Pediatric Research最新文献

{"title":"A developmental role for toll like receptor 4 in the neonatal intestine.","authors":"David J Hackam","doi":"10.1038/s41390-025-03900-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03900-w","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256275","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":"Urbanisation and mental health in left-behind children: systematic review and meta-analysis using resilience framework.","authors":"Kelly Lin, Leona Mak, Jinxuan Cai, Stephen Jiang, Nawaal Fayyaz, Simon Broadley, Jing Sun","doi":"10.1038/s41390-025-03894-5","DOIUrl":"https://doi.org/10.1038/s41390-025-03894-5","url":null,"abstract":"<p><strong>Background: </strong>Prolonged parental separation at young ages has significant adverse effects on development in left-behind-children (LBC). We aimed to compare mental health status, emotional and behavioural problems, and their association with socioemotional development between LBC and their counterparts.</p><p><strong>Methods: </strong>Cross-sectional studies comparing LBC and non-LBC published from 2000 onwards were searched. Primary outcomes included depression, anxiety emotional and behavioural problems. Secondary outcomes included loneliness, self-harm, suicide, and risk-related behaviours. Quality of all included articles was assessed by Joanna Briggs Institute (JBI) critical appraisal. Data was analyzed by random model-based effect method.</p><p><strong>Results: </strong>78 observational studies comprising of 394,308 children aged 2-18 were included. Compared to NLBC, LBC had significantly more depression, anxiety, emotional and behavioural problems, conduct problems, self-harm, loneliness, peer bullying, attempts of smoking and alcohol consumption. Subgroup analyses found that younger LBC between the ages of 6 to 12 were at greater risks of poor mental health, emotional and behavioural problems.</p><p><strong>Conclusion: </strong>Absent parental care prevents healthy socio-emotional development and hinder the formation of secure attachment. Poor social-emotional development leads to worse emotional resilience against psychological stressors, while LBC residing in rural areas also experience additional risk factors of low household income and poor access to mental health services.</p><p><strong>Impact statement: </strong>Prolonged parental separation negatively influences mental health, especially in younger children between the ages 6 to 12. Poor social-emotional development in left-behind children is associated with worse emotional resilience against psychological stressors. Additional risk factors including residing in rural areas, low household income, and poor access to mental health services predisposes left-behind children to high risks of mental illness. Timely support services targeted towards strengthening resilience factor such as learning better emotional and behavioural coping strategies and improving school and peer support to address increased risk of mental health problems are required for current left-behind children.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256284","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/s41390-024-03797-x","DOIUrl":"10.1038/s41390-024-03797-x","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":"97 1","pages":"1-1"},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256287","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":"Brain MRI T2 hyperintensity and neurodevelopmental outcomes in neonatal encephalopathy.","authors":"Rhandi Christensen, Elysa Widjaja, Daphne Kamino, Eva Mamak, Linh G Ly, Emily W Y Tam","doi":"10.1038/s41390-025-03907-3","DOIUrl":"https://doi.org/10.1038/s41390-025-03907-3","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the association between early brain MRI T2 hyperintensity and neurodevelopmental outcomes in term infants with neonatal encephalopathy.</p><p><strong>Methods: </strong>A prospective cohort of neonates born ≥ 36 weeks postmenstrual age with neonatal encephalopathy underwent brain MRI in the early postnatal period. Scans were graded for T2 hyperintensity using Kidokoro scoring, and diffusion restriction using Barkovich scoring. The association between T2 hyperintensity (diffuse, mamillary body, pons) and Bayley-III cognitive, language, and motor composite scores at 3 years was examined using multivariable linear regression modeling.</p><p><strong>Results: </strong>The cohort included 102 term infants (63% males), with brain MRI at a median of 4 days of age (IQR: 1). T2 hyperintensity was present in 76% diffusely, 28% in the mamillary bodies, and 17% in the pons. Diffuse T2 hyperintensity score and mamillary body T2 hyperintensity were not associated with cognitive, language, and motor outcomes at 3 years of age when controlling for diffusion restriction.