World Journal of Pediatrics最新文献

{"title":"Seasonal variation in BMI outcomes at 6 months: secondary analyses of a multidisciplinary healthy lifestyle programme for children and adolescents with obesity.","authors":"José G B Derraik, Kima T Costelloe, Cervantée E K Wild, Lisa E Wynter, Mohammad Shahbaz, Paul L Hofman, Yvonne C Anderson","doi":"10.1007/s12519-025-01016-z","DOIUrl":"10.1007/s12519-025-01016-z","url":null,"abstract":"<p><strong>Background: </strong>While international evidence suggests seasonal variations may influence outcomes of interventions for pediatric obesity, data for Aotearoa New Zealand are limited. We examined seasonal variations in changes in body mass index standard deviation score (BMI SDS) in young people with obesity enrolled in an intervention programme.</p><p><strong>Methods: </strong>We studied 397 children and adolescents (median = 10.1 years; range 3.7-16.8 years) from Whānau Pakari, a multidisciplinary community-based healthy lifestyle programme (initially a randomised clinical trial that subsequently transitioned into the regional childhood obesity service). Participants were stratified by season at entry and 6-month BMI SDS changes (Δ) were evaluated. Lifestyle factors were also assessed. Data were analysed using traditional linear models and machine learning (random forest).</p><p><strong>Results: </strong>68% of participants had BMI SDS reductions at 6 months (mean = - 0.16 SDS; P < 0.0001). Linear models showed seasonal variations in programme effectiveness, with BMI SDS reductions among summer (- 0.17 SDS), autumn (- 0.19 SDS) and winter (- 0.18 SDS) but not among spring entrants. Random forest modelling identified higher baseline BMI SDS and younger age as the most influential predictors of greater 6-month reductions in BMI SDS. Season of entry was more important than any single lifestyle factor; spring entrants exhibited attenuated reductions relative to other seasons.</p><p><strong>Conclusions: </strong>The season at programme entry was an important factor associated with intervention effectiveness. Spring entry was associated with attenuated BMI SDS reductions, likely due to the inclusion of the summer holidays within the 6-month intervention. These findings highlight the need for targeted support during such unstructured periods to improve participant outcomes.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"234-246"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate change and thunderstorm asthma in children: challenges and responses.","authors":"Peng Han, Kun-Ling Shen","doi":"10.1007/s12519-025-01012-3","DOIUrl":"10.1007/s12519-025-01012-3","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"159-166"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971139","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":"Response to: Comments on \"Predicting carbapenem-resistant Enterobacteriaceae infections in pediatric liver transplant recipients\".","authors":"Yang-Yang Wang, Wei-Li Wang, Yan Sun, Wei Zhang, Yun-Tao Zhang, Shun-Liang Gao, Jian Wu, Yan Shen, Zhe-Cheng Zhu, Xue-Li Bai, Qi Zhang, Ting-Bo Liang","doi":"10.1007/s12519-025-01006-1","DOIUrl":"10.1007/s12519-025-01006-1","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"274-275"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715996","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":"Age-related heterogeneity of type 1 diabetes mellitus in children: a single-center retrospective study.","authors":"Shi-Yang Gao, Yi-Guo Huang, Li-Bo Wang, Qian-Wen Zhang, Guo-Ying Chang, Juan Li, Fei-Han Hu, Yu Ding, Xiu-Min Wang","doi":"10.1007/s12519-025-01004-3","DOIUrl":"10.1007/s12519-025-01004-3","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes mellitus is a heterogeneous autoimmune disease with diverse characteristics between ethnicities and ages. Understanding this heterogeneity is essential for optimizing management and developing precision treatments. This study investigates the clinical, metabolic and immunological heterogeneity of type 1 diabetes mellitus in children across different ages of onset.</p><p><strong>Methods: </strong>A retrospective analysis of 401 children newly diagnosed with type 1 diabetes mellitus at a single center from January 2009 to August 2024 was conducted. We compared the clinical characteristics of our cohort with others from different countries. Patients were categorized into three age groups: 6 months-5 years, 5-10 years and ≥ 10 years at diagnosis. Clinical, metabolic, and immunological features were compared among groups.