Pediatric Research最新文献

{"title":"Comparison of diagnostic criteria for disseminated intravascular coagulation in critically ill children.","authors":"Jiao Chen, Xiuxiu Li, Yuxiao Sun, Yanbing Fu, Hongmei Chen","doi":"10.1038/s41390-026-05394-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05394-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess disseminated intravascular coagulation (DIC) incidence and its correlation with pediatric intensive care unit mortality across various scoring systems to identify the most effective diagnostic approach for different subgroups of critically ill children.</p><p><strong>Methods: </strong>This observational cohort study compared five established diagnostic criteria for DIC: the International Society on Thrombosis and Hemostasis overt DIC criteria (DIC-ISTH 2021 and 2025criteria), sepsis-induced coagulopathy criteria (SIC-ISTH and SIC-China criteria) and the Chinese DIC Scoring System.</p><p><strong>Results: </strong>This study of 2015 critically ill children revealed substantial variation in DIC incidence rates across diagnostic criteria, with SIC-ISTH consistently identifying the highest proportion of cases. There was excellent agreement between the 2021 and 2025 DIC-ISTH criteria and near-perfect agreement between the SIC-ISTH and SIC-China criteria, with consistent results across all subgroups. In patients with sepsis, SIC criteria exhibited higher area under the curve (AUC) and sensitivity than DIC criteria. Among patients with hematologic malignancies, mortality rates and sensitivity for mortality discrimination were comparable between SIC and DIC criteria.</p><p><strong>Conclusions: </strong>DIC incidence varies significantly depending on diagnostic criteria and clinical subgroup. SIC criteria provide the most reliable for early detection of DIC. A combination of the SIC-ISTH and DIC-ISTH (2001) criteria is recommended for screening overt-DIC in critically ill pediatric patients.</p><p><strong>Impact: </strong>1. Disseminated intravascular coagulation is a life-threatening condition in pediatric critical care, strongly correlating with multiorgan dysfunction and mortality. 2. No single definition has proven superior, and a universal consensus on the most appropriate diagnostic criteria for pediatric patients remains lacking. 3. This study addresses a critical gap in pediatric critical care by systematically evaluating five established DIC diagnostic criteria in a heterogeneous PICU cohort, including sepsis and hematologic malignancy subgroups. 4. Our key findings directly align with your journal's focus on evidence-based approaches to pediatric research.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The successes of the last 50 years in children's environmental health are the foundation for the next 50.","authors":"Richard J Jackson","doi":"10.1038/s41390-026-05384-8","DOIUrl":"https://doi.org/10.1038/s41390-026-05384-8","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECI biocommentary: John Sunwoo.","authors":"John Sunwoo","doi":"10.1038/s41390-026-05426-1","DOIUrl":"https://doi.org/10.1038/s41390-026-05426-1","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A gestation-dependent association between chorioamnionitis and early transepidermal water loss in extremely preterm infants.","authors":"Colin P McGrath, Michael A Boyle","doi":"10.1038/s41390-026-05443-0","DOIUrl":"https://doi.org/10.1038/s41390-026-05443-0","url":null,"abstract":"<p><strong>Background: </strong>To determine whether chorioamnionitis-exposure in extremely preterm infants was associated with higher transepidermal water loss (TEWL) and to explore whether this relationship varied by gestational age, placental histopathology and illness severity.</p><p><strong>Methods: </strong>In this prospective single-centre cohort study, infants ≤27⁺⁶ weeks' gestational age underwent closed-chamber TEWL measurement on days 1, 3 and 14 in humidified incubators utilizing standardized methodology. Infants were classified according to placental histopathology and inflammation severity. Interactions assessed included gestational and postnatal age, and illness acuity.</p><p><strong>Results: </strong>Thirty-seven infants were included, 13 of which had histological chorioamnionitis. Chorioamnionitis was associated with higher day-one TEWL; however, this was no longer significant after gestational adjustment (p = 0.152). A significant gestation-by-chorioamnionitis interaction was confined to the most immature infants (p = 0.017). In this cohort, higher TEWL was associated with a placental inflammatory response and postnatal instability. Adjusted TEWL declined from days 1 to 14, with the greatest between-group difference on day-one.</p><p><strong>Conclusion: </strong>In this exploratory cohort, the association between histological chorioamnionitis and early TEWL was modified by gestational age, with higher TEWL observed among the most immature exposed infants. These hypothesis-generating findings suggest that fetal inflammation and early physiological instability may both contribute to impaired barrier adaptation.