Translational pediatrics最新文献

{"title":"Is there an association between dietary fiber intake, screen time, and physical activity among students aged 14 to 17 years?-a cross-sectional study.","authors":"Carla Greier, Clemens Drenowatz, Jozsef Dudas, Gerhard Ruedl, Markus Posch, Klaus Greier","doi":"10.21037/tp-2026-0432","DOIUrl":"10.21037/tp-2026-0432","url":null,"abstract":"<p><strong>Background: </strong>Concerns about the impact of screen time, unbalanced diet, and declining physical activity (PA) on health are increasing. Therefore, the aim of the present study was to examine the association between screen time, PA and dietary behavior, with a special consideration of fiber intake in adolescents.</p><p><strong>Methods: </strong>The study is based on cross-sectional data including 410 Austrian adolescents (54.6% girls) with an average age of 15.7±1.0 years. Daily fiber intake was determined using a validated screening instrument (18-item Fiber-Screen). In addition, participants reported average hours per week of leisure-time PA including club sport activities and daily screen time [mobile phone, computer and television (TV)] via a questionnaire.</p><p><strong>Results: </strong>The average fiber intake per day was 14.49 g/day, less than the international recommendations of at least 25 g of fiber per day. Girls got more of their fiber from vegetables and legumes, while boys consumed more bread and potatoes. Regression analyses showed that both PA (β =0.257) and screen time, particularly computer (β =-0.144) and TV time (β =-0.138) are independently associated with fiber intake (P<0.001). Furthermore, sports club members had a significantly higher daily fiber intake than non-sports club members (16.1±6.7 <i>vs.</i> 12.8±4.6 g/d; P<0.001). Sports club participation was also associated with higher PA levels (40.0% <i>vs.</i> 15.0% reported >3 h/week) less time on the computer (51.0% <i>vs.</i> 33.0% reported <1 h/d) compared to non-sports club members (P<0.001) but there was no significant difference in mobile phone use and TV time.</p><p><strong>Conclusions: </strong>The present results show that low fiber intake is widespread among adolescents and that longer screen time and low PA are associated with a low fiber intake, which indicates a clustering of health behaviors. Accordingly, intervention strategies may target several behaviors to promote health in youth.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"299"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931146","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":"A multicenter prospective evaluation of a decision chart for toilet training initiation.","authors":"Chisato Oyake, Yoshitaka Watanabe, Noriko Ueda, Akiko Tange, Sachiko Nozawa, Hirokazu Ikeda","doi":"10.21037/tp-2026-0398","DOIUrl":"10.21037/tp-2026-0398","url":null,"abstract":"<p><strong>Background: </strong>There are currently no widely accepted standardized guidelines for determining the optimal timing to initiate toilet training in children. This study aimed to develop and evaluate the effectiveness of a newly designed tool-the Toilet Training Initiation Decision Chart (TTIDC).</p><p><strong>Methods: </strong>This multicenter, prospective, open-label intervention study included children aged ≥18 months attending 70 nursery schools. Participants were divided into an intervention group, which utilized the TTIDC, and a control group, which followed conventional toilet training practices employed by each school. Weekly observation records were collected from July 1, 2022 to June 30, 2023. The primary endpoints were the duration of toilet training and the age at which toilet training was completed. The TTIDC was developed based on a prior pilot study.</p><p><strong>Results: </strong>Of the 354 children enrolled, 43 completed toilet training during the study period. There was no significant correlation between the age of toilet training initiation and the duration required to complete training. However, the median age at completion was significantly younger in the intervention group (37.5 months) compared with the control group (40.8 months; P=0.002).</p><p><strong>Conclusions: </strong>This chart may serve as an effective tool for initiating toilet training at an appropriate developmental stage. This chart may be associated with completion of toilet training at a younger age, without prematurely accelerating initiation or unnecessarily prolonging the process.