Monitoring Of Children Research Articles

Caregiver satisfaction with the use of continuous glucose monitoring and flash glucose monitoring in very young children with type 1 diabetes

BackgroundNew technologies for the management of children with type 1 diabete (T1D) are constantly and rapidly evolving. However, few real-life studies have been conducted, and rarely in the youngest patients (<6 years). AimTo study parental satisfaction with continuous and flash glucose monitoring devices in young children with T1D. MethodsA questionnaire was completed by the parents of 114 children under the age of 6 years with T1D treated with an insulin pump followed-up in one of the hospitals of the French ADIM network between January and July 2020. ResultsOne hundred and nine patients (96 %) were equipped with a glucose monitor and 95 % (104/109) of parents stated that they were satisfied or very satisfied with their child's monitoring device, with no significant difference in satisfaction rates between flash and continuous glucose monitoring. The parameter most strongly associated with satisfaction was confidence in the reliability of the device (p = 0.008). Parents who struggled to apply the device were significantly less satisfied (p = 0.024). In real-life use, 83 % of parents (90/109) used additional adhesives, 28 % reported mild skin reactions (30/108) and 39 % severe skin reactions (42/108), 50 % stated that applying the device was not painful, and 95 % found the device easy to apply. The most commonly reported unexpected difficulties were device malfunction (by 16 respondents), the device being too large and causing scarring (6 respondents), and lengthy calibration (6 respondents). ConclusionThe vast majority of parents in this group of young children with T1D were satisfied with continuous or flash glucose monitoring. Satisfaction was strongly associated with confidence in the reliability of the device. Reported adverse effects such as skin reaction and difficulties attaching the device highlight the importance of data on real-life use.

Machine Learning Approach to Injury Monitoring in Children and Adolescents

Abstract Pediatric injuries are common and associated with individual suffering and costs for the healthcare systems and society. The incidence of injuries among children in Switzerland has so far been insufficiently monitored. Emergency department patient records can be a valuable database to assess medically relevant injuries and gain information for monitoring and evidence-based prevention. The talk will outline our stepwise development of a machine-learning program for a pediatric injury monitoring system and lessons learnt. In this feasibility study we draw on electronic case histories of children treated for injuries between 2018 and 2022 at the University Children’s Hospital Zürich emergency department (N= to 30’884). The ML- approach follows different steps: step 1. utility evaluation of electronic pediatric patient records regarding ML and injury monitoring and prevention requirements in a test-sample of 100 electronic pediatric case histories; step 2. choice/adaptation of coding tree; step 3. coder training and inter-coder reliability testing; step 4. manual annotation of a sub-sample (n 1000) of the electronic pediatric patient records, step 5. design and testing of the ML program in an iterative process, and step 6. performance testing in a random sample of pediatric patient records. First lessons learnt indicate that electronic case history data contain relevant data and fulfill requirements for monitoring and prevention purposes. The IDB coding system proved too complex and detailed for the pediatric data base, providing too few examples for the ML-learning process, and needed to be adapted. Initial data analyses indicate the majority of cases are classified as less severe (73%) and only few (&amp;lt;1%) as very severe but the later provide the most detailed data. ML is a promising approach and makes use of hospital data for a national monitoring of pediatric injuries in Switzerland.

Machine Learning powered Patient Records Analysis for Injury Monitoring in Children and Adolescents

