A Multimodal Adaptive Optical Microscope For Imaging from Molecules to Organisms.

Understanding biological systems requires observing features and processes across vast spatial and temporal scales, spanning nanometers to centimeters and milliseconds to days, often using multiple imaging modalities within complex native microenvironments. Yet, achieving this comprehensive view is challenging because microscopes optimized for specific tasks typically lack versatility due to inherent optical and sample handling trade-offs, and frequently suffer performance degradation from sample-induced optical aberrations in multicellular contexts. Here, we present MOSAIC, a reconfigurable microscope that integrates multiple advanced imaging techniques including light-sheet, label-free, super-resolution, and multi-photon, all equipped with adaptive optics.

Severe Outcomes From Suspected Human Parvovirus B19 Infection in Immunocompetent Children: The Need for Timely Recognition.

We reported a cluster of 13 previously healthy children who, over a short time frame, received care at a Level III Pediatric Hospital following emergency department (ED) presentations with severe outcomes from suspected human Parvovirus B19 (PVB19) infection, and the presence of PVB19 viremia at presentation. Among these patients, we identified seven cases of myocarditis, one case of acute anterior myocardial infarction due to coronary aneurysms secondary to Kawasaki disease, one case of severe anemia with pancytopenia, two cases of encephalitis, one case of septic shock with meningitis, and one case of septic shock with pancreatitis. Four children required ECMO treatment.

Atraumatic Limping Child, a Challenge for Pediatricians: An Observational Age-Related Study in a Pediatric Emergency Department.

Background: Atraumatic limping is a frequent cause of consultation in Pediatric Emergency Departments (PED) and often represents a challenge for pediatricians for its variability in etiology ranging from benign causes to potential crippling conditions. The aims of this research are to illustrate the clinical features of acute limping children (LC) and to identify the possible red flags that could help to make a diagnosis of severe pathologies.

Methods: We carried out a retrospective study about non-traumatic limping children referred to the PED of Bambino Gesù Children's Hospital over a 2-year period.

Changes in clinical, demographic, and outcome patterns of children hospitalized with non-SARS-CoV-2 viral low respiratory tract infections before and during the COVID pandemic in Rome, Italy.

Introduction: We performed this study aiming to evaluate changes in epidemiology, clinical presentation and outcomes of children hospitalized for viral lower respiratory tract infections (LRTI).

Methods: We performed a retrospective study of children younger than 18 years of age hospitalized for LRTIs with a positive respiratory viral testing from 2018 to 2022. We compared need of pediatric intensive care unit (PICU), invasive ventilation, and other respiratory support, viral etiologies, clinical presentations, imaging, and laboratory results in the precovid (2018-2019) and covid (2020-2022) period.

Children under 6 years with acute headache in Pediatric Emergency Departments. A 2-year retrospective exploratory multicenter Italian study.

Background: Preschool age (i.e. children under six years of age) represents a red flag for requiring neuroimaging to exclude secondary potentially urgent intracranial conditions (PUIC) in patients with acute headache.

Has Anything Changed in the Frequency of Emergency Department Visits and the Profile of the Adolescent Seeking Emergency Mental Care during the COVID-19 Pandemic?

We described changes caused by the COVID-19 pandemic in the frequency of Emergency Department (ED) visits for mental health disorders (MHDs) in adolescents on a wider temporal range-that is, not just "the waves" of the pandemic-and characterized the profile of the adolescent seeking emergency psychiatric care. We conducted a retrospective longitudinal study by analyzing ED visits for MHDs from 10 March 2019 to 10 March 2021. A total of 1407 ED visits for MHDs were registered: 702 in the pre-COVID-19 and 707 in the COVID-19 period.

Are Lung Ultrasound Features More Severe in Children Diagnosed with Bronchiolitis after the COVID-19 Lockdown Period?

The non-pharmacological measures implemented during the SARS-CoV-2 pandemic disrupted the usual bronchiolitis seasonality. Some authors have speculated that, after the lock down period, there would be an increase in the number and severity of respiratory infections due to the re-introduction of respiratory viruses. We collected clinical, microbiological and lung ultrasound data using the classification of the Italian Society of Thoracic Ultrasound (ADET) in children with bronchiolitis during the pandemic compared to the pre-pandemic period, with the aim of assessing whether the epidemic of bronchiolitis during the pandemic was characterized by a more severe lung involvement documented by lung ultrasound.

Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown.

