Reduplication is a common rhetorical method of languages. It reflects the beauty of the languages in rhythm image and expression. This paper aims to make a systematic contrastive study of reduplication in Chinese and English. It also illustrates the forms and functions as well as translation techniques of reduplicatives.
Human rights are universal fundamental protections worth of all individuals, including those with mental health conditions. However, these rights are often observed violated in mental health care settings, where individuals may face forced treatment, isolation, and degrading conditions. Despite global advocacy efforts, to ensuring that these rights are respected, continues to be a challenge for healthcare professionals and the general public. This review examines the current awareness of human rights among mental health professionals and the public, identifies the knowledge gaps, and highlights the recent developments in policy and practice aimed at improving human rights in mental health care. A comprehensive search of academic databases identified relevant studies published between 2019 and 2024. Findings suggest a promising level of public knowledge about human rights, yet negative attitudes and stigma persist. While improvements in mental health services have been observed among healthcare professionals; resource limitations and a lack of social support remain challenging. A gap between knowledge and practice is evident, necessitating further education and training to ensure a deeper understanding of human rights complexities in mental healthcare. Overall, this review underscores the importance of continued efforts to raise awareness and advocate for the human rights of individuals with mental health conditions. By implementing educational and sensitization programs, a supportive environment can be created that empowers them to seek help without fear of discrimination.
Copyright, as a special right of creators, develops automatically under the declarative value once a work is happened in a physical form, with certain limitations as prescribed by law. This study investigates the current limitations in legal protection for copyright owners and proposes a justice-based regulatory framework. The research is structured around three central questions: 1) Why does the existing legal framework for copyright protection fail to deliver justice for copyright owners? 2) What are the essential shortcomings in the current regulations? 3) How can these values be restored to safeguard justice-based protection? Engaging a constructivist paradigm and a sociological legal method, this research utilizes socio-legal methods, including expressive analysis of both primary and secondary data. Data collection was conducted through literature reviews and field studies, with qualitative methods applied to analyse the findings. The study reveals substantial gaps in the current legal framework, particularly within Articles 1, 8, and 9 of the Copyright Law, which ineffectively safeguard the rights of copyright owners. These deficiencies are exacerbated by the widespread misuse of artificial intelligence technologies that modify original works, undermining the economic rights of creators. The analysis finds three main areas of weakness: legal substance, legal structure, and legal culture. The current legal provisions are ineffective in practice, implementation mechanisms are flawed, and societal attitudes towards copyright are driven by pragmatism, leading to frequent violations and unfair royalty distribution. To address these issues, the study recommends a comprehensive modernization of the legal framework, focusing on value and normative modernizations. Key proposals include amendments to the Copyright Law No. 28 of 2014 and Government Regulation No. 56 of 2021 to establish a more equitable and justice-oriented system for copyright protection.
ORIGINAL RESEARCH ARTICLE | Sept. 19, 2024
Anthropometric Profile of Africa Elite Volleyball Club Players by Playing Position: Reports from Men's African Volleyball Club Championship 2023, Preliminary Study
Mbang Bian William, Mekoulou Ndongo Jerson, Endele Marcous Michel, Guessogo Wiliam Richard, Dobgima Fonmboh John, Assomo Ndemba Péguy Brice, Ebal Minye Edmond
Page no 123-128 |
DOI: https://doi.org/10.36348/sijap.2024.v07i07.003
This study aimed to establish anthropometric characteristics of volleyball players who participated in the 2023 Men's African Volleyball Club Championship and to identify the possible differences in these parameters in terms of individual playing positions. Player's age, height, and body mass (bm) were obtained from the African Volleyball Confederation Tournament’s Control Committee. A total of 197 players from 15 teams were included and organized in four groups according to their ranks (G1–G4) and sub-grouped using their playing positions. Significant differences (P<0.05) in age, height and body mass index (bmi) were observed among the studied groups (G1–G4). Players in G4 were the tallest and presented the greatest bm (P<0.05) while those in G3 were the youngest. The lowest bm value was observed in G2 (P<0.05). As far as attributes for the different playing positions are concerned, the Middle Blockers and the Opposite players were the tallest (P<0.05). In addition, the opposite players had the greatest (P<0.05) bm while the liberos possessed the greatest bmi values. This study presented anthropometric profile that differentiated levels of success among the teams. This information should serve as reference for staturo-ponderal’s average characteristics of volleyball players according to their positions at professional level.
