Significance In Children Research Articles

Dynamic changes in peripheral type II innate lymphoid cell (ILC2) subpopulation and its clinical significance in children with hay fever during the pollen season

Objective To analyze the dynamic changes in the expression and function of peripheral type Ⅱ innate lymphoid cell (ILC2) subpopulation and the activity of signal transducers and activators of transcription (STAT6) in children with hay fever during pollen season. Methods A total of 10 patients with hay fever, 10 patients with house dust mite (HDM)-sensitized asthma and 12 healthy controls (HC) were enrolled in this study. Changes in peripheral ILC2 and the intracellular expression of Th2-related cytokines were detected by flow cytometry during and outside the pollen season. Peripheral Lin- cell population was isolated from each group and cultured with the presence of IL-25 or IL-33 for 7 d. The concentrations of IL-5 and IL-13 in culture supernatants were measured by ELISA. Expression of phospho-STAT6 at protein level was quantified by Western blot. Results Within the pollen season, the percentage of peripheral ILC2 cells was significantly higher in children with hay fever [(23.09±7.86)%] than in children with HDM-sensitized asthma [(6.84±3.85)%, P<0.05] and healthy children[(1.69±0.87)%, P<0.05]. In the non-pollen season, the peripheral ILC2 cells in children with hay fever presented a decreasing trend [(11.30±2.45)%], but was still higher than that in HDM-sensitized asthmatics [(3.76±1.96)%, P<0.05] and HC [(1.32±0.91)%, P<0.05] at the same time point. Moreover, peripheral IL-13+ ILC2 cells in children with hay fever [(6.94±3.16)% vs(4.17±1.98)%, P<0.05] and in HDM-sensitized asthmatics [(1.89±0.70)% vs(1.44±0.55)%, P<0.05] during the pollen season were significantly higher than those in the non-pollen season. After the in vitro stimulation with IL25 or IL-33, the levels of IL-5 and IL-13 in culture supernatants were both increased in children with hay fever and HDM-sensitized asthmatics, and a synergistic action was observed when IL25 and IL-33 were used in combination. Meanwhile, the protein level of phospho-STAT4 in Lin- cells was significantly up-regulated in the hay fever group after stimulation with IL25 and IL-33. Conclusions During the pollen season, the abnormal number and function of ILC2 subpopulation in children with hay fever might be another cause of the occurrence of clinical symptoms in a short period of time or acute exacerbation. Key words: Hay fever; House dust mite; Artemisia; Signal transducer and activator of transcription 6; Type Ⅱ innate lymphocyte cells

Zahid Xəlil – Çağdaş uşaq poeziyasının nümayəndəsi kimi

Writing on children's literature, topics that are of interest to them are difficult to explore and the works that shape the aesthetic taste of children are hard to come by. Some of the keynote speakers have devoted their lives to the creation of this literature. One of the poets who wrote modern children's poetry is Zahid Khalil. He brings to life literature about topics that children try to learn, observations of life, and tries to create a series of original images. The article analyzes children's poems, which play an important role in Zahid Khalil's creativity, and explores their themes, ideas and significance for children.

Hematological parameters in children with severe acute respiratory syndrome coronavirus 2 infection

Introduction. Recently, there has been a need to use more readily available parameters to assess the severe acute respiratory syndrome coronavirus 2 infection in children. Material and Methods. A single-center retrospective study included 30 children with severe acute respiratory syndrome coronavirus 2 infection who were admitted to the Isolation Department of the Institute for Child and Youth Health Care of Vojvodina from April to September 2020. A complete blood count with differential was performed. Additionally, systemic inflammatory index, neutrophil-lymphocyte ratio and plateletlymphocyte ratio were calculated. For comparison, age- and sex-matched 30 children negative for severe acute respiratory syndrome coronavirus 2 were included in the study. Results. In the period from April to September 2020, 30 laboratory-confirmed cases of coronavirus-19, aged 0 - 17 years, were admitted to the Institute for Child and Youth Health Care of Vojvodina. The age was not a risk factor for the development of coronavirus-19 (p = 0.707; OR: 1.018; 95% CI: 0.927 - 1.119). The comparison of hematological parameters of severe acute respiratory syndrome coronavirus 2 status showed that hemoglobin concentration (p &lt; 0.01) and hematocrit (p &lt; 0.01) were lower, and the percentage of neutrophil granulocytes (p &lt; 0.05) was higher among severe acute respiratory syndrome coronavirus 2 positive children. Furthermore, it was found that some severe acute respiratory syndrome coronavirus 2 positive children had a higher (p &lt; 0.01), while others had a lower (p &lt; 0.01) percentage of lymphocytes. The systemic inflammatory index, the ratio of neutrophils to lymphocytes, and the ratio of platelets to lymphocytes, were not found to be statistically significantly different (p &gt; 0.05). Conclusion. Low hemoglobin and hematocrit levels, a high percentage of neutrophil granulocytes, and a non-physiological percentage of lymphocytes (both, low and high) may have a diagnostic significance in children with severe acute respiratory syndrome coronavirus 2 infection.

