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Abstract Background and Aims The evolving mutants of SARS‐CoV‐2 have made the COVID‐19 pandemic sustained for over 3 years. In 2022, BA.4 and BA.5 were the Omicron variants dominating the spread globally. Although COVID‐19 was no longer a Public Health Emergency of International Concern (PHEIC) as announced by WHO, the SARS‐CoV‐2 variants remain a challenge to global healthcare under the circumstances of withdrawal and loosening of personal protective behavior in the post‐quarantine era. This study aims to acknowledge the clinical characteristics caused by Omicron BA.4/BA.5 in COVID‐19 naive people and analyze possible factors affecting disease severities. Methods In this retrospective study, we report and analyze the clinical features of 1820 COVID‐19 patients infected with the BA.4/BA.5 Omicron variants of SARS‐CoV‐2 during a local outbreak that occurred in Macao SAR, China, from June to July 2022. Results A total of 83.5% of patients were symptomatic eventually. The most common symptoms were fever, cough, and sore throat. Hypertension, dyslipidemia, and diabetes mellitus were the leading comorbidities. There were significantly more elderly patients (p

Sleep problems are common in children with autism spectrum disorder. Although previous research has shown the positive effects of parent-based sleep intervention, it was mainly focused on face-to-face modality, which might limit accessibility. This study aimed to examine the efficacy of a telehealth-delivered parent-based sleep-focused intervention in treating insomnia in preschool children with autism spectrum disorder. A total of 62 parents/caregivers with a child with autism spectrum disorder and comorbid insomnia (aged 3-6 years) were randomized to receive either three weekly group sessions of sleep-focused intervention via Zoom with telephone support (n = 30) or treatment as usual (n = 32). The intervention group had significantly greater improvements in overall sleep problems (Children's Sleep Habit Questionnaire total score; p < 0.05), bedtime resistance (p < 0.05), and sleep-onset delay (p < 0.05) at post-treatment as compared to the treatment as usual group. The intervention group also showed significant improvements in overall behavioral and emotional problems (p < 0.05), especially externalizing problems (p < 0.05) as measured by Strengths and Difficulties Questionnaire, and parental stress level (p < 0.05) as measured by Depression, Anxiety and Stress Scale-21 as compared to the treatment as usual group (partial [eta][superscript 2] = 0.081-0.101). The findings supported the feasibility and promising effects of a brief parent-based sleep intervention delivered via telehealth.

This study explores the captivating world of toy unboxing videos as a space for emergent bilingual children to engage in translanguaging practices. Through the lens of translanguaging, which encourages the unrestricted use of full linguistic repertoires, this research examines the experiences of two five-year-old immigrant and emergent bilingual children, who employ linguistic repertoires from both English and Korean, within toy unboxing play. Toy unboxing play is not exclusive to these children alone but extends beyond as a shared phenomenon of new play among children across the globe. This ethnographic case study seeks to understand when and how translanguaging is employed in their toy unboxing play and explores the possibilities it opens for fostering inclusive views on linguistic practices among emergent bilingual children. In our findings, we argue that toy unboxing play can be a way of creating translanguaging space facilitating the deployment of children's linguistic repertoires and contributing to their meaning-making and learning processes. The translanguaging practices exhibited by the children in their toy unboxing play demonstrate linguistic flexibility across three key domains: (1) playful interaction with toys and self, (2) emotional interaction with families and intimate others, and (3) transcultural interaction with peers and virtual audience. The study contributes valuable insights into the potentialities of translanguaging within the context of children's play. Translanguaging emerges not only as a linguistic phenomenon but as a holistic approach to communication, reflecting the multifaceted nature of emergent bilingual children's identities and experiences. The hybridized approach observed in their play underscores the importance of recognizing translanguaging as a way of being and belonging for children and families with transnational and transcultural backgrounds. By shedding light on the intricate interplay between language, culture, and play, this research deepens our understanding of inclusive and liberating translanguaging spaces for emergent bilingual children.

