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- Stefano Del Torso (Italy)
- Ivan Bambir (Croatia)
STUDY OF FACTORS ASSOCIATED WITH SLEEP DURATION IN HEALTHY INFANTS AGED 9 MONTHS
- Ciara Broderick Farrell (Ireland)
Abstract
Background and Aims
The aim of this study was to investigate the factors which are associated with total sleep duration in healthy infants at the age of 9 months, in particular: gender, birth weight, breastfeeding length and social class.
Methods
We examined health aspects of Wave 1 of the Infant Cohort of Growing Up in Ireland, which is a national longitudinal study of Irish children. A large number of covariates were investigated as potential predictors for sleep duration based on existing literature on the subject. Chi-square tests were carried out for univariable analyses of the association between sleep duration and all of the categorical variables. T-tests of differences in the mean and 95% confidence interval estimations were carried out for each of the continuous variables. All variables were considered in the initial linear regression model. Insignificant variables were excluded from the final model.
Results
Heavier birth weight was significantly associated with longer sleep duration (β coefficient 0.0001; 95% confidence interval (95% CI) 0.0001, -0.0002; p-value <0.001). Longer sleep duration was associated with later introduction of formula (β coefficient -0.001; 95% CI -0.002, 0; p-value 0.0253), and longer breastfeeding length (β coefficient 0.002; 95% CI 0.001, 0.003; p-value <0.001). We found that if a child was breastfed for 100 days, sleep duration on average increased by approximately 12 minutes per day.
Conclusions
Our findings indicate that longer sleep duration in infancy is significantly associated with a longer period of breastfeeding.
USE OF VIDEO DATA AND FACIAL LANDMARK ANALYSIS AS AN OBJECTIVE ASSESSMENT OF PALATABILITY FOR PAEDIATRIC MEDICINE
- Rabia Aziza (United Kingdom)
Abstract
Background and Aims
For orally-administered drugs, palatability is key in determining patient acceptability and treatment compliance. Therefore understanding children’s taste sensitivity and preferences can support formulators in making paediatric medicines more acceptable. Moreover collecting data in the home setting allows for natural behaviour, with minimal burden for participants. Presently, we explore if the application of computer-vision techniques to videos of children's reaction to gustatory taste strips can provide an objective assessment of palatability.
Methods
Primary school children tasted four different flavoured strips: no taste, bitter, sweet and sour (UCL REC 4612/029). Data was collected at home, under the supervision of a guardian, with responses recorded using the Aparito Atom5™ app and smartphone camera. Participants scored each strip on a 5-point hedonic scale. Facial landmarks were identified in the videos, and quantitative measures such as changes around the eyes, nose and mouth were extracted, to train models to classify strip taste and score.
Results
We received 215 videos and 252 self-reported scores from 64 participants. The hedonic scale elicited expected results: children like sweetness, dislike bitterness and have varying opinions for sourness. We observed a wide facial variation across participants in the magnitude, onset and duration of reactions. Challenges resulting from home-recorded videos are lack of standardisation and inability to provide timely feedback.
Conclusions
This study into children’s taste specificities can improve the measurement of paediatric medicine acceptability. An objective measure of how children feel about the taste of medicines has great potential in helping find the most palatable formulation.
AEROSOL DRUG DELIVERY PERFORMANCE FROM VIBRATING MESH AND JET NEBULISERS IN A SPONTANEOUSLY BREATHING PAEDIATRIC MODEL
- Elena Fernandez Fernandez (Ireland)
Abstract
Background and Aims
Nebuliser selection impacts the efficiency of aerosol therapy in the treatment of respiratory diseases in paediatric patients. Here, we assess the performance, in terms of drug delivery, residual drug volume and concentration, of a vibrating mesh nebuliser (VMN) and a jet nebuliser (JN) in combination with a facemask in a simulated spontaneously breathing paediatric patient.
Methods
3mL of 0.83mg/mL Salbutamol (GSK, IRE) was nebulized using two nebulisers: a VMN/aerosol chamber/valved facemask (Aerogen Solo/Ultra at 2LPM, Aerogen, IRE) and a JN/open aerosol facemask (AirLife MistyFast at driving flow rate of 8LPM, Vyaire, US). A head model (5-year-old) was connected via a filter (Respirgard, Vyaire, US) to a breathing simulator (ASL5000, Ingmar, US) set to simulate a normal paediatric, Vt 300mL, BPM 20 and I:E 1:2, breath pattern. Drug delivery and residual concentration are expressed as a percentage of the nominal dose and determined using UV-spectroscopy at 276nm. Residual volume was determined gravimetrically.