Factors influencing quality of life in children with atopic dermatitis and their caregivers: a cross-sectional study

Better understanding of atopic dermatitis’ effect on quality of life could enhance current management and therapeutic strategies. Studies investigating factors related to the health-related quality of life (HRQOL) of children with atopic dermatitis and their caregivers are limited. This cross-sectional study included 559 children (<16 years) with atopic dermatitis and their caregivers. Disease severity was associated with infants’ HRQOL (moderate: IRR: 1.42, 95% CI 1.20–1.67; severe: IRR: 1.72, 95% CI 1.32–2.24). Age and disease severity were associated with children’s HRQOL (age: IRR: 0.99, 95% CI 0.98–1.00; moderate: IRR: 1.08, 95% CI 1.02–1.14). Quality of life subdomains itching/scratching, emotional distress and sleep disturbance were most reported and increased with higher disease severity. Both caregivers’ mental and physical health were negatively affected by children’s HRQOL (physical: IRR: 0.99, 95% CI 0.99–1.00; mental: IRR: 0.98, 95% CI 0.97–0.99). Sociodemographic characteristics (gender, ethnicity, educational attainment of carers, number of children) did not demonstrate significance in children’s HRQOL model. In conclusion, current atopic dermatitis diagnostics and treatment have to be extended to the factors influencing both children’ as their caregivers’ quality of life and adapting management accordingly. Itching/scratching, emotional distress and sleep disturbance deserve attention. Sociodemographic characteristics in children’s HRQOL models also merit attention in further research.

Reclassification of Variants of Uncertain Significance in Children with Inherited Arrhythmia Syndromes is Predicted by Clinical Factors.

Genetic testing is important to augment clinical diagnosis and inform management of inherited arrhythmias syndromes (IAS), but variants of uncertain significance (VUS) are common and remain a challenge in clinical practice. In 2015, American College of Medical Genetics (ACMG) published updated guidelines for interpretation of genetic results. Despite increasing understanding of human genomic variation, there are no guidelines for reinterpretation of prior genetic test results. Patients at a single tertiary children's hospital with genetic testing for an IAS that demonstrated a VUS were re-evaluated using 2015 ACMG guidelines, clinical information, and publically available databases. Search of the electronic medical record identified 116 patients with genetic testing results available, and 24/116 (21%) harbored a VUS for an IAS. 23 unique VUS were evaluated from 12 genes. Over half of the VUS (12/23 (52%)) were reclassified using 2015 criteria, and 8 (35%) changed to pathogenic and 4 (17%) to benign. Relative risk of reclassification of VUS to a pathogenic variant in a patient with confirmed clinical diagnosis was 4.1 (95% CI 1.23-15.4). Reclassification was not associated with initial testing year. These data demonstrate 52% of VUS in children with IAS are reclassified with application of 2015 ACMG guidelines. Strength of phenotyping is associated with eventual pathogenic classification of genetic variants and periodic re-evaluation of VUS identified on genetic testing for IAS is warranted.

Нарушения системы гемостаза и их клинико-патогенетическое значение при хроническом вирусном гепатите С у детей

