantitatively apportioned using a positive matrix factorization model. Priority control factors for PTMs risk control and management were determined based on the results of source–oriented pollution and risk assessment. The results showed that the average contents (mg kg–1) of Cd (1.9), Cr (99.8), Cu (96.3), Hg (0.2), Pb (61.1), and Zn (239.4) in the FPD were considerably greater than local background values. The sources of PTMs in the FPD are industrial emission, coal combustion and medical activities, mixed source, and natural source, contributing 24.7%, 18.2%, 35.1%, and 22.1% to the total content of PTMs in the FPD, respectively. PTMs in the FPD posed a certain cancer risk to the elderly and children. Industrial emissions and mixed sources are priority control sources, while Cd and Cr are priority PTMs. It is recommended that local eco–environmental departments strengthen environmental monitoring of playgrounds, as well as management of industrial and transportation emissions, to ensure the health of residents.

Integrated Health Solutions: Addressing the Co-occurrence of Otitis Media With Effusion and Early Childhood Caries in Preschool Children.

Introduction: Otitis media with effusion (OME) is a common middle ear condition, which frequently affects children and can lead to hearing impairment, speech delays, and developmental issues. Early childhood caries (ECC) is another prevalent pediatric condition defined by the presence of decayed, missing, or filled tooth surfaces in children under six years old. Objectives: This study aims to determine the prevalence of OME and ECC, the association between these two conditions, and the risk and severity of ECC among preschool children with OME. Methodology: A prospective cross-sectional study was conducted at a single tertiary center. A total of 206 preschool children aged six and below with hearing impairment or speech delay were recruited. They were grouped as follows: with OME (n= 129) and without OME (n = 77). Demographic and socioeconomic data were obtained, followed by otoscopy, anterior rhinoscopy, and tympanometric assessment. The subjects were further stratified into having ECC or not by conducting a dental examination for caries detection, whose findings were documented using Dental Charting and Caries Risk Assessment (CRA). Tympanometric width (TW) was also analyzed to measure its association with tympanic membrane appearance. Results: 51.5% (n=106) of children with OME were found to have ECC. They predominantly had mild ECC (49.1%), and most (51%) were at moderate risk for caries based on the CRA (P < 0.001). A significant association between OME and ECC was observed (p < 0.001). Tympanometry results documented a strong correlation between TW greater than 200 daPa and abnormal tympanic membrane findings in OME (P< 0.001). Conclusions: The association between OME and ECC in preschool children necessitates integrated healthcare approaches for early detection and management. Reliable diagnostic tools, such as tympanic width measurement for OME and CRA for ECC, are crucial in addressing these health issues. Early intervention and comprehensive care can mitigate the risks and improve health outcomes for affected children.

Conjunctival Histopathological Changes and Clinical Tear Film in Children with Atopic Dermatitis.

Evaluation of changes in the ocular surfaces in children with a diagnosis of atopic dermatitis (AD). Thirty-six children with a diagnosis of AD (Eye-AD group) and 40 healthy subjects (Eye-HS group) were enrolled in this prospective case-control study. Tear film break-up time (T-BUT), Schirmer tear test (STT), conjunctival impression cytology (CIC), tear meniscus height (TMH), tear meniscus area (TMA), and ocular surface disease index (OSDI) were measured. The participants were similar in terms of demographic characteristics, such as mean age and gender (p > 0.05). The mean T-BUT was 9.3 ± 2.22 s (5 - 16) in the Eye-AD group and 11.83 ± 2.03 s (7 - 16) in the Eye-HS group. The mean STT was 11.12 ± 3.28 mm (5 - 21) in the Eye-AD group and 15.44 ± 3.8 mm (8 - 20) in the Eye-HS group (p < 0.001, p < 0.001, respectively). The mean OSDI scores were 13.12 ± 1.41 (10 - 15) in the Eye-AD group and 13.97 ± 2.93 (8 - 20) in the Eye-HS group (p = 0.052). Mean TMH and TMA were 306.48 ± 7.29 µm and 0.22 ± 0.004 mm2, respectively, in the Eye-AD group, and 312.94 ± 5.31 µm and 0.027 ± 0.005 mm2, respectively, in the Eye-HS group. In the CIC analyses, 22 of the samples in the Eye-AD group and 35 in the Eye-HS group had a classification of grade 0, 10 in the Eye-AD group and 5 in the Eye-HS group had a classification of grade 1, and 4 in the Eye-AD group and none in the Eye-HS group had a classification of grade 2 (p = 0.015). Pediatric patients with AD may have significant changes in conjunctival histopathology. These changes can be manifested in the tests used to measure the tear film. Dry eye was shown to be present in the majority of children with AD.

