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摘要： LINKED CONTENT This article is linked to Mouratidou et al papers. To view these articles, visit https://***/10.1111/apt.15667 and https://***/10.1111/apt.15899.

关键词： anxiety   day surgery   distraction   meta-analysis   mobile health intervention   nursing   pain   parents   paediatric   systematic review  

摘要： Aims To evaluate the effectiveness of web-based mobile health interventions on paediatric patients and their parents in the day surgery context, where the primary outcome was children's pre-operative anxiety and secondary outcomes were postoperative pain and parents' anxiety and satisfaction with entire course of the day surgery. Design A systematic review and meta-analysis of randomized controlled trials. Data Sources CENTRAL, CINAHL, Scopus, Ovid MEDLINE, and Web of Science were systematically searched without time limits (up to December 2018). Review Methods Studies were appraised using the Cochrane risk of bias tool. A random effect meta-analysis of children's pre-operative anxiety was performed. Results Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web-based mobile health interventions, including age-appropriate videos, web-based game apps, and educational preparation games made for the hospital environment, was examined in pre-operative settings. A meta-analysis (N = 560 children) based on six studies found a statistically significant reduction in pre-operative anxiety measured by the Modified Yale Pre-operative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction. Conclusion Web-based mobile health interventions can reduce children's pre-operative anxiety and increase parental satisfaction. Web-based mobile health interventions could be considered as non-pharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children's postoperative pain and parental anxiety using similar interventions. Impact Web-based mobile health interventions reduce children ' s pre-operative anxiety and could therefore be considered as non-pharmacological distraction tools for children in nursing.

关键词： Adherence   Easypod (TM)   Growth hormone deficiency   Paediatric patients   Small for gestational age   Turner syndrome  

摘要： Background: The easypod (TM) injection device allows automatic recording and transmission of adherence data from patients receiving recombinant human growth hormone (rhGH [Saizen (R)]) to treat growth disorders. This analysis aimed to evaluate the adherence of Saizen (R) administered via easypod (TM) in a cohort of Greek patients from the easypod (TM) connect observational study (ECOS). Methods: The phase IV, open-label, multicentre, observational, and longitudinal ECOS study (EMR200104-520, NCT01363674) enrolled patients treated for a minimum of 6 months and up to 3 years. The primary endpoint was to assess the mean rate of adherence to treatment at different time points, where good adherence was defined as 85%. Change in height, height standard deviation score (SDS), height velocity and height velocity SDS were evaluated after 1 year of treatment as secondary endpoints, together with the impact of adherence on growth outcomes using the Spearman's product moment. Results: Of the 180 patients enrolled, 86 were included in the analysis. The mean adherence to Saizen (R), as recorded via easypoe (TM), was high at each individual time point, and was maintained at 95.5% after 1 year of treatment. Clinically meaningful positive changes were also noted for all of the secondary endpoints (median increase in height = 7.25 cm, height SDS = 0.32, median height velocity = 7.62 cm/year and height velocity SDS = 1.65). However, no significant correlation was noted between adherence and growth outcomes. Conclusions: rhGH replacement therapy using Saizen (R) with easypod (TM) led to full compliance to the treatment in a representative Greek population from ECOS, and provided additional insights on how the easypod (TM) device can assist physicians in monitoring adherence and help to optimise linear growth in paediatric patients with growth disorders.

关键词： Cardiomyopathy   Mitochondria   Paediatrics   Heart failure  

摘要： Background Primary mitochondrial disorders (PMD) are rare conditions resulting in progressive multi-organ failure. Cardiovascular involvement (CVI) has been reported in paediatric patients. However, its age-related prevalence, clinical presentation and prognostic impact are unresolved. We detailed CVI in a cohort of children diagnosed with PMD over two decades at a tertiary referral centre. Results We enrolled 86 PMD patients (M/F = 30/56;mean age 6.4 +/- 8.58 years). CVI was detected in 31 patients (36%), with mean age at onset of 5.7 +/- 7.8 years including the pre- and neonatal phase in 14, often representing the first sign of PMD (42% of those with CVI). Heart disease resulted more common in males and in children with specific aetiologies (Barth, TMEM70 and MELAS syndromes). Hypertrophic, non-compaction and dilated cardiomyopathies were the prevalent disorders, although pulmonary arterial hypertension was also found. Adverse cardiac events (heart failure, resuscitated cardiac arrest, ICD/PM implantation, sudden death) occurred in 19% of children with CVI over a follow-up period of 5.4 +/- 4.3 years. All-cause mortality was higher in patients with CVI compared to those without CVI (45.1% vs 21.8%;p < 0.01);female sex, age at onset < 5 years, acute heart failure at presentation and diabetes also proved independent predictors of outcome. Conclusion Cardiovascular involvement occurred in over one-third of children diagnosed with PMD, often at a very early age, and was associated with adverse prognosis. Final outcome of PMD-related CVI was influenced by the specific underlying aetiology, suggesting the need for tailored management of heart failure and sudden death prevention.