Введение. В последние годы отмечается рост заболеваний печени у детей, среди которых одно из ведущих мест занимает хронический вирусный гепатит С (ХГС). Однако до настоящего времени окончательно не изучено воздействие вируса на организм ребенка, а именно, влияние вируса на гемостазиологический гомеостаз. Цель исследования: изучить нарушения системы гемостаза и оценить их клиникопатогенетическое значение у детей с ХГС. Материалы и методы. В исследование включен 31 пациент с ХГС в возрасте от 3 до 17 лет 17 (55) девочек и 14 (45) мальчиков. Контрольную группу составили 15 детей, относящихся к I или II группам здоровьям. У всех участников исследования оценивали состояние эндотелия, системы гемокоагуляции, эндогенных антикоагулянтов и фибринолиза, агрегационную активность тромбоцитов. Результаты. У детей с ХГС в первые 10 лет заболевания, несмотря на высокий уровень виремии, отсутствовали признаки тяжелого поражения печени. Изменения в системе гемостаза проявлялись повышением агрегационной активности тромбоцитов, фактора фон Виллебранда, содержания эндотелина1 и гомоцистеина, активности антитромбина III и ингибито ра активатора плазминогена. Увеличение вирусной нагрузки при ХГС у детей сопровождалось нарушением коагуляционного гемостаза. Длительная персистенция вируса в организме ребенка сопровождалась увеличением плотности печени по данным непрямой эластометрии. Заключение. ХГС у детей в первые 10 лет заболевания характеризуется относительно мягким течением. Независимо от генотипа вируса выявляются нарушения, затрагивающие сосудистотромбоцитарное, антикоагулянтное и фибринолитические звенья системы гемостаза, которые коррелируют с тяжестью патологического процесса. Introduction. In recent years the increasing incidence of hepatic diseases is noted in children and chronic viral hepatitis C (CHC) occupies among them one of the leading places. However, until now the impact of this virus on the childs organism has not been properly studied yet, in particular the virus effect on hemostasiological homeostasis. Aim: to study haemostatic disorders and to assess their clinical and pathogenetic significance in children suffering from CHC. Materials and methods. The study included 31 patients with CHC aged from 3 to 17 years 17 (55) girls and 14 (45) boys. The control group consisted of 15 children with their health category I and II. The state of endothelium, haemocoagulation system, endogenous anticoagulants and fibrinolysis and the platelet aggregation activity were assessed in all patients. The increase in viral load in children with CHC was accompanied by disturbance of coagulation hemostasis. Prolonged persistence of the virus in the childs body was accompanied by an increase in liver density according to indirect elastometry. Results. In the first 10 years of the disease children with CHC had no symptoms of severe hepatic lesion in spite of high viremia level. Haemostatic changes were manifested by increased platelet aggregation activity, von Willebrand factor, endothelin1 and homocysteine levels, antitrombine III activity and plasminogen activator inhibitor. The increased viral load in children with CHC was followed by disturbance of coagulation hemostasis. Prolonged virus persistence in the childs body was accompanied by higher hepatic density according to indirect liver elastometry data. Conclusion. In the first 10 years of the disease CHC in children is characterized by a relatively mild course. Irrespective of viral genotype disorders are identified affecting vascularplatelet, anticoagulative and fibrinolytic links of hemostasis that correlate with the pathologic process severity.

Free Water Transport and its Association with Cardiovascular Status in Children on Peritoneal Dialysis

Background:Volume overload is one of the most important factors associated with left ventricular hypertrophy (LVH) and cardiovascular disease in chronic peritoneal dialysis (PD) patients. MiniPET is a reliable tool to evaluate free water transport (FWT). In a clinical setting, the significance of FWT has not been evaluated in terms of outcome in children on PD. The objective was to define a FWT value of clinical significance in children on PD, fixing its relationship to left ventricular mass index (LVMI) as a well-known outcome parameter.Methods:MiniPET was performed with 3.86% glucose, 1-h long, to measure FWT in PD patients > 6 years old. An echocardiogram (ECG) was performed within 2 months of the MiniPET. Left ventricular hypertrophy was defined as LVMI ≥ 38.6 g/height2.7 (95th percentile). Receiver operating characteristic curve (ROC) analysis was used to determine the cut-off value of FWT searching the highest sensitivity and specificity to differentiate patients with normal/abnormal LVMI. A p < 0.05 was considered significant.Results:Forty-six studies were performed on 32 patients, 16 males; mean age 11.59 ± 3.07 years. Mean normalized FWT (nFWT) was 144.4 ± 84.8 mL/m2, corresponding to 46.7% of total ultrafiltration. Mean LVMI was 42 ± 11.3 g/m2.7 with a negative correlation to nFWT (p < 0.01). Eighteen out of 32 patients had LVH. The ROC analysis (nFWT vs LVMI) showed an area under the curve of 0.71 (95% confidence interval [CI], 0.53 - 0.89; p = 0.04), allowing a cut-off nFWT value of 110 mL/m2 to be defined, dividing the population into 2 groups of patients according to the LVMI cut-off value of 38,6 g/m2.7.Conclusions:The nFWT showed an inverse correlation to LVMI. A nFWT value < 110 mL/m2 was significantly associated with LVH. The negative relationship observed between nFWT and LVMI, and the cut-off level for nFWT according to the 95th percentile of LVMI, suggest that the regular evaluation of nFWT could become a useful tool in assessing the capacity of PD treatment to keep patients' volume status under control, avoiding cardiovascular impairment.

Interleukin 27 Serum Level And Its Prognostic Significance In Children With Immune Thrombocytopenia

Aim of the work: was to determine the level of IL-27 in patients with immune thrombocytopenia and its relationship to demographic,clinical and laboratory characteristics of patients as well as disease chronicity and response to treatment. Methods: A case control study carried out in Pediatric Hematology outpatient clinic , Zagazig University Hospitals. It included 80 subjects were divided into 4 group 1 included 20 patients with denovo ITP, group 2 included 20 patients with chronic ITP, group 3 included 20 patients with complete remission after 1st line therapy and group 4 (control group) included 20 healthy children as a control group. Results: there is significant difference regarding WBCs and Platelets, there was no significant difference in patients with ITP as regards hemoglobin level. ITP patients had significantly higher levels of IL-27 than controls. patients with acute ITP had the highest levels of IL-27 among patient groups ,while, patients in remission had the lowest IL-27 levels among patient groups. There was significant relationship between 1st line therapy and serum IL-27 in patients with ITP. Patients who received IVIG and combined steroids and IVIG had significantly higher IL-27 levels than others. There was significant relationship between 2nd line therapy and serum IL-27 in patients with chronic ITP. Where patients who received Eltrombopag had significantly lower IL-27 levels than others. Conclusion: we propose that the using of IL-27 as a predictor for ITP occurrence and for responsiveness to treatment but this need to be confirmed in larger studies.

