Respiratory symptoms in post-infancy children:A Dutch pediatric cohort study

Aim: To study the pattern of respiratory symptoms in children in the general population. Method: We followed a cohort of children for up to 2 years through parents completing weekly online questionnaires in the Child-Is-Ill study (“Kind-en-Ziekmeting” in Dutch); the study was running 2012–2015. Inclusion criteria were “an ordinary child” (according to the parents) and <18 years old at inclusion. We especially encouraged participation of post-infancy children. Age at inclusion, sex, smoking exposure, allergy in the family, and frequent infections in the family were noted. Pearson's correlation, principal component analysis, latent class analysis, latent profile analysis, linear regression, and linear mixed effects regression were used in the statistical analyses. Results: Data were collected on 55,524 childweeks in 755 children (50% girls; median age, 7 years; interquartile range, 4–11 years, 97% ≥2 years at inclusion), with reported symptom(s) in 8,425 childweeks (15%), leading to school absenteeism in 25%, doctor's visits in 12%, and parental sick leave in 8%; symptoms lasting ≥3 weeks were rare (2% of episodes). Linear mixed effects regression showed significant, but only limited, effects of season on the proportion of “symptom(s) reported” per individual child. Only runny nose showed a significant, but very small, age effect. However, the variability between the children was considerable. There were no obvious subgroups of children with specific symptom combinations. Conclusion: In any randomly chosen week, the vast majority of children (85%) in our—mainly—post-infancy cohort derived from the general population did not have any symptom, even in the younger age group, even in winter. The children showed considerable variability; no clear subgroups of symptom patterns could be identified, underlining the difficult position of healthcare providers. These results support our opinion that post-infancy children in the general population should not be evaluated as if they are infants when they have recurrent respiratory symptoms. If they clearly deviate from the above-described most common pattern, it is wise to keep an eye on potential, maybe even rare, serious underlying causes

Increased rate of respiratory symptoms in children with Down syndrome:A 2-year web-based parent-reported prospective study

To compare the incidence of respiratory symptoms and short-term consequences between children with Down syndrome and children from the general population, we conducted a prospective parent-reported observational study. Children with Down syndrome (≤ 18 years) were included between March 2012 and June 2014. Caregivers received a baseline questionnaire with follow-up 1-2 years after inclusion. Caregivers received a weekly questionnaire about respiratory symptoms, fever, antibiotic prescriptions, doctor's visits, and consequences for school and work attendance. Children with Down syndrome were compared to a cohort of the general population ("Kind en Ziek" study) with similar weekly questionnaires. A total of 9,011 childweeks were reported for 116 participants with Down syndrome (75% response rate). The frequency of respiratory symptoms was higher in children with Down syndrome than in children from the general population (30% vs 15.2%). In addition, symptoms subsided later (around 8 vs 5 years of age). The seasonal influence was limited, both in children with Down syndrome and children from the general population. Consequences of respiratory disease were significant in children with Down syndrome compared to children from the general population, with a higher rate of doctor's visits (21.3% vs 11.8%), antibiotic prescriptions (47.8% vs 26.3%), and absenteeism from school (55.5% vs 25.4%) and work (parents, 9.4% vs 8.1%). Conclusion: Children with Down syndrome have a higher frequency of respiratory symptoms and symptoms last until a later age, confirming the impression of professionals and caregivers. Individualized treatment plans might prevent unfavorable consequences of chronic recurrent respiratory disease in children with Down syndrome. What is Known: • Children with Down syndrome have an altered immune system and are prone to a more severe course of respiratory tract infections. • The overall conception is that patients with Down syndrome suffer from respiratory tract infections more often. What is New: • Children with Down syndrome suffer from respiratory symptoms more frequently than children from the general population. • The respiratory symptoms in children with Down syndrome subside at a later age compared to children from the general population

(In)Complete acquisition of Turkish among Turkish German bilinguals in Germany and Turkey: an analysis of complex embeddings in narratives

