Association of Corticosteroid Inhaler Type with Saliva Microbiome in Moderate-to-Severe Pediatric Asthma.

: Metered-dose inhalers (MDIs) and dry powder inhalers (DPIs) are common inhaled corticosteroid (ICS) inhaler devices. The difference in formulation and administration technique of these devices may influence oral cavity microbiota composition. We aimed to compare the saliva microbiome in children with moderate-to-severe asthma using ICS via MDIs versus DPIs.

Structural Disruption of Cilia and Increased Cytoplasmic Tubulin in Biliary Atresia-An Exploratory Study Focusing on Early Postoperative Prognosis Following Portoenterostomy.

Biliary atresia (BA) is a progressive hepatobiliary disease in infants, leading to liver failure and the need for transplantation. While its etiopathogenesis remains unclear, recent studies suggest primary cilia (PC) disruption plays a role. This study investigates correlations between PC and cytoplasmic tubulin (TUBA4A) alterations with hypoxia in patients with the isolated form of BA, focusing on native liver survival.

The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients.

Antimicrobial resistance (AMR) is recognized as one of the most important global public health threats. There is an urgent need to reduce the spread of these multidrug-resistant bacteria (MDR-B), particularly in extremely vulnerable patients. The aim of this study was to investigate whether targeted gene amplification performed directly on clinical samples can be used simultaneously with a bundle of enhanced infection control measures in a Pediatric Intensive Care Unit (PICU) endemic to MDR-B.

Paternal Depression and Anxiety During the COVID-19 Pandemic.

The COVID-19 pandemic significantly impacted the lives of families worldwide. Findings suggest a substantial impact of the COVID-19 pandemic on maternal mental health. Yet, much less is known about the impact of COVID-19 on paternal mental health.

Excessive Weight Gain During Pregnancy Increased Ponoxarase 1 Level in Neonatal Cord Blood.

Maternal obesity is increasingly recognized as a risk factor for adverse fetal outcomes, primarily through its association with heightened oxidative stress. This study aimed to evaluate oxidative stress markers in umbilical cord blood of neonates born to obese mothers. Sixty-three pregnant women, who were of normal weight at the start of pregnancy but classified as obese at term, were included.

Impact of the COVID-19 Pandemic on Seizure Control in Pediatric Epilepsy: Risk Factors and Clinical Outcomes.

Epilepsy is a common neurological disorder in children, associated with significant morbidity and socioeconomic burden. The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, potentially exacerbating seizure control among pediatric epilepsy patients. This study aimed to evaluate the pandemic's impact on seizure characteristics and identify risk factors contributing to seizure exacerbation in children with epilepsy.

Pilot Study on the Assessment of Therapeutic Education in Children and Adolescents with Type 1 Diabetes Mellitus.

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder primarily managed through insulin therapy, which is crucial for achieving optimal glycemic control in children and adolescents. Therapeutic education is essential, equipping patients and their families with the knowledge and skills necessary for effective self-management. This familial support plays a critical role in the success of therapy and in fostering an environment conducive to the child's self-management of the condition.

Maternal Uterine Artery Doppler and Serum Marker in the First Trimester as Predictive Markers for Small for Gestational Age Neonates and Preeclampsia: A Pilot Study.

: Although preeclampsia (PE) and small for gestational age (SGA) are known to come from impaired placentation during the first trimester, prior studies have focused mostly on Doppler findings in the second trimester. : In this retrospective pilot study, we enrolled 628 singleton pregnant women who underwent ultrasound in both the first and second trimesters and blood test. For SGA correlation, we further excluded 12 subjects with PE because PE may be the cause of SGA.

Advances in Cardiovascular Multimodality Imaging in Patients with Marfan Syndrome.

Marfan syndrome (MFS) is a genetic disorder affecting connective tissue, often leading to cardiovascular complications such as aortic aneurysms and mitral valve prolapse. Cardiovascular multimodality imaging plays a crucial role in the diagnosis, monitoring, and management of MFS patients. This review explores the advancements in echocardiography, cardiovascular magnetic resonance (CMR), cardiac computed tomography (CCT), and nuclear medicine techniques in MFS.

