Pediatrics open science最新文献

{"title":"Estimated SARS-CoV-2 Seroprevalence Among Children: United States, September 2021 to December 2022.","authors":"Anna Bratcher, Yangyang Deng, Xiaoyi Deng, Yun Kim, Melissa M Coughlin, Melissa Briggs Hagen, Aron J Hall, Brooke E Swanson, William A Meyer, Adi Gundlapalli, Ronaldo Iachan, Jefferson M Jones, Kristie E N Clarke","doi":"10.1542/pedsos.2024-000441","DOIUrl":"https://doi.org/10.1542/pedsos.2024-000441","url":null,"abstract":"<p><strong>Background: </strong>Studying seroprevalence, the prevalence of SARS-CoV-2 antibodies in blood, produces more reliable estimates of infection burden compared with diagnosed cases. In this analysis, United States Nationwide Commercial Laboratory Seroprevalence Study data are used to calculate pediatric seroprevalence trends and their correlation with state-level vaccination.</p><p><strong>Methods: </strong>We tested SARS-CoV-2 antibodies residual serum specimens from pediatric patients during September 2021 to December 2022 for (1) presence of antinucleocapsid (anti-N; infection-induced) antibodies and (2) semiquantitative anti-spike protein (anti-S; vaccination- and infection-induced) immunoglobulin G antibody concentrations. Seroprevalence trends and antibody concentrations by age group over time were evaluated. State-level correlations were calculated between geometric mean concentrations and vaccination data.</p><p><strong>Results: </strong>By December 2022, more than 90% of children older than 2 years showed evidence of SARS-CoV-2 infection. In contrast, seroprevalence in infants younger than 1 year fluctuated around 60% from February 2022 on. Older age groups generally exhibited higher anti-N seroprevalence and higher anti-S antibody concentrations. A positive correlation was observed between state-level geometric mean antibody concentration and vaccination rates for children aged 5 to 11 and 12 to 17 years, but not for those aged 6 months to 4 years.</p><p><strong>Conclusion: </strong>Between September 2021 and November/December 2022, anti-N seroprevalence increased across all age groups except for children younger than 1 year. Seropositivity among these infants remained around 60%. Furthermore, the lowest anti-S concentrations were found in children aged 6 months to 4 years. Given that young children had the lowest seroprevalence, vaccination of those who are pregnant and eligible young children could increase protection through generating an increase in antibody titers.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 4","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280603","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":"Maintenance Fluids for Late Preterm and Term Infants: Is it Time to Reconsider?","authors":"Amanda J Chang, Daniel J York, Wenya Chen, Kaeli N Heidenreich, Malika D Shah","doi":"10.1542/pedsos.2024-000372","DOIUrl":"10.1542/pedsos.2024-000372","url":null,"abstract":"<p><strong>Background: </strong>Late preterm and term infants represent the majority of neonatal intensive care unit admissions globally, yet their fluid management remains underexplored.</p><p><strong>Methods: </strong>We conducted a retrospective medical record review of 174 infants 34 weeks' gestational age or older who received dextrose-containing fluids shortly after birth. These infants had 24-hour serum sodium measurements at our institution between April 2018 and April 2021. We used regression models to analyze the correlation among intravenous fluid (IVF) intake per kilogram, gestational age, fluid balance (FB), weight change, and sodium status, adjusting for clinical factors.</p><p><strong>Results: </strong>At 24 hours, the average IVF intake was 57.2 mL/kg/d (SD 14.9). Of the infants, 130 (75%) had positive FB, 128 (74%) maintained or gained weight, 41 (24%) had sodium levels 132 mEq/L or less, and 68 (39%) had sodium 134 mEq/L or less. Positive FB was associated with weight gain and an increased likelihood of hyponatremia. Regression analysis showed a 0.07-mEq/L decrease in serum sodium (95% CI, -0.09 to -0.05; <i>P</i> < .001) for every milliliter per kilogram of positive FB and a 6% increase in the odds of sodium 132 mEq/L or less (95% CI, 1.03-1.08; <i>P</i> < .001). Term infants exhibited greater decreases in sodium levels than preterm infants. Infants who did not receive enteral feeds had more pronounced sodium decreases compared with those who were fed.