Contamination of surfaces in children's homes with nicotine and the potent carcinogenic tobacco-specific nitrosamine NNK.

Tobacco smoke exposure (TSE) through secondhand and thirdhand smoke is a modifiable risk factor that contributes to childhood morbidity. Limited research has assessed surface TSE pollution in children's environments as a potential source of thirdhand smoke exposure, and none have examined levels of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) on surfaces. This study measured surface NNK and nicotine in children's homes and associations with sociodemographics and parent-reported TSE behaviors. We assessed correlations of surface NNK and nicotine with dust NNK, dust nicotine, and child cotinine. Home surface wipe NNK and nicotine data from 84 children who lived with smokers were analyzed. Tobit and simple linear regression analyses were conducted to assess associations of surface NNK and nicotine with child characteristics. Spearman's (ρ) correlations assessed the strength of associations between environmental markers and child cotinine. Nearly half (48.8%) of children's home surfaces had detectable NNK and 100% had detectable nicotine. The respective geometric means (GMs) of surface NNK and nicotine loadings were 14.0 ng/m2 and 16.4 µg/m2. Surface NNK positively correlated with surface nicotine (ρ = 0.54, p < 0.001) and dust NNK (ρ = 0.30, p = 0.020). Surface nicotine positively correlated with dust NNK (ρ = 0.42, p < 0.001) and dust nicotine (ρ = 0.24, p = 0.041). Children with household incomes ≤$15,000 had higher surface NNK levels (GM = 18.7 ng/m2, p = 0.017) compared to children with household incomes >$15,000 (GM = 7.1 ng/m2). Children with no home smoking bans had higher surface NNK (GM = 18.1 ng/m2, p = 0.020) and surface nicotine (GM = 17.7 µg/m2, p = 0.019) levels compared to children with smoking bans (GM = 7.5 ng/m2, 4.8 µg/m2, respectively). Although nicotine on surfaces is an established marker of thirdhand smoke pollution, other thirdhand smoke contaminants have not been measured on surfaces in the homes of children living with smokers. We provide evidence that the potent carcinogenic tobacco-specific nitrosamine NNK was detectable on surfaces in nearly half of children's homes, and nicotine was detectable on all surfaces. Surface NNK was positively correlated with surface nicotine and dust NNK. Detectable surface NNK levels were found in homes with indoor smoking bans, indicating the role of NNK as a persistent thirdhand smoke pollutant accumulating on surfaces as well as in dust.

Different pollution levels and source profiles of heavy metals in the soil and surface dust of children's playgrounds in a coastal city; source-specific health risk assessment

This study compared the pollution levels, health risks, and sources of heavy metals (HMs) in the dust accumulated on the play equipment and the soil of children's playgrounds located in a humid subtropical city (Bandar Abbas, Iran). Therefore, a total of 74 samples of soil and equipment dust were collected from 37 children's playgrounds and the concentrations of HMs were analyzed by Inductively Coupled Plasma Optical Emission spectroscopy (ICP-OES). The concentration levels of all the studied HMs including As, Cd, Co, Cr, Cu, Mn, Ni, Pb, and Zn in dust were higher than those of soil. Health risks attributed to the HMs in soil and dust were assessed using Monte Carlo simulation approach. Accordingly, the non-carcinogenic (2.60E+1) and carcinogenic (1.71E-5) risks associated with the children's exposure to HM-polluted dust in these places were relatively high. Positive Matrix Factorization (PMF) model and its integration with health risk assessment models showed that the lithogenic source was the main contributor to both HMs concentrations and HMs-induced health risks with >65% contribution. The HMs in the dust accumulated on the equipment surface were found to be originated from the local (suspended local soil) and distant (industrial and traffic airborne emissions) sources, and from the plastic material of play equipment. The latter showed the highest contribution to the non-carcinogenic risk (37.5%). The results of this study imply the necessity for regularly cleaning of touchable surfaces in children's playgrounds, protecting the play equipment against aggressive environmental conditions, and controlling the critical sources of pollution.

