Pediatric Investigation最新文献

{"title":"Network analysis of psychological problems in school-attending students aged 6-16 years in China: A comparison between rural and urban areas.","authors":"Lianjingyi Liang, Wanling Zhang, Ying Li, Yanyu Wang, Raymond C K Chan","doi":"10.1002/ped4.70056","DOIUrl":"https://doi.org/10.1002/ped4.70056","url":null,"abstract":"<p><strong>Importance: </strong>Urbanization significantly shapes the psychological health of children and adolescents.</p><p><strong>Objective: </strong>To apply network analysis to explore psychological problems among students aged 6-16 years from rural and urban areas of China.</p><p><strong>Methods: </strong>Using data from a multi-stage stratified epidemiological survey, we analyzed 19 711 students (9566 urban; 10 145 rural). Among them, 3003 had mental disorders. Screening was conducted using the Child Behavior Checklist (CBCL), followed by the Mini International Neuropsychiatric Interview for Children and Adolescents and psychiatrist interviews. Network analysis was used to compare rural and urban CBCL networks.</p><p><strong>Results: </strong>In the entire sample, social problems, thought problems, rule-breaking behavior, and aggressive behavior were more pronounced in the rural group, while the urban group showed elevated somatic complaints. The rural and urban networks exhibited significant differences in edge weights (<i>M</i> = 0.186, <i>P</i> < 0.001), but showed no significant difference in global network strength (<i>S</i> = 1.608, <i>P</i> = 0.086). Among participants with mental disorders, withdrawn/depressed, social problems, thought problems, rule-breaking behavior, and aggressive behavior were more prominent in the rural group, while the urban group showed more somatic complaints and aggressive behavior. The rural and urban networks exhibited significant differences in edge weights (<i>M</i> = 0.223, <i>P</i> = 0.001) but showed no significant difference in global network strength (<i>S</i> = 3.245, <i>P</i> = 0.358).</p><p><strong>Interpretation: </strong>Urbanization is a significant environmental determinant affecting youth mental health in China, linked to distinct psychological patterns. Rural students tended to show more emotional problems, whereas urban students demonstrated more behavioral issues.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"135-146"},"PeriodicalIF":2.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconceptualizing school refusal behavior and related symptoms from an ecological perspective.","authors":"Xiaoxuan Fan, Kui Wang, Tengteng Fan, Wanling Zhang, Aihua Wang, Chao Yan, Yanyu Wang, Ying Li","doi":"10.1002/ped4.70057","DOIUrl":"https://doi.org/10.1002/ped4.70057","url":null,"abstract":"","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"109-113"},"PeriodicalIF":2.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic burnout and internet gaming disorder in Chinese adolescents: The chain mediating roles of depressive symptoms and negative attentional bias.","authors":"Yalei Li, Yanyu Wang, Jinghua Zhu, Liping Jia, Guohua Lu","doi":"10.1002/ped4.70052","DOIUrl":"https://doi.org/10.1002/ped4.70052","url":null,"abstract":"<p><strong>Importance: </strong>Academic burnout is prevalent among Chinese adolescents and could increase their susceptibility to internet gaming disorder (IGD) by influencing both affective and cognitive factors. However, the underlying mechanisms, particularly the roles of depressive symptoms and attentional bias, remain unclear.</p><p><strong>Objective: </strong>The present research investigated how academic burnout influences IGD among adolescents and examined whether depressive symptoms and attentional bias mediate this association.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted using cluster sampling, recruiting 2042 adolescents aged 11-17 years old. Scales were used to assess academic burnout, IGD, depressive symptoms, and attentional bias. Descriptive statistics and correlation analyses were performed using SPSS 29.0, and the chain mediation model was tested using the PROCESS 4.1 model 6.</p><p><strong>Results: </strong>Academic burnout positively predicted IGD among the adolescents (β = 0.218, <i>P</i> < 0.001). Depressive symptoms and negative attentional bias independently mediated this association, and significant chain mediation via depressive symptoms, followed by negative attentional bias, was observed. Positive attentional bias showed no significant mediating effect.