ABSTRACT The objective of this study was to summarize current evidence on the combined use of synchronized nasal intermittent positive pressure ventilation (sNIPPV) and less‐invasive surfactant administration (LISA) in the management of respiratory distress syndrome (RDS) in preterm infants. We conducted a narrative review of randomized controlled trials, comparative‐effectiveness studies, meta‐analyses, the 2022 European Consensus Guidelines on RDS, and recent clinical cohorts evaluating sNIPPV, LISA, and their combined application. Studies suggest that sNIPPV provides superior extubation tolerance and decreases apnea frequency compared with standard continuous positive airway pressure (CPAP). Compared with the intubation, surfactant administration, and extubation (INSURE) approach, LISA lowers early mechanical ventilation needs and decreases bronchopulmonary dysplasia (BPD) rates. When applied together, the two strategies appear to improve procedural stability and decrease the likelihood of re‐intubation, and may thus contribute to lower BPD rates due to their complementary physiologic effects. The sNIPPV–LISA combination is physiologically complementary and clinically promising. Current evidence supports a reduced rate of respiratory failure and a trend toward reduced BPD compared with CPAP and the INSURE technique of surfactant administration. Larger randomized trials are required to determine its effects on long‐term outcomes.
ABSTRACT Children with language and speech disorders account for approximately 5%–12% of children have language and speech disorders globally. Understanding the cognitive abilities of these children is crucial for identifying how cognitive skills influence speech fluency, language production, and planning effective intervention programs. Subtle differences in cognitive performance have been noted to affect developmental language skills. Therefore, we aimed to compare the cognitive abilities of children with language impairments and stuttering to typically developing controls. Our study was conducted on 69 children. The children were divided into three groups. The first and second groups consisted of children with language/speech impairments and fluency disorders, whereas the third group consisted of typically developing peers. We used standardized methods to assess the children's speech, language, fluency, and cognitive skills. The results demonstrated that although children with language impairments and stuttering had IQ scores that fell within the normal range, their verbal IQ and working memory scores showed specific differences from their typically developing peers. These findings suggest that cognitive abilities should be assessed and monitored in children with communicative disorders, even when overall IQ scores fall within the average range. Subtle differences in cognitive skills may affect speech fluency and language development.
ABSTRACT This study aimed to provide a theoretical basis for improving early diagnosis and complication prevention by exploring the latent classes of pediatric bronchial foreign body complications, analyzing their associated factors, and assessing the impact of different latent classes on healthcare resource utilization. Children who underwent bronchoscopic foreign body removal at the Children's Hospital of Chongqing Medical University from January 1, 2018 to July 31, 2023, were retrospectively reviewed. Latent class analysis was performed on complications with an incidence > 10% (including pneumonia, pulmonary emphysema, granulation tissue, bronchial stenosis, atelectasis, and pulmonary consolidation). Logistic regression was used to identify risk factors among different latent complication classes, and comparative analyses compared healthcare resource utilization. Among the 238 included children, complications with an incidence exceeding 10% were analyzed and clustered into four latent classes: the “Pneumonia Group” (C1, 40 cases, 16.8%), the “Pneumonia‐Atelectasis Group” (C2, 33 cases, 13.9%), the “Emphysema‐Granulation tissue Group” (C3, 106 cases, 44.5%), and the “Bronchial Stenosis‐Granulation tissue Group” (C4, 59 cases, 24.8%). Results identified a history of foreign body aspiration, asymmetric breath sounds, C‐reactive protein ≥ 8 mg/L, and neutrophil percentage as associated factors (p < 0.05). Healthcare resource utilization was significantly lower in groups C3 and C4 regarding hospital stay, treatment costs, and antibiotic days compared to C1 and C2 (p < 0.05). These latent classes offer theoretical support and practical reference for early diagnosis, complication prevention and diagnosis‐related group‐based payment optimization.
ABSTRACT Airway epithelial cells contribute critically to the initiation of allergic airway inflammation via the release of alarmins such as interleukin‐33 (IL‐33). Nevertheless, the intracellular regulatory networks governing epithelial alarmin release remain inadequately defined. Although autophagy has been implicated in epithelial stress adaptation and the transcription factor early growth response 1 ( EGR1 ) is promptly induced upon allergen challenge, it remains uncertain whether EGR1 contributes to IL‐33 release as a representative indicator of epithelial activation through autophagy‐associated processes. In this study, human bronchial epithelial BEAS‐2B cells were exposed to house dust mite (HDM) extract. EGR1 expression was manipulated using gain‐ and loss‐of‐function strategies. Autophagy‐associated alterations were evaluated by monitoring LC3B, p62, and PI3K‐III (Vps34) levels, together with immunofluorescence microscopy. IL‐33 release into culture supernatants was quantified by ELISA as a functional readout of epithelial activation. Pharmacological interference with autophagy was employed to examine functional engagement. An HDM‐driven murine model was utilized to assess in vivo correlates. Publicly accessible transcriptomic datasets were interrogated in an exploratory manner to characterize epithelial stress signatures linked to this axis. HDM treatment upregulated EGR1 in airway epithelial cells, concomitant with autophagy‐associated alterations and enhanced IL‐33 release. Forced EGR1 expression coincided with elevated LC3B‐II levels, diminished p62 accumulation, and increased PI3K‐III abundance, whereas EGR1 silencing produced reciprocal effects. Pharmacological suppression of autophagy attenuated IL‐33 release and inhibition of Class III PI3K blunted the EGR1 overexpression‐driven increase in IL‐33 release. In HDM‐challenged mice, colocalization of EGR1 and LC3B was observed in lung tissue sections. Exploratory transcriptomic profiling further suggested that allergen provocation may elicit a coordinated epithelial stress response characterized by inflammatory and metabolic pathway enrichment. The results show that EGR1 is associated with epithelial autophagy‐related alterations under allergic stimulation, and these changes are accompanied by augmented release of the alarmin IL‐33. These observations support a conceptual framework wherein EGR1 ‐linked autophagy‐associated processes may contribute to epithelial stress responses during early inflammatory events in allergic airway disease. Elucidation of the precise molecular underpinnings and causal relationships awaits further investigation.
ABSTRACT This scoping review maps and compares evidence on enhanced or modified Family‐Centered Care (FCC) models—including Family Integrated Care (FICare) and related variants—against standard FCC/usual neonatal intensive care unit (NICU) care for preterm infants. We aimed to summarize the comparative effects on neonatal growth and development, feeding and hospital utilization metrics, parental engagement, and parental psychosocial outcomes, and to describe program characteristics and contextual factors reported alongside variation in results across settings. We included diverse study designs conducted in NICUs across multiple regions. Growth‐related outcomes were the most commonly reported domain: 30 studies assessed weight gain, growth velocity, feeding progression, discharge weight, or breastfeeding, and 15 studies explicitly reported better growth or feeding‐related outcomes with enhanced FCC/FICare than with standard FCC/usual care. Developmental outcomes were reported in 12 studies, parental psychosocial outcomes in 25 studies, hospital utilization metrics in 28 studies, and parental engagement measures in 22 studies. Benefits were most often described in programs that combined structured parent education with active bedside caregiving, participation in rounds, mentoring, or other implementation supports, although findings varied by program intensity, unit context, and implementation fidelity. Overall, the evidence supports enhanced FCC/FICare as a promising strategy for improving infant–family outcomes in NICUs, while highlighting the need for clearer component definitions, standardized outcome reporting, and longer‐term follow‐up to support scalable, sustainable implementation.