Across all cultures, parents have intuitive ideas ("ethnotheories") of what undesirable child characteristics are as well as how to explain them. Yet there have been relatively few cross-cultural comparisons of parents' ethnotheories about the nature and causes of child misbehavior. 108 mothers of 5-year-old children from the United States (N = 52; M[subscript age] = 5.26, SD = 0.07) and mainland China (N = 56; M[subscript age] = 5.31, SD = 0.20) were recruited to participate in a semi-structured interview that allowed parents to generate open-ended responses in relation to the nature and causes of children's misbehavior. Parents were asked to describe the behaviors they would least like to see in their children, before providing causal attributions to a series of hypothetical vignettes depicting a range of externalizing-type child behaviors. Parents' responses were coded based on common themes. Across both cultures, mothers endorsed social insensitivity as the most undesirable child characteristic. With regard to cross-cultural differences, mothers from the US highlighted aggressive and disruptive behaviors as the most salient child misbehaviors, whereas parents from mainland China emphasized cognitive and motivational difficulties. Regarding causes of child misbehaviors, American mothers were more likely than Chinese mothers to report momentary internal states as the primary causes of child misbehavior, followed by immature development. Conversely, Chinese parents attributed child misbehavior primarily to social influences, followed by temperament. Our results provide a significant contribution to our understanding on how parents across cultures define and explain misbehaviors in young children.

Are children from "Eastern" cultures less emotionally expressive and reactive than children from "Western" cultures? To answer this, we used a multi-level and multi-contextual approach to understand variations in emotion displays and cortisol reactivity among preschoolers living in China and the United States. One hundred two preschoolers from China (N = 58; 55% males) and the United States (N = 44, 48% males) completed three (i.e., control, interpersonal-related, and achievement-related) emotion-challenging paradigms over 3 days. Behavioral emotion expressions were coded, and salivary cortisol was sampled 30 minutes before and across 90 minutes post-task. Without considering context, Chinese preschoolers displayed fewer levels of positive and negative emotion expressions relative to their United States counterparts. However, Chinese preschoolers displayed similar levels of expressions as their United States counterparts during an achievement-related challenge that is more salient to their sociocultural emphases and showed higher negative emotion expressions in this challenge, relative to other contexts. Moreover, only the achievement-related challenge elicited increased cortisol levels among Chinese preschoolers, and this was correlated with higher levels of negative expressions. For US preschoolers, no cortisol increase was observed in any challenging paradigms, nor was cortisol associated with emotional expressions. Findings counter prior notions that East Asian children are generally less emotionally expressive. Instead, an achievement-related challenge elicited higher emotion expression and cortisol reactivity among Chinese preschoolers, suggesting that children's emotion expression and biological reactivity may be most responsive to contexts salient to their socio-cultural environments. We discuss the importance of considering cultural contexts when studying emotion regulation.

Type 2 diabetes mellitus (T2DM) increases the risk of neurological diseases, yet how brain oscillations change as age and T2DM interact is not well characterized. To delineate the age and diabetic effect on neurophysiology, we recorded local field potentials with multichannel electrodes spanning the somatosensory cortex and hippocampus (HPC) under urethane anesthesia in diabetic and normoglycemic control mice, at 200 and 400 days of age. We analyzed the signal power of brain oscillations, brain state, sharp wave associate ripples (SPW-Rs), and functional connectivity between the cortex and HPC. We found that while both age and T2DM were correlated with a breakdown in long-range functional connectivity and reduced neurogenesis in the dentate gyrus and subventricular zone, T2DM further slowed brain oscillations and reduced theta-gamma coupling. Age and T2DM also prolonged the duration of SPW-Rs and increased gamma power during SPW-R phase. Our results have identified potential electrophysiological substrates of hippocampal changes associated with T2DM and age. The perturbed brain oscillation features and diminished neurogenesis may underlie T2DM-accelerated cognitive impairment.

Trade between Mauritius and China has been increasing at a rapid pace. As there are only few studies about Sino-Mauritian trade, there is therefore a need to study the determinants affecting trade flows between the two countries. This paper uses the “Gravity Model” with a sample data of 23 years (1997–2019) to analyze the trade between Mauritius and China. The results show that GDP’s growth rate, exchange rate, and FDI both have significant effects on Mauritian trade; however the former has a positive effect while the latter two has a negative one. The economic mass of the two countries have promoted trade, while an appreciation in Chinese currency and large amounts of direct investment have on the other side hindered Mauritian trade. A concrete trade agreement between the two sides can help in reducing the costs of trade between the two countries and improve the situation.

