BMC Pediatrics最新文献

{"title":"Evaluating the therapeutic efficacy of a modified ketogenic diet in children with autism spectrum disorder: a randomized controlled trial.","authors":"Le Liu, Qingsong Zhao, Jing Zhou, Zhi Liu, De Wu, Kaiyin He","doi":"10.1186/s12887-026-07708-3","DOIUrl":"10.1186/s12887-026-07708-3","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder marked by persistent impairments in social communication and interaction, together with restricted and repetitive behavior or interests. Recent epidemiological data indicate that the prevalence of ASD has continued to increase worldwide. Current behavioral and pharmacological interventions remain limited in efficacy, particularly for associated comorbidities. In this context, metabolic interventions, especially the ketogenic diet (KD), have attracted growing interest as a potential therapeutic strategy.</p><p><strong>Methods: </strong>A total of 62 young children with ASD admitted to Hefei Maternal and Child Health Hospital between January 2024 and January 2025 were prospectively enrolled and randomly assigned to a treatment group or a control group (31 per group). Both groups underwent hospital-based rehabilitation training on weekdays and home-based rehabilitation on weekends over a 2-month period. The treatment group additionally received a modified KD, comprising ketogenic nutritional powder and a structured dietary plan, with lunch provided at the hospital on training days while breakfast, dinner, weekend dietary implementation, and home monitoring were managed by caregivers. The control group followed a regular diet along with the same rehabilitation program. Changes in ASD-related symptoms were assessed using the Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS).</p><p><strong>Results: </strong>After two months of intervention, both groups showed significant reductions in ABC and CARS scores compared with baseline (P < 0.05). Between-group comparison of individual change scores showed larger reductions in the treatment group for both ABC (U = 324.000, P = 0.027) and CARS (U = 273.500, P = 0.003).</p><p><strong>Conclusions: </strong>In this cohort of young children with ASD, the modified ketogenic diet combined with rehabilitation training was associated with greater short-term reductions in ABC and CARS scores than rehabilitation alone. The intervention demonstrated acceptable short-term feasibility.</p><p><strong>Trial registration: </strong>The Project was registered on China Clinical Trial Registry (ChiCTR) with the identifier ChiCTR2300075057 ,Registered 24 August 2023, https://www.chictr.org.cn/ .</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do the measurement properties of the broad-band scales for attention-deficit/hyperactivity disorder in children perform based on the COSMIN guidelines?","authors":"Yueyue Chen, Qiuhan Cai, Siyuan Hu, Zehui Zhao, Jixuan Wang, Liqing Niu","doi":"10.1186/s12887-026-07661-1","DOIUrl":"10.1186/s12887-026-07661-1","url":null,"abstract":"<p><strong>Background: </strong>This study systematically evaluated the measurement properties of ADHD-relevant subscales (i.e., subscales measuring inattention and/or hyperactivity-impulsivity) embedded within broad-band behavior rating scales for children with ADHD, using the COSMIN methodology. The aim was to provide evidence-based support for clinical screening, co-occurring assessment, and treatment monitoring.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, we conducted a systematic literature search across PubMed, Web of Science, Scopus, and ProQuest. Risk of bias and measurement properties were assessed with the COSMIN Risk of Bias Checklist and Updated Criteria for Good Measurement Properties, respectively. Evidence synthesis was performed through an adapted GRADE approach.</p><p><strong>Results: </strong>Thirty-six studies, covering 12 broad-band instruments, were included. The CBCL Attention Problems subscale was rated as \"not recommended\" due to insufficient cross-cultural validity (high quality evidence). The SDQ Hyperactivity-Inattention subscale demonstrated the most favorable evidence profile, with moderate quality evidence for structural validity and internal consistency, and high quality evidence for cross-cultural validity, reliability, and convergent/discriminant validity. The CADBI Inattention and Hyperactivity/Impulsivity subscales showed high quality evidence for structural and cross-cultural validity, and moderate quality evidence for internal consistency. The FTF Attention and Hyperactive/Impulsive subscales had moderate quality evidence for structural validity and internal consistency. The CABI Attention Deficit and Hyperactivity subscale had high quality evidence for reliability, but low quality evidence for structural validity and internal consistency. The remaining instruments (ANSER-PQ, CBAI, ECI-4, YI-4, DSMD, ABC, CSI-4) had limited or unsatisfactory evidence for their ADHD-related subscales.