Acute Promyelocytic Leukemia in Children: A Model of Precision Medicine and Chemotherapy-Free Therapy

Acute promyelocytic leukemia (APL) represents a paradigm of precision medicine. Indeed, in the last decades, the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) completely revolutionized the therapeutic approach to this previously highly fatal disorder. This entirely chemotherapy-free treatment, which provided excellent survival rates, has been initially validated in adults and, recently, translated in the pediatric setting. This review summarizes currently available data on the use of ATRA and ATO combination in pediatric APL, providing a particular focus on peculiar issues and challenges, such as the occurrence of pseudotumor cerebri and death during induction (early death), as well as the advantage offered by the ATO/ATRA combination in sparing long-term sequelae.     

Effects of upholstery materials on the burning behavior of real‐scale residential upholstered furniture mock‐ups

Fire spread and growth on real‐scale four cushion mock‐ups of residential upholstered furniture (RUF) were investigated with the goal of identifying whether changes in five classes of materials (barrier, flexible polyurethane foam, polyester fiber wrap, upholstery fabric, and sewing thread), referred to as factors, resulted in statistically significant changes in burning behavior. A fractional factorial experimental design plus practical considerations yielded a test matrix with 20 material combinations. Experiments were repeated a minimum of two times. Measurements included fire spread rates derived from video recordings and heat release rates (HRRs). A total of 13 experimental parameters (3 based on the videos and 10 on the HRR results), referred to as responses, characterized the measurements. Statistical analyses based on Main Effects Plots (main effects) and Block Plots (main effects and factor interactions) were used. The results showed that three of the factors resulted in statistically significant effects on varying numbers of the 13 responses. The Barrier and Fabric factors had the strongest main effects with roughly comparable magnitudes. Foam was statistically significant for fewer of the responses and its overall strength was weaker than for Barrier and Fabric. No statistically significant main effects were identified for Wrap or Thread. Multiple two‐term interactions between factors were identified as being statistically significant. The Barrier*Fabric interaction resulted in the highest number of and strongest statistically significant effects. The existence of two‐term interactions means that it will be necessary to consider their effects in approaches designed to predict the burning behavior of RUF.     

Reduced‐scale test to assess the effect of fire barriers on the flaming combustion of cored composites: An upholstery‐material case study

Herein, we describe a reduced‐scale test (“Cube” test), measuring the fire performance of specimens including a fire barrier (FB) and a flammable core material, which acts as the main fuel load. The specimen is intended to reproduce a cross‐section of a composite product where heat/mass transfer occurs primarily in a direction perpendicular to the FB. The Cube test procedure and benefits are discussed in this work by adopting residential upholstery furniture as an exemplary study. One flexible polyurethane foam, one polypropylene cover fabric, and 10 commercially available FBs were selected. They were used to compare the fire performance of FBs, measured in terms of peak of heat release rate, in the ASTM E1474‐14 standard test and the newly developed Cube test. Edge effects severely affected the performance of FBs in the ASTM E1474‐14 standard test but not in the Cube test. Furthermore, appropriate test conditions were determined in the Cube test to measure the so‐called “wetting point,” that is, the time and value of heat release rate measured when flammable liquid products were first observed on the bottom of the specimen. The relevance of the “wetting point” in terms of full‐scale fire performance and failure mechanism of FBs is discussed.     

Distinctive Microbial Signatures and Gut-Brain Crosstalk in Pediatric Patients with Coeliac Disease and Type 1 Diabetes Mellitus

