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A genetic etiology is identifiable in 20%–30% of patients with congenital heart defects (CHD). Chromosomal microarray analysis (CMA) can detect copy number variants (CNV) associated with CHD. In previous studies, the diagnostic yield of postnatal CMA testing ranged from 4% to 28% in CHD patients. However, incidental pathogenic CNV and variants of unknown significance are often discovered without any known association with CHD. The study objective was to describe the rate of pathogenic CNV associated with neurodevelopmental impairment (NDI) and compare clinical findings in CHD neonates with genetic results. A single‐center retrospective review was performed on all consecutive newborns with CHD admitted to a tertiary neonatal intensive care unit from January 2013 to March 2019 (n = 525). CHD phenotypes were classified as per the National Birth Defect Prevention Study. CMA detected pathogenic CNV in 21.3% (61/287) of neonates, and karyotype or fluorescence in situ hybridization detected aneuploidies in an additional 11% of the overall cohort (58/525). Atrioventricular septal defects and conotruncal defects showed the highest diagnostic yield by CMA (28.6% and 27.2%, respectively). Among neonates with pathogenic CNV on CMA, 78.7% (48/61) were associated with NDI. Neonates with pathogenic CNV were smaller in length at birth compared to those with benign CNV or variants of unknown significance (p = 0.005) and were more likely to be discharged with an enteral feeding tube (p = 0.027). CMA can discover genetic variants associated with NDI and are common in neonates with CHD. Genetic testing in the neonatal period can heighten awareness of genetic risk for NDI. [ABSTRACT FROM AUTHOR]

PURPOSE OF THE STUDY: This study aims to better understand chronic urticaria (CU) in pediatric patients, including its prevalence, clinical characteristics, relevant laboratory findings, and factors linked to remission to improve guidance for management in children. STUDY POPULATION: This study included 185 pediatric patients with an established chronic urticaria diagnosis followed at a single medical center in Barcelona, Spain from January 2015 to November 2021. METHODS: Clinical, demographic, and laboratory data were collected for 185 patients; 110 charts were reviewed retrospectively and 75 prospectively. Remission was defined as not requiring treatment while asymptomatic for over 6 months. RESULTS: Chronic spontaneous urticaria (CSU) (74.6%) was more common than chronic inducible urticaria (25.4%). Atopic comorbidities were found in 35% of patients, of which atopic dermatitis and allergic rhinitis were most common. Pre-existent psychiatric comorbidities were present in 9% of patients. Autoimmune disease was a comor-bidity for 8% of patients and was only found in the CSU group. Most patients (64.5%) were prescribed only a standard dose second-generation oral antihistamine but 25.8% needed up-dosing of second-generation oral antihistamines and 9.3% required a biologic. The estimated median time to remission was 36.3 months. CONCLUSIONS: The prevalence of atopic, autoimmune, and psychiatric conditions linked to CU was consistent with results in other pediatric studies. Significant laboratory markers included basopenia and positive basophil activation test, both of which were significantly associated with CSU subtype. Interestingly, autoimmune conditions were exclusively present in patients with CSU subtype. Female gender, associated angioedema, presence of inducible factors, and lower eosinophil count were found to be predictors of prolonged time to remission. Most patients were successfully managed with standard doses of second-generation antihistamines but median time to remission was still about 3 years. REVIEWER COMMENTS: This study confirmed the strong association between atopy and CSU, likely caused by common underlying pathophysiology. It may be worth exploring CU in relation to autoimmune and psychiatric comorbid-ities. Laboratory work is not currently part of the diagnostic criteria for CSU and further exploration needs to occur to determine clinical relevance of these markers. Standard therapy with antihistamines is largely effective, but CU often takes years to remit. Additional prospective studies with longer follow up time are needed to improve the management of pediatric patients with CU. [ABSTRACT FROM AUTHOR]

PURPOSE OF THE STUDY: This study aimed to explore the relationship between the childhood asthma and anxiety in adolescence, specifically investigating whether anxiety precedes asthma or if asthma leads to development of anxiety. STUDY POPULATION: Children in Australia were randomly selected using the Medicare database and enrolled in the Longitudinal Study of Australian Children. In this study, a cohort of 4386 children born in 2004 (B cohort) and another of 4983 children in kindergarten in 2004 (K cohort) were included. Data were analyzed at age 4 to 5 years and again at age 14 to 15 years, with 3127 from B cohort and 3537 from K cohort participating at age 14 to 15 years. METHODS: Asthma was defined by using primary caregiver responses to questions about diagnosis, medication use, and wheezing. To assess anxiety, parents completed the verified Strengths and Difficulties Questionnaire. Those above the 90th percentile were considered to have anxiety. Potential confounders such as sex, socioeconomic status, parental smoking, BMI, and ethnicity were also considered. Logistic regression models were used to evaluate the direction of the association between asthma and anxiety, using adjusted models for potential confounders. Statistical analysis included weights for primary sampling units and strata, and software R was used for analysis. RESULTS: A significant portion of children with asthma but not anxiety at age 4 to 5 years developed anxiety by age 14 to 15 years (22.6% in the B cohort and 21.6% in the K cohort). Children with asthma at 4 to 5 years old had a higher risk of anxiety at 14 to 15 years old compared with children without asthma (adjusted odds ratio 1.54 for B cohort, 1.87 for K cohort). In contrast, anxiety at baseline was not associated with risk of asthma at 14 to 15 years old. Development of anxiety was more likely in females. Both asthma and anxiety were associated with low socioeconomic status. CONCLUSIONS: This study found a strong association between childhood asthma and development of anxiety in the following decade, suggesting a causal role of asthma in the development of anxiety. [ABSTRACT FROM AUTHOR]

Stress is an established risk factor in the development of addiction and in reinstating drug seeking. Substance use disorder (SUD) is a dangerous epidemic that affects the brain and behavior. Despite this growing epidemic and its subsequent consequences, there are limited management and treatment options, pharmacotherapies and psychosocial treatments available. To this end, there is a need for new and improved personalized devices and treatments for the detection and management of SUD. Based on documented negative effects of stress in SUD, in this paper, our objective was to select a few significant physiological features from a set of 8 features collected by a chest-worn RespiBAN Professional in 15 individuals. We used three machine learning classifiers on these optimal physiological features to detect stress. Our results indicate that best accuracies were achieved when electrodermal activity (EDA), body temperature and chest-worn accelerometer were considered as features for the classification. Challenges, implications and applications were discussed. In the near future, the proposed methods will be replicated in individuals with SUD.