Frontiers in Pediatrics最新文献

{"title":"Value of adding 0.01% atropine with orthokeratology for myopia in children: an updated meta-analysis of randomized controlled trials.","authors":"Shudan Tu, Huangfang Ying, Liyang Ni, Zilong Zhang, Weiping Hu","doi":"10.3389/fped.2025.1571790","DOIUrl":"10.3389/fped.2025.1571790","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to compare outcomes of 0.01% atropine with orthokeratology (AOK) vs. orthokeratology (OK) alone for slowing the progression of myopia in children.</p><p><strong>Methods: </strong>MEDLINE via PubMed, Embase, Scopus, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Chinese electronic databases of VIP, and Wanfang were searched from inception until 19th August 2024 for randomized controlled trials (RCTs) about the review topic. The primary outcome was a change in axial length (AL) (mm). Secondary outcomes were spherical equivalent refraction (SER) (Diopter), pupil diameter (PD) (mm), amplitude of accommodation (AA) (Diopter), and intraocular pressure (IOP) (mmHg).</p><p><strong>Results: </strong>10 articles corresponding to eight RCTs were included. Meta-analysis found that change in AL was significantly reduced with AOK as compared to OK alone at 6 months (MD: -0.10 95% CI: -0.14, -0.06 I² = 48%), 12 months (MD: -0.08 95% CI: -0.10, -0.07 I² = 0%) and 24 months (MD: -0.14 95% CI: -0.19, -0.08 I² = 0%). Pooled analysis found that AOK did not reduce the progression of SER (MD: 0.06 95% CI: -0.00, 0.12 I² = 7%) and increased PD (MD: 0.63 95% CI: 0.40, 0.85 I² = 86%) as compared to OK alone. Pooled analysis also found a tendency of reduced AA with AOK as compared to OK alone but without significant results (MD: -0.45 95% CI: -1.00, 0.10 I² = 59%). Meta-analysis failed to show a statistically significant difference in change of IOP between AOK and OK (MD: -0.49 95% CI: -1.48, 0.50 I² = 51%).</p><p><strong>Conclusions: </strong>AOK seems to be more efficacious in slowing the progression of myopia in children as compared to OK alone.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1571790"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bibliometric analysis of research trends in mesenchymal stem cell therapy for neonatal bronchopulmonary dysplasia: 2004-2024.","authors":"Lu Bai, Yue Xin","doi":"10.3389/fped.2025.1558301","DOIUrl":"10.3389/fped.2025.1558301","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Bronchopulmonary dysplasia (BPD) is a chronic lung disease predominantly affecting preterm infants, often requiring mechanical ventilation and supplemental oxygen. The pathogenesis of BPD involves a combination of genetic susceptibility and environmental insults, such as oxidative stress and mechanical ventilation. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic option for BPD due to their immunomodulatory, anti-inflammatory, and regenerative properties. This study aims to perform a bibliometric analysis of the publication landscape surrounding MSC therapy for BPD to identify research trends, collaborative networks, influential research clusters, and emerging research frontiers from 2004 to 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A bibliometric analysis was conducted using the Web of Science Core Collection (WoSCC) as the primary database due to its comprehensive citation indexing and standardized metadata. To ensure data integrity, we included publications from January 2004 (when the first relevant MSC studies for BPD began appearing) to November 2024. The search query combined terms related to BPD and MSCs, focusing on English-language articles and reviews. After retrieval, data were cleaned through duplicate removal and relevance verification processes. Quantitative analysis was performed on publication counts, authors, journals, institutions, and countries. Visual analysis tools, VOSviewer ( 1) and CiteSpace ( 2), were employed to map collaboration networks and identify research clusters through co-citation and co-occurrence analyses. Statistical validation of bibliometric distributions was conducted using Bradford's law and Price's law. Citation metrics were normalized by publication year to account for citation accumulation bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 353 publications were analyzed, including 216 articles and 137 reviews, from 555 institutions across 35 countries. Time-series analysis revealed a significant acceleration in publication output after 2015 (&lt;i&gt;p&lt;/i&gt; &lt; 0.01), with a compound annual growth rate of 18.2%. The United States was the leading contributor (131 publications, 37.1%), followed by China (72 publications, 20.4%) and Canada (54 publications, 15.3%). Network analysis identified five