BMJ Paediatrics Open最新文献

{"title":"Hospitalisations for chronic conditions among care experienced and general population children and young people: evidence from the Children's Health in Care in Scotland (CHiCS) cohort study, 1990-2016.","authors":"Mirjam Allik, Edit Gedeon, Marion Henderson, Alastair Leyland","doi":"10.1136/bmjpo-2024-002705","DOIUrl":"10.1136/bmjpo-2024-002705","url":null,"abstract":"<p><strong>Objective: </strong>There is limited evidence on how the physical health of children and young people (CYP) who are care experienced (eg, in foster or out-of-home care) compares to the general population. UK research suggests that the prevalence of some chronic conditions may be similar for these groups.</p><p><strong>Design: </strong>We undertook longitudinal population-wide data linkage of social care, prescription and hospitalisation records for care experienced and general population CYP born 1990-2004, followed from birth to August 2016. We compared prevalence estimates for asthma, diabetes (type 1) and epilepsy between the cohorts and used Poisson and survival models to estimate the association between social care and hospitalisations for these conditions.</p><p><strong>Results: </strong>Care experience was not associated with a higher prevalence of asthma and diabetes, but epilepsy was more prevalent. Care was associated with increased hospitalisation rates for all three conditions, particularly for males. HRs for hospitalisations were highest before and after care and lower while the child was in care, for diabetes these were, respectively 1.88 (95% CI 1.28 to 2.77), 2.40 (95% CI 1.55 to 3.71) and 1.31 (95% CI 0.91 to 1.88) for care experienced CYP compared with general population.</p><p><strong>Conclusions: </strong>Hospitalisations for chronic conditions are higher among care experienced CYP, particularly for males, and outside care episodes. Families with children with chronic conditions should be offered support to manage these conditions and help keep families together. Higher hospitalisations after care suggest that care leavers should be provided more support to help manage their health.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicentre external validation of the Neonatal Healthcare-associated infectiOn Prediction (NeoHoP) score: a retrospective case-control study.","authors":"Lizel G Lloyd, Angela Dramowski, Adrie Bekker, Daynia Elizabeth Ballot, Cecilia Ferreyra, Birgitta Gleeson, Trusha Nana, Michael Sharland, Sithembiso Christopher Velaphi, Jeannette Wadula, Andrew Whitelaw, Mirjam Maria van Weissenbruch","doi":"10.1136/bmjpo-2024-002748","DOIUrl":"10.1136/bmjpo-2024-002748","url":null,"abstract":"<p><strong>Background and objectives: </strong>Neonatal mortality due to severe bacterial infections is a pressing global issue, especially in low-middle-income countries (LMICs) with constrained healthcare resources. This study aims to validate the Neonatal Healthcare-associated infectiOn Prediction (NeoHoP) score, designed for LMICs, across diverse neonatal populations.</p><p><strong>Methods: </strong>Prospective data from three South African neonatal units in the Neonatal Sepsis Observational (NeoOBS) study were analysed. The NeoHoP score, initially developed and validated internally in a South African hospital, was assessed using an external cohort of 573 sepsis episodes in 346 infants, focusing on different birth weight categories. Diagnostic metrics were evaluated, including sensitivity, specificity, positive predictive value and area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>The external validation cohort displayed higher median birth weight and gestational age compared with the internal validation cohort. A significant proportion were born before reaching healthcare facilities, resulting in increased sepsis evaluation, and diagnosed healthcare-associated infections (HAIs). Gram-negative infections predominated, with fungal infections more common in the external validation cohort.The NeoHoP score demonstrated robust diagnostic performance, with 92% specificity, 65% sensitivity and a positive likelihood ratio of 7.73. Subgroup analysis for very low birth weight infants produced similar results. The score's generalisability across diverse neonatal populations was evident, showing comparable performance across different birth weight categories.</p><p><strong>Conclusion: </strong>This multicentre validation confirms the NeoHoP score as a reliable 'rule-in' test for HAI in neonates, regardless of birth weight. Its potential as a valuable diagnostic tool in LMIC neonatal units addresses a critical gap in neonatal care in low-resource settings.