Although most researchers recognise that the language repertoire of bilinguals can mvary, few studies have tried to address variation in bilingual competence in any detail. This study aims to take a first step towards further understanding the way in which bilingual competencies can vary at the level of syntax by comparing the use of syntactic embeddings among three different groups of Turkish/German bilinguals. The approach of the present paper is new in that different groups of bilinguals are compared with each other, and not only with monolingual speakers, as is common in most studies in the field. The analysis focuses on differences in the use of embeddings in Turkish, which are generally considered to be one of the more complex aspects of Turkish grammar. The study shows that young Turkish/German bilingual adults who were born and raised in Germany use fewer, and less complex embeddings than Turkish/German bilingual returnees who had lived in Turkey for eight years at the time of recording. The present study provides new insights in the nature of bilingual competence, as well as a new perspective on syntactic change in immigrant Turkish as spoken in Europe

Modélisation du poly-époxy DGEBA-EDA et de sa réactivité vis-à-vis du cuivre : approche expérimentale et numérique

Grâce à la métallisation de leur surface, des pièces en polymères peuvent substituer certains composants métalliques dans les industries de l'aérospatiale et du transport. Les polymères ont des masses volumiques plus faibles que les métaux et une réactivité chimique limitée, ce qui en fait des candidats idéaux pour les applications spatiales. En combinant techniques expérimentales et simulations numériques, nous avons étudié les mécanismes fondamentaux de la métallisation de surface d'un polymère poly-époxy (DGEBA / EDA). L'objectif de notre étude était de développer un modèle non empirique prenant en compte les mécanismes régissant la nucléation et la croissance des films minces métalliques. Notre groupe a une longue expérience des dépôts chimiques en phase vapeur, CVD. Mais cette technique n'a pas été choisie pour la métallisation de nos surfaces de polymères car les températures requises dans le réacteur étaient trop élevées. Comme alternative, nous avons effectué une évaporation sous ultravide de Cu à température ambiante, conduisant à une diffusion des atomes en phase gazeuse sans énergie cinétique. Les processus d'adsorption et de diffusion sont donc plus proches des conditions thermodynamiques associées aux calculs. Un protocole expérimental a été mis en place afin de créer une surface polymère chimiquement homogène présentant une faible rugosité. Le polymère obtenu a été caractérisé (i) par spectroscopie infrarouge à transformée de Fourier, pour déterminer le taux de polymérisation (supérieur à 90%), (ii) par calorimétrie différentielle à balayage pour obtenir la température de transition vitreuse (Tg) ( 118,1 °C), (iii) par microscopie à force atomique (AFM) pour estimer la rugosité de la surface (Ra ˜ 1 nm), et (iv) par spectroscopie de photoélectrons X (XPS) pour caractériser les liaisons chimiques de surface. La surface de polymère a ensuite été métallisée. Grâce à des analyses AFM, l'épaisseur du film mince a été estimée à 6 nm. Nous avons ensuite utilisé l'XPS pour caractériser les liaisons interfaciales Cu / Poly-époxy. Nous avons déduit de l'interprétation des spectres XPS que le Cu est adsorbé préférentiellement sur un atome d'oxygène spécifique du polymère. Pour identifier clairement ces sites d'adsorption de Cu, nous avons ensuite simulé les spectres XPS du polymère non revêtu, par des calculs quantiques, en utilisant un modèle moléculaire (dimère : 1 molécule de DGEBA liée à 1 molécule d'EDA). Les méthodes Hartree-Fock (HF) et de la théorie de la fonctionnelle de la densité (DFT) nous ont permis de simuler des spectres XPS pour la surface nue, en prenant en compte les effets d'état final et initial. Grâce à ces résultats, nous avons pu décomposer le spectre expérimental en 8 contributions, ce qui conduit à des résultats beaucoup plus précis que les résultats habituels obtenus par l'utilisation exclusive des expériences et de la littérature. Nous avons ensuite effectué des simulations de dynamique moléculaire classique (MD) pour passer d'un modèle moléculaire (dimère) à un modèle de polymère amorphe. Nous avons utilisé le champ de force Amber généralisé (GAFF) et nous avons développé un code de réticulation des molécules de monomères. Le système initial était un mélange stœchiométrique de molécules DGEBA et EDA qui a été équilibré à 700K. Lorsque l'équilibre a été atteint, certaines propriétés structurales (par exemple, la distribution des liaisons) ont été extraites des simulations NPT. À