Coeliac disease (CD) and Type 1 diabetes mellitus (T1DM) are immune-mediated diseases. Emerging evidence suggests that dysbiosis in the gut microbiome plays a role in the pathogenesis of both diseases and may also be associated with the development of neuropathy. The primary goal in this cross-sectional pilot study was to identify whether there are distinct gut microbiota alterations in children with CD (n = 19), T1DM (n = 18) and both CD and T1DM (n = 9) compared to healthy controls (n = 12). Our second goal was to explore the relationship between neuropathy (corneal nerve fiber damage) and the gut microbiome composition. Microbiota composition was determined by 16S rRNA gene sequencing. Corneal confocal microscopy was used to determine nerve fiber damage. There was a significant difference in the overall microbial diversity between the four groups with healthy controls having a greater microbial diversity as compared to the patients. The abundance of pathogenic proteobacteria Shigella and E. coli were significantly higher in CD patients. Differential abundance analysis showed that several bacterial amplicon sequence variants (ASVs) distinguished CD from T1DM. The tissue transglutaminase antibody correlated significantly with a decrease in gut microbial diversity. Furthermore, the Bacteroidetes phylum, specifically the genus Parabacteroides was significantly correlated with corneal nerve fiber loss in the subjects with neuropathic damage belonging to the diseased groups. We conclude that disease-specific gut microbial features traceable down to the ASV level distinguish children with CD from T1DM and specific gut microbial signatures may be associated with small fiber neuropathy. Further research on the mechanisms linking altered microbial diversity with neuropathy are warranted.     

Effectiveness of portable HEPA air cleaners on reducing indoor PM2.5 and NH3 in an agricultural cohort of children with asthma: A randomized intervention trial

We conducted a randomized trial of portable HEPA air cleaners with pre-filters designed to also reduce NH₃ in non-smoking homes of children age 6-12 with asthma in Yakima Valley (Washington, USA). Participants were recruited through the Yakima Valley Farm Workers Clinic asthma education program. All participants received education on home triggers while intervention families additionally received two HEPA cleaners (child's sleeping area, main living area). Fourteen-day integrated samples of PM_2.5 and NH₃ were measured at baseline and one-year follow-up. We fit ANCOVA models to compare follow-up concentrations in HEPA vs control homes, adjusting for baseline concentrations. Seventy-one households (36 HEPA, 35 control) completed the study. Most were single-family homes, with electric heat and stove, A/C, dogs/cats, and mean (SD) 5.3 (1.8) occupants. In the sleeping area, baseline geometric mean (GSD) PM_2.5 was 10.7 (2.3) μg/m³ (HEPA) vs 11.2 (1.9) μg/m³ (control); in the living area, it was 12.5 (2.3) μg/m³ (HEPA) vs 13.6 (1.9) μg/m³ (control). Baseline sleeping area NH₃ was 62.4 (1.6) μg/m³ (HEPA) vs 65.2 (1.8) μg/m³ (control). At follow-up, HEPA families had 60% (95% CI, 41%-72%; p < .0001) and 42% (19%-58%; p = .002) lower sleeping and living area PM_2.5, respectively, consistent with prior studies. NH₃ reductions were not observed.     

Chemical exposures from upholstered furniture with various flame retardant technologies

Upholstered furniture is often manufactured with polyurethane foam (PUF) containing flame retardants (FRs) to prevent the risk of a fire and/or to meet flammability regulations, however, exposure to certain FRs and other chemicals have been linked to adverse health effects. This study developed a new methodology for evaluating volatile organic compound (VOC) and FR exposures to users of upholstered furniture by simulating use of a chair in a controlled exposure chamber and assessing the health significance of measured chemical exposure. Chairs with different fire-resistant technologies were evaluated for VOC and FR exposures via inhalation, ingestion, and dermal contact exposure routes. Data show that VOC exposure levels are lower than threshold levels defined by the US and global indoor air criteria. Brominated FRs were not detected from the studied chairs. The organophosphate FRs added to PUF were released into the surrounding air (0.4 ng/m³) and as dust (16 ng/m²). Exposure modeling showed that adults are exposed to FRs released from upholstered furniture mostly by dermal contact and children are exposed via dermal and ingestion exposure. Children are most susceptible to FR exposure/dose (2 times higher average daily dose than adults) due to their frequent hand to mouth contact.     

