Satellite-Derived PM2.5 Composition and Its Differential Effect on Children’s Lung Function
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Khang Chau↗
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Caretaker perceptions of the effects of parental migration on left-behind children in rural Kyrgyzstan
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Christian Kelly Scott↗
DAISY Complement Protein ML-Ready Data
A total of 172 children from the DAISY study with multiple plasma samples collected over time, with up to 23 years of follow-up, were characterized via proteomics analysis. Of the children there were 40 controls and 132 cases. All 132 cases had measurements across time relative to IA. Sampling was not consistent for all children. There were 47 of the children who had samples taken and evaluated prior to IA (Pre-IA), and 131 children had measurements at or after IA, but prior to diagnosis of clinical T1D (Post-IA). The control children were frequency matched on HLA genotypes and age and sex with an observed lower frequency of first degree relatives within the control group versus the cases For machine learning the children that will develop islet autoantibodies the 40 control and 47 Pre-IA children were down-selected to a single sample time point. For the 40 control children this was the earliest sample collected and for the 47 Pre-IA children it was a random selection of the first or second time point prior to the detection of autoantibodies to assure the age distributions were not significantly different.
machine learning, proteomics, Type 1 Diabetes, com↗
DAISY Complement Protein ML-Ready Data
A total of 172 children from the DAISY study with multiple plasma samples collected over time, with up to 23 years of follow-up, were characterized via proteomics analysis. Of the children there were 40 controls and 132 cases. All 132 cases had measurements across time relative to IA. Sampling was not consistent for all children. There were 47 of the children who had samples taken and evaluated prior to IA (Pre-IA), and 131 children had measurements at or after IA, but prior to diagnosis of clinical T1D (Post-IA). The control children were frequency matched on HLA genotypes and age and sex with an observed lower frequency of first degree relatives within the control group versus the cases For machine learning the children that will develop islet autoantibodies the 40 control and 47 Pre-IA children were down-selected to a single sample time point. For the 40 control children this was the earliest sample collected and for the 47 Pre-IA children it was a random selection of the first or second time point prior to the detection of autoantibodies to assure the age distributions were not significantly different.
Webb-Robertson, Bobbie-Jo M↗
MetaPop: a pipeline for macro- and microdiversity analyses and visualization of microbial and viral metagenome-derived populations
Abstract Background Microbes and their viruses are hidden engines driving Earth’s ecosystems from the oceans and soils to humans and bioreactors. Though gene marker approaches can now be complemented by genome-resolved studies of inter-(macrodiversity) and intra-(microdiversity) population variation, analytical tools to do so remain scattered or under-developed. Results Here, we introduce MetaPop, an open-source bioinformatic pipeline that provides a single interface to analyze and visualize microbial and viral community metagenomes at both the macro - and microdiversity levels. Macrodiversity estimates include population abundances and α- and β-diversity. Microdiversity calculations include identification of single nucleotide polymorphisms, novel codon-constrained linkage of SNPs, nucleotide diversity ( π and θ ), and selective pressures (pN/pS and Tajima’s D ) within and fixation indices ( F ST ) between populations. MetaPop will also identify genes with distinct codon usage. Following rigorous validation, we applied MetaPop to the gut viromes of autistic children that underwent fecal microbiota transfers and their neurotypical peers. The macrodiversity results confirmed our prior findings for viral populations (microbial shotgun metagenomes were not available) that diversity did not significantly differ between autistic and neurotypical children. However, by also quantifying microdiversity, MetaPop revealed lower average viral nucleotide diversity ( π ) in autistic children. Analysis of the percentage of genomes detected under positive selection was also lower among autistic children, suggesting that higher viral π in neurotypical children may be beneficial because it allows populations to better “bet hedge” in changing environments. Further, comparisons of microdiversity pre- and post-FMT in autistic children revealed that the delivery FMT method (oral versus rectal) may influence viral activity and engraftment of microdiverse viral populations, with children who received their FMT rectally having higher microdiversity post-FMT. Overall, these results show that analyses at the macro level alone can miss important biological differences. Conclusions These findings suggest that standardized population and genetic variation analyses will be invaluable for maximizing biological inference, and MetaPop provides a convenient tool package to explore the dual impact of macro - and microdiversity across microbial communities.