Results
Results are displayed as the mean ± SD in the table below.
| Nebuliser Type | VMN | JN | P-value |
| Drug delivered (%) | 30.75 ± 2.19 | 6.45 ± 0.59 | <0.0001 |
| Residual Drug (mL) | 0.03 ± 0.04 | 1.30 ± 0.14 | 0.0003 |
| Residual drug concentration (mg/mL) | N/A | 0.91 ± 0.02 | N/A |
Conclusions
Across both nebuliser types, the VMN delivered a statistically significantly larger drug dose, with less drug remaining in the medication cup. For the JN, the drug concentration increased post nebulisation from 0.83 to 0.91mg/mL. This study highlights the clinical relevance of nebuliser choice on aerosol drug delivery.
MICROBIOLOGY, RISK FACTORS AND ADVERSE OUTCOMES IN BRONCHIOLITIS ADMISSIONS DURING THE SARS-COV2 PANDEMIC: EXPERIENCE IN A TERTIARY PAEDIATRIC HOSPITAL
- Fuensanta Guerrero Del Cueto (Spain)
Abstract
Background and Aims
Seasonality of bronchiolitis changed during the SARS-CoV2 pandemic. This study compares microbiology, risk factors and adverse outcomes in 2020-2021 hospitalizations versus 2010-2015.
Methods
Ambispective observational study: acute-bronchiolitis (ICD-10-J21) hospitalizations (ABH) in children<2 years in a tertiary paediatric hospital.
Multiplex-PCR detections in nasopharyngeal swabs (01/Apr/2020-31/Dec/2021) compared to pre-pandemic (01/Apr/2010-31/Mar/2015) microbiological trends.
Risk factors (sex, age, prematurity, pre-existing conditions, microbiology) examined with chi-squared and logistic regression for adverse outcomes: length of stay (LOS)>5 days, intensive care unit (PICU) admission and bacterial superinfection (BSI).
Results
1024 pre-pandemic ABH (annual average=204.8,SD=18.78; 46.26 ABH/10000 children<2 years emergency consultations), December-January peak.
Winter 2020: only 11 admissions (94.6% reduction). Summer-autumn peak April-Dec/2021: 171 ABH (52.24 ABH/10000).
No significant differences in RSV proportion (pre-pandemic:789/1024(77.1%) versus pandemic:148/182(81.3%); p=0.16).
Pandemic codetections: 20/106(18.87%), 90% with RSV, not associated with adverse outcomes.
Table1. Adverse outcomes
| Pre-pandemic | Pandemic | p | |
| LOS>5 days | 436(42.6%) | 55(30.2%) | 0.002 |
| BSI | 153(15.3%) | 30(16.5%) | 0.681 |
| Pneumonia | 107(10.69%) | 12(6.70%) | NS |
| Urinary-tract infection | 29(2.90%) | 2(1.12%) | NS |
| Bacteriemia | 16(1.6%) | 3(1.68%) | NS |
| Otitis-media | 1(0.1%) | 6(3.35%) | 0.000 |
| PICU | 85(8.3%) | 18(9.9%) | 0.480 |
Table2. Risk factors
| Pre-pandemic | Pandemic | |
| PICU | •Prematurity<28weeks: p=0.000,OR=15.15(95%CI=4.39-52.28) •Prematurity29-34weeks: p=0.000,OR=4.67(95%CI=2.41-9.03) •Prematurity35-36weeks: p=0.005,OR=2.58(95%CI=1.33-5.03) •Bronchopulmonary dysplasia: p=0.000,OR=42.74(95%CI=12.29-148.73) •Age<1month: p=0.000,OR=3.33(95%CI=1.72-6.46) | NS |
| LOS>5 days | •Age<1month: p=0.002,OR=2.5(95%CI=1.41-4.60) •Prematurity: p=0.000,OR=2.3(95%CI=1.41-3.7) | NS |
| BSI | •Female: p=0.008,OR=1.66(95%CI=1.14-2.42) •Age<1month: p=0.002,OR=2.036(95%CI=1.29-3.21) | •Female: p=0.027,OR=2.74(95%CI=2.12-6.71) |
Conclusions
•After an absent 2020 bronchiolitis season, there was an extemporaneous summer-autumn 2021 outbreak; main agents RSV and rhinovirus.
