Pediatric discovery最新文献

{"title":"Integrating Synchronized Nasal Intermittent Positive Pressure Ventilation With Less-Invasive Surfactant Administration: Current Evidence and Evolving Practice in Preterm Neonatal Care.","authors":"Aniket P Singh, Raghuram Mallaiah","doi":"10.1002/pdi3.70068","DOIUrl":"https://doi.org/10.1002/pdi3.70068","url":null,"abstract":"<p><p>The objective of this study was to summarize current evidence on the combined use of synchronized nasal intermittent positive pressure ventilation (sNIPPV) and less-invasive surfactant administration (LISA) in the management of respiratory distress syndrome (RDS) in preterm infants. We conducted a narrative review of randomized controlled trials, comparative-effectiveness studies, meta-analyses, the 2022 European Consensus Guidelines on RDS, and recent clinical cohorts evaluating sNIPPV, LISA, and their combined application. Studies suggest that sNIPPV provides superior extubation tolerance and decreases apnea frequency compared with standard continuous positive airway pressure (CPAP). Compared with the intubation, surfactant administration, and extubation (INSURE) approach, LISA lowers early mechanical ventilation needs and decreases bronchopulmonary dysplasia (BPD) rates. When applied together, the two strategies appear to improve procedural stability and decrease the likelihood of re-intubation, and may thus contribute to lower BPD rates due to their complementary physiologic effects. The sNIPPV-LISA combination is physiologically complementary and clinically promising. Current evidence supports a reduced rate of respiratory failure and a trend toward reduced BPD compared with CPAP and the INSURE technique of surfactant administration. Larger randomized trials are required to determine its effects on long-term outcomes.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70068"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the 2019 Novel Coronavirus Pandemic on Canadian Pediatricians.","authors":"Shaneela Shahid, Peter Rosenbaum, Sebastian Gheorghiu, Ivan D Florez","doi":"10.1002/pdi3.70054","DOIUrl":"10.1002/pdi3.70054","url":null,"abstract":"<p><p>The COVID-19 pandemic has significantly impacted the well-being and practices of healthcare workers. The primary goal of this study was to assess the rate of burnout among Canadian pediatricians during the pandemic using all three components of the Maslach Burnout Inventory-Human Services Survey scale. Three hundred and seventy-seven pediatricians completed the survey; approximately two-thirds of the participants were female, and the mean age was 49 years (standard deviation: 10.7). One hundred and fifty participants (39.7%) felt burned out before the pandemic. Two hundred and sixteen participants (57.1%) felt burned out during the pandemic. More than two-thirds of pediatricians (70%) continued working during the pandemic. Less than 5% of participants were infected with COVID-19. Multivariable logistic regression showed that when adjusted for gender and years of practice, being a younger pediatrician, working as a front-line physician, having a perception of medium to very high level of exposure, and seeing ≥ 20 suspected cases of COVID-19 were associated with high levels of burnout.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70054"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Growth Response 1-Associated Epithelial Autophagy-Related Changes in Allergic Airway Inflammation.","authors":"Xinyang Wang, Jie Ren, Yan Zhao, Zhengxiu Luo","doi":"10.1002/pdi3.70075","DOIUrl":"10.1002/pdi3.70075","url":null,"abstract":"<p><p>Airway epithelial cells contribute critically to the initiation of allergic airway inflammation via the release of alarmins such as interleukin-33 (IL-33). Nevertheless, the intracellular regulatory networks governing epithelial alarmin release remain inadequately defined. Although autophagy has been implicated in epithelial stress adaptation and the transcription factor early growth response 1 (<i>EGR1</i>) is promptly induced upon allergen challenge, it remains uncertain whether <i>EGR1</i> contributes to IL-33 release as a representative indicator of epithelial activation through autophagy-associated processes. In this study, human bronchial epithelial BEAS-2B cells were exposed to house dust mite (HDM) extract. <i>EGR1</i> expression was manipulated using gain- and loss-of-function strategies. Autophagy-associated alterations were evaluated by monitoring LC3B, p62, and PI3K-III (Vps34) levels, together with immunofluorescence microscopy. IL-33 release into culture supernatants was quantified by ELISA as a functional readout of epithelial activation. Pharmacological interference with autophagy was employed to examine functional engagement. An HDM-driven murine model was utilized to assess in vivo correlates. Publicly accessible transcriptomic datasets were interrogated in an exploratory manner to characterize epithelial stress signatures linked to this axis. HDM treatment upregulated <i>EGR1</i> in airway epithelial cells, concomitant with autophagy-associated alterations and enhanced IL-33 release. Forced <i>EGR1</i> expression coincided with elevated LC3B-II levels, diminished p62 accumulation, and increased PI3K-III abundance, whereas <i>EGR1</i> silencing produced reciprocal effects. Pharmacological suppression of autophagy attenuated IL-33 release and inhibition of Class III PI3K blunted the <i>EGR1</i> overexpression-driven increase in IL-33 release. In HDM-challenged mice, colocalization of EGR1 and LC3B was observed in lung tissue sections. Exploratory transcriptomic profiling further suggested that allergen provocation may elicit a coordinated epithelial stress response characterized by inflammatory and metabolic pathway enrichment. The results show that <i>EGR1</i> is associated with epithelial autophagy-related alterations under allergic stimulation, and these changes are accompanied by augmented release of the alarmin IL-33. These observations support a conceptual framework wherein <i>EGR1</i>-linked autophagy-associated processes may contribute to epithelial stress responses during early inflammatory events in allergic airway disease. Elucidation of the precise molecular underpinnings and causal relationships awaits further investigation.