Early Career Investigator

Congratulations to Monica Hsiung Wojcik, the Early Career Investigator for January. Growing up in a non-medical household in Brookline, Massachusetts, she didn’t realize how close she was to Harvard Medical School, where she later obtained her MD. As an undergraduate at Princeton, she studied with the writer John McPhee, who encouraged her to choose a career involving “human stories and journeys.” With that advice, Wojcik turned toward medicine. After Harvard, she remained in the Boston area for her residency and combined fellowship training in neonatology and genetics, and she is currently an attending physician in both fields. Wojcik is involved in clinical effectiveness research related to genomic medicine. In a retrospective cohort study reported in this issue, she and colleagues found that lower neighborhood resources are negatively associated with clinic attendance and suggest that improved access to clinical genetics is needed to improve diagnostic equity. Her advice to others early in their career is to keep an open mind, follow what matters to you most, and surround yourself with supportive colleagues and mentors. See https://doi.org/10.1038/s41390-022-02354-8and https://doi.org/10.1038/s41390-022-02240-3

Comparison of inhaled corticosteroids in asthma

The difference in efficacy between inhaled corticosteroids for the treatment of childhood asthma remains unclear. Zhu et al. analyzed six randomized controlled trials using FEV1 as the primary outcome. The drugs were compared using model-based meta-analysis. The team found that the time taken to reach half the maximal effect was 1.23 weeks for ciclesonide and 2.97 weeks for budesonide. Fluticasone had higher efficacy than either, and the percentage of symptom-free days was lower for beclometasone than for ciclesonide and fluticasone. See https://doi.org/10.1038/s41390-022-02095-8

Maternal COVID-related postnatal stress and infant temperament

To determine whether maternal COVID infection during pregnancy and/or postnatal stress influenced infants’ temperament, Bianco et al. tested 63 mother–infant dyads with prenatal maternal SARS-CoV-2 infections and 110 dyads without infection. Stress and infant outcome were assessed using questionnaires. Although prenatal maternal SARS-CoV-2 infection had no effect on infant temperament, stress and life disruptions caused by the COVID-19 pandemic were associated with infant temperament at 6 months of life. See https://doi.org/10.1038/s41390-022-02071-2

Impact of NIPS on congenital heart disease in trisomy 21 patients

Hart et al. investigated whether noninvasive prenatal screening (NIPS) for congenital heart disease (CHD) has changed the rates of congenital heart defects in trisomy 21 patients in the United States as has been seen in other countries. Using the Pediatric Health Information System database, the authors identified neonates with trisomy 21 over the period 2007–2018. Patients from the pre-NIPS era (2007–2010) were compared with those from the post-NIPS era (2014–2018), and patients from high-termination states compared with those from low-termination states. No difference in proportions of CHD was found between eras. Variations were found between states with high versus low termination states. In an accompanying Insights article, the mother of a trisomy 21 patient describes her daughter’s loving heart. See https://doi.org/10.1038/s41390-021-01416-7and https://doi.org/10.1038/s41390-022-02291-6

Continuous second-hand smoke exposure associated with obesity in boys

In a population-based longitudinal-data study of primary school students in Adachi City, Tokyo, 3605 students were followed from fourth to sixth grade. Second-hand smoke exposure (SHS) was categorized by none, stopped, started, and continuous exposure. The continuous-SHS group showed a greater risk of high BMI than the no-SHS group. In a subanalysis by sex, boys had a greater risk of a high BMI. Interestingly, boys whose exposure had ended were not at higher risk for obesity, implying that stopping exposure may prevent obesity. In an accompanying Comment, McGee et al. discuss why every child deserves a smoke-free home. (Photo: ljubaphoto/Getty.) See https://doi.org/10.1038/s41390-022-02231-4and https://doi.org/10.1038/s41390-022-02337-9

A physiologic profile associated with severe MIS-C

Savorgnan et al. used data from 152 individuals diagnosed with multisystem inflammatory syndrome in children (MIS-C) to develop a severity score and determine risk factors associated with that score. They identified seven physiological variables that corresponded to the MIS-C severity score. Application of these seven variables may allow clinicians to recognize patients likely to require a higher level of intensive care. In an accompanying Comment, Buratti and Jouvet call for collaborative groups to validate this prediction model through multicenter studies. See https://doi.org/10.1038/s41390-022-02108-6and https://doi.org/10.1038/s41390-022-02381-5

Reliability of pulse oximetry in extremely premature infants during movement

Motion artifact is a problem when using pulse oximetry to detect oxygen saturation. Dormishian et al. used two pulse oximeters attached to different extremities to determine reliability of measurement when one extremity was moving. It was found that pulse oximetry with motion artifact was more likely to indicate true hypoxemia than to cause a false reading. In an accompanying Comment, Borenstein-Levin and Kugelman discuss tools available for continuous noninvasive monitoring of oxygenation as well as modalities that increase the time spent by preterms in the desired oxygen saturation range. See https://doi.org/10.1038/s41390-022-02258-7and https://doi.org/10.1038/s41390-022-02384-2