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Automated Measurements of Long Leg Radiographs in Pediatric Patients: A Pilot Study to Evaluate an Artificial Intelligence-Based Algorithm. 自动测量儿科患者的长腿X光片:评估基于人工智能算法的试点研究。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101182
Thies J N van der Lelij, Willem Grootjans, Kevin J Braamhaar, Pieter Bas de Witte

Background: Assessment of long leg radiographs (LLRs) in pediatric orthopedic patients is an important but time-consuming routine task for clinicians. The goal of this study was to evaluate the performance of artificial intelligence (AI)-based leg angle measurement assistant software (LAMA) in measuring LLRs in pediatric patients, compared to traditional manual measurements.

Methods: Eligible patients, aged 11 to 18 years old, referred for LLR between January and March 2022 were included. The study comprised 29 patients (58 legs, 377 measurements). The femur length, tibia length, full leg length (FLL), leg length discrepancy (LLD), hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), and mechanical medial proximal tibial angle (mMPTA) were measured automatically using LAMA and compared to manual measurements of a senior pediatric orthopedic surgeon and an advanced practitioner in radiography.

Results: Correct landmark placement with AI was achieved in 76% of the cases for LLD measurements, 88% for FLL and femur length, 91% for mLDFA, 97% for HKA, 98% for mMPTA, and 100% for tibia length. Intraclass correlation coefficients (ICCs) indicated moderate to excellent agreement between AI and manual measurements, ranging from 0.73 (95% confidence interval (CI): 0.54 to 0.84) to 1.00 (95%CI: 1.00 to 1.00).

Conclusion: In cases of correct landmark placement, AI-based algorithm measurements on LLRs of pediatric patients showed high agreement with manual measurements.

背景:评估儿科骨科患者的长腿X光片(LLR)是临床医生的一项重要但耗时的常规任务。本研究的目的是评估基于人工智能(AI)的腿部角度测量辅助软件(LAMA)在测量儿科患者长腿X光片方面的性能,并与传统的人工测量方法进行比较:纳入2022年1月至3月期间转诊的符合条件的11至18岁LLR患者。该研究包括 29 名患者(58 条腿,377 次测量)。使用 LAMA 自动测量了股骨长度、胫骨长度、全腿长度 (FLL)、腿长差异 (LLD)、髋膝踝角度 (HKA)、机械股骨外侧远端角度 (mLDFA) 和机械胫骨内侧近端角度 (mMPTA),并与一名资深儿科骨科医生和一名放射摄影高级从业人员的人工测量结果进行了比较:76%的 LLD 测量、88% 的 FLL 和股骨长度测量、91% 的 mLDFA 测量、97% 的 HKA 测量、98% 的 mMPTA 测量和 100% 的胫骨长度测量均使用 AI 实现了正确的地标定位。类内相关系数(ICCs)显示人工智能和人工测量之间的一致性为中等到极佳,范围从 0.73(95% 置信区间(CI):0.54 到 0.84)到 1.00(95% 置信区间(CI):1.00 到 1.00):在地标位置正确的情况下,基于人工智能算法的儿科患者 LLR 测量结果与人工测量结果具有很高的一致性。
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引用次数: 0
Clinical Effectiveness of Biological Immunomodulators in SARS-CoV-2-Associated Multisystem Inflammatory Syndrome in Children: A Systematic Review. 生物免疫调节剂对儿童 SARS-CoV-2 相关多系统炎症综合征的临床疗效:系统回顾
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101180
Ji Young Lee, Jimin Kim, Soo-Han Choi, Dong Hyun Kim, Ki Wook Yun, Yae-Jean Kim, Giang Pham Ha Cao, Miyoung Choi, Jong Gyun Ahn

Background: Although there is consensus to use immunoglobulins and corticosteroids as first-line treatments for multisystem inflammatory syndrome in children (MIS-C), the effectiveness of biological immunomodulators in patients refractory to standard therapy remains unclear. We aimed to outline real-world data on biological immunomodulators.

Method: A literature search using Ovid-Medline, EMBASE, Cochrane CDSR, and KMBASE was conducted from September 2021 to August 2022; certainty of evidence was assessed via GRADE.

