0884 INFLAMMATORY FACTORS PRE AND POST ADENOTONSILLECTOMY IN PEDIATRIC OBSTRUCTIVE-SLEEP-APNEA
Bibliographic record
Abstract
Systemic inflammation is commonly advanced as related to pediatric obstructive-sleep-apnea. Increase in high-sensitive CRP has been shown in association with the syndrome, with decrease following adenotonsillectomy. Many inflammatory factors have been identified with complex interaction between factors. We performed a study of interleukines 17 and 23 that control other interleukines on children before and after adenotonsillectomy. Children between 6 to 16 years diagnosed with obstructive-sleep-apnea based on clinical evaluation, anatomic evaluation of upper-airway including classification of tonsils and nocturnal polysomnography that were submitted to adenotonsillectomy and prospectively followed with new evaluation 6 months post treatment. Blood samples were obtained at each evaluation and determination of plasma high-sensitivity-CRP, tumor necrosis factor alpha, interleukins 1,6,10,17,and 23. 31 children, mean age 7.5 ± 0.6 years,36% girls, had changed from pre to post surgery with a mean apnea-hypopnea-index of 15.95 versus 2.9 (p=0.006), a mean oxygen-desaturation-index of 13.7 versus 2.7 (p=0.005). Mean heart rate during sleep changed from 87 to 79 beats/minute (p=0.002).Inflammatory factors also decreased after surgery indicating improvement such as high-sensitivity-CRP (p=0.01),Tumor-necrotic-alpha(p=0.046), interleukines 1 (p=0.019), 17 (p=0.039).But interleukine 6 had no change (p=0.11), as did interleukin 10 (p=0.112) and interleukine 23 (p=0.224). Interleukin 6 was not significantly increased at entry compared to expected normal level and did not change. Adenotonsillectomy did not bring the total group to complete normal AHI despite clear overall improvement. If the pro-inflammatory interleukine 17, secreted predominantly by the T helper 17 cells,is significantly improved,the abnormal up-regulation of 17 appears to have decreased with surgery. The interleukine 23 was not significantly change despite the clinical improvement. Interleukine 23 is a cytokine with immunomodulatory effect. One of its reported activity is to differentiate naïve T cells into IL-17-producing TH17 cells. Adenotonsillectomy may not eliminate mouth-breathing, and persistence of mild sleep-disordered-breathing may still have a negative effect on inflammatory factors. Funding source Study supported by Taiwan Ministry of Science and Technology grant: NZRPG3D0021 and Chang Gung Memorial Hospital grant #: CRRPG5 C0172 and CRRPG5 C0173 to YS Huang
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".