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"332"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931160","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":"A taurine metabolism-related gene program defines clinical and biological features of neuroblastoma and yields an 8-gene candidate prognostic model.","authors":"Benfu Zhong, Yanan Zhang, Zhaosong Wang, Qiuping Dong, Xin Li, Yuren Xia","doi":"10.21037/tp-2026-0426","DOIUrl":"10.21037/tp-2026-0426","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Taurine metabolism-related transcriptional programs have not been systematically characterized in neuroblastoma. We aimed to investigate the clinical relevance and biological features of a taurine metabolism-related gene program in neuroblastoma and to determine whether this candidate space could yield a prognostically informative gene signature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A taurine-related gene program was quantified using single-sample gene set enrichment analysis in the discovery cohort. Its associations with clinicopathologic variables, survival, and hallmark pathways were evaluated, followed by gene-level prognostic screening and construction of a compressed candidate prognostic model. Model performance was assessed in the discovery cohort and externally evaluated in independent validation datasets. Integrative prioritization was then performed to identify core candidate genes, which were further examined using Jansky-based tumor-cell pseudobulk and patient-aware phase analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Taurine single-sample gene set enrichment analysis (ssGSEA) score was significantly associated with Children's Oncology Group (COG) risk group, MYCN status, International Neuroblastoma Staging System (INSS) stage, and overall survival in neuroblastoma. Higher taurine ssGSEA scores were generally observed in clinically more favorable subgroups and were associated with better overall survival in the discovery cohort. At the gene-set level, taurine score showed a strong positive correlation with hypoxia, but negative correlations with E2F targets, G2M checkpoint, MYC targets, and DNA repair, indicating a hypoxia/stress-associated biological context. Gene-level screening identified representative prognostic taurine-related candidates, from which an 8-gene candidate prognostic model was derived. In the discovery cohort, this model showed strong survival stratification and time-dependent discrimination, with 1-, 3-, and 5-year area under the receiver operating characteristic curve (AUC) values of 0.917, 0.906, and 0.913, respectively, and improved concordance when combined with clinical variables. External evaluation showed the strongest support in GSE181559, where Kaplan-Meier stratification was significant and AUCs were 0.701, 0.769, and 0.761 at 1, 3, and 5 years, respectively, whereas additional cohorts suggested inter-cohort heterogeneity and limited fixed-cutoff transferability. Biologically, the 8-gene score was positively associated with proliferative and metabolically active programs, including E2F, G2M, MYC, DNA repair, and glycolysis, but negatively associated with hypoxia and stromal/inflammatory programs. Integrative prioritization and patient-aware analyses further highlighted &lt;i&gt;ADO&lt;/i&gt;, &lt;i&gt;AURKA&lt;/i&gt;, &lt;i&gt;GCLC&lt;/i&gt;, and &lt;i&gt;MMP9&lt;/i&gt; as four core candidate genes linked to a tumor-intrinsic proliferative component.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A taurine metabolism-related transcriptional ","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"316"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931173","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":"Decisional conflict levels and associated factors among parents of pediatric patients undergoing emergency gastric lavage: a cross‑sectional survey.","authors":"Ying Meng, Ran Li, Hongzhi Zhou, Dan Chen","doi":"10.21037/tp-2026-0322","DOIUrl":"10.21037/tp-2026-0322","url":null,"abstract":"<p><strong>Background: </strong>Decisional conflict-defined as a state of uncertainty and hesitation regarding the choice among alternative actions-can adversely affect decision quality, parental psychological well-being, and subsequent treatment adherence. While decisional conflict has been studied in elective and chronic care contexts, little is known about its magnitude and determinants in acute pediatric emergency procedures such as gastric lavage, where parents must make high-stakes decisions under extreme time pressure. This study aimed to assess the level of decisional conflict and identify its associated factors among parents of children undergoing emergency gastric lavage.