Results: Among 258 studies, 10 were selected for analysis, of which 2 were observational studies (with control groups receiving standard therapy of either intravenous immunoglobulins and/or glucocorticoids) and 8 were single-arm studies. In all, 145 patients were treated with biological immunomodulators (anakinra (72; 49%) or infliximab (65; 44%)). In the first observational study, patients in the anakinra group initially exhibited a lower left ventricular ejection fraction than those in the control group. In the second study, patients in the infliximab group required less additional therapy and showed lower newly developed left ventricular dysfunction rate and reduced C-reactive protein levels. The clinical outcomes associated with each biological agent in single-arm studies were not reported individually.

Conclusions: Biological immunomodulators are feasible therapeutic options for refractory MIS-C. Nevertheless, further research is warranted to demonstrate clinical efficacy.

背景:尽管将免疫球蛋白和皮质类固醇作为儿童多系统炎症综合征(MIS-C)的一线治疗已达成共识,但生物免疫调节剂对标准疗法难治患者的疗效仍不明确。我们旨在概述生物免疫调节剂的实际数据:从 2021 年 9 月到 2022 年 8 月,我们使用 Ovid-Medline、EMBASE、Cochrane CDSR 和 KMBASE 进行了文献检索,并通过 GRADE 评估了证据的确定性:在 258 项研究中,有 10 项被选中进行分析,其中 2 项为观察性研究(对照组接受静脉注射免疫球蛋白和/或糖皮质激素的标准疗法),8 项为单臂研究。总共有 145 名患者接受了生物免疫调节剂(阿纳金拉(72;49%)或英夫利昔单抗(65;44%))治疗。在第一项观察性研究中,阿纳金拉组患者的左心室射血分数最初低于对照组。在第二项研究中,英夫利昔单抗组患者所需的额外治疗较少,新出现左心室功能障碍的比例较低,C反应蛋白水平也有所降低。在单臂研究中,与每种生物制剂相关的临床结果未单独报告:结论:生物免疫调节剂是治疗难治性 MIS-C 的可行方案。结论:生物免疫调节剂是治疗难治性 MIS-C 的可行方案,但仍需进一步研究以证明其临床疗效。
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引用次数: 0
Risk Factors and Outcomes Associated with Pneumothorax in Very Preterm Infants. 早产儿气胸的相关风险因素和结果
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101179
Cristina Nogueroles Blanco, Ana Herranz-Barbero, Mar Velilla-Aparicio, Carla Balcells-Esponera, Marta Teresa-Palacio, Miguel Alsina Casanova, Cristina Carrasco Carrasco, Cristina Borràs-Novell, José Manuel Rodríguez-Miguélez, Ma Dolors Salvia-Roigés, Victoria Aldecoa-Bilbao

Background/objectives: Pneumothorax can be a major complication of neonatal lung diseases. We aim to delineate trends and describe the main outcomes related to pneumothorax in very preterm infants (VPI).

Methods: Preterm infants < 32 weeks of gestation admitted in two-level III neonatal intensive care units (1995-2019) were included. Risk factors and outcomes were assessed by logistic regression and adjusted for gestational age (GA).

Results: In total, 4271 VPI with a mean GA of 28.7 ± 2.3 weeks were evaluated. Pneumothorax was diagnosed in 174 patients (4.1%, 95% Confidence Interval (CI) 3.5-4.7) with its incidence inversely proportional to GA: 9.9% in 23-25 w and 2.1% in 30-31 w (p < 0.001), but stable over the years 1995-1999 (5.2%) and 2015-2019 (4.2%) (p = 0.309). Patients with pneumothorax exhibited higher rates of severe intraventricular hemorrhage (IVH) (Odds Ratio (OR) = 2.0 (95%CI 1.3-3.1), p = 0.003), bronchopulmonary dysplasia (OR = 2.7 (95%CI 1.7-4.4), p < 0.001), and death (OR = 8.5 (95%CI 6.2-11.6), p < 0.001). Independent risk factors for pneumothorax were GA, prolonged premature rupture of membranes, and intubation in the delivery room. The composite outcome of death or severe IVH was higher in patients with pneumothorax with an adjusted OR = 6.7 (95%CI 4.7-9.6), p < 0.001. Although VPI mortality has significantly decreased over the years (20.3% 1995-1999 and 11.7% 2015-2019, p < 0.001), we found no significant difference in pneumothorax-related deaths.

