Preschool Group Research Articles

Analysis of etiology and short-term prognosis of childhood arterial ischemic stroke based on the COIST classification

Objective: This study aims to analyze the etiology and short-term prognosis of childhood arterial ischemic stroke (AIS) in Chinese children, based on the COIST classification system. Methods: A total of 380 pediatric patients with a first-ever diagnosis of AIS treated at Beijing Children's Hospital between September 2015 and April 2024 were retrospectively included. Etiology was analyzed according to COIST classification. The patients were categorized into infant and toddler group with 117 cases (>28 days to≤3 years), preschool group with 90 cases (>3 years to≤7 years), school-age group with 90 cases (>7 years to≤11 years), and adolescent group with 83 cases (>11 years to≤18 years). The etiological distribution across age groups and the short-term prognosis of patients with different etiologies were further analyzed. Results: Among the 380 patients, 235 were male (61.8%) and 145 were female (38.2%), with a mean age at presentation of(6.6±4.6)years. Approximately 2/3 of the patients were admitted in the Department of Neurology, with a mean hospital stay of (13.2±6.7)days. (1) Etiological analysis: "Vascular structural abnormalities" were the most common cause, accounting for 38.2% (145/380), followed by "Inflammatory" causes at 31.1% (118/380), "Undetermined" at 11.1% (42/380), "Other identifiable causes" at 9.2% (35/380), "Cardiac diseases" at 6.3% (24/380), and "thrombophilia" at 4.2% (16/380). (2) Etiological distribution by age group: in the infant and toddler group, "vascular structural abnormalities" were 47.9% (56/117), with basal ganglia infarction following minor trauma(combined with basal ganglia calcification) being the most common (40/117). In the preschool group, there were 34 cases (34/90) of "inflammatory" and 33 cases (33/90) of "vascular structural abnormalities", with Moyamoya disease being the most frequent cause (15/90). In the school-age group, there were 37(37/90) cases of "vascular structural abnormalities", with arterial dissection (12/90)being the most common, followed by FCA-i (11/90), and Moyamoya disease (11/90). In the adolescent group, there were 34 cases of "inflammatory"(34/83), with the highest proportion of FCA-i (13/83) in the subgroup, followed by thrombophilia (9/83) and systemic lupus erythematosus (8/83). (3) Short-term prognosis: based on the PSOM scale, 188 cases had good prognosis, accounting for 49.5% (188/380), while 192 cases had poor prognosis, accounting for 50.5% (192/380). According to the mRS score, 207 cases had good prognosis (54.5%) and 173 cases had poor prognosis (45.5%). Subtypes such as "Inflammatory-noninfectious, " FCA-i, Moyamoya disease, and arterial dissection were associated with relatively better outcomes. Less than 1/3 of patients in the "other identifiable causes" group had favorable prognosis. The in-hospital mortality rate was 3.7% (14/380). Conclusions: Vascular structural abnormalities and inflammatory (including infectious and non-infectious) factors are the predominant causes of pediatric AIS; Approximately half of children with AIS had a favorable short-term outcome.

Median effective dose of remimazolam combined with sufentanil for inhibiting laryngeal mask airway insertion responses in children of different ages.

We determined the median effective dose and 95% confidence interval (CI) of remimazolam required to inhibit laryngeal mask airway (LMA) insertion reactions combined with sufentanil 0.3μg/kg in pediatric anesthesia. Children scheduled to undergo elective laryngeal mask anesthesia were divided into the preschool (age: 3-6years) and school-age (6-12years) groups. The timer was started after intravenous remimazolam was administered; thereafter, 0.3μg/kg sufentanil was injected intravenously. The laryngeal mask was placed 3min after remimazolam was finished. If a positive response to LMA insertion, such as movement, swallowing, coughing, hiccups, or other reactions, was observed during the insertion, the dose was increased by 0.03mg/kg for the next patient; if there was no response, the dose was decreased by 0.03mg/kg instead. The trial officially commenced after the first LMA was successfully inserted and continued until alternating positive and negative responses formed seven crossover points. Thereafter, probit regression was performed to calculate the median effective dose (ED50) and 95% effective dose (ED95) with the corresponding 95% CIs. The time from remimazolam administration to the disappearance of the eyelash reflex was recorded. Heart rate and mean arterial pressure were recorded before (T1, baseline values) and 3min after (T2) intravenous remimazolam administration. Adverse reactions were also noted. Overall, 52 children were included; 25 belonged to the preschool group and 27 to the school-age group. In the preschool group, the ED50 and ED95 for remimazolam and their 95% CIs were 0.476 (0.447-0.517) mg/kg and 0.554 (0.515-0.688) mg/kg, respectively. In the school-age group, the ED50 and ED95 for remimazolam and corresponding 95% CIs were 0.427 (0.399-0.463) mg/kg and 0.504 (0.467-0.635) mg/kg, respectively. The dosage for the preschool group was significantly higher than that for the school-age group (p = 0.003). Conversely, the time from remimazolam administration to the disappearance of the eyelash reflex; LMA insertion success rate; or incidence of coughing, movement, swallowing, and hiccups did not differ significantly between the two groups. Remimazolam can be safely used for laryngeal mask anesthesia induction in pediatric patients. https://www.chictr.org.cn/, identifier ChiCTR2400087333.