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 266 parents of children who underwent emergency gastric lavage at a single tertiary children's hospital between January 2025 and February 2026. Participants were recruited using convenience sampling. Data were collected with a self-developed, 20-item decisional conflict instrument designed for the emergency lavage context. The scale demonstrated good internal consistency (Cronbach's α=0.902) and content validity [scale-level content validity index (CVI) =0.91]. Univariate analysis, correlation analysis, and multiple linear regression were performed.</p><p><strong>Results: </strong>The mean age of the children was 4.2±2.8 years, and 69.2% of the parent respondents were mothers. The mean total decisional conflict score was 58.12±6.30 (standardized score 72.6±15.8), with 91.4% of parents exceeding the clinical threshold for significant conflict (standardized score ≥37.5). Multiple linear regression revealed that divorced/widowed/unmarried marital status (β=0.197, P<0.001), lower education level (β=-0.186, P=0.001), absence of a medical background (β=0.176, P=0.001), younger child age (β=-0.159, P=0.004), and lower family monthly income per capita (β=-0.155, P=0.009) were independently associated with higher decisional conflict. The model explained 30.9% of the variance. The \"uncertainty and pressure\" subscale had the highest mean item score (3.25±0.65).</p><p><strong>Conclusions: </strong>Parents of children undergoing emergency gastric lavage experience a high level of decisional conflict, particularly those who are socioeconomically disadvantaged, lack medical knowledge, or have limited spousal support. Clinicians should implement tiered decision support strategies targeting these high-risk groups, such as assigning dedicated social workers or volunteer companions for non-married parents, providing plain-language illustrated decision aids for parents with lower educational attainment, and proactively addressing financial concerns for low income families.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"325"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931206","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":"Decreased H3K79 acetylation and dysregulation of neurodevelopmental genes in fetal down syndrome.","authors":"Shuai Ye, Baoling Bai, Zhuran Zhao, Li Wang, Qing Mu, Yang Zhang, Xinjuan Wang, Ting Zhang, Weidong Yu, Jingzhu Guo","doi":"10.21037/tp-2026-0272","DOIUrl":"10.21037/tp-2026-0272","url":null,"abstract":"<p><strong>Background: </strong>Down syndrome (DS), the most prevalent chromosomal disorder caused by trisomy 21, manifests intellectual disability and cognitive dysfunction. Cumulative studies confirm epigenetic pathways including DNA methylation and non-coding RNAs drive DS pathological progression. Histone post-translational modifications (PTMs) are core epigenetic regulators of fetal brain development. However, genome-wide PTM alterations and their downstream functions in fetal DS brains remain poorly characterized, leaving a key gap in revealing epigenetic mechanisms underlying DS neurodevelopmental defects. To address this, we aimed to establish the first comprehensive landscape of histone PTMs in fetal DS cortex and investigate whether specific PTM changes contribute to aberrant neurodevelopmental gene expression.</p><p><strong>Methods: </strong>Fetal cortexs from control and DS groups were subjected to global histone modification profiling via high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). We detected mono-, di-, and tri-methylation, acetylation, homocysteinylation and malonylation on all four core histones (H2A, H2B, H3, H4). Chromatin immunoprecipitation sequencing (ChIP-seq) was used to map genomic binding profiles of H3 lysine 79 acetylation (H3K79ac). Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed to quantify mRNA levels of candidate neurodevelopmental genes.</p><p><strong>Results: </strong>HPLC-MS/MS analysis identified 172 distinct histone PTMs in control fetal cortices and 168 PTMs in DS fetal cortical samples. Quantitative comparison of 22 quantifiable histone PTMs revealed that H3K79ac showed the most prominent reduction in DS samples, with a 34% decrease (P<0.05). Chromatin immunoprecipitation (ChIP)-seq verified specific H3K79ac occupancy at the genomic loci of three vital neurodevelopmental genes: <i>TNFSF13B</i>, <i>NXPH1</i> and <i>CAMK4</i>. Correspondingly, qRT-PCR revealed aberrant transcription levels of these three genes in DS fetal cortices.</p><p><strong>Conclusions: </strong>This study establishes the first quantitative landscape of histone PTMs in in DS fetal cortical tissues. We demonstrate that depleted H3K79ac acts as a candidate epigenetic driver of DS neuropathology by disrupting the transcription of critical neurodevelopmental genes. This work reveals a novel epigenetic mechanism and a promising therapeutic target for DS-related neurodevelopmental disorders.