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Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports
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作者 Yi-Meng Sun Wang Xin +4 位作者 Yu-Fang Liu Zhe-Ming Guan Hao-Wen Du Ning-Ning Sun Yong-Dong Liu 《World Journal of Clinical Cases》 SCIE 2024年第4期865-871,共7页
BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been ... BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment. 展开更多
关键词 Meckel’s diverticulum Complications Intestinal obstruction PERFORATION Appendicitis in children Mesodiverticular band LIGAMENT Diverticular disease Case report
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Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model
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作者 Yan Jin Wei Chen 《International Journal of Mental Health Promotion》 2024年第3期189-198,共10页
An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese... An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems. 展开更多
关键词 sleep problem emotional regulation authoritative parenting child’s sibling status preschool children
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On Translation of Children’s Literature Based on Reception Aesthetics:A Case Study of The Secret Garden
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作者 HOU Wen-lan LI Ju-yuan 《Journal of Literature and Art Studies》 2024年第3期194-200,共7页
Grounded in reader-centered theories,Reception Aesthetics prioritizes the active engagement and acceptance of target readers.This study examines the translation of children’s literature through the lens of Reception ... Grounded in reader-centered theories,Reception Aesthetics prioritizes the active engagement and acceptance of target readers.This study examines the translation of children’s literature through the lens of Reception Aesthetics,using Li Wenjun’s rendition of The Secret Garden as a case study.The objective is to scrutinize various aspects of the translation-including vocabulary,syntax,rhetorical devices,and cultural nuances-and to discern how the adaptation and application of diverse translation strategies cater to the aesthetic expectations. 展开更多
关键词 Reception Aesthetics translation of children’s literature The secret Garden
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Reflections on Conducting Kindergarten Language Education Activities Based on Children’s Literature
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作者 Pujun Tong 《Journal of Contemporary Educational Research》 2024年第3期118-123,共6页
In early childhood education,language education is a crucial component,yet in kindergarten teaching,there often exists issues such as“emphasis on knowledge and neglect of practice.”To address this problem,teachers n... In early childhood education,language education is a crucial component,yet in kindergarten teaching,there often exists issues such as“emphasis on knowledge and neglect of practice.”To address this problem,teachers need to incorporate children’s literature in a reasonable manner to create a conducive environment for language education for young children.This article analyzes and discusses the significance of integrating children’s literature into kindergarten language education activities,and proposes strategies for addressing the current issues in kindergarten language education activities and conducting them based on children’s literature. 展开更多
关键词 KINDERGARTEN Language education children’s literature
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Research on the Influence of Family Education on Children’s Behavioral Habits
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作者 Jiayi Wen 《Journal of Contemporary Educational Research》 2024年第8期176-180,共5页
Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significan... Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education. 展开更多
关键词 Family education children’s behavior Habit cultivation PARENTs
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The Market Development of Children’s Go Training and the Difficulty and Countermeasure Analysis of Go Training
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作者 Yangcheng Zhao 《Proceedings of Business and Economic Studies》 2024年第3期161-165,共5页
The children’s Go training market is experiencing vigorous growth but also faces several challenges.As the importance of Go in cultural education increases,the market expands,with growing demand and involvement from ... The children’s Go training market is experiencing vigorous growth but also faces several challenges.As the importance of Go in cultural education increases,the market expands,with growing demand and involvement from training and educational institutions.However,the market encounters difficulties such as a shortage of high-quality Go coaches,uniformity in training content and methods,and high training costs.To address these issues,measures can be taken to strengthen the team of Go coaches,diversify training content and methods,and optimize the training cost structure,thereby promoting the healthy development of the children’s Go training market. 展开更多