</p><p><strong>Interpretation: </strong>These findings highlight the affective and cognitive pathways associated with academic burnout and IGD, underscoring the interplay between depressive symptoms and attentional bias. By integrating these mechanisms, this study advanced the interaction of person-affect-cognition-execution model and provided potential targets for prevention and intervention in adolescent IGD.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"159-170"},"PeriodicalIF":2.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of the Child and Adolescent Behavior Inventory in Chinese children aged 8-11 years.","authors":"Hui Xu, Lingying Huang, Lianjingyi Liang, Wanling Zhang, Guoshuang Feng, Shaowei Li, Ying Li","doi":"10.1002/ped4.70049","DOIUrl":"https://doi.org/10.1002/ped4.70049","url":null,"abstract":"<p><strong>Importance: </strong>The Child and Adolescent Behavior Inventory (CABI) is a comprehensive assessment tool for youth psychopathology; however, its psychometric properties have not been established in China.</p><p><strong>Objective: </strong>This study aimed to translate the CABI into Chinese and conduct a thorough evaluation of its reliability and validity in a sample of school-aged Chinese children.</p><p><strong>Methods: </strong>Mothers of 1028 Chinese children (53.3% boys; aged 8-11 years) completed the Chinese version of the CABI. A subsample also completed the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ) for validity testing. Psychometric properties were evaluated using Cronbach's alpha, exploratory confirmatory factor analysis, correlation analyses, and item response theory (IRT).</p><p><strong>Results: </strong>The Chinese CABI scores demonstrated excellent internal consistency. The proposed 11-factor model showed a good fit to the data (comparative fit index = 0.980, root-mean-square error of approximation = 0.034, standardized root mean square residual = 0.047), supporting its structural validity. The scale scores exhibited strong convergent and discriminant validity, with scores correlating strongly with conceptually similar scales on the CBCL and the SDQ. Moreover, the CABI scores demonstrated robust criterion validity by effectively differentiating children with clinical-level problems identified by the CBCL. IRT analyses confirmed that the scale scores provided high measurement precision for moderate-to-high trait levels, supporting their utility for clinical screening. Most of the positive properties mentioned above were consistent between boys and girls.</p><p><strong>Interpretation: </strong>The CABI scale scores on the Chinese parent version showed excellent reliability and validity in Chinese children. Thus, it yields a precise instrument for the assessment of emotional, behavioral, and functional problems in clinical practice and epidemiologic research among Chinese children.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"125-134"},"PeriodicalIF":2.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Instruction for Authors.","authors":"","doi":"10.1002/ped4.70048","DOIUrl":"https://doi.org/10.1002/ped4.70048","url":null,"abstract":"","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"101-108"},"PeriodicalIF":2.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutual associations between self-efficacy and physical fitness in Spanish adolescents: The EHDLA study.","authors":"José Adrián Montenegro-Espinosa, Pablo Galan-Lopez, Rodrigo Yañéz-Sepúlveda, Héctor Gutiérrez-Espinoza, Jorge Olivares-Arancibia, Samuel Manzano-Carrasco, Masoud Rahmati, Brendon Stubbs, Lee Smith, José Francisco López-Gil","doi":"10.1002/ped4.70044","DOIUrl":"https://doi.org/10.1002/ped4.70044","url":null,"abstract":"<p><strong>Importance: </strong>Physical fitness and self-efficacy are recognized as determinants of adolescent health. However, their potential bidirectional associations remain unclear. Understanding this relationship may support the development of integrated physical and psychological health interventions in adolescence.</p><p><strong>Objective: </strong>To examine the bidirectional association between physical fitness and self-efficacy in Spanish adolescents.