Pediatric discovery最新文献

{"title":"Pediatric Chronic Monteggia Fractures: Insights From a Comprehensive Review.","authors":"Gengze Li, Yuan Zhang","doi":"10.1002/pdi3.70033","DOIUrl":"10.1002/pdi3.70033","url":null,"abstract":"<p><p>Monteggia fractures represent relatively infrequent injuries in the pediatric population, accounting for approximately 2% of all forearm fractures. However, the rate of missed diagnoses ranges from 30% to 50%, leading to the development of chronic Monteggia fractures in children. Chronic Monteggia fractures frequently result in elbow deformities and functional limitations, significantly impacting the patients' quality of life. The classification systems and treatment approaches for this condition are complex, and therapeutic strategies remain a subject of considerable debate. This review comprehensively examines the definition, incidence, etiology, classification, pathophysiological characteristics, diagnosis, treatment strategies, and prognosis of chronic Monteggia fractures in children. The aim of this study is to provide a reference for further research into the management of this challenging pediatric orthopedic condition.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 4","pages":"e70033"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879785","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 Profile Analysis of Sleep Patterns in Children With Autism Spectrum Disorder.","authors":"Ke Wang, Qiuhong Wei, Ting Yang, Feiyong Jia, Yan Hao, Jinchen Li, Jie Chen, Tingyu Li, Hongyu Chen, Ximing Xu","doi":"10.1002/pdi3.70030","DOIUrl":"10.1002/pdi3.70030","url":null,"abstract":"<p><p>Sleep disturbances significantly impact children with autism spectrum disorder (ASD), yet their heterogeneous manifestations remain poorly understood. This multicenter prospective cohort study employed latent profile analysis to identify distinct sleep phenotypes among 631 children with ASD (aged 3-6 years) and 768 typically developing (TD) controls across three Chinese cities representing Northern, Central, and Western regions. Analysis of Children's Sleep Habits Questionnaire data revealed three distinct sleep phenotypes based on optimal model fit determined by Bayesian information criterion. Compared to TD children who showed generally better sleep patterns with lower sleep onset delay and fewer disturbances overall, the ASD groups exhibited distinctive profiles: Cluster 1 (9.2%) exhibited severe disturbances across multiple domains (sleep anxiety, parasomnias, night wakings and sleep-disordered breathing) and demonstrated the most severe autism symptoms; Cluster 2 (36.0%) presented a mixed profile with comparable bedtime resistance, sleep duration, and daytime sleepiness to TD children but elevated sleep-disordered breathing; and Cluster 3 (54.8%) showed reduced sleep-disordered breathing but elevated night waking and bedtime resistance. One-year follow-up data indicated that Cluster 3, characterized by mild sleep-disordered breathing, showed significant improvements in core symptoms particularly in social cognition, communication, and motivation domains, whereas Clusters 1 and 2 demonstrated modest changes. These findings suggest that early identification of sleep phenotypes may predict treatment response and inform personalized intervention strategies. Our results underscore the importance of incorporating comprehensive sleep assessment and management into ASD care protocols.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"4 1","pages":"e70030"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794748","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":"Highlighting the CORD-SaFe Trial From Melbourne-Progress Toward Cellular Therapy in Extremely Preterm Newborns.","authors":"Aditya Bhatt, Somashekhar Nimbalkar, Dipen Patel, Reshma Pujara","doi":"10.1002/pdi3.70021","DOIUrl":"10.1002/pdi3.70021","url":null,"abstract":"","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 4","pages":"e70021"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879821","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":"Postnatal Growth Patterns and Deviations in Singleton and Twin Infants: A Prospective Cohort Study on Infants Appropriate and Small for Gestational Age.","authors":"Yannan Wan, Ting Pan, Zhanzhan Zhang, Yuanfeng Zhong, Qian Chen, Xuelin Xia, Lin Zhu, Li Chen, Xuan Zhang","doi":"10.1002/pdi3.70019","DOIUrl":"10.1002/pdi3.70019","url":null,"abstract":"<p><p>Small for gestational age (SGA) and twin infants are at increased risk of growth deviations, but postnatal catch-up growth (CUG) patterns across singleton, twin, appropriate for gestational age (AGA), and SGA groups remain unclear. This prospective cohort study (<i>n</i> = 340) investigated the postnatal growth trajectories and physical growth deviations in singleton and twin AGA and SGA infants during the first year of life. The primary findings indicated that SGA infants exhibited rapid CUG in weight and head circumference within the first 6 months, whereas length catch-up required a longer period. Twin SGA infants displayed distinct patterns: faster weight CUG but slower length CUG compared with singleton SGA infants, with gender differences-male SGA twins had lower length <i>z</i>-scores than SGA singletons. The rate of deviation in physical growth of SGA infants improved significantly within the first year of life, with wasting being infrequent. In conclusion, the mechanism underlying SGA is more complex among twins than singletons. Twin SGA infants require prolonged growth monitoring, and regular follow-up is essential to optimize growth outcomes and mitigate long-term risks. This preliminary study offers a foundation for further investigation into the biological and environmental factors driving these differences.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 4","pages":"e70019"},"PeriodicalIF":0.0,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879790","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":"<i>TREM2</i> Downregulation Disrupts Microglial Function and Synaptic Pruning Through RA/RARα Signaling: Mechanisms Underlying Autism-Like Behaviors.","authors":"Min Lu, Kexin Bai, Yali Bai, Yuan Miao, Tingjiao Zhao, Yi Yang, Jie Chen, Ting Yang, Tingyu Li, Hua Wei","doi":"10.1002/pdi3.70024","DOIUrl":"10.1002/pdi3.70024","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) involves neuroimmune dysregulation and synaptic pruning defects. This study aimed to investigate the role of triggering receptor expressed on myeloid cells 2 (TREM2) in ASD pathogenesis and its link to retinoic acid (RA)/retinoic acid receptor α (RARα) signaling. Prefrontal cortex-specific knockdown of <i>TREM2</i> in rats induced core ASD-like behaviors (e.g., social deficits), microglial hyperactivation, aberrant synaptic pruning, reduced serum soluble TREM2 (sTREM2) levels, and disrupted RA/RARα signaling. Oral RA supplementation (6 mg/[kg·day]) reversed these neuroimmune abnormalities and behavioral impairments. In vitro studies demonstrated that <i>TREM2</i> knockdown and RA supplementation induced RARα-level alterations consistent with in vivo observations. These findings indicated that TREM2 deficiency was a key factor in the pathophysiology of ASD, mediated by the RA/RARα signaling pathway. Furthermore, serum sTREM2 might serve as a potential diagnostic biomarker for ASD. Collectively, these findings underscore the pivotal role of TREM2 in ASD pathogenesis and provide novel perspectives for diagnostic and therapeutic strategies.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 4","pages":"e70024"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879881","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":"Lung Function Improvement in Bronchial Asthma: A Study of Sublingual Immunotherapy.","authors":"Yinming Song, Daiyin Tian, Sha Liu, Fangjun Liu, Jingyue Liu, Ying Li, Li Yan","doi":"10.1002/pdi3.70022","DOIUrl":"10.1002/pdi3.70022","url":null,"abstract":"<p><p>This is a retrospective study. In order to investigate the effect of specific immunotherapy on the improvement of lung function and symptoms in children with bronchial asthma, 256 children with bronchial asthma were selected and divided into an experimental group and a control group according to whether they chose to use sublingual specific immunotherapy or not. The control group was given basic drug therapy, and the experimental group was given specific immunotherapy on the basis of basic drug therapy. Differences between the two groups were compared in terms of lung function, efficacy, and asthma medication dose. The results showed that peak expiratory flow (PEF), maximum expiratory flow at 25% of forced vital capacity (MEF₂₅), maximal mid-expiratory flow curve (MMEF), maximum expiratory flow at 75% of forced vital capacity (MEF₇₅), maximum expiratory flow at 50% of forced vital capacity (MEF₅₀), and airway hyperresponsiveness improved in both groups after 1 year of treatment (<i>P</i> < 0.05), and the result of experimental group was better than that of the control group (<i>P</i> < 0.05). This study shows that sublingual specific immunotherapy combined with inhaled corticosteroid therapy has positive therapeutic effects on asthma patients, which can reduce the dose of medication used in asthma patients and improve symptoms.