A high-flow nasal cannula (HFNC) is a useful respiratory support for children with respiratory distress; however, it elevates the risk of belated intubation. Recently, indices based on percutaneous ...oxygen saturation, a fraction of inspired oxygen, and respiratory rate (RR) have been suggested for the prediction of HFNC failure. We aimed to evaluate various indices predicting HFNC failure in children who started receiving HFNC at a tertiary center for 27 months.
Cases of HFNC failure were classified as hypoxic respiratory failure (HRF) or non-HRF (NHRF) depending on the cause of intubation. The ratio of percutaneous oxygen saturation to the fraction of inspired oxygen (S/F), the ratio of S/F to RR (ROX), the ratio of S/F to RR/median RR (ROX-M), and the ratio of S/F to z-score of RR (ROX-Z) were calculated and compared between groups.
Of the 152 cases, 45 (29.6%) failed to wean from the HFNC support, of which 21 (46.7%) were HRFs and 24 (53.3%) were NHRFs. The S/F and ROX-M at 6 h and 3 h, respectively, predicted HRF well with a high area under the curve. Initial hypercapnia and low weight were good predictors for NHRF.
For the management of children with HFNC, these risk factors and indicators should be monitored to make an early decision regarding intubation.
...the patient experienced sudden left leg weakness and headache. ...at a baseline level, the mutant STING proteins barely displayed any IFN-β promoter activity, whereas the V147L mutation showed ...increased activity even without cGAMP (Fig 2, B and C). Patient ID Liu et al, 2014E7 Jeremiah et al, 2014E8 Munoz et al, 2015E9 Chia et al, 2016E10 Current study N1 N2 N3 N4 N5 N6 J1 J2 J3 J4 A1 - - Inheritance pattern Unrelated Familial - - - Sex (M/F) M F M F F M M M M F M M M Variant origin De novo NA Inherited De novo - De novo (two) Variant c.439G>C, p.Val147Leu c.461A>G, p.Asn154Ser c.463G>A, p.Val155Met c.463G>A, p.Val155Met c.439G>C, p.Val147Leu c.461A>G, p.Asn154Ser c.304T>C, p.Ser102Pro & c.835T>C, p.Phe279Leu Age of onset Infancy (8 wk) Adulthood Teenager Teenager Infancy Infancy Infancy Childhood (3 years) Status at last follow-up Alive Alive Alive Alive Dead Dead Alive Dead Alive Alive Alive Alive Alive Rash or Tachypnea + + + + + + − + + + + + + Gangrene of finger/toe 4/6 NA + + + Lung disease 5/6 − + + + + + + CNS vessel involvement Not reported Not reported Not reported Not reported + Table E4Primers used in this study Primer name Primer sequences Primer name Primer sequences TMEM173_S102P_F 5′-AGGAGGATGTTCAGTGCCTG-3′ TMEM173_S102P_R 5′-GGGTATCCAACGTGTGTCAC-3′ TMEM173_F279L_F 5′-ATCAACCCCTCACCCTACCA-3′ TMEM173_F279L_R 5′-GTTACAGGCTGAGGGAGTGG-3′ MYO18A_A1729V_F 5′-CTGTCTAGGGTGAAGGGAGC-3′ MYO18A_A1729V_R 5′-TCTTTCCTGTACAGCCCTCC-3′ BBS1_R196W_F 5′-AGAATGATGGAGGAGGGCAG-3′ BBS1_R196W_R 5′-TGGAAGTCACTGCAGCTTTA-3′ MMP13_I165N_F 5′-CCAGGAGTACTTAGCACAGGT-3′ MMP13_I165N_R 5′-GCCTTCAAAGTTTGGTCCGA-3′ BRWD3_G1286Q_F 5′-TTCTCCAGACTCTGCCTGTG-3′ BRWD3_G1286Q_F 5′-TTGTTCTACTTGCTGCTCCA-3′ IFN-β_qPCR_F 5′-AAACTCATGAGCAGTCTGCA-3′ IFN-β_qPCR_R 5′-AGGAGATCTTCAGTTTCGGAGG-3′ References 1 G.N. Barber, STING: infection, inflammation...