ORIGINAL RESEARCH ARTICLE | Sept. 19, 2024
Perception of Efficiency in Care: A Study of Time Management and Discharge Planning from Nurses and Patients in Hospital Medical Units
Sania Emara, Hassan Hazeim, Shahna Shahulhameed, Gassan Abudari
Page no 184-193 |
DOI: https://doi.org/10.36348/sjnhc.2024.v07i09.003
Background: Effective time management and efficient discharge planning are crucial for high-quality hospital patient care. This study aimed to understand the perceptions of nurses and patients regarding these aspects to identify areas for improvement. Method: A survey was conducted with 45 nurses and 60 patients in a hospital setting. The nurses’ surveys focused on their experiences with call bell responsiveness, medication administration, and discharge planning. Patient surveys evaluated their perception of nurses’ responsiveness and involvement in the discharge process. Statistical analysis, including ANOVA and correlation tests, was used to assess the data. Results: Nurses reported mixed experiences with call bell response times and varied capabilities for timely medication administration. Challenges included disruptions from call bells, delays in medication delivery, and constraints in discharge discussions and planning. In contrast, patients generally viewed nurses as prompt and attentive, with satisfactory timeliness of care. However, patients expressed dissatisfaction with discharge education. No significant correlations were found between the demographics and perceptions of either group. Conclusion: This study highlights the disparity between nurses' experiences and patients' perceptions of hospital time management and discharge planning. It underscores the need for improved processes and communication strategies to align nurses’ capabilities with patients’ expectations, thereby enhancing overall patient care and satisfaction.
ORIGINAL RESEARCH ARTICLE | Sept. 19, 2024
Can CRP and Lymphocyte Count be Considered as Predictive Factors for the Prognosis of COVID-19 in Intensive Care? An Analytic Study
Sidi Driss El Jaouhari, Najib Bouhabba, Zakaria Hamdani, Karim Filali
Page no 390-396 |
DOI: https://doi.org/10.36348/sjm.2024.v09i09.008
Introduction: SARS Cov2 infection still represents a real threat whose clinical severity results from an inadequate immuno-inflammatory reaction. The objective of our study was to determine the prognostic interest of the value of CRP and the rate of lymphocytes in the management of patients contaminated by SARS-Cov2. Material And Methods: This is a prospective, descriptive and analytical study of interest to patients with severe COVID-19, admitted to medical intensive care at the Oued Eddahab military hospital, for a period of one year. The biological parameters were analyzed on admission and during the stay in intensive care. The ROC curve was used to determine the sensitivity and specificity of CRP and lymphocytes as well as their optimal predictive threshold values. Results: 32 patients were included in our study. The average age of admissions was 65 years ± 12.38 with a sex ratio of 5.4 in favor of men. The optimal predictive threshold for the severity found was 147mg/l for CRP with a sensitization of 95% and a specificity of 83.3%, and 807/mm3 for lymphocytes with a sensitivity of 91.7% and a specificity of 95%. The odds ratio (OR) found for CRP and lymphocytes was > 1. Conclusion: The CRP and the level of lymphocytes at the threshold defined above are risk factors for the severity of Sars-Cov2 infection.
