World Journal of Pediatrics最新文献

{"title":"Integrative metabolomics and machine learning identify biomarkers of adolescent social anxiety disorder.","authors":"Jun-Yu Lai, Bei-Bei Yang, Pei-Jun Ju, Ying Sun, Xiu-Jia Sun, Wen-Hong Cheng, Jing-Hong Chen","doi":"10.1007/s12519-025-00984-6","DOIUrl":"https://doi.org/10.1007/s12519-025-00984-6","url":null,"abstract":"<p><strong>Background: </strong>Social anxiety disorder (SAD) is one of the most prevalent anxiety disorders in adolescents but remains underdiagnosed due to the lack of objective diagnostic tools. This study aimed to identify serum metabolomic alterations in adolescent SAD patients and to develop an interpretable diagnostic model.</p><p><strong>Methods: </strong>In this cross-sectional study, serum samples were collected from 78 adolescents, including 42 drug-naive, first-episode SAD patients and 36 matched healthy controls. Untargeted metabolomic profiling was performed, and feature selection was conducted via least absolute shrinkage and selection operator regression, followed by logistic regression for model construction.</p><p><strong>Results: </strong>Among the 661 detected metabolites, 46 differed significantly between groups, mainly within amino acid and energy metabolism pathways. Five key metabolites, 2-hydroxybutanoic acid, L-alanine, L-asparagine, glutamine and beta-tocopherol, were selected for model construction. The diagnostic model achieved an area under the curve of 0.934 in the training set, but external validation is still lacking, and the findings should be interpreted as hypothesis-generating.</p><p><strong>Conclusions: </strong>Adolescents with SAD exhibit distinct metabolic profiles, and a preliminary diagnostic model was developed. Exploratory microbiota-related observations suggested potential links between gut microbial activity, host metabolism, and anxiety phenotypes, but these findings remain preliminary and outside the scope of the present study. Overall, these findings provide hypothesis-generating support for further investigation of gut-metabolism-brain interactions and highlight the need for larger, externally validated studies to advance biomarker development.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphatic plastic bronchitis.","authors":"Bei-Lei Cheng, Dan Xu, Xi-Ling Wu, Jia-Yao Song, Lan-Fang Tang, Ying-Shuo Wang","doi":"10.1007/s12519-025-00982-8","DOIUrl":"https://doi.org/10.1007/s12519-025-00982-8","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 pandemic on childhood asthma and wheezing disorders.","authors":"Yu-Han Xing, Jayson Ka-Long Wong, Yuan-Yuan Zhu, Ka-Sheung Yip, Edmund Chung-Ming Yung, Jie Wei, Agnes Sze-Yin Leung, Gary Wing-Kin Wong","doi":"10.1007/s12519-025-00978-4","DOIUrl":"https://doi.org/10.1007/s12519-025-00978-4","url":null,"abstract":"<p><strong>Background: </strong>Since the lifting of COVID-19 control measures, infections by common respiratory pathogens have emerged as a public health issue, and the impacts on vulnerable children with wheezing illnesses remain uncertain.</p><p><strong>Methods: </strong>This prospective study enrolled children (< 18 years) hospitalized for wheezing disorders in Hong Kong (2016‒2025). Nasopharyngeal aspirates collected within 12 h of admission were tested via rapid antigen detection, viral culture, and multiplex polymerase chain reaction (PCR) for respiratory viruses. Bacterial pathogens were identified through cultures of blood/airway specimens or PCR, including Chlamydia pneumonia and mycoplasma pneumoniae detection via PCR.</p><p><strong>Results: </strong>A total of 2499 children [66.8% male, median age 2.9 (3.6) years)] with 3272 admissions due to wheezing disorders were identified. There was a substantial reduction in pediatric wheezing admissions during the COVID-19 pandemic (February 2020 to January 2023) compared to the pre-pandemic period (September 2016 to January 2020). After removing pandemic restrictions, wheezing admissions drastically increased from February 2023 to February 2025, exceeding the pre-pandemic level. A fivefold increase was observed in admissions due to \"bronchiolitis\" compared with that during the pandemic period (P < 0.001). The post-pandemic proportion of respiratory syncytial virus (RSV) significantly increased, especially among those under 5 years of age (P < 0.01). Coinfections with multiple pathogens were more common during and after the pandemic than pre-pandemic (P < 0.05).