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Vultures constitute globally the most rapidly declining group of birds. Across their wide distribution range, they share common ecological functions and unfavourable conservation status while being associated with varying habitats, lifestyles, cultural standing, and threats. We reveal conceptualisations about the emblematic yet critically endangered Egyptian vulture along its migratory flyway from the Balkans through the Middle East to Africa. Information was gathered through interviews, focus group discussions, and market surveys, with 420 people in 11 participating countries contributing overall. Our results showed that all vultures are recognised primarily for the environmental cleaning services, but the level of awareness differs between countries. Τhe Egyptian vulture has some perceptual advantages based on its white color, migratory nature, and endangered conservation status. This underlines its suitability as a charismatic flagship species that can potentially benefit other vulture species and thus enforce broader vulture conservation initiatives., Supplementary Information: The online version contains supplementary material available at 10.1007/s10745-022-00340-6., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

We explore the impact of COVID-19 on the psychological wellbeing of healthcare trainees, and the perceived value of a digital support package to mitigate the psychological impacts of the pandemic (PoWerS Study). This mixed-methods study includes (i) exposure to a digital support package; (ii) participant survey to assess wellbeing, perceptions of work and intervention fidelity; (iii) semi-structured qualitative interviews. Interviews were digitally recorded and transcribed, data were handled and analysed using principles of thematic framework analysis. Participants are 42 health and medical trainees (9M, 33F) from 13 higher education institutions in the UK, studying during the COVID-19 pandemic. Survey findings showed high satisfaction with healthcare training (92.8%), but low wellbeing (61.9%), moderate to high perceived stressfulness of training (83.3%), and high presenteeism (50%). Qualitative interviews generated 3 over-arching themes, and 11 sub-themes. The pandemic has impacted negatively on emotional wellbeing of trainees, yet mental health is not well promoted in some disciplines, and provision of pastoral support is variable. Disruption to academic studies and placements has reduced perceived preparedness for future clinical practice. Regular check-ins, and wellbeing interventions will be essential to support the next generation health and care workforce, both in higher education and clinical settings. The digital support package was perceived to be accessible, comprehensive, and relevant to healthcare trainees, with high intervention fidelity. It is a useful tool to augment longer-term provision of psychological support for healthcare trainees, during and after the COVID-19 pandemic.

Background: Albuminuria is a potential biomarker of chronic kidney disease (CKD) in various glomerular diseases. Vesicoureteral reflux (VUR) often progresses to CKD, and study is required of use of albuminuria as a biomarker for this condition. The aim of this study was to evaluate the association between albuminuria and glomerular filtration rate (GFR) or filtration fraction (FF) in children with VUR., Study Design: In this retrospective study, renal parameters of 141 children with VUR were investigated, using inulin clearance, FF, and albuminuria. The association between urinary albumin to creatinine ratio (ACR), GFR, and FF was analyzed in a continuous manner by calculating the β coefficient, and also in a binary manner by calculating the OR., Results: Using both continuous and binary analyses, ACR values were negatively and significantly associated to GFR values in patients with low, normal, or high FF values (Table). It was also positively and significantly associated with FF values in patients with low, normal or high GFR values (Table). No association was found between ACR and gender, VUR stages or laterality, number of urinary tract infection, presence of a single functional kidney, history of reflux surgery, or renal scars or hypertension., Discussion: ACR is associated with CKD in patients with VUR. In addition, increased urinary albumin excretion cannot be completely and solely explained by decreased GFR and/or increased FF values. The two main limitations of this study are the crude assessment of renal scarring, which prevented finer analysis between albuminuria and renal scarring surface area, and that the study cohort may not be representative of the true VUR population., Conclusion: This study shows that albuminuria is associated with decreased renal function in patients with VUR and that it could be used to monitor renal function in this condition., (Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

The incidence of inguinal hernias in children is 1-4% with predominance in boys (10 to 1). Based on the data, 0.8-2.4% of premenstrual girls presenting with inguinal hernias have a complete androgen insensitivity syndrome (CAIS). On the other hand, 80-90% of girls with CAIS present uni- or bilateral inguinal hernias. Unfortunately, this burdened pathology is very rarely looked for by pediatricians, or paediatric surgeons.