Abstract Background Injuries to children and adolescents are common and are associated with individual suffering and costs. Switzerland lacks data of injuries in children and adolescents. This study investigates the feasibility of utilizing machine learning (ML) methodology to automatically extract relevant data from electronic pediatric patient records needed for monitoring and prevention purposes. Methods The feasibility study follows three steps. 1. Utility evaluation of text data from electronic pediatric patient records regarding ML, injury monitoring and prevention requirements in a test-sample. 2. The development of an ML-based approach to extract relevant information based on electronic pediatric patient records (N = 30’884) of children treated for injuries at the University Children’s Hospital Zurich emergency department between 2018-2022. 3. The performance of the ML methodology is evaluated. Results Qualitative and ML expert assessment of the sample showed that the desired data on injuries is contained in the test-sample and necessary requirements are met. Data records differ in detail with severe injuries providing especially rich information records. The international IDB code-tree was proved to be too elaborate and adult-orientated and was adapted. Preliminary data analyses indicate that the number of accidents is highest in the age group from 0 to 4 years (36%). More male (58%) children were treated. Majority of accidents were classified as less severe (73%), few (&amp;lt;1%) as very severe. Further lessons learned, along with more detailed prevalence data on injuries in children and adolescents, will be available by August 2024. Conclusions Extraction of injury information from electronic patient record by means of ML may provide valuable information for injury monitoring and prevention, so far missing in Switzerland. Prerequisites for the successful application of ML are digital record access, usable coding-tree, and detailed text input by the emergency departments. Key messages • An ML-based approach has the potential to improve the data basis by extracting valuable accidents information from existing texts of patient records. • To successfully apply this method, digital record access and detailed text data are needed.

Utilization of Ambulatory Blood Pressure Monitoring in Children and Adolescents With Hypertension.

Utilization of Ambulatory Blood Pressure Monitoring in Children and Adolescents With Hypertension.

7354 A Case of Continuous Glucose Monitoring in Children with Glutamate Dehydrogenase Hyperinsulinism

Abstract Disclosure: K. Kim: None. E. Mun: None. C. Jung Eun: None. R. Lee: None. K. Hae Soon: None. A Case of Continuous Glucose Monitoring in Children with Glutamate Dehydrogenase(GLUD1) Hyperinsulinism Background: Continuous glucose monitoring (CGM) is increasingly being used in pediatric patients with diabetes. CGM can help prevent hypoglycemia and support the management of hypoglycemic problems. Congenital hyperinsulinism is a rare condition in which hypoglycemia occurs due to hyperinsulinemia caused by the dysregulation of insulin secretion, and it can lead to complications such as developmental delay and seizures. Case presentation: A 14 months years old, male infant was referred to the pediatric emergency room representing symptoms of GTC type seizure during 2-3 minutes and hypoglycemia. He had no perinatal problems with no significant family history. During seizure, He was found to have a blood glucose of 39mg/dL, ammonia of 183μmol/L, insulin of 28.3 mcg/mL and ketone 203.4μmol/L. C-peptide was 1.4 ng/mL (≥ 0.5ng/mL) and free fatty acid was 0.492mmol/L (&amp;lt;1.7mmol/L) for evaluation. He was thought to have GDH hyperinsulinism. Blood glucose level was followed up with feeding frequency and protein restricted diet. Congenital hyperinsulinism genetic test was requested. Brain CT showed normal. EEG revealed no focal abnormalities, no persistent asymmetries. CGM was used in patient. Diazoxide was started with 5mg/kg/day in 2 divided doses and then blood glucose level was observed below 60mg/dL 3-4 times for day. Complete blood counts and uric acid levels were measured at baseline and 5 days after starting diazoxide therapy, and thereafter increase to 6.25mg/kg/day Conclusions: In children with GDH hyperinsulinism, the utilization of CGM can serve as a tool to assess the impact of treatment before and after medication therapy, as well as also aiding in hypoglycemia prevention. Presentation: 6/2/2024

Determination of l-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center.

Among malignant diseases which develop during childhood, hematological cancers, such as leukemias and lymphomas, are the most common. Outcomes have greatly improved due to the refinement of multiagent chemotherapy regimens that include enhanced asparaginase therapy. In this study, we aimed to evaluate our experiences related to the analytical and clinical significance of determining l-Asparaginase activity. Since 2016, the Laboratory of the Children's Hospital Zagreb has routinely measured l-Asparaginase activity and to date, has measured more than 280 examples of activity in a total of 57 children with hematological malignancy treated at the Pediatric Oncology Department of the Children's Hospital Zagreb. Three asparaginase products were available: native E. colil-Asparaginase; a pegylated form of this enzyme; and a native product from Erwinia chrysanthemi. A retrospective data analysis was performed. Out of the fifty-seven children, seven had an allergic reaction (12.3%), five (8.8%) had silent inactivation, and seven (12.3%) developed acute pancreatitis. Allergic reactions and silent inactivation were more common in children treated with native E. colil-Asparaginase, while pancreatitis was more common in children treated with the pegylated form. The monitoring of l-Asparaginase activity may help to optimize therapy by identifying patients with 'silent inactivation', and/or by dose correction when l-Asparaginase activity is too high (slow elimination).