Cardiac Markers in Pediatric Laboratory Medicine: Critical Review.

Currently, there are no validated guidelines or recommendations for how to interpret cardiac biomarkers in the pediatric population. The most commonly used cardiac biomarkers are cardiac troponins and natriuretic peptides, but the clinical value of common cardiac biomarkers in pediatric laboratory medicine is restricted due to age- and sex-specific interpretations, and there are no standardized cut-off values. The results from the studies on reference values, as well as results from clinical studies, are difficult to compare with identical studies due to the heterogeneity of subject characteristics (gestational and chronological age, sex, pubertal status, menstrual cycle, exercise), assay characteristics (type of assay, generation of assay, analytical platform used), and experimental protocol characteristics (prospective or retrospective studies, reference population selection, patient population selection, inclusion and exclusion criteria, number of subjects).

Anatomic Variations Important for Dental Implantation in the Mandible-A Systematic Review.

: This is a systematic review on the subject of anatomic landmarks and variations in the mandible that influence implantation placement. With this systematic review, we would like to summarize the results from different studies that are relevant to this subject and that are up to date, presenting their main findings, the measurements of mentioned landmarks, and giving clinical implications that will be helpful to practitioners in their better understanding of this topic. : This study followed all of the elements of PRISMA.

Using artificial intelligence based language interpretation in non-urgent paediatric emergency consultations: a clinical performance test and legal evaluation.

Objective: To evaluate the accuracy of Google Translate (GT) in translating low-acuity paediatric emergency consultations involving respiratory symptoms and fever, and to examine legal and policy implications of using AI-based language interpretation in healthcare.

Methods: Based on the methodology used for conducting language performance testing routinely at the Interpreter Services Department of the Hospital for Sick Children, clinical performance testing was completed using a paediatric emergency scenario (child with respiratory illness and fever) on five languages: Spanish, French, Urdu, Arabic, and Mandarin. The study focused on GT's translation accuracy and a legal and policy evaluation regarding AI-based interpretation in healthcare was conducted by legal scholars.

Antibiotic exposure is associated with minimal gut microbiome perturbations in healthy term infants.

Background: The evolving infant gut microbiome influences host immune development and later health outcomes. Early antibiotic exposure could impact microbiome development and contribute to poor outcomes. Here, we use a prospective longitudinal birth cohort of n = 323 healthy term African American children to determine the association between antibiotic exposure and the gut microbiome through shotgun metagenomics sequencing as well as bile acid profiles through liquid chromatography-mass spectrometry.

The injury effect of osteopontin in sepsis-associated lung injury.

Background: Sepsis is a severe condition causing organ failure due to an abnormal immune reaction to infection, characterized by ongoing excessive inflammation and immune system issues. Osteopontin (OPN) is secreted by various cells and plays a crucial role in inflammatory responses and immune regulation. Nonetheless, the precise function of OPN in sepsis remains to be elucidated.

Incidence and risk factors for clinical omphalitis among neonates in Eastern Uganda using chlorhexidine gel for cord care: a community-cohort study.

Background: Omphalitis is a bacterial infection of the umbilicus and/or surrounding tissues, occurring primarily in the neonatal period. Whereas it is known to be a major route of localized and often systemic infection, studies describing incidence and risk factors remain scanty, especially in resource limited settings where the condition is thought to be common. We assessed the incidence and risk factors for omphalitis among neonates born to women who received a birth kit containing chlorhexidine for umbilical cord care after birth in Eastern Uganda.

Exploring the clinical value of procalcitonin, c-reactive protein, white blood cell count, and neutrophil-to-lymphocyte ratio in the early diagnosis of bloodstream infections in children.

Backgroud: In the diagnosis of bloodstream infections (BSI) in children, compared to the gold standard of blood culture, markers in the blood offer advantages such as rapid results and cost-effectiveness. Therefore, we investigated the clinical value of procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in the early diagnosis of BSI in children.

Methods: This study included a retrospective analysis of 309 suspected BSI cases and patients were categorized into 2 groups based on blood culture results: blood culture-positive group, and blood culture-negative group.

