Pediatric Research最新文献

{"title":"Family reflections: the questions we learn to ask.","authors":"Alex Smith","doi":"10.1038/s41390-026-05533-z","DOIUrl":"https://doi.org/10.1038/s41390-026-05533-z","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171930","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":"Advancing prenatal metal research in birth size using mixture approaches.","authors":"Chih-Fu Wei, Mei-Huei Chen, Ching-Chun Lin, Tzu-Pin Lu, Ya-Wen Chen, Wu-Shiun Hsieh, Pau-Chung Chen","doi":"10.1038/s41390-026-05576-2","DOIUrl":"https://doi.org/10.1038/s41390-026-05576-2","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166778","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":"Pro-inflammatory and matricellular protein expression patterns associated with bronchopulmonary dysplasia severity.","authors":"Saly N Essoh, Fernando A Munoz, Lilia P Christner, Tracy X Cui, Ying-Jian Zhang, Marc B Hershenson, Antonia P Popova","doi":"10.1038/s41390-026-05584-2","DOIUrl":"https://doi.org/10.1038/s41390-026-05584-2","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary inflammation and dysregulated repair have been linked to the development of bronchopulmonary dysplasia (BPD), but disease severity varies widely, and the mechanisms leading to BPD heterogeneity remain unclear. We hypothesized that levels of pro-inflammatory and matricellular proteins in preterm infants airways in the first week of life are associated with BPD severity.</p><p><strong>Methods: </strong>We collected tracheal aspirates from preterm infants, born ≤32 weeks gestational age, receiving mechanical ventilation in the first week of life. Protein levels were measured in the supernatants. BPD severity categories were defined by the Jensen classification.</p><p><strong>Results: </strong>We observed three distinct expression patterns, including (i) proteins increased in any BPD severity, most significantly pro-inflammatory interleukin (IL)-17A and IL-23, (ii) proteins elevated only in grade 1 BPD (IL-12 isoforms, the matricellular protein periostin), and (iii) proteins decreased in grade 2/3 BPD, notably the matricellular protein thrombospondin 1 (THBS1). Low THBS1 discriminated grade 2/3 BPD, whereas high periostin levels discriminated grade 1 BPD, adjusting for sex and birth weight.</p><p><strong>Conclusions: </strong>Tracheal aspirate levels of select pro-inflammatory and matricellular proteins show distinct patterns associated with BPD severity categories. THBS1 and periostin, tissue repair, immune, and angiogenesis regulators, display differential expression and potential roles as biomarkers and therapeutic targets in the pathogenesis of BPD severity categories.</p><p><strong>Impact: </strong>We identify differential patterns and relationships between pro-inflammatory cytokine and matricellular protein expression levels in preterm infant airways by bronchopulmonary dysplasia (BPD) severity. Particularly, low levels of the matricellular protein thrombospondin 1 discriminated grade 2/3 BPD from grade 1 and 0, whereas high levels of the matricellular protein periostin discriminated grade 1 BPD, all after adjusting for sex and birth weight. Quantifying pro-inflammatory and tissue repair signals in preterm infant airways provides novel insights into early mechanisms that may impact BPD severity. Early biomarkers of BPD severity can provide crucial information for diagnosis, prognosis, and potential future treatment selection.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170243","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":"Community-based monitoring of neonatal jaundice using the point-of-care Bilistick® System 2.0.","authors":"Irene Lapucci, Gabriella Tambascia, Lorenzo Zucchini, Maria Teresa Calipa, Maria Vittoria Sola, Luca Ronfani, Laura Travan","doi":"10.1038/s41390-026-05521-3","DOIUrl":"https://doi.org/10.1038/s41390-026-05521-3","url":null,"abstract":"<p><strong>Background: </strong>Neonatal jaundice often peaks after discharge, creating the need for reliable post-discharge monitoring. This study evaluated the feasibility and safety of a hospital-to-community pathway using the Bilistick® System 2.0 within routine Community Health Family Services (CHFS).</p><p><strong>Methods: </strong>This retrospective observational study was conducted within a Local Health Authority in northeastern Italy. Newborns eligible for out-of-hospital bilirubin testing according to a Diagnostic-Therapeutic Assistance Pathway (DTAP) were referred either to CHFS or to hospital follow-up based on bilirubin risk profile, clinical factors, and organizational considerations.</p><p><strong>Results: </strong>Of 397 eligible newborns meeting inclusion criteria, 244 were included. Of these, 108 (44.3%) were referred to CHFS, 135 (55.3%) to hospital follow-up, and 1 was lost to follow-up. Among newborns referred to CHFS, 97 (89.8%) completed monitoring without hospital referral. Eleven were referred to the hospital, of whom 7 received phototherapy. Among newborns referred directly to the hospital, 6 (4.4%) required phototherapy. No sampling-related adverse events, missed phototherapy, exchange transfusions, or cases of kernicterus were recorded.</p><p><strong>Conclusion: </strong>Community-based bilirubin monitoring using the Bilistick® System 2.0 appears feasible and safe for selected low-risk newborns within a structured hospital-to-community pathway.