59 BASIC BIOLOGICAL SCIENCES↗
Is the spatial distribution of brain lesions associated with closed-head injury predictive of subsequent development of attention-deficit/hyperactivity disorder? Analysis with brain-image database
PURPOSE: To determine whether there is an association between the spatial distribution of lesions detected at magnetic resonance (MR) imaging of the brain in children after closed-head injury and the development of secondary attention-deficit/hyperactivity disorder (ADHD). MATERIALS AND METHODS: Data obtained from 76 children without prior history of ADHD were analyzed. MR images were obtained 3 months after closed-head injury. After manual delineation of lesions, images were registered to the Talairach coordinate system. For each subject, registered images and secondary ADHD status were integrated into a brain-image database, which contains depiction (visualization) and statistical analysis software. Using this database, we assessed visually the spatial distributions of lesions and performed statistical analysis of image and clinical variables. RESULTS: Of the 76 children, 15 developed secondary ADHD. Depiction of the data suggested that children who developed secondary ADHD had more lesions in the right putamen than children who did not develop secondary ADHD; this impression was confirmed statistically. After Bonferroni correction, we could not demonstrate significant differences between secondary ADHD status and lesion burdens for the right caudate nucleus or the right globus pallidus. CONCLUSION: Closed-head injury-induced lesions in the right putamen in children are associated with subsequent development of secondary ADHD. Depiction software is useful in guiding statistical analysis of image data.
NASA Discipline Neuroscience↗
Measured air quality impacts after teaching parents about cooking ventilation with a video: a pilot study
BackgroundCooking-related emissions contribute to air pollutants in the home and may influence children’s health outcomes.ObjectiveIn this pilot study, we investigate the effects of a cooking ventilation intervention in homes with gas stoves, including a video-based educational intervention and range hood replacement (when needed) in children’s homes.MethodsThis was a pilot (n = 14), before-after trial (clinicaltrials.gov #NCT04464720) in homes in the San Francisco Bay Area that had a school-aged child, a gas stove, and either a venting range hood or over-the-range microwave/hood. Cooking events, ventilation use, and indoor air pollution were measured in homes for 2–4 weeks, and children completed respiratory assessments. Midway, families received this intervention: (1) education about the hazards of cooking-related pollutants and benefits of both switching to back burners and using the range hood whenever cooking and (2) ensuring the range hood met airflow and sound performance standards. The educational intervention was delivered via a video developed in conjunction with local youth.ResultsWe found substantially increased use of back burners and slight increases in range hood use during cooking after intervening. Even though there was no change in cooking frequency or duration, these behavior changes resulted in decreases in nitrogen dioxide (NO2), including significant decreases in the total integrated concentration of NO2 over all cooking events from 1230 ppb*min (IQR 336, 7861) to 756 (IQR 84.0, 4210; p < 0.05) and NO2 collected on samplers over the entire pre- and post-intervention intervals from 10.4 ppb (IQR 3.5, 47.5) to 9.4 (IQR 3.0, 36.1; p < 0.005). There were smaller changes in PM2.5, and no changes were seen in respiratory outcomes.ImpactThis pilot before-after trial evaluated the use of a four-minute educational video to improve cooking ventilation in homes with gas stoves and one or more school-aged children. Participant behavior changed after watching the video, and there were decreases in indoor air pollutant concentrations in the home, some of which were significant. This brief video is now publicly available in English and Spanish (wspehsu.ucsf.edu/projects/indoor-air-quality), and this provides suggestive evidence of the utility of this simple intervention, which could be particularly beneficial for households that have children with asthma.