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving children's oral health in Wales through partnership.","authors":"Andrew John Dickenson, Paul Brocklehurst, Anwen Cope, Mary Wilson","doi":"10.1136/bmjpo-2024-002989","DOIUrl":"10.1136/bmjpo-2024-002989","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment methods for oesophageal strictures in paediatric patients with epidermolysis bullosa: a systematic review.","authors":"Majid Khademian, Hosein Saneian, Narges Zare, Fatemeh Famouri, Peiman Nasri, Mehri Moghadasi, Roya Kelishadi","doi":"10.1136/bmjpo-2024-002689","DOIUrl":"10.1136/bmjpo-2024-002689","url":null,"abstract":"<p><strong>Background: </strong>Epidermolysis bullosa (EB) is a collection of rare, inherited disorders that require treatment in specialised centres by multidisciplinary teams knowledgeable about the unique features and challenges of EB manifestations and complications.A major gastrointestinal complication in patients with EB is oesophageal strictures. Effective management of oesophageal strictures can significantly improve patients' quality of life. This study systematically reviews the current literature on treatment options for oesophageal strictures in paediatric patients with EB.</p><p><strong>Methods: </strong>In September 2023, we conducted a systematic search for articles on the treatment of oesophageal stricture in patients with EB. We searched PubMed, Scopus, Embase and Ovid database without language or publication date restrictions. We screened 1042 articles, 15 of them were included in the current review. We extracted the following data from these studies: patient demographics, stricture characteristics, procedural details, clinical outcomes, complications and recurrences.</p><p><strong>Results: </strong>Overall, in the reviewed papers, strictures were located mostly in cervical oesophagus followed by thoracic lesions. Moreover, in most of the cases only a single stricture was reported, but multiple strictures were not uncommon. Stricture treatment approaches included medical management, bougienage, as well as fluoroscopic and endoscopic balloon dilation or a combination of these methods. In most studies, fluoroscopic dilation was used as the primary treatment method in 756 procedures. They commonly used general anaesthesia for the procedure, only one study used sedation. Hospital stays were usually brief, with an average duration of 1 day, and in one study patients were discharged after just 4 hours. Most patients experienced symptom relief, could resume oral intake and gained weight soon after the procedure. However, recurrence rates had large variations from 12% to 83%. Studies reported median recurrence intervals ranging from 7 to 18 months. This review showed that complications such as perforation, fever and odynophagia were relatively uncommon, and were controlled by conservative treatment.</p><p><strong>Conclusions: </strong>Both fluoroscopic and endoscopic balloon dilation are widely used methods for the management of oesophageal strictures in patients with EB. Each technique presents its own set of advantages and potential complications. Although the current evidence is notably limited, practical clinical decision-making may favour the fluoroscopic technique over endoscopic balloon dilation due to a comparatively reduced risk of procedural trauma. To ascertain the most effective approach, high-quality randomised controlled trials are imperative to delineate the superiority of one technique over the other.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and diagnostic accuracy of neonatal anthropometric measurements in identifying low birthweight and preterm infants in Africa: a systematic review and meta-analysis.","authors":"Fitsum Weldegebriel Belay, Rekiku Fikre, Akalewold Alemayehu, Andrew Clarke, Sarah Williams, Hannah Richards, Yohannes Chanyalew Kassa, Fanuel Belayneh Bekele","doi":"10.1136/bmjpo-2024-002741","DOIUrl":"10.1136/bmjpo-2024-002741","url":null,"abstract":"<p><strong>Background: </strong>Complications of prematurity are the leading cause of under-5 mortality globally and 80% of newborn deaths are of low birth weight (LBW) babies. Early identification of LBW and preterm infants is crucial to initiate timely interventions.</p><p><strong>Objective: </strong>To evaluate the feasibility and diagnostic accuracy of alternative neonatal anthropometric measurements in identifying LBW and preterm infants in Africa.