Hepatitis during respiratory syncytial virus infection – a case report

Introduction:

Respiratory syncytial virus (RSV) infection is the most common cause of hospitalization in infants and small children. The aim was to present a 13-months old boy diagnosed with acute airway infection, acute otitis media (AOM) and hepatitis during the RSV-infection.

Material and methods:

Serum catalytic activities of alkaline phosphatase (ALP), aspartate aminotranspherase (AST), alanine aminotranspherase (ALT), gamma glutamyl transpherase (GGT), lactate dehydrogenase (LD), and concentrations of bilirubin were monitored during hospitalization and at control examination.

Results:

The child had clinical signs and symptoms of respiratory failure, AOM, and laboratory findings of virus infection and liver disease. On admission, catalytic activities of enzymes were markedly increased, especially the activity of ALP (10333 U/L, i.e. 24-fold increase in comparison with the upper reference limit). The highest increased in AST (339 U/L, 4.5-fold), ALT (475 U/L, 10.3-fold) and LD (545 U/L, 1.5-fold) were registered on the 3^rd day, and the highest increase in GGT (68 U/L, 3.1-fold) occurred on the 11th day. Seven weeks after discharge AST, ALT, GGT and LD decreased into reference range, and ALP remain mildly increased (478 U/L, 1.1 fold increase). RSV was confirmed in nasal lavage fluid.

Conclusion:

Laboratory results in patient with RSV infection needs to be interpreted in the light of both, respiratory and extrapulmonary manifestations of the infection, respectively.     

The Spanish Version of the Empathy Questionnaire (EmQue): Evidence for Longitudinal Measurement Invariance and Relationship With Emotional Regulation

Research Findings: Empathy, or the ability to understand what others are thinking or feeling, can be observed in early developmental stages. The purpose of this study was to validate the Spanish version of the Empathy Questionnaire (EmQue) and examine its longitudinal measurement invariance (LMI) at 2 time points. Parents of 103 children completed the EmQue when their children were 3 (M = 41.76) and 4 (M = 51.65) years old. Confirmatory factor analyses revealed that Grazzani, Ornaghi, Pepe, Brazzelli and Rieffe’s (2016) 3-factor model of emotional contagion (EC), attention to others’ feelings, and prosocial actions (PA) presented the best fit indices at both time points (Time 1: CFI = .931, TLI = .914, and RMSEA = .070; Time 2: CFI = .941, TLI = .935, and RMSEA = .064). Moreover, preliminary evidence was obtained for the LMI of this model. PA scores increased over time. Score reliability ranged from .60 (EC) to .83 (PA). Positive correlations were found between PA and emotional regulation at each time point and across time.Practice or Policy: The great relevance of empathy and prosocial behavior in academic achievement and psychological adjustment justifies the development of reliable instruments to evaluate these constructs from early ages.     

Inherited prothrombotic risk factors in children with first ischemic stroke

Stroke in children is a heterogeneous disorder. Over 100 risk factors for stroke have been reported and genetic predisposition to stroke has been established. The most frequently reported risk factors are congenital heart malformations, hemolytic anemias, collagen vascular diseases, some rare inborn metabolic disorders, trauma, infection and thrombophilia. The aim of this article is to provide an overview of investigated inherited prothrombotic risk factors in children with first ischemic stroke. Various prothrombotic risk factors have been investigated in pediatric stroke including elevated homocysteine and lipoprotein (a), antithrombin, protein C and protein S deficiency, Factor V Leiden, Factor II G20210A and plasminogen activator inhibitor-1 4G/5G polymorphism. Despite similar criteria for inclusion of different studies in meta-analyses investigating first ischemic stroke in children, the obtained results were not consistent for all prothrombotic risk factors. The discrepancies found could be explained by methodological issues like different sample sizes, patient populations included and lack of controls. In order to provide the necessary power for randomized control trials, multi-center, multi-national approaches like International Pediatric Stroke Study have been initiated with the aim to describe risk factors for childhood stroke and explore their relationship with presentation, age, geography, and infarct characteristics. Although it is evident from numerous studies that the frequency of inherited prothrombotic factors is increased in pediatric stroke, single thrombophilia does not fully explain stroke in a child as it represents only a mild risk factor. Further studies are needed, as improved understanding of underlying mechanisms will improve primary and secondary prevention of childhood stroke.     

Prolonged hypervolemic hemodilution decreases functional capillary density of ileal mucosa in pigs revealed by sidestream dark-field imaging

Objective  

Hemodilution changes the physical properties of blood by reducing its hematocrit and blood viscosity. We tested whether prolonged hypervolemic hemodilution (HHD) impairs functional capillary density (FCD) of ileal mucosa in healthy mechanically-ventilated pigs and if there is any correlation between changes in FCD of ileal and sublingual mucosas during HHD.     

