Journal of Pediatrics最新文献

{"title":"Creation of a Novel Longitudinal Pediatrics Resident Curricular Program Addressing the Medical and Social Needs of Children with Medical Complexity.","authors":"Lucas Bruton, Michael Spewak, Jennifer Grage, Joely Mass, Carolyn Foster, Mary E McBride","doi":"10.1016/j.jpeds.2025.114751","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114751","url":null,"abstract":"<p><strong>Objective: </strong>To implement a newly created, longitudinal resident program for the comprehensive care of children with medical complexity (CMC) and to evaluate change in resident confidence in both medical and social domains.</p><p><strong>Study design: </strong>Using Kern's six-step method of curriculum development, we developed and implemented a curricular program at our institution for all pediatrics residents across an academic year from 2023-2024. Program evaluation used retrospective pre- and post-surveys of pediatrics residents assessing overall confidence in completing tasks related to the care of CMC based on published entrustable professional activities.</p><p><strong>Results: </strong>Initial needs assessment data showed that 69.7% of residents felt comfortable/very comfortable caring for CMC in the hospital. In the outpatient setting, >66.7% felt uncomfortable/very uncomfortable and 78.8% were overall uncomfortable. Retrospective pre- and post-surveys showed improved resident confidence in all 14 assessed tasks with a mean change of 0.63 as measured using a five-point Likert scale, with a P value of <0.01 for all changes.</p><p><strong>Conclusion: </strong>A novel, integrated, longitudinal curricular program addressing medical and social aspects of CMC care grounded in adult-learning theory and conceptual frameworks was associated with significant improvements in resident confidence.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114751"},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor.","authors":"Adriana H Tremoulet, Irene Bellicini, Emelia Bainto, Chisato Shimizu, Jane C Burns","doi":"10.1016/j.jpeds.2025.114731","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114731","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114731"},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing Subgaleal Hemorrhage in Neonates.","authors":"Erin E Clark, Eric K Zwemer, Rachel Levy","doi":"10.1016/j.jpeds.2025.114747","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114747","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114747"},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Introduction to Systematic Review and Meta-Analysis for Pediatric Research.","authors":"Sixia Chen, Michael P Anderson","doi":"10.1016/j.jpeds.2025.114726","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114726","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114726"},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head Growth in Infants with Benign Expansion of Subarachnoid Spaces versus Macrocephaly.","authors":"Sasidhar Karuparti, Ashlynn Lizer, Farrell Landwehr, Francisco Narro Garcia, Gabrielle Johnson, Gretchen Koller, Diane Aum, Ali Mian, Jennifer M Strahle","doi":"10.1016/j.jpeds.2025.114743","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114743","url":null,"abstract":"<p><strong>Objective: </strong>To examine head growth in macrocephalic infants with benign expansion of subarachnoid spaces (BESS) relative to those without imaging abnormalities and WHO standard curves.</p><p><strong>Study design: </strong>Patients with macrocephaly who underwent intracranial imaging at St. Louis Children's Hospital between 2012-2022 were identified via radiology records search. Records were retrospectively reviewed to identify patients with isolated macrocephaly (without intracranial abnormalities) and BESS (defined by macrocephaly and concurrent imaging diagnosis of BESS by neuroradiology). Nonlinear least-squares regression of HC by cohort and gender was performed and compared with WHO curves.</p><p><strong>Results: </strong>Infants with macrocephaly and BESS (n=159, 29% female) and macrocephaly without BESS (n=152, 28% female) were included. Infants with BESS have larger HCs than the WHO 97^th-percentile curve (male: P=0.0032, female: P<0.001) as well as infants with isolated macrocephaly (male: P=0.0095, female: P<0.001). Ventricle size (estimate: 1.751; 95% CI -0.728-4.230, P=0.102), but not subarachnoid space (estimate: -0.057; 95% CI -0.697-0.583, P=0.861), appeared to be positively associated with HC z-score, but was not significant. HC rate of change >0.043 cm/day at 5-7 months of age was 82% specific (95% CI 70.0-92.0) for BESS.</p><p><strong>Conclusions: </strong>Infants with BESS have different head growth trajectories compared infants with isolated macrocephaly as well as WHO curves. This study provides preliminary insights into head growth in BESS and may help identify patients more likely to have BESS among those presenting with macrocephaly.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114743"},"PeriodicalIF":3.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Effects on Child Health from US Retrenchment on Global Scientific Collaboration: Examples from Gastroenterology, Hepatology, and Nutrition.","authors":"Christopher P Duggan","doi":"10.1016/j.jpeds.2025.114744","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114744","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114744"},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Expert Vocabulary Usage Patterns between Mental Health and Non-Mental Health Clinicians When Diagnosing Pediatric Anxiety Disorders.","authors":"Mayanka Chandra Shekar, Jordan Tschida, Jeffrey R Strawn, Heidi A Hanson, Daniel Santel, Ian Goethert, Anuj J Kapadia, Tracy Glauser, John Pestian, Greeshma A Agasthya","doi":"10.1016/j.jpeds.2025.114735","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114735","url":null,"abstract":"<p><strong>Objective: </strong>To compare the utilization patterns of expert vocabulary (EVo) in diagnosing pediatric anxiety between mental health and non-mental health clinical notes from electronic health records (EHR) to understand the role of Evo in informing classification and decision-making in anxiety diagnoses.