ICFInternational Classification of Function, Disability and Health ICF-CY International Classification of Function, Disability and Health -Children and Youth Version ROM Range of motion AIM The aim of this study was to determine the effects of repeat botulinum toxin A (BoNT-A)injections in children with spastic cerebral palsy (CP) on the basis of a best evidence synthesis.METHOD This study included 13 original articles after searching the literature to retrieve information. We used the critical review form produced by McMaster University to determine the methodological quality of the studies, and then confirmed the levels of evidence from Sackett. The studies were also evaluated using the International Classification of Function, Disability and Health -Children and Youth Version (ICF-CY).RESULTS A total of 893 children with spastic CP who had been administered repeat BoNT-A injections were evaluated. The evidence level was II in four of the thirteen studies, III in four studies, and IV in five studies. The McMaster review form score was 14 in two studies, 13 in four studies, and 12 in seven studies. The results showed that repeat BoNT-A may be a safe and an effective approach. The first two injections/one repeat especially relieve spasticity and improve fine and gross motor activities.INTERPRETATION Future studies to investigate the effectiveness of repeat BoNT-A in children with spastic CP may be planned within the framework of the ICF-CY to include well-designed randomized controlled trials and those conducted on larger homogenous groups.Cerebral palsy (CP) is a neuromuscular pathology that is caused by an injury to the immature brain, and that limits activity by affecting the development of body function and posture. 1,2 CP is the most common childhood disability, and about 70% to 80% is of the spastic type.

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Bilateral spastic cerebral palsy (BSCP) patients frequently need to use various sitting devices for body control and function. The aim of this study was to investigate whether the use of a belt to position the pelvis in an adjustable chair would affect upper limb function in preschool children with BSCP. Fortyone children with BSCP [mean age 44 ±11, range 18-60 months] classified according to the Gross Motor Function Classification System (GMFCS), as level III (n=21) and level IV (n=20) were fitted with a hip-positioning belt. Upper limb functions were assessed by Quality of Upper Extremity Skills Test (QUEST). The median scores of the following upper extremity functions increased significantly by wearing the hip positioning belt: dissociated movements, grasping, weight bearing and protective extension. The total QUEST score increased from 56.7 (±46.3) to 66.1 (±39.2) (p<0.001). The portable and adaptable hip-positioning belt may be used in daily life to improve upper limb activity in preschool children with moderate to severe BSCP.

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In this paper, we propose a novel authenticated key exchange scheme based on the Bi-GISIS problem for the post-quantum world. The security of the proposed scheme is based on the hardness assumption of the Bi-GISIS problem. The reusable key property is provided for the proposed scheme in the random oracle model by using the bilateral pasteurization method. To obtain an authenticated key exchange scheme, we use the implicit authentication steps. The security analysis of the proposed scheme is presented in the Bellare-Rogaway security model, where weak perfect forward secrecy is provided. We also give novel perspective to the Bi-GISIS based authenticated key exchange problem. INDEX TERMS Lattice-based cryptography, authenticated key exchange, Bi-GISIS problem, reusable keys.

Amaç: Oral motor problemler ile beslenme ve yutma problemleri serebral palsili çocuklarda en sık rastlanan problemlerden bir tanesidir. Yeme İçme Becerisi Sınıflandırma Sistemi (EDACS) serebral palsili çocuklarda yeme ve içme performansını sınıflandırmak için kullanılır. Bu çalışmanın amaçları, EDACS’ı Türkçe’ye çevirmek, değerlendirici-içi güvenirliği ve diğer fonksiyonel sınıflandırma sistemleri ile ilişkisini araştırmaktı. Yöntem: EDACS İngilizce’den Türkçe’ye çevrildi. EDACS’ın Türkçe versiyonu 125 serebral palsili çocuğa uygulandı. Değerlendirici-içi güvenirliği için Türkçe EDACS iki hafta sonra tekrar puanlandı. Çocukların fonksiyonel durumlarını belirlemek için Kaba Motor Fonksiyon Sınıflandırma Sistemi, El Becerileri Sınıflandırma Sistemi ve İletişim Fonksiyonları Sınıflandırma Sistemi seviyeleri de kaydedildi. Sonuçlar: Yaş ortalaması 7,44±3,95 yıl olan 54 kız ve 71 erkek çalışmaya katıldı. Türkçe EDACS’ın değerlendirmeci içi güvenirliği neredeyse mükemmeldi (ICC=0,972 ve Güven Aralığı=0,959-0,980, p&lt;0,001). Türkçe EDACS ile Kaba Motor Fonksiyon Sınıflandırma Sistemi (r=0,769), El Becerileri Sınıflandırma Sistemi (r=0,786) ve İletişim Fonksiyonları Sınıflandırma Sistemi (r=0,824) arasında anlamlı pozitif korelasyon bulundu (p&lt;0,001). Tartışma: Türkçe EDACS son derece güvenilir bir araç olarak bulundu. Serebral palsili çocukların fonksiyonel yeme ve içme becerileri, motor fonksiyon seviyeleri ve iletişim durumları ile ilişkilidir.

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