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we evaluated the diagnostic performance of infant foot length, mid-upper arm circumference (MUAC), head and chest circumferences against birth weight and gestational age. Pooled correlation between the index and the reference methods was estimated. Multiple anthropometric thresholds were considered in estimating the pooled sensitivity, specificity and area under receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>21 studies from 8 African countries met the inclusion criteria. Correlation coefficients with birth weight were 0.79 (95% CI 0.70 to 0.85) for chest circumference, 0.71 (95% CI 0.62 to 0.78) for MUAC and 0.66 (95% CI 0.59 to 0.73) for foot length. Foot length measured by rigid ruler showed a higher correlation than tape measurement. Chest circumference with 28.8 cm cut-off detects LBW babies with AUC value of 0.92 (95% CI 0.71 to 0.97). Foot length identified preterm infants, with 82% sensitivity, 89% specificity and AUC of 0.91 (95% CI 0.69 to 0.98) at a 7.2 cm optimal cut-off point. MUAC had an AUC of 0.83 (95% CI 0.47 to 0.95) for preterm detection. In identifying LBW babies, foot length and MUAC have AUC values of 0.89 (95% CI 0.70 to 0.96) and 0.91 (95% CI 0.73 to 0.97) at 7.3 cm and 9.8 cm optimal cut-off points, respectively. Foot length and MUAC are relatively simple and minimise the risk of exposing infants to cold.</p><p><strong>Conclusion: </strong>Newborn foot length, MUAC, head and chest circumferences have comparable diagnostic accuracy in identifying LBW and preterm babies. Using foot length and MUAC in low-resource settings are the most feasible proxy measures for screening where weighing scales are not available.</p><p><strong>Prospero registration number: </strong>CRD42023454497.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of the COVID-19 pandemic on adolescent mental health in the Lombardy Region, Italy: a retrospective database review.","authors":"Antonio Clavenna, Massimo Cartabia, Ida Fortino, Maurizio Bonati","doi":"10.1136/bmjpo-2024-002524","DOIUrl":"10.1136/bmjpo-2024-002524","url":null,"abstract":"<p><strong>Background: </strong>Previous research has assessed the impact of the COVID-19 pandemic on adolescent mental health (MH). How the pandemic changed healthcare resource utilisation for MH conditions was investigated less, however, in particular in Italy.</p><p><strong>Methods: </strong>Data concerning outpatient visits in child and adolescent mental health services (CAMHSs), access to emergency departments (EDs), hospital admissions and drug prescriptions collected in administrative databases of the Lombardy Region, Italy, concerning adolescents 12-17 years old and occurring in the 2016-2021 period were analysed.Annual and monthly prevalence of healthcare (CAHMS/ED visits/hospital admissions) use for MH conditions and of psychotropic drug prescriptions were estimated. A negative binomial regression model was used to model the pre-pandemic monthly number of prevalent cases by gender. The total number of pandemic (1 March 2020 to 31 December 2021) cases predicted from the model was compared with the number of observed cases.</p><p><strong>Results: </strong>The overall annual rate of healthcare service utilisation slightly increased in the 2016-2019 period (from 63.8‰ to 67.8‰), decreased in 2020 (57.1‰) and returned to values similar to 2016 (64.9‰) the following year. A 2% relative increase was observed in girls, and a 10% decrease in boys, when comparing the prevalence in 2021 with that in 2019. Differences between genders were particularly evident for ED attendance, with an observed/predicted cases ratio in 2021 of 0.81 (95% CI 0.79 to 0.83) in boys, and 1.18 (95% CI 1.16 to 1.20) in girls, and for psychotropic drug prescriptions (0.83 (95% CI 0.82 to 0.84) and 1.24 (95% CI 1.23 to 1.25), respectively).</p><p><strong>Conclusions: </strong>The current study confirms that the use of health services for MH conditions during the COVID-19 pandemic increased among adolescent girls but decreased among boys, and that gender differences emerged in the MH impact of the pandemic.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand-Myanmar border.","authors":"Germana Bancone, Mary Ellen Gilder, Elsie Win, Gornpan Gornsawun, Paw Khu Moo, Laypaw Archasuksan, Nan San Wai, Sylverine Win, Borimas Hanboonkunupakarn, Francois Nosten, Verena Ilona Carrara, Rose McGready","doi":"10.1136/bmjpo-2024-002754","DOIUrl":"10.1136/bmjpo-2024-002754","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hyperbilirubinaemia (NH) is a common problem worldwide and is a cause of morbidity and mortality especially in low-resource settings.