Effective teaching methods-- Project-based learning in physics

The paper presents results of the research of new effective teaching methods in physics and science. It is found out that it is necessary to educate pre-service teachers in approaches stressing the importance of the own activity of students, in competences how to create an interdisciplinary project. Project-based physics teaching and learning seems to be one of the most effective methods for teaching science for understanding. It is necessary to provide in-service teachers instruction （seminars） and prepare sample projects with proposals how to develop, run and evaluate interdisciplinary projects. Projects are important ＂real-world＂ physics modules, modern physics and everyday life problems can be integrated into the high school curriculum. Examples of projects that were worked out are presented.     

精品课程评价指标体系的定量研究

本文应用模糊数学的理论和方法,对精品课程评价过程中大量的模糊数据进行了定量的分析和研究,通过综合评判给出了较为科学的切合客观实际的评价结果。     

Reevaluation of von Willebrand disease diagnosis in a Croatian paediatric cohort combining bleeding scores,phenotypic laboratory assays and next generation sequencing: a pilot study

IntroductionThis study reevaluated von Willebrand disease (vWD) diagnosis in a Croatian paediatric cohort by combining bleeding scores (BS), phenotypic laboratory testing, and next-generation sequencing (NGS).Materials and methodsA total of 25 children (11 males and 14 females, median age 10 years, from 2 to 17) previously diagnosed with vWD were included. BS were calculated using an online bleeding assessment tool. Phenotypic laboratory analyses included platelet count, platelet function analyser closure times, prothrombin time, activated partial thromboplastin time, von Willebrand factor antigen (vWF:Ag), vWF gain-of-function mutant glycoprotein Ib binding activity (vWF:GPIbM), vWF collagen binding activity (vWF:CBA), factor VIII activity (FVIII:C) and multimeric analysis. Next-generation sequencing covered regions of both vWF and FVIII genes and was performed on MiSeq (Illumina, San Diego, USA).ResultsDisease-associated variants identified in 15 patients comprised 11 distinct heterozygous vWF gene variants in 13 patients and one novel FVIII gene variant (p.Glu2085Lys) in two male siblings. Four vWF variants were novel (p.Gln499Pro, p.Asp1277Tyr, p.Asp1277His, p.Lys1491Glu). Three patients without distinctive variants had vWF:GPIbM between 30 and 50%. Patients with identified vWF gene variants had statistically significant lower values of vWF:GPIbM (P = 0.002), vWF:Ag (P = 0.007), vWF:CBA (P < 0.001) and FVIII:C (P = 0.002), compared to those without. Correlations between BS and phenotypic laboratory test results were not statistically significant for either of the tests.ConclusionThe applied diagnostic approach confirmed the diagnosis of vWD in 13 patients and mild haemophilia A in two. Limited utility of BS in the paediatric population was evidenced.     

Complexity and action research: exploring the theoretical and methodological connections

Complexity theory is essentially a formal attempt to question how coherent and purposive wholes emerge from the interactions of simple and sometimes non-purposive components. Explicit recognition of complexity can provide a fresh and enlightening perspective on action research. Through an expository discussion of the foundational postulates of complexity theory this article demonstrates the theoretical and methodological connections between complexity and action research, with particular emphasis on the relevance of complexity in educational and workplace contexts. Complexity is an emerging theoretical perspective, which presents possibilities for revolutionizing approaches to action research, as well as strengthening arguments promoting the value of action research in a wide range of contexts. Complexity, it is argued, can provide a valuable theoretical underpinning for action research. Furthermore, action research provides a valid methodological approach to the study of complexity. This article is primarily theoretical and attempts to demonstrate the application of complexity to a specific action research project will be left to future publication(s). Rather, this article explores the general applicability of complexity as both theory and metaphor in action research. The article begins with a brief exploration of the theory, particularly focusing on its application in the social sciences. The theoretical and methodological connections between complexity and action research are discussed through several of the foundational postulates of complexity, how these manifest in action research and how they add to our understanding of action research itself.     

Unravelling the dynamics of knowledge creation in communities of practice though complexity theory lenses

Drawing on a longitudinal case study of Alpha Chemicals, we use four complexity theory constructs – adaptive tension, enabling leadership, enhanced cooperation, and boundary spanning – to explain the continuous knowledge creation dynamics in Communities of practice (CoPs). Our findings show that the virtual cycle of knowledge creation results from CoPs oscillating between guided and self-directed modes. In a guided mode, adaptive tension and enabling leadership prevail, resulting in knowledge expansion. In a self-directed mode, enhancing cooperation and boundary spanning are the most significant, resulting in knowledge probing. This research uncovers the value of conceptualizing CoPs as complex adaptive systems with emergent and intentional processes coexisting to create a virtual knowledge creation cycle. Our findings complement the dominant theory on CoPs’ insights by moving beyond the control/autonomy debate and highlighting that knowledge creation dynamics results from a flexible combination and recombination of the different top-down and bottom-up forces.