Background: We proposed to analyze thoroughly the impact of the COVID-19 lockdown (CL) in changes of profiles and in trend of the domestic accidents (DAs) in children.

Methods: This was a single experience, cross-sectional study conducted at the emergency department (ED) of III trauma center. We enrolled children under 18 years admitted to ED with a diagnosis of DAs comparing the CL period from 10 March 2020 to 4 May 2020 with the same period of the previous year,10 March 2019 to 4 May 2019.

One Year of Lung Ultrasound in Children with SARS-CoV-2 Admitted to a Tertiary Referral Children's Hospital: A Retrospective Study during 2020-2021.

During the COVID-19 pandemic, the lung ultrasound (LU) turned out to be a pivotal tool to study the lung involvement in the adult population, but the same was not well evaluated in children. We detected the LU patterns through an integrated approach with clinical−laboratory features in children hospitalized for COVID-19 in relation to the temporal trend of the Italian epidemic. We conducted a retrospective study which took place at a pediatric tertiary hospital from 15 March 2020 to 15 March 2021.

Epidemiology, Microbiology and Severity of Bronchiolitis in the First Post-Lockdown Cold Season in Three Different Geographical Areas in Italy: A Prospective, Observational Study.

The aim of this study was to understand the epidemiology, disease severity, and microbiology of bronchiolitis in Italy during the 2021-2022 cold season, outside of lockdowns. Before COVID-19, the usual bronchiolitis season in Italy would begin in November and end in April, peaking in February. We performed a prospective observational study in four referral pediatric centers located in different geographical areas in Italy (two in the north, one in the center and one in the south).

Lung Ultrasound to Detect Pneumothorax in Children Evaluated for Acute Chest Pain in the Emergency Department: An Observational Pilot Study.

Background: Spontaneous pneumothorax is a relatively uncommon and poorly studied condition in children. While several protocols have been developed to evaluate the use of lung ultrasound for dyspneic adult patients in the emergency department, no specific guidelines are present for pediatric emergency physicians.

Objectives: We prospectively analyzed children with acute chest pain and clinical suspicion of pneumothorax evaluated at the pediatric emergency department.

Trend of hoverboard related injuries at a pediatric emergency department.

Introduction: Understanding how the use of hoverboards (HBs) can affect a child's safety is crucial. We describe the characteristics of HB related injuries and provide key messages about child prevention when using these leisure devices.

Methods: This was a retrospective study at an emergency department (ED) of a level-III-trauma center from 2016 to 2019.

The Role of Lung Ultrasound in Diagnosing COVID-19-Related Multisystemic Inflammatory Disease: A Preliminary Experience.

Background: To date, there are no data regarding the systematic application of Point-of-Care Lung Ultrasound (PoC-LUS) in children with Multisystem Inflammatory Syndrome in Children (MIS-C). The main aim of this study is to show the role of Point-of-Care Lung Ultrasound as an additional aid in the diagnosis of COVID-19-related Multisystem Inflammatory Syndrome in Children (MIS-C).

Methods: Between April 2020 and April 2021, patients aged 0-18 years referred to our emergency department for fever, and later hospitalized without a specific diagnosis, underwent PoC-LUS.

Lung ultrasound to detect cardiopulmonary interactions in acutely ill children.

Objective And Design: Our prospective observational study is the first study that evaluates the lung ultrasound (LUS) findings of cardiopulmonary interactions in acutely ill children with elevated pro-brain natriuretic peptide (BNP) levels, with the aim of establishing the specific LUS pattern in this category of patients without primary lung diseases.

Methodology: We prospectively analyzed epidemiological, clinical, laboratory, instrumental, and lung ultrasound parameters in acutely ill children aged 1 month to 18 years admitted to the Department of Pediatrics between March 2020 to August 2020. Among the acutely ill patients evaluated, only patients with pro-BNP > 300 pg/ml and who underwent LUS before the start of any treatment were included.

Cerebrospinal Fluid Shunt Infections in Children: Do Hematologic and Cerebrospinal Fluid White Cells Examinations Correlate With the Type of Infection?

Background: Cerebrospinal fluid (CSF) shunt infections in children represent an increasing problem in clinical practice. However, comprehensive clinical, laboratory and microbiologic data are scarce in pediatric age.

Methods: We conducted a 10-year retrospective study to (1) analyze clinical, laboratory and microbiologic parameters associated with infections in children; (2) analyze results according to the type of catheter (medicated or not), type of infection (first or relapses), type of hydrocephalus (acquired and congenital), presence or not of bacteriemia; (3) describe antibiotic susceptibilities and their evolution during the study period.