SEQUELAE OF HAND BURN: EPIDEMIOLOGICAL AND THERAPEUTIC ASPECTS IN MOROCCAN STUDY

Hand burns can result in both aesthetic and functional sequelae, which are often intertwined, ranging from simple dyschromia to multidigital amputation. They can be minor, requiring medical treatment, or major, requiring surgical treatment consisting of skin grafting or various flaps and plasties. To study the epidemiological, clinical, therapeutic, and evolutionary characteristics of burned hand sequelae, we conducted a retrospective study at the Plastic and Burn Surgery Department of the Mohammed VI University Hospital Center in Marrakech, from January 2013 to December 2017. The study collected 104 cases, including patients with burn sequelae in at least one hand. This work shows that almost one in two patients hospitalized for burns has a burn on at least one hand. The study also shows the frequency of young adult injuries (42%) and children under six years old (33%) in domestic accidents (76%), the frequency of burns to the dorsal surface of the hands from butane flames in the Hand-Face Syndrome in adults, and the frequency of burns to the palmar surface in children. Concerning the sequelae phase, our study shows the frequent association of major sequelae (contractures, retraction, pathological scars) and minor sequelae (dyschromia, itching, scar fragility, cutaneous hyperesthesia). The sequelae were dominated by digital and digito-palmar retractions (65.5%). A functional deficit was observed in more than two-thirds of cases. Various means of reconstruction were used depending on the location and type of sequelae local plasties were performed in 84.6% of cases, and excision-grafts in 76.9% of cases. The most commonly used local plasties were the Z plastie (65.5% of cases) and the trident plasty (26.5% of cases). 78% of the grafts used to treat sequelae were full-thickness skin grafts. The evolution was marked by a satisfactory result for most treated patients. The management of burned hands is multidisciplinary, requiring cooperation between surgeons, physicians, rehabilitators, physiotherapists, and psychologists.

Microbiological Characteristics of Ocular Surface Associated With Dry Eye in Children and Adolescents With Diabetes Mellitus.

To analyze the characteristics of ocular surface microbial composition in children and adolescents with diabetes mellitus and dry eye (DE) by tear analysis. We selected 65 children and adolescents aged 8 to 16 years with DE and non-DE diabetes mellitus and 33 healthy children in the same age group from the Shanghai Children and Adolescent Diabetes Eye Study. Tears were collected for high-throughput sequencing of the V3 and V4 region of 16S rRNA. The ocular surface microbiota in diabetic DE (DM-DE; n = 31), diabetic with non-DE (DM-NDE; n = 34), and healthy (NDM; n = 33) groups were studied. QIIME2 software was used to analyze the microbiota of each group. The DM-DE group had the highest amplicon sequence variants, and the differences in α-diversity and β-diversity of micro-organisms in the ocular surfaces of DM-DE, diabetic with non-DE, and healthy eyes were statistically significant (P < 0.05). Bacteroidetes (15.6%), Tenericutes (9.3%), Firmicutes (21.8%), and Lactococcus (7.9%), Bacteroides (7.8%), Acinetobacter (3.9%), Clostridium (0.8%), Lactobacillus (0.8%) and Streptococcus (0.2%) were the specific phyla and genera, respectively, in the DM-DE group. Compared with the patients with non-DE and healthy children, the microbial diversity of the ocular surface in children and adolescents with diabetes mellitus and DE was higher with unique bacterial phyla and genera composition.

