Complications of the Central Nervous System in Pediatric Patients With Common Cold Coronavirus Infection During 2014–2019

Background@#In pediatric patients, the common cold coronavirus (ccCoV) usually causes mild respiratory illness. There are reports of coronavirus causing central nervous system (CNS) infection in experimental animal models. Some immunocompromised patients have also been reported to have fatal CNS infections with ccCoV. The aim of this study was to investigate the clinical characteristics of CNS complications related to ccCoV infection. @*Methods@#From January 2014 to December 2019, a retrospective analysis was performed of medical records from hospitalized patients under 19 years of age whose ccCoV was detected through polymerase chain reaction in respiratory specimens. The CNS complications were defined as clinically diagnosed seizure, meningitis, encephalopathy, and encephalitis. @*Results@#A total of 436 samples from 420 patients were detected as ccCoV. Among the 420 patients, 269 patients were immunocompetent and 151 patients were immunocompromised.The most common type of ccCoV was OC43 (52% in immunocompetent, 37% in immunocompromised). CNS complications were observed in 9.4% (41/436). The most common type of CNS complication was the fever-provoked seizure under pre-existing neurologic disease (42% in immunocompetent and 60% in immunocompromised patients).Among patients with CNS complications, two immunocompetent patients required intensive care unit admission due to encephalitis. Three patients without underlying neurological disease started anti-seizure medications for the first time at this admission. There was no death related to ccCoV infection. @*Conclusion@#ccCoV infection may cause severe clinical manifestations such as CNS complications or neurologic sequelae, even in previously healthy children.

A Case of the Development of Porocarcinoma in situ from a Preexisting Hidroacanthoma Simplex:Immunohistochemical Staining to Highlight Malignant Transformation / 대한피부과학회지

Porocarcinoma is a malignancy of the eccrine sweat gland. It may arise de novo or develop from pre-existing poroma and hidroacanthoma simplex. A 56-year-old woman was presented with a pinkish plaque on her left posterior thigh. She was diagnosed with hidroacanthoma simplex 6 years ago, and the same lesion had changed in size and shape. Histopathology revealed intraepidermal proliferation of small-sized basaloid cells, continuing to the proliferation of large polygonal tumor cells. This malignant transformation was consistent with the change in p53 expression pattern. The patient underwent wide excision with clear resection margin, and no evidence of recurrence was noted. We highlight this case in that the transition from hidroacanthoma simplex to porocarcinoma in situ was confirmed in the same tissue, as demonstrated by immunohistochemical staining.

Anti‑stress effects of Fameyes in in vitro and in vivo models of stresses / 한국실험동물학회지

Background@#Fameyes (a mixture of Clematis mandshurica Rupr. extract (CMRE) and Erigeron annuus (L.) Pers. extract (EAPE)) containing scutellarin and chlorogenic acid as major components has been reported to relieve mental stress in human subjects, which is reflected in improved scores in psychometric tests measuring levels of depression, anxi‑ ety, well-being, and mental fitness. The aim of this study was to examine the anti-stress activity of Fameyes and to investigate the mechanisms of the anti-stress activity using in vitro and in vivo models of stresses. @*Results@#First, we tested the effect of Fameyes on corticosterone-induced cytotoxicity in SH-SY5Y cells (human neurofibroma cell lines). Corticosterone induced apoptosis and decreased cell viability and mitochondrial membrane potential, but treatment with Fameyes inhibited these cytotoxic effects in a dose-dependent manner. However, CMRE and EAPE (components of Fameyes) did not inhibit the cytotoxic effect of corticosterone individually. Next, we tested the effects of Fameyes on rats that were exposed to different kinds of stresses for four weeks. When the stressed rats were treated with Fameyes, their immobility time in forced swim and tail suspension tests decreased. A reduction was also observed in the serum levels of adrenocorticotropic hormone (ACTH) and corticosterone. Furthermore, upon oral administration of Fameyes, serum serotonin levels increased. These in vitro and in vivo results support the anti-stress effects of Fameyes. @*Conclusions@#In vitro experiments showed anti-stress effects of Fameyes in cell viability, apoptosis, and mitochon‑ drial membrane potential. In addition, in vivo experiments using rats showed anti-stress effects of Fameyes in blood and tissue levels of ACTH, corticosterone, and serotonin, as well as the immobility time in the forced swim and tail sus‑ pension tests. However, we did not specifically investigate which ingredient or ingredients showed anti-stress effects, although we reported that Fameyes contained chlorogenic acid and scutellarin major ingredients.