</p><p><strong>Conclusions: </strong>T2 hyperintensity is a common neuroimaging finding on early brain MRI in neonatal encephalopathy. Diffuse, mamillary body, and pontine T2 hyperintensity were not associated with early neurodevelopmental outcomes and can help guide neuroprognostication in this population.</p><p><strong>Impact statement: </strong>T2 hyperintensity on early brain MRI is a common finding in neonatal encephalopathy, however, it is not associated with neurodevelopmental outcomes at 3 years. These results can help with neuroprognostication in the neonatal intensive care unit. T2 hyperintensity in neonatal encephalopathy on early brain MRI is unlikely to influence future cognitive, language, and motor outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189944","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":"Experimental validation of a novel portable device integrating an oxygen concentrator and a ventilation module for patients with ALI/ARDS in low resource countries: a cross-over non-inferiority trial.","authors":"Sofia Poletto, John Diaper, Aurora Montanarini, Giovanni Merighi, Fabienne Fontao, Xavier Belin, Emanuela Zannin, Walid Habre, Raffaele L Dellacà","doi":"10.1038/s41390-024-03792-2","DOIUrl":"10.1038/s41390-024-03792-2","url":null,"abstract":"<p><strong>Background: </strong>This non-inferiority, cross-over study aims to evaluate a novel proof-of-concept portable respiratory support device specifically designed for low-resource settings. The device integrates a ventilation module and an oxygen concentrator.</p><p><strong>Methods: </strong>We studied twelve 4-week-old piglets with a mean weight of 8.4 kg before and after oleic acid-induced acute respiratory distress syndrome (ARDS). In each condition, animals received 1-h pressure control ventilation using a conventional ventilator (Servo-i, Getinge, SE) and the experimental ventilator in random sequence. Arterial blood gas analysis was performed every half-hour to adjust the ventilator settings. The primary outcome was partial pressure of oxygen to FiO₂ ratio (P/F) with a non-inferiority margin of 50 mmHg.</p><p><strong>Results: </strong>P/F did not differ significantly between the experimental and the control ventilation at baseline (459.6(30.9) vs 454.4(28.6) mmHg) and during ARDS condition (165.1(36.9) vs 182.5(48.4) mmHg). The upper 95% CI of the difference between P/F after ventilation using the control and the experimental ventilator was 37.3 and 44.1 mmHg during baseline and ARDS, respectively.</p><p><strong>Conclusions: </strong>The experimental device was not inferior to a conventional ventilator during both baseline and ARDS conditions, suggesting that it can provide adequate treatment to infants with mild to moderate hypoxemic lung disease in resource-limited care settings.</p><p><strong>Impact statement: </strong>This manuscript provides the results of a non-inferiority study that compared a novel proof-of-concept respiratory support device, integrating a ventilation module and an oxygen concentrator, specifically designed for respiratory support in low-resource settings, with a conventional pediatric intensive care ventilator in an oleic-acid model of acute lung injury. Our results showed that the experimental device was non-inferior to a conventional ventilator, suggesting that it can provide adequate treatment to infants with mild to moderate hypoxemic lung disease in resource-limited care settings. The developed solution can also be relevant for other applications, including home mechanical ventilation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189946","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":"Postacute COVID-19 fatigue, dyspnea and reduced activity in children and adolescents.","authors":"Chia-Wei Lin, Kuan-Yu Chen, Jeng-Hung Wu, Yun-Chung Liu, Ting-Yu Yen, Chun-Yi Lu, Yiing-Mei Liou, Yi-Chien Chiang, Li-Min Huang, Susan Shur-Fen Gau, Luan-Yin Chang","doi":"10.1038/s41390-025-03897-2","DOIUrl":"https://doi.org/10.1038/s41390-025-03897-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to quantify fatigue, dyspnea, and physical activity and identify associated factors in children and adolescents with postacute COVID-19 syndrome.</p><p><strong>Methods: </strong>A prospective cohort study included 74 participants aged 6-18 years with postacute COVID-19 symptoms and 120 age- and sex-matched controls without SARS-CoV-2 antibodies. Participants completed questionnaires assessing fatigue, dyspnea, and physical activity and underwent pulmonary function tests.</p><p><strong>Results: </strong>Children with postacute COVID-19 syndrome reported significantly greater fatigue (parent-rated scores: mean 67.9 vs. 82.4, p < 0.001; child-rated scores: 73.7 vs. 83.0, p < 0.001), increased dyspnea (mMRC grades 3-4: 10.9% vs. 4.1%, p = 0.001), and lower physical activity (median 787.8 vs. 1658.5 MET*min/week, p < 0.001) than controls. They also had a higher prevalence of mixed (8.1% vs. 1.7%, p = 0.029) and restrictive lung disease (29.7% vs. 10.8%, p = 0.001). Older age and COVID-19 were identified as risk factors for fatigue and reduced activity. Fatigue correlated with reduced physical activity but not with pulmonary function.