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"310"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931236","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":"Stakeholder perspectives on managing insulin pump-related skin complications in children with type 1 diabetes: a mixed methods study in China.","authors":"Ting Yuan, Meiying Gao, Chuhao Zhang, Lejing Guan, Yan Zheng, Junfen Fu, Guanping Dong, Wei Wu, Ke Huang, Xiaochun Chen, Guannan Bai","doi":"10.21037/tp-2026-0414","DOIUrl":"10.21037/tp-2026-0414","url":null,"abstract":"<p><strong>Background: </strong>Insulin pump-related skin complications are common in children with type 1 diabetes, yet stakeholder perspectives and management practices remain poorly characterized. We aimed to investigate knowledge, attitudes, practices, and educational needs related to these complications among caregivers, healthcare professionals, and manufacturer technical support staff in China.</p><p><strong>Methods: </strong>This sequential explanatory mixed methods study included a cross-sectional, questionnaire-based survey (n=951) and semi-structured interviews (n=40). Quantitative data were analyzed descriptively, and qualitative data were analyzed using framework analysis. The quantitative and qualitative findings were integrated through triangulation.</p><p><strong>Results: </strong>Among 510 children represented by caregivers, 42.0% were reported to have experienced skin complications. Despite widespread concern, knowledge gaps persisted, particularly regarding infection management, and a knowledge-practice gap was evident. Qualitative findings identified role ambiguity as a structural barrier, with no stakeholder group assuming clear ownership of skin management. Participants described management as largely empirical and lacking standardized protocols. More than 96% of healthcare professionals and manufacturer technical support staff agreed that children and caregivers should receive comprehensive skin management training before pump initiation.</p><p><strong>Conclusions: </strong>Based on self-reported data, this descriptive study suggests that insulin pump-related skin complications were common among Chinese children with type 1 diabetes. Four hypothesis-generating challenges for skin management were identified, including knowledge-practice gaps, role ambiguity, empirical management, and insufficient training. They point to directions for future research such as developing evidence-based guidelines, clarifying interdisciplinary roles, and developing/implementing longitudinal education programs.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"305"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931239","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":"Biomarkers of partial remission in paediatric type 1 diabetes: β-cell stress, immune-metabolic remodelling, and translational priorities-a narrative review.","authors":"Hu Lin, Wei Wu, Ke Huang, Guanping Dong, Junfen Fu","doi":"10.21037/tp-2026-0469","DOIUrl":"10.21037/tp-2026-0469","url":null,"abstract":"<p><strong>Background and objective: </strong>Partial remission after diagnosis of paediatric type 1 diabetes (T1D) is characterised by improved glycaemic control, lower insulin requirements and residual endogenous insulin secretion, but its onset, depth and duration vary substantially between children. Standard clinical indices such as HbA1c, insulin dose-adjusted HbA1c (IDAA1c), C-peptide and continuous glucose monitoring (CGM) metrics capture functional status but provide limited mechanistic information. This narrative review summarises candidate biomarkers that may explain heterogeneity in partial remission and support remission-focused translational studies.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science and the Cochrane Library were searched for English-language articles published from 1 January 2000 to 31 October 2025. Priority was given to paediatric and adolescent studies, longitudinal cohorts spanning diagnosis and the first year after onset, and studies addressing partial remission, IDAA1c or early C-peptide decline. Mixed-age/adult cohorts and experimental studies were included selectively when they informed biological interpretation.</p><p><strong>Key content and findings: </strong>Candidate biomarkers can be organised into two intersecting axes: a β-cell axis reflecting stress, dysfunction and death, and an immune-metabolic axis reflecting immune regulation, inflammatory activity and systemic metabolic adaptation. The proinsulin-to-C-peptide ratio, unmethylated INS-derived cell-free DNA, selected circulating or extracellular vesicle-associated microRNAs, immune-cell phenotypes, soluble mediators and compact omics-derived signatures have varying levels of paediatric evidence. These biomarkers are best interpreted as mechanistic complements to IDAA1c, C-peptide and CGM metrics rather than as replacements for established functional endpoints. Across biomarker classes, associations are modest, assay methods are heterogeneous and external validation remains limited.