</p><p><strong>Conclusions: </strong>Among the included broad-band instruments, given the evidence of insufficient cross-cultural validity, applying the COSMIN criteria to the CBCL Attention Problems subscale would lead to a recommendation against its use; users outside North America should be cautious. The SDQ Hyperactivity-Inattention subscale demonstrates comparatively favorable measurement properties, though this does not establish its overall superiority for ADHD assessment. Future studies should evaluate content validity, measurement error, and responsiveness following COSMIN guidelines.</p><p><strong>Trial registration: </strong>PROSPERO (CRD420250655032).</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a digi-physical tool and working method for paediatric obesity treatment in Abu Dhabi: a non-inferiority intervention study using an external historical comparator.","authors":"Louise Lindberg, Reem Hassan Beck, Pernilla Danielsson, Timmy Nielsen, Asmahan Abdalla, Peter Ekstedt, Deepti Chaturvedi, Nabras Al Qahtani, Claude Marcus, Asma Deeb","doi":"10.1186/s12887-026-07623-7","DOIUrl":"10.1186/s12887-026-07623-7","url":null,"abstract":"<p><strong>Background: </strong>Effective paediatric obesity treatment requires high intensity, scalable interventions. A digi-physical tool for paediatric obesity treatment has shown positive results in Stockholm, Sweden. This study evaluates whether the same treatment method is effective in a different cultural setting.</p><p><strong>Methods: </strong>This non-inferiority intervention study, using an external historical comparator, included 60 consecutively recruited children aged 6-15.9 years with obesity who initiated treatment at Sheikh Shakhbout Medical City in Abu Dhabi between June and December 2023. Patients were treated with Evira, a digi-physical tool and working method enabling high intensity individualized care, real-time monitoring, and interactive patient-clinician communication. The primary outcome was BMI z-score change at 26 weeks. Non-inferiority was assessed using a predefined margin of 0.10 BMI z-score, with outcomes compared to a prior published trial in Stockholm (n = 107).</p><p><strong>Results: </strong>A total of 112 children were included in the analysis (Abu Dhabi cohort, n = 35; Stockholm cohort, n = 77). The adjusted mean change in BMI z-score was - 0.20 (95% CI: - 0.28, - 0.12) in the Abu Dhabi cohort and - 0.20 (- 0.26, - 0.14) in the Stockholm cohort (p = 0.88). Non-inferiority was confirmed, (predefined margin 0.10 was not exceeded). A clinically significant BMI z-score reduction (≥ 0.20 units) was achieved by 45.7% of participants in Abu Dhabi and 36.4% in Stockholm (p = 0.35). Non-retention rates at 26 weeks were 41.7% vs. 28.0%, respectively (p = 0.07).</p><p><strong>Conclusions: </strong>The findings provide promising evidence that treatment outcomes achieved with the digi-physical treatment tool were comparable in the Abu Dhabi and Stockholm cohorts, supporting its feasibility in a second cultural and healthcare setting.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal carbon dioxide removal integrated into continuous renal replacement therapy in pediatric patients with ARDS: a retrospective single-center case series.","authors":"Martin Kuntz, Daniel Matheisl, Isabel Schüle, Daniel Klotz, Hans Fuchs, Hendryk Schneider","doi":"10.1186/s12887-026-07656-y","DOIUrl":"10.1186/s12887-026-07656-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Extracorporeal carbon dioxide removal (ECCO₂R) may facilitate lung-protective ventilation in children with pediatric acute respiratory distress syndrome (PARDS), but pediatric experience remains limited. We aimed to descriptively characterize the clinical use, physiological changes, technical implementation, and observed complications of ECCO₂R integrated into continuous renal replacement therapy (CRRT) in pediatric patients with PARDS and acute kidney injury (AKI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective, uncontrolled, single-center case series of pediatric patients with PARDS and AKI who received ECCO₂R integrated into an already indicated CRRT circuit between November 2023 and November 2025. To avoid non-independence of repeated observations, the first treatment episode per patient was included in the principal analysis (n = 7). Predefined