</p><p><strong>Impact: </strong>To our knowledge, this is the first real-world evaluation of a structured hospital-to-community pathway integrating point-of-care bilirubin testing into routine community care within UNICEF's Baby-Friendly Initiative framework. Among selected newborns referred to community services, 89.8% completed bilirubin monitoring without hospital referral. Community midwives identified infants requiring escalation of care; no missed phototherapy, exchange transfusion, or kernicterus occurred. The model may reduce unnecessary hospital reassessment and disruption to the mother-infant dyad; local administrative estimates indicate a direct cost difference of €32.30 per bilirubin reassessment.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148063","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":"Management of umbilical venous and arterial catheter: Neonatal European Vascular Access Team- ESPR Recommendation 2.","authors":"Fiammetta Piersigilli, Robin van der Lee, Marie-Julie Debuf, Anna Milan, Nadya Yousef, Suzy Van Eenoo, Bernhard Schwaberger, Giulia Iacona, Giovanni Barone, Kevin Hugill, Matheus van Rens","doi":"10.1038/s41390-026-05465-8","DOIUrl":"https://doi.org/10.1038/s41390-026-05465-8","url":null,"abstract":"<p><strong>Impact: </strong>The importance of standardized protocols for assessment, insertion and evaluation is highlighted. Implementation of this recommendation improves patient safety and reduces practice variation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148874","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":"Analysis of brain iron deposition in an in vivo model of pediatric autosomal dominant polycystic kidney disease.","authors":"Emily J S Steinbach, Chu-Yu Lee, Vincent A Magnotta, Olivia Lullmann, McKade Poirier, Levi P Sowers, Jian Xie, Chou-Long Huang, Lyndsay A Harshman","doi":"10.1038/s41390-026-05485-4","DOIUrl":"https://doi.org/10.1038/s41390-026-05485-4","url":null,"abstract":"<p><p>Polycystic kidney disease (PKD) represents one form of chronic kidney disease (CKD) affecting the pediatric population. CKD in early life has been associated with neurocognitive deficits and disturbances in iron metabolism. Excess iron accumulation may exacerbate inflammatory and oxidative stress pathways linked to neurocognitive decline in CKD. No animal studies have yet investigated brain iron metabolism in early-life CKD, including PKD, or confirmed these findings through histological analysis. Utilizing a conditional Pkd2 knockout mouse, we investigated the effect of kidney disease on early brain development and brain iron deposition through neuroimaging and histology. By postnatal day 19, PKD mice had significantly increased blood urea nitrogen (BUN, mean = 141 mg/dL ± 0.6, p < 0.01) and cyst burden (mean = 83.1% ± 5.4, p < 0.01). Brain volumetrics did not differ longitudinally between groups; however, PKD mice had significantly shorter T2* relaxation times across multiple brain regions (total brain, gray and white matter, cerebral cortex, cerebellum, brainstem, hippocampus, and globus pallidus), indicating increased iron deposition. Perl's Prussian blue staining confirmed increased iron in the cerebral cortex of PKD mice. These findings extend prior human CKD neuroimaging data and provide a platform to investigate mechanisms of iron-mediated neuroinjury in early-life CKD.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137897","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":"Targeted proteomics in late-onset neonatal sepsis: an exploratory analysis.","authors":"Janno S Schouten, Şerife Kurul, Renske Gorissen, Irwin K M Reiss, Sten P Willemsen, Jan Mazela, Wendy W J Unger, Sinno H P Simons, Jop Jans, H Rob Taal","doi":"10.1038/s41390-026-05554-8","DOIUrl":"https://doi.org/10.1038/s41390-026-05554-8","url":null,"abstract":"<p><strong>Background: </strong>Late-onset neonatal sepsis (LONS) is a major cause of morbidity and mortality in preterm infants, but early diagnosis remains difficult. We aimed to identify candidate proteomic biomarkers of LONS and evaluate whether these changes could be reproduced by in vitro stimulation.</p><p><strong>Methods: </strong>Longitudinal blood samples were collected from preterm neonates with suspected LONS and non-septic controls in two neonatal intensive care units, at onset and after 24 and 48 hours. In parallel, whole blood from preterm neonates without LONS was stimulated in vitro with E. coli and S. epidermidis. Protein expression was quantified using targeted proteomics.</p><p><strong>Results: </strong>Fifteen neonates with LONS, eight controls, and ten in vitro stimulation samples were included. Sixty-six proteins showed altered expression during LONS. Upregulated proteins were predominantly cytokines and chemokines, whereas downregulated proteins were associated with development, growth, and metabolism. Most alterations normalized within 48 hours. In vitro stimulation reproduced expression changes for a subset of proteins, suggesting direct pathogen-induced immune responses.</p><p><strong>Conclusion: </strong>LONS in preterm neonates is associated with dynamic proteomic alterations. Combined clinical and in vitro analyses identified biologically relevant candidate biomarkers that may support future diagnostic and monitoring strategies. Further validation in larger, independent cohorts is required before clinical use.