</p><p><strong>Methods: </strong>This cross-sectional study used secondary data from the Eating Habits and Daily Living Activities (EHDLA) study, which included 618 adolescents (43.5% boys; aged 12-17 years) from the Region of Murcia, Spain. Physical fitness, including flexibility, speed-agility, cardiorespiratory fitness, and muscular fitness, was assessed using the Assessing Levels of Physical Activity and Fitness battery. Self-efficacy was measured using the Spanish version of the General Self-efficacy Scale. Associations were analyzed using Spearman's correlation coefficients and robust generalized linear models adjusted for relevant covariates.</p><p><strong>Results: </strong>Significant but weak bidirectional associations were observed between self-efficacy and several components of physical fitness, particularly cardiorespiratory fitness, lower-body muscular fitness, and speed-agility (all <i>P</i> < 0.001). Both higher physical fitness and greater self-efficacy independently predicted improved scores in other domains after adjusting for covariates.</p><p><strong>Interpretation: </strong>These findings suggest a bidirectional association between self-efficacy and physical fitness in adolescents, especially for cardiorespiratory fitness, lower-body muscular fitness, and speed-agility. Interventions targeting either physical or psychological factors may generate reciprocal benefits, highlighting the importance of integrated strategies for promoting adolescent health.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"114-124"},"PeriodicalIF":2.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of pediatric epilepsy.","authors":"Junxiao Li, Tinghong Liu, Chang Liu, Jie Deng, Shijie Wu, Suhui Kuang, Xiaotong Li, Zhirong Wei, Shuli Liang","doi":"10.1002/ped4.70043","DOIUrl":"https://doi.org/10.1002/ped4.70043","url":null,"abstract":"<p><p>Pediatric epilepsy is a neurological disorder arising from various etiologies, including structural, genetic, immune, infectious, metabolic, and unknown causes. Anti-seizure medications remain the primary treatment; however, in cases of drug-resistant epilepsy, surgical interventions, ketogenic diet, and emerging therapies have become increasingly effective options. Disease-modifying treatments, such as antisense oligonucleotides and adeno-associated virus-mediated gene replacement, have shown promise in some epilepsy treatments, with early trials reporting moderate seizure reduction. Minimally invasive surgical approaches, including magnetic resonance-guided laser interstitial thermal therapy, have also demonstrated favorable outcomes, showing a 68% seizure-free rate at 2 years in the largest pediatric series. Although the ketogenic diet is effective in some patients, demonstrating superiority over conventional management for >50% seizure reduction, long-term use may be associated with metabolic risks; careful monitoring is warranted. Future treatment strategies are expected to emphasize personalized medicine through the integration of genetic, electrophysiological, and neuroimaging data to optimize therapeutic decision-making and enable targeted interventions based on the underlying etiology.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"86-100"},"PeriodicalIF":2.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese guideline for the prevention and control of complications associated to umbilical venous catheterization in neonates (2025).","authors":"","doi":"10.1002/ped4.70042","DOIUrl":"https://doi.org/10.1002/ped4.70042","url":null,"abstract":"<p><p>This guideline aims to standardize the prevention and management of complications related to umbilical venous catheterization (UVC). It addresses nine clinical questions, categorized into three sections: (1) questions concerning UVC-related infection, (2) catheter position, and (3) UVC maintenance. Literature screening and review were completed for all papers published up to May 31, 2025. Relevant evidence was synthesized through meta-analysis where applicable, and the GRADE methodology was applied to grade the quality of evidence and the strength of recommendations. The guideline establishes a total of nineteen recommendations and suggestions.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of tocilizumab combined with different high-dose methylprednisolone regimens for acute necrotizing encephalopathy in children.","authors":"Fei Li, Kechun Li, Chaonan Fan, Quan Wang, Suyun Qian","doi":"10.1002/ped4.70039","DOIUrl":"https://doi.org/10.1002/ped4.70039","url":null,"abstract":"<p><strong>Importance: </strong>Acute necrotizing encephalopathy (ANE) is a rare but life-threatening pediatric neurological disorder characterized by rapid progression and high mortality. Tocilizumab, an interleukin-6 receptor antagonist, combined with high-dose methylprednisolone [MP, ≥20 mg/(kg·day)], may improve outcomes, yet the optimal MP dosing strategy remains uncertain.