Moderating effects of demographic characteristics on the relationship between parenting practices and energy balance related behaviors of Chinese preschoolers.

Early establishment of energy balance related behaviors (EBRBs) may be effective in combating unhealthy lifestyle in preschoolers. Parents are responsible for cultivating preschoolers' EBRBs directly through parenting practices. Although investigating the impact of various parenting practices on preschoolers' EBRBs is crucial to determine which practices should be recommended to parents to help reverse childhood unhealthy lifestyle, it is important to assess whether these effects of parenting practices on preschoolers' EBRBs would be similar across different groups of preschoolers, necessitating research into the moderating effects of demographic characteristics. Baseline dataset was utilized from an electronic health intervention study of Chinese 3-6-year-old preschoolers. Preschoolers' PA and sleep duration and quality were objectively examined using wGT3X ActiGraph accelerometer. Data related to parents and preschoolers' eating behaviors and sleep problems were subjectively assessed using parent-reported questionnaires. The PROCESS macro version 4.2 was used to perform moderation analysis. When the interaction revealed a p-value of less than 0.05 and the 95% confidence interval did not include 0, the conditional effects of the focal predictor at various levels of the moderator were further examined (p < 0.05) to investigate how the relationship between parenting practices and preschoolers' EBRBs varied with different moderator levels. Married parents exhibited the desired outcomes in the relationship between parenting practices and their preschoolers' EBRBs. In contrast, divorced/separated parents showed unfavorable results in this relationship. The association between the parents' and preschoolers' BMI varied depending on parents' socioeconomic status, the preschoolers' age, and the number of children in the household. The preschoolers' age showed different moderating trend on the relationship between parents' PA and preschoolers' sedentary behaviors as well as the association of eating-related PSE with preschoolers' eating behaviors. The mechanisms linking the parents' PSE to the preschoolers' PA, sedentary behaviors, and sleep duration were influenced by the preschoolers' gender and the number of children in the household. The potential parental influence warrants further investigation with the consideration that the relationship between parenting practices and preschoolers' EBRBs varied across different group of children. NCT06025019.

Современная стандартизация методик Л.А. Венгера, направленных на диагностику развития умственных способностей и произвольности детей старшего дошкольного возраста

&lt;p&gt;The article describes the procedure and results of standardization and definition of norms for methods of diagnosing the level of mental development of children of two age groups (5-6 and 6-7 years old) (&amp;ldquo;Standards&amp;rdquo;, &amp;ldquo;Perceptual modeling&amp;rdquo;, &amp;ldquo;Schematization&amp;rdquo;, &amp;ldquo;Systematization&amp;rdquo;, &amp;ldquo;Educational activity&amp;rdquo;). The main indicators of the development of perception, visual-figurative and verbal-logical thinking, as well as the voluntariness of modern senior preschoolers are reflected. Diagnostic materials and evaluation scales in &amp;ldquo;raw&amp;rdquo; and standard glasses are given. The study involved 490 children: 223 5-6-year-old children (113 boys and 110 girls) and 267 6-7-year-old children (142 boys and 125 girls) who attended senior and preparatory kindergarten groups in Moscow, Veliky Novgorod, Podolsk, Smolensk, Khimki and three rural settlements of the Moscow region. As a result, modern average standards of mental development and arbitrariness for children aged 5-6 and 6-7 years were obtained. The techniques can be used to assess children&amp;rsquo;s readiness for school, identify individual differences and promote the child throughout the year, compare groups of preschoolers among themselves, etc.&lt;/p&gt;

Analysis of the sensitization characteristics and changes trend of common allergens in a hospital of pediatric in Beijing City from 2019 to 2023