physiological outcomes were assessed longitudinally at predefined time points. Longitudinal changes were analyzed using Friedman tests. Safety-related laboratory parameters were analyzed using Wilcoxon matched-pairs signed-rank tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Median age was 12 years (interquartile range [IQR] 6-14 years). ECCO₂R was delivered at a median blood flow of 270 mL/min (IQR 100-300), corresponding to 9% (IQR 6-20%) of the estimated cardiac output. Friedman analysis demonstrated significant longitudinal improvements in all predefined principal physiological outcomes, including arterial carbon dioxide tension (PaCO₂), peak inspiratory pressure (PIP), driving pressure (ΔP), and tidal volume (Vt) (all P &lt; 0.05). Median absolute changes from baseline to 24 h were - 10 mmHg (IQR - 27 to - 3) for PaCO₂, - 11 mbar (IQR - 14 to - 4) for PIP, - 9 mbar (IQR - 18 to - 6) for ΔP, and - 1.6 mL/kg (IQR - 3.6 to - 0.3) for Vt. Four patients were successfully weaned from ECCO₂R. No predefined major bleeding, clinically apparent hemolysis, thromboembolic complications, or device-related infections attributable to ECCO₂R-CRRT were identified; circuit clotting requiring circuit exchange occurred in two patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Integration of ECCO₂R into an already indicated CRRT circuit was technically feasible and temporally associated with reductions in PaCO₂ and ventilatory pressures in this cohort. Although these descriptive findings should be regarded as hypothesis-generating rather than evidence of treatment efficacy or device safety, they suggest that integrated ECCO₂R-CRRT may represent a pragmatic adjunctive support strategy in carefully selected pediatric patients requiring CRRT. Prospective multicenter studies are needed to better define patient selection, anticoagulation strategies, weaning protocols, and the role of integrated ECCO₂R-CRRT within pediatric extracorporeal respiratory support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;German Clinical Trials Register (DRKS), DRKS00038799; retrospectively registered on April 23, ","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric trauma mortality at a level 1 trauma centre: a retrospective case series at Karolinska University Hospital, Stockholm.","authors":"Ammar Yaqoob, Shahzad Akram","doi":"10.1186/s12887-026-07618-4","DOIUrl":"10.1186/s12887-026-07618-4","url":null,"abstract":"<p><p>Paediatric trauma mortality is uncommon in well-resourced systems, limiting clinical exposure and necessitating system-level learning through detailed review of individual deaths. This retrospective descriptive case series characterises paediatric trauma deaths following trauma-call activation at Karolinska University Hospital (KUH), Stockholm, Sweden's primary level 1 trauma centre, between 2016 and 2025. Eligible cases were patients aged 0-17 years who triggered trauma-team activation, were entered into the Karolinska Trauma Registry, and died within 30 days of injury.Among 1,792 paediatric trauma-call activations, 28 patients died, corresponding to a 30-day case fatality rate of 1.6% among activated trauma patients. The cohort comprised 16 males and 12 females (median age 15), and critical injury severity (New Injury Severity Score [NISS] ≥ 25) was observed in 25 of 26 cases.Penetrating trauma accounted for most deaths (15/28), mainly stabbings and gunshot wounds; assault was recorded in half of cases, and prehospital cardiac arrest occurred in 17 patients. Isolated head injury was the most common injury pattern (12/28, 42.9%), followed by thoracoabdominal injury (4/28, 14.3%). The leading recorded causes of death were haemorrhagic shock (14/28, 50.0%) and traumatic brain injury (12/28, 42.9%); cause of death was unavailable in 2 cases (7.1%).Fatal paediatric trauma following trauma-call activation was rare but characterised by severe injury and a substantial burden of violence-related penetrating trauma. The reported case fatality rate applies only to trauma-call activations captured in the registry and should not be interpreted as mortality among all injured children in the region. Detailed case-level review may support clinical audit, service evaluation, and prevention strategies targeting interpersonal violence among children and adolescents.