Is Prone Positioning Worth the Turn in Pediatrics? Unraveling the Oxygenation Mystery in Ventilated Patients with Acute Respiratory Distress Syndrome: An Observational Study Introducing a Novel SF Ratio Method for Non-Invasive Monitoring in Children

Background: Respiratory illnesses are prevalent among children, attributed to factors such as immature immune systems, anatomical variations, and increased susceptibility to infections. Acute respiratory distress syndrome (ARDS) is a significant cause of morbidity and mortality, necessitating various forms of respiratory support in pediatric intensive care units (PICUs). Prone positioning has emerged as a strategy to improve oxygenation in ARDS, but its effectiveness and correlation with non-invasive monitoring parameters remain underexplored.&#x0D; Subjects and Methods: This prospective observational study, conducted in the PICU of Dr. B.C Roy PGIPS, Kolkata, aimed to assess the impact of prone ventilation on oxygenation in children diagnosed with ARDS. The study, spanning 18 months, included 40 patients aged 3 months to 12 years requiring mechanical ventilation. Parameters such as oxygenation index (OI), oxygen saturation index (OSI), PF ratio, and SF ratio were monitored at different time points during supine and prone ventilation. Prone positioning's effectiveness was evaluated based on improvements in these parameters.&#x0D; Results: The study revealed a significant improvement in oxygenation status after four hours of prone ventilation compared to supine ventilation. Oxygenation index, OSI, SF ratio, and PF ratio showed statistically significant changes favoring prone positioning. A strong positive correlation between SF ratio and PF ratio was observed at various time points, emphasizing the potential of SF ratio as a non-invasive alternative. Responders and non-responders to prone positioning were identified based on predefined criteria, highlighting individual variability in treatment response.&#x0D; Conclusion: Prone ventilation demonstrated significant improvements in oxygenation parameters in children with ARDS. The study supports the use of non-invasive SF ratio as a reliable substitute for PF ratio, simplifying monitoring without invasive arterial sampling. This finding has implications for improving ARDS management strategies in pediatric patients, offering a less cumbersome alternative for assessing oxygenation status.

Fifteen Years of Experience in Ambulatory Blood Pressure Monitoring in Children at a Single Center

Fifteen Years of Experience in Ambulatory Blood Pressure Monitoring in Children at a Single Center

Development of a Miniaturized Mechanoacoustic Sensor for Continuous, Objective Cough Detection, Characterization and Physiologic Monitoring in Children With Cystic Fibrosis.

Cough is an important symptom in children with acute and chronic respiratory disease. Daily cough is common in Cystic Fibrosis (CF) and increased cough is a symptom of pulmonary exacerbation. To date, cough assessment is primarily subjective in clinical practice and research. Attempts to develop objective, automatic cough counting tools have faced reliability issues in noisy environments and practical barriers limiting long-term use. This single-center pilot study evaluated usability, acceptability and performance of a mechanoacoustic sensor (MAS), previously used for cough classification in adults, in 36 children with CF over brief and multi-day periods in four cohorts. Children whose health was at baseline and who had symptoms of pulmonary exacerbation were included. We trained, validated, and deployed custom deep learning algorithms for accurate cough detection and classification from other vocalization or artifacts with an overall area under the receiver-operator characteristic curve (AUROC) of 0.96 and average precision (AP) of 0.93. Child and parent feedback led to a redesign of the MAS towards a smaller, more discreet device acceptable for daily use in children. Additional improvements optimized power efficiency and data management. The MAS's ability to objectively measure cough and other physiologic signals across clinic, hospital, and home settings is demonstrated, particularly aided by an AUROC of 0.97 and AP of 0.96 for motion artifact rejection. Examples of cough frequency and physiologic parameter correlations with participant-reported outcomes and clinical measurements for individual patients are presented. The MAS is a promising tool in objective longitudinal evaluation of cough in children with CF.

