medRxiv - Pediatrics最新文献

{"title":"Evaluating the Effectiveness of Nirsevimab in Reducing Pediatric RSV Hospitalizations in Spain","authors":"Sara Jimeno, Adrian Pelaez Laderas, Agustin Labourt, Florencia Acuna, Lucia Linares, Isavel Llana Martin, Angeles Calle, Silvina Natalini Martinez","doi":"10.1101/2024.09.13.24313619","DOIUrl":"https://doi.org/10.1101/2024.09.13.24313619","url":null,"abstract":"Background and objective\u0000Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. Nirsevimab has demonstrated to be a promise tool for preventing severe RSV disease. Although clinical trials have demonstrated the efficacy of Nirsevimab in preventing severe RSV disease, evidence regarding its performance in real-world clinical settings is still limited due to its recent introduction. This study aims to fill this knowledge gap by evaluating the impact of Nirsevimab in a cohort of infants and determining its effectiveness in reducing the burden of RSV disease. Material and Methods\u0000Retrospective study of RSV hospitalizations in children under six months of age, between October 1st and March 31st, across four seasons: pre-COVID (2018-2019), COVID (2019-2020), post-COVID pre-Nirsevimab (2022-2023), and Nirsevimab season (2023-2024). Results\u0000Nirsevimab has demonstrated significant efficacy in reducing RSV-related hospitalizations in infants under six months of age. During the 2023/24 season, following the introduction of Nirsevimab, there was a substantial reduction in RSV-related lower respiratory tract infection (LRTI) hospitalizations. Among infants under 3 months of age, hospitalizations decreased by 79.3% (IRR: 0.21, 95% CI: 0.12-0.34). In infants aged 3 to 6 months, there was a 66.9% reduction (IRR: 0.33, 95% CI: 0.15-0.64). Additionally, Nirsevimab decreased the severity of RSV cases with LRTI who required support of equipment for sanitary use further reducing overall healthcare burden. Conclusion\u0000These results underscore Nirsevimab's vital role in preventing severe RSV infections and hospitalizations, especially among the most vulnerable infants, positioning it as a critical advancement in pediatric respiratory care.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Chlorinated Drinking Water Exposure on Gut Microbiota Development in Infants: a Randomised Controlled Trial.","authors":"Kimberley Parkin, Claus Christopherson, Valerie Verhasselt, Debbie Palmer, Matt Cooper, Susan L Prescott, Desiree Silva, David Jim Martino","doi":"10.1101/2024.09.15.24313601","DOIUrl":"https://doi.org/10.1101/2024.09.15.24313601","url":null,"abstract":"Background: Early gut microbiota disruptions can increase the risk for dysbiosis and predispose to chronic diseases. While chlorinated drinking water is generally considered safe, the antimicrobial effects of chlorine-based disinfectants may negatively impact the developing infant microbiota, which is particularly vulnerable during this critical period. This study investigates the specific effects of chlorinated water on the gut microbiome in infants.\u0000Methods: The waTer qUality and Microbiome Study (TUMS) is a double-blinded, randomized controlled trial (RCT). Six-month old infants (n=197) received either de-chlorinated drinking water (via benchtop filtration), or regular tap water for twelve months. Stool samples were collected at six-months (baseline) and at eighteen-months of age. Metagenomic sequencing was used for faecal microbiome analysis. Samples of participant tap water was also collected pre- and post-intervention.\u0000Results: Participants were balanced for sex, delivery method, and breast-feeding status at time of recruitment between the control (n=98) and treatment (n=99) groups. We collected a total of 170 baseline stool samples (83 in the control group and 87 in the treatment group), and 130 follow-up stool samples (65 in the control group and 65 in the treatment group). Interindividual variation was higher at six-months compared to eighteen months. No significant differences in overall community structure (beta diversity (p=0.35), richness (p=0.98) or Shannon Index (p=0.45)) were found between treatment groups. However, 55 genera were differentially abundant at follow-up (adjusted p-value < 0.01), primarily within the Firmicutes phylum. Analysis of metabolic pathways revealed the chlorinated water group showed significantly higher abundance of antibiotic resistance genes mostly attributable to Escherichia and Klebsiella species.\u0000Conclusion: Water chlorination induces predominantly minor changes in infant gut microbiome composition; but appears to increase the abundance of antibiotic-resistant genes. While water chlorination remains a vital public health tool for ensuring safe drinking water, our findings underscore the need for continued research into the potential for increased antibiotic resistance, and suggest there may be value in exploring alternative disinfectant strategies.