Relación entre la mancha negra extrínseca y la caries dental en una población de Argentina

Many published studies express that the presence of extrinsic black stain on the enamel of tooth surfaces in children and adolescents is associated with less dental caries (CD) activity, this being valid for both primary and permanent dentition.The objective or this researh was to carry out a multifactorial approach to know the relationship between the presence of extrinsic black stain and the presence of caries, in a population of the city of Córdoba, Argentina.Methods. A case-control study (5: 1) was carried out in patients of both sexes from 3 to15 years of age, between the years 2016-2019, who were attended by spontaneous request to the Chair "A" of Pediatric Dentistry, of the Faculty of Dentistry, from the National University of Córdoba (n = 184). All patients underwent a Clinical History. Stimulated saliva was extracted for calcium and phosphate determination and dental biofilm was taken to measure CFU / mL of Streptococcus mutansand Lactobacillus spp.Results. The prevalence of extrinsic black spot was 1.78%. No significant association was found between sex, age and types of dentition between the groups studied. In the problem group, a lower amount of CFU / mL of S. mutans and Lactobacilluss pp was found, a higher concentration of calcium and phosphate and a lower caries index of the primary dentition. Patients with extrinsic black spot had a much lower rate.Conclusions. The extrinsic black spot could be an element of protection against caries, the recommendation for patients who present them would be to remove them from the visible areas and keep them in the rest of the dental elements

The caries pattern of tooth surface of children at SDN Mangaran 2 in Kebun Renteng, Jember Regency

Objective: To determine the caries pattern of tooth surface of children at SDN Mangaran 2 in Kebun Renteng Jember. Methods: Descriptive observational with a cross sectional approach. The sample were students of class I-III totaling 38 students with a total sampling technique. The data were discussed descriptively and presented in tabular form. Results: Caries in primary teeth was more common on the mesial surface and the least on the facial or buccal surface; whereas caries in permanent teeth was more common on the occlusal surface. Conclusion: The mesial surface is the most caries-prone surface in primary teeth, while in permanent teeth it is the occlusal surface

Ultrasonography of the bone surface in children: normal and pathological findings in the bone cortex and periosteum.

Ultrasound (US) is widely used in pediatric musculoskeletal pathology at all ages. Although the focus is often on soft tissues, joints and cartilage, the examiner might be confronted with changes in the underlying bone surface that are important to understand and integrate in the diagnosis. This article illustrates the normal US aspects of the cortical bone surface and periosteum, as well as the most common US anomalies seen in infections, trauma and bone tumors in children.

The effect of feeding methods and non-nutritive sucking habits on early childhood caries and development of occlusion (A cross-sectional study)

Background and objectives: Early Childhood Caries (ECC ) is the most common chronic disease conditioning childhood and involves the presence of one or more decayed (noncavitated or cavitated lesions),missing(due to caries), or filled tooth surfaces in children under 72 months of age.Time and frequency of breast-feeding, artificial feeding and of non-nutritive sucking habits can influence orofacial development, and when negative can provoke instability of orofacial function. Sucking habits involving digits or dummies are the most tangible environmental factors that play a role in the etiology of malocclusion.Subjects and method: A cross sectional study performed on aconvenient samples of 500 preschool child renaged between 4-6 years old in Erbil city. Parents (mothers ) were asked for a permission to include their children in the study. A short interview with the mothers of the children preceded the dental examination. The clinical examination included child weight, height determination and dental examination.Results: The results showed that prevalence of caries in breast fed children was (70.6%), in bottle was (62.4%) and both fed children was (65%) with no significant association between type of feeding and caries prevalence (P=0.298). Mean dmfs in males was (9.84±12.99) which is higher than mean dmfs of females (7.39 ±10.58). Class II canine classification was higher in bottle and both feeding than in breast feeding and there was no prevalence of Class III canine relation was found in bottle feeding.Conclusion: Type of feeding was not found to be related to development of early childhood caries in primary dentition of preschool children. Bottle feeding was considered as a risk factor for development of class II canine relation. Non-nutritive sucking (finger, pacifier sucking and both) were found to be risk factors for the development of anterior open bite and posterior cross bite. Finger sucking produces the development of unilateral posterior cross bite in primary dentition.

