Pediatric Research最新文献

{"title":"Melatonin: a positive influencer of inflammation in neonatal encephalopathy.","authors":"Raymand Pang, Eleanor Molloy, Nicola J Robertson","doi":"10.1038/s41390-025-03876-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03876-7","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009659","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 neonatal health: the promise and challenges of universal genome sequencing in newborn screening.","authors":"David K Stevenson, Ronald J Wong, Jonathan D Reiss, Gary M Shaw, Nima Aghaeepour, Ali Mahzarnia, Ivana Marić","doi":"10.1038/s41390-025-03874-9","DOIUrl":"https://doi.org/10.1038/s41390-025-03874-9","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009509","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":"Utility of NT-proBNP as a biomarker in Congenital Diaphragmatic Hernia.","authors":"Jason Gien","doi":"10.1038/s41390-025-03854-z","DOIUrl":"https://doi.org/10.1038/s41390-025-03854-z","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009719","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":"Concussion in high school sports: findings from injury surveillance.","authors":"Avinash Chandran, Adrian J Boltz, Jillian Baker, Megan Anderson, Neel Rao, Christy L Collins","doi":"10.1038/s41390-025-03863-y","DOIUrl":"https://doi.org/10.1038/s41390-025-03863-y","url":null,"abstract":"<p><strong>Background: </strong>We aimed to examine the epidemiology of concussions within high school (HS) boys' and girls' sports, and to assess the incidence of concussion within HS sports during the timespan inclusive of the COVID-19 pandemic.</p><p><strong>Methods: </strong>We analyzed data captured within High School Reporting Information Online (HS RIO) during 2018/19-2022/23. Injury counts, rates (enumerated per 10,000 athlete-exposures (AEs)), and proportions were used to describe injury characteristics by sport, event type, injury mechanism, and injury history. Injury rate ratios (IRR) and accompanying 95% Confidence Intervals (CIs) were used to evaluate differential injury incidence across event types and sports.</p><p><strong>Results: </strong>A total of 4663 concussions were reported during the study period (Rate = 3.50 per 10,000 AEs). Overall rates were highest in boys' football (8.22 per 10,000 AEs) and girls' soccer (6.11 per 10,000 AEs). Among sex-comparable sports, overall concussion rates were higher in girls' sports as compared with boys' sports (IRR = 2.15; 95%CI = [1.94, 2.37]). Concussion rates fluctuated across the study period and were lower during the COVID-19-impacted seasons, as compared with neighboring years.</p><p><strong>Conclusions: </strong>Our findings underscore the necessity for continuous surveillance of concussions in HS sports and suggest that concussion incidence in girls' sports warrants targeted attention.</p><p><strong>Impact: </strong>Sport-related concussions are a significant concern, particularly in youth athletics, with changes to concussion management and the impact of the COVID-19 pandemic necessitating a re-evaluation of concussion incidence and management in high school sports. In this surveillance study (2018/19-2022/23), boys' football and girls' soccer had the highest concussion rates, with a decrease in incidence observed during the COVID-19 pandemic as compared with surrounding years. The incidence of concussions in girls' sports requires increased scrutiny, especially due to an overall increase in incidence density observed after an initial decrease during the COVID-19 pandemic.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009567","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":"Family reflections: including a lifespan perspective in cerebral palsy care and research.","authors":"Jodi Kreschmer, Duncan Wyeth","doi":"10.1038/s41390-025-03873-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03873-w","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009618","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":"Sleep for infants after discharge from a neonatal ward: Expert- and parent endorsed strategies.","authors":"Eline R de Groot, Agnes van den Hoogen, Mary Anne J Ryan, Monique P L'Hoir, Floortje Kanits, Nathalia E Sierksma, Sophie R D van der Schoor, Mirja Quante, Christy Gliniak, Jeroen Dudink","doi":"10.1038/s41390-025-03811-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03811-w","url":null,"abstract":"<p><strong>Background: </strong>This study aims to outline sleep strategies grounded in scientific research and endorsed by sleep experts, integrating parental input into the evaluation process, to assist parents in supporting infant sleep after discharge from a neonatal ward.</p><p><strong>Methods: </strong>A Delphi method, consisting of three rounds, was employed. Sleep strategies based on scientific literature were presented to sleep experts and parents of infants discharged from a neonatal ward.