Conclusion: Pneumothorax remains a serious threat to VPI, leading to a higher incidence of morbidity, and mortality attributable to this complication has not decreased. Preventive strategies and early recognition are essential for improving disability-free survival in VPI.

背景/目的:气胸是新生儿肺部疾病的主要并发症。我们旨在描述早产儿(VPI)中与气胸相关的趋势和主要结果:方法:纳入在两家三级新生儿重症监护病房(1995-2019 年)住院的妊娠期小于 32 周的早产儿。通过逻辑回归评估风险因素和结果,并根据胎龄(GA)进行调整:共评估了 4271 例 VPI,平均胎龄(28.7 ± 2.3 周)。174名患者(4.1%,95% 置信区间(CI)3.5-4.7)被诊断为气胸,其发生率与胎龄成反比:23-25周为9.9%,30-31周为2.1%(p < 0.001),但在1995-1999年(5.2%)和2015-2019年(4.2%)期间保持稳定(p = 0.309)。气胸患者发生严重脑室内出血(IVH)(Odds Ratio (OR) = 2.0 (95%CI 1.3-3.1),p = 0.003)、支气管肺发育不良(OR = 2.7 (95%CI 1.7-4.4),p < 0.001)和死亡(OR = 8.5 (95%CI 6.2-11.6),p < 0.001)的比例较高。气胸的独立风险因素是GA、胎膜早破时间过长和产房插管。气胸患者的死亡或严重 IVH 的综合结果较高,调整后 OR = 6.7 (95%CI 4.7-9.6),P < 0.001。虽然VPI死亡率逐年大幅下降(1995-1999年为20.3%,2015-2019年为11.7%,p < 0.001),但我们发现气胸相关死亡并无显著差异:气胸仍然是对 VPI 的严重威胁,会导致更高的发病率,而且这种并发症导致的死亡率并未降低。预防策略和早期识别对于提高 VPI 的无残疾存活率至关重要。
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引用次数: 0
Narrative Review of the Theoretical-Methodological Foundations of the TREINI Program. 对 TREINI 计划的理论和方法论基础的叙述性回顾。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101181
Renato Guimarães Loffi, Deisiane Oliveira Souto, Thalita Karla Flores Cruz, Arthur Felipe Barroso de Lima, Fabiana Rachel Martins Costa Rocha, Simone Rosa Barreto, Patrícia Aparecida Neves Santana, Amanda Aparecida Alves Cunha Nascimento, Vitor Geraldi Haase

Scientific knowledge has advanced in the implementation of safe and beneficial interventions for children and adolescents with cerebral palsy (CP). Although the importance of interdisciplinary interventions that integrate all components of the International Classification of Functioning, Disability and Health (ICF) into family-centered practices is widely recognized, this approach is not yet widely adopted. Instead, many programs remain focused on isolated domains. This study presents the theoretical and methodological foundation of TREINI, an interdisciplinary and family-centered program developed for children and youth with CP and other neurodevelopmental disorders. TREINI incorporates intervention strategies that address all ICF domains. It is grounded in the biopsychosocial model of health and utilizes principles based on the best evidence in pediatric rehabilitation, including intensive training, task-oriented training, and a naturalistic learning environment. Unlike traditional rehabilitation approaches, the care provided by the TREINI program is delivered through an intensive and interdisciplinary approach, by a team working collaboratively in a single location. In addition to including evidence-based interventions, the TREINI program features two innovative components: the "City of Tomorrow", a naturalistic learning environment, and the "TREINI Exoflex" therapeutic suit, specifically designed to address deficiencies in the body functions and structures of children with CP and other neurodevelopmental disorders. This program has been carefully designed to support the process of neurological re-education and rehabilitation for children and adolescents with neuropsychomotor developmental delays.

