Development of Medication Literacy Scale for Pediatric Population with Nephrotic Syndrome and Assessment on Reliability and Validity

Objective:To develop a medication literacy scale for the pediatric population with nephrotic syndrome(NS)in order to evaluate its reliability and validity.Methods:According to the medication belief scale,specific medication beliefs,and self-set dimensions,the NS pediatric population health literacy scale was designed to evaluate the medication literacy of 120 children with NS.Items,homogeneity,reliability,and validity of the scale were analyzed.Results:There were statistically significant differences in the Levene F test between the top 27%and the last 27%of the 22 items(P<0.001).The differences in the t-test were statistically significant(P<0.001).Content validity I-CVI:after deletion of item 4,the I-CVI of other items were all higher than 0.91.S-CVI was higher than 0.80,and S-CVI/AVE was higher than 0.90.The internal consistency coefficient(Cronbach'sα)was 0.868.Structural validity:KMO(Kaiser-Meyer-Olkin)statistical value was 0.862,and Bartlett's spherical test value was 1578.172(P<0.001).The extracted 6 common factors explain 70.21%of the variance variation.The loads of 22 items on their main factors are all greater than 0.427 except items 2 and 5.Conclusion:The medication literacy scale for the NS pediatric population has proved its good practicability,but some items of cognition need to be further explored.

Legal and ethical considerations for the conduct of clinical trials with pediatric population especially in Europe

The objectives are to provide the ethical rationale as to why the conduct of scientific research in the pediatric population is moral responsibility?Also,the roles and responsibilities of the research ethics board are emphasized;Institutional Review Board to maintain and receive formal training and education to meet the ethical and regulatory standards for conducting scientific researches in the pediatric population.Another rationale is to ensure that the trial protocol involving the pediatric population conforms to ethical and legal requirements and to protect them while facilitating their participation in the scientific research process.Ethical and legal issues form a huge part of recent research;frauds and malpractices have been shown to throw a big part of healthcare funding and harm pediatrics health;however,improvements have been shown,but flaws are still there.

Comment on review article:Chronic hepatitis C virus infection cascade of care in pediatric patients

An enhanced cascade of care should include a younger population,helping to achieve the goal of the World Health Organization with a focus on elimination in the pediatric population.Furthermore,enhanced screening and awareness efforts and continued education of health care providers will improve the outcomes of chronic hepatitis C virus(HCV)infection in the pediatric population.The present work discusses and comments on the topic"cascade of care in HCV chronic pediatric patients".

Challenges to associate early onset epilepsy with COVID-19 autoimmune encephalitis:A case

BACKGROUND Diagnosis of coronavirus disease 2019(COVID-19)-related neurological events in the pediatric population is challenging.Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism,in addition to the frequency of asymptomatic COVID-19 cases,pose the main challenges for diagnosis.Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis(AIE)is reported.CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE.Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal.Neither the immunological assessment,including viral serologies,antinuclear antibodies,autoimmune antibodies(NMDA,AMPA,CASPR2,LG11,GABARB,Hu,Yo,Ri,CV2,PNMA2,SOX1,Titin,amphiphysin,Recoverin),nor the metabolic assessment for lactate and pyruvate showed significant anomaly.Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE.A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veinoglobulin and high dose of intravenous Corticosteroid.CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.

A fatal case of liver abscess caused by hypervirulent Klebsiella pneumoniae in a diabetic adolescent:A clinical and laboratory study

Importance Hypervirulent variants of Klebsiella pneumoniae(hvKp)are capable of causing life-threatening pyogenic liver abscesses(PLAs),but hvKp caused PLAs was seldom reported in pediatric populations.Hence,there is an urgent need to raise our awareness of this phenomenon in pediatric populations.Objective This study aimed to report the clinical characteristics of hvKp that caused fatal PLA complicated by bacteremia in an adolescent and further identify the microbiological and genomic features of the causative strain.Methods A 14-year-old boy with diabetes mellitus was admitted to our hospital with a diagnosis of PLA complicated by bacteremia.A hypermucoviscous hvKp strain,KPN_19-106,was isolated from the drainage fluid present within the liver abscess cavity and blood.The hypermucoviscosity phenotype of the causative strain was determined by string test.Its virulence was measured using serum resistance assay and Galleria mellonella larvae-killing assay.Antimicrobial susceptibility was determined by broth microdilution method.Genetic information was obtained by whole-genome sequencing and bioinformatics analysis.Results KPN_19-106 belonged to sequence type 380 and serotype K2 and exhibited stronger serum resistance and higher in vivo lethality than the well-characterized hvKp NTUH-K2044 strain.Although KPN_19-106 is susceptible to most antibiotics,no sign of improvement was observed during treatment with such drugs.Whole-genome sequencing revealed that the isolate had integrated multiple mobile genetic elements related to virulence.Interpretation Antibiotic-susceptible hvKp can cause fatal PLA complicated by bacteremia in adolescents,with no improvement during antimicrobial therapy.The causative strain in this case had integrated multiple virulence genes and thus exhibited higher virulence both in vitro and in vivo when compared with NTUH-K2044.