Objetivos: O eritrovírus humano B19 é um vírus da família Parvoviridae constituído por uma cadeia de DNA com tropismo pelas células eritropoiéticas precursoras da medula óssea. Essa relação da patogênese do vírus desencadeia a inibição das formação de hemácias e efeitos citotóxicos levando a um quadro clínico variável conforme a idade. A faixa etária mais afetada é a de menores de 14 anos. Este estudo tem como objetivo destacar a importância do conhecimento sobre as diferentes formas clínicas do eritrovírus B19 na pediatria, para ser uma opção de hipótese diagnóstica na análise sindrômica. Materiais e métodos: O presente trabalho é uma revisão de literatura baseada nos bancos de dados Google Acadêmico, UpToDate, Scielo, PubMed, biblioteca da Faculdade de Medicina da Universidade de São Paulo, num espaço amostral de 2001 a 2021, em línguas português e inglês. As palavras chaves foram: “síndrome de imunodeficiência adquirida”, “aplasia”, “parvovírus humano B19”, “hidropsia fetal”, “eritema infeccioso”, ”eritrovírus”, “diagnóstico”, “doenças hematológicas”,”anemia”. Resultados: Na literatura, encontram-se as principais doenças relacionadas com o eritrovírus B19: eritema infeccioso, crise aplásica transitória, hidropsia fetal, artropatia e síndrome hemofagocítica. O eritema infeccioso é a manifestação clínica mais comum presente na faixa etária escolar. Destaca-se o rash cutâneo associado a uma febre baixa/moderada. A crise aplásica transitória é uma outra importante patologia a ser conhecida e consiste na redução dos níveis basais de hemoglobina, com palidez, fadiga, letargia, febre, cefaléia e náuseas; ocorre em indivíduos que apresentam doença hematológica hemolítica. É mais comum em crianças, sobretudo nas portadoras de anemia falciforme. É válido mencionar que a infecção aguda na gestação pode levar à transmissão placentária, resultando em neonatos com hidropsia fetal e sendo uma importante causa de óbito fetal. Discussão: É importante conhecer a infecção pelo eritrovírus B19 a fim de criar hipóteses diagnósticas para a clínica cotidiana. Deve-se pensar como diagnóstico diferencial de doenças exantemáticas da infância, como rubéola, sarampo, varicela, infecções enterovirais e por estreptococos do grupo Am na presença do rash cutâneo. A crise aplásica transitória deve ser conhecida pelos profissionais da saúde e ser identificada como possibilidade em pacientes falcêmicos. Além disso, é importante o conhecimento da prevenção (lavagem de mãos e isolamento de contato de crianças com quadro clínico de rash) em gestantes, para prevenção do quadro de hidropsia e óbito fetal. Conclusão: Desse modo, baseado na literatura investigada, concluiu-se que as principais doenças relacionadas com o eritrovírus B19 acometem a população pediátrica, sendo uma etiologia importante de conhecimento, com a clínica clássica do eritema infeccioso, de hidropsia e óbito fetais.

This study adopts a cultural ecological perspective to examine how cumulative effects of external transcultural and cultural strengths are related to baseline and changes in three markers of Mexican-origin adolescents' self-growth (i.e., resilience, life meaning, and discipline). Using a three-wave longitudinal data set (5 years) of 604 adolescents, cumulative strengths (CS) was calculated, and growth curve analyses showed a similar pattern of findings for both transcultural and cultural cumulative strengths models: Adolescents with higher CS showed higher baseline resilience, life meaning, and discipline. While there were no significant associations between adolescents' CS scores and the increase in resilience, adolescents with higher CS scores showed steeper declines in life meaning and discipline (although these declines were no longer significant for cultural CS when transcultural and cultural CS were simultaneously tested in the same model). The findings emphasize a cultural ecological understanding of Mexican-origin youths' positive development from early to later adolescence. They also provide support for a CS model and have implications for positive psychology theories.

Background: With the right support, people with learning disabilities can be 'good enough' parents (Coren et al., 2011; Murphy & Feldman, 2002). Parenting programmes exist to support parents and are made accessible for people with learning disabilities who are expecting a baby, but evaluation of the benefit of these interventions is poor due to a lack of accessible outcome measures (May & Harris, 2020; Wade et al., 2008). The Tool to Measure Parenting Self-Efficacy in the antenatal period (TOPSE ante-natal) measures the impact of parenting interventions on an individual's self-efficacy during the antenatal period. This study aimed to modify the TOPSE ante-natal tool through a process of inclusive research, to support a consistent approach to evaluating parenting interventions from the perspective of parents-to-be with learning disabilities. Methods: A two-phase study using interviews and discussion groups was conducted in a process of inclusive research to modify the TOPSE ante-natal tool. Phase one involved conducting eight cognitive interviews (interviews to understand how individuals process and recall information) with parents with learning disabilities. These were conducted remotely via Microsoft Teams, transcribed verbatim and analysed using content analysis (Krippendorff, 2013). Participants were recruited using snowballing techniques through the advisory groups' networks. Phase two included three discussion groups with study collaborators and advisors (n = 14) to assess the accessibility and acceptability of adaptations of the tool, each making further refinements for consideration. Findings: Interviews and discussion groups highlighted how parents-to-be with learning disabilities experienced some of the original TOPSE-ante-natal negative statements, including negative points on a Likert scale, difficult to comprehend. Figurative statements and unfamiliar words also caused confusion, and statements focussed on the pressures of parenting were experienced as confrontational by people with learning disabilities. Statements were removed or replaced and agreed upon in discussion groups to ensure that the tool was accessible and meaningful to people with learning disabilities. Conclusions: We have used a process of inclusive research to modify a self-efficacy tool for parents-to-be with learning disabilities that is freely available on the TOPSE website (https://www.topse.org.uk/site/). The next steps are for this tool to be used and validated in future studies evaluating parenting interventions for people with learning disabilities. This will inform a knowledge base of what interventions should be used by practitioners who are supporting people with learning disabilities to prepare for parenthood.

