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Long society scientific session
Session Type
Long society scientific session
Room
Hall C
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Session Description
Pre recorded + Live Q&A

What is new in managing the noncompliant asthmatic?

Session Type
Long society scientific session
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Room
Hall C
Lecture Time
09:00 - 09:20

Which children benefit from bronchoscopy?

Session Type
Long society scientific session
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Room
Hall C
Lecture Time
09:20 - 09:40

SERPINA1 GENE POLYMORPHISMS AND THE RISK OF DEVELOPING WHEEZING/SCHOOL AGE ASTHMA.

Session Type
Long society scientific session
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Room
Hall C
Lecture Time
09:40 - 09:50

Abstract

Abstract Body

BACKGROUND Most asthmatics start wheezing in early childhood, but it is difficult to predict if early wheeze will persist to school- age asthma. Wheezing phenotypes might represent different clinical entities having specific genetic factors.

OBJECTIVE To investigate the relationship between 10 independent single nucleotide polymorphisms (SNPs) of SERPINA1, gene encoding alpha1- antitrypsin, and wheezing phenotypes and doctor- diagnosed asthma in a population- based Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.

METHODS Wheezing data, reports of physician- diagnosed asthma and data on the SERPINA1 gene SNPs were available for 7964 children. Binary logistic regression was used to assess the associations between allele prevalence and wheezing and asthma phenotypes. P values were adjusted to account for multiple hypotheses using the Benjamini- Hochberg false discovery rate.

RESULTS Only within a subgroup of children with asthma who had no prior diagnosis of preschool wheeze was there a trend for association between rs28929474 (Glu342Lys, Pi*Z causing AAT deficiency; P= 0.0058, adjused P= 0.058). No SNPs was associated with wheezing and asthma in those subgroups with preschool wheeze.

CONCLUSIONS Analyzed SNPs in SERPINA1 are not associated with wheezing phenotypes. Only rs28929474, the most common pathologic SNP (Pi*Z) in the SERPINA1 gene, might be associated with a risk of developing school- age asthma without exhibiting preschool wheeze.

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INNOVATIVE IDENTIFICATION SYSTEM WITH AI OF RSV INFECTION

Session Type
Long society scientific session
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Room
Hall C
Lecture Time
09:50 - 10:00

Abstract

Abstract Body

Background and aims:

Respiratory syncytial virus (RSV) is still responsible for many deaths and serious cases worldwide, especially in infants and children with underlying diseases. Identifying RSV infection based on symptoms and signs had been impossible, though using an artificial intelligence (AI) method with patients' self-reports, we aimed to identify RSV infections.

Methods:

We enrolled patients between 4 and 12 months of age, visited the pediatrics outpatient department of Yokohama Municipal Citizen's Hospital, Japan, from January 2009 to December 2015. All patients completed registering the self-report, and patients who reported cough, and rhinorrhea was performed a rapid antigen test. Using this data, we trained the gradient boosting tree model based on the signs and symptoms. We evaluated the discrimination by an area under the receiver-operating characteristic (AUC ROC), and basic discriminative metrics with a threshold defined by Youden-Index in 10-folds cross-validation. Besides, we examined the clinical impact of implementation by excluding unsuspected group with an adjusted threshold based on sensitivity.

Results:

In extracted datasets (n=1483), the AUC ROC achieved 0.851 for distinguishing positive (n=213) and negative (n=1270). The sensitivity and specificity were 80.4% and 74.8%, respectively. The top 2 important features were the seasons and types of cough. The threshold could adjust to 98.2% of sensitivity, and 33.9% of patients were fell into the unsuspected group.

Conclusions:

We demonstrated an AI with proper identification performance based on symptoms and signs, despite considered impossible previously. Our model could exclude one-third of suspicious cases approximately, possibly performing before the visit.

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EVALUATION OF AEROSOL DELIVERY IN PAEDIATRIC PATIENTS VIA HIGH FLOW NASAL THERAPY

Session Type
Long society scientific session
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Room
Hall C
Lecture Time
10:00 - 10:10

Abstract

Abstract Body

Background & aims: High flow nasal therapy (HFNT) has become a widely adopted method that facilitates aerosol delivery to paediatric patients. The aim of this study was to assess the effect of gas flow rate and humidification on aerosol delivery during simulated paediatric HFNT.

Methods: A 2mL dose of 2mg/mL of salbutamol was aerosolised using a vibrating mesh nebuliser (Aerogen Solo, Aerogen, Ireland). A breathing simulator (IngMar Medical, US) was used to generate the paediatric breathing pattern (30 BPM, Vt 50, I/E 1:3). The bench setup included a head model of a 4-month-old paediatric patient and nasal cannula (FPH, NZ). The nebuliser was placed on the dry side of the humidifier (FPH, NZ). An absolute filter was used to capture the tracheal dose at each gas flow rate (1 & 8 LPM) and quantified using UV spectrophotometry at 276nm. Results were expressed as the percentage of the nominal dose placed in the nebuliser’s medication cup.

Results:
Figure 1. Results of tracheal dose (%). Experiments were performed in triplicates (n=3).

Conclusions: These findings confirm that gas flow rate had a significant effect on aerosol delivery corroborating previous published studies1. These doses could be expected to be within the therapeutic range as they exceed previously reported effective doses in infants2. Humidification did not have a statistically significant effect on tracheal dose.

References:

1 Li J, et al. Pediatr Pulmonol 2019; : ppul.24274.

2 Chua HL, et al. Eur Respir J 1994; 7: 2185–91.

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THE EFFECT OF INDOOR ENVIRONMENT ON THE SEVERITY OF ASTHMA IN CHILDREN

Session Type
Long society scientific session
Date
16.10.2020, Friday
Session Time
09:00 - 10:40
Room
Hall C
Lecture Time
10:10 - 10:20
Presenter

Abstract

Abstract Body

Background and aims:

Evidence has been shown that ambient air quality is associated with the risk of asthma. However, the effect of indoor air quality on asthma exacerbation in children is less known. We want to search for asthma exacerbation early signs and environmental factors by wearing devices and air box.

Methods:

We enrolled children with asthma by GINA guideline. Indoor air pollutant levels (PM2.5, temperature, and humidity) were monitored by smart wireless air quality detector (EdiGreen AirBox) linking to smart phone applications. Daily activity, step counts, heart rate, and calorie were monitored by smart watches. Risk factors, Asthma Control Test (ACT) scores, life quality scores, and severity of asthma by GINA guideline were collected by questionnaires every outpatient clinic visit. We evaluated if the physiological, environmental factors, life quality scores may change with the severity of asthma by GEE model.

Results:

Finally, 34 children with asthma finished the follow-up. For indoor meteorological parameters, we found the severity of asthma was associated with temperature (β=1.853, 95% CI, 1.278-2.684) and humidity (β=0.742, 95% CI, 0.626-0.879). BMI (β= 1.325, 95% CI, 1.034-1.699), calorie consumption (β= 1.001, 95% CI, 1.000-1.002), and miniPAQLQ (β=1.462, 95% CI, 1.233-1.732) were significantly associated with asthma severity.

Conclusions:

Indoor temperature and humidity play a role in the severity of asthma. By collecting air quality and physiological parameters longitudinally, major changes over time may help patients determine whether the symptoms are worsening and avoid asthma triggering.

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