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· Big data analysis, such as common data model and artificial intelligence, can solve relevant questions and improve clinical care. · Recent deep learning studies achieved 0.887–0.996 areas under the receiver operating characteristic curve for automated interictal epileptiform discharge detection. · Recent deep learning studies achieved 62.3%–99.0% accuracy for interictal-ictal classification in seizure detection and 75.0%– 87.8% sensitivity with a 0.06–0.21/hr false positive rate in seizure forecasting. |
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· The need for data-driven modeling of multiomics interactions was recently highlighted. · Many artificial intelligence-driven models have been developed, but only a few have incorporated biological domain knowledge within model architectures or training procedures. · Here we provide a comprehensive review of deep learning models to decipher complex multiomics interactions regarding the biological guidance imposed upon them to facilitate further development of biological knowledge-guided deep learning models. |
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· Severe cases of coronavirus disease, Kawasaki disease (KD), and multisystem inflammatory syndrome in children (MIS-C) share similar findings: a protracted clinical course, multiorgan involvement, and similar activated biomarkers. · Here we propose etiological agents in KD and MIS-C as species in the microbiota and introduce a common pathogenesis through the protein-homeostasis-system hypothesis. · Early proper dose of corticosteroids and/or intravenous immunoglobulin may help to reduce morbidity and mortality in these diseases. |
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Question: What is the overall effect of obesity interventions among Korean children and what affects their effectiveness? Finding: Interventions were strongly favored over controls. Interventions including at least one physical activity component were significantly better than those that did not. Sex, age, baseline weight category, intervention duration, and the number of intervention components were not significant. Meaning: Future obesity interventions for Korean children must seek to include physical activity components. |
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Question: Does steroid use for 2–6 weeks in children affect bone mineral content (BMC) or density (BMD)? Finding: Steroid use for 2–6 weeks significantly decreased BMC and BMD of the whole body, total body less the head, lumbar spine, and distal radius. A significant negative correlation was observed among BMD, duration, and cumulative dose. Meaning: Steroid use for 2–6 weeks in children negatively affected BMC and BMD. |
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Question: Could probiotics be used as a therapeutic modality in nonalcoholic fatty liver disease/nonalcoholic steatohepatitis? Finding: There seem no added advantages over lifestyle modifications compared to Probiotics. Meaning: There does not seem to be an advantage of probiotics over lifestyle modifications in improving obesity-associated metabolic derangement in children. |
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· Childhood chronic kidney disease (CKD) is complex and requires lifetime medical treatment. · Children with CKD are at risk for emotional, behavioral, social, and academic difficulties that significantly affect their quality of life. · Caring for children with CKD is stressful for families. · These unique challenges are crucial and can negatively impact treatment outcomes. · Awareness of and addressing these evolving psychosocial issues can foster their developing needs. |
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Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants? Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants. Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants. |
· Recently, the importance of a short-term treatment regimen including rifamycin has been highlighted in the treatment of latent tuberculosis infection (LTBI). · Four prospective or retrospective studies in children consistently reported that a 4-month daily rifampicin regimen (4R) had a higher completion rate than and comparable safety to a nine-month daily isoniazid regimen. · We suggest rifampicin 20–30 mg/kg/day for children aged 0–2 years and 15–20 mg/kg/day for children aged 2–10 years in 4R to treat LTBI. |
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Background: According to the National Family Health Survey– 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.
Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among... |
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· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations. · Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age. · Platelet counts are positively correlated with gestational age at birth and postnatal age. · Thrombocytosis is more common in preterm than in term infants. · Thrombocytosis in newborns is reactive and resolves spontaneously without complications. |
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· Mutations in the kisspeptin (KISS1), kisspeptin receptor (KISS1R), makorin ring finger protein 3 (MKRN3), and delta-like homolog 1 (DLK1) genes are associated with idiopathic central precocious puberty (ICPP). · A few genes related to pubertal onset have been implicated in ICPP. · Epigenetic factors such as DNA methylation, histone posttranslational modifications, and noncoding ribonucleic acids may be related to ICPP |
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There have been global tri-phasic epidemic periods of retinopathy of prematurity (ROP). In recent years, its incidence has reportedly been 10%–40% depending on country and study population. Current treatment strategies for ROP include laser photocoagulation, surgical treatment, and anti-vascular endothelial growth factor treatment, the role of which has drawn attention in recent years. |
Growing point-of-care ultrasound (POCUS) use in pediatric patients has led to the need for POCUS education for pediatric residents. Recent experimental studies have suggested that POCUS education improves self-rated POCUS confidence and comfort in pediatric resident training. Considering the effective and sustainable POCUS education curriculum in pediatric resident training, simulation-based education would be a solution. |
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Question: What is the natural course of viral load in children with coronavirus disease 2019 (COVID-19)? Finding: A significant number of patients still had a relatively high viral load once clinically asymptomatic. Nearly half of the patients experienced viral rebound, which contributed to prolonged viral detection in their respiratory specimens. Meaning: Further studies are needed to determine the clinical significance of viral rebound in asymptomatic or mild pediatric cases of COVID-19. |