Objective: This study aimed to analyze the test results and changing trend of specific IgE (sIgE) for common allergens in children in the hospital from 2019 to 2023, so as to provide a basis for the diagnosis and treatment of allergic diseases in children. Methods: The test results of children who were admitted to Beijing Children's Hospital, Capital Medical University and underwent serum allergen sIgE quantitative detection (Immuno CAP system) from January 1, 2019 to December 31, 2023 were retrospectively included. According to the allergen type, the allergens were divided into food allergens and inhaled allergens (dust mite group, mold group, animal dander group and pollen group). The trends in sIgE positive rates across different years, age-related differences, and monthly distribution characteristics were analyzed. Results: A total of 44 633 allergen sIgE quantitative test results were included in the study. Among them, 23 024 samples were tested for food allergen sIgE and 21 609 samples were tested for inhaled allergen sIgE. The positive rates of food allergens (egg white, milk, wheat, peanut, soybean, shrimp) sIgE increased year by year, and the differences were statistically significant (χ2=97.3, 78.9, 95.6, 122.4, 84.7, 24.5, P<0.001). The positive rate of inhaled allergen sIgE also increased year by year, and the difference was statistically significant (χ2=36.2, 326.2, 432.2, 973.2, P<0.001). There were significant differences in the sensitization patterns of food and inhaled allergens among different age groups. The most common food allergen was egg white in infant group (<1 year old) (23.0%), milk in young children group (1-2 years old) (40.7%), and egg white in preschool group (3-6 years old) (28.8%). Peanut was the most common allergen in school-age group (7-12 years old) and adolescent group (13-18 years old) (16.9% and 14.1%, respectively). Among the inhaled allergens, animal dander (3.6%) was the most common allergen in the infant group (<1 year old), and mold (15.3%) was the most common allergen in the young child group (1-2 years old). The most common allergens in preschool group (3-6 years old), school-age group (7-12 years old) and adolescent group (13-18 years old) were pollen (39.7%, 53.0%, 53.5%). There were significant differences in the positive rates of inhaled allergens (dust mite, mold, animal dander, pollen) sIgE in the 12 months of 2023 (χ2=26.9, 26.7, 56.7, 55.5, P=0.005, 0.005,<0.001,<0.001). The positive rate of pollen sIgE was the highest, with peaks in April (54.8%) and September (60.5%). The positive rate of sIgE for molds peaks in June (46.4%). Conclusion: The trends in sIgE levels among children visiting Beijing Children's Hospital, Capital Medical University, from 2019 to 2023, suggests to a certain extent that the prevalence of allergic diseases among children in Beijing City is increasing annually. There were significant age differences in sIgE sensitization patterns among children of different ages, and the distribution of sIgE positive rates for inhaled allergens was also different in different months. In clinical practice, the allergen test report is interpreted comprehensively according to the patient's medical history, age, visit month and other factors.

The Motor Melody in action Planning: The Case of Autistic Children and their Non-Autistic Siblings.

it is well known that during an intentional behavior, the final goal of the action shapes the entire sequence of motor acts. This chained organization has been previously demonstrated to be altered in school-age autistic children, who modulate only the final motor act according to the action goal. Here, we investigate the temporal modulation during the intentional action in three groups of preschoolers: neurotypical, autistic, and non-autistic siblings of autistic children. the participants engaged in a simple task of reaching and grasping an object and placing it into two containers of different sizes. neurotypical children adjusted both reaching and placing times according to the width of the containers, indicating an action-chained organization. In contrast, both autistic children and non-autistic siblings adapted only the placing - but not the reaching- time according to the container size, exhibiting an unchained organization of intentional actions. despite not being included among the diagnostic criteria, motor alterations are present in a large number of autistic individuals, detectable from an early age. Being motor signs also expressed by non-autistic siblings, our findings suggest a potential link between motor abnormalities and the pathogenesis of autism. Thereby, tasks similar to the one employed here could be valuable for screening children with an increased likelihood of atypical neurodevelopment.

DIGITAL TOOLS IN PRESCHOOL SETTINGS: DYNAMICS, CHALLENGES AND TEACHERS’ ATTITUDES TOWARDS DIGITALIZATION

One of the key challenges of ECE is the integration of digital devices into the educational process as a means of expanding children’s learning opportunities and teacher-child interaction, rather than replacing it (Saljo, ). In international preschool practice, digital tools are widely used: in organizing play environment (Marsh et al., , Fleer, Rai, ) and play-based education (Verenikina et al., , Gillen, Kucirkova, ). In Russia, despite the increasing digitalization and the growing availability of gadgets for preschoolers, in preschool education there remains a contradictory attitude towards the use of digital technologies (Soldatova, , Rubtsova et al., ). This study aims to analyze the dynamics of the use of digital tools in kindergartens over the past  years, to identify teachers’ perspective on learning and play and the integration of digital tools into the educational process. The sample includes  preschool classrooms; the digital environment quality was assessed with ECERS- (item  “Appropriate use of technology”).  preschool teachers participated in semi-structured interviews, and  video-cases of using digital devices in the educational process with preschoolers were analyzed. Informed consents were obtained from all the participants; the data were anonymized. A comparative analysis of the average scores by each year showed that there are no qualitative and quantitative changes in relation to the use of digital tools in the educational process: .% of teachers do not use digital tools, an unsatisfactory level of quality of use was recorded in .% of preschool groups, minimal – .%, good – .%. Analysis reveals  trends: avoidance or formal use without taking into account the age specifi cs and children’s interests. Prohibitive and restrictive policies regarding the use of digital devices by preschoolers are widespread. Teachers lack instruments for integrating digital technologies into preschool practice as cultural tools that expand children’s learning opportunities.