Diuretic Responsiveness and Its Prognostic Significance in Children With Heart Failure

BackgroundLoop diuretics are considered first-line therapy for congestion in children with heart failure, although some patients remain volume overloaded during treatment. We sought to characterize loop diuretic responsiveness (DR) in children hospitalized with acute decompensated failure and to determine whether a decreased response was associated with worse outcomes. Methods and ResultsDR was calculated for 108 consecutive children ˂21 years of age who were hospitalized with acute decompensated heart failure. DR was defined as net fluid (mL) output per 1 mg of furosemide equivalents during the first 72 hours of treatment with a loop diuretic. The primary outcome was the composite end point of inpatient death or use of mechanical circulatory support. The median DR was 6.0 mL/mg (interquartile range -2.4 to 15.7 mL/mg). Thirty-two percent of patients remained in a positive fluid balance after 72 hours of treatment with a loop diuretic. Death or use of mechanical circulatory support occurred in 29 patients (27%). Low DR was associated with the composite end point, even after adjusting for net urine output and loop diuretic dose indexed to weight (odds ratio 5.3; P = .003). Patients with low DR also experienced longer length of hospital stay than patients with greater DR (median 33 days vs 11 days; P = .002). ConclusionIn children hospitalized with acute decompensated heart failure, early diminished loop DR during decongestion therapy is common and portends a poor prognosis.

The impact of Classroom Activity in Enhancing Working Memory Development in Preschoolers

Introduction Working Memory develops during toddlerhood and continues through adolescence and early adulthood. The primary factors determining the level of brain development in pediatrics are genetics and the environment (Basset, Denham, Wyatt, & Warren-Khot, 2012). Although the genetic factor cannot be manipulated, research shows that the environmental component can be substantially changed (Lillard, 2012). The environment involves the interactions that a child is exposed to. Such research suggests that the children who exhibit delayed in the level of working memory could be helped with adequate ways of specialized training. The proficiency of working memory is dictated by how fast and efficient information travels between different areas of the brain. How well a child performs academically, socially, and emotionally is defined by the working memory level he or she has (NSCDC, n.d.). The study will focus on how classroom activitieswill benefit preschoolers’ social and working memory development. According to a working paper of Building the Brain's Air Traffic Control System, “Large individual differences in working memory at kindergarten entry can have important implications for children’s adjustment and success in and out of school as well as in their relationships with others”. Scientists have emphasized the importance of social domain; playing and activities with peers or adults can be an effective practice for improving children’s braindevelopment. The significance of children’s interacting in preschool groups is to carry out prosaically behaviors in the social development (Evangelou, 1989). Preschool group’sinteraction among young children can have several advantages for preschoolers' critical development, such as offering instruction, involving in collaboration activities, promoting socialization, and being aware of peers' roles in different social positions (Evangelou, 1989). Preschool classrooms increase social development in order to improve working memory in preschoolers. Since these brain faculties develop from early childhood to post-puberty, it is arguably true that older children have better working memory skills compared to younger ones. The research question: Is classroom activities helpful for preschoolers' social and working memory development?

Analysis of the initial symptoms and its diagnostic significance in children with neuroblastoma

Objective To explore the significance of the initial clinical symptoms and clinical manifestations of neuroblastoma(NB) to achive early identification of NB. Methods A retrospective study was performed on patients diagnosed with NB, who attended the Hematology Oncology Center, Beijing Children′s Hospital from March 31st, 2007 to March 31st, 2015.The clinical characteristics were compared between the children <1-year-old and ≥ 1-year-old.The result was analyzed to compare the difference in clinical symptoms and tumor biologic characteristics of patients with different initial clinical symptoms between 2 groups. Results A total of 330 patients were included in the study, 43 of them were younger than 1 year old, and their most common symptoms were cough and fever(each 17 cases, and accounted for 39.5%, respectively); while the most common symptoms in patients ≥1-year-old (287 cases) was fever(177 cases, 61.7%), followed by lymphadenopathy(107 cases, 37.3%), bone pain(97 cases, 33.8%) and anemia(48 cases, 16.7%). The frequency of symptoms differed significantly between 2 groups(all P<0.05), such as fever(39.5% vs.61.7%, χ2=6.68), anemia(4.7% vs.16.7%, χ2=6.00), bone pain(0 vs.33.8%, χ2=18.99), abdo-minal pain(0 vs.25.3%, χ2=10.19), diarrhea(16.3% vs.3.0%, χ2=12.73), lymphadenopathy(7.0% vs.37.3%, χ2=14.12) and anorexia(9.3% vs.33.4%, χ2=9.21). Patients had fever, anemia, lymphadenopathy, cutaneous hemorrhagic spot or periorbital ecchymosis, bone pain, abdominal pain, exophthalmos, and anorexia early in the initial course of the disease, whose serum lactate dehydrogenase values were significantly increased(P<0.05). Patients suffered from fever, anemia, lymphadenopathy, bone pain, limbs dysfunctions, abdominal pain at the beginning of the disease, whose urine vanillymandelic acid values were higher than normal(P<0.05). Conclusions The study of symptomology suggests the most common symptoms in patients with NB <1-year-old are cough and fever, while those ≥1-year-old are fever, lymphadenopathy, bone pain, and anemia.For patients with symptoms mentioned, carrying out the necessary NB-diagnose-related laboratory and imaging studies was statistically relevant to patients′ ages(<1-year-old and ≥1-year-old), which may contribute to earlier identification and diagnosis of NB. Key words: Neuroblastoma; Symptomatology; Identifying

