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Evaluation and management of the child with hypothyroidism

World Journal of Pediatrics 2019年第2期15卷 124-134页

作者： alexander k.c.leung alexander A.c.leung Department of Pediatrics The University of Calgaryand The Alberta Children's Hospital#200233-16th Avenue NWCalgaryAB T2M 0H5Canada Department of Medicine The University of CalgaryCalgaryABCanada

Background Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout *** recognition and treatment of hypothyroidism is,therefore,of utmost importance to optimize physical and neurodevelopmental *** sources A PubMed search was completed in clinical Queries using the key terms 'hypothyroidism'.Results Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism).Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism,*** than 95% of infants with congenital hypothyroidism have few,if any,clinical manifestations of *** screening programs allow early detection of congenital *** developed countries,Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and ***,iodine deficiency associated with goiter is the most common cause of *** hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary *** of the clinical features would allow prompt diagnosis and institution of *** To optimize neurocognitive outcome in infants with congenital hypothyroidism,treatment with levothyroxine should be started as soon as possible,preferably within the first 2 weeks of *** with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive *** target is to keep serum TSH cific reference range,with elimination of all symptoms and signs of hypothyroidism.

关键词： Dysgenesis Dyshormonogenesis Hashimoto thyroiditis Hypothyroidism Iodine deficiency Levothyroxine Mental retardation Stunted growth

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childhood Langerhans cell histiocytosis:a disease with many faces

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World Journal of Pediatrics 2019年第6期15卷 536-545页

作者： alexander k.c.leung Joseph M.Lam kin Fon Leong Department of Pediatrics The University of Calgaryand The Alberta Children's Hospital#20023316th Avenue NWCalgaryAB T2M 0H5Canada Department of Pediatrics University of British ColumbiaVancouverBCCanada Department of Dermatology and Skin Sciences University of British ColumbiaVancouverBCCanada Pediatric Institute Kuala Lumpur General HospitalKuala LumpurMalaysia

Background Langerhans cell histiocytosis(LcH)is a group of diseases characterized by the proliferation and accumulation of Langerhans *** presentations of LcH vary *** sources A PubMed search was conducted using clinical Queries with the key term "Langerhans cell histiocytosis".The search strategy included meta-analyses,randomized controlled trials,clinical trials,observational studies,and *** paper is based on,but not limited to,the search *** Generally,patients with LcH can be divided into two groups based on the extent of involvement at diagnosis,namely,single-system LcH and multisystem *** involvement may be unifocal or *** with isolated bone lesions typically present between 5 and 15 years of age,whereas those with multisystem LcH tend to present before 5 years of *** clinical spectrum is broad,ranging from an asymptomatic isolated skin or bone lesion to a life-threatening multisystem *** manifestations include,among others,"punched out" lytic bone lesion,seborrheic dermatitis-like erup-tion,erythematous/reddish-brown crusted/scaly papules/maculopapules/plaques/patches,and eczematous lesions,diabetes insipidus,hepatosplenomegaly,cytopenias,lymphadenopathy,and an acute fulminant disseminated multisystem condition presenting with fever,skin rash,anemia,thrombocytopenia,lymphadenopathy,and *** diagnosis is clinicopathologic,based on typical clinical findings and histologic/immunohistochemical examination of a biopsy of lesional *** cD1a,S100,and/or cD207(Langerin)immunohistochemical staining of lesional cells is required for a definitive *** waiting is recommended for patients with skin-only *** with symptomatic or refractory skin-only LcH may be treated with topical tacrolimus/corticosteroids,topical nitrogen mustard,oral methotrexate,or oral *** current recommended first-line therapy for patients with multisystem LcH i

关键词： cytopenia Diabetes insipidus Eczematous lesions Hepatosplenomegaly Lymphadenopathy Seborrheic dermatitis-like eruption

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Staphylococcal-scalded skin syndrome:evaluation,diagnosis,and management

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World Journal of Pediatrics 2018年第2期14卷 116-120页

