***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives This study aim ed to up date and vali date a prediction rule for  respiratory syncytial virus ( RSV ) hospitalization in preterm infants 33–35 weeks gestational age ( WGA ) . Study Design The RISK study consisted of 2 multicenter prospect i ve birth cohorts in 41 hospitals . Risk factors were assessed at birth among healthy preterm infants 33–35 WGA . All hospitalizations for respiratory tract infection were screened for proven RSV infection by immunofluorescence or polymerase chain reaction . Multivariate logistic regression analysis was used to up date an existing prediction model in the derivation cohort ( n = 1,227 ) . In the validation cohort ( n = 1,194 ) , predicted versus actual RSV hospitalization rates were compared to determine validity of the model . Results RSV hospitalization risk in both cohorts was comparable ( 5.7 % versus 4.9 % ) . In the derivation cohort , a prediction rule to determine probability of RSV hospitalization was developed using 4 predictors : family atopy ( OR 1.9 ; 95%CI , 1.1–3.2 ) , birth period ( OR 2.6 ; 1.6–4.2 ) , breastfeeding ( OR 1.7 ; 1.0–2.7 ) and siblings or daycare attendance ( OR 4.7 ; 1.7–13.1 ) . The model showed good discrimination ( c-statistic 0.703 ; 0.64–0.76 , 0.702 after bootstrapping ) . External validation showed good discrimination and calibration ( c-statistic 0.678 ; 0.61–0.74 ) . Conclusions Our prospect ively vali date d prediction rule identifies infants at increased RSV hospitalization risk , who may benefit from targeted preventive interventions . This prediction rule can facilitate country-specific , cost-effective use of RSV prophylaxis in late preterm infants BACKGROUND AND OBJECTIVES : Palivizumab effectively prevents severe respiratory syncytial virus ( RSV ) disease in preterm infants . Our objective was to test whether palivizumab prophylaxis given to preterm infants during the first RSV season reduces the incidence of subsequent recurrent wheezing up to 3 years of life . METHODS : We conducted an observational prospect i ve multicenter ( 52 registered hospitals in Japan ) case-control study in preterm infants with a gestational age between 33 and 35 weeks followed for 3 years . During the 2007–2008 RSV season , the decision to administer palivizumab was made based on st and ard medical practice . In April 2008 , 52 hospitals were recruited . Study participants were prospect ively followed to the age of 3 years . Parents of study subjects reported the infants ’ physician ’s assessment of recurrent wheezing , used a report card and a novel mobile phone-based reporting system by using the Internet . The primary end point was the incidence of physician-diagnosed recurrent wheezing . RESULTS : Of 444 preterm infants enrolled , 349 received palivizumab during the first 6 months of life and 95 infants did not . Physician-diagnosed recurrent wheezing was observed in 6.4 % and 18.9 % of infants in the treated and untreated groups , respectively ( P < .001 ) . This difference remained significant after adjustment for known risk factors of recurrent wheezing ( P < .001 ) . CONCLUSIONS : Palivizumab prophylaxis administered to preterm infants 33 to 35 weeks ’ gestational age is associated with a significantly lower incidence of recurrent wheezing during the first 3 years of life BACKGROUND AND OBJECTIVES Palivizumab can reduce hospitalizations due to respiratory syncytial virus ( RSV ) , but many eligible infants fail to receive the full 5-dose series . The efficacy of clinical decision support ( CDS ) in fostering palivizumab receipt has not been studied . We sought a comprehensive solution for identifying eligible patients and addressing barriers to palivizumab administration . METHODS We developed workflow and CDS tools targeting patient identification and palivizumab administration . We r and omized 10 practice s to receive palivizumab-focused CDS and 10 to receive comprehensive CDS for premature infants in a 3-year longitudinal cluster-r and omized trial with 2 baseline and 1 intervention RSV seasons . RESULTS There were 356 children eligible to receive palivizumab , with 194 in the palivizumab-focused group and 162 in the comprehensive CDS group . The proportion of doses administered to children in the palivizumab-focused intervention group increased from 68.4 % and 65.5 % in the two baseline seasons to 84.7 % in the intervention season . In the comprehensive intervention group , proportions of doses administered declined during the baseline seasons ( from 71.9 % to 62.4 % ) with partial recovery to 67.9 % during the intervention season . The palivizumab-focused group improved by 19.2 percentage points in the intervention season compared to the prior baseline season ( p < 0.001 ) , while the comprehensive intervention group only improved 5.5 percentage points ( p = 0.288 ) . The difference in change between study groups was significant ( p = 0.05 ) . CONCLUSIONS Workflow and CDS tools integrated in an EHR may increase the administration of palivizumab . The support focused on palivizumab , rather than comprehensive intervention , was more effective at improving palivizumab administration ABSTRACT The Alere i respiratory syncytial virus ( RSV ) assay is an isothermal nucleic acid amplification test capable of detecting RSV directly from respiratory specimens , with results being available in ≤13 min after test initiation . The objective of this study was to evaluate the performance characteristics of the Alere i RSV assay in a point-of-care setting by using direct nasopharyngeal ( NP ) swab specimens ( direct NP ) and nasopharyngeal swab specimens eluted and transported in viral transport medium ( VTM NP ) . The study was a prospect i ve , multicenter , clinical trial conducted at 9 sites across the United States to evaluate the clinical performance of the Alere i RSV assay with respiratory specimens obtained from both children ( age , < 18 years ) and older adults ( age , > 60 years ) . The performance of the Alere i RSV assay was compared with that of the reference method , the Prodesse ProFlu+ real-time reverse transcriptase PCR ( RT-PCR ) assay . All specimens with discrepant test results were tested further by a second FDA -cleared PCR assay ( the Verigene respiratory virus plus nucleic acid test ; Luminex Inc. , TX ) . A total of 554 subjects with signs and symptoms of respiratory infections were enrolled , and respiratory sample s were collected in this study . In comparison with the ProFlu+ real-time RT-PCR , the overall sensitivity and specificity of Alere i RSV assay for the detection of RSV were 98.6 % ( 95 % confidence interval [ CI ] , 94.4 to 99.7 % ) and 98.0 % ( 95 % CI , 95.8 to 99.1 % ) , respectively , for direct NP and 98.6 % ( 95 % CI , 94.4 to 99.7 % ) and 97.8 % ( 95 % CI , 95.5 to 98.9 % ) , respectively , for VTM NP . The Alere i RSV is a highly sensitive and specific molecular assay ideal for rapid RSV detection in patients in the point-of-care setting due to its minimal h and s-on time and rapid result availability BACKGROUND Respiratory syncytial virus ( RSV ) infection is associated with subsequent wheeze and asthma . We previously reported on the causal relationship between prevention of RSV infection during infancy and reduced frequency of subsequent wheeze using a double-blind , r and omised , placebo-controlled trial ( MAKI ) . We continued follow-up and analysed the effect of RSV prevention during infancy on asthma and lung function at age 6 years . METHODS We studied 429 infants born at 32 - 35 weeks of gestation between 2008 - 10 who had r and omly received either palivizumab for RSV immunoprophylaxis or placebo during the RSV season of their first year of life . After the first year of follow-up , single , assessor-blind follow-up of children continued until they were aged 6 years . Primary outcomes were parent-reported current asthma and forced expiratory volume in 0·5 s ( FEV0·5 ) . The trial is registered in the IS RCT N registry , number IS RCT N73641710 . FINDINGS 395 ( 92 % ) of 429 participants completed this 6-year follow-up study . Parent-reported current asthma was reported in 28 ( 14·1 % ) of 199 children in the RSV prevention group and 47 ( 24·0 % ) of 196 children in the placebo group ( absolute risk reduction [ ARR ] 9·9 % , 95 % CI 2·2 to 17·6 ) . The difference in current asthma , which was a composite endpoint , was due to a difference in infrequent wheeze ( one to three episodes in the past year ; 12 [ 6·0 % ] of 199 vs 26 [ 13·4 % ] of 194 , ARR 7·4 % , 95 % CI 1·5 to 13·2 ) . FEV0·5 percentage predicted values were similar between the RSV prevention group ( 89·1 % [ SD 10·6 ] ) and placebo group ( 90·1 % [ 11·1 ] ) , with a mean difference of 1·0 ( 95 % CI -1·3 to 3·3 ) . The proportion of children with current physician-diagnosed asthma was similar between the RSV prevention group ( 19 [ 10·3 % ] of 185 ) and placebo group ( 18 [ 9·9 % ] of 182 ) , with an ARR of -0·4 ( 95 % CI -6·5 to 5·8 ) . INTERPRETATION In otherwise healthy preterm infants , this single-blind , r and omised , placebo-controlled trial showed that RSV prevention did not have a major effect on current asthma or lung function at age 6 years . Future research will inform on the effect of RSV prevention on asthma at school age in the general population . FUNDING AbbVie Infants with Down syndrome ( DS ) face an increased risk of respiratory tract infections . Recent studies describe DS as independent risk factor for a complicated clinical course in infants with respiratory syncytial virus ( RSV ) infection . The prospect i ve observational German Synagis ™ Registry comprises data from 249 children below 25 months of age with DS and palivizumab prophylaxis 2009–2016 ( 1191 administrations ; mean 4.8 per patient and season ) . The median gestational age and the birth weight in patients without and with DS were 31 versus 37 weeks ( P < 0.001 ) and 1590 versus 2750 g , respectively ( P < 0.001 ) . Patients with DS significantly more often had congenital heart disease ( CHD ) , siblings in kindergarten or school , treatment with oxygen at home , immunodeficiency , and neuromuscular impairment . The RSV-related hospitalization rate in patients with DS was 1.20 % ; the hospitalization rate in patients without DS was 0.71 % . Conclusion : Data from 249 children with DS receiving palivizumab prophylaxis in seven consecutive RSV seasons ( 2009–2016 ) in Germany reveal important differences between patients with and without DS concerning the main indication for palivizumab use and additional risk factors . Bearing in mind the limitations of an uncontrolled postmarketing observational study , the results confirm the field effectiveness of palivizumab prophylaxis in this special population .What is Known:• Recent studies describe the Down syndrome as independent risk factor for a complicated clinical course in infants with RSV infection . What is New:• Compared with other infants receiving palivizumab prophylaxis , patients with Down syndrome significantly more often had congenital heart disease , siblings in kindergarten or school , treatment with oxygen at home , immunodeficiency , and neuromuscular impairment.• In infants with palivizumab prophylaxis breakthrough , RSV-related hospitalization rates were not significantly higher in those with Down syndrome Background Although information about the incidence of viral respiratory illnesses and their associated cost can help health officials explore the value of interventions , data are limited from middle-income countries . Methods During 2008–2010 , we conducted a prospect i ve cohort study and followed ~1,800 Argentinian children aged ≤5 years to identify those children who were hospitalized or who sought care at an emergency room with any acute respiratory infection sign or symptom ( e.g. , rhinorrhea , cough , wheezing , tachypnea , retractions , or cyanosis ) . Respiratory sample s were obtained for respiratory syncytial virus , influenza , parainfluenza , adenovirus , and metapneumovirus testing by immunofluorescence and for rhinovirus by real-time reverse transcription polymerase chain reaction . Results The incidence of respiratory 
    Output:
    
It is our impression that the adoption of these guidelines would help reduce the burden of RSV