LANGUAGE∙ Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children∙ Factors other than etiology are equally important to a comprehensive understanding of ...CAP∙ Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification
Drug allergy 'label' may have consequences of a lifetime for a child. Many children with alleged drug allergy are proven to be tolerant to the culprit medication when challenged. The field of drug ...hypersensitivity (DH) is a recently evolving field of research, with still a lack of studies in children regarding the epidemiology and diagnostic tools. Clinical history is significant to diagnose and classify the type of DH in children. Diagnostic tools are evaluated in a limited number of children, so the guidelines are mainly in line with adult guidelines. In this paper, we aim to review the clinical characteristics, main drugs, risk factors, and diagnosis of DH to aid in the accurate diagnosis in children.
Perturbations of the infant gut microbiota can shape development of the immune system and link to the risk of allergic diseases.
We sought to understand the role of the gut microbiome in patients ...with atopic dermatitis (AD). The metagenome of the infant gut microbiome was analyzed according to feeding types.
Composition of the gut microbiota was analyzed in fecal samples from 129 infants (6 months old) by using pyrosequencing, including 66 healthy infants and 63 infants with AD. The functional profile of the gut microbiome was analyzed by means of whole-metagenome sequencing (20 control subjects and 20 patients with AD). In addition, the total number of bacteria in the feces was determined by using real-time PCR.
The gut microbiome of 6-month-old infants was different based on feeding types, and 2 microbiota groups (Bifidobacterium species–dominated and Escherichia/Veillonella species–dominated groups) were found in breast-fed and mixed-fed infants. Bacterial cell amounts in the feces were lower in infants with AD than in control infants. Although no specific taxa directly correlated with AD in 16S rRNA gene results, whole-metagenome analysis revealed differences in functional genes related to immune development. The reduction in genes for oxidative phosphorylation, phosphatidylinositol 3-kinase–Akt signaling, estrogen signaling, nucleotide-binding domain–like receptor signaling, and antigen processing and presentation induced by reduced colonization of mucin-degrading bacteria (Akkermansia muciniphila, Ruminococcus gnavus, and Lachnospiraceae bacterium 2_1_58FAA) was significantly associated with stunted immune development in the AD group compared with the control group (P < .05).
Alterations in the gut microbiome can be associated with AD because of different bacterial genes that can modulate host immune cell function.
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This study analyzed the regional characteristics of raindrop size distribution (DSD) in the southern coastal area of South Korea. Data from March 2016 to February 2017 were recorded by four Particle ...Size Velocity (PARSIVEL) disdrometers installed at intervals of ~20 km from the coastline to inland areas. Within 20 km from the coastline, multiple local maxima in the probability density function (PDF) were observed at mass-weighted mean diameter D
m
= 0.6 mm and normalized intercept parameter logN
w
= 5.2 for stratiform rainfall, but these features were not observed more than 20 km from the coastline. On the basis of mean D
m
−logN
w
values, stratiform rainfall clearly differed between coastal and inland areas. For convective rainfall, there was a linear relationship between D
m
and N
w
with distance from the coastline. PDF analyses of diurnal variation in DSD confirmed that in spring and autumn multiple local maxima appear in the daytime. The multiple local maxima in D
m
and logN
w
were respectively lower and higher at nighttime than in the daytime in the spring and summer season. These features were highly dependent on the prevailing wind. There was a pattern of increasing A and decreasing b in the radar reflectivity−rainfall rate (Z−R) relationship (Z = AR
b
) with distance from the coastline, and these features were more pronounced in convective rainfall. These diurnal variabilities were regular in stratiform rainfall, and there were large differences in quantitative precipitation estimation depending on the land or sea breeze in the coastal area.