在对患有脑性瘫痪(CP)的儿童和青少年实施安全有益的干预措施方面,科学知识已经取得了进步。尽管人们普遍认识到将国际功能、残疾和健康分类(ICF)的所有组成部分整合到以家庭为中心的实践中的跨学科干预措施的重要性,但这种方法尚未被广泛采用。相反,许多计划仍然专注于孤立的领域。本研究介绍了 TREINI 的理论和方法论基础,TREINI 是一项跨学科、以家庭为中心的计划,专为患有 CP 和其他神经发育障碍的儿童和青少年而开发。TREINI 融合了针对 ICF 所有领域的干预策略。该计划以生物心理社会健康模式为基础,采用基于儿科康复最佳证据的原则,包括强化训练、任务导向训练和自然学习环境。与传统康复方法不同的是,特雷尼计划提供的护理是由一个团队在同一地点协同工作,通过密集的跨学科方法进行的。除了以证据为基础的干预措施外,特雷尼计划还包括两个创新组成部分:"明日之城"--一个自然主义的学习环境,以及 "特雷尼 Exoflex "治疗服,该治疗服是专门针对患有脊髓灰质炎和其他神经发育障碍的儿童的身体功能和结构缺陷而设计的。这项计划经过精心设计,旨在为神经心理运动发育迟缓的儿童和青少年的神经再教育和康复过程提供支持。
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引用次数: 0
Influence of Unperceived Victimization on Adolescent Well-Being. 未意识到的受害对青少年幸福感的影响。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101183
Elisa Larrañaga, Maria Carmen Cabrera, Santiago Yubero

Background: Bullying has been shown to have negative consequences on the health and well-being of adolescents. Some students may experience various bullying behaviors and not consider themselves victims, finding themselves in a situation of unperceived mistreatment. Few studies have focused on the relationship between self-reported victimization behaviors and self-identification as a victim. Our objective is to determine the prevalence of unperceived victimization and analyze its relationship with adolescent distress. Methods: A total of 964 adolescents aged between 12 and 19 years participated. Standardized instruments were used to assess psychological distress, bullying in the last month and previous years, perception of victimization, and resilience. Results: More than 20% of adolescents are in a situation of unperceived victimization, not recognizing themselves as victims despite reporting bullying behaviors. Among girls and middle adolescence, perceiving oneself as a victim increases the likelihood of feeling distress. The likelihood of experiencing distress increases with previous victimization and decreases with high resilience. Conclusions: Mental health professionals should consider bullying as a factor of distress in adolescence. It is essential to refer adolescent victims of bullying to specialized mental health resources to adequately address their well-being and increase resilience as a protective factor.

背景:事实证明,欺凌行为会对青少年的健康和幸福造成负面影响。有些学生可能经历过各种欺凌行为,但并不认为自己是受害者,他们发现自己处于一种未被察觉的虐待境地。很少有研究关注自我报告的受害行为与自我认定为受害者之间的关系。我们的目的是确定未意识到自己是受害者的普遍程度,并分析其与青少年困扰之间的关系。研究方法共有 964 名 12 至 19 岁的青少年参加了调查。我们使用标准化工具来评估心理困扰、最近一个月和过去几年的欺凌行为、受害感和复原力。结果显示超过 20% 的青少年处于未感知受害的状态,尽管他们报告了欺凌行为,但并不承认自己是受害者。在女孩和青春期中期,认为自己是受害者会增加感到痛苦的可能性。经历痛苦的可能性随着受害经历的增加而增加,随着复原力的提高而降低。结论心理健康专业人员应将欺凌视为青春期困扰的一个因素。有必要将遭受欺凌的青少年转介到专门的心理健康资源机构,以充分解决他们的福祉问题,并提高作为保护因素的抗逆力。
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引用次数: 0
Free-Weight Resistance Training Enhances Core Muscle Strength but Does Not Translate to Improved Athletic Performance in Adolescent Canoe/Kayak Athletes. 自由重量阻力训练能增强青少年皮划艇/皮划艇运动员的核心肌力,但并不能转化为运动成绩的提高。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101177
Ting-Ting Lee, Bo-Jen Ko, Chu-Han Chang, I-Shiung Cheng

Background/objectives: While previous evidence has shown that using free weights for resistance training is a more practical approach to enhancing strength, there is a relatively low prevalence of free-weight resistance training among adolescent kayak/canoe athletes. Therefore, this study aims to assess the impact of free-weight resistance training on body composition and various performance factors among adolescent canoe/kayak athletes.

Methods: Twenty-seven young sprint kayakers and canoeists (14 ± 1 years; 164 ± 7 cm; 56 ± 8 kg) completed this study. Following baseline assessments, athletes were randomly divided into two training groups: the free-weight resistance training group (FW) or the control group (C). The FW group underwent free-weight resistance training sessions twice weekly for 24 weeks. The C group maintained their regular bodyweight training sessions during the same timeframe. All participants performed both the pre- and post-training assessments for the following dependent variables: body composition, upper-body power, upper-body isometric muscle strength, isometric mid-thigh pull, core strength, countermovement jump, balance, anaerobic ability, and aerobic performance.