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal study on differential impacts of the COVID-19 pandemic and normalized prevention and control on overweight and obese adolescents in China.","authors":"Yulituzeayi Maitituersun, Ran Su, Guan Yang, Alimujiang Yimiti Taerken","doi":"10.1186/s12887-026-07558-z","DOIUrl":"10.1186/s12887-026-07558-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic and its subsequent normalized prevention and control phase on the body mass index (BMI) and prevalence of overweight and obesity among adolescents aged 13-18 years in China, providing a basis for formulating growth and development intervention strategies in the post-pandemic era.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using a random cluster sampling method, 120,459 adolescents aged 13-18 years from 15 junior and senior high schools across 4 districts/prefectures in Xinjiang, China, were selected as study subjects based on geographical distribution characteristics from 2017 to 2021. Height and weight were measured in strict accordance with the National Student Physical Health Standard, and physical status was classified into underweight, normal weight, overweight, obesity, and combined \"overweight+obesity\" based on BMI. Relevant data were analyzed using normality tests, one-way ANOVA, χ² test, and binary logistic regression, accounting for the clustered sampling design. The significance level was set as 5%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean BMI of adolescents aged 13-18 years in 2020 increased significantly by 0.2 kg/m² compared with previous years, while showing a declining trend in 2021 (F=104.862, P&lt;0.001). BMI changes exhibited gender and age differences, with girls showing greater fluctuation than boys (F = 114.950, 30.063, both P &lt; 0.001). Statistically significant differences were also observed across all age groups (all P &lt; 0.05). Detection rates of nutritional status categories showed: compared with 2017-2019, the underweight rate decreased to 10.6% in 2020, while overweight and \"overweight+obesity\" rates increased to 9.5% and 12.0%, respectively (both P&lt;0.05); compared with 2020, the underweight rate rebounded to 13.9% in 2021, while overweight and \"overweight+obesity\" rates decreased to 8.0% and 10.7%, respectively (both P&lt;0.05), with particularly significant changes observed in girls and the 13-15-year-old group. Logistic regression analysis (with 2017 as reference) indicated that in 2020, the risk of underweight decreased (OR=0.668, 95% CI: 0.633-0.706), while the risks of overweight (OR=1.280, 95% CI: 1.199-1.366) and \"overweight+obesity\" (OR=1.364, 95% CI: 1.286-1.448) increased; in 2021, the risk of underweight increased (OR=0.917, 95% CI: 0.872-0.965), while the risk of \"overweight+obesity\" decreased (OR=1.201, 95% CI: 1.131-1.275), with these associations being more pronounced in girls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The initial stage of the COVID-19 pandemic was associated with a significant negative impact on the weight status of Chinese adolescents aged 13-18 years, manifested by increased BMI and elevated detection rates of overweight and obesity. As prevention and control entered a normalized phase, this impact gradually diminished, with weight distribution showing a tendency to return to pre-pandemic status. Futu","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a clinical prediction model for gastrointestinal hemorrhage in pediatric IgA vasculitis.","authors":"Rong-Jie Li, Xiang Yun, Qing Tang, Li Huang, Lian Cheng Lan, Xiu-Qi Chen, Qing-Wen Shan","doi":"10.1186/s12887-026-07547-2","DOIUrl":"10.1186/s12887-026-07547-2","url":null,"abstract":"<p><strong>Objective: </strong>To develop and internally validate a preliminary clinical prediction model for incident gastrointestinal hemorrhage (GH) occurring after admission in children with IgA vasculitis (IgAV), with continuous laboratory predictors retained in original scale to maximize predictive information.</p><p><strong>Methods: </strong>Single-center retrospective cohort including 662 pediatric IgAV patients (2016-2022). The primary derivation cohort comprised 599 patients without overt bleeding on admission, among whom 126 (21.0%) developed delayed-onset GH ≥ 24 h post-admission. Eight admission-based predictors were selected for the Primary Continuous Model (PCM): abdominal pain, vomiting, neutrophil count, eosinophil count, mean platelet volume, albumin, complement C3, and IgA. D-dimer was excluded from the PCM because restricted cubic spline analysis demonstrated a significant non-linear, threshold-dependent relationship rather than a linear association with GH risk (P for non-linearity = 0.032); it was subsequently incorporated into the Simplified Bedside Score (SBS) via its clinically established dichotomous cutoff of 210 µg/L. Multivariable logistic regression with Enter method was performed. Internal validation included 1000-bootstrap resampling, Hosmer-Lemeshow calibration assessment, and decision curve analysis. A simplified dichotomized nine-point bedside scoring system was derived post hoc for clinical triage.