Differential sleep subtypes in children with OSA of different ages

ObjectiveThe aim of this study was to evaluate the variations in sleep architecture and types of sleep disturbances in preschool and school-age children diagnosed with obstructive sleep apnea (OSA). MethodsChildren who underwent polysomnography (PSG) were enrolled and divided into two groups based on age: a preschool group and a school-age group. We analyzed differences in sleep architecture and types of sleep disturbances between these groups. ResultsTotal sleep time was significantly higher in the preschool group compared to the school-age group (P < 0.05). The percentage of Stage N1 sleep (N1%) was also higher in the preschool group (p < 0.05). Conversely, the percentage of Stage N2 sleep (N2%) was lower in the preschool group (p < 0.05). Additionally, the average and minimum heart rates were higher in the preschool group, while the minimum oxygen saturation, including during non-rapid eye movement (NREM) and REM stages, was lower compared to the school-age group (P < 0.05). The prevalence of positional OSA (P-OSA) was lower, and the prevalence of REM OSA (R-OSA) was higher in the preschool group (P < 0.05). ConclusionThe prevalence of P-OSA was lower, and R-OSA was higher in preschool children compared to school-age children. Furthermore, the types of sleep disturbances in preschool children with OSA showed significant differences from those in school-age children with OSA.

Phenotypic and Genetic Spectrum in 309 Consecutive Pediatric Patients with Inherited Retinal Disease.

Inherited retinal dystrophies (IRDs) are a common cause of blindness or severe visual impairment in children and may occur with or without systemic associations. The aim of the present study is to describe the phenotypic and genotypic spectrum of IRDs in a pediatric patient cohort in Retrospective single-center cross-sectional analysis. Presenting symptoms, clinical phenotype, and molecular genetic diagnosis were assessed in 309 pediatric patients with suspected IRD. Patients were grouped by age at genetic diagnosis (preschool: 0-6 years, n = 127; schoolchildren: 7-17 years, n = 182). Preschool children most frequently presented with nystagmus (34.5% isolated, 16.4% syndromic), no visual interest (20.9%; 14.5%), or nyctalopia (22.4%; 3.6%; p < 0.05); schoolchildren most frequently presented with declining visual acuity (31% isolated, 21.1% syndromic), nyctalopia (10.6%; 13.5%), or high myopia (5.3%; 13.2%). Pathogenic variants were identified in 96 different genes (n = 69 preschool, n = 73 schoolchildren). In the preschool group, 57.4% had isolated and 42.6% had syndromic IRDs, compared to 70.9% and 29.1% in schoolchildren. In the preschool group, 32.4% of the isolated IRDs were related to forms of Leber's congenital amaurosis (most frequent were RPE65 (11%) and CEP290 (8.2%)), 31.5% were related to stationary IRDs, 15.1% were related to macular dystrophies (ABCA4, BEST1, PRPH2, PROM1), and 8.2% to rod-cone dystrophies (RPGR, RPB3, RP2, PDE6A). All rod-cone dystrophies (RCDs) were subjectively asymptomatic at the time of genetic diagnosis. At schoolage, 41% were attributed to cone-dominated disease (34% ABCA4), 10.3% to BEST1, and 10.3% to RCDs (RP2, PRPF3, RPGR; IMPG2, PDE6B, CNGA1, MFRP, RP1). Ciliopathies were the most common syndromic IRDs (preschool 37%; schoolchildren 45.1%), with variants in USH2A, CEP290 (5.6% each), CDH23, BBS1, and BBS10 (3.7% each) being the most frequent in preschoolers, and USH2A (11.7%), BBS10 (7.8%), CEP290, CDHR23, CLRN1, and ICQB1 (3.9% each) being the most frequent in syndromic schoolkids. Vitreoretinal syndromic IRDs accounted for 29.6% (preschool: COL2A1, COL11A1, NDP (5.6% each)) and 23.5% (schoolage: COL2A1, KIF11 (9.8% each)), metabolic IRDs for 9.4% (OAT, HADHA, MMACHD, PMM2) and 3.9% (OAT, HADHA), mitochondriopathies for 3.7% and 7.8%, and syndromic albinism accounted for 5.6% and 3.9%, respectively. In conclusion we show here that the genotypic spectrum of IRDs and its quantitative distribution not only differs between children and adults but also between children of different age groups, with an almost equal proportion of syndromic and non-syndromic IRDs in early childhood. Ophthalmic screening visits at the preschool and school ages may aid even presymptomatic diagnosis and treatment of potential sight and life-threatening systemic sequelae.