Role of lung ultrasound for the etiological diagnosis of acute lower respiratory tract infection (ALRTI) in children: a prospective study.

Objective And Design: Our prospective study assesses the role of detailed lung ultrasound (LUS) features to discriminate the etiological diagnosis of acute lower respiratory tract infection (ALRTI) in children.

Methodology: We analyzed patients aged from 1 month to 17 years admitted between March 2018 and April 2020 who were hospitalized for ALRTI. For all patients, history, clinical parameters, microbiological data, and lung ultrasound data were collected.

Acute strabismus in neurological emergencies of childhood: A retrospective, single-centre study.

Objectives: Acute strabismus (AS) is the most common ocular motility disorder in children. In the emergency setting evaluation, the primary concern is to exclude a potentially dangerous underlying condition, requiring immediate intervention. Our first aim was to describe the epidemiology, clinical features, and underlying causes of AS in a cohort of children presenting to the emergency department (ED).

Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study.

Background: Lung ultrasound (US) in the evaluation of suspected pediatric pneumonia is increasingly used and has a recognized role in evaluating pleural effusions, although there are no detailed studies specifically addressing its use in the pediatric population.

Objectives: To define lung US findings of severe pediatric community-acquired pneumonia that required surgical procedures during admission.

Materials And Methods: Our prospective case-control study compared lung US findings in patients ages 1 month to 17 years admitted with community-acquired pneumonia that required surgical procedures from findings those who did not.

Lung Ultrasound in Children with COVID-19: Preliminary Findings.

Recent evidence indicates the usefulness of lung ultrasound (LUS) in detecting coronavirus disease 19 (COVID-19) pneumonia. However, no data are available on the use of LUS in children with COVID-19 pneumonia. In this report, we describe LUS features of 10 consecutively admitted children with COVID-19 in two tertiary-level pediatric hospitals in Rome.

Measurement of junctional tension in epithelial cells at the onset of primitive streak formation in the chick embryo via non-destructive optical manipulation.

Directional cell intercalations of epithelial cells during gastrulation has, in several organisms, been shown to be associated with a planar cell polarity in the organisation of the actin-myosin cytoskeleton and is postulated to reflect directional tension that drives oriented cell intercalations. We have characterised and applied a recently introduced non-destructive optical manipulation technique to measure the tension in individual epithelial cell junctions of cells in various locations and orientations in the epiblast of chick embryos in the early stages of primitive streak formation. Junctional tension of mesendoderm precursors in the epiblast is higher in junctions oriented in the direction of intercalation than in junctions oriented perpendicular to the direction of intercalation and higher than in junctions of other cells in the epiblast.

The Osteoarticular Infection in a Pediatric Emergency Setting: A Challenging Diagnosis.

Objectives: The study aimed to evaluate the emergency department (ED) presentation of children with a diagnosis of osteomyelitis, septic arthritis, or both.

Methods: A retrospective single-center study was conducted on all children aged between 1 month and 18 years evaluated in the ED over a 7-year period and having a final diagnosis of osteoarticular infection. One hundred seventeen patients were enrolled.

The Role of Viral Coinfection in Bronchiolitis Treated With High-Flow Nasal Cannula at Pediatric Emergency Department During 2 Consecutive Seasons: An Observational Study.

Background: The role of multiple respiratory viruses in bronchiolitis treated with high-flow nasal cannula (HFNC) has not been thoroughly investigated. We evaluated the contribution of coinfection on clinical course of bronchiolitis treated with HFNC and on response to this treatment.

Methods: We selected 120 children with bronchiolitis, younger than 12 months, admitted to Emergency Department between 2016 and 2018 and treated with HFNC.

Uncommon Presentation of Childhood Leukemia in Emergency Department: The Usefulness of an Early Multidisciplinary Approach.

Leukemia is the most common childhood malignancy, and it is often characterized by pallor, fatigue, cytopenia, and organomegaly; sometimes musculoskeletal symptoms, mainly characterized by diffuse bone pain in the lower extremities, are the onset clinical characteristics of the disease. In these cases, the disease may initially be misdiagnosed as reactive arthritis, osteomyelitis, or juvenile idiopathic arthritis delaying appropriate diagnosis and management. Even if leukopenia, thrombocytopenia, and a history of nighttime pain are reported to be the most important predictive factors for a pediatric leukemia, blood examinations can sometimes be subtle or within normal limits, and this represents a further diagnostic difficulty.