•Longer pre-pandemic LOS; higher pandemic incidence of AOM; other adverse outcomes not significantly different.
•Risk factors for PICU and LOS in pre-pandemic period: prematurity and age, not significant during pandemic; females higher bacterial superinfection in both periods.
COVID-19, THE OMICRON VARIANT AND ITS ASSOCIATION WITH CROUP IN CHILDREN, A SINGLE CENTER STUDY IN HONG KONG
- Chung Yan Michelle Lam (Hong Kong PRC)
Abstract
Background and Aims
The 5th wave of the COVID-19 pandemic in Hong Kong was dominated by the omicron BA.2 variant, which may have more upper airway involvement affecting children. This pilot study aims at analysing any associations between the COVID-19-omicron-variant and croup in children.
Methods
This retrospective study reviewed electronic medical records of all patients admitted to Tuen Mun Hospital of Hong Kong from 1 January 2018 to 31 March 2022 with diagnostic code of croup (ICD-10 code J05.0). Patients were categorised into the Non-COVID period(1 January 2018 - 31 December 2019); COVID-pre-omicron period (1 January 2020 - 31 December 2021) and COVID-omicron period (1 January 2022- 31 March 2022). Their disease associations and severity were compared through incidence rates, Westley Croup Severity Score, length of hospital stay, medications use, respiratory support and intensive care unit admissions.
Results
The rate of croup patients infected by COVID-19 in the COVID-omicron period (90%) was much higher than those in COVID-pre-omicron period (3.6%, p< 0.001). Meanwhile, these patients also had higher Westley Scores (moderate + severe disease: COVID-omicron: 56.7%; COVID-pre-omicron: 20.4%; p=0.002; Non-COVID: 24.2%, p< 0.001), longer length of hospital stay (median: COVID-omicron 3.00 days ; COVID-pre-omicron:2.00 days, p<0.001, Non-COVID: 2.00 days, p=0.033) , and higher dexamethasone requirements (mean : COVID-omicron = 0.78mg/kg; COVID-pre-omicron= 0.48mg/kg, p < 0.001; Non-COVID =0.58mg/kg , p=0.006) while compared to croup patients in COVID-pre-omicron period and non-COVID period respectively.
Conclusions
The omicron variant of COVID-19 is a significant contributing factor to croup and can lead to more severe disease in children of Hong Kong.
VOICE OR INSTRUMENTAL MUSIC? NEWBORNS’ EARLY DISCRIMINATION OF VOCAL AND INSTRUMENTAL MELODIES: A FMRI BASED DYNAMIC EFFECTIVE CONNECTIVITY STUDY
- Manuela Filippa (Switzerland)
Abstract
Background and Aims
Newborn infants show early specialization in treating human voices, but little is known whether this specialization is only for speaking or also for singing voices. 45 newborns were scanned using functional magnetic resonance imaging while listening to a melody (without words) sang by a female voice (voice condition) or played by a musical instrument: a flute (instrument condition).
Methods
To explore the dynamic task-based effective-connectivity, we employed psychophysiological interaction of co-activation patterns (PPI-CAPs) analysis with auditory cortices as seeds regions to investigate moment-to-moment changes in task-driven modulation of brain activity.
Results
Our findings revealed unique, condition-specific, dynamically occurring PPI-CAPs. Based on the PPI effects, the auditory cortex during the voice condition co-activates with cortical sensorimotor, salience, and right temporal gyrus, while during the instrument condition the auditory cortex with the visual and the superior frontal areas. Both stimuli activate the precuneus and posterior cingulate, with a concomitant deactivation of the salience network, only for the instrumental condition. In line with adult studies, the singing voice condition, activating the somatomotor network, evokes proprioceptive and motor aspects of the auditory perception, in addition to the salience network - filtering relevant elements of the vocal stimulus. The right temporal gyrus – sensitive to speech stimuli – is activated only by singing voice in a lateralized manner.
Conclusions
Distinct brain activations for instrumental and vocal melodies were found in newborns. When sang, the same melody activates brain regions evoking body experience and regions important for filtering of relevant stimuli, in comparison to instrumental melodies.