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 3","pages":"e70022"},"PeriodicalIF":0.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208986","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":"Outcome of Children Requiring Intensive Care Following Hematopoietic Stem Cell Transplantation: A Single Center Experience.","authors":"Natalia Builes, Byron E Piñeres-Olave, Laura Niño-Serna","doi":"10.1002/pdi3.70023","DOIUrl":"10.1002/pdi3.70023","url":null,"abstract":"<p><p>Hematopoietic stem cell transplant (HSCT) is associated with some complications requiring advanced support in the pediatric intensive care unit (PICU). However, the outcome of children requiring admission to a PICU following HSCT in middle-income countries (MICs) are limited. One hundred and four children undergoing hematopoietic stem cell transplantation at a bone marrow transplant service in Colombia from January 2012 to June 2019 were enrolled. Baseline characteristics and clinical courses were described. In addition, we compared some characteristics of patients who survived or died in the PICU through a bivariate analysis. Twenty five PICU admissions were reported. Sixty-four percent survived to be discharged from any PICU admission. Immunodeficiency was the most common underlying disease among patients admitted to the PICU (33%). Respiratory problems (12/25, 48%), and cardiovascular instability (10/25, 40%) were the most common reasons for admission. Cardiovascular support was the most common PICU treatment (21/25, 84%), followed by respiratory support (18/25, 72%). We found that children who require admission to PICU after an allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) present a high mortality rate. Invasive respiratory support, higher vasoactive-inotropic score, renal replacement therapy, and the presence of multi-organ failure were associated with mortality.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 3","pages":"e70023"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208989","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":"Succinate Promotes M1 Polarization of Intestinal Macrophages in Mice With Necrotizing Enterocolitis Through the PI3K/AKT Pathway.","authors":"Sha Liu, Fang-Ling Tang, Xiao-Lin Yan, Xiao-Chen Liu, Qing Ai, Lu-Quan Li, Lei Bao","doi":"10.1002/pdi3.70026","DOIUrl":"10.1002/pdi3.70026","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disorder that frequently affects premature infants, and its pathogenesis is closely related to macrophage polarization. This study investigated the effects of succinate, a metabolite of the intestinal flora, on macrophage polarization in NEC. Succinate aggravated intestinal injury caused by NEC and inhibited the proliferation of damaged mouse monocyte‒macrophage leukemia cells (RAW264.7 cells). It was confirmed by multiple methods that succinate intervention promotes the polarization of intestinal macrophages toward the M1 phenotype in neonatal NEC. This polarization was characterized by a significant upregulation of inducible nitric oxide synthase (iNOS) protein levels and <i>iNOS</i> mRNA expression, along with a marked suppression of arginase 1 (ARG1) protein levels and <i>Arg1</i> mRNA expression. Moreover, immunofluorescence analysis revealed that in the NEC intestine, the coexpression of the M1 macrophage marker F4/80⁺/CD86⁺ was significantly increased, whereas the coexpression of the M2 macrophage marker F4/80⁺/CD206⁺ was significantly decreased. Mechanistic studies revealed that succinate upregulated the expression levels of phosphorylated protein kinase B (<i>p</i>-AKT) and hypoxia-inducible factor 1 alpha (HIF1a) by activating the PI3K/AKT signaling pathway through its specific receptor succinate receptor 1 (SUCNR1). Further experiments revealed that the expression of polarization-related markers in M1-type macrophages was significantly suppressed after treatment with the SUCNR1-neutralizing antibody or the PI3K inhibitor LY294002. These findings suggest that succinate may activate the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway via SUCNR1 to promote the polarization of NEC macrophages toward the M1 phenotype, thereby accelerating NEC progression.