</p><p><strong>Methods: </strong>A study was carried out at Shoklo Malaria Research Unit (SMRU) clinics along the Thailand-Myanmar border to evaluate a non-invasive test for diagnosis of NH in a low-resource setting. Performance of a transcutaneous bilirubinometer Dräger Jaundice Meter JM-105 was assessed against routine capillary serum bilirubin testing (with BR-501 microbilirubinometer) before phototherapy during neonatal care in the first week of life. Results were analysed by direct agreement and by various bilirubin thresholds used in clinical practice. Total serum bilirubin was also measured in cord blood at birth and tested for prediction of hyperbilirubinaemia requiring phototherapy in the first week of life.</p><p><strong>Results: </strong>Between April 2020 and May 2023, 742 neonates born at SMRU facilities were included in the study. A total of 695 neonates provided one to nine capillary blood samples for analysis of serum bilirubin (total 1244 tests) during the first week of life. Performance of transcutaneous bilirubinometer was assessed in 307 neonates who provided 687 paired transcutaneous capillary blood tests. Bilirubin levels were also measured in 738 cord blood samples. Adjusted values of transcutaneous bilirubinometer showed excellent agreement with capillary serum bilirubin concentration (intraclass correlation coefficient=0.923) and high sensitivity (>98%) at all clinical thresholds analysed across 3 years of sampling and multiple users. Concentrations of bilirubin detected in cord blood were not useful in identifying neonates at risk of hyperbilirubinaemia requiring treatment.</p><p><strong>Conclusions: </strong>The transcutaneous bilirubinometer is a reliable tool to screen neonates and identify those needing confirmatory blood testing. Bilirubin concentrations in cord blood are not predictive of hyperbilirubinaemia in neonates.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, symptomatology and factors associated with asthma in adolescents aged 13-14 years from rural Sri Lanka: an analytical cross-sectional study.","authors":"Tharusha Chamanthi Siriwardhana, Vimansha Sumanapala, Thiweda Subhanee, Savithri Sulakkhana, Periyasami Sivabalan Sridharan, Sajeewa Thennakoon, Shashanka Rajapakse","doi":"10.1136/bmjpo-2024-002907","DOIUrl":"10.1136/bmjpo-2024-002907","url":null,"abstract":"<p><strong>Background: </strong>Asthma is the most common chronic disease affecting children. However, the epidemiology of asthma in adolescents from rural geographies is lacking.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted in secondary schools located in the municipal council area of the rural district of Anuradhapura, Sri Lanka. Random sampling was used to select 32 grade 8 classes from 6 out of 9 schools. The prevalence and symptomatology of asthma were determined using the validated International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire and asthma symptom control using the asthma control test (ACT) translated into Sinhalese.</p><p><strong>Results: </strong>The study sample consisted of 1029 participants aged 13-14 years, including 528 (51.3%) boys and 501 (48.7%) girls. The prevalence of wheeze ever, current wheeze and wheeze while playing was 32.6% (n=335), 23.7% (n=244) and 25.2% (n=259), respectively. The prevalence of parent-reported physician-diagnosed asthma was 19.0% (n=196; 95% CI 16.7 to 21.6). Severe asthma was reported by 157 (15.3%; 95% CI 13.1 to 17.6) adolescents. The independent factors associated with severe asthma were sleeping on a cloth laid on the floor instead of a bed (p<0.02, adjusted-OR 9.72; 95% CI 1.56 to 60.78), cooking using sawdust (p=0.04, adjusted-OR 8.71; 95% CI 1.10 to 68.69) eczema (p<0.01; adjusted-OR 7.39; 95% CI 3.34 to 16.39) and allergic rhinitis (p<0.01; adjusted-OR 5.50; 95% CI 3.80 to 7.98). While having a cemented floor in the house (p<0.04; adjusted-OR 0.68; 95% CI 0.47 to 0.99) was a protective factor. Poor control of asthma symptoms was detected in 29 (29.9%) adolescents which was associated with comorbid allergic rhinitis (p<0.01; unadjusted-OR 5.40; 95% CI 1.84 to 15.82).</p><p><strong>Conclusion: </strong>Almost one in four adolescents had current wheeze, and 15.3% had severe asthma. Severe asthma was independently associated with allergic rhinitis, eczema, cooking using sawdust as fuel and sleeping on a cloth on the floor instead of a bed. Poor symptom control was found in 29.9% of severe asthmatics which was associated with comorbid allergic rhinitis.