</p><p><strong>Results: </strong>A literature search identified 11 sleep strategies. These strategies were incorporated in Delphi round 1. Out of 17 sleep experts, 13 reviewed and revised these 11 sleep strategies, resulting in a list of 8 sleep strategies. In round 2, these strategies were ranked by 14 out of 17 sleep experts, with \"knowledge gathering\" being ranked the most important sleep strategy. In round 3, the same list of 8 sleep strategies was ranked by 35 parents. They found \"sleep hygiene\" and \"swaddling\" the most important strategies.</p><p><strong>Conclusion: </strong>This study offers 8 sleep strategies that are grounded in scientific research, supported by experts, and evaluated by parents. Experts and parents prioritize sleep strategies differently. Therefore, healthcare professionals should offer practical and customized sleep strategies that align with the unique needs of each family.</p><p><strong>Impact: </strong>Experts and parents prioritize sleep strategies differently. This study offers a summary of sleep strategies that are grounded in scientific research, supported by experts, and include parental feedback in the evaluation process. Healthcare professionals can use these strategies to offer practical and customized sleep advise that aligns with the unique needs of each family.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009648","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":"Machine learning models for neurocognitive outcome prediction in preterm born infants.","authors":"Menne R van Boven, Frank C Bennis, Wes Onland, Cornelieke S H Aarnoudse-Moens, Max Frings, Kevin Tran, Trixie A Katz, Michelle Romijn, Mark Hoogendoorn, Anton H van Kaam, Aleid G Leemhuis, Jaap Oosterlaan, Marsh Königs","doi":"10.1038/s41390-025-03815-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03815-6","url":null,"abstract":"<p><strong>Background: </strong>Outcome prediction after preterm birth is important for long-term neonatal care, but has proven notoriously challenging for neurocognitive outcome. This study investigated the potential of machine learning to improve neurocognitive outcome prediction at two and five years of corrected age in preterm infants, using readily available predictors from the neonatal setting.</p><p><strong>Methods: </strong>Predictors originating from the antenatal and neonatal period of preterm infants born <30 weeks gestation were used to predict adverse neurocognitive outcome on the Bayley Scale and Wechsler Preschool and Primary Scale of Intelligence. Machine learning models were compared to conventional logistic regression and validated using internal cross-validation.</p><p><strong>Results: </strong>Best performing models were a random forest (two-year outcome) and a support vector machine (five-year outcome) with an area under the receiver operating characteristic curve (AUC) of 0.682 and 0.695 respectively, reaching high negative predictive values (95% and 91%, respectively). These models performed significantly better than the conventional models.</p><p><strong>Conclusions: </strong>The models reached moderate overall predictive performance, yet with promising potential for early identification of children without adverse neurocognitive outcome. Machine learning modestly improved neurocognitive outcome prediction. Future research may harvest the predictive potential of a wider variety of routine (clinical) data, such as vital sign time series.</p><p><strong>Impact: </strong>Early prediction of neurocognitive outcome in preterm infants will enable targeted follow-up and deployment of early (preventative) interventions to improve outcome. Neurocognitive outcome remains notoriously challenging using conventional models, while existing machine learning models depend on advanced MRI-derived predictors with limited potential for implementation into daily clinical practice. This study developed machine learning models for neurocognitive outcome prediction using predictors that are readily available in neonatal settings. Neurocognitive outcome prediction remains challenging due to low AUC and PPV, however, the models demonstrate high NPV, indicating potential for identifying children at low risk for adverse outcome.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009587","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":"Optimising CPAP and oxygen levels to support spontaneous breathing in preterm rabbits.","authors":"Ebony R Cannata, Kelly J Crossley, Erin V McGillick, Megan J Wallace, Michelle K Croughan, Dominic Jurkschat, Sophie J E Cramer, Arjan B Te Pas, Stuart B Hooper, Marcus J Kitchen","doi":"10.1038/s41390-025-03802-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03802-x","url":null,"abstract":"<p><strong>Background: </strong>Very preterm infants often require respiratory support after birth with current recommendations suggesting the use of continuous positive airway pressure (CPAP) of 4-8 cmH₂O and an initial fraction of inspired oxygen (FiO₂) of 0.21-0.3. We have examined the interaction of high and low CPAP and FiO₂ levels on breathing rates and lung aeration in preterm rabbits.