Pediatric Research最新文献

{"title":"Correction: Age-specific ETCOc measured by non-dispersive infrared spectroscopy predicts neonatal phototherapy.","authors":"Yixiang Wu, Chenyu Zhu, Yuan Zheng, Yanan Zhao, Hongxun Xu, Ruoyun Tang, Yingbo Rao, Zhongyue Li, Lizhong Du","doi":"10.1038/s41390-026-05516-0","DOIUrl":"https://doi.org/10.1038/s41390-026-05516-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228502","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":"Higher risk of testicular atrophy after partial orchiectomy performed before one year of age.","authors":"Jia You, Jun Wang","doi":"10.1038/s41390-026-05585-1","DOIUrl":"https://doi.org/10.1038/s41390-026-05585-1","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216581","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":"Performance of large language models in pediatric infectious disease education: a multi-condition comparative study.","authors":"Kubra Aykac, Osman Cubuk, Osman Oguz Demir, Young June Choe, Soichiro Kawata, Kamila Ludwikowska, Mike Yat Wah Kwan, Malik Aydin, Yasemin Ozsurekci","doi":"10.1038/s41390-026-05578-0","DOIUrl":"https://doi.org/10.1038/s41390-026-05578-0","url":null,"abstract":"<p><strong>Background: </strong>Evaluating how appropriate current large language models (LLMs) respond to common pediatric infectious disease (PID) questions is important for understanding their potential role in education and clinical support. Therefore, we evaluated and compared the clinical quality of answers produced by different LLMs when given professionally written, clinician-style case descriptions, using a purpose-built multi-domain evaluation tool.</p><p><strong>Methods: </strong>Three different LLMs, including DeepSeek-V3.2-Exp, ChatGPT-5, and Gemini 2.5 Flash, were investigated using 12 relevant PID scenarios. Each scenario included five open-ended questions: etiology, clinical features, diagnostics, treatment options, and complications. Two PID specialists independently reviewed all responses using a Likert scoring tool.</p><p><strong>Results: </strong>All three models received high overall scores. ChatGPT-5 achieved perfect domain scores (10.0), whereas DeepSeek-V3.2-Exp showed similarly strong results, with only minor reductions in diagnostics (9.83) and treatment (9.92). Gemini 2.5 Flash demonstrated higher variability, particularly in treatment (8.83) and diagnostics (9.75), while matching the other models in clinical findings and complications (10.0) and scoring 9.83 in etiology. However, there were no statistically significant differences across models in domain-level comparisons (all p > 0.05). In addition, model-level analyses similarly demonstrated high accuracy (6.0; 5.98; 5.85), completeness (3.0; 2.97; 2.87), and safety (1.0; 1.0; 0.97) for ChatGPT-5, DeepSeek-V3.2-Exp, and Gemini 2.5 Flash, respectively (accuracy: p = 0.074; completeness: p = 0.066; safety: p = 0.14).</p><p><strong>Conclusion: </strong>Current LLMs performed highly in structured, expert-reviewed PID scenarios and may assist with information organization and early-stage clinical reasoning. However, their optimal use remains within clinician-supervised workflows, where AI-generated outputs complement, rather than replace, human clinical judgment.</p><p><strong>Impact: </strong>Current large language models (LLMs) show consistently high-quality performance across pediatric infectious disease scenarios, with no significant differences between models. Our study adds a structured, multi-domain comparison using clinician-style cases and expert evaluation, providing detailed insights into accuracy, completeness, and safety. The findings support the use of LLMs in medical education and early clinical reasoning, while highlighting their role as clinician-supervised tools rather than replacements for clinical judgment. The results demonstrate the reliability of LLMs in organizing clinical information and identifying key diagnostic and management elements in standardized scenarios.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216647","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":"Profile of human milk oligosaccharides and maternal FUT2 polymorphism: genotype-phenotype correlation and proposed cut-off for secretor status.","authors":"Klara Yuliarti, Sander Sebastian van Leeuwen, Muchtaruddin Mansyur, Ina S Timan, Yulia Ariani, I Gusti L Sidiartha, Erna Simanjuntak, Damayanti Rusli Sjarif","doi":"10.1038/s41390-026-05579-z","DOIUrl":"https://doi.org/10.1038/s41390-026-05579-z","url":null,"abstract":"<p><strong>Background: </strong>Human milk oligosaccharides (HMO) are complex carbohydrates which is undigestible to humans and confer health benefits. The synthesis of HMOs is determined by fucosyltransferase enzymes, which are encoded by FUT2/FUT3 genes. Polymorphisms of the FUT2 result in various secretor status. This study aimed to identify the proportion of secretor and FUT2 genotype-phenotype correlation in Indonesian mothers.