Information of aerodynamic parameters of volcanic ash particles, such as
terminal velocity, axis ratio, and canting angle, are necessary for
quantitative ash-fall estimations with weather radar. In ...this study,
free-fall experiments of volcanic ash particles were accomplished using a
two-dimensional video disdrometer under controlled conditions. Samples containing a rotating symmetric axis were selected and divided into
five types according to shape and orientation: oblate spheroid with
horizontal rotating axis (OH), oblate spheroid with vertical axis (OV),
prolate spheroid with horizontal rotating axis (PH), prolate spheroid with
vertical rotating axis (PV), and sphere (Sp). The horizontally (OH and PH)
and vertically (OV and PV) oriented particles were present in proportions of
76 % and 22 %, and oblate and prolate spheroids were in proportions of
76 % and 24 %, respectively. The most common shape type was OH (57 %). The terminal velocities of OH, OV, PH, PV, and Sp were obtained analyzing
2-D video disdrometer data. The terminal velocities of PV were highest compared to those of
other particle types. The lowest terminal velocities were found in OH
particles. It is interesting that the terminal velocities for OH decreased
rapidly in the range 0.5<D<1 mm, corresponding to the
decrease in axis ratio (i.e., smaller the particle, the flatter the shape).
The axis ratios of all particle types except Sp were found to be converged
to 0.94 at D>2 mm. The histogram of canting angles followed unimodal and bimodal distributions
with respect to horizontally and vertically oriented particles,
respectively. The mean values and the standard deviation of entire particle
shape types were close to 0 and 10∘, respectively,
under calm atmospheric conditions.
Abstract
Benefits of breastfeeding for both the mother and the child are well established, but a comprehensive and robust study to investigate the protective effect of breastfeeding and attenuated ...time effect stratified by cause of morbidity are lacking. This study is based on the nationwide birth cohort in Korea that includes data on all infants born from 2009 to 2015. Of 1,608,540 children, the median follow-up period was 8.41 years (interquartile range, 6.76-10.06). When compared to children with fully formula feeding, the hospital admission rate was 12% lower in those with partially breastfeeding and 15% lower in those with exclusive breastfeeding. The apparent protective effect of breastfeeding was reduced with increasing age. Our study provides potential evidence of the beneficial association of breastfeeding on subsequent hospital admissions. The protective effect declined over time as the children grew older. Encouraging any breastfeeding for at least the first 6 months among infants is an important public health strategy to improve overall child health.
The ongoing COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study is a prospective birth cohort investigating the origin and natural courses of childhood allergic diseases, ...including atopic dermatitis, food allergy, allergic rhinitis and asthma, with long-term prognosis. Initiated under the premise that allergic diseases result from a complex interplay of immune development alterations, environmental exposures, and host susceptibility, the COCOA study explores these dynamic interactions during prenatal and postnatal periods, framed within the hygiene and microbial hypotheses alongside the developmental origins of health and disease (DOHaD) hypothesis. The scope of the COCOA study extends to genetic predispositions, indoor and outdoor environmental variables affecting mothers and their offsprings such as outdoor and indoor air pollution, psychological factors, diets, and the microbiomes of skin, gut, and airway. We have embarked on in-depth investigations of diverse risk factors and the pathophysiological underpinnings of allergic diseases. By employing multi-omics approaches—proteomics, transcriptomics, and metabolomics—we gain deeper insights into the distinct pathophysiological processes across various endotypes of childhood allergic diseases, incorporating the exposome using extensive resources within the COCOA study. Integration with large-scale datasets, such as national health insurance records, enhances robustness and mitigates potential limitations inherent to birth cohort studies. As part of global networks focused on childhood allergic diseases, the COCOA study fosters collaborative research across multiple cohorts. The findings from the COCOA study are instrumental in informing precision medicine strategies for childhood allergic diseases, underpinning the establishment of disease trajectories.
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