</p><p><strong>Results: </strong>The primary eight-variable continuous model achieved an apparent AUC of 0.790 (95% CI: 0.748-0.832) and a bootstrap optimism-corrected AUC of 0.763. Calibration was excellent (Hosmer-Lemeshow P = 0.917). Five predictors demonstrated independent association with delayed-onset GH (P < 0.05): abdominal pain, vomiting, neutrophil count, MPV, and C3. The simplified dichotomized bedside scoring system yielded a corrected AUC of 0.779, with sensitivity of 77.0% and specificity of 70.2%. Restricted to clinically significant overt severe GH (n = 102), the corrected AUC increased to 0.801.</p><p><strong>Conclusion: </strong>This admission-based preliminary prediction model achieves moderate discrimination for post-admission GH in pediatric IgAV. The primary continuous model preserves predictive information, while a simplified dichotomized scoring system facilitates bedside triage. In conclusion, this admission-based model preserves substantial predictive information and provides a validated baseline framework; we now propose and open this simplified dichotomized scoring system for external validation across international multicenter pediatric cohorts.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between sensory processing sensitivity trait and emotional and behavioral problems among Egyptian children.","authors":"Zeinab Nazeeh Shata, Esraa Tarek Badr, Hoda Aly Omran, Muhammad Alkasaby, Aboalmagd Hamdaalah, Azza Soliman, Sally Samir Othman","doi":"10.1186/s12887-026-07415-z","DOIUrl":"10.1186/s12887-026-07415-z","url":null,"abstract":"<p><strong>Background: </strong>Sensory processing sensitivity (SPS) is a personality trait that has been linked to various mental health outcomes among highly sensitive children.</p><p><strong>Objective: </strong>To investigate the SPS trait and its relationship with emotional and behavioral problems among Egyptian children.</p><p><strong>Methods: </strong>A cross-sectional study was conducted targeting parents of Egyptian children aged 4-17 years. Participants (n = 391) were recruited via different online platforms. Besides a questionnaire on sociodemographic data, parents completed the Arabic version of Strengths and Difficulties Questionnaire (SDQ), and the Highly Sensitive Person Scale (HSPS) for children.</p><p><strong>Results: </strong>Sampled children's mean age was 9 ± 3.75 years, and 57.5% were males. Nearly half of them had \"at-risk/elevated\" total SDQ score (46.3%). The highest \"at-risk/elevated\" score was on the emotional problems subscale (55%). Prosocial behavior had the lowest \"at-risk/elevated\" score (12%). Hypersensitivity was found in 10.2% of the sampled children. A higher percentage of hypersensitive children had statistically significant \"at-risk/elevated\" scores on the emotional problems subscale compared to non-hypersensitive children (82.5% vs. 66.7%, p = 0.04). On the other hand, a lower percentage of hypersensitive children had statistically significant \"at-risk/elevated\" scores regarding hyperactivity and prosocial behavior compared to non-hypersensitive ones (27.5% vs. 48.1%, p = 0.01 and 7.5% vs. 28.5%, p = 0.004, respectively).</p><p><strong>Conclusion: </strong>The current study uncovered the substantial presence of the SPS trait among Egyptian children and its association with emotional problems. This calls for further studies to investigate its impact on the child and family, its moderators, and the effectiveness of psychosocial interventions for children with high SPS.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between vancomycin trough concentration monitoring and gestational age in neonates: a single-center, retrospective observational study.","authors":"Hui Chen, Xing Liu, Kanglu Ju, Xiao Song, Kai Zhao, Zeyang Wei, Bo Guo","doi":"10.1186/s12887-026-07630-8","DOIUrl":"10.1186/s12887-026-07630-8","url":null,"abstract":"<p><strong>Background: </strong>The vancomycin dosing regimen for neonates is primarily determined by gestational age (GA) and postnatal age(PNA). Nonetheless, initial trough concentrations frequently fall below therapeutic levels in neonates administered vancomycin. This study seeks to examine the relationship between vancomycin trough concentrations and gestational age in neonates, thereby offering a reference for individualized vancomycin dosing tailored to neonates of varying gestational ages.