</p><p><strong>Conclusion: </strong>Positive FB was common and strongly associated with hyponatremia in infants receiving standard IVF rates. These effects were most significant in term and unfed infants. Current fluid strategies may overestimate needs, particularly for term infants not receiving enteral feeds.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210693","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":"Influence of Community-Level Factors on Health Care Provider Recommendations for HPV Vaccine.","authors":"Mallory K Ellingson, Sean T O'Leary, Jason L Schwartz, Linda M Niccolai","doi":"10.1542/pedsos.2024-000263","DOIUrl":"10.1542/pedsos.2024-000263","url":null,"abstract":"<p><strong>Introduction: </strong>Parents who receive a recommendation for the human papillomavirus (HPV) vaccine from a health care provider (HCP) are more likely to accept vaccination for their children. HPV vaccine coverage varies widely by geography and community-level factors; however, little is known about how HCP recommendations for HPV vaccines vary at the community level. In this study, we examined the association between community-level factors and receipt of a recommendation for the HPV vaccine. We also examined the interaction between community-level factors and patient characteristics.</p><p><strong>Methods: </strong>We conducted a multilevel multivariable weighted logistic regression analysis of 2014 to 2019 National Immunization Survey-Teen (NIS-Teen) linked to 2010 US Census Bureau data at the zip code level.</p><p><strong>Results: </strong>Parents' report of receipt of a recommendation for the HPV vaccine was associated with higher population density (adjusted odds ratio [aOR], 1.20; 95% CI, 1.10-1.30), higher community-level education (aOR, 1.37; 95% CI, 1.23-1.52), and higher rates of unemployment (aOR, 1.14; 95% CI, 1.04-1.25). There was also a statistically significant interaction between adolescent race and ethnicity and zip code poverty status: non-white adolescents living in high-poverty zip codes were 1.16 times more likely (95% CI, 1.02-1.32) to have received an HCP recommendation for the HPV vaccine compared with non-white adolescents in low-poverty zip codes.</p><p><strong>Conclusions: </strong>Our findings indicate that evidence-based interventions that focus on HCPs or are practice based may have the greatest impact in nonurban areas. Efforts to promote vaccine recommendations to all age-eligible patients by HCPs will also promote more equitable coverage.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059456","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":"Opioid use disorder medications among youth in primary care: Subgroup analysis of the PROUD trial.","authors":"Laura J Chavez, Onchee Yu, Paige D Wartko, Jordan M Braciszewski, Joseph E Glass, Viviana E Horigian, Julia H Arnsten, Mark T Murphy, Angela L Stotts, Sarah M Bagley, Gwen T Lapham, Jeffrey H Samet","doi":"10.1542/pedsos.2024-000392","DOIUrl":"10.1542/pedsos.2024-000392","url":null,"abstract":"<p><strong>Objective: </strong>Medications for opioid use disorder (OUD) are under-utilized among adolescents and young adults (\"youth\"). Offering buprenorphine or naltrexone in primary care settings may reduce barriers to their use among youth. We conducted a secondary, patient-level analysis of the PROUD cluster-randomized clinical trial, which tested the implementation of a nurse care management intervention to support prescribing OUD medications.</p><p><strong>Methods: </strong>12 primary care clinics from 6 health systems were randomized in 2018 and patient-level data was collected from 2 years before to 2 years after randomization. The primary outcome was any OUD medication treatment (i.e., buprenorphine or extended-release injectable naltrexone) during the post-randomization period for youth ages 16-25 years.</p><p><strong>Results: </strong>A total of 20,253 youth ages 16-25 years were seen in intervention and 26,562 in usual care clinics during the study period. Comparing patients by clinic arm, we did not detect a statistically significant difference in the odds of receiving OUD medication treatment after randomization (odds ratio 1.75, 95% CI 0.63-4.89). Among the small number of patients (n=67) who received OUD medication after randomization, median treatment days were 81.5 days (IQR 30-177) and 64 days (IQR 24-206) in intervention or usual care clinics, respectively.