Pediatric Research最新文献

{"title":"Physician perspectives on communication quality in pediatric care.","authors":"Katherine F Guttmann, Gabriella Raviv, Andrea S Weintraub","doi":"10.1038/s41390-024-03715-1","DOIUrl":"10.1038/s41390-024-03715-1","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore physician perspectives on communication quality across pediatric contexts.</p><p><strong>Methods: </strong>We conducted semi-structured interviews over a 4-month period. Purposive sampling was conducted to ensure a broad sampling of pediatricians from multiple subspecialties and practice settings. Interviews were conducted until thematic saturation was reached. An interview guide was created based on existing literature. Interviews were transcribed and analyzed for key themes.</p><p><strong>Results: </strong>Eleven pediatricians enrolled in our study. Following thematic analysis, results were organized into four primary themes: Communication Education, High Quality Communication; Low Quality Communication; and Communication Factors and Barriers. Participants prioritized information transfer as a key aspect of communication quality. They identified communication quality as having wellness implications for clinicians.</p><p><strong>Conclusion: </strong>Participants prioritize information transfer and state that clinicians often neglect bidirectional information exchange. Participants often lacked formal communication skills training which may make it difficult to navigate common barriers such as language and cultural differences, lack of time, and interprofessional dysfunction. Formal communication skills training may help overcome challenges and may enhance physician wellness while improving patient care.</p><p><strong>Impact: </strong>While the importance of clinician-parent communication in pediatric settings has been established, little is known about provider perceptions of communication quality. Participants identified information transfer as a key aspect of communication quality, often neglecting bidirectional information exchange. Participants often lacked formal communication skills training which may make it difficult to navigate common barriers such as language and cultural differences, lack of time, and interprofessional dysfunction. Formal communication skills training may help with these challenges and may enhance physician wellness while improving patient care. More work is needed to explore the impact of communication skills training on each of these factors.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591028","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":"Dietary intake and sleep in late childhood - do shorter children have distinct patterns?","authors":"Naama Fisch-Shvalb, Maya Zur, Liora Lazar, Raanan Shamir, Moshe Phillip, Michal Yackobovitch-Gavan","doi":"10.1038/s41390-024-03678-3","DOIUrl":"10.1038/s41390-024-03678-3","url":null,"abstract":"<p><strong>Background: </strong>The exceptional growth rate during adolescence demands increased dietary intake. We aimed to compare diet and lifestyle of pre-adolescents with height and weight below the 10^th percentile, with those of pre-adolescents of higher height and weight.</p><p><strong>Methods: </strong>This case-control study included healthy pre-pubertal girls (≥9 years) and boys (≥10 years). The case groups included 31 girls and 32 boys with height and weight <10th percentile, and weight percentile ≤height percentile. The control groups comprised 24 girls and 24 boys, with height ≥25th percentile, BMI 5th-85th percentiles. Participants completed 3-day food diaries and lifestyle-related questionnaires.</p><p><strong>Results: </strong>Energy intake/estimated-requirement and protein/body-weight were comparable in the case and control groups, both in boys and girls. In boys, fat (P = 0.050) and carbohydrate (P ≤ 0.001) intakes/body-weight were higher in the case group versus controls; and iron (P < 0.001), zinc (P = 0.005), vitamin A (P < 0.001), calcium (P = 0.005), and vitamin C (P = 0.034) consumption were lower. In girls, carbohydrate/body-weight was higher in the case group compared to controls (P = 0.007); micronutrient intake was comparable, and lower than recommended. Compared to controls, short and thin boys reported less sleep during weekdays (P < 0.001).</p><p><strong>Conclusions: </strong>Relatively short, thin pre-adolescents may have distinct dietary intake and sleeping patterns compared to taller peers, especially boys.</p><p><strong>Impact: </strong>Nutrition is a key environmental determinant of childhood growth. Not much is known about late nutritional impact on growth in children whose anthropometric indices are below the 10th percentile. We compared food diaries and lifestyle questionnaires of pre-pubertal pre-adolescents with height <10th percentiles and weight≤height for age and sex, with those of peers with indices in higher percentiles. We found distinct differences in micronutrient intakes and sleep duration in the shorter boys, but no energy deficit in either sex. We suggest that diet and lifestyle parameters should be evaluated in children with relatively low anthropometric indices, to ensure optimal growth.