Analysis of Hearing Monitoring in Children during Annual Visits to an Outpatient Hearing Health Service Program

Preserving the integrity of the auditory system is crucial for language development, learning, and social interaction. Any interruption in these processes during development can result in significant functional impairments. The objective was to carry out a longitudinal analysis of audiological data from children who underwent an initial assessment at SASA in 2018 and were followed up for 4 years at the outpatient's annual consultations. This is a retrospective cross-sectional study with children who underwent initial assessment for hearing loss and follow-up at a reference service for the Unified Health System (SUS), from January 2018 to December 2022. Children aged 0 to 12 years old who underwent an initial assessment for hearing loss and follow-up in the service's database, where secondary data analyses will be carried out. Data from 127 subjects with an average age of 20 months were analyzed. 60.62% of the subjects were diagnosed with some degree of hearing loss, and the etiology of the change remained unknown in 29.90% of the cases. A considerable percentage of subjects remained under follow-up during annual consultations. There was good adherence to annual returns and follow-ups at the outpatient clinic, indicating a high attendance rate.

The Quality Of Growth Monitoring In Children By Integrated Healthcare Center Cadres

Latar Belakang: Pemantauan tumbuh kembang pada anak merupakan salah satu alat untuk mengetahui status gizi anak. Prevalensi berat badan kurang adalah 19,6% yang terdiri dari 5,7% gizi buruk dan 13,9% gizi kurang. Banyak faktor yang mempengaruhi pemantauan tumbuh kembang anak di tingkat Puskesmas diantaranya adalah anak yang ditimbang, alat penimbangan yang digunakan, cara menimbang, cara mencatat hasil penimbangan ke dalam grafik pertumbuhan, cara menginterpretasikan hasil penimbangan, dan tindakan yang harus dilakukan kader sesuai hasil penimbangan.Tujuan: Untuk mengetahui kualitas pemantauan tumbuh kembang anak yang dilakukan oleh kader Puskesmas Terpadu Puskesmas Sukaraja Tiga Kecamatan Marga Tiga Kabupaten Lampung Timur.Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain deskriptif. Populasi penelitian ini adalah kader Puskesmas Sukaraja Tiga yang tercatat berada di wilayah kerja Puskesmas Sukaraja Tiga sebanyak 160 orang dan berasal dari 32 Puskesmas yang berada di wilayah Puskesmas Sukaraja Tiga. Sampel dalam penelitian ini berjumlah 160 kader. Teknik pengambilan sampel yang digunakan dalam penelitian ini adalah total sampling. Analisis data menggunakan analisis data univariat.Hasil: Penelitian ini menunjukkan bahwa 100 (62,5%) responden melakukan penimbangan dengan baik, 102 (63,8%) responden mencatat hasil penimbangan dengan baik, dan 110 (68,8%) responden kurang mengartikan hasil pemantauan tumbuh kembang pada anak.Kesimpulan: Kualitas pemantauan tumbuh kembang balita oleh kader posyandu berdasarkan cara menginterpretasikan hasil penimbangan ke KMS didapatkan 110 (68,8%) responden menginterpretasikan hasil pemantauan tumbuh kembang balita di cara yang tidak baikSaran kepada Puskesmas Sukaraja Tiga untuk dapat melakukan pembinaan lebih rutin seperti melakukan penyuluhan tentang grafik pertumbuhan dan cara pengisiannya untuk meningkatkan keterampilan kader mengenai pemantauan pertumbuhan pada anak. Kata Kunci : Penimbangan, Pencatatan, Interpretasi Hasil, Kader ABSTRACT Background: Growth monitoring in children is a tool to determine the nutritional status of the children. The prevalence of underweight is 19.6% consisting of 5.7% of malnutrition and 13.9% undernourished. Many factors affect the growth monitoring in children at the integrated healthcare center level including the children who are weighed, the weighing equipment used, the way how to weigh, how to record the weighing results into the growth chart, how to interpret the weighing results, and actions that must be taken by cadres according to the weighing results.Purpose: To determine the quality of growth monitoring in children by integrated healthcare center cadres at the Sukaraja Tiga public health center, Marga Tiga District, East Lampung Regency.Methods: This study is a quantitative study with a descriptive design. The population of this study were 160 integrated healthcare center cadres who are recorded as being in the work area of Sukaraja Tiga public health center and are from 32 integrated healthcare centers located in Sukaraja Tiga public health center area. The sample in this study was 160 cadres. The sampling technique used in this study was total sampling. The data analysis used univariate data analysis.Results: This study showed that 100 (62.5%) respondents carried out the weighing well, 102 (63.8%) respondents recorded the results of weighing well, and 110 (68.8%) respondents poorly interpreted the results of growth monitoring in children.Conclusion: The quality of monitoring the growth of children under five by posyandu cadres based on the way of interpreting the results of weighing to KMS, it was found that 110 (68.8%) respondents interpreted the results of monitoring the growth of children under five in a way that was not goodSuggestion that Sukaraja Tiga public health center can provide more routine guidance such as conducting counseling about the growth chart and how to fill it out to improve cadres’ skills regarding growth monitoring in children. Keywords : Weighing, Recording, Results Interpretation, Cadres