distinct collaborative clusters, with limited cross-cluster collaboration. Citation analysis, normalized for publication age, revealed that the American Journal of Respiratory and Critical Care Medicine had the highest field-weighted citation impact (3.8). Keyword co-occurrence analysis demonstrated a significant shift from whole-cell therapies to extracellular vesicle research after 2018, with \"microvesicles\" and \"exosomes\" emerging as high-intensity burst terms (burst strength &gt;5.0). The co-citation analysis identified three primary research clusters: stem cell therapy mechanisms (42.3% of citations), respiratory physiology and pathology (38.1%), and clinical neonatology ","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1558301"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buried penis; what buried the penis?","authors":"Mohamed Fawzy, Ahmed T Hadidi","doi":"10.3389/fped.2025.1590147","DOIUrl":"10.3389/fped.2025.1590147","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the histological and immuno-histochemical features of dartos fascia in buried penis (BP) as compared to dartos fascia in hypospadias and normal children.</p><p><strong>Materials and methods: </strong>The study included 40 children, operated on in our center between January 2023 and January 2024. Patients were divided into 3 groups; <b>group A</b>: 13 patients with BP, <b>group B</b>: 14 patients with different grades of distal Hypospadias, and <b>group C</b> with 13 patients who were referred for circumcision (control group). All dartos fascia specimens were blindly examined by the same pathologist. The 3 groups were assessed for histological findings including collagen, elastin, nerve fibers, tactile bodies, fat, smooth muscles.</p><p><strong>Results: </strong>In group A (BP), there was statistically significant dominance of thick collagen fibers (thick fibers) <i>p</i> < 0.001, thick smooth muscle fibers (<i>P</i> < 0.001), thick convoluted nerve fibers (<i>p</i> = 0.004) and less fat (<i>P</i> < 0.001) as compared to the hypospadias and control groups. In the hypospadias group, intermediate collagen fibers were the predominant type of fibers (<i>p</i> < 0.001), in addition to long, thin and short thin elastin fibers (<i>p</i> < 0.001) compared to the buried penis and the control groups. The hypospadias group also had significant predominance of chaotic disorganized nonparallel smooth muscle fibers <i>p</i> = 0.003.</p><p><strong>Conclusion: </strong>The fascia in BP is characterized by abnormally thick collagen fibers, thick smooth muscle fibers and thick convoluted nerve fibers. This may explain why the penis is drawn inwards in BP and suggests that it is probably recommended to excise this abnormal fascia during the surgical correction.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1590147"},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"<i>They fell through the cracks:</i>\" caregiver perspectives on the difficulties of COVID-19 implementation transitions for children and youth with special healthcare needs (CYSHCN).","authors":"D Grace Smith, Mary Kathryn Cancilliere, Tara M Hayes, Anashua Rani Elwy, Indra Neil Sarkar","doi":"10.3389/fped.2025.1440680","DOIUrl":"10.3389/fped.2025.1440680","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 virus and its relevant prevention protocol had significant impacts on children and youth with special healthcare needs (CYSHCN), including those with physical, intellectual, and developmental disabilities. Previous studies have examined the first year of the pandemic, identifying the implications of social distancing, remote services/education, and masking and testing protocol on the mental, physical, and developmental well-being of this population.</p><p><strong>Objectives: </strong>We focus on moments of transition, when vaccines were disseminated and mandates/resources removed. By identifying how protocol and interventions in these moments included, neglected, or negatively impacted CYSHCN, we can inform more inclusive, safe, and equitable decision-making in future health crises.</p><p><strong>Methods: </strong>We report the transition-moment-related reflections of fourteen focus groups conducted among caregivers (including parents) of CYSHCN between March and December of 2022 (<i>n</i> = 77). Focus groups were conducted in close partnership with a local non-profit organization, and facilitation protocol were co-developed by community leaders in the CYSHCN area. Focus groups were recorded, transcribed, and analyzed using directed content analysis and thematic analysis, guided by implementation science theories on interventions' relative dis/advantages and perceived adaptability.