关键词： 幼儿科学探索   教师指导   策略  

摘要： 教师对幼儿进行科学探索的指导工作有助于幼儿打好科学基础。幼儿在科学探究学习过程中,由于其对科学的理解和认识还不是十分的清晰,这对于教师的指导过程无疑是增加了很大的困难。因而为了帮助孩子从幼儿时期建立科学思维,教师必须要采取必要的手段促使幼儿进行自主的科学探索过程。科学思维的建立要从娃娃抓起,从幼儿幼儿园生活中逐渐渗透科学在生活中的意义和用途,孩子能够逐渐对科学产生浓厚的探索兴趣,为孩子在未来走科学发展创新的道路上更加的顺利。下面我们将会围绕教师如和采取有效的指导措施让幼儿进行科学合理的认识和理解进行细致的分析。

关键词： Active appearance model   automatic modelling   finite element analysis   patient-specific model   unilateral crossbite  

摘要： The evaluation of temporomandibular joint (TMJ) dysfunction using finite element models is a time consuming process that requires extensive technical knowledge. We combined a statistical active appearance model with automated modelling algorithms to biomechanically study the relationship between TMJ malformations and dysfunction in radiographs from 20 paediatric patients with unilateral crossbite. A fitting algorithm (fitting error < 4%) recognised the TMJ shape and adjusted the dimensions of each patient-specific 2D FE model, which was then used to compute 2 different joint movements. Significant functional differences were observed between the crossbite and non-cross bite sides, and the shape-function relation was verified.

关键词： Probiotics   Paediatrics   Necrotizing enterocolitis   Acute infectious diarrhoea   Allergy   Functional gastrointestinal disorders  

摘要： During the last decade several paediatric studies have been published with different possible indications for probiotics, leading to a global increase of probiotics' market. Nevertheless, different study designs, multiple single/combined strains and small sample size still leave many uncertainties regarding their efficacy. In addition, different regulatory and quality control issues make still very difficult the interpretation of the clinical data. The objective of this review is to critically summarise the current evidence on probiotics' efficacy and safety on a different number of pathologies, including necrotizing enterocolitis, acute infectious diarrhoea, allergic diseases and functional gastrointestinal disorders in order to guide paediatric healthcare professionals on using evidence-based probiotics' strains. To identify relevant data, literature searches were performed including Medline-PubMed, the Cochrane Library and EMBASE databases. Considering probiotics strain-specific effects, the main focus was on individual probiotic strains and not on probiotics in general.

关键词： Chronic non-bacterial osteomyelitis   Chronic recurrent multifocal osteomyelitis   Bone autoinflammation   Lymphoplasmacellular osteomyelitis  

摘要： Purpose of Review To describe in detail the clinical synopsis and pathophysiology of chronic non-bacterial osteomyelitis and SAPHO syndrome. Recent Findings Chronic non-bacterial osteomyelitis (CNO) has been identified as a disease entity for almost 50 years. This inflammatory bone disorder is characterized by osteolytic as well as hyperostotic/osteosclerotic lesions. It is chronic in nature, but it can present with episodic flairs and phases of remission, which have led to the denomination "chronic recurrent osteomyelitis", with its severe multifocal form "chronic recurrent multifocal osteomyelitis" (CRMO). For almost three decades, an infectious aetiology had been considered, since especiallyPropionibacterium acneshad been isolated from bone lesions of individual patients. However, this concept has been challenged since long-term antibiotic therapy did not alter the course of disease and modern microbiological techniques (including PCR) failed to confirm bone infection as an underlying cause. Over recent years, a profound dysregulation of cytokine expression profiles has been demonstrated in innate immune cells of CNO patients. A hallmark of monocytes from CNO patients is the failure to produce immune regulatory cytokines interleukin-10 (IL-10) and IL-19, which have been linked with genetic and epigenetic alterations. Subsequently, a significant upregulation of pro-inflammatory, NLRP3 inflammasome-dependent cytokines (IL-1 beta and TNF-alpha), has been demonstrated. The current knowledge on CNO, the underlying molecular pathophysiology, and modern imaging strategies are summarized;differential diagnoses, treatment options, outcome measures, as well as quality of life studies are discussed.