Holm, Stephanie M↗
Evaluation of Serial Testing After Exposure to COVID-19 in Early Care and Education Facilities, Illinois, March–May 2022
Objective: To understand SARS-CoV-2 transmission in early care and education (ECE) settings, we implemented a Test to Stay (TTS) strategy, which allowed children and staff who were close contacts to COVID-19 to remain in person if they agreed to test twice after exposure. We describe SARS-CoV-2 transmission, testing preferences, and the number of in-person days saved among participating ECE facilities. Methods: From March 21 through May 27, 2022, 32 ECE facilities in Illinois implemented TTS. Unvaccinated children and staff who were not up to date with COVID-19 vaccination could participate if exposed to COVID-19. Participants received 2 tests within 7 days after exposure and were given the option to test at home or at the ECE facility. Results: During the study period, 331 TTS participants were exposed to index cases (defined as people attending the ECE facility with a positive SARS-CoV-2 test result during the infectious period); 14 participants tested positive, resulting in a secondary attack rate of 4.2%. No tertiary cases (defined as a person with a positive SARS-CoV-2 test result within 10 days after exposure to a secondary case) occurred in the ECE facilities. Most participants (366 of 383; 95.6%) chose to test at home. Remaining in-person after an exposure to COVID-19 saved approximately 1915 in-person days among children and staff and approximately 1870 parent workdays. Conclusion: SARS-CoV-2 transmission rates were low in ECE facilities during the study period. Serial testing after COVID-19 exposure among children and staff at ECE facilities is a valuable strategy to allow children to remain in person and parents to avoid missing workdays.
Public, Environmental & Occupational Health↗
Analysis of the first ten years of FDA’s rare pediatric disease priority review voucher program: designations, diseases, and drug development
Abstract Background The Rare Pediatric Disease (RPD) Priority Review Voucher (PRV) Program was enacted in 2012 to support the development of new products for children. Prior to requesting a voucher, applicants can request RPD designation, which confirms their product treats or prevents a rare disease in which the serious manifestations primarily affect children. This study describes the trends and characteristics of these designations. Details of RPD designations are not publicly disclosable; this research represents the first analysis of the RPD designation component of the program. Results We used an internal US Food and Drug Administration database to analyze all RPD designations between 2013 and 2022. Multiple characteristics were analyzed, including the diseases targeted by RPD designation, whether the product targeted a neonatal disease, product type (drug/biologic), and the level of evidence (preclinical/clinical) to support designation. There were 569 RPD designations during the study period. The top therapeutic areas were neurology (26%, n = 149), metabolism (23%, n = 131), oncology (18%, n = 105). The top diseases targeted by RPD designation were Duchenne muscular dystrophy, neuroblastoma, and sickle cell disease. Neonatology products represented 6% (n = 33), over half were for drug products and 38% were supported by clinical data. Conclusions The RPD PRV program was created to encourage development of new products for children. The results of this study establish that a wide range of diseases have seen development—from rare pediatric cancers to rare genetic disorders. Continued support of product development for children with rare diseases is needed to find treatments for all children with unmet needs.