</p><p><strong>Impact: </strong>Late-onset neonatal sepsis in preterm neonates is associated with pronounced and dynamic changes in protein expression patterns. Targeted proteomics identified candidate biomarkers related to inflammatory signaling, growth, and metabolic pathways. Longitudinal analyses demonstrated rapid normalization of many proteins within 48 hours after sepsis onset. In vitro stimulation distinguished proteins directly induced by pathogen exposure from secondary systemic responses. The identified proteins may serve as targets for future research into diagnostic and monitoring biomarkers for neonatal sepsis in preterm infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148375","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":"Beyond diagnosing acute kidney injury: defining what we need from kidney biomarkers.","authors":"Akash Deep","doi":"10.1038/s41390-026-05540-0","DOIUrl":"https://doi.org/10.1038/s41390-026-05540-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137883","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":"Management of Peripheral Venous Access Devices (PVADs): Neonatal European Vascular Access Team - ESPR recommendation 5.","authors":"Matheus van Rens, Robin van der Lee, Agnes van den Hoogen, Carmen Rodriguez-Perez, Fiammetta Piersigilli, Silke Mader, Isabel Geiger, Giovanni Barone, Suzy Van Eenoo, Kevin Hugill","doi":"10.1038/s41390-026-05462-x","DOIUrl":"https://doi.org/10.1038/s41390-026-05462-x","url":null,"abstract":"<p><strong>Impact: </strong>Vascular access is a pervasive facet of contemporary neonatal practice, yet it lacks standardization, and some practices lack supporting evidence. This recommendation introduces a structured, evidence-based approach to neonatal peripheral venous access, addressing longstanding challenges such as high failure rates and inconsistent clinical practices. Its novelty lies in integrating advanced visualization tools, standardized assessment protocols (RaSuVA, TLC), and modern securement strategies to optimize catheter longevity and safety. By shifting from habit-driven decisions to individualized vascular access planning, it sets a new standard for safer, more effective neonatal IV therapy.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137888","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":"Association between eye-tracking measures and Griffiths-III developmental scores at 18 months in healthy term-born children.","authors":"Sonia M Lenehan, Vicki Livingstone, John M O'Toole, Sean R Mathieson, Eugene M Dempsey, Deirdre M Murray, Geraldine B Boylan","doi":"10.1038/s41390-026-05421-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05421-6","url":null,"abstract":"<p><strong>Background: </strong>Current neurodevelopmental assessment tools strive to identify atypical development but have limitations. This study explored the potential of eye-tracking (ET) as an objective tool for assessing neurodevelopment at 18 months of age.</p><p><strong>Methods: </strong>Healthy term-born children were prospectively recruited. At 18 months of age, participants underwent ET assessment and developmental assessment using the Griffiths Scales of Child Development-3rd edition (Griffiths-III). ET tasks assessed working memory, visual attention, and social cognition. Measures extracted from the ET tasks included first fixation, mean fixation duration, and saccadic reaction time. Pearson's correlation coefficients and multivariable linear regression analyses were used to examine associations between ET measures and Griffiths-III scores and subscales.</p><p><strong>Results: </strong>Fifty-three children were included. The ET happy task (measures social cognition) showed the strongest correlation with Griffiths-III scales; mean fixation duration on the mouth was significantly associated with subscale A (Foundations of Learning) (r = 0.30, p = 0.03), subscale B (Language and Communication) (r = 0.57, p < 0.001), subscale D (Personal-Social-Emotional) (r = 0.37, p = 0.01) and overall General Development (r = 0.39, p < 0.001). In multivariable analysis, ET measures explained 36, 41, and 55% of variance in subscales A, B, and D, respectively.</p><p><strong>Conclusion: </strong>Eye-tracking measures, especially those measuring social cognition (Happy task) were associated with early language, social-emotional, and general developmental outcomes at 18 months of age. These findings support further investigation of ET as a complimentary objective approach for early neurodevelopmental assessment.</p><p><strong>Impact: </strong>Eye-tracking (ET) measures were associated with four of the five Griffiths-III subscales and overall General Development (GD) in a cohort of healthy term-born children. The strongest associations were observed between measures in the happy task and the Language and Communication subscale (Griffiths-III, subscale B). ET may provide complementary markers of early language, social cognition, and general developmental outcomes. Multivariable models combining ET measures explained variance in Griffiths-III outcomes, particularly in the Foundations of Learning, Language and Communication, and Personal-Social-Emotional subscales. Future research should focus on developing age-appropriate ET tasks with standardized scoring for the early assessment of language, communication, and social development.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137937","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}