Factors Affecting Intensive Care Unit Nurses’ Care Burden of Patients with Hematologic Neoplasm

Purpose@#This study was a descriptive study to identify the factors affecting nurses' care burden of patients with hematologic neoplasm (PHN) in the intensive care unit (ICU). @*Methods@#A total of 139 ICU nurses were enrolled and data were collected using self-report questionnaires about compassion satisfaction, compassion fatigue, nursing work performance, and the care burden of PHN. Data were analyzed using the independent t-test and one–way analysis of variance, Pearson's correlation coefficient, and hierarchical regression analysis. @*Results@#The average of nurses’ care burden of PHN was 35.75 points in the ICU. Analyzing the correlations among the main variables showed that the care burden of PHN showed a negative correlation with compassion satisfaction and nursing work performance, and a positive correlation with compassion fatigue. We noted that the compassion satisfaction showed a negative correlation with burnout and a positive correlation with nursing work performance. The factor affecting the care burden of PHN was burnout (β=.30, p=.019), and showed a significant explanatory power of 16.0% (F=7.37, p<.001) @*Conclusion@#Efforts such as policies and nurse support programs are needed to reduce burnout, a factor that affects care burden of PHN in intensive care nurses.

Boosting of Cross-Reactive Antibodies to Endemic Coronaviruses by SARS-CoV-2 Infection but not Vaccination with Stabilized Spike

Pre-existing antibodies to endemic coronaviruses (CoV) that cross-react with SARS-CoV-2 have the potential to influence the antibody response to COVID-19 vaccination and infection for better or worse. In this observational study of mucosal and systemic humoral immunity in acutely infected, convalescent, and vaccinated subjects, we tested for cross reactivity against endemic CoV spike (S) protein at subdomain resolution. Elevated responses, particularly to the {beta}-CoV OC43, were observed in all natural infection cohorts tested and were correlated with the response to SARS-CoV-2. The kinetics of this response and isotypes involved suggest that infection boosts preexisting antibody lineages raised against prior endemic CoV exposure that cross react. While further research is needed to discern whether this recalled response is desirable or detrimental, the boosted antibodies principally targeted the better conserved S2 subdomain of the viral spike and were not associated with neutralization activity. In contrast, vaccination with a stabilized spike mRNA vaccine did not robustly boost cross-reactive antibodies, suggesting differing antigenicity and immunogenicity. In sum, this study provides evidence that antibodies targeting endemic CoV are robustly boosted in response to SARS-CoV-2 infection but not to vaccination with stabilized S, and that depending on conformation or other factors, the S2 subdomain of the spike protein triggers a rapidly recalled, IgG-dominated response that lacks neutralization activity. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=61 SRC="FIGDIR/small/21265574v1_figA1.gif" ALT="Figure 1"> View larger version (22K): org.highwire.dtl.DTLVardef@168d38aorg.highwire.dtl.DTLVardef@1183afcorg.highwire.dtl.DTLVardef@1c88b77org.highwire.dtl.DTLVardef@13c6e0a_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOGraphical AbstractC_FLOATNO Antibody responses to SARS-CoV-2 and endemic CoV spike proteins were measured in diverse cohorts. While antibodies to SARS-CoV-2 were induced across all isotypes, only IgA and IgG responses to endemic CoV were robustly boosted, and only among naturally-infected but not vaccinated individuals. These recalled, cross-reactive responses to endemic CoV primarily recognized the better conserved S2 domain and were non-neutralizing. While other antiviral activities of broadly cross-reactive S2-specifc antibodies are not known, the differing antigenicity of natural infection and vaccination with stabilized pre-fusion spike has potential implications for the breadth and level of protection afforded by each. C_FIG

Analysis of Trends in Regulatory Science and Regulatory Science Experts Training Projects: US, Japan, Singapore, and Korea