On the Role and Significance of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (CAPPP) Within the Planned National Health Centers.

On the Role and Significance of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (CAPPP) Within the Planned National Health Centers.

Serum urea nitrogen and creatinine changes and its clinical significance in children with retinoblastoma before and after chemotherapy

Objective To analyze the alterations in blood urea nitrogen (BUN) and serum creatinine (Scr) in children with retinoblastoma(Rb) before and after chemotherapy and the clinical significance of the chemotherapy effect, and to provide the evidence for the further improvement of the safety of treatment. Methods A total of 280 children with Rb were enrolled in the study, and each of them was treated with CEV (Carboplatin+ Etoposide+ Vincristine) methods.There subjects included 153 males and 127 females, with a mean treatment of 4.5 cycles (range 2 to 12 cycles) and a mean age of 21.5 months (range 1 to 84 months). Among them, 149 cases were diagnosed clinically, 131 cases were diagnosed pathologically.Eight cases were in the extraocular stage, 3 cases were in glaucoma and 269 cases in intraocular period(101 cases of single eyes and 168 cases of double eyes). BUN and Scr were detected before the first course of chemotherapy and after the last course of chemotherapy. Results BUN and Scr values were analyzed before and after chemotherapy.BUN was 3.05 mmol/L before chemotherapy and 3.46 mmol/L after chemotherapy in the group aged from 4 months to less than 12 months (73 cases), the values of BUN after chemotherapy was higher than that before chemotherapy, and only in this group the change was statistically different (t=-2.829, P=0.006), but all BUN values in this group were not beyond the highest reference value(1.70 mmol/L-7.10 mmol/L). Before initial chemotherapy, 149 patients(53.2%) had Scr below the reference range(male: 30-104 μmol/L, female: 30-84 μmol/L), and 20 cases(7.0%) had the BUN below the reference value.In 2 cases, BUN(7.25 mmol/L and 7.34 mmol/L, respectively)before the initial chemotherapy was slightly higher than the normal value, but the value was normal(5.01 mmol/L and 4.98 mmol/L, respectively)after the last chemotherapy.In one case, the BUN(5.62 mmol/L)was normal before the initial chemotherapy, but it was elevated(7.33 mmol/L) after the last chemotherapy.In another one case, the BUN was normal before and after chemotherapy, but the value after chemotherapy was 4.69 times higher than that before chemotherapy. Conclusions Renal function of Rb children before treatment is normal.Seven percent of these patients have BUN under the BUN reference range, and 53.2% of these patients have Scr under the Scr reference range.It suggested that the reference values of BUN and Scr need to be adjusted.BUN of infant Rb may increase significantly after chemotherapy, but it does not meet the current diagnostic criteria of mild nephrotoxicity.Still, the early renal damage needs to be noticed. Key words: Retinoblastoma; Blood urea nitrogen; Serum creatinine; Clinical significance; Chemotherapy

Model Pembelajaran Kesenian di PAUD Ya Ummi Fat Desa Bermi Kecamatan Mijen Kabupaten Demak (Studi Analisis Kurikulum Kesenian untuk Prodi PGRA STAIN Kudus)

&lt;p&gt;The process of learning in early childhood should be done with the aim of providing the basic concepts that has significance for children, namely&lt;br /&gt;through real experience that allows the child to demonstrate the activity and curiosity (curiosity). To achieve this goals, teachers have a position to put his role as a companion, mentor, fasilltator and motivator for their children. This is done to balance the teacher’s roles and parenting who are too dominant to be more democratic so that children have the freedom to explore the world around them. PGRA department as an institution which printers prospective teachers of RA / TK must provide the basics of science and learning models, especially the learning associated with the arts as an asset child to learn comfortably. This is based on the principle that early childhood learning should be delivered by way of playing and singing.&lt;/p&gt;