</p><p><strong>Results: </strong>Caregivers provided transition-moment reflections of how the timing, support, and in/flexibility of pandemic intervention implementation and de-implementation negatively impacted their CYSHCN. We generated three themes to describe these views: (1) \"<i>Our kiddos didn't have a plan when this happened</i>:\" Lack of transition support into isolation meant loss of necessary structures and services; (2) \"<i>He couldn't comprehend</i>:\" Transition communication, particularly surrounding mandates and protocol, was not handled well for CYSHCN; and (3) \"<i>Listen, we're still in the middle of pandemic</i>:\" Transition timing neglected consideration of CYSHCN.</p><p><strong>Discussion: </strong>CYSHCN needs were neglected in the pandemic's transition moments, creating significant implications for their mental/emotional, physical, and cognitive/developmental well-being. Reflecting these findings, and particularly facets that extend established literature, we urge inclusive research and policy models, empowering members of the CYSHCN community as leaders in knowledge and protocol production, particularly when considering the adaptability and relative advantage of interventions. Such models are crucial in developing messaging around pandemic policies, creating infrastructural support for flexibility, and adding supports and delays when de-implementing mandates.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1440680"},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a routine respiratory follow-up after prematurity less than 32 weeks gestation or below 1,500 g birthweight at preschool age-a two-year experience.","authors":"Michaela Höck, Anna Zschocke, Ulrike Pupp-Peglow, Carolin Marcher, Barbara Brunner, Maria Schütz, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.3389/fped.2025.1604037","DOIUrl":"10.3389/fped.2025.1604037","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence indicates that prematurity adversely affects lung function, even in early childhood, thus, a routine respiratory follow-up was implemented in our clinical setting. The aim of this study was to evaluate the acceptance of this examination and assess the feasibility of forced expiratory maneuvers and bronchodilator responsiveness test (BRT) in former preterm infants at preschool age and to present initial results.</p><p><strong>Methods: </strong>In November 2022, a respiratory follow-up was implemented for former preterm infants born at less than 32 weeks of gestation or with a birth weight below 1,500 g, who were born between 2016 and 2019 at Innsbruck Medical University Hospital. The evaluation included a standardized clinical examination, collection of medical history, spirometry, and a BRT.</p><p><strong>Results: </strong>A total of 107 former preterm infants (median gestational age 29.9 (28.1; 31.1) weeks and mean birthweight 1,250.5 (±355.6) grams performed spirometry. Successful spirometry was achieved by 93 (86.9%) children. Among these, 64 (59.8%) had normal pulmonary function and were symptom-free, however, ten (15.6%) showed a positive BRT. Twenty-nine children (27.1%) exhibited pathological test results and/or respiratory symptoms, with 13 (44.8%) of them testing positive for bronchial hyper-responsiveness. Fourteen children (13.1%) did not meet the quality control criteria for spirometry but were symptom-free.</p><p><strong>Conclusion: </strong>Our study demonstrated that a respiratory follow-up for preterm infants is highly accepted and feasible at preschool age. Up to 30% of infants were identified with impaired lung function and subsequently received appropriate management, highlighting the importance of standardized and routine respiratory follow-up for these children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1604037"},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical relevance of bacterial and/or viral coinfection in acute bronchiolitis in an Italian neonatal unit during the 2021-2023 seasons.","authors":"Venere Cortazzo, Marilena Agosta, Domenico Umberto De Rose, Valeria Fox, Velia Chiara Di Maio, Gianluca Vrenna, Martina Rossitto, Barbara Lucignano, Stefania Ranno, Annamaria Sisto, Cristina Russo, Annabella Braguglia, Maria Paola Ronchetti, Andrea Dotta, Carlo Federico Perno, Paola Bernaschi","doi":"10.3389/fped.2025.1577913","DOIUrl":"10.3389/fped.2025.1577913","url":null,"abstract":"<p><strong>Background: </strong>Acute bronchiolitis is a leading cause of hospitalization in young children worldwide, and literature reports conflicting data regarding the role of coinfections.</p><p><strong>Objective: </strong>To evaluate the possible clinical relevance of bacterial and/or viral respiratory coinfection in a cohort of newborns/infants hospitalized for bronchiolitis.