</p><p><strong>Conclusions: </strong>We did not find evidence that implementing a primary care nurse care management model meaningfully increased OUD medication treatment among youth. In this special population, youth-centered approaches may be needed to promote prescribing and overcome known barriers to care, such as provider and patient hesitancy to use OUD medications.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736540","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":"Reducing Bias in Substance Use Detection in Adolescents Via Standardized Substance Use Screening.","authors":"Mariam Ranginwala, Mary V Greiner, Katie Fox, Jacqueline Unkrich, Sarah J Beal","doi":"10.1542/pedsos.2024-000157","DOIUrl":"10.1542/pedsos.2024-000157","url":null,"abstract":"","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784331","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":"Mitigation of Racial and Ethnic Differences in Chlamydia and Gonorrhea Testing.","authors":"Michelle L Pickett, Rachel Cafferty, Chella Palmer, T Charles Casper, Cara Elsholz, Andrea T Cruz, Kristin S Stukus, Cynthia J Mollen, Erin M Augustine, Jennifer L Reed, Monika K Goyal","doi":"10.1542/pedsos.2025-000513","DOIUrl":"10.1542/pedsos.2025-000513","url":null,"abstract":"<p><strong>Background and objectives: </strong>Minoritized adolescents have higher proportions of chlamydia (CT) and gonorrhea (GC) testing compared with their white peers. Interventions to mitigate bias in care delivery are needed. The objective of this study was to determine whether electronic health record (EHR)-integrated clinical decision support (CDS) mitigates differential testing of patients based on their race and ethnicity.</p><p><strong>Methods: </strong>This planned secondary analysis of a prospective pragmatic parent trial at 6 pediatric emergency departments compared targeted vs universally offered CT/GC testing in patients aged 15-21 years. Adolescents completed a tablet-based sexual health screen to determine CT/GC risk. During the targeted phase, CDS was based on the CT/GC risk assessment. During the universally offered phase, a patient's desire for CT/GC testing triggered EHR-embedded CDS. Racial and ethnic differences with respect to CT/GC testing were compared between phases using a logistic regression model.</p><p><strong>Results: </strong>During the baseline phase, almost all racial and ethnic groups were more likely to have CT/GC testing compared with non-Hispanic white patients, with the largest difference in non-Hispanic Black patients (adjusted odds ratio, 2.10; 95% CI, 1.83-2.41). Despite the CDS, there was no change in testing during the targeted phase, meaning differential CT/GC testing in minoritized groups persisted (<i>P</i> = .35). However, CDS did mitigate racial and ethnic differences in the universally offered phase, meaning all racial and ethnic groups had CT/GC testing at a similar proportion (<i>P</i> = .01).</p><p><strong>Conclusions: </strong>Universally offered CT/GC testing using an EHR-embedded CDS can mitigate racial and ethnic differences in CT/GC testing among adolescents in a pediatric emergency department.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021179","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":"Comparing Complex Chronic Conditions Versions to Identify Children With Medical Complexity.","authors":"Sriram Ramgopal, Julia A Heneghan, Christopher M Horvat, Carolyn M Foster","doi":"10.1542/pedsos.2024-000253","DOIUrl":"https://doi.org/10.1542/pedsos.2024-000253","url":null,"abstract":"","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280607","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":"Screening and Monitoring for Eating Disorders in Youth Presenting for Obesity Treatment.","authors":"Anna B Tanner, Lesley Williams, Andrea B Goldschmidt","doi":"10.1542/pedsos.2024-000333","DOIUrl":"10.1542/pedsos.2024-000333","url":null,"abstract":"","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061453","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":"Strategies for Improving Breastfeeding Rates: Perspectives of Public Health Staff.","authors":"Bryanne N Colvin, Mackenzie Cunningham, Emma Forbes, Chanel Peguero, Katherine Boguszewski, Marc T Kiviniemi, Fern R Hauck, Rachel Moon, Ann Kellams, Margaret G Parker, Eve R Colson","doi":"10.1542/pedsos.2024-000229","DOIUrl":"10.1542/pedsos.2024-000229","url":null,"abstract":"<p><strong>Objective: </strong>To inform development of a breastfeeding intervention for public assistance clients, we aimed, through qualitative methods, to explore public health staff members' perspectives of facilitators and barriers to initiating and continuing breastfeeding for clients and strategies to improve breastfeeding rates.