Question: Are multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) in infants, 2 sides of the same coin? Finding: Here we report on a 4-month-old girl with MIS-C and signs of KD with shock. Most (83%) infants with MIS-C had features of KD, especially KD shock syndrome. Meaning: MIS-C is similar to KD, and likely is a consequence of dysregulated immune responses secondary to sudden acute respiratory syndrome coronavirus 2 infection. |
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Question: What are the distinctive features of rural children with atopic dermatitis? Finding: Birch and dog dander were the second most sensitized aeroallergens (32.6%), followed by house dust mites. Doctors and guardians reported food allergy comorbidities differently (19.9% and 43.5%, respectively). Dietary restrictions without medical evaluation were observed in 39.7% of patients. Meaning: Effects of pollen distribution and indirect animal exposure should be evaluated. Evidence-based dietary restrictions must be implemented. |
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∙ Prevalence rate of developmental disabilities has been reported from 8% to 15% and its rate is increasing worldwide. ∙ The critical period of intervention for developmental delay is before the child reaches 3 years of age. ∙ All primary care pediatricians should conduct developmental surveillance and screening tests to infants and children at scheduled visits. Through this, they are liable for providing early identification and timely intervention. |
Neonatal encephalopathy is the most important reason for morbidity and mortality. The early detection of neonate with high risk for hypoxic ischemic encephalopathy (HIE) and treatment are important for prevent long term complication. Hypothermia is currently standard treatment option for HIE. Several clinical studies have been performed due to improve the long term outcome. New therapeutic options including xenon, allopurinol, erythropoietin, topiramate will help to reduce neuropsychiatric disability. |
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Question: Is fetal nuchal cord a risk factor for autism spectrum disorder (ASD)? Finding: Five articles (1 cohort, 4 case-control; total 3,088 children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (odds ratio, 1.11; 95% confidence interval, 0.66–1.57). There was homogeneity among studies that reported a risk of ASD (I2=0.0). Meaning: Fetal nuchal cord is not a risk factor for ASD. |
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Since the introduction of a universal Japanese encephalitis (JE) vaccination program and urbanization, the incidence of JE has dramatically decreased in Korea. However, recent JE cases have occurred, predominantly among unvaccinated adults and with a shift in age distribution. Continuous surveillance of the seroprevalence of JE is required to establish a proper immunization policy in Korea. |
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· Hypertension is defined as a blood pressure (BP) >90th (elevated) or 95th (hypertension) percentile in children by height, age, and sex and >95th percentile in neonates by age, birth weight, and sex. · Although the oscillometric method can be used for screenings, the auscultatory method remains the gold standard. The hybrid method employs the auscultatory and electronic methods and can reduce bias. · BP measurement mobile device applications have a potential for development. |
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· Clinical manifestations of upper gastrointestinal (UGI) tract involvement in Crohn's disease (CD) are common but often clinically underestimated. · Diagnosing CD by confirming inflammation of the UGI tract histologically is challenging because macroscopic and microscopic findings overlap with those of other diseases. · Ongoing efforts are needed to enable a standardized assessment of UGI CD in the future. |
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Question: Can multisystem inflammatory syndrome in childhood (MIS-C) occur in the neonate associated with coronavirus disease 2019 (COVID-19)? Finding: A 9-day-old neonate infected with COVID-19 had fever, respiratory distress, and gastrointestinal symptoms suggestive of MIS-C. This neonate recovered after treatment with intravenous immunoglobulin (IVIG). Meaning: IVIG successfully treated a rare case of a 9-day-old neonate with COVID-19 and severe symptoms suggestive of MIS-C. |
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Question: How many children and adolescents have experienced nonfatal injuries in the previous year? Finding: Among Korean children and adolescents, 8.1% experienced at least one injury per year. We found no significant change in the incidence of injuries over the previous 12 years. Meaning: The incidence of injuries is higher than this estimation; therefore, more attention and effort are needed to prevent injuries among children and adolescents. |
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∙ Pediatric obesity can involve endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty. ∙ Prediabetes and type 2 diabetes in youth aged 10–19 years had a prevalence of 25.9% and 0.6% in 2013–2014, respectively. ∙ Dyslipidemia in Korean adolescents aged 10–18 years had a prevalence of 7.64% (total cholesterol ≥200 mg/dL), 6.09% (low-density lipoprotein cholesterol ≥130 mg/dL), 8.69% (triglyceride ≥150 mg/dL), and 12.52% (high-density lipoprotein cholesterol ≤40 mg/dL) in 2007–2018. ∙ Metabolic syndrome in Korean youth has a prevalence of 1.9%–14.7% in males and 1.7%–12.6% in females with wide variation in definitions. ∙ Appropriate comorbidity screening and management and/or specialist referral are necessary for obese children and adolescents. |
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· Pediatric cerebrospinal fluid (CSF) components have been extensively evaluated as biomarkers of various neurologic diseases. · Several promising candidate CSF biomarkers, including Tau, glial fibrillary acidic protein, neuron-specific enolase, S100β, and interleukins, have been studied in pediatric patients with seizure disorders, central nervous system infections, inflammation, tumors, hypoxic-ischemic encephalopathy, traumatic brain injuries, intraventricular hemorrhage, and congenital hydrocephalus. · Circulating microRNAs in the CSF are a promising class of biomarkers for various neurological diseases. |
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Question: What are the clinical spectrum, course, and short-term outcomes of multisystem inflammatory syndrome in children (MIS-C)? Finding: MIS-C can have variable clinical manifestations. Fever is most common, followed by gastrointestinal and cardiovascular symptoms. Early identification and appropriate management lead to favorable outcomes. Meaning: MIS-C can present in a myriad of ways and severities. High suspicion is necessary to ensure its early identification and appropriate management and favorable patient outcomes. |
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