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How young people experienced Long COVID services: a qualitative analysis.","authors":"Olivia Taylor, Georgia Treneman-Evans, Madeleine Riley, Joanne Bond-Kendall, Katharine Pike","doi":"10.1101/2024.09.12.24312643","DOIUrl":"https://doi.org/10.1101/2024.09.12.24312643","url":null,"abstract":"Abstract Objective We aimed to evaluate how acceptable paediatric Long COVID services were to patients and clinicians. This paper focuses on how acceptable Long COVID services were to paediatric patients.\u0000Design This study was explorational. Semi-structured qualitative interviews with 13 paediatric patients were used to understand the experiences of patients with Long COVID.\u0000Setting Participants were recruited from specialist paediatric services in the Southwest of England from June 2022 to September 2023.\u0000Patients Participants were children and young people (CYP) aged 11-17 years old with a Long COVID diagnosis who accessed the specialist services in the Southwest of England. Results\u0000Four themes were reported. Accessing specialist clinics helped CYP to feel validated, they appreciated consulting with clinicians who were knowledgeable about Long COVID and empathetic. CYP found comfort in knowing other CYP were experiencing Long COVID. CYP wanted to be proactive in their Long COVID management, appreciating regular appointments and the opportunity to learn about their condition. CYP desired normality, and therefore sought flexible appointment times, online appointments, and reasonable adjustments. CYP found the waiting times to access Long COVID services were too long.\u0000Conclusions Our results stress the importance to CYP of several features of the care received in the specialist clinics. These relate to the experiences of CYP with Long COVID but potentially extend to CYP with other conditions, particularly long-term and/or poorly understood conditions. The results support creating community-based support groups for CYP with long-term medical conditions, providing online flexible appointments, offering early reasonable adjustments for school and providing quicker access to specialist clinics.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Novel Dynamic Leak Model to Simulate Leak for Performance Testing of Manual Neonatal Resuscitation Devices. Does Leak Matter? A Bench Study","authors":"Stephanie Morakeas, Murray Hinder, Thomas Drevhammar, Viktoria Gruber, Alistair Mcewan, Mark Tracy","doi":"10.1101/2024.09.12.24313593","DOIUrl":"https://doi.org/10.1101/2024.09.12.24313593","url":null,"abstract":"Background: Newborn resuscitation is commonly performed in the presence of face mask leak. Leak is highly variable, pressure dependent and often unrecognised. The effectiveness of resuscitation devices to deliver adequate inflations in the presence of leak is unknown. Bench models simulating continuous leak have disadvantages of not accurately reflecting leak occurring during clinical resuscitation. A dynamic leak model based on pressure release valves was thus developed. Aim: To assess self-inflating bag (SIB) and T-piece resuscitator (TPR) ventilation performance in the presence of dynamic (DLM) compared to continuous (CLM) leak models in a bench study. Method: Five predefined leak levels were tested for each leak model (0-87%). Resuscitation devices were connected to a test lung (compliance 0.6 mL/cmH2O) and respiratory parameters were measured using respiratory function monitors before (patient interface) and after (actual) an induced leak at 40, 60, 80 inflations/min. Results: 3,600 inflations were analysed. DLM showed a decrease in actual tidal volumes from 0%-87% leak with tidal volume differences (SIB 4.8mL, TPR 2.9mL), contrasting to minimal change for CLM (SIB -0.6mL, TPR 0.3mL). CLM demonstrated larger differences between patient interface and actual leak. The absolute difference at 60 inflations/min at 87% leak were SIB 37.5%, TPR 18.2% for CLM compared to SIB 4.6%, TPR 1.4% for DLM. Conclusion: CLM may underestimate the impact of resuscitation device performance with poor correlation between patient interface and actual delivered volume. DLM demonstrates several advantages with more accurate representation of face mask leak and will prove useful in modelling all systems delivering PPV.