作者： alexander k.c.leung Benjamin Barankin kin Fon Leong Department of Pediatrics The Alberta Children's HospitalThe University of CalgaryCalgary#200233-16th Avenue NWCalgaryAB T2M 0H5Canada Toronto Dermatology centre TorontoONCanada The Pediatric Institute Kuala Lumpur General HospitalKuala LumpurMalaysia

Background Staphylococcal-scalded skin syndrome(SSSS),also known as Ritter disease,is a potentially life-threatening disorder and a pediatric *** diagnosis and treatment is imperative to reduce the morbidity and mortality of this *** purpose of this article is to familiarize physicians with the evaluation,diagnosis,and treatment of *** sources A PubMed search was completed in clinical Queries using the key terms"Staphylococcal scalded skin syn-drome"and"Ritter disease".Results SSSS is caused by toxigenic strains of Staphylococcus *** of the amino-terminal extracellular domain of desmoglein 1 by staphylococcal exfoliative toxins results in disruption of keratinocytes adhesion and cleavage within the stratum granulosum which leads to bulla *** diagnosis is mainly clinical,based on the findings of tender erythroderma,bullae,and desquamation with a scalded appearance especially in friction zones,periorificial scabs/crusting,positive Nikolsky sign,and absence of mucosal *** empiric treatment with intravenous anti-staphylococcal antibiotic such as nafcillin,oxacillin,or flucloxacillin is essential until cultures are available to guide *** or cefuroxime may be used should the patient have penicillin *** the patient is not improving,critically ill,or in com-munities where the prevalence of methicillin-resistant *** is high,vancomycin should be *** A high index of suspicion is essential for an accurate diagnosis to be made and treatment promptly initiated.

关键词： Blisters Desquamation Erythroderma Exfoliative toxins Staphylococcus aureus

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Erythema nodosum

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World Journal of Pediatrics 2018年第6期14卷 548-554页

作者： alexander k.c.leung kin Fon Leong Joseph M.Lam Department of Pediatrics The Alberta Children's HospitalThe University of Calgary#200233-16th Avenue NWCalgaryAB T2M 0H5Canada Pediatric Institute Kuala Lumpur General HospitalKuala LumpurMalaysia Department of Pediatrics and Department of Dermatology and Skin Sciences University of British ColumbiaVancouverBCCanada

Background Erythema nodosum can be associated with a number of systemic diseases. There is, however, a paucity of information in the pediatric literature on this condition. The purpose of this article is to familiarize pediatricians with the evaluation, diagnosis, and treatment of erythema nodosum. Data sources A PubMed search was completed in clinical Queries using the key terms 'erythema nodosum'. Results clinically, erythema nodosum presents with a sudden onset of painful, erythematous, subcutaneous nodules mainly localized to the pretibial areas. Lesions are usually bilateral and symmetrical, ranging from 1 to 5 cm in diameter. Erythema nodosum may be associated with a variety of conditions such as infection, medications, sarcoidosis, pregnancy, inflamma-tory bowel disease, vaccination, autoimmune disease, malignancy, and miscellaneous causes. The condition is idiopathic in approximately 50% of cases. The diagnosis is mainly clinical with biopsy reserved for atypical cases. To evaluate for the underlying cause, some basic laboratory screening studies are worthwhile in most cases and include a complete blood cell count, erythrocyte sedimentation rate and/or c-reactive protein, throat swab culture, antistreptococcal O titers, and a chest radiograph. Other tests should be individualized, guided by the history and physical examination results. Most cases of ery-thema nodosum are self-limited and require no treatment. Bed rest and leg elevation are generally recommended to reduce the discomfort. Nonsteroidal anti-inflammatory drugs are the first-line treatment for pain management. conclusions As erythema nodosum is often a cutaneous manifestation of a systemic disease, a thorough search should be performed to reveal the underlying cause.