关键词 children’s Go Training market development Go training
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A Study of Health Prescribing for Children with Tourette’s Disorders in Children’s Health Education Specialty Care Clinics
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作者 Wenping Yang Le Wang +2 位作者 Sha Wang Nannan Ma Li Mei 《Journal of Clinical and Nursing Research》 2024年第7期261-266,共6页
Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Met... Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development. 展开更多
关键词 children’s health education specialty care clinic Childhood Tourette’s disorder Health prescription
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Research on Children’s Game Activity Design Strategies Based on Embodied Cognition Theory
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作者 Xiangmiao He 《Journal of Contemporary Educational Research》 2024年第4期54-58,共5页
Edutainment,in the kindergarten education stage,emphasizes the game as the basic activity and combines the content of education with the form of the game,thus it also forms the educational method of gamification teach... Edutainment,in the kindergarten education stage,emphasizes the game as the basic activity and combines the content of education with the form of the game,thus it also forms the educational method of gamification teaching.Through investigation and analysis,it is found that the current kindergarten game activity design has the problem of improper combination of educational content and game form.The current kindergarten game activity design has problems such as stereotypes,children’s lack of active learning opportunities in activities,teachers’insufficient theoretical understanding,inappropriate teacher guidance methods,and so on.Embodied cognition theory attaches importance to the important role of the body in the development of cognition,provides new guidance for classroom teaching,and opens up a new path for classroom teaching reform.Based on the perspective of embodied cognition theory,the concept of body and mind integration should be adhered to in kindergarten teaching with games as the basic activity,experiential teaching situation should be created,children’s subjective experience should be respected,and games and interactions should be designed to promote children’s physical and mental participation,thus laying a foundation for the realization of children’s individual freedom,autonomy,and all-round development.Therefore,this paper aims at the existing problems in the current kindergarten gamification teaching and discusses the design strategy of children’s game activities based on embodied cognition theory. 展开更多
关键词 Embodied cognition children’s play Game activity design
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Group Psychological Intervention for Children with Hyperactivity Disorder
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作者 Ying Xu 《International Journal of Mental Health Promotion》 2023年第1期81-97,共17页
ADHD is a broad psychiatric disorder that affects children of normal or near-normal intelligence.It is character-ized by inattention,hyperactivity,and age-inappropriate impulsivity,and it is often accompanied by learn... ADHD is a broad psychiatric disorder that affects children of normal or near-normal intelligence.It is character-ized by inattention,hyperactivity,and age-inappropriate impulsivity,and it is often accompanied by learning dif-ficulties,behavioral,emotional,and interpersonal problems.On the other hand,hyperactive tendencies in children with ADHD exhibit ADHD-like behaviors such as lack of self-control,inattention,hyperactivity,and emotional impulsivity.However,because their symptoms are less severe,they do not meet the diagnostic criteria for ADHD but are ADHD or at risk of developing ADHD.The purpose of this study is to alleviate and reduce children’s hyperactivity symptoms by investigating the current situation of the children studied,and systemati-cally intervening and educating children with ADHD through psychological group intervention.Research data shows that ADHD is most commonly diagnosed in school-age children,and in 70%–80%of children with ADHD,symptoms persist into adolescence and 30%into adulthood.Through the use of group psychological intervention in the experiment,the prevalence rate of children with hyperactivity disorder tendency has been effectively reduced.This shows that group psychological intervention training has a significant effect on improving hyper-activity symptoms in children with ADHD tendency. 展开更多