</p><p><strong>Methods: </strong>We conducted focus groups with staff from Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Massachusetts and Virginia, US, to identify strategies WIC staff use to encourage and support breastfeeding, by leveraging facilitators and overcoming barriers, to inform the development of a breastfeeding intervention. Data collection and analysis followed an iterative process using constant comparison by a diverse group of researchers with expertise in qualitative methods. Focus groups were continued until thematic saturation was reached.</p><p><strong>Results: </strong>51 WIC staff members participated in 7 focus groups. Themes related to strategies used to promote breastfeeding included providing education, with subthemes relating to anticipatory guidance, normalization of breastfeeding, and the importance of tailored messaging; education format, with subthemes regarding timing of education and engagement of support networks; relationship building, including subthemes of establishing rapport and sharing personal experiences; and resource provision.</p><p><strong>Conclusions: </strong>WIC staff identified the importance of providing specific, concrete information about breastfeeding; strategies to breastfeed while working and caring for other children; the importance of connecting with clients to build trust; and increasing social support for breastfeeding clients. This study provided valuable information to help guide development of a breastfeeding intervention.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12582381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447094","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":"Prevalence of Abuse-Specific Injuries in Infants With Prior Injury Evaluated for Abuse.","authors":"Nara Cho, Kristin G Crichton, Sara Helwig, Krista K Wheeler, Rachel M Stanley, Megan M Letson, Kristine A Campbell, Angela N Bachim, Colleen J Bressler, Carmen M Coombs, Lori Frasier, Nicole Johnson, Sara Kilbride, Jan Leonard, Daniel M Lindberg, Noelle T Tran, Joanne N Wood, Farah W Brink","doi":"10.1542/pedsos.2025-000731","DOIUrl":"10.1542/pedsos.2025-000731","url":null,"abstract":"<p><strong>Background and objectives: </strong>Physical abuse is a common cause of morbidity in infants but is often missed in those with medically minor injuries, increasing the risk for escalating violence. Our objective was to compare the prevalence of abuse-specific injuries among infants with and without prior injuries.</p><p><strong>Methods: </strong>This is a retrospective, multicenter study of infants (aged <12 months) undergoing child abuse pediatrics provider (CAP) consultation for suspected physical abuse between 2/2021 and 12/2022 at 10 participating US centers. Encounters were dichotomized into those with and without history of prior injury. The groups were compared for rates of diagnostic screening and prevalence of abuse-specific injuries. The association of prior injuries with identification of abuse-specific injury was assessed using logistic regression controlling for demographics and presence of prior injury.</p><p><strong>Results: </strong>We identified 2352 eligible encounters (median age: 4.2 months), of which 13% had a history of prior injury. In infants who underwent diagnostic testing, injury identification was significantly higher in those with prior injury (45% vs 22%, <i>P</i> < .05). Adjusting for patient characteristics, the presence of prior injury in infants was associated with higher odds of at least 1 type of abuse-specific injury being identified, compared with those without prior injury (adjusted odds ratio = 2.81, 95% CI = 2.10-3.76).</p><p><strong>Conclusion: </strong>Infants with prior injury undergoing CAP evaluation for suspected physical abuse have higher odds of abuse-specific injuries compared with those without prior injury. This study emphasizes the importance of standardized history and evaluation in infants presenting with concerning injuries.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069618","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}