Results: After 24 weeks of training, the free-weight resistance training group exhibited a significant increase in body weight (from 56 ± 5 kg to 58 ± 4 kg, p < 0.05) and improvements in the number of straight leg raise repetitions (from 23 ± 6 to 26 ± 4, p < 0.05) compared to the control group. However, the two groups observed no significant differences between upper-body isometric muscle strength, power, balance, and anaerobic/aerobic performance.

Conclusions: A 24-week training duration might be insufficient for novice participants in resistance training. Future research should consider incorporating an adaptation period or a learning phase for movements before training, thereby enhancing the efficacy of free-weight resistance training in increasing strength.

背景/目标:虽然以往的证据表明,使用自由重量进行阻力训练是增强力量的一种更实用的方法,但在青少年皮划艇/独木舟运动员中,自由重量阻力训练的普及率相对较低。因此,本研究旨在评估自由重量阻力训练对青少年皮划艇/独木舟运动员身体成分和各种成绩因素的影响:27 名年轻的短跑皮划艇运动员(14 ± 1 岁;164 ± 7 厘米;56 ± 8 千克)完成了本研究。基线评估后,运动员被随机分为两个训练组:自由重量阻力训练组(FW)或对照组(C)。FW 组每周进行两次自由重量阻力训练,为期 24 周。C 组则在同一时间内保持常规的体重训练。所有参与者在训练前和训练后都进行了以下因变量的评估:身体成分、上半身力量、上半身等长肌力、等长大腿中部拉力、核心力量、反身跳、平衡、无氧能力和有氧表现:训练 24 周后,与对照组相比,自由重量阻力训练组的体重明显增加(从 56±5 千克增加到 58±4 千克,P<0.05),直腿抬高重复次数也有所提高(从 23±6 次增加到 26±4 次,P<0.05)。然而,两组在上半身等长肌力、力量、平衡和无氧/有氧表现方面没有明显差异:结论:对于阻力训练新手来说,24 周的训练时间可能是不够的。未来的研究应考虑在训练前加入动作适应期或学习阶段,从而提高自由重量阻力训练在增强力量方面的效果。
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引用次数: 0
The Microbiota in Children and Adolescents with Asthma. 儿童和青少年哮喘患者的微生物群。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-27 DOI: 10.3390/children11101175
Lucio Casali, Giulia Maria Stella

The role of the respiratory microbiome has been deeply explored for at least two decades. Its characterization using modern methods is now well-defined, and the impacts of many microorganisms on health and diseases have been elucidated. Moreover, the acquired knowledge in related fields enables patient stratification based on their risk for disease onset, and the microbiome can play a role in defining possible phenotypes. The interplay between the lung and gut microbiomes is crucial in determining the microbial composition and immuno-inflammatory reaction. Asthma is still not a well-defined condition, where hyperreactivity and the immune system play important roles. In this disease, the microbiome is mostly represented by Proteobacteria, Streptococcus, and Veillonella, while Cytomegalovirus and Epstein-Barr viruses are the most prevalent viruses. A mycobiome may also be present. The passage from infancy to adolescence is examined by evaluating both the clinical picture and its relationship with possible variations of the microbiome and its effects on asthma. Otherwise, asthma is considered a heterogeneous disease that often starts in childhood and follows a particular personalized track, where adolescence plays a pivotal role in future prognosis. Under this point of view, the microbiota, with its possible variations due to many factors, both internal and external, can modify its composition; consequently, its inflammatory action and role in the immunological response has obvious consequences on the clinical conditions.