</p><p><strong>Conclusions: </strong>Lifting restrictions led to a resurgence of wheezing admissions and respiratory infections. Continued pathogen monitoring in the post-pandemic era is crucial, and preventive measures for future health crises are needed.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive exercise recommendations for pediatric asthma: an evidence synthesis.","authors":"Hong-Zhen Xu, Nan Lin, Guan-Nan Bai, Yu-Lin Liu, Xiao-Hui Jia, Cong Huang, Liang Hu, Han-Qing Shao, Qi-Yun Shang, Li-Fang Zhang, Ying-Shuo Wang, Yuan-Yuan Zhang, Lan-Fang Tang, Yun-Lian Zhou, Guo-Hong Zhu, Jian-Guo Hong, Zhi-Min Chen","doi":"10.1007/s12519-025-00976-6","DOIUrl":"https://doi.org/10.1007/s12519-025-00976-6","url":null,"abstract":"<p><strong>Background: </strong>Bronchial asthma is a common chronic respiratory disease in children. For many years, concerns about exercise-induced bronchoconstriction have limited physical activity in this population, with negative consequences for both physical and mental health. Recent evidence indicates that exercise should be incorporated into the daily routine of children with asthma, with appropriately prescribed programs shown to improve disease control, lung function, and quality of life. This study aims to systematically describe the safety, benefits and key factors of exercise for children with asthma.</p><p><strong>Data sources: </strong>Initiated by the National Clinical Research Center for Child Health, this set of recommendations was developed by a multidisciplinary team of 17 experts. A comprehensive Literature search was conducted across PubMed, Embase, Cochrane and other databases, yielding 64 studies that met inclusion criteria up to May 2025. The Oxford Centre for Evidence-Based Medicine 2011 levels of evidence were used to evaluate evidence quality. Two rounds of expert voting were conducted using Delphi methodology to formulate final recommendations on key clinical topics.</p><p><strong>Results: </strong>Recommendations were formulated across nine core domains: exercise safety, exercise-related benefits, pre-exercise screening, exercise prescription design, plan adjustment and progression, pre-exercise preparation, exercise monitoring, outcome assessment and the management of exercise-induced bronchoconstriction. Specific guidance is offered on individualized exercise planning based on asthma control status, physical fitness, exercise habits and environmental factors. Recommendations also address appropriate modalities of aerobic, resistance and flexibility training, strategies for monitoring intensity and progression and both pharmacologic and non-pharmacologic approaches to exercise-induced bronchoconstriction prevention and management.</p><p><strong>Conclusions: </strong>These recommendations provide scientific and practical guidance for the development and implementation of individualized exercise prescriptions in children with asthma. Moreover, they highlight the importance of multidisciplinary collaboration and reinforce exercise as an integral component of asthma management. Further high-quality clinical research is needed to optimize exercise protocols and evaluate long-term outcomes.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in pediatric flexible bronchoscopy.","authors":"Shu-Xian Li, Xiao-Fen Tao, Hu-Jun Wu, Fang Jin, Guo-Hong Zhu, Ying-Shuo Wang, Lan-Fang Tang, Zhi-Min Chen, Lei Wu","doi":"10.1007/s12519-025-00967-7","DOIUrl":"https://doi.org/10.1007/s12519-025-00967-7","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pet ownership in early childhood at ages 1 and 4-5 years on mental health at ages 7-8: findings from the INMA project.","authors":"Llúcia González, Mònica Guxens, Blanca Sarzo, Ainara Andiarena, Loreto Santa-Marina, Adonina Tardón, Jordi Julvez, Cristina Rodríguez-Dehli, Marisa Rebagliato, Marisa Estarlich","doi":"10.1007/s12519-025-00942-2","DOIUrl":"https://doi.org/10.1007/s12519-025-00942-2","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore associations between the presence of pets at one and 4-5 years of age with internalizing and externalizing problems at 7-8 years.</p><p><strong>Methods: </strong>Participants comprised 1893 families from the INfancia y Medio Ambiente (INMA) project. Information was collected on the presence of (1) any pet, (2) dogs, (3) cats, (4) birds or (5) other animals. Pet ownership was categorized as never, always, only at age 1 and only at age 4-5. Internalizing and externalizing problems were measured at ages 7-8 years through the Strengths and Difficulties Questionnaire, a Likert questionnaire on children's behavioural and emotional symptoms. Negative binomial regression models and Tukey's multiple comparison tests were used to analyse data sets. Five sensitivity analyses were performed.