关键词： Drug-induced Group A β-hemolytic streptococcal infection Sarcoidosis Subcutaneous pretibial nodules Tuberculosis Yersinia infection

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Gianotti-crosti syndrome(papular acrodermatitis of childhood)in the era of a viral recrudescence and vaccine opposition

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World Journal of Pediatrics 2019年第6期15卷 521-527页

作者： alexander k.c.leung consolato Maria Sergi Joseph M.Lam kin Fon Leong Department of Pediatrics The University of CalgaryCalgaryCanada The Alberta children's Hospital #200233-16th Avenue NWCalgaryAB T2M OH5Canada The University of Alberta EdmontonABCanada Departments of Pediatrics Dermatology and Skin SciencesUniversity of British ColumbiaVancouverBCCanada Pediatric Institute Kuala Lumpur General HospitalKuala LumpurMalaysia

Background Gianotti-crosti syndrome is characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical *** sources A PubMed search was conducted using clinical Queries with the key terms"Gianotti-crosti syndrome"OR"papular acrodermatitis".The search strategy included meta-analyses,randomized controlled trials,clinical trials,observa-tional studies,and *** paper is based on,but not limited to,the search *** The eruption of Gianotti-crosti syndrome is found predominantly on the cheeks,extensor surfaces of the extremities,and *** is a sparing of antecubital and popliteal fossae as well as palms,soles,and mucosal *** often asymptomatic,the lesions may be mildly to moderately ***-crosti syndrome is most common in children between 1 and 6 years of *** Epstein-Barr virus and the hepatitis B virus are the most common pathogens associated with Gianotti-crosti *** treatment for Gianotti-crosti syndrome is necessary because it is *** an era of vaccine hesitancy and refusal,Gianotti-crosti syndrome may be important to mention to parents,because it can occur and trigger *** Gianotti-crosti syndrome is mainly a disease of early childhood,characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical *** the advent of more universal vaccination against hepatitis B virus,Epstein-Barr virus has become the most common etiologic agent of Gianotti-crosti *** cases of post-vaccination Gianotti-crosti syndrome have been ***,the emphasis should be placed on its self-limiting attribution.

关键词： Epstein-Barr virus Hepatitis B virus Papular acrodermatitis Papular symmetrical eruption

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小儿急性腹痛

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中国实用乡村医生杂志 2004年第11期11卷 40-42页

作者： alexander k.c.leung M.B.B.S David L.Sigalet M.D Ph.D 胡浩 University of calgary Faculty of Medicine CalgaryAlberta 中国医科大学86期英文1班

腹痛是小儿的常见症状.尽管大多数小儿急性腹痛的症状有自限性,但仍然应该视为内、外科的急症来处理.能够早期作出腹痛的正确诊断是最困难的,而这又是开展治疗和抑制病情恶化的关键.本文为小儿急性腹痛的评估提供一个综合的临床指导方针.

关键词：小儿腹痛诊断

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Testing and modelling of transient adhesion phenomena in rolling-sliding contacts

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Friction 2024年第5期12卷 1016-1027页

作者： Daniel kVARDA alexander MEIERHOFER klaus SIX Faculty of Mechanical Engineering Brno University of TechnologyBrno61669Czech Republic Virtual Vehicle Research GmbH Graz8010Austria

Transient adhesion effects in rolling–sliding contacts influence all aspects of train–track *** is of high importance specifically when these effects result in critically low adhesion,which poses a risk to traction and braking of railway *** study presents a model that can replicate the transient changes of the coefficient of adhesion with tested water and solid particle *** experimental data for the model are measured using a commercial ball-on-disc *** experimental results showed a liquid reservoir in front of the contact area that slowly reduces in *** observation was used in the modelling approach to divide the calculation into two stages where the reservoir is present and when it *** model was able to reproduce the occurrence of low adhesion region seen in experimental results with different particle concentrations.