</p><p><strong>Study design: </strong>We conducted a retrospective study using a cohort less than age 25 from Cincinnati Children's Hospital including 897,685 patients with 61,586,446 notes. We analyzed EVo, collected from mental health clinicians, in both mental and non-mental health notes. We compared classification accuracy using EVo-based patient-level embedding from all clinical notes, mental-health notes, and non-mental health notes for two tasks: 1) pre- vs post-diagnosis anxiety patients, and 2) pre-diagnosis anxiety vs non-anxiety patients.</p><p><strong>Results: </strong>EVo usage was highest in pre-diagnosis anxiety, lower in non-anxiety, and lowest in post-diagnosis. Classification models using EVo features from all, mental-health, and non-mental health notes showed similar F1 scores for pre-diagnosis anxiety (0.70 ± 0.2 for two categories). For anxiety vs non-anxiety classification, all clinical and non-mental health notes had better F1 scores than mental-health notes (above 0.90 for three categories). There was a notable difference in class-wise performance across both tasks.</p><p><strong>Conclusion: </strong>There are significant differences in anxiety EVo use between mental health and non-mental health clinicians. Despite less anxiety-specific terminology, non-mental health notes still captured key aspects of patient presentations, emphasizing the importance of including all clinicians' notes in analysis. EVo's utility for anxiety classification is most effective in pre-diagnostic phases, suggesting the need for a dedicated diagnostic lexicon and further study before incorporating EVo into classification models.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114735"},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclosporine in Kawasaki Disease: Addressing Limitations and Future Directions.","authors":"Moein Ashouri, Mahan Khani","doi":"10.1016/j.jpeds.2025.114729","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114729","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114729"},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the Neonatal Workforce: Why the Future of Neonatal Care Depends on Investing in NNPs.","authors":"Jessica Jones, William L Hull, Meredith Farmer","doi":"10.1016/j.jpeds.2025.114730","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114730","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114730"},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Electroencephloagram in Infants born Moderate to Late Preterm and Association with Subsquent Neurodevelopment.","authors":"Soraia Ventura, Mary Anne Ryan, Sean R Mathieson, Vicki Livingstone, John M O'Toole, Geraldine B Boylan","doi":"10.1016/j.jpeds.2025.114728","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114728","url":null,"abstract":"<p><strong>Objectives: </strong>To compare among infants born moderate to late preterm (MLP) and full-term their neurophysiological sleep patterns on electroencephalogram (EEG) and to evaluate the association of sleep EEG findings with subsequent neurodevelopment.</p><p><strong>Study design: </strong>Infants enrolled at Cork University Maternity Hospital underwent a daytime sleep EEG at 4 months and Griffiths III developmental assessment at 18 months corrected age. Sleep spindles were manually annotated. Sleep macrostructure (ie, total sleep and sleep stages durations, and latencies to sleep and REM) was assessed. EEG spectral power and coherence were quantified. These features were compared between groups. Associations between sleep features differing between groups and Griffiths III scores were investigated.</p><p><strong>Results: </strong>The mean (SD) gestational ages for infants born MLP (30/59 females) and term (40/96 females) were 34.5 (1.3) and 39.8 (1.2) weeks, respectively. Both groups showed similar sleep spindle features. Infants born MLP had shorter stage N2 sleep duration (MLP: median [IQR] of 2.75 [1.88-4.63]; term-born: 4.50 [2.50 to 6.50] minutes, P<0.001), had higher NREM power on delta 1 (MLP: 702.49 [557.46-840.67] μV²; term-born: 593.34 [449.21-749.36] μV², P=0.011] and delta 2 (MLP: 245.31 [194.17-327.77] μV², term-born: 215.32 [164.78-283.39] μV², p=0.028) and diverging coherence. NREM delta 1 and 2 spectral power were positively associated with personal-social-emotional development (partial Spearman correlation (r_s)=0.25, P=0.009 and r_s=0.25, P=0.011, respectively) and gross motor development (r_s=0.21, P=0.028 and r_s=0.20, P=0.036, respectively). Some parameters of intra- and inter-hemispherical coherence were also correlated with Griffiths III subscales of development.</p><p><strong>Conclusions: </strong>Analyzing multiple sleep EEG features at 4 months corrected age, we identified alterations in sleep biomarkers of infants born MLP, likely reflecting early differences in brain organization and function. These different sleep features in infants born MLP compared with those at term may indicate divergent trends in brain maturation.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114728"},"PeriodicalIF":3.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}