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge of Childhood and Adolescent Cancer Among Primary Caregivers: An Observational and Prospective Study","authors":"Gladys Areli Meza Soto, Maribel Lopez Gonzalez, Maria Azucena Montoya Hernandez, Josseline DC Zarate Amador, Marian Del Rocio Galan Solano, Jose Alberto Estrada Alvarez","doi":"10.1101/2024.09.09.24312956","DOIUrl":"https://doi.org/10.1101/2024.09.09.24312956","url":null,"abstract":"Background: Childhood and adolescent cancer represents a significant public health issue, being the leading cause of disease-related mortality in this age group. Previous studies in Greece, Turkey, and Mexico have shown that parents and caregivers lack adequate knowledge about this topic. Despite WHO efforts to create new strategies, late diagnosis persists in Mexico. Early identification of initial signs and symptoms by parents and caregivers is crucial for seeking timely medical care. Objective: To evaluate the knowledge of childhood and adolescent cancer among primary caregivers in primary care settings.\u0000Methods: An observational, descriptive, cross-sectional, and prospective study was conducted at Family Medicine Unit No. 69 in Coatzacoalcos, Veracruz, from April 2023 to January 2024. The \"Survey for parents and caregivers about knowledge of cancer in children\" by Dr. Ana Cecilia Vazquez was administered with prior informed consent. Qualitative and quantitative variables were analyzed using percentages and measures of central tendency, respectively. Bivariate analysis was performed using the Chi-square test with SPSS software.\u0000Results: A total of 374 caregivers were evaluated, with an age range of 17 to 78 years (X̅=35.5, σ= ± 11.8). The majority were female (60.2%), married (48.7%), maternal caregivers (54%), with professional education (38%), and employed (62.3%). 77.8% of the caregivers had inadequate knowledge, while 22.2% had adequate knowledge about childhood and adolescent cancer. There was a statistically significant association (p<0.05) between knowledge and sociodemographic variables such as maternal role, age, education level, marital status, and number of children.\u0000Conclusion: The alternate hypothesis that primary caregivers possess adequate knowledge of childhood and adolescent cancer is rejected. It is essential to develop educational strategies to increase knowledge about childhood cancer to improve early detection. This includes using educational materials and audiovisual media such as the PAHO video \"The rhythm that gives us life\" and distributing brochures and questionnaires targeted at caregivers.\u0000Keywords: cancer, child, childhood, adolescent, adolescence.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Fathers in Preemie Prep for Parents (P3) Program on Couples Preterm Birth Preparedness","authors":"Mir A Basir, Siobhan McDonnell, Ruta Brazauskas, U Olivia Kim, S Iqbal Ahamed, Jennifer J McIntosh, Kris Pizur-Barnekow, Michael B Pitt, Abbey Kruper, Steven R Leuthner, Kathryn E Flynn","doi":"10.1101/2024.09.11.24313503","DOIUrl":"https://doi.org/10.1101/2024.09.11.24313503","url":null,"abstract":"Objective\u0000Evaluate the effect of fathers participation in the Preemie Prep for Parents (P3) program on maternal learning and fathers preterm birth knowledge.\u0000Methods\u0000Mothers with preterm birth predisposing medical condition(s) enrolled with or without the father of the baby and were randomized to the P3 intervention (text-messages linking to animated videos) or control (patient education webpages). Parent Prematurity Knowledge Questionnaire assessed knowledge, including unmarried fathers legal neonatal decision-making ability.\u0000Results\u0000104 mothers reported living with the father of the baby; 50 participated with the father and 54 participated alone. In the P3 group, mothers participating with the father (n=33) had greater knowledge than mothers participating alone (n=21), 85% correct responses vs. 76%, p=0.033. However, there was no difference in knowledge among the control mothers, 67% vs. 60%, p=0.068. P3 fathers (n=33) knowledge scores were not different than control fathers (n=17), 77% vs. 68%, p=0.054. Parents who viewed the video on fathers rights (n=58) were more likely than those who did not (n=96) to know unmarried fathers legal inability to decide neonatal treatments, 84% vs. 41%, p<0.001.\u0000Conclusions\u0000Among opposite-sex cohabitating couples, fathers participation in the P3 program enhanced maternal learning. Practice Implications\u0000The potential of the P3 program to educate fathers may benefit high-risk pregnancies.