关键词 Attention deficit hyperactivity disorder children’s group psychological intervention
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An Intervention Study of Language Cognition and Emotional Speech Community Method for Children’s Speech Disorders
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作者 Yali Qiang 《International Journal of Mental Health Promotion》 2023年第5期627-637,共11页
Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through t... Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods. 展开更多
关键词 Language cognition and emotion speech community children’s speech disorder
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添加拉考沙胺、吡仑帕奈治疗儿童局灶性癫痫的临床疗效及对血清S100β、NSE水平的影响
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作者 曹志伟 张润春 王玉珍 《中国妇幼健康研究》 2024年第9期49-56,共8页
目的探讨添加拉考沙胺、吡仑帕奈治疗儿童局灶性癫痫的临床疗效及对血清S-100β蛋白(S100β)、神经元特异性烯醇化酶(NSE)水平的影响。方法选择2019年12月至2022年12月唐山市妇幼保健院收治的122例初始单药治疗控制不佳的局灶性癫痫患... 目的探讨添加拉考沙胺、吡仑帕奈治疗儿童局灶性癫痫的临床疗效及对血清S-100β蛋白(S100β)、神经元特异性烯醇化酶(NSE)水平的影响。方法选择2019年12月至2022年12月唐山市妇幼保健院收治的122例初始单药治疗控制不佳的局灶性癫痫患儿为研究对象。采用随机数字表法将患者分为拉考沙胺组(添加拉考沙胺治疗)和吡仑帕奈组(添加吡仑帕奈治疗),每组各61例。比较两组疗效,治疗前后智商、认知功能、血清S100β、NSE水平及治疗期间不良反应的差异。结果两组治疗1个月、3个月、6个月治疗应答率比较差异均无统计学意义(P>0.05);拉考沙胺组操作智商(PIQ)评分较治疗前增高(Z=2.775,P<0.05),且高于吡仑帕奈组(Z=2.432,P<0.05);拉考沙胺组短时记忆广度评分较治疗前增高(Z=2.849,P<0.05),吡仑帕奈组治疗后注意分配测验、短时记忆广度评分较治疗前降低(Z值分别为2.522、2.475,P<0.05),拉考沙胺组治疗后注意分配测验、短时记忆广度评分高于吡仑帕奈组(Z值分别为3.065、4.035,P<0.05);两组治疗后血清S100β、NSE水平较治疗前均降低(t值分别为14.575、14.096、10.747、10.841,P<0.05),组间比较差异无统计学意义(P>0.05);吡仑帕奈组易怒不良反应发生率高于拉考沙胺组,差异有统计学意义(P<0.05)。结论添加拉考沙胺和吡仑帕奈治疗儿童局灶性癫痫均可有效控制癫痫发作,降低血清S100β、NSE水平,对智力影响较小;吡仑帕奈对患儿认知功能和精神状态有一定负面影响。 展开更多
关键词 儿童 癫痫 拉考沙胺 吡仑帕奈 s-100Β蛋白 神经元特异性烯醇化酶
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Magnetic resonance imaging in children and adolescents with chronic inflammatory bowel disease 被引量:8
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作者 Hans-Joachim Mentzel Steffen Reinsch +1 位作者 Monika Kurzai Martin Stenzel 《World Journal of Gastroenterology》 SCIE CAS 2014年第5期1180-1191,共12页
Inflammatory bowel diseases(IBD) represent challenges, both from a diagnostic, and therapeutic point of view. Deep-seated anatomic structures are difficult to assess by ultrasound technique alone. As radiation-free al... Inflammatory bowel diseases(IBD) represent challenges, both from a diagnostic, and therapeutic point of view. Deep-seated anatomic structures are difficult to assess by ultrasound technique alone. As radiation-free alternative cross-sectional imaging method, magnetic resonance imaging of the intestinal structures is costly and time-consuming. Examination of pediatric patients imply additional considerations: reduction of body motions in younger children and consideration of the most appropriate preparation, and examination technique. The demanding Sellink technique is the only means for appropriately distending the lesser intestine in order to detect small bowel strictures. Oral intake of contrast medium(CM) alone shows its limitations regarding distensibility. The need for intravenous contrast media application needs to be considered, too. Active inflammation of both intestinal wall, and mesentery can be demonstrated accurately. Nevertheless, viable alternatives to CM application is desirable, considering non-negligible adverse reactions. Recent data suggest diffusion weighted imaging might fill this diagnostic gap. Irrespective of sequence technique chosen, bowel movement remains a major obstacle. Antispasmolytics in their function as smooth muscle relaxants help in improving image quality, however, their use in children might be off-label. Optimal preparation for the examination and appropriate imaging technique allow for diagnosing typical patterns of changes in IBD, such as bowel wall thickening, ulcers, mural stratification, strictures, creeping fat, and comb sign, and lymphadenopathy. The article gives a detailed overview of current significance of magnetic resonance imaging pediatric patients suffering from IBD, considering indications, limitations, and safety aspects. 展开更多
关键词 children Adolescents Inflammatory bowel disease Crohn’ s disease Ulcerative colitis Magnetic resonance imaging Enterography
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Children’s Health, Parent-Child Activities, Using Digital Devices, and Social Competence: Serial Mediation
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作者 Ching-Fen Lee Shain-May Tang 《Health》 2023年第8期883-894,共12页