</p><p><strong>Conclusions: </strong>No single biomarker is currently ready for routine clinical staging of partial remission in paediatric T1D. The most realistic translational path is prospective validation of standardised, parsimonious biomarker panels interpreted alongside IDAA1c, C-peptide and CGM endpoints to improve risk stratification, endotype enrichment and pharmacodynamic monitoring in remission-focused trials.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"351"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931256","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":"Cohen versus Lich-Gregoir ureteral reimplantation for pediatric primary vesicoureteral reflux: a systematic review and meta-analysis of comparative studies.","authors":"Bowen Liang, Jiayi Li, Zhiguang An, Ke Xu","doi":"10.21037/tp-2026-0377","DOIUrl":"10.21037/tp-2026-0377","url":null,"abstract":"<p><strong>Background: </strong>Cohen and Lich-Gregoir ureteral reimplantation are the two most widely used open reconstructive options for children with primary vesicoureteral reflux (VUR), yet their relative advantages remain debated. We aimed to compare anti-reflux efficacy, perioperative outcomes, and complication profiles between these procedures using direct comparative evidence only.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were searched from inception to March 2026 for comparative studies evaluating Cohen versus Lich-Gregoir reimplantation in children with primary VUR. Outcomes included persistent postoperative reflux, overall complications, reoperation, operative time, length of stay (LOS), postoperative acute retention of urine (ARU), obstruction/hydronephrosis, hematuria, and febrile urinary tract infection (UTI). A bilateral VUR subgroup analysis was prespecified. Risk of bias was assessed with ROBINS-I, and certainty of evidence was judged using a GRADE-informed approach. Because fewer than 10 studies contributed to each synthesis, formal publication-bias testing was not performed.</p><p><strong>Results: </strong>Nine retrospective comparative studies involving 655 children (370 Cohen, 285 Lich-Gregoir) were included. Baseline age and preoperative reflux grade were comparable between groups. There were no significant differences in persistent postoperative VUR [odds ratio (OR) 0.72, 95% confidence interval (CI): 0.34-1.54], overall complications (OR 0.97, 95% CI: 0.30-3.09), reoperation (OR 0.54, 95% CI: 0.15-1.94), obstruction/hydronephrosis (OR 1.15, 95% CI: 0.34-3.83), or febrile UTI (OR 0.45, 95% CI: 0.18-1.12). Lich-Gregoir was associated with shorter operative time [mean difference (MD) 28.59 minutes, 95% CI: 3.37-53.81] and shorter LOS (MD 3.41 days, 95% CI: 2.15-4.61). ARU occurred more often after Lich-Gregoir (6.4% <i>vs.</i> 1.7%; OR 0.32, 95% CI: 0.12-0.91), whereas hematuria was markedly more common after Cohen. In bilateral VUR, Lich-Gregoir retained advantages in operative time and LOS, but differences in overall complications, persistent reflux, and ARU were not statistically significant. Evidence certainty was low to very low across outcomes and was limited by retrospective study design, serious risk of bias, inconsistent complication definitions, and heterogeneity in surgical platform and perioperative care.</p><p><strong>Conclusions: </strong>Cohen and Lich-Gregoir reimplantation provide comparable anti-reflux efficacy and similar major postoperative outcomes in children with primary VUR. Lich‑Gregoir was associated with shorter operative time with very high heterogeneity, but procedure selection should also consider its higher risk of postoperative urinary retention and the still-limited evidence in bilateral disease.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"326"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931292","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":"Emerging genes implicated in human congenital heart disease: a 2023-2025 scoping review.","authors":"Shani Israel, Sarah U Morton","doi":"10.21037/tp-2026-0487","DOIUrl":"10.21037/tp-2026-0487","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease (CHD) is the most common major congenital anomaly and a leading cause of infant morbidity and mortality. The rapid expansion of genomic technologies has accelerated the discovery of rare genetic variants implicated in CHD pathogenesis. However, most individuals with CHD still lack an identifiable molecular etiology. The purpose of this scoping review is to systematically characterize genes reported in the recent literature as candidate CHD-associated genes and contextualize these findings within the stages of cardiac morphogenesis.