</p><p><strong>Results: </strong>The median cohort age was 8.58 years; 48.9% were male. Diabetic ketoacidosis occurred in 56.1% of patients, higher than in the Finnish and American cohorts. Most clinical characteristics are not significantly different among age groups. The 6 months-5 years group had a lower area under the curve (AUC) for C-peptide compared to the other age groups. The ≥ 10 years group was more likely to be thyroid antibody positive and have vitamin D deficiency. Immunologically, type 1 diabetes mellitus patients showed significantly increased counts of T lymphocytes, CD3 + CD8 + T cells and B lymphocytes, along with decreased interleukin-2 and increased interleukin-6 levels compared to healthy controls. Of note, the 6 months-5 years group had a higher CD4/CD8 ratio, which was negatively correlated with C-peptide AUC.</p><p><strong>Conclusions: </strong>Significant heterogeneity in type 1 diabetes mellitus features exists across age groups. Early-onset patients showed poorer islet function and late-onset patients were more prone to metabolic complications. Collectively our study emphasizes the need for age-specific management strategies.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"247-257"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Divergent epigenetic profile underlie pubertal disorders in MKRN3-associated central precocious puberty and Prader-Willi syndrome: insights from a frameshift variant.","authors":"Yu-Yu Jin, Xiao Wang, Lin Yang, Jian Mu, Fei-Hong Luo","doi":"10.1007/s12519-026-01017-6","DOIUrl":"10.1007/s12519-026-01017-6","url":null,"abstract":"<p><strong>Background: </strong>MKRN3 gene loss-of-function mutations cause central precocious puberty (CPP), whereas its deletion in Prader-Willi syndrome (PWS) paradoxically leads to hypogonadism. The mechanistic basis for these opposing reproductive phenotypes remains largely unclear.</p><p><strong>Methods: </strong>We performed whole-exome sequencing in 98 Chinese CPP patients along with a systematic review of previously reported MKRN3 pathogenic and likely pathogenic variants to summarize genotype-phenotype correlations. Subsequently, genome-wide DNA methylation profiling was performed in CPP patients with the MKRN3 pathogenic variant, and the results were compared with those of patients with PWS, idiopathic CPP, and healthy controls.</p><p><strong>Results: </strong>A pathogenic frameshift MKRN3 variant [c.476dupC (p.Ala159fs*15)], representing the first frameshift mutation reported within the inter-C3H1 hotspot region in an Asian cohort, was identified. Patients with severe MKRN3 variants exhibited significantly earlier pubertal onset (5.80 vs. 7.50 years, P = 0.029) and higher GnRH-stimulated peak LH levels (34.55 vs. 11.00 IU/L, P = 0.047) than those with missense mutations. Methylation analysis revealed no differences in MKRN3 but identified 18,609 differentially methylated positions between MKRN3-CPP and PWS. Key findings included hypermethylation of IGSF10 (Δβ = 0.37), ZC3H18 (Δβ = 0.27), SH3RF3 (Δβ = 0.36), and PTH1R (Δβ = 0.28), alongside hypomethylation of MAGEL2 (Δβ = - 0.19), and PTPA (Δβ = - 0.23), where Δβ represents the difference in DNA methylation β values between groups.</p><p><strong>Conclusions: </strong>We identified a first frameshift pathogenic variant localized to the inter-C3H1 region in Asia, further confirming its functional significance. Our study suggests an epigenetic framework that could potentially explain how divergent pubertal phenotypes in MKRN3 deficiency might arise from dysregulated epigenetic programming of downstream neuroendocrine pathways.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"258-271"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126525","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":"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":"174-193"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923401/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undifferentiated autoinflammatory diseases: a systematic review.","authors":"Si-Ming Peng, Zhong-Xun Yu, Hong-Mei Song","doi":"10.1007/s12519-025-01000-7","DOIUrl":"10.1007/s12519-025-01000-7","url":null,"abstract":"<p><strong>Background: </strong>Undifferentiated autoinflammatory diseases (uAIDs) represent a newly recognized category of AIDs that fail to meet the diagnostic criteria for established monogenic or polygenic AIDs. This systematic review aims to clarify the prevalence of uAIDs and summarize the clinical features and treatment responses of affected patients.</p><p><strong>Methods: </strong>A systematic literature review of PubMed, Web of Science, EMBASE, Cochrane and Scopus was performed in accordance with the 2020 PRISMA guidelines. English-language studies mentioning uAIDs were included for analysis. The classification criteria used for the diagnosis of uAIDs, as well as the demographic data, clinical manifestations and treatment responses of patients, were extracted and analyzed. Study quality was assessed via the tool developed by Hoy et al. The primary outcome, the pooled prevalence of uAIDs, was calculated via common- or random-effects meta-analyses, as appropriate.