دراسة واقع استخدام أطفال الروضة للأجهزة الالکترونیة وفاعلیة الضوابط التربویة من وجهة نظر الامهات فی مدینة الریاض

الملخص هدفت الدراسة الحالية للتعرف على الجوانب المتعلقة بإستخدام الطفل السعودي في مرحلة رياض الأطفال للأجهزة الإلکترونية من حيث عدد الساعات، ونوع البرامج، والآثار المترتبة على استخدام الطفل للأجهزة الإلکترونية، ومعرفة الضوابط التربوية المتبعة من قبل الأمهات عند استخدام الطفل للأجهزة الإلکترونية، والبدائل المقدمة من قبل الأمهات للحد من استخدام الطفل للجهاز الإلکتروني. بالإضافة الى التعرف على الفرق بين واقع استخدام الطفل للأجهزة الإلکترونية، من حيث عدد الساعات، ومتغير مستوى التعليمي للأب، ومستوى التعليمي للأم، وجنس الطفل بمدينة الرياض بالمملکة العربية السعودية. وقد أجريت الدراسة على (386) أما من أمهات الأطفال الملتحقين بمرحلة رياض الأاطفال بمدينة الرياض، تم اختيارهن بطريقة عشوائية، وتم جمع البيانات باستخدام استبانة تم إعدادها بما يناسب أهداف الدراسة، وعولجت البيانات باستخدام الأساليب الإحصائية المناسبة، وتلخصت أهم النتائج التي توصلت إليها الدراسة في أن عدد الساعات التي يقضينها الأطفال على الأجهزة الإلکترونية تقدر من ساعة إلى ساعتين في اليوم، ومقدار استخدام الأطفال للأجهزة الإلکترونية أسبوعيا بلغت يوما أو يومين في الأسبوع، أما بالنسبة لنوع البرامج المستخدمة في الأجهزة الإلکترونية فقد کانت الألعاب الإلکترونية هي الأکثر استخداما ويليها البرامج التعليمية.وتوصلت نتائج الدراسة إلى أن من أکثر الضوابط المستخدمة للحد من استخدام الطفل للأجهزة وضع اتفاقيات قبل شراء الجهاز، ووجود الأم في نفس المکان أثناء استخدام الطفل للجهاز، والاتفاق باختيار المحتوى الخاص بالأجهزة الإلکترونية. کما وجدت الدراسة أن تخصيص أوقات عائلية بدون اجهزة وممارسة الأنشطة الحرکية هما أکثر بديلين متبعين للحد من استخدام الطفل للأجهزة الإلکترونية. وتوصلت الدراسة ايضا إلى وجود فروق دالة احصائيا في أن المستوى التعليمي للأب والأم يؤثر ايجابيا في واقع استخدام الطفل للأجهزة الإلکترونية من حيث عدد ساعات أستخدام الطفل للجهاز جيث وجد أنه مع ارتفاع المستوى التعليمي للأب والأم يزداد معدل الوقت الذي تقضيه الأسرة في نشاط أسري هادف بعيدا عن الاجهزة الالکترونية.کما وجد أن معدل استخدام الطفل للأجهزة الإلکترونية لا يتغير بتغير جنس الطفل. Abstract The aim of this study was to gain insight into the nature of kindergarten aged children’s use of electronic devices, in terms of the numbers of hours children use them, and the kinds of programs used, as well as gaining knowledge about the regulations set by parents for children when using these devices. In addition, the researchers aimed to invesitigate the alternatives to these devices that children were offered by their parents and whether that parents educational level had any statistical significance to children’s use of these devices. The study was conducted in city of Riyadh, Saudi Arabia. 386 mothers who were chosen randomly participated in the study. The study found that children spent approximately 1-2 hours a day, 1-2 days a week using electronic devices. As for the kind of programs they peferred the study found that chidren perferred electronic games the most, this was followed by educational programs. Amongst the parental regulations set by parents for use of electronic devices the study found that the most prominent method was having agreements between the child and parent, this was followed by having mothers close to their children while devices were in use. Mothers also opted to choose the programs that their children were allowed to use to asure their suitability. This was followed by arranging family outings and engaging children in physical activities as alternatives to electronic devices. In addition, the study found differences of statistical significance in children’s use of these devices due to parent’s educational level as the higher educated the parents were, the more time the family spent on activities that were not related to electronic devices. The study also found that the average usage time was not affected by the child’s gender.

Gudommelig gymnastikk – kroppslighetens plass i Rudolf Steiners pedagogiske tenkning

ABSTRACT English title: Divine Gymnastics - The Significance of the Body in Rudolf Steiner's Pedagogy This article discusses how Rudolf Steiner’s belief in the importance of the body and movement inschool comes across in his book Oppdragelse og tidens andliv (1986) a collection of public lecturesheld in 1923 in Ilkley, England. I will juxtapose Steiner’s descriptions of the body’s significance forchildren’s processes of bildung with other ideas of reform pedagogy. My intention is to see whetherSteiner’s appreciation of the body and movement in school can be of relevance to today’s debate oneducational policy. Steiner views bodily processes as a foundation for mental processes and arguesthat one should make movement a central part of schools’ artistic work and view it as a contributionto the holistic processes of bildung. In the lectures, he places special emphasis on eurythmy as aschool subject. The conclusion is that Steiner’s lectures contribute to viewing education as somethingmore than knowledge-acquisition.

