Pediatric Research最新文献

{"title":"Long-term follow-up of Chinese patients with methylmalonic acidemia of the cblC and mut subtypes.","authors":"Lili Hao, Shiying Ling, Si Ding, Wenjuan Qiu, Huiwen Zhang, Kaichuang Zhang, Ting Chen, Xuefan Gu, Lili Liang, Lianshu Han","doi":"10.1038/s41390-024-03581-x","DOIUrl":"https://doi.org/10.1038/s41390-024-03581-x","url":null,"abstract":"<p><strong>Background: </strong>Methylmalonic acidemia (MMA) is the most common organic acidemia in China, with cblC (cblC-MMA) and mut (mut-MMA) being the predominant subtypes. The present study aimed to investigate the prognostic manifestations and their possible influence in patients with these two subtypes.</p><p><strong>Methods: </strong>A national multicenter retrospective study of patients with cblC-MMA and mut-MMA between 2004 and 2022 was performed. We compared the clinical features between patients with two subtypes or diagnosed with or without newborn screening (NBS) and further explored the potentially influential factors on the prognosis.</p><p><strong>Results: </strong>The 1617 enrolled MMA patients included 81.6% cblC-MMA patients and 18.4% mut-MMA patients, with an overall poor prognosis rate of 71.9%. These two subtypes of patients showed great differences in poor prognostic manifestations. The role of NBS in better outcomes was more pronounced in cblC-MMA patients. Predictors of outcomes are \"pre-treatment onset\", \"NBS\", variants of c.80A > G and c.482G > A and baseline levels of propionylcarnitine and homocysteine for cblC-MMA; \"pre-treatment onset\", \"responsive to vitB12\", variants of c.914T > C and baseline propionylcarnitine and propionylcarnitine/acetylcarnitine ratio for mut-MMA. Besides, prognostic biochemical indicators have diagnostic value for poor outcomes in mut-MMA.</p><p><strong>Conclusions: </strong>The study provided potential predictors of the long-term outcome of patients with cblC-MMA and mut-MMA.</p><p><strong>Impact: </strong>Predictors of outcomes are \"pre-treatment onset\", \"NBS\", MMACHC variants of c.80A > G and c.482G > A and baseline propionylcarnitine and homocysteine for cblC-MMA, \"pre-treatment onset\", \"responsive to vitB12\", MMUT variants of c.914T > C and baseline propionylcarnitine and propionylcarnitine/acetylcarnitine ratio for mut-MMA. This study with larger sample sizes effectively validated the prediction power and emphasized the importance of NBS in improving the outcomes of both MMA subtypes. The study enhances understanding of the phenotypic and prognostic variations of MMA disease and the predictors will help in the improvement of diagnosis and treatment strategies to achieve a better prognosis for MMA.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292949","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":"Expanding the horizon of continuous glucose monitoring into the future of pediatric medicine.","authors":"Lourdes Morales-Dopico, Sarah A MacLeish","doi":"10.1038/s41390-024-03573-x","DOIUrl":"https://doi.org/10.1038/s41390-024-03573-x","url":null,"abstract":"<p><p>Glucose monitoring has rapidly evolved with the development of minimally invasive continuous glucose monitoring (CGM) using interstitial fluid. It is recommended as standard of care in the ambulatory setting, nearly replacing capillary glucose testing in those with access to CGM. The newest CGM devices continue to be smaller and more accurate, and integration with automated insulin delivery systems has further revolutionized the management of diabetes, leading to successful improvements in care and quality of life. Many studies confirm accuracy and application of CGM in various adult inpatient settings. Studies in adult patients increased during the COVID 19 Pandemic, but despite reassuring results, inpatient CGM use is not yet approved by the FDA. There is a lack of studies in inpatient pediatric settings, although data from the NICU and PICU have started to emerge. Given the exponential increase in the use of CGM, it is imperative that hospitals develop protocols for CGM use, with a need for ongoing implementation research. In this review we describe how CGM systems work, discuss benefits and barriers, summarize research in inpatient pediatric CGM use, explore gaps in research design along with emerging recommendations for inpatient use, and discuss overall CGM utility beyond outpatient diabetes management. IMPACT: Current CGM systems allow for uninterrupted monitoring of interstitial glucose excursions, and have triggered multiple innovations including automated insulin delivery. CGM technology has become part of standard of care for outpatient diabetes management, endorsed by many international medical societies, now with significant uptake, replacing capillary glucose testing for daily management in patients with access to CGM technology. Although CGM is not approved by the FDA for inpatient hospital use, studies in adult settings support its use in hospitals. More studies are needed for pediatrics. Implementation research is paramount to expand the role of CGM in the inpatient setting and beyond.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292947","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 implementation and strategy of triadic communication in pediatric oncology: a scoping review.","authors":"Jinlin Ye, Lei Yang, Anna Axelin, Susanna Likitalo, Chuan Wen, Xianhong Li","doi":"10.1038/s41390-024-03590-w","DOIUrl":"https://doi.org/10.1038/s41390-024-03590-w","url":null,"abstract":"<p><p>Triad child-parent-professional communication is considered a priority in evaluating and optimizing therapeutic alliance in pediatric oncology. This scoping review aimed to map the existing evidence in implementation, influencing factors, and strategies of triadic communication in pediatric oncology. Using Arksey and O'Malley's framework, we searched 5 databases and grey literature until June 15th, 2024. Two researchers selected studies and extracted data independently. The PAGER framework was employed to summarize the implications of existing research to inform future research and practice. A total of 24 articles were included. Healthcare professionals usually initiate triadic communication. Communication topics rarely focused on prognosis, emotions, and end-of-life care. The triad child-parent-professional exhibited similarities in language, emotional, and decision-making communication preferences but differed regarding skills and information preferences. The roles of the triad parts were unclear, especially nurses' role, responsibilities, and contributions were seldom specified. Factors influencing the implementation spanned individual, organizational, and socio-cultural levels. Five types including 21 specific suggested strategies were identified to facilitate implementation, yet few strategies were adopted by patients and caregivers, and limited effectiveness studies have evaluated specific strategies. Overall, while triadic communication has received considerable attention in the world, its practical implementation in real-world settings remains largely underdeveloped. IMPACT: Our research has mapped the global trajectories of triadic communication between child-parent-professional throughout the cancer journey. A precise delineation of roles and responsibilities within the triadic communication framework in pediatric oncology is crucial for augmenting collaborative efforts and achieving optimal coordination among stakeholders. Healthcare professionals could partner with families to comprehend individual communication preferences, cultivating a collaborative relationship that honors each participant's needs and enhances informed decision-making. The findings equip healthcare professionals with a range of strategies to navigate communication with children with cancer and their parents.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292951","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":"Long-chain polyunsaturated fatty acids supplementation and sepsis: a systematic review and meta-analysis.","authors":"Ariadna Witte Castro, María L Couce, Carmela de Lamas, Mª Rosario López-Giménez, Miguel Ángel Jiménez Varas, C Zozaya, Miguel Saenz de Pipaon","doi":"10.1038/s41390-024-03579-5","DOIUrl":"https://doi.org/10.1038/s41390-024-03579-5","url":null,"abstract":"<p><strong>Background: </strong>Long chain polyunsaturated fatty acids (LCPUFAs) have proven to be essential for development in preterm infants and have been studied for their capacity to reduce inflammation and infection rates, including sepsis in enteral and parenteral nutrition. The aim of this review and meta-analysis is to gather the information available on this subject to determine if n-3 polyunsaturated fatty acids can reduce sepsis incidence in preterm infants.</p><p><strong>Methods: </strong>This systematic review was conducted by searching in the databases MEDLINE (via PubMed), ISI-Web of Science, EMBASE, SCOPUS, SciELO, and Cochrane Library databases. We analyzed the data regarding sepsis using the Grading of Recommendations Assessment, Development and Evaluation approach to assess the quality of the evidence.</p><p><strong>Results: </strong>A total of 40 trials were included for review and 35 trials had the data available for quantitative analysis. LCPUFAs supplementation did not reduce incidence of sepsis (relative risk (RR), confidence interval (CI) 0.95 [0.87, 1.03] P = 0.87; I² = 0%). These results remained consistent after the sensitivity analysis.</p><p><strong>Conclusion: </strong>The results of this systematic review and meta-analysis indicate that LCPUFA supplementation is not associated with a significant decrease in the incidence of sepsis in premature infants.</p><p><strong>Impact: </strong>Reviewing the information available about LCPUFA supplementation and sepsis since the results in previous Clinical Trials (CT) are inconclusive. It summarizes the results of 42 CT and we have not found conclusive results regarding sepsis in the literature. It could be of clinical interest for pediatricians and nutritionists.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292948","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":"Maternal pregnancy diet quality, night eating, and offspring metabolic health: the GUSTO study","authors":"Ling-Wei Chen, See Ling Loy, Mya Thway Tint, Navin Michael, Yi Ying Ong, Jia Ying Toh, Peter D. Gluckman, Kok Hian Tan, Yap-Seng Chong, Keith M. Godfrey, Johan G. Eriksson, Fabian Yap, Yung Seng Lee, Mary F. F. Chong","doi":"10.1038/s41390-024-03574-w","DOIUrl":"https://doi.org/10.1038/s41390-024-03574-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>We investigated the understudied influence of maternal diet quality, food timing, and their interactions during pregnancy on offspring metabolic health.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Maternal diet at 26–28 weeks’ gestation was assessed using a 24-h recall and adherence to the modified-healthy-eating-index (HEI-SGP) reflects diet quality. Predominant night-eating (PNE) was defined as consuming &gt;50% of total daily energy intake from 19:00 to 06:59. Outcomes were offspring composite metabolic syndrome score and its components measured at age 6 years. Multivariable linear regressions adjusted for relevant maternal and child covariates assessed associations of diet quality and PNE with these outcomes.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Up to 758 mother-child pairs were included. The mean(SD) maternal HEI-SGP score was 52.3(13.7) points (theoretical range: 0-100) and 15% of the mothers demonstrated PNE. Maternal diet quality showed inverse relationship with offspring Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) [β(95% CI): –0.08(–0.15, –0.02) per-10-point HEI-SGP increment; <i>P</i> = 0.012]. Maternal PNE was associated with a higher offspring HOMA-IR [0.28(0.06, 0.50); <i>P</i> = 0.012], with similar estimates after adjustment for children’s BMI and diet quality; the association was stronger for boys (<i>P</i>-interaction&lt;0.001) and among mothers with lower diet quality (&lt;median HEI-SGP) (<i>P</i>-interaction = 0.062).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Maternal PNE and low dietary quality were associated with a higher level of insulin resistance in early childhood, especially among boys.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>We demonstrated that maternal predominant night-eating behavior and low-quality diet are associated with higher offspring insulin resistance.</p>\u0000</li>\u0000<li>\u0000<p>Maternal low-quality diet and predominant night-eating behavior synergistically interact to influence offspring insulin resistance, particularly among boys.</p>\u0000</li>\u0000<li>\u0000<p>While maternal diet quality and food timing impact the mother’s health, their influence on offspring long-term health outcomes through developmental programming is not well understood.</p>\u0000</li>\u0000<li>\u0000<p>Our findings highlight the significance of maternal food timing and calls for further studies on its influence on child health through developmental programming. Targeting both dietary quality and food timing during pregnancy could be a promising intervention strategy.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252344","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":"Clinical correlates of a high cardiorespiratory risk score for very low birth weight infants","authors":"Sherry L. Kausch, Claire C. Slevin, Amanda Duncan, Karen D. Fairchild, Douglas E. Lake, Jessica Keim-Malpass, Zachary A. Vesoulis, Brynne A. Sullivan","doi":"10.1038/s41390-024-03580-y","DOIUrl":"https://doi.org/10.1038/s41390-024-03580-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>A pulse oximetry warning system (POWS) to analyze heart rate and oxygen saturation data and predict risk of sepsis was developed for very low birth weight (VLBW) infants.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We determined the clinical correlates and positive predictive value (PPV) of a high POWS score in VLBW infants. In a two-NICU retrospective study, we identified times when POWS increased above 6 (POWS spike). We selected an equal number of control times, matched for gestational and chronologic age. We reviewed records for infection and non-infection events around POWS spikes and control times. We calculated the frequencies and PPV of a POWS spike for infection or another significant event.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We reviewed 111 POWS spike times and 111 control times. Days near POWS spikes were more likely to have clinical events than control days (77% vs 50%). A POWS spike had 52% PPV for suspected or confirmed infection and 77% for any clinically significant event. Respiratory deterioration occurred near more POWS spike times than control times (34% vs 18%).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>In a retrospective cohort, infection and respiratory deterioration were common clinical correlations of a POWS spike. POWS had a high PPV for significant clinical events with or without infection.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>There are significant gaps in understanding the best approach to implementing continuous sepsis prediction models so that clinicians can best respond to early signals of deterioration.</p>\u0000</li>\u0000<li>\u0000<p>Infection and respiratory deterioration were common clinical events identified at the time of a high predictive model score.</p>\u0000</li>\u0000<li>\u0000<p>Understanding the clinical correlates of a high-risk early warning score will inform future implementation efforts.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252228","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":"Gut microbiome and inflammation in response to increasing intermittent hypoxia in the neonatal rat","authors":"Magdalena Latkowska, Charles L. Cai, Marina Mitrou, Matthew Marcelino, Jacob V. Aranda, Kay D. Beharry","doi":"10.1038/s41390-024-03569-7","DOIUrl":"https://doi.org/10.1038/s41390-024-03569-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Intermittent hypoxia (IH) and oxidative stress play key roles in gut dysbiosis and inflammation. We tested the hypothesis that increasing numbers of daily IH episodes cause microbiome dysbiosis and severe gut injury.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Neonatal rats were exposed to hyperoxia (Hx), growth restriction, and IH. For IH, pups were exposed to 2–12 daily episodes from birth (P0) to postnatal day 7 (7D) or P0-P14 (14D), with or without recovery in room air (RA) until P21. Animals raised in RA from P0 to P21 served as normoxia controls. Stool was expressed from the large intestines for microbiome analysis, and tissue samples were assessed for histopathology and biomarkers of inflammation.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Hx and IH caused a significant reduction in the number and diversity of organisms. The severity of gut injury and levels of inflammatory cytokines and TLR4 increased, while total glutathione (tGSH) declined, with increasing daily IH episodes. The number of organisms correlated with the villi number (<i>p</i> &lt; 0.05) and tGSH depletion (<i>p</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The critical number of daily IH episodes that the newborn gut may sustain is 6, beyond which irreversible damage occurs. The immature gut is highly susceptible to IH-induced injury, and IH may contribute to pathological outcomes in the immature gut.</p><h3 data-test=\"abstract-sub-heading\">Impact statement</h3><ol>\u0000<li>\u0000<span>1.</span>\u0000<p>The neonatal gut at birth is highly susceptible to intermittent hypoxia (IH) injury.</p>\u0000</li>\u0000<li>\u0000<span>2.</span>\u0000<p>IH causes gut dysbiosis, inflammation, and glutathione depletion.</p>\u0000</li>\u0000<li>\u0000<span>3.</span>\u0000<p>The severity of gut injury worsens as a function of increasing daily IH episodes.</p>\u0000</li>\u0000<li>\u0000<span>4.</span>\u0000<p>The critical number of daily IH episodes that the newborn gut may sustain is 6, beyond which irreversible damage occurs.</p>\u0000</li>\u0000</ol>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252229","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":"Language learning in the context of a global pandemic: proximal and distal factors matter","authors":"Gerald F. Giesbrecht, Marcel van de Wouw, Dana Watts, Meaghan V. Perdue, Susan Graham, Beatrice P. Y. Lai, Lianne Tomfohr-Madsen, Catherine Lebel","doi":"10.1038/s41390-024-03583-9","DOIUrl":"https://doi.org/10.1038/s41390-024-03583-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Public health measures implemented during the COVID-19 pandemic fundamentally altered the socioecological context in which children were developing.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Using Bronfenbrenner’s socioecological theory, we investigate language acquisition among 2-year-old children (<i>n</i> = 4037) born during the pandemic. We focus on “late talkers”, defined as children below the 10th percentile on the MacArthur-Bates Communicative Development Inventories-III.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Overall, the proportion of late talkers declined as a function of pandemic wave, with 13.0% of those born during the first wave classified as late talkers compared to 10.4% born in wave two, and 8.0% born during wave three. In sex-based analysis, we observed a 15.9% prevalence of late talking among female toddlers, which was significantly different from the norming sample. In contrast, the prevalence of late talking among male toddlers was 9.1%. Using hierarchical logistic regression to identify both proximal and distal factors associated with being a late talker, we found that male sex, lower socioeconomic status, greater screen time, receiving childcare at home, disruptions to childcare, and experiencing greater exposure to public health restrictions were associated with increased odds for being a late talker.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>We interpret the findings in relation to the need to consider the special needs of young children in disaster preparation and response.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>Two-year-old children acquiring language in the context of the COVID-19 pandemic have vocabulary size similar to historical norms.</p>\u0000</li>\u0000<li>\u0000<p>A higher-than-expected prevalence of late talkers (below the 10th percentile) was observed among females and children born during the first wave of the pandemic.</p>\u0000</li>\u0000<li>\u0000<p>Motivated by Bronfenbrenner’s socioecological theory, we show that both proximal and distal environmental factors are associated with vocabulary size.</p>\u0000</li>\u0000<li>\u0000<p>Infants exposed to stricter public measures had reduced vocabulary size.</p>\u0000</li>\u0000<li>\u0000<p>The findings suggest a need to recognize the developmental needs of children as part of the public health response to emergencies.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252273","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":"Mediative role of body mass index in cardiorespiratory fitness-associated vascular remodeling in youth","authors":"Luisa Semmler, Lisa Baumgartner, Heidi Weberruß, Raphael Pirzer, Renate Oberhoffer-Fritz","doi":"10.1038/s41390-024-03589-3","DOIUrl":"https://doi.org/10.1038/s41390-024-03589-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Data on fitness-associated arterial remodeling in children is limited. We assessed the relation between cardiorespiratory fitness (CRF) and intima-media thickness (IMT), diameter, IMT:diameter-ratio (IDR), and tensile stress of the common carotid artery (CCA) in 697 healthy German schoolchildren. Further, we explored how body mass index (BMI) may influence these associations.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We measured the vascular parameters with a high-resolution ultrasound device. We determined CRF using the FITNESSGRAM® PACER test and calculated each child’s allometrically scaled peak oxygen uptake capacity (VO₂peak).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>VO₂peak, reflecting CRF, showed positive direct effects on IMT (girls: <i>p</i> &lt; 0.001; boys: <i>p</i> = 0.02) and diameter in girls (<i>p</i> &lt; 0.001). Considering BMI as a mediator, higher CRF was indirectly linked to decreases in IMT (girls: <i>p</i> = 0.04; boys: <i>p</i> = 0.02) and diameter (both <i>p</i> &lt; 0.001), reflecting a competitive mediation. CRF indirectly mitigated the BMI-associated decrease in IDR (both <i>p</i> &lt; 0.001) and increase in tensile stress (both <i>p</i> &lt; 0.001) without affecting any of these parameters directly.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>CRF appears to be linked to uniform arterial remodeling with balanced hemodynamics and to further alleviate BMI-associated, potentially adverse vascular alterations, highlighting its significant role in cardiovascular health in youth.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>Data on CRF-associated arterial remodeling in youth is limited.</p>\u0000</li>\u0000<li>\u0000<p>Higher VO₂peak, reflecting higher CRF, was positively associated with IMT in girls and boys and diameter in girls. These direct effects were counteracted by the indirect BMI-mediated effect of CRF on IMT and diameter, reflecting a competitive mediation.</p>\u0000</li>\u0000<li>\u0000<p>A higher CRF indirectly mitigated the BMI-associated decrease in IDR and increase in tensile stress without directly affecting any of these parameters.</p>\u0000</li>\u0000<li>\u0000<p>Our findings indicate homogenous remodeling and balanced hemodynamics with increasing CRF—and opposite effects with increasing BMI.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252274","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":"Formula with large, milk phospholipid-coated lipid droplets in late-moderate preterm infants: a double-blind RCT","authors":"Andreas Kakaroukas, Marieke Abrahamse-Berkeveld, Louise Hayes, Richard J. Q. McNally, Janet E. Berrington, Ruurd M. van Elburg, Nicholas D. Embleton","doi":"10.1038/s41390-024-03476-x","DOIUrl":"https://doi.org/10.1038/s41390-024-03476-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Limited evidence exists on the preferred feeding method when breastfeeding is not possible in late and moderate preterm (LMPT) infants. This RCT evaluates growth, safety, and tolerance of a concept infant formula (IF) with large, milk phospholipid-coated lipid droplets enriched in dairy lipids in LMPT infants with primary objective to demonstrate non-inferiority of daily weight gain from randomization to 3 months corrected age compared to a standard IF.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>LMPT infants were randomized before or around term equivalent age to either the concept (<i>n</i> = 21) or standard IF (<i>n</i> = 20). Forty-one breastfed (BF) infants served as reference.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Due to unintended low recruitment, non-inferiority in daily weight gain could not be demonstrated for the Concept compared to the Control group, but was compared to the BF group. Other outcomes were similar between the formula groups, except for an apparent larger head circumference gain in the Concept group. No apparent differences in growth and body composition outcomes were observed between the Concept and BF reference groups.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This small-scale study suggests the concept IF is a safe alternative for parents who choose IF to feed their LMPT infant. Larger trials are needed to better determine impacts on head growth or body composition.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>In a small group of late and moderate preterm infants, growth from randomization until 3 months corrected age of infants fed with a concept infant formula with large, milk phospholipid-coated lipid droplets was not -significantly different from infants fed a standard infant formula.</p>\u0000</li>\u0000<li>\u0000<p>Infants in the Concept group had non-significant larger gain in head circumference compared to the Control group; larger trials are needed to confirm this finding.</p>\u0000</li>\u0000<li>\u0000<p>Both formulas were well-tolerated, with no differences in adverse events.</p>\u0000</li>\u0000<li>\u0000<p>The concept formula is potentially a safe alternative for parents of moderate to late preterm infants who choose to use formula milk.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252275","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}