Background: Studies have pointed out the influence of different children’s activities and prolonged use of digital products on their social development. However, whether the parent-child activities and using digital ... Background: Studies have pointed out the influence of different children’s activities and prolonged use of digital products on their social development. However, whether the parent-child activities and using digital devices were serial mediators of the relationship between children’s health and social development needs further verification. Purpose: This study explored how parent-child activities and children’s use of digital devices influence the relationship between children’s health and their social competence. Method: This study used data from Kids in Taiwan: National Longitudinal Study of Child Development and Care. A total sample of 2164 participants was used in this study. Serial mediation analyses were performed using model six of Hayes’ PROCESS (2012). Results: This study found that parent-child activities and the use of digital devices can serially mediate the relationship between children’s health and social competence. Children’s health could directly improve their social competence, but it could also serially mediate social competence by increasing parent-child activities and reducing the use of digital devices. Conclusion: Childcare policy planners and parenting educators should not only call on parents to reduce the use of electronic products for their children, but also encourage parents to spend more time interacting with their children, so that children can learn social skills by interacting with others in their daily lives. 展开更多
关键词 children’s Health social Competence Parent-Child Activities Using Digital Devices PREsCHOOLER
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How do Metafictive Fictional Science Picturebooks Introduce Natural Science Knowledge to Children?——Wolves and The Magic School Bus:Inside a Hurricane
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作者 CI Feng-rui 《Journal of Literature and Art Studies》 2023年第7期477-491,共15页
This paper explores metafiction’s role in fictional science picturebooks and its resolution of the contradictions between fictional stories and scientific knowledge in existing research by analysing two children’s p... This paper explores metafiction’s role in fictional science picturebooks and its resolution of the contradictions between fictional stories and scientific knowledge in existing research by analysing two children’s picturebooks,Wolves(Gravett,2015)and The Magic School Bus(Cole,1995).The paper first identifies both books as metafictive science picturebooks by analysing their content.Secondly,the author analyses the structure of the two picturebooks and exposes that they both have two narrative lines as the composite structure:science knowledge and fictional stories.Thirdly,the article discusses the metafictive elements in Wolves and The Magic School Bus from the content perspectives,which are relevant to“reality”,in order to evaluate how metafiction enhances fictional science picturebooks in supporting children’s learning of science,conveying knowledge to children,and avoiding children’s misunderstanding of fiction and scientific information. 展开更多
关键词 children’s literature science education METAFICTION PICTUREBOOKs
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From the Voices in the Narratives of After-School Support Advisors: Support for Children’s After-School Support Advisors in Japan
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作者 Kenji Shigeno 《Cultural and Religious Studies》 2023年第10期451-458,共8页
This paper examines how advisors perceive the voices made by Mr.A(pseudonym),the founder of after-school support for children(Initiative Z:pseudonym)in Japan,to advisors who support children.Furthermore,the purpose of... This paper examines how advisors perceive the voices made by Mr.A(pseudonym),the founder of after-school support for children(Initiative Z:pseudonym)in Japan,to advisors who support children.Furthermore,the purpose of this study is to find out how advisors think about the voices and that the voices have led or not advisors to support children,if to do so,what points are key to continuing support for children.Therefore,in Initiative Z,I conducted a survey of two advisors who were approached by Mr.A,who is involved in supporting children as an advisor.As a result of analyzing the narratives obtained from interviews with the two advisors,it was found that the advisor had a sense of being recognized by Mr.A because Mr.A acknowledged the advisor’s way of life.This feeling on the part of the advisor led to trust in Mr.A,and the advisor was in tune with Mr.A’s thoughts on after-school support,suggesting that the advisor was providing support to the child. 展开更多
关键词 children’s after-school support ADVIsOR voice trust