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal analysis of the association between Kawasaki disease incidence and PM_2.5 exposure: a nationwide database study in Japan.","authors":"Kota Yoneda, Daisuke Shinjo, Naoto Takahashi, Kiyohide Fushimi","doi":"10.1136/bmjpo-2024-002887","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002887","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease (KD) is an acute vasculitis primarily affecting children. While some studies suggest a link between KD and PM_2.5 exposure, findings remain inconsistent. This study aimed to perform spatiotemporal analysis to investigate the impact of monthly and annual exposure to PM_2.5 and other air pollutants on the incidence of KD before and after the advent of the COVID-19 pandemic.</p><p><strong>Methods: </strong>In this retrospective analysis, we used the Japanese administrative claims database to identify the incidence of KD in children under age 5 in 335 secondary medical care areas across Japan before (from July 2014 to December 2019) and during (from January 2020 to December 2021) the COVID-19 pandemic. For each of these periods, we developed hierarchical Bayesian models termed conditional autoregressive (CAR) models that can address the spatiotemporal clustering of KD to investigate the association between the monthly incidence of KD and exposure to PM_2.5, NO, NO₂ and SO₂ over 1-month and 12-month durations. The pollution data were collected from publicly available data provided by the National Institute for Environmental Studies.</p><p><strong>Results: </strong>In the before-pandemic and during-pandemic periods, 55 289 and 14 023 new cases of KD were identified, respectively. The CAR models revealed that only 12-month exposure to PM_2.5 was consistently correlated with KD incidence, and each 1 µg/m³ increase in annual PM_2.5 exposure corresponded to a 3%-10% rise in KD incidence. Consistent outcomes were observed in the age-stratified sensitivity analysis.</p><p><strong>Conclusions: </strong>Annual exposure to PM_2.5 was robustly linked with the onset of KD. Further research is needed to elucidate the underlying mechanism by which the spatiotemporal distribution of PM_2.5 is associated with KD.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal encephalopathy: a systematic review of reported treatment outcomes.","authors":"Fiona Quirke, Linda Biesty, Malcolm Battin, Frank Harry Bloomfield, Mandy Daly, Elaine Finucane, Patricia Healy, Tim Hurley, Jamie J Kirkham, Eleanor Molloy, David M Haas, Shireen Meher, Elaine Ní Bhraonáin, Karen Walker, James Webbe, Declan Devane","doi":"10.1136/bmjpo-2024-002510","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002510","url":null,"abstract":"<p><strong>Background: </strong>Neonatal encephalopathy (NE) is a multi-organ condition potentially leading to death or long-term neurodisability. Therapeutic hypothermia is the standard treatment for NE; however, long-term impairments remain common. Studies of new treatments for NE often measure and report different outcomes. Core outcome sets (COSs), a minimum set of outcomes to be measured and reported in all studies for a condition, address this problem. This paper aimed to identify outcomes reported (primary, secondary, adverse events and other reported outcomes) in (1) randomised trials and (2) systematic reviews of randomised trials of interventions for the treatment of NE in the process of developing a COS for interventions for the treatment of NE.</p><p><strong>Methods: </strong>We completed a systematic search for outcomes used to evaluate treatments for NE using MEDLINE, Embase, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews and the WHO International Clinical Trials Registry Platform. Two reviewers screened all included articles independently. Outcomes were extracted verbatim, similar outcomes were grouped and outcome domains were developed.</p><p><strong>Results: </strong>386 outcomes were reported in 116 papers, from 85 studies. Outcomes were categorised into 18 domains. No outcome was reported by all studies, a single study reported 11 outcomes and it was not explicitly stated that outcomes had input from parents.</p><p><strong>Discussion: </strong>Heterogeneity in reported outcomes means that synthesis of studies evaluating new treatments for NE remains difficult. A COS, that includes parental/family input, is needed to ensure consistency in measuring and reporting outcomes, and to enable comparison of randomised trials.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"8 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}