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Record W3011929389 · doi:10.1111/pai.13245

Persistent ventilation inhomogeneity after an acute exacerbation in preschool children with recurrent wheezing

2020· article· en· W3011929389 on OpenAlexaff
Krzysztof Kowalik, Ruixue Dai, Shahideh Safavi, Myrtha E. Reyna, Wendy Lou, C Lépine, Erica McDonald, Mirjam J. Schaap, May Brydges, Aimée Dubeau, Kathy Boutis, Indra Narang, Thomas Eiwegger, Theo J. Moraes, Félix Ratjen, Padmaja Subbarao

Bibliographic record

VenuePediatric Allergy and Immunology · 2020
Typearticle
Languageen
FieldMedicine
TopicAsthma and respiratory diseases
Canadian institutionsPublic Health OntarioUniversity of TorontoSickKids Foundation
FundersNational Institute for Health and Care Research
KeywordsMedicineEmergency departmentSpirometryAsthmaPediatricsExacerbationOutpatient clinicPulmonary function testingCohortInternal medicine

Abstract

fetched live from OpenAlex

Abstract Background Preschool children with recurrent wheezing suffer high morbidity. It is unclear whether objective measures of asthma control, such as pulmonary function tests (PFTs), provide additional information to the clinical assessment. Methods We recruited children between 3 and 6 years old, with a history of recurrent wheezing in the preceding year and treated for acute wheezing exacerbation in the emergency department (ED) into an observational cohort study. Children attended two outpatient visits: the first study visit within five days of discharge from the ED and the second study visit 12 weeks after the ED visit. We performed standardized symptom score (test for respiratory and asthma control in kids (TRACK)), multiple breath washout (MBW), spirometry, and clinical assessment at both visits. Results Seventy‐four children, mean (standard deviation (SD)) age of 4.32 years (0.84), attended both visits. Paired FEV 0.75 and lung clearance index (LCI) measurements at both time points were obtained in 37 and 34 subjects, respectively. Feasibility for all tests improved at visit 2 and was not age‐dependent. At the second study visit, a third had controlled asthma based on the TRACK score, and the mean lung clearance index (LCI) improved from 9.86 to 8.31 ( P = .003); however, 46% had an LCI in the abnormal range. FEV 0.75 z ‐score improved from −1.66 to −1.17 ( P = .05) but remained in the abnormal range in 24%. LCI was abnormal in more than half of the children with “well‐controlled” asthma based on the TRACK score. There was no correlation between PFT measures and TRACK scores at either visit. Conclusions Lung clearance index demonstrates a persistent deficit post‐exacerbation in a large proportion of preschoolers with recurrent wheezing, highlighting that symptom scores alone may not suffice for monitoring these children.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.017
Threshold uncertainty score0.392

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.010
GPT teacher head0.228
Teacher spread0.218 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations11
Published2020
Admission routes1
Has abstractyes

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