Narjess Boutalbi, Samuel Dahan, William Rozalen, Thibault Beretti, Laurene Fortis, Lucie Delefosse, Robin Cloarec, Benoit Testud, Virginie Fouilloux, Célia Gran, Giulia Danielou, Florent Paoli, Fedoua El-Louali, Julie Blanc, Camille Velly, Guillaume Carles, Chloe Wanert, Sophie Quennelle, Stéphane Lebel, Solène Denantes, Pierre Bourgoin, Matthieu Laborier, Sophie Arnaud, Dominique Santelli, Edouard Aries, Chloé Allary, Isabelle Grandvuillemin, Clotilde Desrobert, Johanna Calderon, Farid Boubred, Fabrice Michel, Caroline Ovaert, Mathieu Milh, Marien Lenoir, Béatrice Desnous
{"title":"Early motor outcomes in infants with complex congenital heart disease: the predictive role of NSE and S100B.","authors":"Narjess Boutalbi, Samuel Dahan, William Rozalen, Thibault Beretti, Laurene Fortis, Lucie Delefosse, Robin Cloarec, Benoit Testud, Virginie Fouilloux, Célia Gran, Giulia Danielou, Florent Paoli, Fedoua El-Louali, Julie Blanc, Camille Velly, Guillaume Carles, Chloe Wanert, Sophie Quennelle, Stéphane Lebel, Solène Denantes, Pierre Bourgoin, Matthieu Laborier, Sophie Arnaud, Dominique Santelli, Edouard Aries, Chloé Allary, Isabelle Grandvuillemin, Clotilde Desrobert, Johanna Calderon, Farid Boubred, Fabrice Michel, Caroline Ovaert, Mathieu Milh, Marien Lenoir, Béatrice Desnous","doi":"10.1038/s41390-025-04437-8","DOIUrl":"https://doi.org/10.1038/s41390-025-04437-8","url":null,"abstract":"<p><strong>Background: </strong>Children with complex congenital heart disease (CCHD) are at high risk for early neurodevelopmental delays across all domains. Neuromotor delay often emerges first and may impact broader development. Identifying early biomarkers of motor function could capture a critical window for intervention. We assessed the prognostic value of neuron-specific enolase (NSE) and S100B in predicting 4-month motor outcomes in newborns undergoing cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>Between December 2021 and October 2024, we conducted a prospective, single-centre study including term neonates with (CCHD) who required cardiac surgery within the first two months of life. NSE and S100B levels were measured at five perioperative time points. Blinded Alberta Infant Motor Scale (AIMS) assessment at four months evaluated motor outcomes.</p><p><strong>Results: </strong>Of 35 newborns, 27 completed follow-up. Preoperative NSE levels were significantly higher in infants with AIMS scores below the 10th percentile (32.7 vs. 20.9 ng/mL, p = 0.044) and negatively correlated with AIMS percentiles (ρ = -0.617, p = 0.006. There was no significant association between motor outcomes, MRI findings or S100B levels.</p><p><strong>Conclusions: </strong>Higher preoperative NSE levels predict poor early motor outcomes in CCHD and may be a marker for early risk stratification and intervention.</p><p><strong>Impact: </strong>Neuron-specific enolase (NSE) may serve as an early biomarker of neuromotor development in newborns with complex congenital heart disease (CCHD). Elevated preoperative NSE levels were associated with poorer motor outcomes at four months. NSE may serve as an additional biomarker within a multimodal risk stratification strategy, complementing clinical, imaging, and electrophysiological assessments to refine prognostic evaluation. These findings highlight the prognostic value of perioperative biomarkers for predicting early motor outcomes and support earlier identification of at-risk newborns, enabling targeted neurodevelopmental interventions. This work adds new evidence to limited literature on biological predictors of motor development after neonatal cardiac surgery.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138202","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":"Hands down, early wins: the case for active, play and training based therapies in unilateral cerebral palsy.","authors":"D Fehlings, I Novak, A C Eliasson","doi":"10.1038/s41390-025-04398-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04398-y","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131495","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 CX3CR1/CX3CL1 (fractalkine) pathway in IgA vasculitis nephritis: guilty party or innocent bystander?","authors":"Patricio E Ray, Matthew D Griffin","doi":"10.1038/s41390-025-04385-3","DOIUrl":"https://doi.org/10.1038/s41390-025-04385-3","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131552","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":"Neuro-imaging in cCMV infection: let's try and speak the same language.","authors":"Linda S de Vries, Sylke J Steggerda, Ana Alarcon","doi":"10.1038/s41390-025-04407-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04407-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125603","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":"Transforming