</p><p><strong>Methods: </strong>Neonates and infants younger than three months admitted to neonatal units from October 2021 to March 2023 because of acute bronchiolitis were included in this retrospective study. Analyses were performed with Stata 11.1 (<i>p</i> < 0.05). Data were summarized as medians (IQR) or counts (%). Appropriate tests were used based on data type and distribution, with Benjamini-Hochberg correction for multiple comparisons. Odd Ratios (ORs) were unadjusted.</p><p><strong>Results: </strong>In a cohort of 240 patients, respiratory coinfection was associated with a longer hospital stay (<i>p</i> < 0.001) and the need for invasive mechanical ventilation (<i>p</i> < 0.001) compared to viral mono-infection, highlighting a potential role in patient outcome. Moreover, we observed that premature patients are more likely to contract a respiratory coinfection than a viral mono-infection (<i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>Coinfections increased the clinical severity of bronchiolitis more than simple viral mono-infection in our cohort, contributing to a longer hospital stay and the need for invasive mechanical ventilation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1577913"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices of polio vaccination among mothers attending vaccination sites in Gaza during the conflict.","authors":"Abdel Hamid El Bilbeisi, Amany El Afifi, Samer Abuzerr, Isra Kanan Alwahedy, Saja Kanan Alwahedy","doi":"10.3389/fped.2025.1569650","DOIUrl":"10.3389/fped.2025.1569650","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the knowledge, attitudes, and practices (KAP) related to polio vaccination among mothers attending vaccination sites in Gaza during the ongoing conflict.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from 1 to 12 September, 2024, targeting a representative sample of 474 mothers from ten primary healthcare centers across the governorates of Gaza. Participants were randomly selected using a cluster sampling method. Data on socio-demographics and KAP towards polio vaccination were collected through a validated, interview-based questionnaire. Statistical analysis was performed using SPSS version 26.</p><p><strong>Results: </strong>Of the 474 mothers surveyed, 44.7% were between 26 and 30 years old. Around 35.4% had a primary-level education, 48.1% were employed, 48.5% had two to three children, and 49.4% had children aged between one day and less than twelve months. The majority of mothers exhibited good knowledge (85.7%), positive attitudes (86.1%), and good practices (67.1%) regarding childhood vaccination. Knowledge scores were significantly associated with the mother's age, number of children, and the children's age. Attitude scores were significantly related to the mother's age and number of children (<i>P</i> < 0.05 for all). However, no significant relationship was observed between socio-demographic factors and practice scores.</p><p><strong>Conclusion: </strong>Most mothers demonstrated good knowledge and positive attitudes towards polio vaccination, although only about two-thirds reported good vaccination practices. Younger mothers and those with younger children had better knowledge, while middle-aged mothers expressed more positive attitudes. Importantly, socio-demographic factors were not linked to practice levels. The relatively low adherence to vaccination practices requires further attention.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1569650"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of infantile subglottic hemangioma: a 10-year experience of 25 cases.","authors":"Xiaoben Liang, Rong Xu, Hongming Xu, Jiarui Chen, Xiaoyan Li","doi":"10.3389/fped.2025.1499656","DOIUrl":"10.3389/fped.2025.1499656","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the clinical appearances of infantile subglottic hemangioma (SGH) and the diagnostic value of flexible fiberoptic laryngoscopy (FFL) combined with contrast-enhanced CT (CECT).</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 25 children diagnosed with SGH from January 2012 to January 2022.</p><p><strong>Results: </strong>FFL showed a smooth, rounded, vascular-appearing submucosal lesion in the subglottic wall, while CECT revealed an enhancing lesion, obscuring the airway lumen. Among the 25 cases (8 males and 17 females; 10 left-sided, 11 right-sided, and 4 middle), the clinical appearances contained stridor (25), respiratory distress (13), three-concave sign (10), barking cough (9), feeding difficulty (8), cyanosis (2), and hoarseness (2). SGH with cutaneous hemangiomas accounted for 24% (6/25). The age at presentation ranged from 1 day to 8 months (median, 33 days), including 96% (24/25) of cases aged <6 months. Moreover, 92% (23/25) of cases had a history of misdiagnosis, 22 respiratory infections, 5 laryngomalacia, 1 laryngeal cyst, and 1 asthma, individually or in combination. Except for one case that died of polygenic abnormality and another case lost to follow-up, the remaining 23 cases were cured after oral propranolol.