ABSTRACT
Objective@#To investigate the association between sleep with emotional and behavioral problems of preschool children in Wuhu City.@*Methods@#A cluster sampling survey was conducted among senior class of 12 kindergartens in Wuhu City, a total of 1 158 preschool children were investigated. The self designed questionnaire was used to investigate the general situation and sleep characteristics. Strengths and Difficulties Questionnaire (SDQ) and Sleeping Quality Questionnaire for Children Aged 2-5 years were used to investigate their emotional behavior and sleep disorders.@*Results@#About 44.21% of respondents had emotional and behavioral problems, among which peer interaction was the most prominent. There were gender differences in sleeping alone and the need of comforters for sleep. 41.97% of preschool children detected at least one type of sleep disorder, and the detection rate of disturbed sleep was 33.83% in girls, which was higher than that of boys(25.97%). Abnormal sleep and disturbed sleep increased the risk of emotional and behavioral problems in preschool girls( OR=2.33, 95%CI =1.25-4.34; OR=4.92, 95%CI =1.28-19.00), adequate sleep reduced the risk( OR=0.46, 95%CI =0.27-0.77). Abnormal sleep increased the risk of boys emotional and behavioral abnormalities( OR=1.86, 95%CI =1.08-3.19), while sleeping alone reduced the risk( OR=0.59, 95%CI =0.37-0.95).@*Conclusion@#Sleep behaviors are associated with the occurrence of emotional and behavioral problems in preschool children in a sex specific manner.
ABSTRACT
<p><b>OBJECTIVE</b>To explore if CHA2DS2 VASc score can predict substrate for persistent atrial fibrillation ( AF) and outcome post catheter ablation of AF.</p><p><b>METHODS</b>From January 2011 to December 2012,116 patients underwent catheter ablation of persistent AF in our department and were enrolled in this study. CHA2DS2VASc score was calculated as follows: two points were assigned for a history of stroke or transient ischemic attack and age ≥ 75 and 1 point each was assigned for age ≥ 65, a history of hypertension, diabetes,recent cardiac failure, vessel disease, female. Left atrial geometry ( LA) was reconstructed with a 3.5 mm tip ablation catheter with fill-in threshold 10 in CARTO system. The mapping catheter was stabled at each endocardial location for at least 3 seconds for recording. The electrogram recordings at each endocardial location were analyzed with a custom software embedded in the CARTO mapping system. Interval confidence level (ICL) was used to characterize complex fractionated atrial electrograms (CFAEs) . As the default setting of the software, ICL more than or equal to 7 was considered sites with a highly repetitive CFAEs complex. CFAEs index was defined as the fraction of area of ICL more than or equal to 7 to the left atrial surface. The CFAEs index and outcome of catheter ablation among different CHA2DS2VASc groups were compared.</p><p><b>RESULTS</b>Of the 116 patients, CHA2DS2VASc was 0 in 33 patients, 1 in 31 patients and ≥ 2 in 52 patients. Left atrial surface ((121.2 ± 18.9) cm2, (133.6 ± 23.8) cm2, (133.9 ± 16.1) cm2, P = 0.008), left atrial volume ((103.6 ± 24.8) ml, (118.3 ± 27.8) ml, (120.9 ± 20.9) ml, P = 0.005) and CFAEs index (44.6% ± 22.4%, 54.2% ± 22.2%, 58.7% ± 23.1%, P = 0.023) increased in proportion with increasing CHA2DS2VASc. ICLmax, ICLmin and CFAEs spatial distribution were similar among the three groups. During the mean follow-up of (13 ± 8) months, the recurrence rate were 36.4%, 35.5%, 55.8% among the three groups (P = 0.025).</p><p><b>CONCLUSION</b>A high CHA2DS2VASc score is associated with extensive AF substrate and higher recurrence rate post catheter ablation of persistent AF.</p>