Surfactant Protein A Inhibits Human Rhinovirus C Binding and Infection of Airway Epithelial Cells from Pediatric Asthma.

Rhinovirus C (RV-C) infection can trigger asthma exacerbations in children and adults, and RV-C-induced wheezing illnesses in preschool children correlate with the development of childhood asthma. Surfactant protein A (SP-A) plays a critical role in regulating pulmonary innate immunity by binding to numerous respiratory pathogens. Mature SP-A consists of multiple isoforms that form the hetero-oligomers of SP-A1 and SP-A2, organized in 18-mers.

New paradigms in acute viral bronchiolitis: Is it time to change our approach?

Viral bronchiolitis is the most common pediatric acute respiratory infection leading to hospitalization, and it causes a significant healthcare burden worldwide. Current guidelines recommend supportive management after many clinical trials on specific therapies failed to demonstrate benefits. However, several studies in the past decade have revealed that bronchiolitis may not be a homogeneous disease, but instead may constitute an umbrella comprised of different "endotypes" and "phenotypes" based on patient characteristics, etiology, pathophysiological mechanisms, and clinical presentation.

Bleeding Complications between Bivalirudin and Heparin for Extracorporeal Membrane Oxygenation in Neonates with Congenital Diaphragmatic Hernia.

Introduction: Neonates with congenital diaphragmatic hernia (CDH) who undergo repair while on extracorporeal membrane oxygenation (ECMO) are at risk of developing post-operative bleeding complications. Balanced anticoagulation is critical to maintain ECMO flow and avoid bleeding. Heparin has historically been our first-line anticoagulant; however, recently, we transitioned to bivalirudin, a direct thrombin inhibitor.

The evolution of nutritional care in children with food allergies - With a focus on cow's milk allergy.

Cow's milk allergy (CMA) remains one of the most common and complex paediatric food allergies. In the last decade, our understanding has advanced in terms of immunoglobulin E (IgE)-mediated CMA and focus is now also paid to non-IgE-mediated CMA, particularly in some Western countries where incidence rates are high. We have had significant progress in the last 10 years in relation to our understanding of existing supportive tests for IgE-mediated CMA, with the advancement of newer tests, such as the basophil activation test (BAT), which have shown great promise.

Fasting intact insulin by mass spectrometry is associated with metabolic dysfunction-associated steatotic liver disease in youth.

Background: Fasting intact insulin concentrations can predict metabolic dysfunction-associated steatotic liver disease (MASLD) in adults without diabetes; however, research in youth is limited. We sought to determine whether fasting intact insulin, measured by liquid chromatography-tandem mass spectrometry, is associated with MASLD in children.

Methods: This retrospective cross-sectional analysis used data and samples from children who participated in studies across 3 universities between 2014 and 2022.

Overexpression of TNFα in TNF∆ARE+/- mice increases hepatic periportal inflammation and alters bile acid signaling in mice.

Background: Intestinal inflammation is a common factor in ~70% of patients diagnosed with primary sclerosing cholangitis. The TNF∆ARE+/- mouse overexpresses TNFα and spontaneously develops ileitis after weaning. The aim of this study was to examine the influence of ileitis and TNFα overexpression on hepatic injury, fibrosis, inflammation, and bile acid homeostasis.

Lactation Support for Breastfeeding and Chestfeeding People with HIV: A Call for Research to Examine Telelactation Experience, HIV Knowledge, and Lactation Consultants' Attitudes Related to Infant Feeding with HIV.

Clinical guidelines for infant feeding among people with HIV in the U.S. were updated in 2023 to encourage providers to utilize a shared decision-making approach that includes breastfeeding/chestfeeding (B/CF) when appropriate.

Perturbations of tryptophan catabolism via the kynurenine pathway are associated with stage 2 postoperative outcomes in single ventricle heart disease.

Preliminary evidence suggests perturbations of the kynurenine pathway (KP) of tryptophan metabolism in infants with single ventricle heart disease (SVHD). In 72 infants with SVHD undergoing stage 2 palliation (S2P) and 41 controls, we quantified serum KP metabolite concentrations via tandem mass spectroscopy pre-S2P and post-S2P at 2, 24, and 48 h and assessed metabolite relationships with post-S2P outcomes (length of stay, hypoxemia burden, and intubation duration). Pre-S2P, SVHD infants had lower tryptophan and serotonin levels and higher kynurenic acid, 3-hydroxykynurenine, and picolinic acid levels than controls.

Transcriptional Regulation of Protein Synthesis by Mediator Kinase Represents a Therapeutic Vulnerability in MYC-driven Medulloblastoma.

MYC-driven medulloblastoma (MB) is a highly aggressive cancer type with poor prognosis and limited treatment options. Through CRISPR-Cas9 screening of MB cell lines, we identified the Mediator-associated kinase CDK8 as a critical regulator of MYC-driven MB. Loss of CDK8 substantially reduces MYC expression, induces pronounced transcriptional changes, suppresses monosome assembly, and decreases ribosome biogenesis and protein synthesis, consequently inhibiting MB growth.

Multisite implementation of a sexual health survey and clinical decision support to promote adolescent sexually transmitted infection screening.

Background: Adolescents are at high risk for sexually transmitted infections (STIs) and frequently present to emergency departments (EDs) for care. Screening for STIs using confidential patient-reported outcomes represents an ideal use of electronic screening methodology.

Objectives: The objectives of this study were to implement a patient-facing, confidential electronic survey to assess adolescent risk for STIs and consent for testing with integrated provider facing electronic clinical decision support (CDS) across six geographically dispersed pediatric EDs and evaluate implementation based on survey and CDS usage metrics.

Frontline Ph-negative B-cell precursor acute lymphoblastic leukemia treatment and the emerging role of blinatumomab.

This narrative review seeks to summarize chemotherapeutic regimens commonly used for patients with newly diagnosed Philadelphia (Ph) chromosome-negative B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in the frontline setting and to describe the latest clinical research using the bispecific T-cell-engaging immunotherapy blinatumomab in the first-line treatment setting. Current standard-of-care chemotherapeutic backbones for newly diagnosed Ph-negative BCP-ALL are based on the same overarching treatment principle: to reduce disease burden to undetectable levels and maintain lasting remission. The adult treatment landscape has progressively evolved following the adoption of pediatric-inspired regimens.

Leveraging Multi-omics to Disentangle the Complexity of Ovarian Cancer.

To better understand ovarian cancer lethality and treatment resistance, sophisticated computational approaches are required that address the complexity of the tumor microenvironment, genomic heterogeneity, and tumor evolution. The ovarian cancer tumor ecosystem consists of multiple tumors and cell types that support disease growth and progression. Over the last two decades, there has been a revolution in -omic methodologies to broadly define components and essential processes within the tumor microenvironment, including transcriptomics, metabolomics, proteomics, genome sequencing, and single-cell analyses.

Unexpected Malrotation in Patients with Congenital Heart Disease Undergoing Gastrostomy Tube Placement: Is Routine Preoperative Upper Gastrointestinal Series Imaging Necessary?

Our aim is to determine the rate of unexpected malrotation identified on routine preoperative upper gastrointestinal (UGI) contrast study in infants with congenital heart disease (CHD) prior to gastrostomy tube (GT) placement and quantify any associated delay in care. We performed a retrospective review of infants with CHD who underwent GT placement following initial cardiac surgery at a single center between 2016 and 2021. Patients were identified in the electronic medical record.