Mease, Catherine (ORCID:000900050156198X)↗
A Generalizable Evaluated Approach, Applying Advanced Geospatial Statistical Methods, to Identify High Lead Exposure Locations at Census Tract Scale: Michigan Case Study
BACKGROUND: Despite great progress in reducing environmental lead (Pb) levels, many children in the United States are still being exposed. OBJECTIVE: Our aim was to develop a generalizable approach for systematically identifying, verifying, and analyzing locations with high prevalence of children’s elevated blood Pb levels (EBLLs) and to assess available Pb models/indices as surrogates, using a Michigan case study. METHODS: We obtained ~1:9 million BLL test results of children <6 years of age in Michigan from 2006–2016; we then evaluated them for data representativeness by comparing two percentage EBLL (%EBLL) rates (number of children tested with EBLL divided by both number of children tested and total population). We analyzed %EBLLs across census tracts over three time periods and between two EBLL reference values (≥5 vs. ≥10 μg/dL) to evaluate consistency. Locations with high %EBLLs were identified by a top 20 percentile method and a Getis-Ord Gi* geospatial cluster “hotspot” analysis. For the locations identified, we analyzed convergences with three available Pb exposure models/indices based on old housing and sociodemographics. RESULTS: Analyses of 2014–2016 %EBLL data identified 11 Michigan locations via cluster analysis and 80 additional locations via the top 20 percentile method and their associated census tracts. Data representativeness and consistency were supported by a 0.93 correlation coefficient between the two EBLL rates over 11 y, and a Kappa score of ~0:8 of %EBLL hotspots across the time periods (2014–2016) and reference values. Many EBLL hotspot locations converge with current Pb exposure models/indices; others diverge, suggesting additional Pb sources for targeted interventions. DISCUSSION: This analysis confirmed known Pb hotspot locations and revealed new ones at a finer geographic resolution than previously available, using advanced geospatial statistical methods and mapping/visualization. It also assessed the utility of surrogates in the absence of blood Pb data. This approach could be applied to other states to inform Pb mitigation and prevention efforts. https://doi.org/10.1289/EHP9705
54 ENVIRONMENTAL SCIENCES↗
The relationship between below average cognitive ability at age 5 years and the child’s experience of school at age 9
Background At age 5, while only embarking on their educational journey, substantial differences in children’s cognitive ability will already exist. The aim of this study was to examine the causal association between below average cognitive ability at age 5 years and child-reported experience of school and self-concept, and teacher-reported class engagement and emotional-behavioural function at age 9 years. Methods This longitudinal cohort study used data from 7,392 children in the Growing Up in Ireland Infant Cohort, who had completed the Picture Similarities and Naming Vocabulary subtests of the British Abilities Scales at age 5. Principal components analysis was used to produce a composite general cognitive ability score for each child. Children with a general cognitive ability score more than 1 standard deviation (SD) below the mean at age 5 were categorised as ‘Below Average Cognitive Ability’ (BACA), and those scoring above this as ‘Typical Cognitive Development’ (TCD). The outcomes of interest, measured at age 9, were child-reported experience of school, child’s self-concept, teacher-reported class engagement, and teacher-reported emotional behavioural function. Binary and multinomial logistic regression models were used to examine the association between BACA and these outcomes. Results Compared to those with TCD, those with BACA had significantly higher odds of never liking school [Adjusted odds ratio (AOR) 1.82, 95% CI 1.37–2.43, p < 0.001], of being picked on (AOR 1.27, 95% CI 1.09–1.48) and of picking on others (AOR 1.53, 95% CI 1.27–1.84). They had significantly higher odds of experiencing low self-concept (AOR 1.20, 95% CI 1.02–1.42) and emotional-behavioural difficulties (AOR 1.34, 95% CI 1.10–1.63, p = 0.003). Compared to those with TCD, children with BACA had significantly higher odds of hardly ever or never being interested, motivated and excited to learn (AOR 2.29, 95% CI 1.70–3.10). Conclusion Children with BACA at school-entry had significantly higher odds of reporting a negative school experience and low self-concept at age 9. They had significantly higher odds of having teacher-reported poor class engagement and problematic emotional-behavioural function at age 9. The findings of this study suggest BACA has a causal role in these adverse outcomes. Early childhood policy and intervention design should be cognisant of the important role of cognitive ability in school and childhood outcomes.