ORIGINAL RESEARCH ARTICLE | Sept. 18, 2024
Comprehensive Survey on the Performance of Lignocaine in Root Canal Treatment
Uzmaa Shaikh, Kalyani Thakre, Gayatri Jagtap, Bhagyashree Jadhav, Dr. Vaidehi Kulkarni, Dr. Hussain Mookhtiar, Dr. Vivek Hegde
Page no 212-222 |
DOI: https://doi.org/10.36348/sjodr.2024.v09i09.004
Objective: The study aimed to evaluate the efficacy of lignocaine as a local anesthetic in root canal treatment, particularly focusing on its use in lower teeth, different administration techniques, and its performance in patients with specific challenges such as inflammation or allergy. Methods: A survey-based approach was utilized to gather data from clinicians on their experiences with lignocaine in endodontic procedures. The study assessed the success rates of various techniques, including the inferior alveolar nerve block (IANB), intraligamentary, and intraosseous injections. The impact of different adrenaline ratios (1:100,000, 1:80,000, and 1:200,000) on anesthesia duration and effectiveness was also analyzed. Results: Lignocaine with 1:100,000 adrenaline was effective in the majority of cases, with IANB being the primary technique used for lower Lignocaine was identified as the anesthetic of choice by the majority of participants, preferred for its rapid onset and adequate duration of action. Most clinicians reported that lignocaine provided effective anesthesia for routine root canal procedures when inflammation was present or additional duration was required, clinicians recommended using supplemental techniques such as intraligamentary and intraosseous. Alternative anesthetics like articaine and bupivacaine were used successfully in patients with lignocaine allergies. Conclusion: Lignocaine remains a reliable anesthetic for root canal treatments, particularly in the lower jaw, when used with appropriate techniques and adrenaline ratios. However, challenges such as inflamed tissues and patient allergies require alternative strategies, including supplemental injection techniques and the use of different anesthetic agents. Clinicians should be adaptable in their approach to ensure effective anesthesia and patient safety. The study aimed to evaluate the efficacy of lignocaine as a local anesthetic in root canal treatment, particularly focusing on its use in lower teeth, different administration techniques, and its performance in patients with specific challenges such as inflammation or allergy.
ORIGINAL RESEARCH ARTICLE | Sept. 18, 2024
A Study on Serum Hepatic Enzymes in Smokers and Nonsmoker’s Adult Male
Dr. Mst. Arifa Afroz, Dr. Md Farucul Hasan, Dr. Md. Mostaqimur Rahman, Dr. Kamruzzaman Abne Taz, Dr. Md. Abdus Sabur Khan, Dr. M.A. Aziz, Dr. Tasnim Khanam, Dr. Sharmin Binte Haider
Page no 682-688 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i09.007
Background: Cigarette smoking is one of the greatest indirect causes of global death and disease. Cigarette smoke consists of many chemicals, including cytotoxic, carcinogenic and free radicals, therefore it affects many organs including liver either directly or indirectly. Objective: The aim of this study was to find out level of serum hepatic enzymes in smokers and non-smokers adult male. Method: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh, from January 2019 to December 2019. Total study subjects were one hundred and twenty with age ranging from 20 to 50 years of male gender, selected from attendance of admitted patients and third & forth class employees of Dhaka Medical College Hospital, Dhaka. Study subjects were grouped smokers as Group A and age and gender matched, nonsmokers as Group B. Group A smokers again divided into three groups. Group A1- heavy smokers (who consume 20 cigarette sticks or more per day) consist of thirty study subjects, Group A2- moderate smokers (who consume 11-19 cigarette sticks per day) consist of thirty study subjects and Group A3- light smokers (who consume 1-10 cigarette sticks per day) consist of thirty study subjects. Serum Alanine Transaminase (ALT), Aspartate transaminase (AST) and Alkaline phosphatase (ALP) level of all study subjects were estimated and recorded. Results: Mean age of the study subjects in group A1, A2, A3 & B were 33.88 years, 34.60 years, 34.60 years and 29.80 years. There was a significant increase in serum ALT, AST and ALP level in heavy, moderate and light smokers when compared to nonsmokers, but the increase was more significant in heavy smokers when compared to moderate smokers, also moderate smokers when compared to light smokers. Conclusion: This study revealed that significantly higher level of serum hepatic enzymes with smokers when compared to that of non smokers. This significantly higher level was also seen in heavy smokers in comparison to moderate smokers, moderate smokers in comparison to light smokers.