</p><p><strong>Methods: </strong>Prematurely delivered rabbits (29/32 days gestation) received CPAP of either 5cmH₂O (5CPAP; n = 12) or 15 cmH₂O (15CPAP; n = 14), and a FiO₂ of either 0.3 (5CPAP/0.3, n = 6 or 15CPAP/0.3, n = 7) or 0.6 (5CPAP/0.6, n = 6 or 15CPAP/0.6, n = 7). Breathing rates, lung aeration (functional residual capacity; FRC), lung bulging and air accumulation in the stomach were measured using phase-contrast X-ray imaging.</p><p><strong>Results: </strong>Kittens receiving 0.6 FiO₂ had higher breathing rates (5CPAP/0.6: 32.6±6.4 breaths/min; p = 0.0064 and 15CPAP/0.6: 36.9±3.5breaths/min; p = 0.0010) than 5CPAP/0.3 kittens (11.8±4.1breaths/min). Kittens receiving 15CPAP/0.6 tended to have higher FRC volumes (34.9±4 mL/kg) than kittens receiving 5 cmH₂O CPAP (5CPAP/0.3: 13.1±6mL/kg; p = 0.0675 and 5CPAP/0.6: 13.5±6 mL/kg; p = 0.1720) and 15CPAP/0.3 (22.5 ± 6.6 mL/kg; p = 0.4245). Lung bulging and air accumulation in the stomach were not different between groups.</p><p><strong>Conclusion: </strong>Preterm rabbits supported with both 15 cmH₂O CPAP and 0.6 FiO₂ increased spontaneous breathing rates and lung aeration without increasing the risk of air in the stomach or lung bulging.</p><p><strong>Impact: </strong>While current guidelines recommend the use of low CPAP (4-8 cmH₂O) and low FiO₂ levels (0.21-0.3 FiO₂) to support preterm infants at birth, the optimum levels are unknown. This study has shown that 15 cmH₂O of CPAP and FiO₂ of 0.6 improved lung aeration and breathing in preterm rabbits, compared with a CPAP of 4 cmH₂O and FiO₂ of 0.3. These results add to the evidence indicating that initial high CPAP and high FiO₂ levels, followed by titration of both, enhance respiratory support for preterm newborns.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009662","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":"Assessing competency in less invasive surfactant administration: simulation-based validity evidence for the LISA-AT scores.","authors":"Niklas Breindahl, Emma Therese Bay, Christian Heiring, Ingrid Rose MacLean-Nyegaard, Amalie Gudiksen, Andreas Frithioff, Tine Brink Henriksen, Martin Grønnebæk Tolsgaard, Lise Aunsholt","doi":"10.1038/s41390-025-03868-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03868-7","url":null,"abstract":"<p><strong>Background: </strong>The Less Invasive Surfactant Administration Assessment Tool (LISA-AT) was developed to support operator training and competence assessment. This study aimed to gather validity evidence in the simulated setting to support using the LISA-AT scores.</p><p><strong>Methods: </strong>Validity evidence was gathered using the Messick framework. The lowest quartile (Q1) for the median of the experts' LISA-AT scores defined the minimum passing score.</p><p><strong>Results: </strong>Ten experts and 23 novices were enrolled in this study. Eight of the original 15 LISA-AT metrics effectively discriminated between novices and experts and demonstrated high test-retest reliability (Spearman's rho = 0.87), high internal consistency, and good inter-rater reliability (Cronbach's alpha = 0.88 and 0.82, respectively). The LISA-AT discriminated between novices' and experts' first two attempts with median [IQR] scores of 29 [26-32] vs 39 [39-40]). The minimum passing score was defined as 39/40 points, and the novices used a median [IQR] of 6 [5-7] attempts, ranging from 4 to 9 attempts, to reach this score. Compared with the expert group, the novices' laryngoscopy skills and time remained significantly different even after attaining the minimum passing score.</p><p><strong>Conclusion: </strong>We found strong validity evidence to support using the LISA-AT scores to train new LISA operators to the minimum passing score to ensure competence in the simulated setting.</p><p><strong>Impact: </strong>This study showed robust validity evidence for using the Less Invasive Surfactant Administration Assessment Tool (LISA-AT) to train LISA novices with a high test-retest reliability, high internal consistency, and good inter-rater reliability. Eight of the original 15 LISA-AT metrics effectively discriminated between novices and experts, with a minimum passing score of 39/40 points, corresponding to the lowest quartile (Q1) of the experts' performances. Novices typically needed six attempts in the simulated setting, ranging from four to nine. However, their laryngoscopy skills and duration remained significantly different from experts. Using the LISA-AT score can ensure competence in the simulated setting before advancing to supervised clinical procedures.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009520","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":"ECI biocommentary.","authors":"Ellen C Ingolfsland","doi":"10.1038/s41390-025-03855-y","DOIUrl":"https://doi.org/10.1038/s41390-025-03855-y","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009601","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}