Bowe, Andrea K.↗
Forest Cover Associated with Improved Child Health and Nutrition: Evidence from the Malawi Demographic and Health Survey and Satellite Data
Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P5.002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystems services of forests are important factors in improving human health and nutrition outcomes.
malawi↗
Management of Pulmonary Arterial Hypertension in the Pediatric Patient
Purpose of Review: Pediatric pulmonary arterial hypertension (PAH) is associated with significant morbidity and mortality. Herein we review the diagnosis and classification for pediatric PAH and detail the current therapeutic options available for use in the pediatric PAH population. Recent Findings: Classification and treatment of pediatric PAH is guided by adult criteria and treatment algorithms, yet the distribution of factors contributing to PAH in children differs significantly from that seen in adults. It is necessary to understand these differences in order to appropriately tailor therapy to the needs of the child or adolescent. An expanding array of targeted PAH drugs are now approved for use in adults, and many of these drugs are used “off-label” to treat children and adolescents with PAH. Use of these novel therapies has coincided with marked improvement in outcomes, suggesting significant benefit. However, because most of these drugs have not been studied in rigorous randomized, controlled trials in children, it is critical that physicians understand their mechanisms of action, potential benefits, and safety profiles. Summary: Pediatric PAH outcomes have improved substantially in the modern era, coinciding with the “off-label” use of targeted PAH drugs in children and adolescents. Ideally, care should be provided at centers with specialized expertise in the diagnosis and treatment of pediatric PAH by providers who understand the appropriate diagnostic algorithms, classification schemes, and treatment approaches.
62 RADIOLOGY AND NUCLEAR MEDICINE↗
Image transformers for classifying acute lymphoblastic leukemia
Cancer is the leading cause of death by disease in American children. Each year, nearly 16,000 children in the United States and over 300,000 children globally are diagnosed with cancer. Leukemia is a form of blood cancer that originates in the bone marrow and accounts for one-third of pediatric cancers. This disease occurs when the bone marrow contains 20% or more immature white blood cell blasts. Acute lymphoblastic leukemia is the most prevalent leukemia type found in children, with half of all annual cases in the U.S. diagnosed for subjects under 20 years of age. To diagnose acute lymphoblastic leukemia, pathologists often conduct a morphological bone marrow assessment. This assessment determines whether the immature white blood cell blasts in bone marrow display the correct morphological characteristics, such as size and appearance of nuclei. Pathologists also use immunophenotyping via multi-channel flow cytometry to test whether certain antigens are present on the surface of blast cells; the antigens are used to identify the cell lineage of acute lymphoblastic leukemia. These manual processes require well-trained personnel and medical professionals, thus being costly in time and expenses. Computerized decision support via machine learning can accelerate the diagnosis process and reduce the cost. Training a reliable classification model to distinguish between mature and immature white blood cells is essential to the decision support system. Here, we adopted the Vision Transformer model to classify white blood cells. The Vision Transformer achieved superb classification performance compared to state-of-the-art convolutional neural networks while requiring less computational resources for training. Additionally, the latent self-attention architecture provided attention maps for a given image, providing clues as to which portion(s) of the image were significant in decision-making. We applied the Vision Transformer model and a convolutional neural network model to an acute lymphoblastic leukemia classification dataset of 12,528 samples and achieved accuracies of 88.4% and 86.2%.
Cho, Priscilla↗
Spontaneous bodily coordination varies across affective and intellectual child-adult interactions
Research on child-adult interactions has identified that the morphology of bodily coordination seems to be sensitive to age and type of interaction. Mirror-like imitation emerges earlier in life and is more common during emotionally laden interactions, while anatomical imitation is acquired later and associated with cognitive tasks. However, it remains unclear whether these morphologies also vary with age and type of interaction during spontaneous coordination. Here we report a motion capture study comparing the spontaneous coordination patterns of thirty-five 3-year-old (20 girls; M age = 3.15 years) and forty 6-year-old children (20 girls; M age = 6.13 years) interacting with unacquainted adults during two storytelling sessions. The stories narrated the search of a character for her mother (Predominantly Affective Condition) or an object (Predominantly Intellectual Condition) inside a supermarket. Results show that children of both ages consistently coordinated their spontaneous movements towards adult storytellers, both in symmetric and asymmetric ways. However, symmetric coordination was more prominent in 3-year-old children and during predominantly emotional interactions, whereas asymmetric coordination prevailed in 6-year-old children and during predominantly intellectual interactions. These results add evidence from spontaneous interactions in favor of the hypothesis that symmetric coordination is associated with affective interactions and asymmetric coordination with intellectual ones.