关键词： coefficient of adhesion tribology transient effects wheel-rail contact

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Prediction of ball-on-plate friction and wear by ANN with data-driven optimization

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Friction 2024年第6期12卷 1235-1249页

作者： alexander kOVALEV Yu TIAN Yonggang MENG State key Laboratory of Tribology in Advanced Equipment Tsinghua UniversityBeijing 100084China

For training artificial neural network(ANN),big data either generated by machine or measured from experiments are used as input to"learn"the unspecified functions defining the *** experimental data are fed directly into the optimizer allowing training to be performed according to a predefined loss *** predict sliding friction and wear at mixed lubrication conditions,in this study a specific ANN structure was so designed that deep learning algorithms and data-driven optimization models can be *** ball-on-plate friction and wear data were analyzed using the specific training procedure to optimize the weights and biases incorporated into the neural layers of the ANN,and only two independent experimental data sets were used during the ANN optimization *** the training procedure,the ANN is capable to predict the contact and hydrodynamic pressure by adapting the output data according to the tribological condition implemented in the optimization algorithm.

关键词： machine learning deep learning artificial neural network mixed lubrication

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Unveiling the atomic-scale transition between light harvesting and photoprotective states in plant photosynthesis

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Science china chemistry 2024年第5期67卷 1375-1377页

作者： alexander V.Ruban School of Biological and Behavioural Sciences Queen Mary University of LondonLondon E14NSUK

Non-photochemical chlorophyll fluorescence quenching(NPQ) stands as a cornerstone in the realm of photosynthesis research, attracting generations of dedicated scientists in their quest to unravel its mysteries. This mechanism, crucial for safeguarding photosynthesis, plays a pivotal role in regulating light harvesting, particularly in oxygenic photosynthesis where the oxygen-evolving photosystem II (PSII)is susceptible to photodamage [1].

关键词： harvesting protective attracting

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Insights into the hydrogen evolution reaction in vanadium redox flow batteries:A synchrotron radiation based X-ray imaging study

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Journal of Energy chemistry 2024年第4期91卷 132-144页

作者： kerstin köble Alexey Ershov kangjun Duan Monja Schilling alexander Rampf Angelica cecilia TomášFaragó Marcus Zuber Tilo Baumbach Roswitha Zeis Helmholtz Institute Ulm Karlsruhe Institute of Technology89081 UlmGermany Laboratory for Applications of Synchrotron Radiation Karlsruhe Institute of Technology76131 KarlsruheGermany Institute for Photon Science and Synchrotron Radiation Karlsruhe Institute of Technology76344 Eggenstein-LeopoldshafenGermany Department of Electrical Electronicsand Communication EngineeringFaculty of EngineeringFriedrich-Alexander-Universität Erlangen-Nürnberg(FAU)91058 ErlangenGermany Department of Mechanical and Industrial Engineering University of TorontoToronto M5S 3G8OntarioCanada

The parasitic hydrogen evolution reaction(HER)in the negative half-cell of vanadium redox flow batteries(VRFBs)causes severe efficiency ***,a deeper understanding of this process and the accompanying bubble formation is *** benchmarking study locally analyzes the bubble distribution in thick,porous electrodes for the first time using deep learning-based image segmentation of synchrotron X-ray *** large three-dimensional data set was processed precisely in less than one minute while minimizing human errors and pointing out areas of increased HER activity in *** study systematically varies the electrode potential and material,concluding that more negative electrode potentials of-200 m V *** hydrogen electrode(RHE)and lower cause more substantial bubble formation,resulting in bubble fractions of around 15%–20%in carbon felt ***,the bubble fractions stay only around 2%in an electrode combining carbon felt and carbon *** detected areas with high HER activity,such as the border subregion with more than 30%bubble fraction in carbon felt electrodes,the cutting edges,and preferential spots in the electrode bulk,are potential-independent and suggest that larger electrodes with a higher bulk-to-border ratio might reduce HER-related performance *** described combination of electrochemical measurements,local X-ray microtomography,AI-based segmentation,and 3D morphometric analysis is a powerful and novel approach for local bubble analysis in three-dimensional porous electrodes,providing an essential toolkit for a broad community working on bubble-generating electrochemical systems.

关键词： Vanadium redox flow battery Synchrotron X-ray imaging Tomography Hydrogen evolution reaction Gas bubbles Deep learning

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