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70075"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Family-Centered Care and Family Integrated Care for Preterm Infants in Neonatal Intensive Care Units: Comparative Outcomes and Implementation Features-A Scoping Review.","authors":"Aditya Hemendra Bhatt, Somashekhar Marutirao Nimbalkar, Dipen Vasudev Patel, Reshma Kushal Pujara","doi":"10.1002/pdi3.70070","DOIUrl":"10.1002/pdi3.70070","url":null,"abstract":"<p><p>This scoping review maps and compares evidence on enhanced or modified Family-Centered Care (FCC) models-including Family Integrated Care (FICare) and related variants-against standard FCC/usual neonatal intensive care unit (NICU) care for preterm infants. We aimed to summarize the comparative effects on neonatal growth and development, feeding and hospital utilization metrics, parental engagement, and parental psychosocial outcomes, and to describe program characteristics and contextual factors reported alongside variation in results across settings. We included diverse study designs conducted in NICUs across multiple regions. Growth-related outcomes were the most commonly reported domain: 30 studies assessed weight gain, growth velocity, feeding progression, discharge weight, or breastfeeding, and 15 studies explicitly reported better growth or feeding-related outcomes with enhanced FCC/FICare than with standard FCC/usual care. Developmental outcomes were reported in 12 studies, parental psychosocial outcomes in 25 studies, hospital utilization metrics in 28 studies, and parental engagement measures in 22 studies. Benefits were most often described in programs that combined structured parent education with active bedside caregiving, participation in rounds, mentoring, or other implementation supports, although findings varied by program intensity, unit context, and implementation fidelity. Overall, the evidence supports enhanced FCC/FICare as a promising strategy for improving infant-family outcomes in NICUs, while highlighting the need for clearer component definitions, standardized outcome reporting, and longer-term follow-up to support scalable, sustainable implementation.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70070"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nipocalimab in Early-Onset Severe Hemolytic Disease of the Fetus and Newborn.","authors":"Aditya Hemedra Bhatt, Somashekhar Marutirao Nimbalkar, Dipen Vasudev Patel, Reshma Kushal Pujara","doi":"10.1002/pdi3.70067","DOIUrl":"10.1002/pdi3.70067","url":null,"abstract":"","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70067"},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screen Exposure and Academic Achievement: A Systematic Review.","authors":"Teresa Pinheiro, Ilídia Cabral, Joana Monteiro, Virgínia Monteiro, Alberto Caldas","doi":"10.1002/pdi3.70071","DOIUrl":"10.1002/pdi3.70071","url":null,"abstract":"<p><p>This systematic review examined recent evidence on how screen exposure influences the development of academic skills and educational achievement. Digital technologies have become central to children's daily lives, reshaping both learning opportunities and leisure activities. Although recreational screen use has frequently been linked to negative outcomes, the effects of educational use remain less well defined. A bibliographic search was conducted in PubMed, Scopus, Web of Science, and Mendeley for articles published between 2020 and 2024 that addressed screen use in relation to academic skills. Thirty-one studies met the inclusion criteria. Excessive exposure was most often associated with delays in language development, poorer executive function and self-regulation and reduced motor proficiency. In contrast, interactive and well-structured educational applications showed potential to support literacy, numeracy, socio-emotional development, and classroom engagement. Limitations of the available evidence include the predominance of studies in preschool populations, a lack of clear definitions of \"screen exposure\" and \"educational tool,\" and insufficient differentiation between devices and content types. The findings highlight the importance of parental and educational mediation and underscore the need for further longitudinal studies to clarify the long-term impact of educational screen use across developmental stages.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70071"},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbrella Review for Pediatric Sepsis and Robust Prediction Potential Worldwide.","authors":"Wenbo Fu, Yumei Li, Kee Chong Ng, Sheng Fu","doi":"10.1002/pdi3.70069","DOIUrl":"10.1002/pdi3.70069","url":null,"abstract":"<p><p>Pediatric sepsis remains a significant global health burden with considerable mortality and morbidity, particularly in resource-limited settings. This umbrella review synthesizes current evidence from systematic reviews and meta-analyses on the definitions, epidemiology, diagnostic approaches, prognostic models, and emerging prediction technologies of pediatric sepsis worldwide. Through comprehensive evaluation of 18 high-quality systematic reviews published between 2019 and 2024, we identified critical gaps in early recognition and management protocols while highlighting promising technological innovations