Cornejo, Carlos↗
Staged progression epidemic models for the transmission of invasive nontyphoidal Salmonella (iNTS) with treatment
We develop and analyze a stage-progression compartmental model to study the emerging invasive nontyphoidal Salmonella (iNTS) epidemic in sub-Saharan Africa. iNTS bloodstream infections are often fatal, and the diverse and non-specific clinical features of iNTS make it difficult to diagnose. We focus our study on identifying approaches that can reduce the incidence of new infections. In sub-Saharan Africa, transmission and mortality are correlated with the ongoing HIV epidemic and severe malnutrition. We use our model to quantify the impact that increasing antiretroviral therapy (ART) for HIV infected adults and reducing malnutrition in children would have on mortality from iNTS in the population. We consider immunocompromised subpopulations in the region with major risk factors for mortality, such as malaria and malnutrition among children and HIV infection and ART coverage in both children and adults. We parameterize the progression rates between infection stages using the branching probabilities and estimated time spent at each stage. We interpret the basic reproduction number R 0 as the total contribution from an infinite infection loop produced by the asymptomatic carriers in the infection chain. The results indicate that the asymptomatic HIV+ adults without ART serve as the driving force of infection for the iNTS epidemic. We conclude that the worst disease outcome is among the pediatric population, which has the highest infection rates and death counts. Our sensitivity analysis indicates that the most effective strategies to reduce iNTS mortality in the studied population are to improve the ART coverage among high-risk HIV+ adults and reduce malnutrition among children.
59 BASIC BIOLOGICAL SCIENCES↗
Development of intuitive theories of motion - Curvilinear motion in the absence of external forces
College students and children between the ages of 4 and 12 were asked to draw the path a ball would take upon exiting a curved tube. As in previous studies, many subjects erroneously predicted curvilinear paths. However, a clear U-shaped curve was evident in the data: Preschoolers and kindergartners performed as well as college students, whereas school-aged children were more likely to make erroneous predictions. A second study suggested that the youngest children's correct responses could not be attributed to response biases or drawing abilities. This developmental trend is interpreted to mean that the school-aged children are developing intuitive theories of motion that include erroneous principles. The results are related to the 'growth errors' found in other cognitive domains and to the historical development of formal theories of motion.
Kaiser, M. K.↗
Project KEWL: Kinect Engineering With Learning
Project KEWL is a joint project between NASA/JPL and NASA/JSC to stimulate interest of children in Science, Technology, Engineering and Math (STEM) and bring the NASA space exploration experience to the classroom, museum and ultimately the living room. Using the Kinect game controller KEWL allows children to engage in NASA s missions in a fundamentally new way. KEWL allows children to experiment with gravity on Mars and the Moon; navigate through the International Space Station; fix a torn solar array on the ISS; drive a robot on Mars; visit an Asteroid; learn about the differences in gravity on different planets and control Robonaut 2 using their body as the input device. Project KEWL complements NASA s outreach investments in television, mobile platforms and the web by engaging the public through the rapidly expanding medium of console gaming. In 2008, 97% of teenagers played video games and 86% played on a home gaming console. (source: http://pewresearch.org/pubs/953/) As of March 2011, there have been more than 10 million Kinects sold. (source: http://www.itproportal.com/2011/03/10/kinect-record-breaking-sales-figures-top-10-million/) Project KEWL interacts with children on a platform on which they spend much of their time and teaches them information about NASA while they are having fun. Project KEWL progressed from completely custom C++ code written in house to using a commercial game engine. The art work and 3D geometry models come from existing engineering work or are created by the KEWL development team. Six different KEWL applications have been demonstrated at nine different venues including schools, museums, conferences, and NASA outreach events. These demonstrations have allowed the developers the chance to interact with players and observe the gameplay mechanics in action. The lessons learned were then incorporated into the subsequent versions of the applications.
Norris, Jeff↗