呼吸道微生物组的作用已被深入探讨了至少二十年。目前,利用现代方法对其特征进行了明确界定,并阐明了许多微生物对健康和疾病的影响。此外,在相关领域获得的知识可根据患者的发病风险对其进行分层,微生物组可在确定可能的表型方面发挥作用。肺部和肠道微生物组之间的相互作用对决定微生物组成和免疫炎症反应至关重要。哮喘仍不是一种定义明确的疾病,过度反应和免疫系统在其中发挥着重要作用。在这种疾病中,微生物组主要以变形杆菌、链球菌和维龙菌为代表,而巨细胞病毒和 Epstein-Barr 病毒则是最常见的病毒。霉菌生物群也可能存在。通过评估临床表现及其与微生物组的可能变化之间的关系以及微生物组对哮喘的影响,来研究从婴儿期到青春期的变化。否则,哮喘被认为是一种异质性疾病,通常始于儿童期,并遵循特定的个性化轨迹,其中青春期对未来的预后起着关键作用。从这一角度来看,微生物群可能会因多种内外因素而发生变化,从而改变其组成;因此,微生物群的炎症作用和在免疫反应中的作用会对临床症状产生明显的影响。
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引用次数: 0
Effects of an 8-Week Active Play Intervention on Body Composition and Fundamental Motor Skills in Preschool Children. 为期 8 周的积极游戏干预对学龄前儿童身体成分和基本运动技能的影响
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-26 DOI: 10.3390/children11101173
Katherine E Spring, Danielle Lang, Melissa M Pangelinan, Danielle D Wadsworth

Objective: Examine the effect of an 8-week teacher-guided active play intervention on preschoolers' body composition and fundamental motor skills. Methods: Participants were from two local preschool centers randomly assigned to either the intervention (n = 25, 3.91 ± 0.53 years) or the control group (n = 25, 3.69 ± 0.81 years). All measures were assessed at baseline (week 0), post-intervention (weeks 9-11), and follow-up (weeks 30-33). Bioelectrical Impedance assessed body composition (fat mass (FM) and fat-free mass (FFM)). The Peabody Developmental Motor Scales, Second Edition (PDMS-2) assessed fundamental motor skills (gross motor quartile (GMQ)). Results: A significant Group × Time interaction for GMQ at post-intervention (p = 0.03), with the intervention group scoring significantly higher on GMQ. A significant main effect of Time (p < 0.001) indicated that GMQ increased in both groups across the 33-week period. For FM, a significant main effect of Time at both post-intervention (p < 0.05) and follow-up testing (p < 0.001) indicated that participants increased FM over the 33-week period. Lastly, there was a significant main effect of Time for FFM at post-intervention (p = 0.003) and follow-up (p < 0.001). Interestingly, there was a significant Group × Time interaction (p < 0.05) at follow-up testing showing that FFM increased over time but significantly more for the control group. Conclusions: Results indicate that active play interventions might be a successful pathway to improve gross motor skills in young children. Further research is needed to understand the effect that active play interventions have on body composition in preschoolers.

目的研究为期 8 周、由教师指导的积极游戏干预对学龄前儿童身体成分和基本运动技能的影响。方法参与者来自当地的两个学前教育中心,随机分配到干预组(25 人,3.91 ± 0.53 岁)或对照组(25 人,3.69 ± 0.81 岁)。所有测量均在基线(第 0 周)、干预后(第 9-11 周)和随访(第 30-33 周)时进行。生物电阻抗评估身体成分(脂肪量(FM)和无脂肪量(FFM))。皮博迪运动发育量表第二版(PDMS-2)评估基本运动技能(粗大运动四分位数(GMQ))。结果显示干预后的 GMQ 存在明显的 "组×时间 "交互作用(p = 0.03),干预组的 GMQ 得分明显更高。时间的主效应显着(p < 0.001),表明在 33 周的时间里,两组的 GMQ 都有所提高。至于 FM,在干预后(p < 0.05)和后续测试(p < 0.001)中,时间的主效应都很明显,这表明参与者的 FM 在 33 周内有所增加。最后,在干预后(p = 0.003)和后续测试(p < 0.001)中,时间对 FFM 有明显的主效应。有趣的是,在后续测试中,组别 × 时间的交互作用非常明显(p < 0.05),这表明随着时间的推移,FFM 有所增加,但对照组的增加幅度更大。结论结果表明,积极游戏干预可能是提高幼儿粗大运动技能的成功途径。要了解积极游戏干预对学龄前儿童身体成分的影响,还需要进一步的研究。
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引用次数: 0
Proteomic Signatures of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Narrative Review. 与 COVID-19 有关的儿童多系统炎症综合征(MIS-C)的蛋白质组特征:叙述性综述。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-26 DOI: 10.3390/children11101174
Maria-Myrto Dourdouna, Elizabeth-Barbara Tatsi, Vasiliki Syriopoulou, Athanasios Michos