Швидка нейтралізація травмуючих гіпертермічних чинників ушкодження при опіках у дітей на етапах само-, взаємо- та першої долікарської допомоги

Occupying a leading position in the structure of general injuries, burn injuries in children remain an urgent issue of combustiology in particular and medicine in general. At the same time, many issues related to the organization of first aid to such patients still remain unregulated. To this end, a study aimed at conducting a comparative analysis of the clinical effectiveness of emergency care for children with burn injuries, including the use of the suggested algorithm, was conducted. Materials and methods. 153 cases of burn injuries with boiling water of IIab–III degree on the area of 10–40% of the body surface in children aged from 8 months to 16 years, who were treated at the Clinical Center for Thermal Injury and Plastic Surgery of the Municipal Non-profit Enterprise «Vinnytsia Regional Pirogov Clinical Hospital Vinnytsya Regional Council» in the period of 2015–2020 were analyzed. All patients underwent comprehensive diagnosis and treatment including surgery. Depending on the nature of first aid, children were divided into two groups: patients of the main group (n=97) underwent prompt neutralization of the traumatic effects of exogenous hyperthermic factors on the injured areas from the moment the injury was sustained. Childrenin the control group (n=56) sought help on the 5th–14th day after the injury. The duration of prompt neutralization did not exceed 15 minutes or was not performed at all. It was often combined with the irrational use of pharmacological agents and folk remedies. Results. Comparative analysis of the course of the disease in children of the main group and the comparison group reliably confirmed the benefits of prompt neutralization of traumatic effects of hyperthermic exogenous and endogenous damage factors in burn injuries manifested by a more favorable course of the disease, faster improvement, lower local and systemic inflammatory response, shorter hospital stay with less occurrence of various complications, repeated surgical interventions, better aesthetic and functional results. Conclusions. The obtained results objectively confirmed the importance and effectiveness of the suggested system of organization of care for children with burn injuries, especially at the stages of self-help, mutual assistance and first aid. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: burn injuries, children, first aid, traumatic hyperthermic agents, neutralization.

Influence of orthopedic shoes on the indicators of the interzonal load distribution on the foot when walking patients with cerebral palsy

BACKGROUND: Clinical observations of patients with spastic forms of cerebral palsy and surveys showed the most commonly used technical rehabilitative device of this patient contingent are orthopedic shoes. However, almost no clinical and instrumental studies examine the effect of such shoes on the walking characteristics of patients with cerebral palsy (CP).&#x0D; AIM: This study aims to estimate the effect of orthopedic shoes on the interzonal load distribution on the plantar foot surface in children with CP and adolescents with different levels of gross motor function disorders (GMFCS).&#x0D; MATERIALS AND METHODS: Biomechanical studies were conducted in 42 patients with CP 5-16 years old with GMFCS 13 level while wearing standard and orthopedic shoes. In 14 healthy children controls while wearing standard shoes (a total of 112 feet). Biomechanical examinations were performed on the software and hardware complex DiaSled-M-Scan with matrix plantar pressure meters in the form of insoles. Statistical data analysis was performed using nonparametric methods via SPSS software for Windows.&#x0D; RESULTS: The use of complex orthopedic shoes in patients with level GMFCS 1 did not improve but worsened their foot loading parameters. The shoes reduced the loading of the heel, increased the toe-heel load ratio, and mediolateral load distribution in the fascicle area. In patients with GMFCS 2, the positive effect of orthopedic shoes was limited to improving the mediolateral load distribution in the fascicle area. In patients with GMFCS 3, the positive effect of orthopedic shoes was noted in the majority of the tested parameters.&#x0D; CONCLUSION: Thus, the study showed that in children and adolescents with CP using complex orthopedic shoes led to the most significant normalization of interzonal load distribution under the foot in GMFCS 3 patients, less significant in GMFCS 2 patients, and worsened the parameters in GMFCS 1 patients.

