Does maternal education impact infant and child care practices in African setting? The case of Northern Nigeria

Background: In many African settings, infant and child care practices are dictated by long-established social norms and cultural values, some of which may be disastrous to the health of the baby. To determine how maternal education is related with child health and rearing practices in Kano. Materials and Methods: Using a descriptive cross-sectional design, 386 randomly selected mothers of under-five children and their babies were examined. Data were analyzed using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, NY, USA). Children's weight-for-height, height-for-age, and weight-for-age Z-scores were obtained. Infant and child care, feeding and weaning practices were assessed and scored based on a system adapted from past study. Results: The mean ± standard deviation of the mothers was 27.3 ± 5.2 years, 69.7% had at least secondary school education. The mothers had 4 ± 2 children, and 79.3% were ≥12 months old. More than half of the children (58.2%) had suffered one or more of the common childhood diseases within the previous month, 60.3% had a form of malnutrition and less than half (42.5%) were fully immunized for age. Varying infant and child care, feeding and weaning practices were observed. Overall, half (49.2%) of the mothers had good care practices, 42.2% had good feeding practices and 57.6% had good weaning practices. Interestingly, neither the mothers' care practices nor the feeding practices were statistically associated with their educational status. However, the proportion of the mothers with good weaning practices was higher among those with no secondary education (59.7%). Conclusion: The finding suggests that cultural beliefs are specific areas of focus in campaigns for improving infant and child care and rearing practices of mothers, and eventually for reducing the high infant and child morbidity and mortality in the Northern Nigeria

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

White Paper on Light Sterile Neutrino Searches and Related Phenomenology

International audienceThis white paper provides a comprehensive review of our present understanding of experimental neutrino anomalies that remain unresolved, charting the progress achieved over the last decade at the experimental and phenomenological level, and sets the stage for future programmatic prospects in addressing those anomalies. It is purposed to serve as a guiding and motivational "encyclopedic" reference, with emphasis on needs and options for future exploration that may lead to the ultimate resolution of the anomalies. We see the main experimental, analysis, and theory-driven thrusts that will be essential to achieving this goal being: 1) Cover all anomaly sectors -- given the unresolved nature of all four canonical anomalies, it is imperative to support all pillars of a diverse experimental portfolio, source, reactor, decay-at-rest, decay-in-flight, and other methods/sources, to provide complementary probes of and increased precision for new physics explanations; 2) Pursue diverse signatures -- it is imperative that experiments make design and analysis choices that maximize sensitivity to as broad an array of these potential new physics signatures as possible; 3) Deepen theoretical engagement -- priority in the theory community should be placed on development of standard and beyond standard models relevant to all four short-baseline anomalies and the development of tools for efficient tests of these models with existing and future experimental datasets; 4) Openly share data -- Fluid communication between the experimental and theory communities will be required, which implies that both experimental data releases and theoretical calculations should be publicly available; and 5) Apply robust analysis techniques -- Appropriate statistical treatment is crucial to assess the compatibility of data sets within the context of any given model

White Paper on Light Sterile Neutrino Searches and Related Phenomenology

This white paper provides a comprehensive review of our present understanding of experimental neutrino anomalies that remain unresolved, charting the progress achieved over the last decade at the experimental and phenomenological level, and sets the stage for future programmatic prospects in addressing those anomalies. It is purposed to serve as a guiding and motivational "encyclopedic" reference, with emphasis on needs and options for future exploration that may lead to the ultimate resolution of the anomalies. We see the main experimental, analysis, and theory-driven thrusts that will be essential to achieving this goal being: 1) Cover all anomaly sectors -- given the unresolved nature of all four canonical anomalies, it is imperative to support all pillars of a diverse experimental portfolio, source, reactor, decay-at-rest, decay-in-flight, and other methods/sources, to provide complementary probes of and increased precision for new physics explanations; 2) Pursue diverse signatures -- it is imperative that experiments make design and analysis choices that maximize sensitivity to as broad an array of these potential new physics signatures as possible; 3) Deepen theoretical engagement -- priority in the theory community should be placed on development of standard and beyond standard models relevant to all four short-baseline anomalies and the development of tools for efficient tests of these models with existing and future experimental datasets; 4) Openly share data -- Fluid communication between the experimental and theory communities will be required, which implies that both experimental data releases and theoretical calculations should be publicly available; and 5) Apply robust analysis techniques -- Appropriate statistical treatment is crucial to assess the compatibility of data sets within the context of any given model

Global Retinoblastoma Presentation and Analysis by National Income Level

This cross-sectional analysis reports the retinoblastoma stage at diagnosis across the world during a single year, investigates associations between clinical variables and national income level, and investigates risk factors for advanced disease at diagnosis. Key PointsQuestionIs the income level of a country of residence associated with the clinical stage of presentation of patients with retinoblastoma? FindingsIn this cross-sectional analysis that included 4351 patients with newly diagnosed retinoblastoma, approximately half of all new retinoblastoma cases worldwide in 2017, 49.1\% of patients from low-income countries had extraocular tumor at time of diagnosis compared with 1.5\% of patients from high-income countries. MeaningThe clinical stage of presentation of retinoblastoma, which has a major influence on survival, significantly differs among patients from low-income and high-income countries, which may warrant intervention on national and international levels. ImportanceEarly diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. ObjectivesTo report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and ParticipantsA total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and MeasuresAge at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. ResultsThe cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4\%) were female. Most patients (n=3685 {[}84.7\%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n=2638 {[}62.8\%]), followed by strabismus (n=429 {[}10.2\%]) and proptosis (n=309 {[}7.4\%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5\%) patients having intraocular retinoblastoma and 2 (0.3\%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1\%) having extraocular retinoblastoma and 94 of 498 (18.9\%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 {[}95\% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 {[}95\% CI, 4.30-7.68]). Conclusions and RelevanceThis study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs