Pediatric Research最新文献

{"title":"Invited Commentary: \"Is physical fitness associated with leukocyte telomere length in youth with type 1 diabetes?\"","authors":"George Paltoglou","doi":"10.1038/s41390-025-03988-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03988-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649954","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":"Evaluating 3D-printed models for congenital heart disease: impact on parental anxiety and procedural understanding.","authors":"Linda Grefen, Felix Rudolf, Christopher Herz, Nikolaus A Haas, André Jakob, Christian Hagl, Paul Philipp Heinisch, Jürgen Hörer, Nikolaus Thierfelder, Maximilian Grab","doi":"10.1038/s41390-025-03999-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03999-x","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of the impact of 3D-printed models on parental education and anxiety in parents of children with congenital heart disease (CHD) who are undergoing interventions or surgeries.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was conducted at LMU University Hospital and the German Heart Center Munich. Parents (n = 57) of pediatric CHD patients were randomized into two groups: a control group using standardized paper-based methods and an intervention group using additional 3D-printed models. Parental anxiety was assessed using the Visual Analog Scale (VAS) and the State-Trait Anxiety Inventory, while procedural understanding and satisfaction with the education were evaluated using custom-developed questionnaires.</p><p><strong>Results: </strong>Both educational methods significantly increased procedural understanding (control 77.5% to 92.3%; 3D model: 77% to 89.4%, p < 0.0001, respectively). Significant reduction of anxiety was observed in both groups, (VAS reduction control: -0.9, p = 0.0342; 3D model: -1.1, p = 0.0116). Parents with medical background or those informed by pediatricians had lower anxiety whereas those seeking information online exhibited higher anxiety levels.</p><p><strong>Conclusion: </strong>Both educational methods significantly reduced parental anxiety and improved procedural understanding. 3D-printed models were well-received and will be integrated into routine practice to enhance education on CHD procedures and optimize physician-parent communication.</p><p><strong>Impact statement: </strong>Using additional 3D-printed models of congenital heart defects significantly reduces parental anxiety and increases procedural understanding of complex interventions or surgeries. Physicians are in desperate need of new visualization methods for an efficient patient education. This study underscores the need for tailored educational and psychological support for parents based on their previous experiences.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649952","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":"Predicting optimal endotracheal tube depth in children based on height and middle finger length.","authors":"Yang Zhang, Jiarong Wang, Hao Cheng, Wenjun Guo","doi":"10.1038/s41390-025-03987-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03987-1","url":null,"abstract":"<p><strong>Background: </strong>Current calculation formulas cannot accurately predict intubation depth in children due to variations in growth and development patterns and unique anatomical characteristics of the pediatric airway. This study aims to develop a method for determining the appropriate ETT insertion depth in pediatric patients.</p><p><strong>Methods: </strong>This study included 205 patients aged 4-12 years who underwent elective surgery under general anesthesia with tracheal intubation. The general condition of the enrolled children was recorded, and growth parameters were measured preoperatively. Multivariate linear regression analysis was employed to develop a new formula for predicting intubation depth.</p><p><strong>Results: </strong>The novel multivariate-based formula was derived using height and middle finger length [D (cm) = 0.06 × height (cm) + 0.89 × middle finger length (cm) + 3.4] as reference variables. Bland-Altman analysis demonstrated mean differences between the optimal depth and ETT depth was -0.05 cm (95% LOA, -1.38 to 1.28 cm) for the new formula and 1.24 cm (95% LOA, -0.74 to 3.23 cm) for the traditional formula, respectively. This study demonstrated significant individual variations in tracheal intubation depth in pediatric patients.</p><p><strong>Conclusion: </strong>The height- and middle finger length-referenced formulas predicted the depth of intubation more accurate than the traditional age-based formula in pediatric patients.</p><p><strong>Impact: </strong>The prediction formula is effective in reducing the misalignment rate in children undergoing tracheal intubation under general anesthesia. The new formula, which incorporates both height and middle finger length, was found to predict the optimal endotracheal intubation depth with greater accuracy than the traditional formula. This provides an accurate and easy way for clinicians to calculate the depth of intubation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649955","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 di(2-ethylhexyl) phthalate exposure increases the risk of congenital heart disease in mice offspring.","authors":"Haiqun Shi, Zehua Zhang, Anna Shen, Tong Ding, Rui Zhao, Yan Shi, Jianyuan Zhao, Ke Cai, Feng Wang","doi":"10.1038/s41390-025-03997-z","DOIUrl":"10.1038/s41390-025-03997-z","url":null,"abstract":"<p><strong>Abstrct: </strong>BACKGROUD: Epidemiological data suggest that maternal occupational exposure to mixed phthalates comprising di(2-ethylhexyl) phthalate (DEHP) increases the risk of congenital heart disease (CHD). In this study, we used mice as an animal model to validate impact of first-trimester DEHP exposure on the risk of CHD in offspring, to elucidate the possible mechanisms and to provide a potential feasible intervention.</p><p><strong>Methods and results: </strong>Eight-week-old C57BL/6J pregnant mice were randomly divided into standard and DEHP diet groups. The incidence of CHD in DEHP diet group offspring was up to 14.41% observed via Hematoxylin-eosin (HE) staining. Quantitative PCR analysis revealed that expression of key genes involved in cardiogenesis were suppressed at the transcriptional level, which may be due to decreased nuclear translocation of p65. The inhibition of DEHP on key genes was rescued to some extent by choline through driving p65 into nuclear. In the mice, supplementation of choline during DEHP exposure reduced the incidence of CHD in offspring from 14.41% to 4.63%.</p><p><strong>Conclusions: </strong>Our study demonstrates that mice first-trimester DEHP exposure significantly increases the risk of CHD in the offspring via inhibiting mRNA levels of key genes in cardiogenesis, and choline could protect against the pathogenesis.</p><p><strong>Impact: </strong>Our study provides key mechanistic insights into the risk of CHD by DEHP exposure during early pregnancy, and provides choline as a potentially effective intervention. DEHP suppressed the expression of key genes involved in embryonic cardiac septum development at the transcriptional level via inhibiting nuclear translocation of p65. Choline can play a role in rescuing the inhibition of DEHP on cardiogenesis genes via driving p65 translocate into the nuclear.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634337","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 wake-up call for India to improve the TB elimination strategies.","authors":"Abhijit Poddar, S R Rao","doi":"10.1038/s41390-025-04014-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04014-z","url":null,"abstract":"<p><strong>Impact: </strong>To augment a recent study highlighting the concerning rise in the global burden of multidrug-resistant tuberculosis (MDR-TB) among children and adolescents, this article presents the realities in India, stressing the urgent need for enhanced TB elimination strategies. It explores how insufficient data, rising air pollution, and recent U.S. sanctions impede the detection and control of pediatric TB burden including MDR-TBs in India. This article serves as a wake-up call for stakeholders to take decisive actions while facilitating future research and policy development. We provide targeted recommendations to address vulnerabilities and prevent a potential public health crisis.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634335","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":"Microbes, metabolites, and inflammation: mapping the early neonatal intestinal landscape.","authors":"Muralidhar H Premkumar, Lovya George, Venkatesh Sampath","doi":"10.1038/s41390-025-04016-x","DOIUrl":"10.1038/s41390-025-04016-x","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625285","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":"Effect of different intranasal dexmedetomidine doses on pediatric postoperative delirium and agitation: network meta-analysis.","authors":"Huan Wu, Ping Wu, Liubo Xiang, Qianqian Huang, Yi Xiang, Jianshu Zhang, Zhihao Zhao, Tao Xu","doi":"10.1038/s41390-025-03851-2","DOIUrl":"https://doi.org/10.1038/s41390-025-03851-2","url":null,"abstract":"<p><strong>Objectives: </strong>Our research served to explore the influences of intranasal dexmedetomidine (DEX) at different doses on agitation, delirium, and other complications among children undergoing general anesthesia.</p><p><strong>Methods: </strong>A systematic search was executed in EMBASE, Cochrane Library, PubMed, and Web of Science, from the establishment of the database until February 12, 2024. The data analytics was implemented through R software and STATA version 16.0.</p><p><strong>Results: </strong>The final analysis incorporated 15 randomized controlled trials (RCTs) containing 1965 pediatric participants in total. The findings uncovered that relative to normal saline (NS), intranasal DEX at doses of 1 μg/kg [RR = 0.31, 95%CI = (0.17, 0.56)], 1.5 μg/kg [RR = 0.28, 95%CI = (0.09, 0.85)], and 2 μg/kg [RR = 0.18, 95%CI = (0.08, 0.36)] remarkably reduced the prevalence of post-anesthetic emergence agitation (EA) in children, with the 2 μg/kg dose demonstrating the highest effectiveness (SUCRA = 0.8997). Additionally, DEX at doses of 1 μg/kg [MD = -3.36, 95%CI = (-6.46, -0.44)] and 2 μg/kg [MD = -2.59, 95%CI = (-5.17, -0.32)] effectively reduced the Pediatric Anesthesia Emergence Delirium (PAED) score, with the 1 μg/kg dose ranking as the most efficacious according to SUCRA analysis (SUCRA = 0.8557).</p><p><strong>Conclusions: </strong>DEX prominently reduces the prevalence of emergence agitation and delirium. At doses of 2 μg/kg and 1 μg/kg, DEX effectively lowers the incidence of EA and PAED scores.</p><p><strong>Impact: </strong>Our research attempts to appraise the influence of discrepant doses of intranasal dexmedetomidine (DEX) on the incidence of postoperative agitation and delirium among children undergoing general anesthesia. The research elucidates the impact of various DEX doses on reducing postoperative agitation, PAED scores, and the need for postoperative analgesics, offering valuable guidance for selecting optimal dosing strategies in clinical practice. The research results support considering individual differences in children when choosing different doses of DEX to provide more suitable sedation and analgesia regimens, thereby improving postoperative recovery quality.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625253","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":"Upper and lower airway microbiota across infancy and childhood.","authors":"Ariel J Hernandez-Leyva, Anne L Rosen, Christopher P Tomera, Elaina E Lin, Elikplim H Akaho, Allison M Blatz, William R Otto, Joey Logan, Lisa R Young, Rebecca M Harris, Samantha A Whiteside, Andrew L Kau, Audrey R Odom John","doi":"10.1038/s41390-025-03942-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03942-0","url":null,"abstract":"<p><strong>Background: </strong>The upper and lower respiratory tracts feature distinct environments and responses affecting microbial colonization but investigating the relationship between them is technically challenging. We aimed to identify relationships between taxa colonizing the nasopharynx and trachea across childhood.</p><p><strong>Methods: </strong>We employed V4 16S rRNA gene sequencing to profile nasopharyngeal swabs and tracheal aspirates collected from 172 subjects between 20 weeks and 18 years of age. These samples were collected prior to elective procedures over the course of 20 weeks in 2020 from subjects enrolled in a cross-sectional study. After extraction, sequencing, and quality control, we studied the remaining 147 of 172 nasopharyngeal swabs and 95 of 172 tracheal aspirates, including 80 subject-matched pairs of samples.</p><p><strong>Results: </strong>Sequencing data revealed that the nasopharynx is colonized by few, often highly abundant taxa, while the tracheal aspirates feature greater diversity. The patterns of colonization identified in the nasopharynx correlate with subject age across childhood.</p><p><strong>Conclusion: </strong>Our data suggests that there are relatively few species that colonize both the nasopharyngeal tract and the trachea. Furthermore, we observe a pattern of change in the nasopharyngeal microbiota that is correlated with age, suggesting a possible developmental progression of the nasopharyngeal microbiota across childhood.</p><p><strong>Impact: </strong>The airway microbiota in childhood plays important roles in respiratory health and immune development. In this work, we report on paired nasopharyngeal swab and tracheal aspirate samples from a cross-sectional cohort of children from infancy to 18 years. We find that the upper and lower airway microbiota are unlikely to share taxa and do not correlate in terms of diversity. We show that the composition of the upper airway microbiota is strongly correlated with age, with a stereotypic developmental trajectory during childhood and adolescence. Our results inform our understanding of airway microbiota assembly and may be used to predict airway disease in young children.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615999","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":"Disrupting and restoring protection: maternal antibiotic exposure and neonatal IgA transfer via breastfeeding.","authors":"Olivier Gasser, Gergely Toldi","doi":"10.1038/s41390-025-03992-4","DOIUrl":"https://doi.org/10.1038/s41390-025-03992-4","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606040","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":"Improved linear growth after routine zinc supplementation in preterm very low birth weight infants.","authors":"Tina A Seidu, Luc P Brion, Roy Heyne, L Steven Brown, Theresa Jacob, Audrey Edwards, Cheryl S Lair, Myra H Wyckoff, David B Nelson, Dimitrios Angelis","doi":"10.1038/s41390-025-03935-z","DOIUrl":"10.1038/s41390-025-03935-z","url":null,"abstract":"<p><strong>Background: </strong>This study was designed (1) to compare growth, morbidity and mortality in < 33-week gestational age (GA) (very preterm, VPT) or very low birth weight (BW < 1500 grams, VLBW) infants before (Epoch-1) and after implementing routine enteral zinc (Zn) supplementation (Epoch-2) to meet recommendations, and (2) to assess serum Zn levels and associated variables.</p><p><strong>Methods: </strong>Single-center prospective cohort of 826 infants. The primary outcome was the change (Δ) in Z-scores of accurate length (Δlength_z), weight and head circumference from birth to discharge home.</p><p><strong>Results: </strong>In Epoch-2 vs Epoch-1 Δlength_z adjusted for confounding variables increased by 0.27 [95% confidence interval (CI) 0.13, 0.42, P < 0.001]. However, morbidity and mortality did not change. In Epoch-2 Zn decreased with GA and postnatal age: low ( < 0.74 mcg/mL) levels were observed in 51% infants. Retinopathy of prematurity (ROP) was independently associated with the lowest Zn [adjusted odds ratio 0.042 (CI 0.006, 0.306), area under the curve=0.928].</p><p><strong>Conclusion: </strong>Routine enteral Zn supplementation was independently associated with improved linear growth but did not prevent occurrence of low Zn. ROP was independently associated with the lowest Zn.</p><p><strong>Implications: </strong>Multicenter studies are needed to assess whether dosage of enteral Zn should be increased and whether Zn could help prevent ROP.</p><p><strong>Impact: </strong>Implementation of routine enteral zinc (Zn) supplementation was associated with improved linear growth from birth to discharge and a more frequent physiologic growth curve in preterm very low birth weight infants. Serum Zn levels decreased with gestational age and with postnatal age. Low serum Zn levels were observed frequently despite routine Zn supplementation as currently recommended, which suggests a need to re-evaluate current enteral zinc supplementation guidelines for this population. Retinopathy of prematurity among infants < 33 weeks' gestation was independently associated with low gestational age, low birthweight, stage of bronchopulmonary dysplasia and the lowest serum Zn level.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606108","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}