Clinical analysis of 124 cases of mycoplasma pneumoniae infection with conjunctivitis in children

Objective: To explore the distribution characteristics of symptoms and signs of respiratory mycoplasma pneumoniae infection complicated with conjunctivitis in children of different age groups. Methods: A retrospective case series study was conducted. Data of children who were treated in Beijing Children's Hospital Affiliated to Capital Medical University from September 20, 2023 to November 30, 2023, had definite mycoplasma pneumoniae infection as confirmed by mycoplasma pneumoniae nucleic acid or mycoplasma pneumoniae IgM antibody test, and had conjunctivitis as the first diagnosis in ophthalmology department were continuously collected. The included children were divided into infant group (age<4 years), preschool group (age 4 to 6 years), and school-age group (age>6 years) for analysis. Information such as the time of ocular symptoms onset, the time of systemic symptoms onset, conjunctival sac secretion, subconjunctival hemorrhage, conjunctival congestion, corneal epithelial damage, co-infection with other pathogens, and treatment of all children was collected and compared among children of different age groups. Results: During this period, there were a total of 31 133 children with positive laboratory test results for mycoplasma pneumoniae. Among them, 835 children visited the ophthalmology department during the same period, and 124 cases (229 eyes) had conjunctivitis as the first diagnosis. The age was (5.43±2.83) years, including 72 males and 52 females. There were 37 cases (69 eyes) in the infant group, 48 cases (92 eyes) in the preschool group, and 39 cases (68 eyes) in the school-age group. Among the 229 eyes, 179 eyes (78.16%) had conjunctival secretion, all manifested as mucopurulent secretion; 12 eyes (5.24%) had corneal epithelial defect; and 26 eyes (11.35%) had subconjunctival hemorrhage. There was 1 eye (1.45%) with subconjunctival hemorrhage in the infant group, 16 eyes (17.39%) in the preschool group, and 9 eyes (13.24%) in the school-age group. The proportion of subconjunctival hemorrhage in the preschool group and school-age group was higher than that in the infant group (both P<0.05). Thirty-nine cases (31.45%) were found to have co-infection with viruses in laboratory tests, including influenza A virus, adenovirus, respiratory syncytial virus, and coxsackievirus. The proportion of children in all age groups with ocular symptoms first was higher than that with systemic symptoms first. There was no statistically significant difference among children in the three age groups in terms of whether there was conjunctival secretion, whether there was corneal epithelial damage, whether there was co-infection with viruses, and the interval between ocular symptoms and systemic symptoms onset (all P>0.05). Conclusions: The characteristic ocular manifestations of children with mycoplasma pneumoniae infection complicated with conjunctivitis are conjunctival congestion and subconjunctival hemorrhage, and the signs are more obvious in preschool children. The conjunctival sac secretion of such children with conjunctivitis is mostly manifested as mucopurulent. Ocular symptoms may be the first manifestation of mycoplasma pneumoniae infection.

Impaired respiratory functions in children with cat sensitization in the early ages of childhood

Background To evaluate the respiratory functions in children with cat sensitization accompanying allergic respiratory diseases and to compare these with those of healthy controls, as well as within themselves by classifying according to their diseases, domestic cat exposure, and age groups. Methods This prospective case-control study included 130 children aged 3–17 years with cat sensitization (CS group) accompanying respiratory allergic diseases and 70 age- and sex-matched healthy controls (HC group). The cases’ demographic parameters were recorded, and respiratory functions were analyzed using IOS and spirometry. Results At IOS evaluation, zR5, R5-20, Fres, and AX values were higher in children in the CS group compared to the HC group (p = 0.029, p = 0.008, p = 0.001, and p < 0.001, respectively), while zX5 and zX20 values were lower (p = 0.001 and p < 0.001). R5-20 and AX were higher in asthma compared to allergic rhinitis (p = 0.008, p = 0.015), but were insignificant compared to asthma and allergic rhinitis coexistent group (p > 0.05). R5-20, Fres, and AX were higher, and zX20 was lower in the preschool age group (p < 0.001). No correlation was found between zFEV1, zFVC, zFEV1/FVC, zFEF25-75, and zR5 values in the CS group (p > 0.05). Conclusions Pulmonary resistance was higher and reactance was lower in the entire and peripheral airways in children with cat sensitization accompanying respiratory allergic diseases compared to the healthy controls. Peripheral airway resistance and reactance were more impaired in the asthma group compared to allergic rhinitis. However, peripheral airway resistance and main airway reactance were more impaired in the preschool age group than in the older ones.

The impact of the type of playful massage movements on the perception of tactile stimulation in children: EEG study

Tactile play and playful massage are a normal interaction between adults and children in many cultures. Experimental data show that activation of the C-tactile system during such playful touches contributes to children’s socialization and the establishment of psychoemotional bonds in the parent-child dyad. However, comprehensive studies of the effects of different types of touch on perception of tactile stimulation in children have not been conducted before. Twenty-three children participated in the present study: 10 in the preschool age group and 13 in the elementary school age group. Children in both groups received play massage containing different types of touch with simultaneous recording of electroencephalogram (EEG) and heart rate. EEG processing included determination of spectral power, alpha rhythm peak frequency and fractal dimension. Analysis of the results showed that the relaxing effect of the procedure was more pronounced in children of primary school age, which can be explained both by the greater maturity of the CNS and the greater need for tactile contact, which is not realized in the school environment.