Update on Ambulatory Blood Pressure Monitoring in Children

Update on Ambulatory Blood Pressure Monitoring in Children

The Role of Therapeutic Drug Monitoring in Children.

The use of biologic therapies has changed the treatment landscape for children with inflammatory bowel disease. While the novel biologics have improved clinical outcomes, there remains a significant gap in achieving endoscopic remission, prolonged steroid-free remission, and drug durability. Contributing to this gap is the paucity of real-world pharmacokinetic studies in children and a failure to dose optimize therapy during induction. Emerging data from a pediatric clinical trial and several observational studies have shown that the combination of proactive therapeutic drug monitoring and achievement of early therapeutic concentrations is effective in achieving improved outcomes. The next steps will be to leverage these past studies to develop more innovative clinical trials to properly assess the safety and effectiveness of proactive therapeutic drug monitoring in children.

Therapeutic Drug Monitoring in Children and Adolescents: Findings on Fluoxetine from the TDM-VIGIL Trial.

Fluoxetine is the recommended first-line antidepressant in many therapeutic guidelines for children and adolescents. However, little is known about the relationships between drug dose and serum level as well as the therapeutic serum reference range in this age group. Within a large naturalistic observational prospective multicenter clinical trial ("TDM-VIGIL"), a transdiagnostic sample of children and adolescents (n = 138; mean age, 15; range, 7-18 years; 24.6% males) was treated with fluoxetine (10-40 mg/day). Analyses of both the last timepoint and all timepoints (n = 292 observations), utilizing (multiple) linear regressions, linear mixed-effect models, and cumulative link (mixed) models, were used to test the associations between dose, serum concentration, outcome, and potential predictors. The receiver operating curve and first to third interquartile methods, respectively, were used to examine concentration cutoff and reference values for responders. A strong positive relationship was found between dose and serum concentration of fluoxetine and its metabolite. Higher body weight was associated with lower serum concentrations, and female sex was associated with lower therapeutic response. The preliminary reference ranges for the active moiety (fluoxetine+norfluoxetine) were 208-328 ng/mL (transdiagnostically) and 201.5-306 ng/mL (depression). Most patients showed marked (45.6%) or minimal (43.5%) improvements and reported no adverse effects (64.9%). This study demonstrated a clear linear dose-serum level relationship for fluoxetine in youth, with the identified reference range being within that established for adults.

Microcirculatory Monitoring in Children with Congenital Heart Disease Before and After Cardiac Surgery

In this prospective observational study, we investigated whether congenital heart disease (CHD) affects the microcirculation and whether the microcirculation is altered following cardiac surgery with cardiopulmonary bypass (CPB). Thirty-eight children with CHD undergoing cardiac surgery with CPB and 35 children undergoing elective, non-cardiac surgery were included. Repeated non-invasive sublingual microcirculatory measurements were performed with handheld vital microscopy. Before surgery, children with CHD showed similar perfused vessel densities and red blood cell velocities (RBCv) but less perfused vessels (p < 0.001), lower perfusion quality (p < 0.001), and higher small vessel densities (p = 0.039) than children without CHD. After cardiac surgery, perfused vessel densities and perfusion quality of small vessels declined (p = 0.025 and p = 0.032), while RBCv increased (p = 0.032). We demonstrated that CHD was associated with decreased microcirculatory perfusion and increased capillary recruitment. The microcirculation was further impaired after cardiac surgery. Decreased microcirculatory perfusion could be a warning sign for altered tissue oxygenation and requires further exploration.Graphical abstract