</p><p><strong>Methods: </strong>This was a cross-sectional study, recruiting 120 healthy mothers aged at least 18 years who exclusively breastfed. Breastmilk samples were obtained at infant's age 2-5 weeks old. Analysis of HMO was performed using Ultra High-Performance Liquid Chromatography-Fluorescence Detection. Sequencing of entire coding region was performed to find genetic variants of FUT2. The ROC analysis was done to determine the threshold value of 2'FL based on FUT2 genotype.</p><p><strong>Results: </strong>The proportion of secretor was 65.8%. A novel FUT2 variant was identified, c.851C>G. There was a significant association between secretor genotype and phenotype (p < 0.001). A threshold value of 425.9 mg/L for 2'FL was obtained, with 98.7% sensitivity and 100% specificity.</p><p><strong>Conclusion: </strong>Proportion of secretor in Indonesian is lower than of Caucasian. The widely used 2'FL cut-off at 25-50 mg/L needs to be re-evaluated based on clinical health impact or genotype findings.</p><p><strong>Impact: </strong>This study answered the question of secretor proportion in Indonesian mothers (65.8%). The significant differences among countries implied that the consequences of secretor status to infant's health should be elaborated, including the contribution of less common HMOs. We demonstrated a strong correlation between FUT2 genotype-phenotype and discovered a novel FUT2 variant, c.851C>G. This study obtained a secretor cut-off at 2'FL 425 mg/L based on ROC curve for FUT2 genotype and 2'FL values. This cut-off needs to be evaluated in light of clinical impact, ideally in a longitudinal study design to capture dynamic of human milk across lactation period.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207341","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":"PFAS exposure in 12-year-old children and its association with metabolic markers.","authors":"Naomi Lejeune, Elke Rouxel, Christine Monfort, Hélène Tillaut, Corentin Goxe, Florence Rouget, Frank Giton, Éric Gaudreau, Fabrice Lainé, Ronan Garlantézec, Sylvaine Cordier, Cécile Chevrier, Charline Warembourg","doi":"10.1038/s41390-026-05396-4","DOIUrl":"https://doi.org/10.1038/s41390-026-05396-4","url":null,"abstract":"<p><strong>Background: </strong>Per- and polyfluoroalkyl substances (PFAS) are long-lasting industrial chemicals with widespread exposure, but their effects on adolescent cardiometabolic health remain underexplored. This cross-sectional study evaluated associations between PFAS concentrations and metabolic biomarkers at age 12.</p><p><strong>Methods: </strong>The study included 451 participants from the French PELAGIE mother-child cohort. At age 12, serum levels of six PFAS and metabolic biomarkers (leptin, adiponectin, fructosamine, total cholesterol, LDL, HDL, triglycerides) were measured. Cross-sectional associations were assessed using multivariable linear regression models and Quantile G-computation mixture models, adjusted for potential confounders and stratified by sex and pubertal stage.</p><p><strong>Results: </strong>In the overall population, perfluoroundecanoic acid (PFUdA) was associated with higher total cholesterol and LDL cholesterol levels. In pre-menarcheal girls, perfluorohexane sulfonate (PFHxS) was associated with higher total cholesterol and LDL cholesterol levels, and PFAS mixture analyses also showed positive associations with these lipid markers. In boys, perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were associated with higher triglyceride levels in peripubertal boys, whereas perfluorooctane sulfonate (PFOS) was associated with lower triglyceride levels in postpubertal boys.</p><p><strong>Conclusion: </strong>Findings indicate potential associations between PFAS exposure and metabolic biomarkers at age 12, with variations by sex and pubertal status, emphasizing the need for longitudinal investigations.</p><p><strong>Impact: </strong>PFAS were detected in all serum samples, showing widespread exposure among the adolescents. Exposure to PFAS was associated with blood lipid markers at age 12, with differences in associations observed across sex- and pubertal stage-specific groups. This study is one of the few to consider the stage of pubertal development in the associations between PFAS and metabolic health markers. The findings suggest that pubertal development should be considered when evaluating the health effects of PFAS exposure during adolescence.