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ABSTRACT: Like many innovations in surgery, implementing enhanced recovery after surgery (ERAS) programs in pediatric surgery has lagged behind its adult counterpart. Our institutions have recently made a concerted effort to introduce and implement ERAS widely throughout the Department of Pediatric Surgery, which includes 10 surgical specialties. Our strategy revolved around the early inclusion of all stakeholders, significant educational efforts, and creating a roadmap for development and implementation of ERAS programs. It culminated in the first Canadian pediatric ERAS conference, which was held in Montreal on April 28, 2023, and served as a launching pad for instituting an ERAS culture in our hospital. Throughout the process, we identified specific themes that helped emphasize the rationale for pediatric ERAS programs and kept stakeholders engaged in the efforts. In this paper, we share these strategies and themes, believing they can aid other pediatric institutions seeking to initiate an ERAS culture.Level of evidence: V

This article presents the notion about Slow Invariant Manifold (SIM) and their fundamental role in model reduction techniques (MRTs) for challenges encountered in mechanical engineering within dissipative systems of chemical kinetics. Focusing on the reaction routes of complex mechanisms, we construct and compare primary approximations of the SIM through MRTs, including the Spectral Quasi Equilibrium Manifold (SQEM) and Intrinsic Low Dimensional Manifold (ILDM). These methods effectively transform high-dimensional complex problems into lower dimensions, solving them without compromising crucial information about the complex systems modified for homogeneous reactive systems. Employing the sensitivity analysis by using the MATLAB's toolbox, we present the numerical findings in a tabular format obtained through MRTs. This study provides the understanding about the accessible exploration of numerical solutions, improving insights of the complex variation within the system., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

This study investigates the dynamic characteristics of the dual-mode resonant non-linear Schrodinger equation with a Bhom potential. Hydrodynamics, nonlinear optical fibre communication, elastic media, and plasma physics are just a few of the mathematical physics and engineering applications for this model. The study aims to achieve two main objectives: first, to discuss bifurcation analysis, and second, to extract optical soliton solutions using the extended hyperbolic function method. The study successfully derives various wave solutions, including bright, singular, periodic singular and dark solitons, based on the governing model. The findings conferred in this article show a crucial advancement in understanding the propagation of waves in non-linear media. Additionally, bifurcation of phase portraits of ordinary differential equation consistent with the partial differential equation under consideration is conducted. We also highlight specific constraint conditions that ensure the presence of these obtained solutions. The existing literature shows that these methods are first time applied on this model., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: This study aimed to assess the anthropometric measures and pubertal growth of children and adolescents with Type 1 diabetes mellitus (T1DM) and to detect risk determinants affecting these measures and their link to glycemic control., Patients and Methods: Two hundred children and adolescents were assessed using anthropometric measurements. Those with short stature were further evaluated using insulin-like growth factor 1 (IGF-1), bone age, and thyroid profile, while those with delayed puberty were evaluated using sex hormones and pituitary gonadotropins assay., Results: We found that 12.5% of our patients were short (height SDS < -2) and IGF-1 was less than -2 SD in 72% of them. Patients with short stature had earlier age of onset of diabetes, longer duration of diabetes, higher HbA1C and urinary albumin/creatinine ratio compared to those with normal stature (p < 0.05). Additionally, patients with delayed puberty had higher HbA1c and dyslipidemia compared to those with normal puberty (p < 0.05). The regression analysis revealed that factors associated with short stature were; age at diagnosis, HbA1C > 8.2, and albumin/creatinine ratio > 8 (p < 0.05)., Conclusion: Children with uncontrolled T1DM are at risk of short stature and delayed puberty. Diabetes duration and control seem to be independent risk factors for short stature., (© 2024. The Author(s).)