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"273 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical prediction models to diagnose neonatal sepsis in low-income and middle-income countries: a scoping review","authors":"Samuel R Neal, Sarah Sturrock, David Musorowegomo, Hannah Gannon, Michele Zaman, Mario Cortina-Borja, Kirsty Le Doare, Michelle Heys, Gwen Chimhini, Felicity Fitzgerald","doi":"10.1101/2024.09.05.24313133","DOIUrl":"https://doi.org/10.1101/2024.09.05.24313133","url":null,"abstract":"Neonatal sepsis causes significant morbidity and mortality worldwide but is difficult to diagnose clinically. Clinical prediction models (CPMs) could improve diagnostic accuracy. Neonates in low-income and middle-income countries are disproportionately affected by sepsis, yet no review has comprehensively synthesised CPMs validated in this setting. We performed a scoping review of CPMs for neonatal sepsis diagnosis validated in low-income and middle-income countries. From 4598 unique records, we included 82 studies validating 44 distinct models. Most studies were set in neonatal intensive or special care units in middle-income countries and included neonates already suspected of sepsis. Three quarters of models were only validated in one study. Our review highlights several literature gaps, particularly a paucity of studies validating models in low-income countries and the WHO African region, and models for the general neonatal population. Furthermore, heterogeneity in study populations, definitions of sepsis and reporting of models may hinder progress in this field.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating whole genome sequencing for rare diseases in newborn screening: evidence synthesis from a series of systematic reviews","authors":"Karoline Freeman, Jacqueline Dinnes, Bethany Shinkins, Corinna Clark, Inès Kander, Katie Scandrett, Shivashri Chockalingam, Aziza Osman, Naila Dracup, Rachel Court, Furqan Butt, Cristina Visintin, James R Bonham, David Elliman, Graham Shortland, Anne Mackie, Zosia Miedzybrodzka, Sian Morgan, Felicity Boardman, Yemisi Takwoingi, Sian Taylor-Phillips","doi":"10.1101/2024.09.03.24312979","DOIUrl":"https://doi.org/10.1101/2024.09.03.24312979","url":null,"abstract":"<strong>Background</strong> Assessment of newborn screening using whole genome sequencing (WGS) presents considerable challenges for policy advisors, not least given the logistics of simultaneously evaluating the evidence for 200 rare genetic conditions. The ‘genotype first’ approach has the potential for harms, and benefits are uncertain.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black Women and the Preemie Prep for Parents (P3) Program: Exploratory Analysis of a Clinical Trial","authors":"Siobhan M McDonnell, Kathryn E Flynn, Kris Barnekow, U Olivia Kim, Ruta Brazauskas, S Iqbal Ahamed, Jennifer J McIntosh, Michael B Pitt, Steven R Leuthner, Abbey Kruper, Mir A Basir","doi":"10.1101/2024.08.28.24312637","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312637","url":null,"abstract":"Background: The smartphone Preemie Prep for Parents (P3) program was developed to address the gap in prenatal education of preterm birth in high-risk pregnancies. Despite a higher incidence of preterm birth, Black women are less likely to receive prenatal education. Methods: Pregnant women with medical conditions that predisposed them to preterm birth were randomized to receive the P3 program or links to American College of Obstetricians and Gynecologists webpages (control). The P3 group received periodic text messages, starting as early as 18 weeks gestational age, each with a link to a short, animated educational video. Participants completed the Parent Prematurity Knowledge Questionnaire, PROMIS Anxiety scale, and a feedback survey. This is a subgroup analysis of the Black, non-Hispanic participants in the P3 trial. Results: Of the 26 Black non-Hispanic women enrolled, the P3 group (n=14) had higher knowledge scores than the control group (n=12), 67.5% correct vs. 43.6% (difference 24.0; 95% CI, 7.4 to 40.6), without experiencing an increase in anxiety. More P3 participants reported discussing preterm birth with their partner (100%) than control participants (57%; difference 43; 95% CI, 6 to 80).\u0000Conclusions: The P3 program appears to be an effective method of providing preterm birth education to Black pregnant women.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental origins of the Autism Spectrum Disorder in the Middle East and North Africa Region: A Systematic Review and Meta-Analysis of adjusted risk factors","authors":"Aishat F. Akomolafe, Fathima R. Mahmood, Bushra M. Abdallah, Amgad M. Elshoeibi, Elhassan Mahmoud, Aisha Abdulla Al-Khulaifi, Nour Darwish, Yara Dweidri, Duaa Yousif, Hafsa Khalid, Majed Al-Theyab, Muhammad Waqar Azeem, Durre Shahwar, Madeeha Kamal, Majid Alabdulla, Salma M. Khaled, Tawanda Chivese","doi":"10.1101/2024.08.27.24312654","DOIUrl":"https://doi.org/10.1101/2024.08.27.24312654","url":null,"abstract":"<strong>Background and Objectives</strong> The etiology of autism spectrum disorder (ASD) is poorly understood, with sparse data from the Middle East and North Africa (MENA) region, which has a unique climate and socio-epidemiological setting. This research investigated the developmental (early life) risk factors associated with ASD in the MENA region.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}