academic medicine through social media: why isn't it working for me?","authors":"Kikelomo Babata, Daniel O'Reilly, Damian Roland","doi":"10.1038/s41390-025-04388-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04388-0","url":null,"abstract":"<p><p>Physicians significantly underutilize social media despite its potential for global medical communication and public education. Purposeful use of social media-with strategic content, optimized timing, and platform-specific approaches-can dramatically improve research dissemination and clinical influence. We outline challenges introduced by the shift from chronological timelines to algorithm-driven content delivery, which prioritizes engagement over evidence. These changes reduce the visibility of traditional scientific content. Our research confirms that posts with broad public appeal consistently generate higher engagement than narrow academic discussions. We present evidence-based case studies, including COVID-19 social media campaigns that reached over 4 million impressions per month and influenced public policy. We also highlight best practices for educational videos. Finally, we illustrate how online collaborations between researchers and families can improve clinical practice using the example of families of children with trisomy 18. Effective social media engagement requires visual abstracts, short videos, and simplified messages tailored for algorithms. Medical hashtags, strategic timing, and collaborations with ethical influencers can further enhance reach. When used ethically and strategically, social media becomes a transformative tool-combating misinformation, informing the public, and supporting professional advancement. For physicians in all specialties, social media literacy is becoming an essential skill for modern healthcare communication. IMPACT: Strategic use of social media empowers physicians to disseminate evidence-based research amidst misinformation and algorithmic bias. This article provides a practical framework for optimizing academic engagement online, bridging the gap between digital reach and academic scholarly recognition. Effective digital scholarship legitimizes science. It is essential to uphold credibility, influence public discourse, and support informed clinical care.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131663","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":"Choline supplementation in classic homocystinuria: impact on homocysteine and hepatic steatosis.","authors":"Sevde Kahraman, Asuman Gedikbasi, Meryem Karaca, Celal Caner Ercan, Mehmet Cihan Balci, Gulden Gokcay","doi":"10.1038/s41390-025-04383-5","DOIUrl":"https://doi.org/10.1038/s41390-025-04383-5","url":null,"abstract":"<p><strong>Background: </strong>Classic homocystinuria is a sulfur metabolism disorder caused by cystathionine beta synthase (CBS) deficiency. The primary aim of treatment is to maintain plasma homocysteine (Hcy) concentration within the target range. This study investigated choline status and the effect of choline supplementation in CBS-deficient homocystinuria patients with elevated Hcy levels despite standard therapy.</p><p><strong>Methods: </strong>Fifteen CBS-deficient homocystinuria patients and 20 controls with normal Hcy levels were enrolled. The study group received 1000 mg/day of choline bitartrate for 8 weeks. The control group was not given any supplements. Anthropometric measurements, biochemical tests, liver magnetic resonance proton density fat fraction imaging, and food consumption records of the participants in the study group were evaluated at baseline and at the end of the study.</p><p><strong>Results: </strong>All participants demonstrated inadequate dietary choline intake. Choline supplementation significantly increased plasma free and total choline levels (p < 0.01) and reduced average plasma Hcy levels from 123.1 ± 52.2 to 61.1 ± 42.9 µmol/L (p < 0.01). In three of the four patients with hepatic steatosis at the beginning of the study, the condition regressed with choline supplementation.</p><p><strong>Conclusion: </strong>In conclusion, choline supplementation should be considered in CBS-deficient homocystinuria patients with low plasma choline and high Hcy levels despite standard therapy.</p><p><strong>Impact: </strong>Choline supplementation further decreases plasma homocysteine levels in patients with classic homocystinuria who still have elevated plasma homocysteine levels on standard therapy. Choline supplementation led to a remarkable surge in plasma free and total choline levels, which marked a significant breakthrough for classic homocystinuria patients. Remarkably, choline supplementation reversed hepatic steatosis in three out of four patients, highlighting its powerful therapeutic potential.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131497","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}