</p><p><strong>Results: </strong>Families that always owned a pet made up 24.4% of the sample. In addition, 11.5%, 4.5%, 3.8% and 17.6% of the families owned a dog, cat, bird or other animal, respectively. The median (P25-P75) for internalizing problems was 3 (1-5) and 5 (3-8) for externalizing problems. Owning a cat only at age 4-5 increased mental health problems: relative rate ratio (RRR) [95% confidence interval (CI)] 1.37 (1.05-1.79) for internalizing and 1.26 (1.02-1.56) for externalizing. Always having other animals was a protective factor for internalizing problems with an RRR of 0.80 (0.66-0.96). These associations remained after multiple comparison testing and sensitivity analyses.</p><p><strong>Conclusion: </strong>Owning a cat only at 4-5 years of age was linked to more internalizing and externalizing problems, whereas always having other animals was a protective factor against internalizing problems.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in standardized diagnosis and management of pediatric gastrointestinal bleeding.","authors":"Qian-Cheng Xu, Zi-Yu Liu, Fei Gao, Ya-Te He, Xiao-Rui He, Wei Zheng, Mi-Zu Jiang","doi":"10.1007/s12519-025-00980-w","DOIUrl":"https://doi.org/10.1007/s12519-025-00980-w","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal bleeding (GIB) is a prevalent clinical condition in pediatric populations that is characterized by etiological heterogeneity across age groups with potentially life-threatening risks in critical cases. Current management strategies predominantly extrapolate from adult-based studies and guidelines. This is despite substantial differences between pediatric and adult patients regarding bleeding etiology, risk stratification, peri-endoscopic pharmacotherapy, hemostatic technique selection, and salvage interventions after initial hemostasis failure.</p><p><strong>Data sources: </strong>A systematic literature review was conducted via PubMed, Embase, and the Chinese Journal Full-text Database up to February 2025. Search terms included \"pediatric\", \"upper gastrointestinal bleeding\", \"peptic ulcer\", \"lower gastrointestinal bleeding\" and \"endoscopic diagnosis and treatment\". This review synthesizes current evidence to optimize standardized management of pediatric GIB.</p><p><strong>Results: </strong>Early and comprehensive assessment of children with GIB, early identification of high-risk factors for GIB, timely use of endoscopic examination, proactive treatment, optimization of diagnosis and treatment processes, and multidisciplinary consultation have important impacts on the outcome of GIB in children.</p><p><strong>Conclusions: </strong>Ensuring hemodynamic stability and vital signs in children with GIB, early identification of disease cause and timely, and effective hemostatic treatment are key to improving treatment success, reducing complications and lowering mortality.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel factors associated with sleep duration and bedtime regularity in U.S. children with and without neurodevelopmental disorders: a nationally representative study.","authors":"Freda Patterson, Shannon M Robson, Lauren B Covington, Carissa M Baker-Smith, Shannon Mayberry, Ben Brewer, Zugui Zhang, Anjana Bhat","doi":"10.1007/s12519-025-00964-w","DOIUrl":"https://doi.org/10.1007/s12519-025-00964-w","url":null,"abstract":"<p><strong>Background: </strong>This study compared multilevel factors associated with sleep duration and bedtime regularity in children with and without neurological and developmental disorders (NDD) using a nationally representative sample.</p><p><strong>Methods: </strong>We combined data from the 2016-2017, 2018-2019, and 2020-2021 United States National Survey of Children's Health (NSCH), including 86,014 children aged 9-17 years. Parent-reported outcomes included adequate sleep duration (yes/no) and bedtime regularity (yes/no). We assessed the relationship between twenty independent individual, social, and environmental variables on the sleep outcomes. We used random survival forest decision trees to identify the five most predictive variables [in terms of variable importance (VIMP)]. Regression analyses were then used to assess directionality and independent associations.