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196020","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":"Clesrovimab in the new era of RSV prevention: one season, one dose, one chance.","authors":"Fajia Farhath, Sushil Kumar K","doi":"10.1038/s41390-026-05586-0","DOIUrl":"https://doi.org/10.1038/s41390-026-05586-0","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Respiratory syncytial virus (RSV) remains a leading cause of lower respiratory tract infection and hospitalization in infancy worldwide. Historically, prevention relied on monthly palivizumab administration for selected high-risk infants, despite evidence that a substantial proportion of severe RSV disease occurs in previously healthy term infants. The recent introduction of maternal RSV vaccination and long-acting monoclonal antibodies has transformed the prevention landscape. Clesrovimab (MK-1654; Enflonsia) is a long-acting monoclonal antibody designed to provide season-long protection following a single dose. In the pivotal phase 2b/3 CLEVER trial, clesrovimab reduced RSV-associated medically attended lower respiratory tract infection and hospitalization among infants entering their first RSV season, with a safety profile comparable to placebo. The absolute risk reduction for RSV hospitalization was approximately 1.9 percentage points, corresponding to an estimated number needed to treat of 51 infants over 150 days of follow-up. In this policy-focused clinical perspective informed by a narrative review, we examine the emerging role of clesrovimab within contemporary RSV prevention strategies. We discuss efficacy, safety, implementation challenges, economic considerations, and remaining evidence gaps, including the absence of head-to-head comparisons with nirsevimab, limited post-licensure data, and uncertainties regarding long-term effectiveness and affordability. Future success will depend not only on efficacy but also on equitable access, sustainable implementation, and ongoing surveillance. CLINICAL RELEVANCE: The emergence of long-acting monoclonal antibodies has expanded preventive options for infants at risk of RSV-associated lower respiratory tract disease during their first RSV season. For clinicians, the key shift is that RSV prevention is increasingly being considered within a broader population-health framework rather than solely as a risk-based intervention for selected high-risk groups. Clesrovimab, alongside nirsevimab and maternal RSV vaccination, represents one component of an evolving prevention strategy aimed at reducing RSV-associated morbidity and hospitalization during early infancy. From a practical perspective, successful implementation will depend on timely administration, integration into neonatal discharge planning and well-child care pathways, and coordination with maternal immunization programs. As RSV prevention moves into routine clinical practice, equitable access, sustained coverage, affordability, and ongoing post-licensure surveillance will be as important as efficacy demonstrated in clinical trials. Ultimately, the greatest reductions in RSV-related hospitalization are likely to result from effective delivery of preventive strategies to the infants at highest risk during the RSV season. KEY POINTS: RSV continues to impose a substantial burden on infants worldwide despite decades of clinical recognition","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196007","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":"Emerging data of use of biologics in eosinophilic esophagitis in children.","authors":"Diana Flynn, Christos Tzivinikos","doi":"10.1038/s41390-026-05483-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05483-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196031","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":"Neurobehavioural outcomes after term IUGR from adolescence to adulthood: a cross-species scoping review.","authors":"Ginevra Chincarini, Courtney P Gilchrist, Meaghan E Coyle, David W Walker, Mary Tolcos, Angela Cumberland","doi":"10.1038/s41390-026-05583-3","DOIUrl":"https://doi.org/10.1038/s41390-026-05583-3","url":null,"abstract":"<p><p>Intrauterine growth restriction (IUGR) is associated with long-term neurobehavioural alterations. This scoping review mapped evidence on neurobehavioural outcomes following IUGR in term-born humans and preclinical animal models. Following PRISMA-ScR guidelines, six databases were searched from January 1985 to February 2025. Clinical studies were included if they assessed motor, cognitive, or anxiety outcomes in adolescents or young adults born at term with IUGR, small for gestational age (SGA), or low birth weight (LBW). Preclinical studies were included if IUGR was induced via placental insufficiency and behavioural outcomes