依托泊苷联合卡铂用于复发性髓母细胞瘤患儿的疗效与安全性

目的:探讨依托泊苷联合卡铂用于复发性髓母细胞瘤患儿的疗效与安全性。方法:选取浙江大学医学院附属儿童医院在2011年1月至2014年6月收治的72例复发性髓母细胞瘤患儿（3～15岁），随机分为CE组和对照组，每组36例，CE组采用依托泊苷＋卡铂给药方式化疗；对照组采用经典伊立替康＋替莫唑胺＋长春新碱方案化疗。比较两组患儿临床疗效、卡诺夫斯基健康状况量表（KPS）评分、儿科生活质量测定量表4.0（PedsQLTM4.0）评分、总生存期（OS）、无事件生存（EFS），记录患儿治疗期间药物不良反应的发生情况。结果:治疗后CE组和对照组完全缓解率（CR）分别为41.67%（15/36）和27.78%（10/36），总缓解率（OR）分别为94.44%（34/36）和77.78%（28/36），差异有统计学意义（P<0.05）。两组患儿治疗前KPS评分及PedsQLTM4.0评分无统计学差异（P＞0.05），治疗后CE组和对照组的KPS评分分别为（80±8）和（75±10）分，PedsQLTM4.0评分分别为（89±11）和（84±11）分，差异均有统计学意义（均P<0.05）。截至末次随访时间，CE组有3例失访，对照组有2例失访。截至末次随访时间，CE组和对照组总生存率分别为78.8%（26/33）和55.9%（19/34），差异有统计学意义（P<0.05），无事件生存率分别为72.7%（24/33）和52.9%（18/34），差异无统计学意义（P＞0.05）。CE组化疗期间共出现10例3级以上不良反应，发生率为27.78%（10/36），对照组化疗期间共出现9例3级以上不良反应，发生率为25.00%（9/36），差异无统计学意义（P＞0.05）。结论:依托泊苷联合卡铂方案能够明显提高患儿临床缓解率，延长患儿总生存率，同时不增加化疗不良反应，但对无事件生存率的影响并不明显。     

谈陶瓷装饰中的婴戏纹饰与西方艺术品中的儿童形象

婴戏纹饰即描绘儿童游戏时的画作,是中国人物画的一种,更是陶瓷装饰中常见的传统题材。其主要以儿童为主要绘画对象,表现儿童纯真,或借以其他物象,组成吉祥图案,在我国陶瓷绘画上广泛运用,有着深刻的社会形态特征和思想文化的背景。其始于唐代,兴盛于宋金,明清两朝日臻成熟,并延续至今。在西方艺术史当中,儿童形象大都通过神话人物或宗教相关的艺术品走进人们视野,用以表现某些宗教思想或精神诉求。本文主要探讨陶瓷婴戏纹饰在我国历史发展历程中的演变概况,以及笔者对我国陶瓷婴戏纹饰和西方艺术品中儿童形象横向对比下的一些思考。     

儿童用品TBT通报数据可视化预警研究

探索采用数据可视化技术分析儿童用品TBT通报数据,以可视化图形图像呈现通报热点并揭示趋势信息,提出对策与建议,助力为儿童用品产业升级、TBT预警数据分析和信息传播工作提供新思路,提高中小企业的国外市场准入机会。     

Association of solid fuel use with risk of stunting in children living in China

Stunting adversely affects physical and mental outcomes of children. It has not been examined whether household air pollution from solid fuel combustion is a risk factor for stunting in children. In a total of 41,439 children aged 6-17 across China, height was measured using a unified protocol. Multivariable linear regression models and logistic regression models were used to assess the associations of solid fuel use for cooking/heating with stunting in children. Adjusted for covariates, cooking/heating with solid fuel was significantly associated with a lower z-score for height for age and sex (β = −0.21 [−0.32 to −0.09] and −0.17 [−0.31 to −0.03], respectively) and an increased risk of stunting with an estimated ORs of 1.34 [1.07~1.68] and 1.37 [1.02~1.83], respectively. The risk of stunting associated with solid fuel use was statistically significant in high-age children. And the effect was greater on girls than on boys, though the difference was not statistically significant. Our study suggested that Chinese children living in households using solid fuel had a significantly higher risk of stunting than those living in households using cleaner fuel.