</p><p><strong>Conclusion: </strong>Children and adolescents with postacute COVID-19 syndrome, particularly older individuals, experience greater fatigue and reduced physical activity than controls. These findings highlight the importance of quantifying postacute COVID-19 symptoms and their associations with physiological assessments.</p><p><strong>Impact: </strong>This prospective, age- and sex-matched cohort study revealed that children and adolescents with postacute COVID-19 syndrome perceived higher fatigue levels, had higher dyspnea scores, had a greater prevalence of mixed lung and restrictive lung disease, and exhibited less physical activity than their control counterparts. Fatigue correlated with reduced physical activity but was not consistently correlated with pulmonary function test results. This study highlights the importance of quantifying postacute COVID-19 symptoms and exploring the associations between individual symptoms and the impact of coronavirus infection on various systems, including the neurological, musculoskeletal, cardiopulmonary, and immune systems.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123394","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":"Development and validation of a prediction model for bronchopulmonary dysplasia using respiratory severity score.","authors":"Takahiro Kanzawa, Fumie Kinoshita, Fumihiko Namba, Taihei Tanaka, Makoto Oshiro, Takahiro Sugiura, Yuichi Kato, Masafumi Miyata, Yasumasa Yamada, Osuke Iwata, Masahiro Hayakawa, Yoshiaki Sato","doi":"10.1038/s41390-025-03862-z","DOIUrl":"https://doi.org/10.1038/s41390-025-03862-z","url":null,"abstract":"<p><strong>Background: </strong>To develop and validate a prediction model for severe bronchopulmonary dysplasia (BPD) that integrates the respiratory severity (RS) score with early postnatal risk factors.</p><p><strong>Methods: </strong>This retrospective cohort study included preterm infants born at less than 32 weeks gestation or with a birth weight of less than 1500 g, from Aichi Prefecture (training dataset) and Saitama Medical University (validation dataset) from April 1, 2016, to March 31, 2020. The primary outcome was severe BPD, defined as the use of home oxygen therapy or death due to BPD. We used classification and regression tree (CART) analysis to explore the relationship between outcomes and BPD risk factors in the training dataset.</p><p><strong>Results: </strong>The incidence of severe BPD was 149 out of 2026 (7.3%) in the training dataset and 35 out of 387 (8.9%) in the validation dataset. CART analysis identified gestational age and the RS score as significant predictors of outcome in the day 7 and day 14 models, with C-statistics of 0.789 and 0.779, respectively. When applied to the validation dataset, these models achieved C-statistics of 0.753 and 0.827, respectively.</p><p><strong>Conclusion: </strong>Our prediction models demonstrated the ability to predict severe BPD, with the RS score being a crucial predictor.</p><p><strong>Impact: </strong>Many existing prediction models for bronchopulmonary dysplasia (BPD) use multiple predictors, and do not provide specific cutoff values, which complicates their clinical application. To address this issue, we developed a prediction model for severe BPD based on a score derived from mean airway pressure and inhaled oxygen concentration at 1-2 weeks of age. This user-friendly model can be easily integrated into clinical practice, facilitating treatment decisions based on predicted probabilities.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123392","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":"Correction: Trends of extreme hyperbilirubinemia related infant mortality in select European countries (1990-2019).","authors":"Ramesh Vidavalur, Karl F Schettler, Carlo Dani, Sotirios Fouzas, Gabriela Mimoso, Manuel Sanchez-Luna, Vinod K Bhutani, Daniele De Luca","doi":"10.1038/s41390-024-03791-3","DOIUrl":"10.1038/s41390-024-03791-3","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123390","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":"Depletion of phytosterols from intravenous lipid emulsions: to be or not to be.","authors":"Barath Jagadisan, Anil Dhawan","doi":"10.1038/s41390-025-03877-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03877-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123391","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":"Is cardiomyopathy intrinsic to Marfan syndrome?","authors":"Alexis M Wolf, Carolyn M Wilhelm, James Strainic, Timothy J Mead","doi":"10.1038/s41390-025-03899-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03899-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123393","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}