Validation of Gender Friendly Breastfeeding Knowledge scale among young adults

Introduction: Breastfeeding is the most effective intervention to improve child health. Young adults, both genders play an important role in society supporting breastfeeding as they will be stepping towards parenthood in the near future. Bringing awareness and busting the myths among them is essential. This study aimed to develop a Gender Friendly Breastfeeding Knowledge scale based on a conceptual framework that reflected the knowledge of young adults and evaluates its validity and reliability. Methodology:  Development of the questionnaire for Conceptual framework and item generation was done using PubMed, Google Scholar, other sources and expert opinion. The type of measurement was structured as a 5-point Likert scale. The Lawshe technique to assess the content validity ratio. A cross-sectional survey in graduation colleges situated in Mangalagiri or within the radius of 30 km of Mangalagiri, Andhra Pradesh, India was conducted in 2020. 1400 Adult males and females aged 20-25 years and perusing full-time graduation course were recruited. For each item in the Gender Friendly Breastfeeding Awareness scale, we assessed individual item characteristics and item-test correlation. To check to construct validity, we performed exploratory factor analysis and confirmatory factor analysis. Results: Expert panel retained 23 items from initially 30 items. The content validity index score for the each of 23-items in the scale was more than 0.80. A four-factor structure perfectly fitted the data and illustrated 54 percent of the variation in knowledge of breastfeeding. Four stages of CFA were completed. The chi-square = 860.534 was significantly above the 0.01 level.  Cronbach's a = 0.787 based on standardized items reflected the overall internal consistency of the gender-friendly breastfeeding awareness scale. Conclusion: Gender-friendly breastfeeding knowledge scale is a valid and reliable tool, it is recommended that this scale be used in communities, educational institutions, and in relevant research to assess breastfeeding knowledge among young adults of both genders, thereby promoting breastfeeding practices in the future

Gene-Gene and Gene-Environmental Interactions of Childhood Asthma: A Multifactor Dimension Reduction Approach

Background: The importance of gene-gene and gene-environment interactions on asthma is well documented in literature, but a systematic analysis on the interaction between various genetic and environmental factors is still lacking. Methodology/Principal Findings: We conducted a population-based, case-control study comprised of seventh-grade children from 14 Taiwanese communities. A total of 235 asthmatic cases and 1,310 non-asthmatic controls were selected for DNA collection and genotyping. We examined the gene-gene and gene-environment interactions between 17 singlenucleotide polymorphisms in antioxidative, inflammatory and obesity-related genes, and childhood asthma. Environmental exposures and disease status were obtained from parental questionnaires. The model-free and non-parametrical multifactor dimensionality reduction (MDR) method was used for the analysis. A three-way gene-gene interaction was elucidated between the gene coding glutathione S-transferase P (GSTP1), the gene coding interleukin-4 receptor alpha chain (IL4Ra) and the gene coding insulin induced gene 2 (INSIG2) on the risk of lifetime asthma. The testing-balanced accuracy on asthma was 57.83 % with a cross-validation consistency of 10 out of 10. The interaction of preterm birth and indoor dampness had the highest training-balanced accuracy at 59.09%. Indoor dampness also interacted with many genes, including IL13, beta-2 adrenergic receptor (ADRB2), signal transducer and activator of transcription 6 (STAT6). We also used likelihood ratio tests for interaction and chi-square tests to validate our results and all tests showed statistical significance

Pineal parenchymal tumor of intermediate differentiation: Imaging spectrum of an unusual tumor in 11 cases

Introduction: Pineal parenchymal tumor of intermediate differentiation (PPTID) was recognized in the 2007 World Health Organization (WHO) classification as a new pineal parenchymal neoplasm, intermediate in malignancy (WHO grade II or III) between pineocytoma (grade I) and pineoblastoma (grade IV). The imaging spectrum of this new tumor has not been previously delineated. We describe the imaging spectrum in 11 pathologically proven PPTIDs and identify findings that may suggest the preoperative diagnosis of this newly recognized entity. Methods: Electronic medical records over the last 9 years and teaching files between the years 1985 and 1995 were searched for atypical pineal lesions. Additional cases were added from the teaching files of contributing authors. Results: Imaging studies in nine patients (9/11) showed bulky, aggressive pineal region masses with local brain invasion; two patients (2/11) demonstrated circumscribed pineal masses. Two patients had spinal metastases at presentation. On computed tomography (CT), five patients had classic "exploded" calcifications characteristic of pineal parenchymal tumors. All tumors were heterogeneously hypointense on T1WIs and heterogeneously hyperintense on T2WIs. Post-contrast scans showed marked heterogeneous (10/11) or uniform (1/11) enhancement. Cystic foci were identified in eight cases. Intratumoral hemorrhage was present in one case. Conclusion: While no singular neuroimaging feature is pathognomonic of PPTID, these tumors are usually larger, demonstrate local invasion, and appear much more heterogeneous than pineocytoma. Because PPTIDs have a higher grade and increased potential for recurrence as compared to pineocytomas, it is important to consider this diagnosis as shorter follow-up, and adjuvant therapy may be indicated in selected cases. © 2010 Springer-Verlag.Articl

A multivariate analysis of factors determining tumor progression in childhood low-grade glioma: a population-based cohort study (CCLG CNS9702)

The purpose of this study was to identify risk factors for the progression of low-grade glioma in children from a large population-based cohort. Patient and tumor details of a national cohort of children with low-grade glioma, recruited into an international multidisciplinary clinical strategy, were subjected to univariate and multivariate analyses of progression-free survival and overall survival. From the cohort of 798 patients, 639 patients were eligible, with a median age 6.71 years (0.26–16.75 years); 49% were males; 15.9% had neurofibromatosis type 1, 63.7% pilocytic astrocytoma, 5.9% fibrillary astrocytoma, 4.2% mixed neuronal-glial tumors, and 3.6% others; 21.1% were diagnosed clinically. Anatomically implicated were 31.6% cerebellum, 24.6% chiasma/hypothalamus, 16.0% cerebral hemispheres, 9.9% brain stem, 6.1% other supratentorial midline structures, 5.9% optic nerve only, 4.5% spinal cord, and 1.4% others. The 5-year overall survival and progression-free survival in the whole cohort were 94.6% and 69.4%, respectively. There was a significant association between age and site (P < .001) and extent of tumor resection and site (P < .001). Multivariate analysis identified young age, fibrillary astrocytoma, and extent of surgical resection as significant independent risk factors for progression. Hypothalamic/chiasmatic tumors demonstrated the most sustained tendency to progress. In conclusion, the influence of age and anatomical site upon the risk of tumor progression suggests that these factors strongly influence tumor behavior for the majority of pilocytic tumors. Age <1 year and 1–5 years, fibrillary histology, completeness of resection, and chiasmatic location are candidates for stratification in future studies