evaluated at equivalent developmental stages. Data were charted and synthesised narratively. Twenty-eight studies (16 clinical, 12 preclinical) were included. Motor and cognitive outcomes were frequently assessed; anxiety-related behaviours were examined in fewer clinical studies despite frequent assessment in preclinical models. Motor coordination and memory outcomes were reported in both human and animal studies, though inconsistent diagnostic criteria and heterogeneous outcome measures limited cross-species comparisons. Most clinical studies classified participants as SGA or LBW; only two applied antenatal criteria to confirm IUGR. This evidence map reveals broad coverage of motor and cognitive domains but limited examination of anxiety outcomes in clinical populations. Standardising diagnostics and aligning behavioural assessments across species are priorities for translational comparability. This review was originally registered in PROSPERO (CRD42020197400) as a systematic review. The protocol has since been adapted to a scoping review framework; the PROSPERO registration reflects the original systematic review methodology, as PROSPERO does not accept scoping review registration. The adapted methodology is described in the Methods section below. Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42020197400 . IMPACT: This is the first scoping review to map both clinical and preclinical evidence on neurobehavioural outcomes following IUGR beyond childhood into adolescence and young adulthood. Motor and cognitive outcomes are widely studied across species, but anxiety domains remain under-examined, particularly in human cohorts. Diagnostic inconsistency (SGA/LBW used as proxies for IUGR) and narrow species representation in preclinical studies are major barriers to translational alignment.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196082","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":"Editor’s Focus","authors":"","doi":"10.1038/s41390-026-05517-z","DOIUrl":"10.1038/s41390-026-05517-z","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":"100 3","pages":"955-955"},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149177747","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":"Japan at the limits of viability: national experience and evolving outcomes of infants born at 22-23 weeks' gestation.","authors":"Tetsuya Isayama, Hidehiko Nakanishi, Miki Konishi, Masayo Kokubo, Masanori Fujimura, Shinya Hirano, Satoshi Kusuda","doi":"10.1038/s41390-026-05266-z","DOIUrl":"https://doi.org/10.1038/s41390-026-05266-z","url":null,"abstract":"<p><p>Infants born at 22-23 weeks' gestation represent the limits of viability with substantial international variation in outcomes. Japan has consistently reported some of the highest survival rates; however, the underlying healthcare systems and clinical practices have not been comprehensively synthesized. This review summarizes Japan's national experience using data from a nationwide network database, epidemiologic studies, clinical practice surveys, and international comparisons. Survival at discharge is approximately 60% and 80% for infants born at 22 and 23 weeks' gestation, respectively, with relatively low rates of severe intraventricular hemorrhage and necrotizing enterocolitis. Key healthcare system features include regionalized perinatal care promoting antenatal maternal transfer, a nationwide clinical network for benchmarking, and universal health insurance. Clinical practice is characterized by active resuscitation and meticulous, individualized, pathophysiology-based management, including invasive respiratory support, echocardiography-guided hemodynamic management, intensive neuroprotection, and specialized nursing care. The effectiveness of these practices remains uncertain, and further research is needed. Continuous outcome monitoring and quality improvement are essential to refine context-specific strategies. IMPACT: This review provides the comprehensive synthesis of Japan's national experience in the care of infants born at 22-23 weeks' gestation, integrating outcomes with healthcare system structures and clinical practices. It identifies key system-level and clinical factors-such as regionalized perinatal care, nationwide data-driven quality improvement, and pathophysiology-based management-that may contribute to Japan's high survival rates and relatively low morbidity. It highlights the importance of integrated \"package-of-care\" approaches and continuous outcome monitoring, offering insights that may inform strategies to improve outcomes at the limits of viability globally.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196046","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}