Nicole G Hall, Padma Garg, Jessica K Jackson, Neha Varshney, David Sawaya, Timothy D Howard, Parvesh Mohan Garg
{"title":"Epigenetic changes associated with severe necrosis and survival in preterm infants with surgical necrotizing enterocolitis.","authors":"Nicole G Hall, Padma Garg, Jessica K Jackson, Neha Varshney, David Sawaya, Timothy D Howard, Parvesh Mohan Garg","doi":"10.1038/s41390-025-04381-7","DOIUrl":"https://doi.org/10.1038/s41390-025-04381-7","url":null,"abstract":"<p><strong>Background: </strong>We aim to determine the epigenetic changes assessed by DNA methylation associated with necrosis severity and survival in preterm infants with surgical necrotizing enterocolitis (NEC).</p><p><strong>Methods: </strong>Using Illumina's Infinium EPIC v2.0 BeadChips, the DNA methylation profiles of 46 infants with NEC were generated from intestinal tissue collected during laparotomy. Samples were categorized by disease severity and survival outcome. STRING functional enrichment analyses and MCODE network analyses of the genes found to contain CpG sites with significantly different methylation levels (Benjamini-Hochberg adjusted p-value ≤ 0.01) were used to investigate the biological relevance of the epigenetic differences between sample groups.</p><p><strong>Results: </strong>4570 CpG sites showed a significant difference in methylation when comparing survivors (n = 34) and non-survivors (n = 12) of surgical NEC (p < 0.05). 19,518 CpG sites showed a significant difference in methylation when comparing NEC patients with low (n = 18) and high necrosis (n = 28) (p < 0.05). Genes with the greatest number of significant methylation sites include PRDM16, SEPTIN9, FOXP1, POLR1C, and several homeobox genes. NOTCH and Rap1 signaling were two of the major pathways identified.</p><p><strong>Conclusion: </strong>The DNA methylation profiles of infants with surgical NEC were found to differ, depending on necrosis severity and survival outcome.</p><p><strong>Impact: </strong>The DNA methylation profiles in surgical necrotizing enterocolitis (NEC) were found to differ depending on necrosis severity and survival outcome. Significant differences in the DNA methylation levels of thousands of genes helped identify molecular pathways that may be epigenetically regulated and involved in disease progression. These genes and molecular pathways are potential therapeutic targets for NEC, an incompletely understood and life-threatening disease.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131514","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}
Matheus F P T van Rens, Anita Huis, Kevin Hugill, Robin van der Lee, Willem P de Boode
{"title":"Detection of peripheral infusion-related infiltration and extravasation in neonates: a scoping review.","authors":"Matheus F P T van Rens, Anita Huis, Kevin Hugill, Robin van der Lee, Willem P de Boode","doi":"10.1038/s41390-025-04367-5","DOIUrl":"https://doi.org/10.1038/s41390-025-04367-5","url":null,"abstract":"<p><strong>Background: </strong>Short peripheral catheter (SPC) use is widespread in neonatal care but is associated with serious complications like infiltration and extravasation. Early recognition and prompt management are essential for improving outcomes.</p><p><strong>Objective: </strong>To examine the evidence on SPC infiltration and extravasation complications in neonates, focusing on incidence, risk factors, detection tools, research gaps, and opportunities for standardization.</p><p><strong>Methods: </strong>Following the Joanna Briggs Institute (JBI) scoping review framework, we systematically searched five databases (PubMed, EMBASE, CINAHL, Cochrane, and Web of Science) for studies published between January 2000 and May 2024. The search was conducted over a 3-month period (March-May 2024). Studies were included if they focused on SPC-related infiltration or extravasation in neonates in hospital settings. Exclusion criteria included studies on central or arterial lines, non-primary research, or lacking separate neonatal data. Two reviewers independently screened all records using a standardized template.</p><p><strong>Results: </strong>2879 records were identified, after 820 duplicates and one retracted article were removed, 2058 were left for initial screening. Of these, 1904 were screened in full, and 30 studies met the inclusion criteria. The reported incidence of infiltration and extravasation ranged widely (up to 70%). Risk factors identified included catheter insertion site, technique, and dwell time, and patient characteristics such as low birth weight. Detection was predominantly by subjective visual and tactile assessment, although emerging technologies such as near-infrared spectroscopy and sensor-based tools were explored in some studies.