Cortical current density magnitudes during transcranial direct current stimulation correlate with skull thickness in children, adolescent and young adults.

Transcranial direct current stimulation protocols are often applied with a fixed parameter set to all subjects participating in an interventional study. This might lead to considerable effect variation in inhomogeneous subject groups or when transferring stimulation protocols to different age groups. The aim of this study was to evaluate magnitude differences of the electric current density distribution on the gray matter surface in children, adolescent and adults in correlation with the individual volume conductor geometry. We generated individual six compartment finite element models from structural magnetic resonance images of four children (age: 10.95 a±1.32 a), eight adolescents (age: 15.10 a±1.16 a) and eight young adults (age: 21.62 a±2.45 a). We determined the skull thickness in the models as Euclidean distance between the surface of the cerebrospinal fluid compartment and outer skull boundary. For tDCS simulations, we modeled 5×7cm patch electrodes impressing 1mA current intensity as anode and cathode over the left M1 and the right fronto-polar orbit, respectively. The resulting current density was analyzed on the gray matter surface. Our results demonstrate higher cortical current density magnitudes in children compared to adults for a given tDCS current strength. Above the evaluated cortex, the skull thickness increased with age. In conclusion, we underline the importance of age-dependent and individual models in tDCS simulations.

Parental hostility predicts reduced cortical thickness in males.

Although impacts of negative parenting on children's brain development are well-documented, little is known about how these associations may differ for males and females in childhood. We examined interactions between child sex and early and concurrent parental hostility on children's cortical thickness and surface area. Participants included 63 children (50.8% female) assessed during early childhood (Wave 1: M age=4.23years, SD=0.84) and again three years later (Wave 2: M age=7.19years, SD=0.89) using an observational parent-child interaction task. At Wave 2, children completed a structural MRI scan. Analyses focused on regions of interest. After correcting for multiple comparisons, Wave 1 parental hostility predicted males' reduced thickness in middle frontal and fusiform cortices, and Wave 2 parental hostility was concurrently associated with males' reduced thickness in the middle frontal cortex. Interactions between sex and parenting on children's surface area did not survive corrections for multiple comparisons. Our findings provide support for a male-specific neural vulnerability of hostile parenting across development. Results have important implications for uncovering neural pathways to sex-differences in psychopathology, learning, and cognitive disabilities.

The Effect of 0.01% Atropine Eye Drops on the Ocular Surface in Children for the Control of Myopia-The Primary Results from a Six-Month Prospective Study.

PurposeTo evaluate the effect of 0.01% atropine eye drops on the ocular surface in children for the control of myopia.MethodsA total of 72 participants were recruited for this prospective study. Prior to and after 1, 3, and 6 months of 0.01% atropine administration, an ocular surface disease index (OSDI) questionnaire was obtained, Keratograph 5M was used for the measurement of the tear meniscus height (TMH), noninvasive keratographic tear film break-up time (NK-BUT, the first keratographic break-up time, [NK-BUTfirst] and the average keratographic break-up time, [NK-BUTave]), bulbar redness (BR), meiboscore (MS), and anterior segment optical coherence tomography (AS-OCT) was used to calculate the inferior tear meniscus area (TMA).ResultsAfter using the 0.01% atropine eye drops for 1 month, 9 subjects complained of discomfort immediately after administration, but this quickly subsided, and 1 subject was temporarily dazzled. All the ocular surface symptoms were mild and occurred rarely. After 3 months, these complaints no longer occurred. Compared with the baseline values, the OSDI scores (0.08 ± 0.28), values of TMH (0.23 ± 0.04 mm), TMA (0.0420 ± 0.0444 mm2), NK-BUTfirst (9.39 ± 5.25 s), NK-BUTave (10.49 ± 4.94 s), BR (0.63 ± 0.37), and MS (0.89 ± 0.70) did not change significantly after 6 months of 0.01% atropine eye drop administration (P > 0.05).ConclusionIn this 6-month prospective study, no side effects were observed on the ocular surface after using 0.01% atropine in children.