Background@#The need for regulatory science development to evaluate advanced regulatory products is gradually increasing without hindering the technological development. Creating a research environment and fostering experts through the establishment of regulatory agency-led policies are essential for the development of regulatory science. Method: This is a comparative study of the United States, Japan, Singapore, and Korea. The literature and websites of each regulatory agency were reviewed, and the focus was on advantages and comparing advantages based on definition, development trends, and expert training projects. @*Results@#The United States is striving to develop regulatory science in response to changes in the new pharmaceutical industry through the regulatory science report, and to foster expert both inside and outside the Food and Drug Administration (FDA). Japan is promoting regulatory science centered on regulatory science centers, and is focusing on researching work-related regulatory science within the Pharmaceuticals and Medical Devices Agency (PMDA) and improving employees’ ability to make regulatory decisions. Singapore was aiming to improve Southeast Asia’s regulatory capabilities under the leadership of Centre of Regulatory Excellence (CoRE) within Duke-NUS University. In 2021, Korea is in its early stages, starting to run a university's degree program related to regulatory science this year. @*Conclusion@#Regulatory science should be developed with the aim of improving the regulatory ability of the Ministry of Food and Drug Safety with Korea’s independent concept of regulatory science.

Draft Genome Sequence of the White-Rot Fungus Schizophyllum commune IUM1114-SS01

The monokaryotic strain, Schizophyllum commune strain IUM1114-SS01, was generated from a basidiospore of dikaryotic parental strain IUM1114. It even showed the decolorizing activities for several textile dyes much better than its parental strain. Based on the results of a single-molecule real-time sequencing technology, we present the draft genome of S. commune IUM1114-SS01, comprising 41.1 Mb with GC contents of the genome were 57.44%.Among 13,380 protein-coding genes, 534 genes are carbon hydrate-active enzyme coding genes.

A Prospective Study Comparing Steroid Injection and Needle Fenestration for the Treatment of Chronic Plantar Fasciitis / 대한족부족관절학회지

Purpose@#This study sought to compare needle fenestration with a corticosteroid injection for the treatment of chronic plantar fasciitis. We hypothesized that needle fenestration would be as effective as a corticosteroid injection while avoiding the potential adverse effects of the corticosteroid. @*Materials and Methods@#Forty female patients with unilateral chronic plantar fasciitis who did not respond to a minimum of 6 months of various conservative treatments were prospectively randomized to receive either a corticosteroid injection or needle fenestration. Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for all patients before treatment and at 3-, 6-, and 12-month following treatment. @*Results@#The corticosteroid injection group had a before-treatment average AOFAS Ankle-Hindfoot score of 56.4, which increased to 87.3 at 3 months and 78.2 at 6 months after treatment but decreased to 62.4 at 12 months. The needle fenestration group had a before treatment average AOFAS ankle-hindfoot score of 49.5, which increased to 77.8 at 3 months and 92.1 at 6 months after treatment and remained at a high score of 89.4 at 12 months. There were no complications in either group. @*Conclusion@#In the treatment of chronic plantar fasciitis, needle fenestration is as effective at 3- and 6-month post-treatment as a corticosteroid injection. Also, unlike a corticosteroid, its effect remains until 12 months post-treatment.

Features and Functions of Systemic and Mucosal Humoral Immunity Among SARS-CoV-2 Convalescent Individuals

Understanding humoral immune responses to SARS-CoV-2 infection will play a critical role in the development of vaccines and antibody-based interventions. We report systemic and mucosal antibody responses in convalescent individuals who experienced varying disease severity. Robust antibody responses to diverse SARS-CoV-2 antigens and evidence of elevated responses to endemic CoV were observed among convalescent donors. SARS-CoV-2-specific IgA and IgG responses were often negatively correlated, particularly in mucosal samples, suggesting subject-intrinsic biases in isotype switching. Assessment of antibody-mediated effector functions revealed an inverse correlation between systemic and mucosal neutralization activity and site-dependent differences in the isotype of neutralizing antibodies. Serum neutralization correlated with systemic anti-SARS-CoV-2 IgG and IgM response magnitude, while mucosal neutralization was associated with nasal SARS-CoV-2-specific IgA. These findings begin to map how diverse Ab characteristics relate to Ab functions and outcomes of infection, informing public health assessment strategies and vaccine development efforts.