Temporal trend of the global prevalence rate of tension-type headache in children and adolescents in 1990-2021

To investigate the prevalence of tension-type headache (TTH) in children and adolescents aged 0-19 years globally in 1990-2021, and to provide a basis for the prevention and treatment of TTH. Based on the Global Burden of Disease Study data, the age-standardized prevalence distribution of TTH and its changing trend were analyzed among the children and adolescents aged 0-19 years, with different sexes, age groups, sociodemographic index (SDI) regions and countries/territories. The age-standardized prevalence rate (ASPR) of TTH in children and adolescents aged 0-19 globally in 2021 was 17 339.89/100 000, which was increased by 1.73% since 1990. The ASPR in females was slightly higher than that in males (1990: 17 707.65/100 000 vs 16 403.78/100 000; 2021: 17 946.29/100 000 vs 16 763.09/100 000). The ASPR in adolescence was significantly higher than that in school-aged and preschool periods (1990: 27 672.04/100 000 vs 10 134.16/100 000; 2021: 28 239.04/100 000 vs 10 059.39/100 000). Regions with high SDI exhibited a higher ASPR than the other regions, with significant differences in prevalence rates across different countries. From 1990 to 2021, there was a slight increase in global ASPR, with an average annual percentage change (AAPC) of 0.06%. Females experienced a smaller increase than males based on AAPC (0.04% vs 0.07%). There was reduction in ASPR in preschool and school-aged groups, with an AAPC of -0.02%, while there was a significant increase in ASPR in adolescence, with an AAPC of 0.07%. ASPR decreased in regions with low-middle and low levels of SDI, with an AAPC of -0.02% and -0.04%, respectively, while it increased in regions with middle SDI, with an AAPC of 0.24%. There is a consistent increase in the ASPR of TTH in children and adolescents aged 0-19 years globally, with significant differences across sexes, age groups, SDI regions and countries/territories.

Diversity in perceptual, social, and executive functions in preschoolers from Germany and Iran

The cultural background and age shape the cognitive and social development of children. This study aimed to compare perceptual, executive, and social functioning in two age groups of preschoolers from Germany and Iran. One hundred sixty-five children (83 Iranian and 82 German) participated in the study, with 87 children aged three years and 78 children aged four years. The participants completed a series of tasks to assess different cognitive functions, including the theory of mind as a measure of social cognition, picture mental rotation test to evaluate spatial ability, and several tests including digit span, Corsi block tapping, day-night, grass-snow, dimensional change card sort, and active and passive vocabulary tests to assess executive functions. The findings revealed that German children performed better than their Iranian peers regarding spatial ability and theory of mind. Additionally, German children outperformed Iranian children in working memory, cognitive flexibility, and verbal fluency, while Iranian children demonstrated better inhibitory control. Furthermore, the correlational analysis indicated that in German children, executive function correlated with the theory of mind, whereas in Iranian children, executive function was associated with perceptual functions. Age impacted the results. These results highlight the role of cultural factors in shaping cognitive functioning and emphasize the need to consider cultural influences when examining cognitive development in different populations.

Clinical characteristics and toxicological spectrum analysis of 493 cases of acute poisoning in children

ObjectiveThis retrospective study aimed to analyze the clinical characteristics and toxicological spectrum of acute poisoning in children treated at our pediatric intensive care unit. The findings provide a basis for the treatment and prevention of acute poisoning in children.MethodsClinical data of hospitalized children aged 0 to14 years with acute poisoning, treated between January 2015 and December 2023, were collected and analyzed. The analysis included the types of poisoning, sex and age distribution of children, routes and causes of poisoning, time from poisoning to medical consultation, length of hospital stays, and treatment outcomes.ResultsAmong the 493 cases of acute poisoning in children, pesticide poisoning (n = 252, 51.1%) was the most common type, followed by medication poisoning (n = 182, 36.9%). Chemical poisoning accounted for 7.7% (n = 38), while food poisoning and inhalation of harmful gases accounted for 3.0% (n = 15) and 1.2% (n = 6), respectively. The main route of poisoning was oral ingestion (n = 477, 96.8%), while accidental ingestion accounted for a large proportion (n = 379, 79.4%), and adolescents aged 11 to 14 years accounted for 20.6% (n = 98).Apart from the predominance of girls attempting suicide by self-administering antipsychotic medications (n = 88, 75.9%) due to depression, there was no significant difference in sex distribution among other types of poisoning children. The highest incidence of poisoning except children who self-administer antipsychotic drugs occurred in children aged 1–3 years (n = 267, 54.2%) and 8–14 years (n = 135, 27.4%), with the highest proportion in the preschool age group. The average time from poisoning to medical consultation was 33.4 ± 54.9 h, and majority of children received treatment within 48 h after poisoning (n = 423, 85.8%). The overall effective treatment rate was 96.8%.ConclusionAcute poisoning in children has complex and diverse causes, with accidental ingestion being the main route. Prevention should be emphasized, including strengthening child safety education and improving parental supervision. Moreover, psychological health education is crucial for adolescents during their puberty. In the event of acute poisoning, prompt medical consultation and appropriate treatment are necessary to mitigate adverse outcomes.