The level of exhaled nitric oxide and its clinical significance in children with Mycoplasma pneumoniae pneumonia

Objective To investigate the changes of levels of exhaled nitric oxide and the clinical significance in children with Mycoplasma pneumoniae pneumonia(MPP). Methods From June 2014 to March 2017, 95 children with MPP and 64 children with bronchial pneumonia in Jinshan Branch of The Sixth People's Hospital of Shanghai were collected, 32 healthy children were enrolled as controls.According to the imaging examination, patients with MPP were further grouped into lobar pneumonia group, bronchopneumonia group and interstitial pneumonia group.FeNO and lung function were measured in all children. Results The level of FeNO in the MPP group was (7.25±3.41) ppb, which was lower than that in the non-MPP group and control group[(11.24±3.52)ppb, (10.51±4.23)ppb](t=5.82, 5.77, all P 0.05). The FEV1, FEV1/FVC%, FEF25%-75% of the MPP group[(66.23±13.21), (84.62±6.73), (58.65.±19.43)]were lower than those of the control group and non-MPP group[(91.81±11.36), (93.80±8.91), (86.80±20.71); (85.43±10.32), (90.18±11.35), (74.73±17.91)](t=4.35, 3.62, 4.78; 4.56, 7.12, 5.06, all P 0.05). In the MPP group, the FEV1, FEV1/FVC%, FEF25%-75% were not associated with FeNO level(r=-0.15, P>0.05; r=-0.06, P>0.05; r=0.07, P>0.05). Conclusion The level of FeNO in children with MPP is lower, and the level of FeNO is not significantly correlated with the parameters of lung function, and FeNO can be used as an inflammatory marker to evaluate the correlation between MP infection and airway inflammation. Key words: Pneumonia, mycoplasma; Nitric oxide; Maximal midexpiratory flow rate; Forced expiratory volume; Child

동화와 스토리텔링을 활용한 초등영어과 교수․학습모형 탐색

동화와 스토리텔링을 활용한 초등영어과 교수․학습모형 탐색

Distinct Co-Occurring Mutational Profiles in Acute Myeloid Leukemia Confers Prognostic Significance in Children and Young Adults with FLT3/ITD Mutations

▪FLT3/ITD mutations occur in approximately 15%-25% of AML in children and young adults and can be amenable to targeting with FLT3 inhibitors. We have demonstrated that those with high ITD allelic ratio (AR) have an adverse prognosis, which can be ameliorated in part by hematopoietic stem cell transplant (HSCT) in CR1. However, even with aggressive therapy only a subset FLT3/ITD (ITD+) patients are cured, suggesting that within this cohort there exists heterogeneity among responses to therapy and overall outcomes. As next generation sequencing has illuminated the distinct and complex genomic profiles of pediatric AML, we hypothesized that presence of cooperating mutations may provide further prognostic information in this group of patients.In an international collaborative effort, children and young adults (n=1786; age < 1 month - 29 years, non-APL or Down syndrome) treated on the CCG/COG trials (2961, AAML03P1, AAML0531; n=1472) as well as those treated on the DCOG/BFM/MRC trials (ANLL87, ANLL97, BFM98, BFM04, MRC12, MRC15; n=314) were included in this study. All patients were tested for FLT3/ITD, NPM1, CEBPA, WT1, and NUP98-NSD1 mutations. COG patients underwent either targeted exome or clinical sequencing, while patients in DCOG/BFM/MRC analysis underwent targeted clinical sequencing of hotspot regions in 9 genes. As expected given the heterogeneity of AML, we detected a variety of co-occurring mutations among the ITD+ patients (n=255), ranging from 1-13 (median 2) additional mutations. Overall, we identified 82 different genes with alterations co-occurring with FLT3/ITD mutations. The most prevalent co-occurring mutations were WT1 (26%), NPM1 (21%), NRAS (17%), and CEBPA (6%; Fig 1A). The most common co-occurring fusions were NUP98-NSD1 (18%) and DEK-NUP214 in (6%; Fig 1A). A subset of patients (n=13) harbored FLT3/ITD as well as WT1 and NUP98-NSD1 alternations (ITD+/WT1+/NUP98-NSD1+), referred to as triple positive patients.We evaluated the prognostic impact of the most common co-occurring mutational profiles as seen in ITD+ children treated on the above cooperative group trials. Clinical outcome of those with FLT3/ITD and favorable (NPM1) or adverse (WT1 or NUP98/NSD1) prognostic factors was contrasted to patients without those risk defining lesions. These presence of the 3 co-occurring mutations added significant prognostic impact when comparing to patients without the 3 mutations (ITD+/other; p<0.001; Fig 1B). Patients with ITD+/other had an event free survival (EFS) of 31% compared to that of 48% in FLT3/ITD negative patients (Fig 1B). Patients with dual ITD/NPM1 mutations (ITD+/NPM1+) had the most favorable outcome with an EFS of 62%, while ITD+ patients harboring either a NUP98-NSD1 and/or WT1 mutation had the most inferior outcome with an EFS of 17%. We sought to further interrogate the effect of the co-occurring mutations in a more homogenously treated cohort of patients treated on COG AAML0531. The ITD+/NPM1+ patients experienced an EFS of 54% which was similar to ITD negative patients. In contrast, ITD+ patients harboring NUP98-NSD1 and/or WT1 experienced an EFS of 24%. Again, the addition of the 3 aberrations to FLT3/ITD demonstrated significant prognostic impact (p<0.001). The triple positive patients experienced an overall survival of <10%. Given the demonstrated significance of AR in risk determination in FLT3/ITD patients, we evaluated the significance of WT1 and NUP98/NSD1 variants in ITD+ patients with a low AR (AR<0.4; n=35). Patients with low AR and WT1 or NUP98/NSD1 variants had a similar dismal outcome as those with higher AR.Using comprehensive genomic sequencing and outcome evaluation in a large international cooperative study, we found that FLT3/ITD mutations co-occur with a number of other mutations. Importantly, we found that the 3 variants NPM1, WT1, and NUP98-NSD1 can further risk stratify ITD+ patients, regardless of AR. Patients with ITD+/NPM1+ disease experience more favorable outcomes, while ITD+/WT1+ or NUP98-NSD1+ mutant patients do poorly, and triple positive patients have very poor outcomes. This suggests that ITD mutations do not exclusively serve as driving events, rather that co-occurring mutations may impact leukemogenesis and responses to therapy, thus identifying a cohort of patients requiring novel therapeutic approaches to meaningfully improve outcomes. [Display omitted] DisclosuresGibson:Galen: Research Funding; Pfizer: Research Funding.