This study was prompted by the fact that nanofluid exhibits a completely different behavior from the base fluid, usually water. It was expected that there should be a reduction in the pumping power when pumping nanofluids as compared to pure liquids, without nanofluids. Pump action and their performance are defined in terms of their characteristic curves. These curves usually supplied by pump manufacturers are for water only. This research reveals performance curves for nanofluid and compares it with those obtained for water. By pumping separate concentrations of copper nanofluids which contains 5g, 10g, 15g and 20g of copper nanoparticles, through a constructed nanofluid pump testing machine, the various flow parameters obtained were used to characterize a one horse power centrifugal pump. The flow parameters included; time to pump 2.5, 5.0, and 7.5 liters of copper nanofluids, flow rate, head gained, Pump vibration due to pumping activities, pump speed, fluid power, brake power and the pump efficiencies. These parameters were used to plot performance characteristics curves for the different copper nanofluid concentrations which were then compared with those obtained for ordinary water. The results show a reduction in the pumping power as compared to pure liquids, without nanofluids. The performance characteristic curve obtained for water when compared to those obtained for copper nanofluids, revealed that there was an increased in pump efficiency at lower concentration of the copper nanofluid. Lastly, the relevance of the distinct properties of nanofluids to exhibit enhanced thermal conductivity and convective heat transfer coefficient compared to the base fluid was established.
ORIGINAL RESEARCH ARTICLE | Sept. 17, 2024
Supporting Indonesian Online Waqf as Islamic Economics Source: Waqif Behaviour Approach in Java Island
Emmy Hamidiyah Syaiin, Yusuf Haji Othman, Irfan Syauqi Beik
Page no 305-314 |
DOI: https://doi.org/10.36348/sjef.2024.v08i09.004
Indonesia has great potential for asset waqf and cash waqf. Technological advancements show significant growth through fintech platforms for donations, zakat, and waqf. However, the magnitude of the potential of waqf and the advancement of financial technology is not in line with its realisation; this is a fundamental problem in Indonesia. The study aims to analyse the support of online waqf, an approach to waqf behaviour in Indonesia, by examining the influence of waqf literacy, trust, and attitude on behavioural intentions and behaviour of users who pay online cash waqf with age as a moderating variable. The study used a quantitative method with a survey approach to waqif in Indonesia, totalling 242 respondents through purposive sampling domiciled on the island of Java. Data analysis uses a structural equations model with the partial least squares (SEM-PLS). The study found that waqf literacy, beliefs, and attitudes have a significant relationship and a positive influence on behavioural intentions and user behaviour. Age has a significant impact on moderating the relationship between literacy and behavioural intentions. Behavioural intentions are significantly related to online waqf user behaviour. The implications of the research are increasing the support of literacy, trust and attitude to increase the potential for the realisation of online waqf in Indonesia, especially on the island of Java. The waqif behaviour approach strengthens the literature on Muslim social contributions. Further research examines the behavioural aspects of online waqf recipients (nazir) with qualitative and quantitative method approaches.
ORIGINAL RESEARCH ARTICLE | Sept. 17, 2024
Inferior Turbinate/Nasal Cavity Ratio: A Novel Objective Tool with Potential Clinical Implications
Erekosima B. U, Jaja B. N. R, Horsfall A. U, Ikenga V. O, Oparaodu U. A, Robinson, E. D, Paul J. N, Peterside A
Page no 383-389 |
DOI: https://doi.org/10.36348/sjm.2024.v09i09.007
Background: The nasal cavity is the upper part of the respiratory tract which communicates with the external environment through the anterior apertures. It also communicates with the nares, and the nasopharynx via the posterior apertures. The nasal cavity is divided into two by a septum, each cavity consisting of a roof, floor, medial wall, and lateral wall. The nasal cavity is formed laterally by the inferior, middle and superior nasal conchae (turbinates). Aim: The aim of the study was to investigate the dimensions of the inferior turbinate as seen in selected Nigeria subjects and develop novel anatomical parameters and indices with potential clinical implications. Methods: This retrospective study was done in the Radiology department of the Rivers State University Teaching Hospital following ethical approval, 339 CT films of adults (males and females) were analysed in this study. Sex and side differences were analysed using t-test, while relationship between anatomical structures were analysed using the Chi square test. The confidence interval was set at 95% and p < 0.05 was considered significant. The volume of the inferior turbinate and nasal cavity were measure and the inferior