</p><p><strong>Methods: </strong>PubMed was searched using predefined terms related to CHD and genetic variants, supplemented by a prospectively maintained internal database. We included human studies published between January 2023 and December 2025 that identified pathogenic, likely pathogenic, or uncertain monogenic variants in at least one patient with CHD. Animal-only studies, chromosomal abnormalities, copy number variants, multigenic associations, transcriptomic/proteomic analyses, reviews, and maternal-only genetic studies were excluded. Gene-disease validity classifications were assigned using the Clinical Genome Resource (ClinGen) CHD Gene Curation Expert Panel framework.</p><p><strong>Results: </strong>Of 2,834 screened articles, 391 studies met inclusion criteria, identifying 912 unique genes reported as candidate CHD-associated genes. Frequently reported genes included <i>PTPN11, NOTCH1, GATA4, JAG1, MYH6, GATA6</i>, and <i>LZTR1</i>. Identified genes spanned all major stages of cardiogenesis, including developmental priming, cardiac progenitor specification, left-right axis formation, neural crest migration, outflow tract development, septation, and postnatal structural remodeling. Studies increasingly implicated ciliary dysfunction, transcriptional regulation, ribosomal biology, and multigenic inheritance in CHD pathogenesis. Emerging methodologies included stem cell-derived cardiac models, machine learning-based gene prioritization, and epigenetic analyses.</p><p><strong>Conclusions: </strong>Recent literature substantially expands the catalog of candidate genes that may be associated with CHD and highlights the biologic complexity underlying cardiac morphogenesis. Integration of genomic, developmental, and functional approaches will be essential to improve mechanistic understanding, refine genetic counseling, and support future precision medicine strategies for CHD.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"347"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931204","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":"Establishing a nomogram model for predicting hospital length of stay in children with II-III degree scald burns based on admission assessment indicators.","authors":"Ying Gao, Biyun He, Jing Huang, Yang Pan","doi":"10.21037/tp-2026-0199","DOIUrl":"10.21037/tp-2026-0199","url":null,"abstract":"<p><strong>Background: </strong>Existing pediatric burn studies have primarily focused on risk factors or survival outcomes, while predictors of hospital length of stay (LOS) remain insufficiently explored. This study aimed to develop and validate a nomogram predicting LOS by incorporating the clinical characteristics of children with II-III degree scald burns.</p><p><strong>Methods: </strong>This retrospective study collected cases of pediatric patients with II-III degree scald burns admitted to Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases between July 2024 and August 2025. A generalized linear regression model for predicting LOS was established based on univariate Gamma regression, multicollinearity tests, and multivariate Gamma regression to screen variables, followed by construction of a nomogram. Model performance and calibration were internally validated using root mean square error (RMSE), mean absolute error (MAE), cross-validation, and 1,000-times bootstrap resampling.</p><p><strong>Results: </strong>A total of 191 children (male: 64.9%; female: 35.1%) with II-III degree scald burns were included, with the majority aged between 1 and 3 years. Multivariate analysis showed that burn time before admission, total body surface area, albumin, blood glucose, white blood cell count, hemoglobin and skin condition were independent predictors of LOS in children with II-III degree scald burns. The model established had the lowest Akaike information criterion value, indicating the best fit. The Gamma generalized linear model demonstrated moderate predictive performance with a cross-validated R² of 0.31, along with acceptable calibration and mild optimism in bootstrap internal validation.</p><p><strong>Conclusions: </strong>We constructed a nomogram to predict LOS in children with scald burns, which may help clinicians assess LOS early and optimize treatment.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 8","pages":"308"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931232","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}