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591013","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":"Mutation spectrum and genotype-phenotype correlation of pediatric patients with methylmalonic acidemia.","authors":"Fengying Lu, Bin Zhang, Yuqi Yang, Ye Shi, Fangxiu Zheng, Qin Zhou, Yingping Chen, Lingna Zhou, Bin Yu","doi":"10.1038/s41390-024-03687-2","DOIUrl":"https://doi.org/10.1038/s41390-024-03687-2","url":null,"abstract":"<p><strong>Background: </strong>MMA incidence is significantly greater in China than in the rest of the world, but the mutation spectrum of MMA in China has not yet been mapped.</p><p><strong>Methods: </strong>We summarized published MMA-related articles and conducted a systematic meta-analysis of the literature.</p><p><strong>Results: </strong>We analyzed the gene variants information of 926 pediatric MMA patients in China; 517 were children with combined MMA, and 409 were children with isolated MMA. Almost all combined MMA cases were caused by MMACHC gene mutations (cblC-type). The c.609G>A variation was the most common in cblC-type children, accounting for 43.01%, followed by c.658_660delAAG, c.482G>A, c.80A>G, and c.394C>T variations. Mut-type MMA patients accounted for 98.8% (404/409) of all isolated MMA cases. The variant MMUT c.729_730insTT accounted for 10.30% (80/802) of all variants and was the most common variant in mut-type children, followed by c.323G>A and c.1106G>A.</p><p><strong>Conclusions: </strong>Our study summarized and characterized the mutation spectrum of Chinese pediatric patients with MMACHC and MMUT variants, and we also analyzed the relationships between common variants, onset time, and clinical phenotype. These findings will contribute to understanding the phenotypic characteristics and overall pathogenesis of MMA patients, supporting the goal of gene therapy.</p><p><strong>Impact: </strong>The incidence of methylmalonic academia (MMA) in China is significantly greater than that in the rest of the world, but the mutation spectrum of MMA in China has not yet been mapped. In this paper, for the first time, we investigated hot-spot gene variants in MMA patients in China and comprehensively described the MMA gene mutation spectrum of the Chinese population. We explored the relationship between MMA genotype and clinical phenotype in patients, providing a basis for family genetic counseling, prenatal diagnosis, and newborn screening.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583845","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":"Commentary on the invisible connection of mothers' BMI, emotional appetite, and food choices with childhood obesity.","authors":"Alessandra Mazzocchi, Veronica D'Oria, Carlo Agostoni","doi":"10.1038/s41390-024-03683-6","DOIUrl":"https://doi.org/10.1038/s41390-024-03683-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583833","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":"Obesity-related subclinical hypothyroidism in childhood: Elevated triglycerides but not basal metabolic rate.","authors":"Beata Tersander, Roger Olsson, Banu K Aydin, Rasmus Stenlid, Iris Ciba, Hannes Manell","doi":"10.1038/s41390-024-03691-6","DOIUrl":"https://doi.org/10.1038/s41390-024-03691-6","url":null,"abstract":"<p><strong>Background: </strong>Studies on the associations between obesity-related subclinical hypothyroidism with basal metabolic rate and risk factors of cardiovascular disease in children and adolescents are scarce.</p><p><strong>Methods: </strong>Retrospective cohort study of children with obesity (n = 294) from the Uppsala Longitudinal Study of Childhood Obesity cohort. Differences in basal metabolic rate quantified by indirect calorimetry, and the cardiovascular risk factors; body mass index, blood lipids, fasting and 2 h oral glucose tolerance test glucose, glycated haemoglobin and insulin resistance, between subjects with and without subclinical hypothyroidism were investigated. The associations of baseline thyroid stimulating hormone (TSH) and ΔTSH with change in cardiovascular risk factors over time were assessed.</p><p><strong>Results: </strong>Subjects with subclinical hypothyroidism had elevated triacylglycerides but no alterations in basal metabolic rate or other measured cardiovascular risk factors. ΔTSH was positively associated with Δtriacylglycerides, Δtotal-cholesterol and ΔLDL-cholesterol, independently of age, sex, Δbody mass index and ΔT₄. In the subclinical hypothyroidism group, 92% of individuals normalised their TSH 0.9-2.9 years later.</p><p><strong>Conclusions: </strong>Children with obesity and subclinical hypothyroidism did not have an altered basal metabolic rate but elevated triacylglycerides. During the follow-up period, TSH changed in parallel with several blood lipids. Elevated TSH often normalised without pharmaceutical intervention within 3 years.