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Rong Wu

and 5 more

Introduction: The goal of this study was to evaluate the association between maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG) and risk of childhood asthma/wheeze by conducting a meta-analysis of cohort studies. Methods: A systematic literature search of several databases was conducted through January 2020 to identify relevant studies. The exposure of interest was maternal pre-pregnancy BMI (e.g., underweight, overweight, obesity, and continuous BMI) and GWG (e.g., inadequate GWG, excessive GWG, GWG < 9 kg, GWG > 15 kg, and continuous GWG). Random-effects models were used to calculate the pooled odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Twenty-one cohort studies were included (N = 150,198 mother-child pairs). Age of children was 3 months to 16 years. Maternal overweight (OR = 1.13; 95% CI: 1.07 - 1.19) and obesity (OR = 1.39; 95% CI: 1.23 - 1.58) were associated with higher odds of childhood asthma/wheeze; each 1-kg/m2 increase in maternal pre-pregnancy BMI was associated with a 4% increase in the odds of childhood asthma/wheeze. GWG < 9 kg (OR = 1.08; 95% CI, 1.01 - 1.14) was slightly associated with higher odds of childhood asthma/wheeze. Subgroup analyses have identified several variables associated with the between-study heterogeneity. Conclusions: Maternal overweight and obesity are associated with an elevated risk of childhood asthma/wheeze, suggesting that maternal pre-pregnancy BMI need to be considered in studies on the early origins of asthma. Further studies are needed to confirm the association between GWG and risk of childhood asthma/wheeze.

Hiromi Tanabe

and 14 more

BACKGROUND: Chemokine (C-C motif) ligand 17 (CCL17; also known as thymus and activation-regulated chemokine or TARC) is a pro-allergic factor, and high CCL17 levels in cord blood (CB) precede the allergic predisposition later in life. Offspring of pregnant mice treated with short-chain fatty acid (SCFA) have been shown to be protected against allergic diseases. The maternal microbial metabolome during pregnancy may affect foetal allergic immune responses. To examine this, the associations between CB CCL17 and gut SCFA levels in pregnant Japanese women were investigated here. METHODS: This study was conducted as part of the Chiba Study of Mother and Child Health; 434 healthy pregnant women were recruited. The CB CCL17 and maternal non-specific IgE levels were measured using CB sera at birth and maternal sera at 32 weeks of gestation. Stool samples were collected from pregnant women at 12 (n = 59) and 32 (n = 58) weeks of gestation and used for gut microbiota analysis, based on barcoded 16S rRNA sequencing and metabolite levels. RESULTS: The CB CCL17 levels correlated negatively with butyrate concentrations at 12 weeks of gestation. In contrast, CB CCL17 levels correlated positively with isobutyrate levels at 12 weeks of gestation, and valerate and lactate concentrations at 32 weeks of gestation in maternal faeces. CONCLUSION: The metabolites in maternal faeces may alter the foetal immune responses. This study provides the first link between maternal metabolites during pregnancy and the risk of allergic diseases in human offspring, even before birth.

Shayan Shahidi

and 4 more

Objective: To determine the number of academic papers which have been submitted and published by ENT specialty trainees at each level of higher surgical training. Design: A cross-sectional survey was designed and validated according to the ‘Good Practice in Conduct of and Reporting of Survey Research’ checklist. Settings: Voluntary completion of a web-based questionnaire which was distributed to participants between 11 May – 22 June 2020. Participants: All ENT higher surgical trainees (ST3-ST8 level) in the UK. Main outcomes measured: The number of submitted and published articles by each higher surgical trainee. Comparisons were made between deaneries, training grades and trainees who had achieved a higher degree. Trainees in academic training pathways and those in less than full-time training were analysed separately. Results: One hundred fifty-three ENT speciality trainees across the UK took part in the survey, giving a national response rate of 46.5%. There was a slight male preponderance in the respondents, with 85 males and 68 females completing the survey. Across all years of training, the mean number of first author publications was three and for non-first author publications the mean number was two. For trainees at ST8 level, these numbers were nine and five, respectively. Trainees undertaking a PhD programme produced a mean number of nine first author publications – 5.31 more than the rest (p < 0.0001). Those in academic training pathways achieved 3.48 more publications compared to those who were not (p = 0.092). Trainees with additional undergraduate degrees and those in less than full-time training had an overall lower number of first author publications compared to the general cohort. Conclusions: ENT specialty trainees achieve a higher average number of academic publications than is currently required in order to successfully obtain a Certificate of Completion of Training (CCT). This is particularly the case for trainees in an academic training programme and those with a higher degree. It is the authors’ hope that the data from this study will help in informing and guiding junior trainees, educational supervisors and training programme directors when considering the level of research engagement required for gaining a CCT.

Diane Picard

and 5 more

Introduction: The first aim of the study was to compare three clinical scales at baseline: the Sunnybrook Facial Grading System (SFGS), the eFACE and the MBLF protocol. Then we intend to specify their sensibility to predict sequelae of Bell’s palsy at 12 months. Methods: We carried out a longitudinal study of 23 patients with Bell’s palsy. We reported every three months, from baseline to follow-up at 12 months, all the results of their facial assessment. In order to precise the criterion validity of the three clinical scales at baseline, effect of House and Brackmann severity grades was tested on SFGS composite score, eFACE dynamic score and MBLF total score. Then, these three scores were compared between group A (patients without sequelae at 12 months) and group B (patients with sequelae). Sensibility in predicting sequelae at 12 months was specified with Receiver Operating Characteristics curve for each clinical scale. Results: Grades effect on each clinical scale was found (p< .005). At baseline, no significant difference was observed between group A and group B on clinical scales. At three months, only the MBLF total score was significant to predict recovery (χ2 = 8.37, p < .0038*, AUC = .769). From the 6th month, the three clinical scales could predict sequelae at 12 month (p <.005). Conclusion: Clinical tools are essential to assess patients with Bell’s palsy at baseline and follow-up. At baseline, the dynamic scores are not significantly different. At 3 months, only the MBLF significantly discriminated patients with or without sequelae at 12 months. At 6 months, all three scales were able to predict sequelae at 12 months.

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