</p><p><strong>Methods: </strong>A retrospective observational study was undertaken to collect clinical data on neonates treated with vancomycin and subjected to trough concentration monitoring in the Neonatal Intensive Care Unit (NICU) at Northwest Women's and Children's Hospital over the preceding six years.</p><p><strong>Results: </strong>Utilizing a two-piecewise linear regression model, the P-value for the log-likelihood ratio was 0.007, indicating statistical significance, and an inflection point was identified at 34.6 weeks(approximately 242 days). For gestational ages less than 34.6 weeks, a positive correlation was observed between GA and the initial vancomycin trough concentration (TCV) (β = 0.08, 95% CI: 0.01, 0.14, p = 0.021). Conversely, for gestational ages exceeding 34.6 weeks, a negative trend of borderline significance (β = -0.10, 95% CI: -0.20 to 0.00, P = 0.059).</p><p><strong>Conclusion: </strong>Vancomycin trough concentrations in neonates exhibit a significant correlation with GA. This retrospective study, conducted at a single center, revealed a non-linear relationship between gestational age and initial vancomycin trough concentrations in neonates, identifying an inflection point at approximately 34.6 weeks. The results indicate that existing gestational age-based dosing protocols may inadequately account for pharmacokinetic transitions, underscoring the necessity for prospective studies to validate therapeutic drug monitoring protocols stratified by gestational age.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined use of the pediatric Yorkhill malnutrition score and mid-upper arm circumference for identifying nutritional risk and predicting length of hospital stay in hospitalized children: a pilot study.","authors":"Emre Çelik, Muhammet Furkan Korkmaz, Yunus Özkaya, Servet Yüce, Tuğçe Dilara Soyubelli, Murat Tutanç","doi":"10.1186/s12887-026-07609-5","DOIUrl":"10.1186/s12887-026-07609-5","url":null,"abstract":"<p><strong>Background: </strong>Childhood malnutrition remains a critical public health challenge among hospitalized pediatric populations, contributing to increased morbidity and prolonged length of hospital stay (LOS). In countries undergoing nutritional transition, such as Türkiye, the \"double burden of malnutrition\"-characterized by the coexistence of undernutrition and obesity-is exacerbated by socio-economic inequities. This study aimed to assess the prevalence and risk factors of malnutrition in hospitalized children and to evaluate the predictive validity of two rapid screening tools: the Pediatric Yorkhill Malnutrition Score (PYMS) and mid-upper arm circumference (MUAC), with attention to their utility in identifying socio-economic vulnerability.</p><p><strong>Methods: </strong>This pilot study was conducted between January and July 2024 in a tertiary university hospital in Türkiye. A total of 100 children (50 girls, 50 boys), aged 1 month to 18 years, were evaluated. Nutritional status was assessed using World Health Organization (WHO) anthropometric Z-scores. Malnutrition risk was screened via PYMS and age-adjusted MUAC Z-scores. A novel socio-economic malnutrition risk classification was developed based on household income, family size, and maternal employment status. This pilot study tested the combined use of routine anthropometric measurements and practical screening tools such as PYMS and MUAC for a later large-scale, school-based screening.</p><p><strong>Results: </strong>The double burden of malnutrition was evident: 13.0% had acute malnutrition and 11.0% chronic malnutrition (stunting); among children aged 5-18 years, 34.5% were overweight and 21.8% obese. The LOS was significantly longer in the PYMS high-risk group compared to the low-risk group (p = 0.001), and in the MUAC moderate malnutrition group (p < 0.05). PYMS demonstrated high specificity (95.89%) for acute malnutrition but limited sensitivity for stunting. Among children aged > 5 years, MUAC Z-scores correlated significantly with body mass index (BMI) Z-scores (p < 0.05). Children classified as high-risk by the socio-economic model had significantly lower height-for-age Z-scores (p < 0.05).</p><p><strong>Conclusions: </strong>This study highlights the impact of socio-economic inequities-such as low income and household overcrowding-on chronic malnutrition and confirms the clinical relevance of the double burden of malnutrition. PYMS and MUAC effectively predict prolonged hospitalization and adverse clinical outcomes. The integration of socio-economic risk assessment with routine malnutrition screening may guide equitable resource allocation and improve care for vulnerable pediatric populations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}