</p><p><strong>Objective: </strong>To evaluate the comparative effectiveness and safety of two high-dose MP regimens [20 mg/(kg·day) vs. 30 mg/(kg·day)], each in combination with tocilizumab for ANE.</p><p><strong>Methods: </strong>This retrospective cohort study included 23 ANE patients treated with tocilizumab and high-dose MP at Beijing Children's Hospital from January 2023 to January 2025. Patients were divided into two groups based on the initial MP dosage: 20 mg/(kg·day) (<i>n</i> = 11) and 30 mg/(kg·day) (<i>n</i> = 12). Primary outcomes included mortality and anti-inflammatory response. Secondary outcomes were the incidence of severe neurological sequelae, assessed using the pediatric overall performance category (POPC) score, and the frequency of treatment-related adverse events.</p><p><strong>Results: </strong>Overall mortality rate was 26.1% with a lower rate observed in the 30 mg/(kg·day) group (16.7%) compared to the 20 mg/(kg·day) group (36.4%). Most patients (78.3%) had severe ANE (ANE Severity Score ≥5), and 91.3% presented with multi-organ dysfunction and brainstem involvement. Both groups demonstrated significant reductions in procalcitonin, cerebrospinal fluid protein, and cerebrospinal cytokines after 3 days of MP therapy (<i>P</i> < 0.05). Compared with the 20 mg/(kg·day) group, the 30 mg/(kg·day) MP group had significantly lower rates of severe neurological sequelae (POPC score 4-6) at discharge (41.7% vs. 90.9%; <i>P</i> = 0.027) and at 6-12 months follow-up (30.0% vs. 85.7%; <i>P</i> = 0.050). No statistically significant differences in adverse event rates were observed between the two groups (<i>P</i> > 0.05), and no tocilizumab-related adverse events were reported.</p><p><strong>Interpretation: </strong>In pediatric ANE, tocilizumab combined with 30 mg/(kg·day) MP was associated with improved neurological outcomes compared with 20 mg/(kg·day), with comparable mortality and safety profiles. These findings suggest that a higher initial MP dose may offer neuroprotective advantages, warranting further validation in prospective, multicenter studies.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"38-46"},"PeriodicalIF":2.0,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six artificial intelligence innovation strategies applied to autism spectrum disorder research: A narrative review.","authors":"Ting Zhang, Zhenkun Cao, Wei Li, Zhihai Lv","doi":"10.1002/ped4.70038","DOIUrl":"https://doi.org/10.1002/ped4.70038","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by deficits in social communication and restricted behaviors. Traditional assessment and intervention methods rely heavily on subjective and time-consuming approaches, which limit their clinical impact. Advances in artificial intelligence (AI) offer transformative opportunities for ASD research and practice. This narrative review proposes six AI-driven strategies that address six core research challenges: uncovering causal mechanisms, modeling dynamic neurodevelopment, integrating multimodal data, individualized computational modeling, collaborative learning across institutions, and enhancing social training. We highlight the potential of causal inference to clarify gene-environment interactions, spatio-temporal graph neural networks to capture neurodevelopmental heterogeneity, and multimodal fusion for unified representation learning. Digital twin technologies enable personalized brain modeling and neuromodulation optimization, while social brain reverse engineering and federated learning frameworks support computational hypothesis generation and privacy-preserving collaboration, respectively. Large language models further facilitate context-aware social interventions. We also discuss key challenges-including data heterogeneity, interpretability, ethics, and clinical translation-and outline directions for building a more precise, human-centered research paradigm. This review aims to move beyond incremental tool improvements toward reconstructing scientific paradigms, thereby accelerating the effective translation of AI innovations into clinical ASD applications.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"182-198"},"PeriodicalIF":2.0,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}