Serum Prolactin Level Monitoring in Children and Adolescents on Antipsychotic Treatment: Evaluating the Current Practice in Al Ain, United Arab Emirates

AimsThe use of antipsychotics in children and adolescents requires close supervision in a specialist clinic. The decision to commence antipsychotics should be made jointly with the young person, their parents, carers, and healthcare professionals. It is critical to provide age-appropriate information and discuss the possible benefits and side effects, including raised serum prolactin levels, potentially leading to serious consequences such as reduced bone density and abnormal pubertal development. This audit aimed to appraise the antipsychotic prescribing practice in children and adolescents in psychiatric outpatient clinicians in Al Ain Hospital, United Arab Emirates. The authors analysed the compliance against the standards set out in The National Institute for Health and Clinical Excellence (NICE) Clinical Guidance 155 concerning monitoring prolactin levels in children on antipsychotic medications at baseline, 12 weeks, and every six months thereafter.MethodsThis Hospital-wide audit involved a retrospective review of case notes. A questionnaire was developed to capture the required information anonymously. The audit sample comprised 135 children under the age of 16 who were on antipsychotics for more than six months and were followed up in the child psychiatry clinic between January 2018 and December 2019. We chose this pre-Coronavirus Disease 2019 (COVID-19) period when services were running as usual. Data collection took place between September and December 2022.ResultsOut of 135, 28 (21%) patients were males, with 51 (38%) being Emirati citizens. The sample age ranged between 6 and 16 years, with a mean of 13.5 years. Risperidone was the most commonly used antipsychotic. The majority of patients (63%) had a diagnosis of psychosis in the context of Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder, and intellectual disability. None of the patients had a baseline prolactin measurement performed, while only 10 (7%) had prolactin levels checked at 12 weeks. No patient had prolactin levels checked at six-monthly intervals.ConclusionThis audit has identified a clear need to develop local guidance on monitoring antipsychotic side effects in children and adolescents. We recommend enhanced staff training in monitoring for the relevant side effects and introducing a mechanism to electronically alert the prescribing clinician when the time of monitoring is due. We suggest educating the patients about symptoms of high prolactin levels and re-audit the practice after one year of implementing the above action plan.No financial sponsorship has been received for this evaluative exercise.

Design and Development of Information Systems for Data Collection and Monitoring of Children's Growth and Development as an Effort to Prevent Stunting in Kotapari Village

Stunting is one of the problems being faced by Kotapari Village. The absence of an information system about stunting that is easily accessible to the public is one of the aspects that has slowed down the resolution of the stunting problem. To accelerate the resolution of the stunting problem, it is considered necessary to have an information system that can help the community easily and quickly. Methods of data collection is done by interviews and observation. In this study the system development method used is waterfall with the supporting software used are PHP and MySQL. Seeing the reality above, it is deemed necessary to build a website-based information system that is useful to facilitate Kotapari Village and the Community in working to resolve the stunting problem in Serdang Bedagai Regency. Apart from being able to provide stunting information to the community, this application also has a child health check menu related to child growth and a discussion menu that can be used by the community to communicate with Kotapari Village.