partir de ce mélange liquide de monomères, notre code de réticulation a identifié et relié les atomes réactifs (à une distance interatomique prédéfinie < 3 Å). Après chaque étape de polymérisation, le système a été rééquilibré à 700K (simulations NPT). Après plusieurs cycles de réticulation/simulation de dynamique moléculaire, nous avons pu atteindre un taux de polymérisation de 93% et la fonction de distribution radiale (RDF), la masse volumique (1.115 à 300K) et la température de transition vitreuse Tg (115,5 °C) ont été calculées. La Tg est en accord avec la valeur expérimentale de 118,1 °C, validant notre approche numérique pour développer un modèle pour les polymères poly-époxy.Metallization of polymer surfaces can lead to the substitution of metallic components. Polymers have lower densities and limited chemical reactivity, making them ideal candidates for the space applications. Through experiments and calculations, we studied the fundamental mechanisms of surface metallization of a poly-epoxy polymer (DGEBA/EDA). The objective of our study was to develop a non-empirical model that could take into account the mechanisms governing the nucleation and growth of thin metal films. Our group has a long experience in chemical vapor deposition, CVD, and metallization of polymer composites. But we did not applied CVD at first because of the high temperatures required in the reactor. We alternatively used ultrahigh vacuum evaporation of Cu at ambient temperature. Therefore, we make sure that atoms diffuse in the gas phase without kinetic energy. Adsorption and diffusion processes are thus closer to thermodynamic conditions that prevails in calculations. An experimental protocol was refined in order to create a chemically homogeneous polymer surface with a low roughness (Ra<1nm). The bulk and the surface of the pristine polymer were characterized (i) by Fourier Transform Infrared Spectroscopy, to determine the polymerization rate (above 90%), (ii) by differential scanning calorimetry in order to obtain the glass transition temperature (Tg) (118.1 °C), (iii) by atomic force microscopy (AFM) to calculate surface roughness (Ra ˜ 1 nm), and (iv) by X-ray photoelectron spectroscopy (XPS) to characterize surface chemical bonding. The surface was then metallized. Through AFM, the thickness of the thin film was estimated at 6 nm. We then used XPS to characterize the Cu/Poly-epoxy interfacial bonding. We deduced that Cu adsorbed preferentially on a specific oxygen atom of the polymer. To clearly identify this Cu adsorption site, we further simulated the XPS spectra of our clean or metallized polymer by quantum calculations, using a dimer model (1 molecule of DGEBA connected to 1 molecule of EDA). In the Hartree-Fock (HF) and Density Functional Theory (DFT) framework, we first simulated the XPS spectra for the pristine surface taking into account initial and final state effects. Thanks to these results, we were able to analyze the experimental spectrum with 8 contributions, leading to much more accurate results than the usual results obtained by the exclusive use of experiments and literature. We then performed classical Molecular Dynamics (MD) simulations to move from a dimer model to an amorphous polymer model. We used the general Amber force field (GAFF) and we developed a code to mimic the reticulation of monomers molecules. We started from a stoichiometric mixture of DGEBA and EDA molecules. When equilibration was reached, structural properties at 700K (e.g. distribution of bonds) were extracted from the results of the NPT simulations. From this melt of monomers, the homemade reticulation code identified and connected reactive atoms (at a pre-defined inter-atomic distance < 3Å). After each step of polymerization, the system was equilibrated at 700K (NPT simulations). After multiple reticulation/MD cycles we could achieve a polymerization rate of 93% and the Radial Distribution Function (RDF), the density and the glass transition temperature Tg were calculated. The value of the computed density was 1.115 at 300K and the calculated Tg (115.5 °C) was in good agreement with the experimental Tg of 118.1 °C, validating our numerical approach to develop a model for poly-epoxies

Cross-Classified Multilevel Model Parameter Estimations for Measures of the Dutch Listening Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.

<p>*: <i>p</i> < .05</p><p>**: <i>p</i> < .01</p><p>***: <i>p</i> < .001</p><p>Cross-Classified Multilevel Model Parameter Estimations for Measures of the Dutch Listening Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.</p

Cross-classified Multilevel Model Parameter Estimations for Measures of the Dutch Writing Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.