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Analysis of the Writing Characteristics of the Title Music,Using“Scenes of Childhood”and“Children’s Garden”as Examples
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作者 LEI Shuwen 《Psychology Research》 2023年第6期276-278,共3页
In European thought and culture,there exists a group of passionate artists who are fascinated by the intention,passion,and richness of artistic expression.They strive to establish connections between different art for... In European thought and culture,there exists a group of passionate artists who are fascinated by the intention,passion,and richness of artistic expression.They strive to establish connections between different art forms.Musicians not only attempt to represent masterpieces through the language of music but also aim to convey subjective experiences of emotions and personal imagination to listeners by adding titles to their musical works.This study examines two pieces,“Scenes of Childhood”and“Children’s Garden”,and analyzes the different approaches employed by the composers in portraying similar content. 展开更多
关键词 scenes of childhood children’s corner title music
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Research on the Teaching Optimization Path in Children’s Creative Art Curriculum Under the Perspective of“Sanquan Education”
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作者 Guiju Li 《Journal of Contemporary Educational Research》 2023年第12期136-141,共6页
Children’s creative art curriculum is a professional course supported by art materials and techniques and facilitated through creative activities,aiming at cultivating students’ability to organize creative art activ... Children’s creative art curriculum is a professional course supported by art materials and techniques and facilitated through creative activities,aiming at cultivating students’ability to organize creative art activities using various art materials and techniques.In light of the evolving focus in China’s colleges and universities from“what to know”to“how to apply,”the pivotal question for educators is how to maximize the value of children’s creative art curriculum.Based on this,this article takes“Sanquan education”as the starting point,combines factual and theoretical arguments,and analyzes the teaching optimization path of children’s creative art curriculum under the perspective of Sanquan education,to improve the quality and efficiency of teaching. 展开更多
关键词 sanquan education children’s creative art curriculum Teaching optimization paths
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Chen Peilun's Landscape Painting:Endure Your Appreciation and Trigger Your Imagination
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《China & The World Cultural Exchange》 2002年第2期17-17,共1页
关键词 Chen Peilun’s Landscape Painting:Endure Your Appreciation and Trigger Your imagination
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The Translation of Children's Literature under the Guidance of Reception Aesthetics 被引量:2
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作者 杜娟 《海外英语》 2015年第21期256-257,259,共3页
In recent years,a great majority of excellent foreign children' s literary works have sprung up in the domestic market,so the translation of children' literature are drawn much attention.However,the relevant s... In recent years,a great majority of excellent foreign children' s literary works have sprung up in the domestic market,so the translation of children' literature are drawn much attention.However,the relevant studies which guide the translation of children literature are quite few.Reception Aesthetics which take readers reception as a goal provides a new prospective for the translation of children s literature and promote its development. 展开更多
关键词 children’s literature translation of children’s literature Reception Aesthetics DOMEsTICATION FOREIGNIZATION
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Analysis of the Features of Children's Picture Book and Discussing the Possible Strategies of Translating Children's Picture Story Book from English to Chinese 被引量:2
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作者 黄雯怡 《海外英语》 2017年第16期193-196,共4页
Translation of children's literature has developed so quickly in recent years that many scholars have turned to research it. However, as special readers, children's reading ability are limited. This thesis ana... Translation of children's literature has developed so quickly in recent years that many scholars have turned to research it. However, as special readers, children's reading ability are limited. This thesis analyzes and discusses the features of children's book and the possible strategies on translation of children's book. 展开更多
关键词 children’s literature formal equivalence dynamic equivalence
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