</p><p><strong>Results: </strong>A greater proportion of children with NDDs versus those who are typically developing (TD) had parent reports of not achieving adequate sleep duration (34.0% versus 30.9%, respectively) and bedtime regularity (18.8% versus 13.7%, respectively). For adequate sleep, achieving bedtime regularity, having more family meals together and older age emerged as the most important independent variables for both TD children and those with NDDs. For bedtime regularity, achieving adequate sleep, and having more family meals together were the most proximal independent variables for NDD and TD children.</p><p><strong>Conclusion: </strong>Increasing the frequency of family meals and addressing both sleep duration and bedtime regularity may serve as key modifiable intervention targets to improve sleep health in children, including those with NDDs.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer in children living with HIV: challenges and perspectives in the antiretroviral therapy era.","authors":"Elena Chiappini, Andrea Costantino, Daniela Masci, Maria Raffaella Petrara, Luisa Galli, Anita De Rossi","doi":"10.1007/s12519-025-00971-x","DOIUrl":"https://doi.org/10.1007/s12519-025-00971-x","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for the diagnosis and management of childhood immunoglobulin A vasculitis.","authors":"Lan-Jun Shuai, Qiu-Ye Zhang, Xiao-Zhong Li, Zan-Hua Rong, Guang-Min Nong, Tao Wang, Jin-Hai Ma, Yan-Ming Lu, Dong-Mei Zhao, Xiao-Qing Li, Xue-Mei Tang, Wei Zhang, Si-Rui Yang, Liang-Zhong Sun, Hai-Guo Yu, Wei Zhou, Sheng Hao, Jun Yang, Hua-Wei Mao, Ji-Hong Xiao, Ya-Jun Wang, Jian-Jiang Zhang, Tian Shen, Ying Wang, Yao-Long Chen, Hui Liu, Ya-Jia Sun, Yong-Zhen Li, Hong-Mei Song, Xiao-Chuan Wu","doi":"10.1007/s12519-025-00974-8","DOIUrl":"https://doi.org/10.1007/s12519-025-00974-8","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin A vasculitis (IgAV) is the most common cause of systemic vasculitis in childhood. Due to the continued use of the disease name \"anaphylactoid purpura\" in China, several misunderstandings have arisen in clinical practice and treatment regimens differ widely. In addition, new research and evidence-based data have grown. The Subspecialty Group of Immunology, Society of Pediatrics, Chinese Medical Association and the Chinese Alliance of Pediatric Rheumatic and Immunologic Diseases initiated an update of guidelines for the diagnosis and management of childhood IgAV. The aim therefore was to provide agreed consensus recommendations for diagnosis and treatment for children with IgAV.</p><p><strong>Methods: </strong>This study utilized the Delphi technique to develop an evidence-based expert consensus for childhood IgAV. We conducted a systematic literature review to retrieve evidence, which was graded using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria. Two rounds of Delphi voting and a consensus meeting involving 23 experts were conducted. Recommendations were accepted when ≥ 75% of experts agreed.</p><p><strong>Results: </strong>In total, five recommendations for diagnosis, six for treatment, one for prognosis, and two for health education for pediatric IgAV were accepted. Diagnostic recommendations included the use of the European Alliance of Associations for Rheumatology/Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society-endorsed Ankara 2008 classification criteria for IgAV diagnosis. In addition, appropriate use of imaging, gastrointestinal endoscopy, skin biopsy, and kidney biopsy are recommended. Kidney biopsy is recommended for children with IgAV presenting with nephrotic syndrome/nephrotic-range proteinuria, reduced estimated glomerular filtration rate, acute nephritis syndrome, or persistent moderated/mild proteinuria. Treatment recommendations involved indications for glucocorticoid use, immunosuppressant use, and intravenous immunoglobulin use. It also addressed the inappropriate use of prophylactic glucocorticoid treatment and recommended against routine employment of plasmapheresis. Health education placed emphasis on the inappropriate use of anti-anaphylactic treatment and proffers dietary suggestions.</p><p><strong>Conclusions: </strong>This guideline provides evidence-based recommendations for the diagnosis and management of IgAV in children. This will facilitate improved and standardized care.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}