Postoperative complications in the pediatric population. Malnutrition or phase angle? Which one do we use?

Malnutrition increases post-operative risks like infections and prolonged stays. Pediatric assessment challenges require using anthropometric measurements and phase angle, which reflects body cell mass and health outcomes. Phase angle varies by maturation stages, making it crucial for pre-surgical evaluations alongside BMI. This study aimed to determine the relationship between nutritional status, phase angle, and postoperative complications in pediatric patients who underwent surgery. Prospective study with patients aged 3-17 undergoing major non-ambulatory surgery. Anthropometric measurements (weight, height, BMI Z-scores) hand grip strength, dietary intake and body composition via bioimpedance to assess phase angle were recorded. Postoperative complications were monitored, including surgical site infections, morbidity (pneumonia, inotropic support, infections, thromboembolism), and mortality. Surgical risks and pre- and postoperative conditions were documented. After the application of the selection criteria, a total of 391 patients who underwent surgery were included; 60% (n = 235) were within the range of the preschool and school-age groups. During the follow-up period, 51 (13%) patients developed at least one postoperative complication, with surgical site infections being the most common. Moreover, as phase angle decreased, the length of stay (LOS) increased in all the participants. Among children aged ≤12 years old, malnutrition was a risk factor for complications [OR 3.86 (1.61-9.27 95%CI)], whereas among adolescents, phase angle served as a protective factor [OR 0.63 (0.42-0.94 95%CI)]. Significant associations were observed between nutritional status, by BMI z-score, and post-surgical complications in younger patients. Additionally, in adolescents, the phase angle emerged as a protective factor against these complications.

Etiologic and demographic characteristics of syncope in children and adolescents: a nationwide population-based study in Korea.

Syncope is common among children and adolescents. Although it is most commonly caused by vasovagal syncope, it can also be due to undiagnosed, potentially serious, or even life-threatening conditions. We aimed to investigate the distribution of subsequent sinister diagnoses, such as heart disease (HD) and epilepsy, and analyze their demographic characteristics in children presenting with syncope. This nationwide, population-based study was conducted using the Korean Health Insurance Review and Assessment Service database. Patients aged <19 years at the time of their first visit between January 2010 and December 2014, who had primary, secondary, or additional diagnostic codes for syncope, were selected and followed up for a minimum of 5 years from the index date to investigate subsequent diagnoses of HD or epilepsy. Patient demographics, diagnostic codes, and prescriptions were retrieved from the database. A total of 75,839 patients with new-onset syncope were identified, of which 239 (0.3%) and 2,516 (3.3%) were subsequently diagnosed with HD and epilepsy, respectively. In the infant, toddler, and preschool age groups, the proportions of patients with subsequent diagnoses of HD and epilepsy were relatively lower (5/5,353, 0.1%) and higher (206/5,353, 3.8%), respectively, than the proportions in the other age groups. A male preponderance was noted for patients with syncope who were later diagnosed with HD or epilepsy (P<0.001). The proportion of patients experiencing syncope with a subsequent diagnosis of HD was relatively high in the summer. The subsequent diagnosis of potentially life-threatening diseases in pediatric syncope, including HD and epilepsy, is relatively low in all age groups. In addition to comprehensive history taking and physical examination, demographic data such as age and sex, and season of occurrence, can aid in diagnosing the underlying cause of pediatric syncope by helping to identify patients who may require further investigations.

Frequency of Anicteric Hepatitis A Virus Infection in a Group of Pre-School Egyptian Children Presenting with Gastroenteritis like Manifestations

Abstract Background Hepatitis A virus (HAV) infection is one of the most frequent communicable diseases with an estimated 1.5 million cases diagnosed each year globally. Most infections in children under the age of six are asymptomatic and if infection occurs, it is usually anicteric. Therefore, the disease is underreported. Aim To determine the prevalence of HAV infection in a group of Pre-School Egyptian children presenting with gastroenteritis like manifestations and anicteric-hepatitis and to correlate that with social and demographic risk factors. Patients and Methods This was a cross sectional study conducted at Ain Shams University Children’s hospital emergency room and outpatient clinic, Cairo, Egypt during the period from February 2023 to July 2023 and performed on 385 preschool Egyptian child presented with acute gastroenteritis like manifestations; who were jaundice free, with no past history of HAV infection, HAV vaccination or chronic liver disease. To all enrolled cases, history was taken, clinical examination done, socioeconomic status and liver enzymes assessed, HAV IgM antibody was evaluated only in group with elevated liver enzymes double upper limit of normal for age and sex and for cases with positive HAV IgM, complete blood count and international normalized ratio (INR) withdrawn to assess severity of the disease. Results Among the enrolled cases, only 32 cases had elevated liver enzymes (8.3%), 4 cases had positive HAV IgM (1%) with no stastical difference between males and females. Poor hand hygiene was significantly higher in group with elevated liver enzymes compared to other studied cases. Lower score in family possessions in socioeconomic evaluation was significant in the group with positive HAV IgM in comparison to the remained studied population. Conclusion Frequency of anicteric HAV infection is not uncommon in preschool age group with gastroenteritis like manifestations. Hand hygiene and family possessions can influence its prevalence. Hepatomegaly, right hypochondrial tenderness and certain cut values of transaminases may be used as good NPV values in diagnosis of HAV infection.