The concomitant risk of physical inactivity and sedentary lifestyle development causing various non-communicable diseases is recognized worldwide. Therefore, development of strategies to form a concrete public health policy overcoming this problem is most important. This study observed the distribution and changes of Body Mass Index (BMI) over six years among boys and girls. Data on children height and weight and their BMI were collected. A total of 5369 (3368 male and 2001 female) children were recruited from 10 schools in Macao. The children were 6 years old in 2008 and turned 11 in 2013. Statistical analyses involved descriptive statistics, t-test, and a Chi-squared test. The findings indicated greater BMI among males than females across all age at the 0.05 level of significance, and the ages of 8 and 9 seemed to be a sensitive period for an increase in overweight and obesity. The results indicate the need to have focused strategies and structured interventions for males at the critical ages from 8 to 9 years.

There is evidence that rapid weight gain during the first year of life is associated with being overweight later in life. Therefore, overweight tendencies need to be detected at an appropriate age, and suitable strategies need to be implemented for weight management to achieve optimal long-term health. The objective of this study was to investigate comparisons in BMI status and associated categories in male and female students over ten years in two phases, including 2008-2013 and 2009-2014. Weight and height data were collected to obtain BMI (Body Mass Index) over ten years in two phases. The first phase occurred from 2008 to 2013, and the second phase occurred from 2009 to 2014 in a population of 10846 school children (Males: 6970, 64.3%, and females: 3875, 35.7%) in Macau. Their ages ranged from 6 years old in 2008 to 11 years old in 2013. The same age range was observed in the second phase, i.e., 2009-2014. Statistical analyses included descriptive statistics, such as the mean, standard deviation, t-tests to determine gender differences (year-wise) and a Chi square test for independence to determine the relationship between BMI (Underweight, Standard, Overweight and Obese) and age groups. In the first phase (2008-2013), the findings indicated a higher BMI level among the male students than the female students across all age groups (2008 t = 5.24, 2009 t = 88.25, 2010 t = 11.32, 2011 t = 17.45, 2012 t = 19.70 and 2013 t = 19.92). In the second phase (2009-2014), a higher BMI level was found among the male students than the female students across all age groups (2009 t = 2.68, 2010 t = 2.886, 2011 t = 3.076, 2013 t = 4.228, and 2014 t = 2.405). The results of the two phases combined (2008 to 2014 and 2009 to 2014) revealed that male students in 2008 had a higher BMI level than their counterparts in 2009 in the two age categories (8 years t = 3.025 and 11 years t = 3.377). Female students in the second phase (2009-2014) showed a higher BMI level than their male counterparts (9 years, t = 3.151). The results indicate the need to have focused strategies and structured interventions for male students at the critical age range of 8 to 9 years old. The results of this study also imply the need for the delivery of suitable school intervention activities at the appropriate time. Specifically, the prevention of weight gain should start early in life to encourage the development of healthier behaviours and habits throughout childhood and later ages.

The geometry of unconformities carved by deep time ice sheets is often obscured and restricted by discontinuous exposure, or outcrop conditions that do not readily permit the examination of glacial unconformities (for example, steeply dipping strata). Here, we present new uncrewed aerial vehicle (UAV) data from selected outcrops across northern, central and southern Namibia to shed further light on the nature of the basal Dwyka Group unconformity. This includes the onlap relationship of basal diamictites onto the Gomatum palaeo-fjord system in northern Namibia, highly complex mapped ice flow orientations elsewhere in the northern Kaokoveld, previously undiscovered grooves along the Fish River area, and a set of subglacial grooves along the border with South Africa along the Orange River. In the latter two cases, photogrammetric methods integrating orthophotos and digital elevation models reveal the presence of subglacial grooves. Furthermore, subglacial grooves often show different orientations to striations and fabrics measured in overlying diamictites, raising fresh questions about the nature of small-scale flow variations beneath Late Palaeozoic ice sheets.