turbinate/nasal cavity ratio was calculated. Results: The mean volume of the inferior turbinate for males was 2.01±0.12, female was 2.22±0.14 and for the entire population it was 2.12±0.13. The mean volume of the nasal cavity for male and female were 15.98±0.40 cm3 and 14.73±0.34 cm3, respectively, whereas the average for the population was 15.35±0.37 cm3. Conclusion: To the best of our knowledge, this is the first research that used well defined anatomical landmarks in estimating the volume of the nasal cavity and inferior turbinate. This study also provided a clinically objective tool in assessing the degree of nasal cavity obstruction by providing a grading system for the inferior turbinate/nasal cavity. This tool will particularly be very useful in resource poor settings like ours where nasal endoscopy and rhinometry may not be readily available and affordable. Therefore radiologist can use this grading system to grade the degree of inferior turbinate hypertrophy and predict the degree of nasal obstruction and severity of symptoms.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
Review on Updated Management of Prurigo Nodularis (PN)
Md. Tauhidur Rahman, Sazia Afrin, Fatamatuz Zohura Antora, Jaheda Akter, Sadia Rubana Nila, Fatima Wahida
Page no 367-371 |
DOI: https://doi.org/10.36348/sjm.2024.v09i09.005
Background: Prurigo Nodularis (PN) presents as a challenging chronic dermatological condition characterized by intensely pruritic nodules on the skin, leading to significant morbidity. Despite its prevalence and impact on patients' quality of life, treatment options remain limited, necessitating evidence-based approaches to address this complex condition effectively. Objective: This study aims to provide an updated overview of evidence-based management strategies for PN, highlighting recent advancements in treatment modalities. Method: A systematic review of clinical studies on PN treatment was conducted by searching the PubMed and Scopus databases from January 1, 2001, to December 1, 2023. A total of 706 unique studies published in English were identified and screened for inclusion criteria. Only primary clinical studies investigating treatment strategies in PN patients were included, while case reports and series with fewer than five patients were excluded. Relevant publications were further supplemented by searching bibliographies for additional studies meeting the inclusion criteria. Results: The review identified significant advancements in evidence-based management strategies for PN, driven by a growing body of clinical research and therapeutic innovation. Pharmacological interventions targeting pruritus, inflammation, and lesion resolution have shown efficacy, including topical agents such as corticosteroids, emollients, Vitamin D3 analogues, tacrolimus creams, and systemic therapies like antihistamines, gabapentinoids, immunosuppressant and anti-inflammatory agents, JAK inhibitors, retinoids, and sometimes selective serotonin reuptake inhibitors (SSRIs). Additionally, emerging biological agents and non-pharmacological approaches, such as multidisciplinary interventions, have demonstrated promise in improving patient outcomes. Conclusion: Evidence-based management of PN represents a dynamic field with evolving treatment modalities. While challenges persist, including limited efficacy and safety concerns of certain treatments, recent developments in targeted therapies, systemic immunomodulators, and novel pharmacological approaches offer hope for improved patient care. Further research into genetic underpinnings and personalized therapies is warranted to address the heterogeneous nature of PN and enhance treatment efficacy and safety.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
A Study on Case Fatality of COVID-19 Patients with Ischemic Heart Disease in Selected Hospitals in Dhaka City
Dr. S. M. Aminul Islam, Dr. Khandaker Md Safiul Kabir, Dr. Md. Shahnur Islam
Page no 372-381 |
DOI: https://doi.org/10.36348/sjm.2024.v09i09.006
Objective: To identify the significant level of Case fatality of Covid-19 Patients with Ischemic Heart Disease in selected hospitals in Dhaka city. Method: This cross sectional study was carried out at NICVD/ Lab aid cardiac hospital/ Universal cardiac hospital from January 2023 to February 2023. Where a total of 384 adults (>18 ages) with Ischemic Heart Disease who admitted in hospital and tested positive for Covid- 19 were included as a sample population. After collecting data from sample population, data was checked and re-checked for completeness and correctness. The Collected data was analyze via statistical Software’s like STATA, SPSS etc. Results: during the study, majority were belonging to 51-60 years age group, 32.81%. followed by 27.60% were belong to 41-50 years age group and 23.18% belong to >61 years age group and majority were male, 80%.42.71% had normal weight whereas 28.13% were overweight & 24.74% were obese. 