Pattern and Outcome of Lower Respiratory Tract Infections in Pediatric Critically Ill Patients in Intensive Care Unit during Winter Season 2022-23

Abstract Background Lower respiratory tract infection (LRTIs) are the worldwide leading cause of morbidity and mortality among children under the age of five years. However, epidemiological data in the pediatric population are poor. Objective This study aims to describe the pattern of LRTIs in critically ill patients admitted to the PICU of Ain Shams university hospital between October 2022 to March 2023 to shed the light on causative organisms, ventilatory modes used, length of stay and outcome. Methods A retrospective descriptive study including all patients admitted to PICU with LRTIs between October 2022 and March 2023. Patients were excluded from this study if they had a definite history (from their parents) of a chronic lung disease; as bronchial asthma, bronchiectasis, etc.), or if they had a frank diagnosis of such disease clearly stated in their medical files prior to PICU admission. All data were collected from the official PICU files of Ain Shams University hospital. Results The study comprised 192 patients divided into: an infant group below 2 years representing 156 (81.3%) patients, a preschool group between 2-5 years representing 24 (12.5%) patients and a school group between 5-14 years representing 12(6.3%) patients. 62% of patients were males with a median(IQR) age 0.33 (0.166-1) years. The median (IQR) weights was 5.75 (4.1-9.5) Kgs. 93.2% of cases were diagnosed as pneumonia and 6.8% bronchiolitis. Viral infections constituted 64.1% of cases, RSV (27%), rhinovirus (19.8%), enterovirus (14.6%) and adenovirus (9.9%). Viral infections prevailed in the infant group. Bacterial infections constituted (13.5%) of cases. Klebseilla pneumoniae first with (9.9%), then pseudomonas aeruginosa (3.6%) and staphylococcus aureus (3.4%). The rest of cases (22.4%) were mixed infections. 92.7% of our patients were put initially on non-invasive (NIV) mode, 12.4% of whom reverted to invasive modes. Factors contributing to this inversion were; low initial SO2, hypercapnia, associated comorbidities, hypoalbuminemia and lymphopenia. The length of stay in the PICU was less than 2 weeks in 86.6% of cases with a median (IQR) 7(5-10) days. 13.5% of patients exceeding 2 weeks of stay were those with bacterial or mixed infections and those suffering from comorbidities. 157 (81.8%) of patients were survivors. Factors contributing to poor outcome were essentially the same factors related to the use of invasive ventilation as well as to the prolonged stay in PICU. Conclusion LRTI of viral origin (especially RSV) is predominant in infants below 2 years of age during the winter season with a relatively more benign course and a better outcome. Bacterial infections, on the other hand, tend to affect older children (preschool age) with more aggressive course and poorer outcome. Klebsiella pneumoniae is a bacterium which causes serious nosocomial LRTI with poor outcome and bears no relation to seasonal variation. Previous PICU and NICU admissions and the presence of associating comorbidities especially cardiac, neurological and genetic (Down syndrome) tend to prolong the PICU stay and worsen the outcome.

ACTUAL PROBLEMS OF DEVELOPING SAFE BEHAVIOR SKILLS IN CHILDREN OF THE SENIOR PRESCHOOL GROUP

In the article, the authors consider the problems that hinder the development of safe behavior skills of children of the senior preschool group. A literary review of the works of foreign and Kazakhstani teachers and scientists on the safe behavior of older preschool children is made. The definitions of “safety” and “safe behavior” are analyzed. The current state of work on the development of safe behavior skills in a preschool organization, at home, on the street is studied; the characteristic of behavioral reactions of senior preschool children is given; the normative legal documents, the State mandatory standard of preschool education and training of the Republic of Kazakhstan and the Standard curriculum of preschool education and training of the Republic of Kazakhstan in the educational direction “Formation of socio-emotional skills” are analyzed. The purpose of the study is to identify current problems that hinder the development of safe behavior skills in children of the senior preschool group. The authors analyzed the types of child safety (social, physical and psychological, information, transport, educational, environmental, medical, legal and others), which are currently debatable. Based on the analysis of psychological and pedagogical literature, the current problems of ensuring and threatening the safety of children at home, on the street, in a preschool organization are identified. The ways of solving the problems reflected in foreign and Kazakhstani studies on ensuring the safety of older preschool children are considered. In the perspective of our research, determining the effectiveness of “playful learning” in the development of safe behavior skills and its implementation in the educational process of a preschool organization.