</p><p><strong>Conclusions: </strong>For an infant with respiratory symptoms, who has repeated condition or poor effect after routine treatment, SGH should be considered, especially in infants under 6 months old. FFL combined with CECT is recommended to make a definite diagnosis of SGH.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1499656"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of physical activity and screen time with vitamin D status among children with disabilities.","authors":"Wen Wang, Zhe Wang, Haixia Sun, Guowei Li, Su Liu, Zheng Xue","doi":"10.3389/fped.2025.1558685","DOIUrl":"10.3389/fped.2025.1558685","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) and screen time (ST) may influence vitamin D status in children with disabilities, yet their relationships remain understudied in this population.</p><p><strong>Methods: </strong>We analyzed data from 645 children with disabilities aged 3-19 years. PA and ST were categorized into quartiles. Multiple linear regression models were used to examine associations between PA, ST, and vitamin D levels, adjusting for demographic and clinical characteristics.</p><p><strong>Results: </strong>Higher PA was positively associated with vitamin D levels (<i>β</i> = 0.984, 95% CI: 0.388-1.58, <i>p</i> = 0.003) in fully adjusted models. Participants in the highest PA quartile had significantly higher vitamin D levels compared to the lowest quartile (<i>β</i> = 6.884, 95% CI: 2.736-11.031, <i>p</i> = 0.003). Conversely, ST showed an inverse association with vitamin D levels (<i>β</i> = -0.8, 95% CI: -1.414 to -0.186, <i>p</i> = 0.015), with the highest ST quartile showing significantly lower vitamin D levels compared to the lowest quartile (<i>β</i> = -8.098, 95% CI: -13.318 to -2.877, <i>p</i> = 0.005). Males were more likely to engage in high PA (66.31%), and both PA and ST showed significant age-related patterns.</p><p><strong>Conclusions: </strong>Our findings reveal clear links between physical activity, screen time, and vitamin D levels in children with disabilities. Promoting physical activity and reducing screen time may be effective strategies to improve vitamin D status in this population.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1558685"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tachycardia and persistent pulmonary hypertension of the newborn.","authors":"Ourania Kaltsogianni, Ravindra Bhat, Anne Greenough, Theodore Dassios","doi":"10.3389/fped.2025.1607907","DOIUrl":"10.3389/fped.2025.1607907","url":null,"abstract":"<p><strong>Background: </strong>It is not known whether tachycardia in persistent pulmonary hypertension of the newborn (PPHN) is due to the use of inotropic agents or is a pathophysiological process related to the disease <i>per se</i>. In this study, we aim to test the hypothesis that tachycardia in PPHN would be related to non-invasive indices of PPHN.</p><p><strong>Methods: </strong>This is a retrospective study of ventilated infants with echocardiographically confirmed PPHN at the Neonatal Intensive Care Unit of King's College Hospital NHS Foundation Trust. The difference of the partial pressure of arterial (PaCO₂) to end-tidal CO₂ (EtCO₂) or PaCO₂-EtCO₂ gradient was calculated as an index of PPHN severity and was related to the level of tachycardia at acute PPHN and after the resolution of PPHN (pre-extubation).</p><p><strong>Results: </strong>Fifteen infants with PPHN were studied, whose median (interquartile range, IQR) gestational age was 35.7 (34.1-40.3) weeks and birth weight was 2.95 (2.17-3.20) kg. It was found that the median (IQR) heart rate was higher during acute PPHN [158 (122-169) bpm] compared with that during pre-extubation [119 (111-136) bpm, <i>p</i> = 0.016]. The difference in the heart rate at acute illness and pre-extubation was significantly related to the difference in the PaCO₂-EtCO₂ gradient (correlation coefficient = 0.732, <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>There was a significant association between tachycardia and the severity of PPHN in ventilated infants, possibly describing that tachycardia is the result of PPHN <i>per se</i>, as well as the effect of inotropes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1607907"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}