Understanding the impact of repository gas, generated from degradation of waste and its interaction with the host rock, is essential when assessing the performance and safety function of long-term disposal systems for radioactive waste. Numerical models based on conventional multi-phase flow theory have historically been applied to predict the outcome and impact of gas flow on different repository components. However, they remain unable to describe the full complexity of the physical processes observed in water-saturated experiments (e.g., creation of dilatant pathways) and thus, the development of novel representations for their description is required when assessing fully saturated clay-based systems. This was the primary focus of Task A within the international cooperative project DECOVALEX-2019 (D-2019) and refinement of these approaches is the primary focus of this study (Task B in the current phase of DECOVALEX-2023). This paper summarises development of enhanced numerical representations of key processes and compares the performance of each model against high-quality laboratory test data. Experimental data reveals that gas percolation in water-saturated compacted bentonite is characterised by four key features: (i) a quiescence phase, followed by (ii) the gas breakthrough, which leads to a (iii) peak value, which is then followed by (iv) a negative decay. Three models based on the multiphase flow theory have been developed. These models can provide good initial values and reasonable responses for gas breakthrough (although some of them still predict a too-smooth response). Peak gas pressure values are in general reasonably well captured, although maximum radial stress differences are observed at 48 mm from the base of the sample. Here, numerical peak values of 12.8 MPa are predicted, whereas experimental values are about 11 MPa. These models are also capable of providing a reasonable representation of the negative pressure decay following peak pressure. However, other key specific features (such as the timing of gas breakthrough) still require a better representation. The model simulations and their comparison with experimental data show that these models need to be further improved with respect to model parameter calibration, the numerical representation of spatial heterogeneities in material properties and flow localisation, and the upscaling of the related physical processes and parameters. To further understand gas flow localisation, a new conceptual model has been developed, which shows that discrete channels can possibly be induced through the instability of gas-bentonite interface during gas injection, thus providing a new perspective for modeling gas percolation in low-permeability deformable media.

Early childbearing is associated with high maternal stress and family violence. However, the long-term effects of rapid repeat pregnancy (RRP) in young motherhood on child outcomes remain largely unknown. This study examined the pathways between maternal RRP at young ages and child psychosocial problems and emergency room visits in later years. A total of 232 Chinese mother-child dyads provided baseline data in 2015 (Time 1; T1) and follow-up data 6 years later in 2021 (Time 2; T2). At T1, mothers completed questionnaires about child physical abuse frequency and family cohesion and reported their own stress levels. At T2, mothers were re-surveyed with the same questionnaires about child physical abuse frequency and family cohesion. Children's psychosocial problems were assessed through parent proxy-reports and records of emergency room visits were retrieved from hospital databases. After adjusting for demographic information, maternal history of RRP was associated with child physical abuse at T1 ([beta] = 0.15, p < 0.05) and in turn linked to child physical abuse recurrence ([beta] = 0.22, p < 0.01) and emergency room visits at T2 ([beta] = 0.22, p < 0.001). Improved family cohesion over time did not break the link between maternal RRP and child physical abuse recurrence. Poor family dynamics can lead to child physical abuse recurrence and worsen developmental outcomes in children, particularly when coupled with other risk factors such as maternal RRP at young ages. Early interventions to enhance support and reduce vulnerabilities are important for preventing child physical abuse in at-risk families.

Abstract Background This study aims to evaluate the 5-year impact of a Health Empowerment Program (HEP) on mitigating problematic conducts and enhancing the health-related quality of life (HRQOL) among children living in poverty. Methods A prospective cohort study (N = 239, Intervention group: n = 124, Comparison group: n = 115) was established with participants recruited between July 2013 and March 2016 and followed until November 2021. During the 5-year study period, children and their parents from the intervention group were invited to join a multi-dimensional HEP. At baseline and follow-up, both intervention and comparison groups were assessed using the Chinese Strengths and Difficulties Questionnaire (SDQ) and Chinese Child Health Questionnaire Parent Form 28 (CHQ-PF28). Multiple linear regressions were conducted to identify changes in outcome variables as the effect of the HEP. Results Upon completion of the 5-year follow-up, children in the intervention group showed a larger decline in conduct problems (B = − 0.66, p