Background/objectives: Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of COVID-19. MIS-C has overlapping features with other pediatric inflammatory disorders including Kawasaki Disease (KD), Macrophage Activation Syndrome (MAS), Toxic Shock Syndrome and sepsis. The exact mechanisms responsible for the clinical overlap between MIS-C and these conditions remain unclear, and biomarkers that could distinguish MIS-C from its clinical mimics are lacking. This study aimed to provide an overview of how proteomic methods, like Mass Spectrometry (MS) and affinity-based proteomics, can offer a detailed understanding of pathophysiology and aid in the diagnosis and prognosis of MIS-C.

Methods: A narrative review of relevant studies published up to July 2024 was conducted.

Results: We identified 15 studies and summarized their key proteomic findings. These studies investigated the serum or plasma proteome of MIS-C patients using MS, Proximity Extension, or Aptamer-based assays. The studies associated the proteomic profile of MIS-C with laboratory and clinical parameters and/or compared it with that of other diseases including acute COVID-19, KD, MAS, pediatric rheumatic diseases, sepsis and myocarditis or pericarditis following COVID-19 mRNA immunization. Depending on the method and the control group, different proteins were increased or decreased in the MIS-C group. The limitations and challenges in MIS-C proteomic research are also discussed, and future research recommendations are provided.

Conclusions: Although proteomics appear to be a promising approach for understanding the pathogenesis and uncovering candidate biomarkers in MIS-C, proteomic studies are still needed to recognize and validate biomarkers that could accurately discriminate MIS-C from its clinical mimics.

背景/目的:儿童多系统炎症综合征(MIS-C)是 COVID-19 感染后的一种并发症。儿童多系统炎症综合征与川崎病(KD)、巨噬细胞活化综合征(MAS)、中毒性休克综合征和败血症等其他儿科炎症性疾病有重叠特征。造成 MIS-C 与这些疾病临床重叠的确切机制仍不清楚,也缺乏能将 MIS-C 与其临床模拟物区分开来的生物标志物。本研究旨在概述蛋白质组学方法(如质谱法(MS)和基于亲和力的蛋白质组学)如何详细了解病理生理学并帮助诊断 MIS-C 和预后:方法:对截至 2024 年 7 月发表的相关研究进行叙述性综述:结果:我们确定了 15 项研究,并总结了这些研究的主要蛋白质组学发现。这些研究使用 MS、Proximity Extension 或基于 Aptamer 的检测方法研究了 MIS-C 患者的血清或血浆蛋白质组。这些研究将 MIS-C 的蛋白质组特征与实验室和临床参数联系起来,并/或与其他疾病的蛋白质组特征进行比较,包括急性 COVID-19、KD、MAS、小儿风湿病、败血症以及 COVID-19 mRNA 免疫后的心肌炎或心包炎。根据不同的方法和对照组,MIS-C 组中不同的蛋白质会增加或减少。本文还讨论了MIS-C蛋白质组学研究的局限性和挑战,并提出了未来的研究建议:尽管蛋白质组学似乎是了解MIS-C发病机制和发现候选生物标志物的一种很有前景的方法,但仍需要进行蛋白质组学研究,以识别和验证能准确区分MIS-C和其临床模拟物的生物标志物。
{"title":"Proteomic Signatures of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Narrative Review.","authors":"Maria-Myrto Dourdouna, Elizabeth-Barbara Tatsi, Vasiliki Syriopoulou, Athanasios Michos","doi":"10.3390/children11101174","DOIUrl":"10.3390/children11101174","url":null,"abstract":"<p><strong>Background/objectives: </strong>Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of COVID-19. MIS-C has overlapping features with other pediatric inflammatory disorders including Kawasaki Disease (KD), Macrophage Activation Syndrome (MAS), Toxic Shock Syndrome and sepsis. The exact mechanisms responsible for the clinical overlap between MIS-C and these conditions remain unclear, and biomarkers that could distinguish MIS-C from its clinical mimics are lacking. This study aimed to provide an overview of how proteomic methods, like Mass Spectrometry (MS) and affinity-based proteomics, can offer a detailed understanding of pathophysiology and aid in the diagnosis and prognosis of MIS-C.</p><p><strong>Methods: </strong>A narrative review of relevant studies published up to July 2024 was conducted.</p><p><strong>Results: </strong>We identified 15 studies and summarized their key proteomic findings. These studies investigated the serum or plasma proteome of MIS-C patients using MS, Proximity Extension, or Aptamer-based assays. The studies associated the proteomic profile of MIS-C with laboratory and clinical parameters and/or compared it with that of other diseases including acute COVID-19, KD, MAS, pediatric rheumatic diseases, sepsis and myocarditis or pericarditis following COVID-19 mRNA immunization. Depending on the method and the control group, different proteins were increased or decreased in the MIS-C group. The limitations and challenges in MIS-C proteomic research are also discussed, and future research recommendations are provided.</p><p><strong>Conclusions: </strong>Although proteomics appear to be a promising approach for understanding the pathogenesis and uncovering candidate biomarkers in MIS-C, proteomic studies are still needed to recognize and validate biomarkers that could accurately discriminate MIS-C from its clinical mimics.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Results of an Innovative Scalable Digital Treatment for Diabetes Distress in Families of School-Age Children with Type 1 Diabetes. 针对 1 型糖尿病学龄儿童家庭糖尿病困扰的创新型可扩展数字疗法的早期成果。
IF 2 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-26 DOI: 10.3390/children11101169
Susana R Patton, Jessica S Pierce, Nicole Kahhan, Matthew Benson, Mark A Clements, Larry A Fox