Comparison of Preanalytical Sample Stability between Serum and Ethylenediaminetetraacetic Acid Plasma for the Measurement of Biological Analytes

Background@#In this study, we aim to examine the effects of pre-analytical factors such as specimen type (serum or plasma), collection and storage conditions, and time, on the results of chemiluminescence immunoassay. @*Methods@#Blood samples were collected from 10 individuals and aliquoted into two sets of K3-ethylenediaminetetraacetic acid (EDTA) and serumseparating tubes (SST) each, for plasma and serum collection, respectively.For all the samples, one set of tubes was centrifuged within 1 hour and other set was centrifuged after 4 hours, followed by cell separation.Chemiluminescence assay was performed for adrenocorticotropic hormone (ACTH), parathyroid hormone (PTH), osteocalcin, C-telopeptide, and insulin at 0, 6, 24, and 48 hours after centrifugation; all the samples were assayed in duplicate. The samples were stored at 4℃ before the assay. @*Results@#The results obtained showed that the levels detected in plasmas were more consistent and stable as compared to serum. After a 6-hour storage at 4℃, a significant decrease was observed in the levels of ACTH and osteocalcin in plasma and serum; whereas, PTH and C-telopeptide levels were stable in plasma but decreased significantly in serum. Insulin levels in serum showed a decrease after a 6-hour storage while the levels in plasma were found to be stable until 24-hour storage. Serum samples separated after 4 hours showed a significant decrease in all hormone levels, while C-telopeptide and insulin levels were stable in plasma samples separated after 4 hours. @*Conclusions@#The results were found to be more stable in plasma samples from K3-EDTA tubes as compared to serum samples from SST in the measurement of unstable biological analytes. These results suggest that K3-EDTA tubes are preferable in the specimen collection for assaying biological analytes.

Comparison of Body Fluid Differential CountsUsing a Manual Counting Method oran Automated Hematology Analyzer

Background@#Two methods of counting cells in body fluids were compared;manual counting using a Neubauer chamber, and automated cell countingusing an XN-350 hematology analyzer. @*Methods@#Cells from 32 body fluid samples were counted by manualexamination and by an automated analyzer. Total cells (TC), white bloodcells (WBC), red blood cells (RBC), polymorphonuclear leukocytes (PMN),mononuclear leukocytes (MN), neutrophils, lymphocytes, monocytes, andeosinophils were each counted by both methods. The results were comparedusing the Pearson correlation test, Bland-Altman regression analysis, andPassing-Bablok regression analysis. @*Results@#The two methods showed very strong correlation in TC, WBC,RBC, PMN, and MN counts, strong correlation in % neutrophils, and %lymphocytes, and weak correlation in % monocytes and % eosinophils.Using Bland-Altman regression analysis, the mean biases for TC, WBC, andRBC were -270, -257.4, and -1,256.09, respectively, and 0.15 for PMN andMN. Research parameters were compared as well: mean biases were -1.31,-2.46, -5.16, and -3.58 for % neutrophils, % monocytes, % lymphocytes,and % eosinophils, respectively. Passing-Bablok regression equationswere y=1.039x+20, y=1.037x+19, y=1.259x+0.0, y=0.983x+1.541, andy=0.983x+0.125 for TC, WBC, RBC, PMN, and MN, respectively. The equationswere y=0.955x+2.194 for % neutrophils, y=0.965x+1.184 for % monocytes,y=1.003x+0.161 for % lymphocytes, and y=x+0.75 for % eosinophils. @*Conclusions@#WBC differential count results performed by an automatedhematology analyzer generally show good correlation with our referencemethod, Neubauer chamber counting.

Association between Cardiometabolic Risk Factors and Decreased Glomerular Filtration Rate in Korean Women