</p><p><strong>Impact: </strong>Chorioamnionitis-exposure and epidermal immaturity are frequent hallmarks of extreme prematurity. Although several morbidities have been attributed to chorioamnionitis, a skin component remains unclear. We report a gestation-dependent association between chorioamnionitis and skin integrity, most evident in infants at or below approximately 25 weeks' gestational age. A fetal inflammatory response may contribute to both elevated transepidermal water loss and postnatal instability, suggesting these may contribute alongside immaturity to impaired barrier function in the most preterm infants. Our findings suggest extremely preterm infants exposed to intrauterine inflammation may be uniquely vulnerable to fluid imbalance or skin injury owing to compromised barrier integrity.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It is time for change: cumulative stress in extremely preterm infants in neonatal care.","authors":"Danton Matheus de Souza","doi":"10.1038/s41390-026-05448-9","DOIUrl":"https://doi.org/10.1038/s41390-026-05448-9","url":null,"abstract":"<p><strong>Impact: </strong>The publication of a commentary provides an opportunity to increase the visibility of a manuscript published in the journal by highlighting a research phenomenon with significant potential.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nothing about us without us: advancing family-centered research and care in neonatal encephalopathy.","authors":"Julia K Charlton, Tom Wiebe","doi":"10.1038/s41390-026-05433-2","DOIUrl":"https://doi.org/10.1038/s41390-026-05433-2","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early development of cortical networks is modulated by Family Nurture Intervention: a multicenter replication study.","authors":"Pauliina Yrjölä, Michael M Myers, Robert J Ludwig, Martha G Welch, Sampsa Vanhatalo, Anton Tokariev","doi":"10.1038/s41390-026-05432-3","DOIUrl":"https://doi.org/10.1038/s41390-026-05432-3","url":null,"abstract":"<p><strong>Background: </strong>Prematurity is associated with a high risk of abnormal neurodevelopment, inflicting life-long neurocognitive consequences with major public health importance. This calls for early biomarkers of functional brain development to serve as indicators of the effect of environmental enrichment in neonatal intensive care units (NICU).</p><p><strong>Methods: </strong>Here, we studied whether the previously found functional brain network effects of Family Nurture Intervention (FNI) are replicated in an independent trial, and when these effects arise in early brain development. We compared networks in infants following FNI treatment to infants receiving standard NICU care (SC) and to term-born healthy controls (HC).</p><p><strong>Results: </strong>We found that the prior network results, i.e. decrease in the strength of phase-based networks of FNI infants, replicated fully within the same site and partially at an external validation site. Moreover, longitudinal tracking of cortical networks disclosed an early divergence of trajectories between FNI and SC groups during the preterm period, resulting in no detectable difference in the functional networks of FNI and HC infants at term age, while the corresponding networks of SC infants showed significant difference.</p><p><strong>Conclusion: </strong>The findings together support the idea that FNI may modulate early developmental trajectories of cortical networks and mitigate effects of prematurity.</p><p><strong>Impact: </strong>Previously reported brain network effects of Family Nurture Intervention (FNI) replicated fully in an independent trial within the same site and partially at an external validation site. Developmental analysis revealed that FNI lead infants to a different trajectory of brain development compared to infants receiving standard care, resulting in no detectable difference in their functional networks compared to healthy term-born counterparts at term age. The findings together support the idea that FNI may modulate early developmental trajectories of cortical networks and mitigate the effects of prematurity. FNI provides an accessible and cost-effective intervention with potentially substantial global impact.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of the pediatric research workforce: implications of an evolving fellowship training landscape.","authors":"Kimberly Montez, Elizabeth E Halvorson, Maya I Ragavan","doi":"10.1038/s41390-026-05459-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05459-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin resistance in children: time to test the foundations.","authors":"Elaine Catherine Kennedy, Colin Patrick Hawkes","doi":"10.1038/s41390-026-05458-7","DOIUrl":"https://doi.org/10.1038/s41390-026-05458-7","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gut-brain axis in IgA vasculitis with neurological involvement: from association to experimentally tractable hypotheses.","authors":"Qian Xu","doi":"10.1038/s41390-026-05492-5","DOIUrl":"https://doi.org/10.1038/s41390-026-05492-5","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}