<p>*: <i>p</i> < .05</p><p>**: <i>p</i> < .01</p><p>***: <i>p</i> < .001</p><p>Cross-classified Multilevel Model Parameter Estimations for Measures of the Dutch Writing Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.</p

Cross-classified Multilevel Model Parameter Estimations for Measures of the Dutch Reading Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.

<p>*: <i>p</i> < .05</p><p>**: <i>p</i> < .01</p><p>***: <i>p</i> < .001</p><p>Cross-classified Multilevel Model Parameter Estimations for Measures of the Dutch Reading Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.</p

Cross-classified Multilevel Model Parameter Estimations for Measures of the Dutch Speaking Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.

<p>*: <i>p</i> < .05</p><p>**: <i>p</i> < .01</p><p>***: <i>p</i> < .001</p><p>Cross-classified Multilevel Model Parameter Estimations for Measures of the Dutch Speaking Proficiency Test (Standard Errors in Parentheses) per Mother Tongue and Country of Birth.</p

The Challenge of Immunoglobulin-G Subclass Deficiency and Specific Polysaccharide Antibody Deficiency--a Dutch Pediatric Cohort Study

PURPOSE: Immunoglobulin(Ig)G-subclass deficiency and specific polysaccharide antibody deficiency (SPAD) are among the most frequent causes of recurrent respiratory infections in children. Little is known about their prevalence, clinical presentation and prognosis. No study has been published in a Western-European nor in a mainly non-tertiary cohort until now. Therefore, we performed this observational cohort study in children recruited from secondary and tertiary pediatric practices all over The Netherlands. METHODS: Dutch pediatricians were monthly asked to report patients with IgG-subclass deficiency and/or SPAD. Demographic, clinical and laboratory characteristics were collected. Separate informed consent was asked from parents and children (≥ 12 years of age) for annual update of the medical status. RESULTS: 49 children with confirmed IgG-subclass deficiency and/or SPAD were included. The majority of children (69%) was reported by four (out of 12) secondary hospitals with a pediatric immunologist in the staff. 45 children had ≥ 1 low IgG-subclass level and 11 had SPAD. IgG2 deficiency was the most prevalent IgG-subclass deficiency (37/49;76%). 10% of these children already showed bronchiectasis. Two-thirds were male (33/49;67%, p = 0.015). From 10 years of age, only boys were left and only boys showed progressive immunodeficiency during follow-up (11/24; 46%). CONCLUSIONS: This is the first Western-European mainly non-tertiary cohort of children with IgG-subclass deficiency and/or SPAD. The disease course is not always benign, especially in boys. Most children were reported and managed in secondary hospitals with a pediatric immunologist in the staff. To identify more patients, the awareness of these diseases among general pediatricians should increase

Increased rate of respiratory symptoms in children with Down syndrome: A 2-year web-based parent-reported prospective study

To compare the incidence of respiratory symptoms and short-term consequences between children with Down syndrome and children from the general population, we conducted a prospective parent-reported observational study. Children with Down syndrome (≤ 18 years) were included between March 2012 and June 2014. Caregivers received a baseline questionnaire with follow-up 1–2 years after inclusion. Caregivers received a weekly questionnaire about respiratory symptoms, fever, antibiotic prescriptions, doctor’s visits, and consequences for school and work attendance. Children with Down syndrome were compared to a cohort of the general population (“Kind en Ziek” study) with similar weekly questionnaires. A total of 9,011 childweeks were reported for 116 participants with Down syndrome (75% response rate). The frequency of respiratory symptoms was higher in children with Down syndrome than in children from the general population (30% vs 15.2%). In addition, symptoms subsided later (around 8 vs 5 years of age). The seasonal influence was limited, both in children with Down syndrome and children from the general population. Consequences of respiratory disease were significant in children with Down syndrome compared to children from the general population, with a higher rate of doctor’s visits (21.3% vs 11.8%), antibiotic prescriptions (47.8% vs 26.3%), and absenteeism from school (55.5% vs 25.4%) and work (parents, 9.4% vs 8.1%). Conclusion: Children with Down syndrome have a higher frequency of respiratory symptoms and symptoms last until a later age, confirming the impression of professionals and caregivers. Individualized treatment plans might prevent unfavorable consequences of chronic recurrent respiratory disease in children with Down syndrome