Study on the Relativity between Cytogenetics and Cytomorphology and its Prognosis Significance in Children with Acute Myelogenous Leukemia

Objective: The main objective of this study was to retrospectively evaluate that the cytogenetic abnormalities is an important prognostic factor for the cure of acute myeloid leukemia (AML).Methods: This retrospective study enrolled newly diagnosed 70 cases (37 males and 33 females, aged 10.1 months to 14.5 years) of pediatric patients with AML during 2010 January - 2016 February from the Second Affiliated Hospital of Anhui Medical University. Excluding criteria were cases secondary to treatment-related MDS and AML. Samples were obtained from bone marrow cells in patients after treatment on the anterior superior iliac spine, blood diseases laboratory by direct culture or 24/48 hour short-term culture, G -banding technique for testing. Follow-up of 1 - 60 months, the analysis of treatment response rates of different karyotypes, distribution ratios in various subtypes, normal karyotype and abnormal karyotype. ISPSS17.0 software statistics was used for statistical analysis. Groups were compared using chi-square test; Survival rate was calculated by method of Kaplan Meier and survival difference between groups were compared with breslow test.Results: Among 70 cases, 42 cases were detected for chromosomal abnormalities (i.e. 60% of the total number of cases), M3 abnormal karyotype distortion rate of 78.5%, M2 abnormal karyotype aberrations 63.3%, M4 60.0%, M1 50%, M5 lowest 38.9 %, M7 nuclear aberrations highest rate was 100%. Total chromosomal aberration rate was 60%. Acute myeloid leukemia cases, t (8; 21) at most, there are 15 cases, and the presence of abnormal karyotype 86.7% in the original part of differentiated myeloid leukemia (M2); t (15; 17) has 11 cases, exists only in acute promyelocytic cell leukemia (M3). After treatment, the remission rate of t (8; 21) was 80%; the remission rate of t (15; 17) was 90%; the remission rate of other abnormal karyotype abnormalities was 50%; the remission rate of total abnormal karyotype was 71.4%. The event free survival rate was significantly different between normal karyotype, t (8; 21), t (15; 17) and other abnormal karyotype groups (P&lt;0.05).Conclusions: Acute myeloid leukemia karyotype abnormalities among FAB subtypes are different; M3 is the highest rate of abnormal karyotype aberrations, M2, M4 medium, M5 minimum. t (15; 17) seen in acute promyelocytic leukemia (APL), prognosis is good; t (8; 21) is more common in M2, prognosis is good, also found in M4 and M5, worse prognosis; +8 Abnormalities found in AML M2, M3, M4, M5 and M6 subtypes, prognosis medium; inv (16) high white blood cells, low platelet poor prognosis, AML patients with normal karyotype prognosis medium. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 35-41