Background@#Decreased glomerular filtration rate (GFR) was associated with increased mortality and decreased quality of life in previous studies. In Korean adults, the prevalence rates of cardiometabolic risk factors are higher in women than in men after middle age. We evaluated the association between cardiometabolic risk factors and decreased GFR in Korean women. @*Methods@#We evaluated 2,339 subjects using data from the Korea National Health and Nutrition Examination Survey VII-1 (2016) after excluding participants with GFRs of <15 mL/min/1.73 m2. Normal GFR was ≥60 mL/min/1.73 m2, and decreased GFR was 15–59 mL/min/1.73 m2. Socioeconomic status, lifestyle factors, body mass index, waist circumference, and comorbidities were evaluated to analyze the association between cardiometabolic risk factors and decreased GFR. The odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate logistic regression analyses. @*Results@#As age increased, the OR for decreased GFR increased. In comparison with women with waist circumferences of <85 cm, the women with waist circumferences of ≥85 cm (OR, 1.94; 95% CI, 1.22–3.10) had a significant increase in the OR for decreased GFR. In women with diabetes mellitus, the OR for decreased GFR significantly increased (OR, 3.14; 95% CI, 1.70–5.81). @*Conclusion@#Decreased GFR was associated with age, abdominal obesity, and diabetes mellitus in Korean women. Control of abdominal obesity and appropriate management of diabetes mellitus are needed to prevent chronic kidney disease in Korean women.

The Characteristics of Electronic Cigarette User among Korean Smokers: The Sixth Korean National Health and Nutrition Examination Survey, 2013–2015

BACKGROUND: Although the electronic cigarette (e-cigarette) market is growing rapidly, few studies have been conducted on e-cigarettes in South Korea. This study aims to analyze the general characteristics of Korean adult smokers with e-cigarette use.METHODS: This study used data from the 6th National Health and Nutrition Survey (NHANS). Multivariate logistic regression analysis was conducted to examine subjects' general characteristics and a questionnaire related to smoking cessation, stress perception, and depression. A frequency analysis of reasons for using e-cigarettes was conducted of 318 subjects of the 2015 NHANS who were smokers and used e-cigarettes.RESULTS: The study found that smokers with experience using e-cigarettes were younger and had a higher income level (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.03–2.05) than smokers without e-cigarette experience. Professional, management, and office worker groups were associated with e-cigarette use (OR, 1.40; 95% CI, 1.10–1.77). Willingness to quit smoking was also higher in subjects with experience using e-cigarettes (OR, 1.35; 95% CI, 1.09–1.68). The most common reason for smoking cessation in both groups was concern about their own and their family's health. About 50% of smokers with experience using e-cigarettes thought e-cigarettes would be more helpful for smoking cessation than regular cigarettes.CONCLUSION: Although the safety and rationale of using e-cigarettes as a smoking cessation aid are unproven, many smokers consider them a method of smoking cessation. It is necessary to provide correct information on e-cigarettes.

First Report of a Patient With Natural Killer-Lymphoblastic Leukemia/Lymphoma in Korea

No abstract available.

Association Between Prolonged Closure Time on the Platelet Function Analyzer-200 and Risk of Perioperative Blood Transfusion

No abstract available.

Establishing Reference Intervals for Complete Blood Cell Count in Healthy Korean Elderly Individuals

BACKGROUND: Different age groups may have different reference intervals. However, the currently used reference interval for complete blood count (CBC) in clinical laboratories is based on results from healthy adults between 20 and 50 years of age. In this study, we aimed to establish reference intervals for 16 CBC parameters in Korean healthy elderly individuals. METHODS: A total of 3,359 healthy adults were selected from 4,253 adults (aged ≥20 years) who underwent regular health check-ups, based on a medical examination by interview. The reference intervals for CBC in two groups (aged <60 and ≥60 years), and the partitioning of reference intervals between the two age groups were established. RESULTS: Most CBC parameters showed no significant differences in reference intervals between the two age groups. Among the men, platelet distribution width (PDW) was the only parameter that required a separate reference interval between the two age groups. Among the women, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and eosinophil % required separate reference intervals between the two age groups. CONCLUSIONS: The reference intervals for most CBC parameters were not significantly different between the two age groups. Except for PDW in men and MCV, MCHC, RDW, and eosinophil % in women, reference intervals for CBC parameters in individuals younger than 60 years of age could also be applied to those that are 60 years of age or older.

An adaptive DC-balanced and multi-mode stimulator IC with 1GΩ output impedance for compact electro-acupuncture system.