</p><p><strong>Results: </strong>Thirty-five articles were included. Although termed variably, the definition of uAIDs consistently includes the following key points: patients with clinical signs and symptoms of systemic inflammation; patients who fail to meet the criteria for any well-defined polygenic AIDs; next-generation sequencing is negative or inconclusive; and other confounding conditions are excluded. The pooled prevalence of uAIDs among patients with AIDs was 21% (95% confidence interval: 14-29). Fever, arthralgia and abdominal pain were the most common clinical manifestations. Colchicine was the most frequently reported immunosuppressant in the literature, while interleukin (IL)-1-targeted biologics achieved remission in 70% of treated patients.</p><p><strong>Conclusions: </strong>A diagnosis of uAIDs should be considered in patients who present with autoinflammatory features, such as fever, arthralgia and abdominal pain and who do not meet the diagnostic criteria for monogenic or polygenic AIDs or other confounding conditions. The responsiveness to IL-1-targeted biologics implies that the IL-1 pathway may be a potential gateway in uAIDs. Future prospective studies with standardized criteria are needed to overcome current limitations of exclusion-based diagnosis and study heterogeneity in uAIDs research.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"194-211"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688344","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":"Prospective associations between media parenting practices and adolescent video game use.","authors":"Jason M Nagata, Derek Sportsman, Jennifer H Wong, Sahana Nayak, Elizabeth J Li, Kyle T Ganson, Timothy Piatkowski, Jinbo He, Alexander Testa, Fiona C Baker","doi":"10.1007/s12519-025-01009-y","DOIUrl":"10.1007/s12519-025-01009-y","url":null,"abstract":"<p><strong>Background: </strong>Despite the rise of adolescent video gaming, evidence-based parenting guidelines and research on its specific behavioral impacts remain limited. This study evaluated whether media parenting practices are prospectively associated with video game use in adolescents 1 and 2 years later.</p><p><strong>Methods: </strong>We analyzed 7407 adolescents (51.6% male, age: 12.9 ± 0.6 years) from the Adolescent Brain Cognitive Development Study (year 3: 2019-2021 to year 5: 2021-2023). Multiple mixed-effects ordinal logistic regression and generalized linear models assessed the associations between parent media practices (screen time modeling, mealtime screen use, bedroom screen use, use to control behavior, monitoring and limiting) and video game behaviors (mature-rated games, problematic use and weekend video game time) 1 and 2 years later, adjusting for covariates.</p><p><strong>Results: </strong>Higher parental screen time modeling, mealtime screen use and bedroom screen use were associated with higher odds of playing mature-rated video games, whereas higher parental monitoring of screen time and limiting screen time were associated with lower odds of playing mature-rated video games and less total video game use 1 and 2 years later. Higher mealtime screen use, bedroom screen use and use of screens to control behavior were associated with greater total video game use 1 and 2 years later.</p><p><strong>Conclusions: </strong>This study demonstrates that certain media parenting practices can reduce adolescent video game use, while low parental involvement is linked to more problematic video game use behaviors. This study shows that parenting practices, including screen modeling, may influence adolescents' video game behaviors.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"225-233"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12871385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Predicting carbapenem-resistant Enterobacteriaceae infections in pediatric liver transplant recipients\".","authors":"Ayman M Mustafa, Fahmi H Kakamad","doi":"10.1007/s12519-025-01005-2","DOIUrl":"10.1007/s12519-025-01005-2","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"272-273"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709864","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":"The future of severe acute respiratory syndrome-cornavirus and coronavirus disease.","authors":"Kam Lun Ellis Hon, Alexander K C Leung, Karen Ka Yan Leung, Wun Fung Hui, Muralidharan Jayashree","doi":"10.1007/s12519-025-01011-4","DOIUrl":"10.1007/s12519-025-01011-4","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"167-173"},"PeriodicalIF":4.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971144","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}