A sustainable energy strategy powered wireless sensor network system for monitoring child safety

Children's safety education and environmental monitoring are the stability of a family and the foundation of a country's future development. Therefore, the safety of young children is never an independent problem in any aspect, nor is it a problem solved afterwards, but a long-term problem with monitoring effect. We need to use all accurate information to prevent potential safety hazards in advance and protect the healthy growth of children. In addition to using school resources to carry out health education for children, parents and society can also take precautions. The place environment of the kindergarten is a security system with an internal structure, from the equipment in the kindergarten to the dynamic monitoring. Many countries use sensor networks to achieve security monitoring in various fields. We can also use similar methods in terms of child safety. This paper constructs a system model based on sustainable energy strategy powered wireless sensor network system, and optimizes it to adapt to the safety monitoring system of children's external environment. First of all, based on child safety management and environmental education, this paper uses literature survey, questionnaire survey and other methods to study the current situation of attention to child safety in various countries. With this topic as the background, summarize the main problems faced by children's safety, and propose targeted solutions. According to the children's monitoring system, wireless sensor networks are used to build the monitoring system, and sustainable energy is used as the optimization mechanism of sensors. Finally, the sustainable Energy Strategy Powered Wireless Sensor Network System is applied to the children's environment system, and real-time data collection and remote monitoring are used to view children's activity information. Research shows that sustainable energy provides the endurance of wireless sensor safety monitoring system. This child safety monitoring system can be used in any environment and conditions, and has achieved good results.

Droplet Digital PCR Development for Adenovirus Load Monitoring in Children after Hematopoietic Stem Cell Transplantation

Human adenovirus (AdV) reactivation after hematopoietic stem cell transplantation (HSCT) is associated with life-threatening clinical manifestations. Although real-tme quantitative PCR (qPCR) has been widely used to measure AdV loads, it has not been standardized for AdV. Droplet digital PCR (ddPCR) is a novel pathogen detection technology that enables the absolute quantification of viral loads. ddPCR would enable a more accurate AdV DNA detection compared with qPCR. In this study, ddPCR was developed for AdV DNA and its performance characteristics compared with those of qPCR. AdV DNAemia incidence during the first 12 weeks after allogenic HSCT was then retrospectively examined by qPCR and ddPCR in 97 HSCT procedures using the preserved 545 DNA samples. ddPCR exhibited better reproducibility and sensitivity, as well as equivalent quantifiability, compared with qPCR. AdV DNA among HSCT patients was detected in 11 (2.0%) and 49 (9.0%) of 545 samples by qPCR and ddPCR, respectively. AdV DNA levels >1000 copies/mL were observed in five cases by qPCR and/or ddPCR. However, two patients developed fulminant hepatitis and died; other patients remained asymptomatic with subsequently undetectable AdV DNA. In conclusion, ddPCR was more sensitive and reproducible in detecting AdV DNA among pediatric HSCT recipients than qPCR. ddPCR offers the potential to provide a more accurate DNAemia detection, determine cutoff values for treatment initiation, and enable antiviral efficacy assessment.

Role of Orbital Ultrasound in the Monitoring of Children with Raised Intracranial Pressure—Prospective Observational Study Conducted in Tertiary Care Centre

AbstractOur objective was to evaluate the role of optic nerve sheath diameter measurement by orbital ultrasound in monitoring children with nontraumatic coma and increased intracranial pressure (ICP). A single-center prospective observational study was conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital in Puducherry, India. Children admitted to the PICU with features of raised ICP were enrolled. Baseline characteristics and raised ICP characteristics were recorded. Optic nerve sheath diameter (ONSD) measurements were taken in all children in the supine position using bedside ultrasound with a 12 MHz linear probe. The probe was initially placed in the axial plane, and measurements were taken at a distance of 3 mm posterior to the site at which the optic nerve enters the globe. Measurements were recorded sequentially 8th hourly till ICP features got resolved or the patient died. Along with each measurement, clinical parameters were recorded. The ONSD measurements were compared with clinical features. We also recruited children admitted to the PICU for other conditions without features of raised ICP as controls. We compared ONSD measurements of cases with controls. In total, 185 children were recruited, of which 81 had features of raised ICP and 104 were without increased ICP. The ONSD measurements in children with raised ICP were significantly higher as compared with those without ICP. Among children with raised ICP, there was a negative correlation between ONSD and Glasgow Coma Scale scores (r = −0.739, p ≤ 0.0001). In children with raised ICP, there was a significant difference in ONSD at different intervals, demonstrating a falling trend from admission to 32nd-hour readings. ONSD measurements were higher in children with clinical signs of increased ICP compared with controls, thereby suggesting that this noninvasive measure may be helpful in the neuromonitoring of children with neurologic insults.