The role of cyclooxygenase-2 (COX-2) and inflammatory markers in the progress of Alport syndrome in Egyptian children.

Background: Chronic inflammation and its control are crucial to the responses of glomerular and renal tubular cells. This contributes to the pathogenic mechanisms and advancement of the disease in Alport syndrome. The study aimed to elucidate the role of cyclooxygenase-2, Interleukin 4, Plasminogen activating inhibitor 1, and Prostaglandin E2 in the development and course of Alport syndrome.

Importance and fitness of family medicine milestone project from America to Taiwan.

Background: The six core competencies of ACGME - patient care (PC), medical knowledge (MK), systems-based practice (SBP), practice-based learning and improvement (PBLI), professionalism (PROF), and interpersonal and communication skills (ICS) - represent domains in which physicians must ultimately demonstrate competence. Although the ACGME's six core competencies have been applied in Taiwan with the milestone project, the application of the six core competences in the Family Medicine milestones for residency training have not yet been established.

Methods: We recruited 61 family medicine physicians from 25 hospitals from four major geographic areas for a Delphi round one survey and 72 physicians from 27 hospitals for a Delphi round two survey.

Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study.

Background: This study aimed to explore the risk factors for early intraventricular hemorrhage (IVH) in extremely low birth weight infants (ELBWIs) to provide guidance for early intervention, thereby improving survival rates and quality of life for these vulnerable infants.

Methods: A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. Standard head ultrasound screening (HUS) was used to assess the presence and severity of IVH on days 1-3 and 5-7 post-birth.

Frequency and types of antibiotic usage in a referral neonatal intensive care unit, based on the world health organization classification (AwaRe).

Background: Excessive prescription of antibiotics in infants increases the risk of short-term and lifelong morbidity and mortality. Nonetheless, the use of antibiotics in neonatal intensive care units (NICUs) is significantly high. This is primarily because neonatologists are concerned about the fragile immune systems of newborns, their vulnerability to serious infectious diseases, and the challenge of accurately distinguishing between infectious and non-infectious conditions.

Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study.

Background: Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia.

Methods: This study reviewed the medical records of women with preeclampsia at ≥ 28 weeks of gestation between January 2015 and December 2020.

A randomized, placebo-controlled, cross-over trial of ketamine in Rett syndrome.

Background: Preclinical studies and anecdotal case reports support the potential therapeutic benefit of low-dose oral ketamine as a treatment of clinical symptoms in Rett syndrome (RTT); however, no controlled studies have been conducted in RTT to evaluate safety, tolerability and efficacy.

Design: This was a sequentially initiated, dose-escalating cohort, placebo-controlled, double blind, randomized sequence, cross-over study of oral ketamine in 6-12-year-old girls with RTT to evaluate short-term safety and tolerability and explore efficacy.

Methods: Participants were randomized to either five days treatment with oral ketamine or matched placebo, followed by a nine-day wash-out period and then crossed-over to the opposite treatment.

Oculomotor Function in Children and Adolescents with Autism, ADHD or Co-occurring Autism and ADHD.

Oculomotor characteristics, including accuracy, timing, and sensorimotor processing, are considered sensitive intermediate phenotypes for understanding the etiology of neurodevelopmental conditions, such as autism and ADHD. Oculomotor characteristics have predominantly been studied separately in autism and ADHD. Despite the high rates of co-occurrence between these conditions, only one study has investigated oculomotor processes among those with co-occurring autism + ADHD.

Genome-wide association analysis of composite sleep health scores in 413,904 individuals.

Recent genome-wide association studies (GWASs) of several individual sleep traits have identified hundreds of genetic loci, suggesting diverse mechanisms. Moreover, sleep traits are moderately correlated, so together may provide a more complete picture of sleep health, while illuminating distinct domains. Here we construct novel sleep health scores (SHSs) incorporating five core self-report measures: sleep duration, insomnia symptoms, chronotype, snoring, and daytime sleepiness, using additive (SHS-ADD) and five principal components-based (SHS-PCs) approaches.