Surgical treatment of children with hip dysplasia complicated with avascular necrosis of the femoral head

Introduction. Avascular necrosis of the femoral head complicates the surgical treatment of hip dysplasia and aggravates the prognosis.&#x0D; Aim. We studied the immediate and medium-term results of reconstructive treatment in 18 children with hip dysplasia complicated by avascular femoral head necrosis, which developed after closed repositioning of a congenitally dislocated femur.&#x0D; Material and methods. Average age at the time of operation was 4.2 0.2 years. The patients were divided into two groups. Group 1 included 12 children with hip subluxation who underwent extra-articular reconstructions on articular components, spinal tunneling of the neck and head, and hardware unloading of the joint and group 2 included six patients with hip dislocation in whom an additional open reduction was performed. Functional results were estimated using DAubigne-Postel classification, whereas X-ray results were evaluated using Kruczynski classification.&#x0D; Results. Duration of observation was 37 years (average, 4.2 0.3 years). Functional results were good (1518 points) in nine joints in group 1, satisfactory (1214 points) in three joints in group 1 and five in group 2, and unsatisfactory (11 points) in one joint in group 2. X-ray results were good in six joints in group 1, satisfactory in six joints in group 1 and five in group 2, and unsatisfactory in one joint in group 2.&#x0D; Conclusions. Extra-articular reconstructive and stimulatory interventions combined with hardware decompression helps improve the shape and structure of the femoral head, and formation of congruent articular surfaces in children with subluxation of the thigh complicated by avascular necrosis.

Alterations of Tear Film and Ocular Surface in Children with Type 1 Diabetes Mellitus

ABSTRACTPurpose: To investigate whether diabetes mellitus (DM) affects ocular surface of children with well-controlled type 1 DM.Methods: Sixty-five diabetic patients and 55 age-matched controls enrolled to study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test, and conjunctival impression cytologic analysis were performed.Results: Schirmer test and TBUT results were significantly lower in DM group than controls (p = 0.001, for all). OSDI scores of all participants were within normal range. Impression cytology analysis showed grade 0 changes in all participants and there was no difference between groups for goblet cell density (p > 0.05). The TBUT results were significantly associated with duration of DM (r = −0.309, p = 0.036).Conclusion: Diabetic children without symptoms, signs, and definite diagnosis of dry eye still had lower TBUT and Schirmer test results than controls; however, impression cytology analysis was similar in both groups.

Ensembling rules in automatic analysis of pressure on plantar surface in children with pes planovalgus

PurposeThis paper presents a method of ensembling rules obtained through induction of several basic types of decision trees. Material and methodsThe proposed method uses rules generated by means of well-known decision trees: CART, CHAID, exhaustive CHAID and C4.5. The method was tested on data describing pressure distribution under foot during gait in children with pes planovalgus (PV) and typical foot. Children with pes planovalgus underwent surgical intervention and were re-examined. Overall, 316 gait cycles have been used in analysis. ResultsThe obtained results consist of a set of rules for all considered cases and show that the proposed method may be a useful tool of gait analysis on the basis of parameters that have a physical interpretation. ConclusionsThe presented method for mining rules useful in this respect may be successfully used by persons with a typically medical knowledge and could improve the understanding of the human gait phenomenon. There is obviously no reason why this method could not be used in the case of other data as well.

The developing role of transparent surfaces in children's spatial representation

Children adeptly use environmental boundaries to navigate. But how do they represent surfaces as boundaries, and how does this change over development? To investigate the effects of boundaries as visual and physical barriers, we tested spatial reorientation in 160 children (2–7 year-olds) in a transparent rectangular arena (Condition 1). In contrast with their consistent success using opaque surfaces (Condition 2), children only succeeded at using transparent surfaces at 5–7 years of age. These results suggest a critical role of visually opaque surfaces in early spatial coding and a developmental change around the age of five in representing locations with respect to transparent surfaces. In application, these findings may inform our usage of windows and glass surfaces in designing and building environments occupied by young children.