A compact and low-power electro-acupuncture (EA) IC and its Premeasurement System as off-chip board for verification are proposed for medical treatment and experiment. The multi-mode stimulator EA IC can perform adaptive charge balancing with various load condition as well as programmable supply voltage for 5 different stimulation modes. The proposed EA IC occupies 2.2 mm × 1.5 mm including pads manufactured through 0.11 µm 1P6M CMOS technology and dissipates 1.8 mW at 1.2 V supply supporting 256 different current level with >1G output impedance. The Premeasurement System with corresponding specification to the proposed fabricated EA IC is fully implemented and tested on the human body and animal.

Predictive and Prognostic Factors of Viral Encephalitis in Pediatric Patients / 대한소아신경학회지

PURPOSE: Encephalitis is an inflammation affecting brain parenchyma. At the time of presentation, it may be difficult to differentiate between viral encephalitis and altered mental status or seizures during febrile illness. The aim of the present study is to identify the predictive factors and to determine the prognostic factors of viral encephalitis in children presenting as seizure with fever. METHODS: From the retrospective review of the medical records, children with seizures or altered mental status during febrile illness who presented to Samsung Medical Center between January 2008 and May 2013 were included in the study. RESULTS: 81 patients were enrolled in this study (female:male=32:49). The mean age at admission was 4.9±4.3 years (range 0–14 years old). The patients were categorized into two groups according to the clinical diagnosis: (1) Viral encephalitis (VIRAL ENC, n=66), (2) Complex febrile seizures imitating viral encephalitis(C-FS, n=15). The predictive factors of viral encephalitis were focal and/or lateralized abnormalities in electroencephalography (EEG) (P<0.001). CONCLUSION: EEG can be helpful to predict the viral encephalitis, in pediatric patient who shows delayed restoration of consciousness after seizure during febrile illness.

Using Array-Based Comparative Genomic Hybridization to Diagnose Pallister-Killian Syndrome

Pallister-Killian syndrome (PKS) is a rare multisystem disorder characterized by isochromosome 12p and tissue-limited mosaic tetrasomy 12p. In this study, we diagnosed three pediatric patients who were suspicious of having PKS using array-based comparative genomic hybridization (array CGH) and FISH analyses performed on peripheral lymphocytes. Patients 1 and 2 presented with craniofacial dysmorphic features, hypotonia, and a developmental delay. Array CGH revealed two to three copies of 12p in patient 1 and three copies in patient 2. FISH analysis showed trisomy or tetrasomy 12p. Patient 3, who had clinical features comparable to those of patients 1 and 2, was diagnosed by using FISH analysis alone. Here, we report three patients with mosaic tetrasomy 12p. There have been only reported cases diagnosed by chromosome analysis and FISH analysis on skin fibroblast or amniotic fluid. To our knowledge, patient 1 was the first case diagnosed by using array CGH performed on peripheral lymphocytes in Korea.

Clinical outcomes and neurodevelopmental outcome of prenatally diagnosed agenesis of corpus callosum in single center of Korea

OBJECTIVE: With recent advances and frequent use of prenatal ultrasound, the antenatal diagnosis of agenesis of the corpus callosum (ACC) is not rare in obstetrics practices. However, information regarding the long-term neurological outcome remains uncertain. The aim of this study was to investigate clinical outcomes of prenatally diagnosed ACC and to analyze postnatal neurodevelopmental outcomes of ACC neonates born in our single center. METHODS: We retrospectively reviewed 56 cases of prenatally suspected ACC referred to our center. RESULTS: Fifty-six fetuses were diagnosed with ACC, and 12 of those were followed-up in our center until delivery. Of the remaining 44, 7 were delivered after being referred back to the original hospital, 23 were lost to follow-up, and 14 had unknown outcomes. Among all 56, 29 were considered to have isolated ACC and 27 were considered to have non-isolated ACC. Of the 10 live fetuses delivered in our center, four had isolated ACC, three had non-isolated ACC, and the rest had outcomes unrelated to ACC. Neurodevelopmental outcome was followed-up until approximately age 3 years. Of the four with isolated ACC, three (75%) had normal neurodevelopmental outcomes. CONCLUSION: Similar to other studies, the results of our single-center study included positive neurodevelopmental outcomes for those with isolated ACC. However, despite our endeavor to counsel patients with prenatally diagnosed ACC, the delivery rate in our center was quite low. Therefore, larger, multicenter, retrospective studies including long-term neurological development outcomes are crucial and urgently needed to provide better counseling.