</p><p><strong>Impact: </strong>The present study found that subclinical hypothyroidism in paediatric obesity is related to elevated triglycerides. The present study found that subclinical hypothyroidism is not associated to basal metabolic rate in paediatric obesity. TSH change over time correlated with the change in triglycerides and LDL and total cholesterol. Among subjects with subclinical hypothyroidism at baseline 92% normalised without pharmaceutical intervention within 3 years. This research adds to the knowledge of the longitudinal, natural course of elevated TSH in paediatric obesity which is expected to help to make informed decisions regarding follow-up and evaluation of this patient group.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583856","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":"Metabolomic profiling of human feces and plasma from extrauterine growth restriction infants.","authors":"Jiang Duan, Qinghua Zhong, Liyan Luo, Yue Ning, Zhiye Qi, Sixian Wang, Kun Liang","doi":"10.1038/s41390-024-03690-7","DOIUrl":"https://doi.org/10.1038/s41390-024-03690-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Extrauterine growth restriction (EUGR) affects a substantial proportion of preterm infants and may influence both short-term complications and long-term sequelae. While many preterm infants with EUGR are secondary to small for gestational age (SGA) or very low birth weight (VLBW), a subset of EUGR infants do not exhibit these conditions. The purpose of this study is to investigate the metabolic profiles and biomarkers of EUGR infants in the absence of SGA and VLBW.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 100 feces (n = 50) and plasma samples (n = 50) were collected from participants categorized as either EUGR (EUGR group) or non-EUGR (NonEUGR group) in the absence of SGA and VLBW. Metabolites were characterized via UPLC-MS/MS using the Discovery HD4&lt;sup&gt;®&lt;/sup&gt; platform. Data normalization, partial least squares discriminant analysis (PLSDA), and KEGG enrichment analysis of metabolite profiles were performed using the MetaboAnalyst 6.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The clinical characteristics of preterm infants differed significantly between the EUGR and NonEUGR groups at discharge, including length of stay, weight Z-score, weight, height Z-score, height, head circumference, and fat-free mass. The PLSDA model exhibited clustering within groups and separation between groups. A total of 58 and 71 differential metabolites were identified in feces and plasma samples, respectively. They were involved in pathways such as caffeine, galactose, glutathione, cysteine, and methionine metabolisms. In the feces sample, 1-palmitoyl-galactosylglycerol exhibited a significant negative correlation with the growth characteristics of preterm infants, while 1-palmitoyl-2-palmitoleoyl-GPC displayed the opposite pattern. In plasma samples, androsterone glucuronide displayed a significant positive correlation with the growth characteristics of preterm infants, whereas 2-methoxyhydroquinone sulfate generated an opposite pattern. Moreover, 2-oleoylglycerol and sphinganine-1-phosphate exhibited the highest area under the curve in feces and plasma samples, respectively, according to diagnostic ROC curves.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Preterm infants with EUGR, in the absence of SGA and VLBW, exhibit specific clinical characteristics and metabolomic profiles. Sphinganine-1-phosphate and 2-oleoylglycerol may hold promise as diagnostic markers for EUGR in the absence of SGA and VLBW.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;The objective of this study is to identify the differential metabolites in preterm infants with extrauterine growth restriction (EUGR) in the absence of small for gestational age (SGA) or very low birth weight (VLBW). Preterm infants with EUGR without SGA and VLBW exhibit specific clinical characteristics and metabolomic profiles. Sphinganine-1-phosphate and 2-oleoylglycerol emerged as potential diagnostic biomarkers for EUGR. This study enhances our understanding of the metabolomic profile in preterm infants with EUGR wi","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576147","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":"Vitamin D for very preterm infants-determining the how, when, and why.","authors":"Sarah N Taylor","doi":"10.1038/s41390-024-03685-4","DOIUrl":"https://doi.org/10.1038/s41390-024-03685-4","url":null,"abstract":"<p><p>A recent survey study found that 400 IU/day vitamin D is the most common dose in United States neonatal intensive care units. Results of clinical trials are inconsistent, and, therefore, have not determined the optimal vitamin D dose for efficacy and safety in the neonatal intensive care unit. Future studies must consider the unique attributes of perinatal vitamin D metabolism and the potential role of vitamin D in immune function and organ development. IMPACT: Preterm infant vitamin D metabolism is a complex yet important area of research.