One of the most documented effects of exposure to nature is physical and psychological restoration. Restoration refers to the recovery or strengthening of adaptive resources (e.g., attentional... Show moreOne of the most documented effects of exposure to nature is physical and psychological restoration. Restoration refers to the recovery or strengthening of adaptive resources (e.g., attentional capabilities, positive emotions, etc.) that are being spent in meeting the demands of everyday life. The restorative process has been widely studied in adults, but less is known about the restorative effects that exposure to nature has for children and adolescents. To fill this gap in the literature, we conducted a systematic review aiming at systematically summarizing the accumulated evidence about the restorative effects of nature exposure on children and adolescents and reporting the main findings in terms of the restoration of (1) cognitive, (2) emotional, (3) social or (4) behavioural resources. To conduct the study, we followed the PRISMA procedure. Databases were extracted from Web of Science, PUBMED, and SCOPUS. Studies were selected if (a) they included non-adult participants, (b) they included empirical results at least for one of the four selected variables, (c) the study was published in English and (d) the study had been peer-reviewed. According to these criteria, 30 studies were finally selected.Selected studies were categorized in terms of sample size, duration of the intervention (if applicable), and quality of the study (following the National Heart, Lung, and Blood Institute assessment tool). Results show that exposure to nature has significant restorative effects, but the effects differ across the selected variables. Due to methodological limitations, such as a lack of measurement standardization, and the scarcity of experimental and longitudinal studies, caution should be exercised when interpreting the available results. Suggestions for future lines of research in this area are provided. Show less
Background: Pediatric patients admitted for acute lung disease are treated and monitored in the hospital, after which full recovery is achieved at home. Many studies report in-hospital recovery,... Show moreBackground: Pediatric patients admitted for acute lung disease are treated and monitored in the hospital, after which full recovery is achieved at home. Many studies report in-hospital recovery, but little is known regarding the time to full recovery after hospital discharge. Technological innovations have led to increased interest in home-monitoring and digital biomarkers. The aim of this study was to describe at-home recovery of 3 common pediatric respiratory diseases using a questionnaire and wearable device. Methods: In this study, patients admitted due to pneumonia (n = 30), preschool wheezing (n = 30), and asthma exacerbation (AE; n = 11) were included. Patients were monitored with a smartwatch and a questionnaire during admission, with a 14-day recovery period and a 10-day "healthy" period. Median compliance was calculated, and a mixed-effects model was fitted for physical activity and heart rate (HR) to describe the recovery period, and the physical activity recovery trajectory was correlated to respiratory symptom scores. Results: Median compliance was 47% (interquartile range [IQR] 33-81%) during the entire study period, 68% (IQR 54-91%) during the recovery period, and 28% (IQR 0-74%) during the healthy period. Patients with pneumonia reached normal physical activity 12 days postdischarge, while subjects with wheezing and AE reached this level after 5 and 6 days, respectively. Estimated mean physical activity was closely correlated with the estimated mean symptom score. HR measured by the smartwatch showed a similar recovery trajectory for subjects with wheezing and asthma, but not for subjects with pneumonia. Conclusions: The digital biomarkers, physical activity, and HR obtained via smartwatch show promise for quantifying postdischarge recovery in a noninvasive manner, which can be useful in pediatric clinical trials and clinical care. Show less
Kruizinga, M.D.; Heide, N. van der; Moll, A.; ZhuParris, A.; Yavuz, Y.; Kam, M.L. de; ... ; Driessen, G.J.A. 2021
Background: Digital devices and wearables allow for the measurement of a wide range of health-related parameters in a non-invasive manner, which may be particularly valuable in pediatrics.... Show moreBackground: Digital devices and wearables allow for the measurement of a wide range of health-related parameters in a non-invasive manner, which may be particularly valuable in pediatrics. Incorporation of such parameters in clinical trials or care as digital endpoint could reduce the burden for children and their parents but requires clinical validation in the target population. This study aims to determine the tolerability, repeatability, and reference values of novel digital endpoints in healthy children.MethodsApparently healthy children (n = 175, 46% male) aged 2-16 were included. Subjects were monitored for 21 days using a home-monitoring platform with several devices (smartwatch, spirometer, thermometer, blood pressure monitor, scales). Endpoints were analyzed with a mixed effects model, assessing variables that explained within- and between-subject variability. Endpoints based on physical activity, heart rate, and sleep-related parameters were included in the analysis. For physical-activity-related endpoints, a sample size needed to detect a 15% increase was calculated.FindingsMedian compliance was 94%. Variability in each physical activity-related candidate endpoint was explained by age, sex, watch wear time, rain duration per day, average ambient temperature, and population density of the city of residence. Estimated sample sizes for candidate endpoints ranged from 33-110 per group. Daytime heart rate, nocturnal heart rate and sleep duration decreased as a function of age and were comparable to reference values published in the literature.ConclusionsWearable- and portable devices are tolerable for pediatric subjects. The raw data, models and reference values presented here can be used to guide further validation and, in the future, clinical trial designs involving the included measures. Show less
Zielinska, A.; Billini, M.; Moll, A.; Kremer, K.; Briegel, A.; Martinez, A.I.; ... ; Thanbichler, M. 2017
Most bacteria possess a peptidoglycan cell wall that determines their morphology and provides mechanical robustness during osmotic challenges. The biosynthesis of this structure is achieved by a... Show moreMost bacteria possess a peptidoglycan cell wall that determines their morphology and provides mechanical robustness during osmotic challenges. The biosynthesis of this structure is achieved by a large set of synthetic and lytic enzymes with varying substrate specificities. Although the biochemical functions of these proteins are conserved and well‐investigated, the precise roles of individual factors and the regulatory mechanisms coordinating their activities in time and space remain incompletely understood. Here, we comprehensively analyze the autolytic machinery of the alphaproteobacterial model organism Caulobacter crescentus, with a specific focus on LytM‐like endopeptidases, soluble lytic transglycosylases and amidases. Our data reveal a high degree of redundancy within each protein family but also specialized functions for individual family members under stress conditions. In addition, we identify two lytic transglycosylases and an amidase as new divisome components that are recruited to midcell at distinct stages of the cell cycle. The midcell localization of these proteins is affected by two LytM factors with degenerate catalytic domains, DipM and LdpF, which may serve as regulatory hubs coordinating the activities of multiple autolytic enzymes during cell constriction and fission respectively. These findings set the stage for in‐depth studies of the molecular mechanisms that control peptidoglycan remodeling in C. crescentus. Show less