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, 'Remedy to Diabetes Distress' (R2D2).

Methods: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access to digital treatment materials for 10 weeks. We examined the feasibility and acceptability of R2D2. We used the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, parent and child, respectively) to examine treatment effects by time and delivery arm. We performed sensitivity analyses to characterize families who responded to R2D2.

Results: It was feasible for families to access R2D2 mHealth content independently, though attendance at telehealth visits was variable. Parents and children reported high satisfaction scores. There were significant pre-post reductions in PPAIDC (p = 0.026) and PAIDC (p = 0.026) scores but no differences by delivery arm. There were no differences in child age, sex, race, or pre-treatment HbA1c for responders versus non-responders, though families who responded reported higher PPAID-C scores pre-treatment (p = 0.01) and tended to report shorter diabetes duration (p = 0.08).

Conclusions: Initial results support the acceptability and treatment effects of R2D2 regardless of the frequency of adjunctive virtual visits. Characterizing responders may help to identify families who could benefit from R2D2 in the future.

目的本文报告了一项新的移动医疗干预措施的初步结果,该措施旨在减少1型糖尿病(T1D)学龄儿童家庭的糖尿病困扰(DD),名为 "糖尿病困扰补救措施"(R2D2):我们将 34 个家庭(儿童平均年龄 = 10 ± 1.4 岁;53% 为男性,85% 为白人,平均 HbA1c = 7.24 ± 0.71%)随机分配到三个实施组中的一个,三个实施组的区别仅在于 10 周内远程医疗访问的次数:零次访问 = 自我指导 (SG),三次访问 = 增强自我指导 (ESG),八次访问 = 视频访问 (VV)。所有家庭都可以在 10 周内全天候访问数字治疗资料。我们研究了 R2D2 的可行性和可接受性。我们使用 "糖尿病-儿童问题领域"(PPAIDC 和 PAIDC,分别指父母和儿童)来按时间和提供方式检查治疗效果。我们进行了敏感性分析,以确定对 R2D2 有反应的家庭的特征:结果:尽管远程医疗访问的出席率参差不齐,但家庭独立访问 R2D2 移动医疗内容是可行的。家长和儿童的满意度都很高。PPAIDC(p = 0.026)和PAIDC(p = 0.026)得分在前后有明显降低,但各实施部门之间没有差异。接受治疗与未接受治疗的儿童在年龄、性别、种族或治疗前 HbA1c 方面没有差异,但接受治疗的家庭在治疗前的 PPAID-C 得分更高(p = 0.01),且糖尿病持续时间更短(p = 0.08):初步结果支持 R2D2 的可接受性和治疗效果,与辅助虚拟访问的频率无关。对应答者进行特征描述可能有助于识别将来可能从 R2D2 中受益的家庭。
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引用次数: 0
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Children-Basel
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