Exclusive enteral nutrition induces early clinical, mucosal and transmural remission in paediatric Crohn's disease

Background and aims: Exclusive enteral nutrition (EEN) induces clinical and mucosal healing (MH) in Crohn's disease (CD), with MH the best determinant of future outcome. We investigated efficacy of EEN for inducing early clinical, biochemical, mucosal and transmural remission of CD and related early endoscopic response to outcomes at 1 year. Methods: In a prospective, open label study 34 children (mean 13.1 years; 21 males) with new diagnosis CD were offered EEN, 26 completed a minimum 6 weeks EEN and underwent paired clinical, biochemical and endoscopic assessment at start and completion using PCDAI, BMI, CRP and Simple Endoscopic Score for CD (SES-CD). A subset, 16/26, had paired MR enterography scored. Early good endoscopic response (complete MH, or near complete, SES-CD 0-3) was related to outcome at 1 year. Results: EEN improved mean PCDAI (37.88-7.01, p < 0.001; BMI Z scores (-1.54 to -0.54, p < 0.01); weight Z score (-0.79 to -0.08, p < 0.03); CRP (44.86-5.5, p < 0.001); endoscopy (SES-CD 14.28-3.88, p < 0.001) and MRE (5.14-2.79, p = 0.01). Of 26 children, 22 (84 %) achieved clinical remission; 20 (76 %) biochemical remission. Fifteen (58 %) had early good endoscopic response (11 complete, 4 near complete MH) and 3/14 (21 %) had complete transmural remission of ileal CD (MRE-CD: 0-1). Early good endoscopic response was associated with reduced endoscopic confirmed relapse (53 vs. 100 %, p = 0.02), anti-TNF use (33 vs. 88 %, p = 0.01) and hospitalisation (40 vs. 88 %) at 1 year. Conclusions: EEN is effective for inducing early clinical, biochemical, mucosal and transmural remission. Early endoscopic remission improves outcomes at 1 year

From Story to Science: The Contribution of Reading Fiction and Hybrid Stories to Conceptual Change with Young Children

WOS: 000478898800005This quasi-experimental study with 34 preschoolers explores how fictional and hybrid storybooks contribute to conceptual changes in preschoolers' understanding of lunar concepts. Interviews and children's drawings before and after reading sessions provided the data. Findings revealed that (i) young children have intuitive knowledge and alternative explanations from their experiences and lay culture, (ii) storybook messages and illustrations cause misconceptions and (iii) hybrid stories increase protoscientific explanations among children of both genders. Combining accurate scientific information and enjoyable context makes hybrid storybooks effective edutainment for preschoolers.Ahi Evran University Scientific Research Projects Coordination UnitAhi Evran University [EGT.A4.18.020]The study was supported by the Ahi Evran University Scientific Research Projects Coordination Unit. Project number: EGT.A4.18.020