</p><p><strong>Conclusions: </strong>SPC-related infiltration and extravasation remain frequent in neonatal care. Despite increasing interest in objective detection tools, their clinical adoption is limited. Standardized definitions and validated early detection methods are essential for improving outcomes and guiding evidence-based practice.</p><p><strong>Impact: </strong>Addressing a critical neonatal concern-peripheral infiltration/extravasation remains a serious concern in neonatal practice, though its definition and incidence vary widely. This review consolidates existing knowledge, emphasizing the lack of standardized definitions and the need for consensus in clinical assessment. Bridging evidence gaps in prevention-few substantive measures are clinically proven to reduce the incidence and severity of SPC-related complications. This review highlights the limitations of current strategies and the potential of emerging technologies, advocating for robust clinical validation. Guiding future research and practice-the findings call for standardized protocols, multicenter trials, and objective detection tools to improve neonatal vascular access management and patient safety.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125580","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":"Total hydrocortisone dosage in extremely low birth weight infants and neurodevelopment up to school age.","authors":"Akinobu Taniguchi, Basile Chrétien, Takashi Maeda, Kazuto Ueda, Ryosuke Miura, Ryuichi Tanaka, Toshihiko Suzuki, Yukako Muramatsu, Erina Kataoka, Eiko Kato, Hikaru Yamamoto, Koji Takemoto, Miharu Ito, Seiji Hayashi, Yuichiro Sugiyama, Kazuki Nishida, Yoshiaki Sato","doi":"10.1038/s41390-025-04426-x","DOIUrl":"https://doi.org/10.1038/s41390-025-04426-x","url":null,"abstract":"<p><strong>Background: </strong>An association between total hydrocortisone (HC) dosage in infants with extremely low birth weight (ELBW) and subsequent neurodevelopmental outcomes up to school age remains unclear.</p><p><strong>Method: </strong>We conducted a retrospective longitudinal cohort study across eight centers in Japan, including ELBW infants born between 2015 and 2017. We investigated the association between total HC dosage administered up to 36 weeks postmenstrual age and neurodevelopmental outcomes to school age.</p><p><strong>Results: </strong>Linear mixed model analysis showed a significant association between higher HC dosage and lower developmental and intelligence quotient (DQ/IQ) scores. This trend persisted at 6 years of age, suggesting a sustained effect of HC on cognitive outcomes. For every 10 mg increase in HC dosage, IQ scores decreased by 2.82 points (95% CI: -3.89 to -1.06, p = 0.001). The interaction term between HC dosage and time was not statistically significant (0.10, 95% CI: -0.18 to 0.37, p = 0.481), suggesting the association of HC dosage on DQ/IQ did not vary substantially throughout the study period.</p><p><strong>Conclusions: </strong>We found a relationship between total neonatal HC dosage in ELBW infants and DQ/IQ scores over time that persisted at school age. Clinicians should be aware of this potential dose-dependent effect on neurodevelopmental outcomes.</p><p><strong>Impact: </strong>As neonatal dexamethasone administration is known to affect neurodevelopment outcomes, hydrocortisone (HC) is considered an alternative to dexamethasone as a glucocorticoid treatment. In infants with extremely low birth weight (ELBW), a relationship has been noted between total HC dosage and neurodevelopment in early childhood. We confirmed the association between total HC dosage in infants with ELBW and poor developmental and intelligence quotients to school age. Although HC is commonly used in the management of ELBW infants, clinicians should be aware of its potential dose-dependent effects on neurodevelopmental outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131559","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}
Maiara de Aguiar da Costa, Júlio César Claudino Dos Santos, Cinara Ludvig Gonçalves
{"title":"When access is not enough: vaccine hesitancy in high-income countries.","authors":"Maiara de Aguiar da Costa, Júlio César Claudino Dos Santos, Cinara Ludvig Gonçalves","doi":"10.1038/s41390-025-04393-3","DOIUrl":"https://doi.org/10.1038/s41390-025-04393-3","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131613","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}