that demonstrate robust prediction potential. Our analysis revealed substantial variation in sepsis outcomes across different healthcare settings, with approximately 85% of global pediatric sepsis deaths occurring in low- and middle-income countries (LMICs). Quantitative synthesis of prediction models demonstrated pooled sensitivity of 0.81 (95% confidence interval [CI]: 0.76-0.85) and specificity of 0.79 (95% CI: 0.74-0.84), with area under the receiver operating characteristic curve values ranging from 0.78 to 0.94 depending on resource setting and model complexity. The integration of machine learning algorithms with traditional clinical markers showed particular promise for developing context-appropriate prediction tools that function effectively across resource settings. Etiological analysis revealed distinct pathogen profiles by age and geography: Gram-negative organisms were predominant in neonates (68%) and LMICs (72%), while Gram-positive pathogens accounted for 58% of cases in high-income country settings. Antimicrobial resistance exceeded 50% for common pathogens in LMICs, critically complicating empirical treatment. This review provides a comprehensive foundation for future research directions and implementation strategies to reduce the global burden of pediatric sepsis through precision medicine approaches and health system strengthening.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70069"},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Abilities and Their Implications for Language and Speech Disorders-Insights From Phoniatric Practice.","authors":"Ghada Tarek Orabi, Raghda Abdelsalam Nagaty Hanady","doi":"10.1002/pdi3.70072","DOIUrl":"10.1002/pdi3.70072","url":null,"abstract":"<p><p>Children with language and speech disorders account for approximately 5%-12% of children have language and speech disorders globally. Understanding the cognitive abilities of these children is crucial for identifying how cognitive skills influence speech fluency, language production, and planning effective intervention programs. Subtle differences in cognitive performance have been noted to affect developmental language skills. Therefore, we aimed to compare the cognitive abilities of children with language impairments and stuttering to typically developing controls. Our study was conducted on 69 children. The children were divided into three groups. The first and second groups consisted of children with language/speech impairments and fluency disorders, whereas the third group consisted of typically developing peers. We used standardized methods to assess the children's speech, language, fluency, and cognitive skills. The results demonstrated that although children with language impairments and stuttering had IQ scores that fell within the normal range, their verbal IQ and working memory scores showed specific differences from their typically developing peers. These findings suggest that cognitive abilities should be assessed and monitored in children with communicative disorders, even when overall IQ scores fall within the average range. Subtle differences in cognitive skills may affect speech fluency and language development.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70072"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent Class Analysis of Pediatric Bronchial Foreign Body Complications and Their Associated Factors.","authors":"Yong Qian, Ling Wang, Chao Niu, Donghai Wang, Yetao Luo","doi":"10.1002/pdi3.70074","DOIUrl":"10.1002/pdi3.70074","url":null,"abstract":"<p><p>This study aimed to provide a theoretical basis for improving early diagnosis and complication prevention by exploring the latent classes of pediatric bronchial foreign body complications, analyzing their associated factors, and assessing the impact of different latent classes on healthcare resource utilization. Children who underwent bronchoscopic foreign body removal at the Children's Hospital of Chongqing Medical University from January 1, 2018 to July 31, 2023, were retrospectively reviewed. Latent class analysis was performed on complications with an incidence > 10% (including pneumonia, pulmonary emphysema, granulation tissue, bronchial stenosis, atelectasis, and pulmonary consolidation). Logistic regression was used to identify risk factors among different latent complication classes, and comparative analyses compared healthcare resource utilization. Among the 238 included children, complications with an incidence exceeding 10% were analyzed and clustered into four latent classes: the \"Pneumonia Group\" (C1, 40 cases, 16.8%), the \"Pneumonia-Atelectasis Group\" (C2, 33 cases, 13.9%), the \"Emphysema-Granulation tissue Group\" (C3, 106 cases, 44.5%), and the \"Bronchial Stenosis-Granulation tissue Group\" (C4, 59 cases, 24.8%). Results identified a history of foreign body aspiration, asymmetric breath sounds, C-reactive protein ≥ 8 mg/L, and neutrophil percentage as associated factors (<i>p</i> < 0.05). Healthcare resource utilization was significantly lower in groups C3 and C4 regarding hospital stay, treatment costs, and antibiotic days compared to C1 and C2 (<i>p</i> < 0.05). These latent classes offer theoretical support and practical reference for early diagnosis, complication prevention and diagnosis-related group-based payment optimization.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70074"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic Management of Cervicomedullary Decompression in a Child With Down Syndrome: A Case Report.","authors":"Muhammad Saad, Marium Amjad","doi":"10.1002/pdi3.70078","DOIUrl":"10.1002/pdi3.70078","url":null,"abstract":"","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":" ","pages":"e70078"},"PeriodicalIF":0.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}