80.47% had chest pain, followed by 13.28% had dyspnea, 12.50% had cough, 10.68% had palpitation, 4.17% had vomiting. where 46.61% had STEMI, followed by 17.19% had NSTEMI, 19.27% had unstable angina, 25.78% had systemic hypertension, 21.88% had diabetes mellites, 6.77% had Heart valve disease, 4.43% had Arrhythmia. Plus, majority didn’t get their vaccination, 89.60%.49.48% had abnormal level of anxiety status whereas 55.73% had abnormal level of depression. Multivariable logistic regression found residence, age, profession, and income to be statistically significantly associated with anxiety after controlling for the other factors found to be significant at the univariate level. Plus, Chronic disease, STEMI, NSTEMI to be statistically significantly associated with anxiety after controlling for the other factors found to be significant at the univariate level. Cardiovascular Drug Therapy at Hospitalization of Covid-19 shows Medical therapy included ACE inhibitors (22.1% of the patients), ARBs (20.57%). mean length of hospital stay was 10.7±2.7 days, with an overall in-hospital mortality of 5.8% (515 of 8910 patients) in this population of patients with completed outcomes. Conclusion: Our findings indicate that health care providers, particularly cardiologists and nurses, should take extra care to detect and evaluate all heart disease patients for level of anxiety and depression in a clinical setting. There is a need to develop a quick screening approach in hospitals dealing with cardiovascular inpatients to identify those needing extra evaluation and care.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
Outcome of Empirical Antibiotic Prescription for the Treatment of Community Acquired Pneumonia
Dr. S. M. Aminul Islam, Dr. Khandaker Md Safiul Kabir, Dr. Md. Shahnur Islam
Page no 677-681 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i09.006
Background: The primary cause of illness and death in Bangladesh is community acquired pneumonia (CAP). Many hospitals in Bangladesh lack the resources to perform sputum cultures and sensitivity tests, making it difficult to identify the etiological agent of an infection. As a result, antibiotics are prescribed on a "empirical basis" rather than as part of a specific anti microbial treatment. The optimal antibiotic for treating CAP should be chosen using an empirical approach. Objective: The purpose of this study is to evaluate the effectiveness of various empirical antibiotic choices in the management of CAP. Methods: Eighty-two patients with CAP were included in this prospective observational research at a tertiary medical college hospital in Bangladesh. Inclusion and exclusion criteria were used to choose patients. Chest x-rays confirmed the diagnosis of CAP. The antibiotic was chosen based on clinical experience, which is an empirical method. The majority of patients received a combination antibiotic, whereas the remaining handful received monotherapy. The result served as an evaluation of the empiricism used in selecting the antibiotic. During the research, data were recorded in standardized formats. SPSS was used for the statistical analysis. Results: A total of 82 people were treated, and of them, 62 (or 76%) were men and 20 (or 24%) were women. The average age was 54.4% (9.6%). The round of antibiotics was supposed to last for a week. There were no unwanted medication reactions. No cases of lung abscess or parenchymal damage to the lungs occurred, and only one patient had paraneumonic effusion. Every single person made a full recovery. Conclusion: In many hospitals in Bangladesh, the choice of antibiotic for treating CAP is made on a "empirical" basis. Selecting an appropriate antibiotic requires better sputum culture and sensitivity testing in hospital labs.
Background: A deficiency is a public health issue for many children and adults. In wartime hardship, patients eat little meat, dark vegetables, and fruits, which can cause vitamin A deficiency and corneal dryness, erosion, ulceration, and perforation. The purpose of this study was to identify the characteristics and demographics of vitamin A insufficiency in Sudan during the 2023-2024 war. Methodology: This prospective descriptive study was carried out between June 15, 2024, and August 15, 2024, at Dr. Khalil's Ophthalmology Center in North Kordofan, Sudan. The study looked at 100 individuals who presented at the clinic complaining of deficient night vision (including full coverage during the notification period). Results: In this study, only six patients had corneal opacity, with 67% being males and 33% females. In terms of Bitto's spots, 12% are present, with males and females having 58% and 42%, respectively, and 46% having dry eyes. 52% were males and 48% were females in terms of retinal pigmentation. Only one female patient exhibited peripheral retinal pigmentation, which was due to retinitis pigmentosa; all patients had inadequate food intake; and no diarrhea was reported. Conclusion: In Sudan, the rise in vitamin deficiency can be attributed to the inadequate development of all health system programs. Additionally, the devastating war, which primarily affects young people, has forced most people to leave their homes and become either displaced or refugees. Consequently, 69% of the patients were 17 years old or younger.