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576167","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":"Cerebral blood flow in neonatal encephalopathy: biomarker or potential target?","authors":"Julia K Charlton, Khushboo Kanwal","doi":"10.1038/s41390-024-03684-5","DOIUrl":"https://doi.org/10.1038/s41390-024-03684-5","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576035","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":"Comparison of BiliCocoon phototherapy with overhead phototherapy in hyperbilirubinemic neonates. A randomized clinical trial.","authors":"Mette L Donneborg, Pernille K Vandborg, Niels H Bruun, Lars Bender, Tina Møller, Helle H Thomsen, Finn Ebbesen","doi":"10.1038/s41390-024-03692-5","DOIUrl":"10.1038/s41390-024-03692-5","url":null,"abstract":"<p><strong>Background: </strong>Around 2-6% of term or late preterm neonates receive phototherapy for hyperbilirubinemia. Standard treatment today is overhead phototherapy. A new device has been developed, the BiliCocoon, where the neonates are \"wrapped\" presumably making them more comfortable. The aim was to compare the efficacy and performance of the BiliCocoon with overhead LED phototherapy.</p><p><strong>Methods: </strong>A randomized open-label multicenter trial in three Danish neonatal units. Healthy hyperbilirubinemic neonates, gestational age ≥33 weeks and postnatal age 24 h to 14 days were randomized to 24 hours' of treatment with BiliCocoon or overhead blue LED phototherapy with an equal level of irradiance. A mixed effect model with random effect by center was used to compare the percentage decrease in total serum bilirubin (TSB) between the treatments.</p><p><strong>Results: </strong>Totally 83 neonates were included. Mean TSB reduction in the BiliCocoon group (N = 42), adjusted for baseline TSB, was significantly lower than in the overhead LED group (N = 41), 29% vs. 38% (p-value < 0.01). Overall difference in temperature by treatment (BiliCocoon vs overhead) was 0.70 [0.37; 1.02] °C, p-value < 0.01.</p><p><strong>Conclusion: </strong>Bilirubin reducing efficacy of BiliCocoon was lower than that of overhead phototherapy, but it was sufficient for nearly all neonates during 24 hours of treatment.</p><p><strong>Impact: </strong>The BiliCocoon has a bilirubin reducing efficacy, sufficient for almost all neonates during 24 hours of phototherapy. The BiliCocoon does not have an equal bilirubin reducing efficacy as overhead phototherapy. The duration of light exposure was longer for the neonates treated in the BiliCocoon. A few neonates can be exclusively breastfed in the BiliCocoon throughout the treatment. The reason for stopping breastfeeding in the BiliCocoon was most often, that the neonates developed hyperthermia.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568496","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":"Transforming pediatric healthcare: a decade of innovation in global hospitals (2015-2024).","authors":"Anjali Alamshaw, Vivian Nguyen, Jasmin Joshi, Amber Osorno, Hana Baig, Anthony Chang","doi":"10.1038/s41390-024-03697-0","DOIUrl":"https://doi.org/10.1038/s41390-024-03697-0","url":null,"abstract":"<p><strong>Background: </strong>As pediatric hospitals continue to grow in innovation, it is important to create a standardized metric to measure this growth and create a network to encourage further innovation. We worked to classify all pediatric hospitals on a scale of innovation with the goal of encouraging collaboration that can lead to more overall innovation.</p><p><strong>Methods: </strong>All pediatric hospitals worldwide were ranked on a scale of innovation from 1 to 3, with 1 being the most innovative, or \"established,\" and 3 being the least innovative, or \"nascent.\" This scale is based on information found on the hospital's website or in articles about the hospital with regards to their innovation. These hospitals were ranked in 2015, 2020, and between 2023 and 2024 among five different raters.</p><p><strong>Results: </strong>The number of worldwide hospitals in each category of innovation was evaluated in 2015, 2020, and 2023-2024. Between 2015 and 2024, there was a 48% decrease in the number of \"nascent\" hospitals, a 4.5% increase in \"emerging\" hospitals, and a 120% increase in \"established\" hospitals.</p><p><strong>Conclusion: </strong>The changes that hospitals have undergone in their respective categories of innovation over the past nine years suggest an overall increase in innovation.</p><p><strong>Impact: </strong>Pediatric hospitals worldwide have become more innovative over the past decade, but there is very limited literature that has assessed this trajectory at a broad level. Creating a standardized metric of innovation can promote a culture that enables less innovative hospitals to collaborate with their more innovative counterparts This metric of innovation is the first that we've seen in the literature that assesses all pediatric hospitals on a scale of innovation and tracks their progress over time.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564556","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}