Purpose: We assessed the correlation between urodynamic score and presence of symptoms in children with lipomyelomeningocele, and the usefulness of this measure in monitoring these children., Materials and Methods: We prospectively evaluated 29 patients 1 month to 13 years old (mean 1.9 years) with lipomyelomeningocele from 1995 to 2010. A 4-parameter urodynamic score ranging from 0 to 17 was assigned to each patient at diagnosis and followup. Indications for surgery were presence of symptoms and signs or abnormal urodynamic score. Children were divided into 2 groups, symptomatic and asymptomatic. The latter group was further divided into operated and conservatively managed cases. Average followup was 6.7 years (range 2 to 16)., Results: The symptomatic group contained 11 children (38%) operated on at a mean age of 2.9 years. Mean followup was 6.7 years (range 2 to 12). All patients presented with an abnormal urodynamic score. Postoperative urodynamic score improved in 6 patients (55%), remained abnormal in 4 (36%) and deteriorated in 1 (9%). The asymptomatic group contained 18 patients, of whom 7 (39%) were operated on at a mean age of 1.4 years. Mean followup was 10 years (range 3 to 16). Postoperative score improved in 6 patients (86%) and remained unchanged in 1 (14%). A total of 11 cases (61%) were managed conservatively, with a mean followup 4.3 years (range 2 to 7). Of these patients 3 (27%) presented with late urodynamic score deterioration at 3, 5 and 6 years of followup while remaining asymptomatic., Conclusions: Urodynamic score is a useful tool in monitoring children with lipomyelomeningocele because it has a good correlation with the presence of symptoms., (Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Tinea capitis is a fungal infection of the scalp and hair shaft that mainly affects prepubescent children. Its clinical aspects range from a mild noninflammatory infection resembling seborrheic dermatitis to a highly inflammatory swelling reaction (kerion). We report the cases of 2 children who underwent surgical treatment of their kerions under general anesthesia. One lesion had been incised and the other excised. This inappropriate treatment made conservative treatment after surgery more difficult. We recommend that abscesslike lesions on the scalps of children be carefully investigated by surgeons and dermatologists to determine whether they are the result of a dermatophytic infection in order that the appropriate conservative treatment can be initiated.

Objectives: To investigate the development of the ureterovesical junction in rats., Methods: A total of 110 albino rats (50 prenatal and 60 newborn) with a gestation of 21 days were studied at the age of 17 days after conception until 5 days after birth. The lower urinary tract was microdissected. Microphotography (110 animals), histologic examination (44 animals), and scanning electron microscopy (66 animals) of the ureterovesical junction were performed. Urea and creatinine from the amniotic fluid of 20 fetuses and from the urine of 10 neonates were measured., Results: At day 17 after conception, separate penetration of the mesonephric duct and ureter into the wall of the urogenital sinus was observed. Continuity between the lumen of the ureter and the urogenital sinus was established on day 19 after conception. The straight passage of the intramural ureter into the urogenital sinus at day 17 after conception changed to the definitive L-shape with a vertical entry into the bladder on day 5 after birth. In the distal ureter, the change of the mesenchymal tissue into immature smooth muscle was first observed at birth, and the muscle became mature on the fifth postnatal day. At birth, Waldeyer's sheath was recognized. The creatinine and urea levels were stable prenatally (average 22.4 micromol/L and 6.88 mmol/L, respectively) and rose significantly postnatally (average 133 micromol/L and 32.65 mmol/L, respectively)., Conclusions: The attachment of the ureter to the urogenital sinus and later to the bladder, the modification of its passage, and its mobility within Waldeyer's sheath may be essential in preventing vesicoureteral reflux. The production of urine and its flow does not seem to be the trigger of ureteral smooth muscle formation.