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 4","pages":"e70026"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879836","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":"Single-Cell Profiling of Pediatric High-Grade Gliomas Reveals OPC-Like Subpopulations Driving Tumorigenic Lineage Transitions.","authors":"Tian Tian, Chong Huang, Lusheng Li","doi":"10.1002/pdi3.70027","DOIUrl":"10.1002/pdi3.70027","url":null,"abstract":"<p><p>Pediatric high-grade gliomas (pHGG) were first defined as a distinct entity in the 2021 fifth edition of the WHO classification of tumors of the central nervous system. These tumors, designated primarily as Grade 4, include the following subtypes: (1) diffuse midline glioma with H3-K27 alterations (DMG, H3-K27M), (2) diffuse hemispheric glioma with H3-G34 mutations (DHG, H3G34M), and (3) diffuse pediatric-type high-grade glioma with wild-type H3 and isocitrate dehydrogenase (pHGG, H3-WT/IDH WT). Clinically, pHGGs are known for their poor outcomes and marked tumor heterogeneity. Despite this, the characteristics of the tumor microenvironment (TME) and the processes governing tumor cell lineage transitions remain incompletely understood. In this study, we used single-cell RNA sequencing (scRNA-seq) to analyze pHGG tumor cells (excluding infant-type hemispheric gliomas). Through comprehensive bioinformatic approaches-including cell proportion analysis, Gene Ontology (GO) enrichment, metabolic activity inference via scMetabolism, proliferation gene scoring, stemness assessment by CytoTRACE2, SCENT, and pseudotime trajectory analysis with Monocle2-we thoroughly investigated the TME features and heterogeneity of these aggressive brain tumors. Our findings highlight the presence of oligodendrocyte precursor cell (OPC)-like subpopulations, with epidermal growth factor receptor (<i>EGFR</i>)-expressing OPC-like cells emerging as a potential tumorigenic origin in diffuse midline gliomas due to their distinct stemness properties. Notably, platelet-derived growth factor receptor alpha (<i>PDGFRA</i>)-positive cells exhibit high specificity in DMG, suggesting greater diagnostic and therapeutic potential than <i>EGFR</i>. Next-generation sequencing (NGS) and multiplex immunofluorescence analyses confirmed their distinct expression pattern, supporting PDGFRA as a key molecular marker. Moreover, OPC-like cells at different differentiation states may drive lineage transitions in DMG. Together, these findings enhance our understanding of pHGG-especially DMG-and point to new avenues for targeted therapy.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 3","pages":"e70027"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208993","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":"Evaluating the Impact of the Wrapping Bag <i>TECOtherm Wrabbit</i> on Temperature Stability During Therapeutic Hypothermia Treatment of Hypoxic Ischemic Encephalopathy.","authors":"Rashid Katamesh, Katharina Witt, Sebastian Ebert","doi":"10.1002/pdi3.70025","DOIUrl":"10.1002/pdi3.70025","url":null,"abstract":"<p><p>During hypoxic ischemic encephalopathy (HIE) therapy for neonates, the patient temperature must be kept at 33.5°C as stable as possible throughout the therapy time. Therefore, hypothermia devices with a fluid-circulated temperature-regulating mat have become established. However, therapeutic interventions often require medical personnel to open the mat to reach the patient. This can lead to a loss of thermal regulation due to heat exchange between the patient and environment which can result in a slower or stopped therapy. To mitigate this issue, the wrapping bag <i>TECOtherm Wrabbit</i> was proposed to shield the patient from external temperature fluctuations and maintain therapeutic efficacy. We conducted a laboratory experiment using a test model to evaluate the effectiveness of the wrapping bag under two conditions: with and without <i>TECOtherm Wrabbit</i>, both under dry and moistened states at room temperatures of 21°C and 27°C. The objective was to assess the retention of patient temperature during possible interventions. Results indicated a significant decrease in temperature when the wrapping bag was not used. Conversely, the use of the wrapping bag demonstrated a slight but controlled temperature change. These findings suggest that the wrapping bag can effectively aid in maintaining patient temperature during necessary clinical interventions. Further clinical research is warranted to validate the application of wrapping bag in maintaining neonatal temperature stability during hypothermic therapy.</p>","PeriodicalId":520221,"journal":{"name":"Pediatric discovery","volume":"3 3","pages":"e70025"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208823","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}