BMC Pediatrics最新文献

{"title":"Comparison of the completed and discontinued pediatric drug clinical trials in Mainland China: a cross-sectional analysis based on the data from 2003 to 2023.","authors":"Zi-Ming Wang, Rui-Rui Du, Li Yang","doi":"10.1186/s12887-025-06038-0","DOIUrl":"10.1186/s12887-025-06038-0","url":null,"abstract":"<p><strong>Background: </strong>Pediatric drug clinical trials are essential for ensuring the accessibility and safety of medications intended for children. In recent years, the Chinese government has implemented various measures to foster the development of pediatric drug clinical trials, and these efforts have yielded noticeable results. This study analyzed pediatric drug trial data from ClinicalTrials.gov and the Drug Clinical Trial Registration and Information Publication Platform. Its primary purpose was to discuss the issues and challenges faced by pediatric drug clinical trials in China and propose potential solutions.</p><p><strong>Methods: </strong>This study conducted a cross-sectional analysis of concluded pediatric drug clinical trials (completed or discontinued) in mainland China from 2003 to 2023. Descriptive statistics were performed on the included data, and both univariate subgroup analysis and binary logistic regression were utilized to analyze the factors influencing completion duration and trial discontinuation.</p><p><strong>Results: </strong>A total of 722 concluded pediatric drug clinical trials were extracted, with the overall number increasing annually at an average annual growth rate of 21.5%. We found that there existed imbalance in various aspects such as drug type, diseases, age, and the types and distribution of trial institutions. The analysis of trial durations indicated a progressive reduction in the completion cycles of pediatric drug clinical trials conducted in China, with notable variations across different subgroups. Four variables-trial size, the establishment of Data Monitoring Committees (DMCs), control type, and disease-exerted significant influence on the discontinuation of pediatric drug clinical trials. The primary reasons for trial discontinuation are issues related to safety or efficacy as reflected in trial outcomes (27.2%), as well as adjustments in commercial strategies or trial plans (24.6%).</p><p><strong>Conclusions: </strong>Despite the ongoing increase in the number of pediatric drug clinical trials in China, significant challenges and imbalances persist across various dimensions. To enhance the quality and efficiency of these trials and collectively advance pediatric drug research and development, it is imperative to refine the existing legal and regulatory frameworks, promote the professionalization and standardization of pediatric drug clinical trials, bolster the application of emerging methods and technologies, such as seamless design and artificial intelligence.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"807"},"PeriodicalIF":2.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278982","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 snacking habits and sleep problems in children aged 6 to 12: a cross-sectional study in Iran.","authors":"Seyyed Payam Shariatpanahi, Awat Feizi, Hamidreza Roohafza","doi":"10.1186/s12887-025-06202-6","DOIUrl":"10.1186/s12887-025-06202-6","url":null,"abstract":"<p><strong>Background: </strong>Sleep problems in children significantly impact physical and mental development. Studies suggest that snacking habits influence sleep quality. This study examines the association between snacking habits and sleep problems among children aged 6 to 12 in Iran.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 729 children. Sleep status were assessed using the Children's Sleep Habits Questionnaire (CSHQ), while snacking habits were evaluated through a questionnaire covering nine food items. Latent class regression analysis with a distal outcome was used to classify participants into sleep and snacking habits profiles and assess their associations.</p><p><strong>Results: </strong>In our analysis, three snacking habits classes-Healthy, Unhealthy, and Mixed healthy and unhealthy were identified alongside two sleep status profiles: Healthy sleep and Disrupted sleep. Children with unhealthy snacking habits had higher odds of experiencing sleep problems (OR = 2.23, p = 0.004), while those in the Mixed healthy and unhealthy group also showed an increased risk (OR = 2.34, p = 0.004). Adjusted models confirmed the persistence of these associations (OR = 1.90, p = 0.030 for the Unhealthy group and OR = 1.93, p = 0.047 for the Mixed group). Boys were more likely than girls to adopt unhealthy snacking habits (p = 0.002). Further analysis indicated that the association between snacking habits and sleep problems was more pronounced in boys, whereas no significant relationship was observed among girls.</p><p><strong>Conclusions: </strong>Unhealthy and mixed healthy and unhealthy snacking habits are associated with increased odds of sleep disturbances in children especially boys underscoring the need for targeted dietary interventions to support pediatric sleep health.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"804"},"PeriodicalIF":2.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273794","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":"Radiation-free cochlear implant position estimation in pediatric patients using impedance telemetry.","authors":"Julia Veloso de Oliveira, Enrike Rosenkranz, Stephan Schraivogel, Nora Magdalena Weiss, Marco Caversaccio, Dennis Hedderich, Wilhelm Wimmer","doi":"10.1186/s12887-025-06242-y","DOIUrl":"10.1186/s12887-025-06242-y","url":null,"abstract":"<p><strong>Background: </strong>Cochlear implants (CIs) play a crucial role in providing children with profound hearing loss the ability for auditory perception and spoken language development. Following implantation, patients typically undergo a computed tomography (CT) or X-ray examination to assess electrode positions in the cochlea. Besides economic factors, this imposes radiation risks on patients, particularly for younger patients who are more sensitive to its harmful effects.</p><p><strong>Objective: </strong>This study aims to evaluate the performance of an impedance telemetry-based estimation algorithm for assessing postoperative CI placement. While the algorithm has been validated in an adult cohort, this research explores its applicability in pediatric patients.</p><p><strong>Materials and methods: </strong>The insertion depth estimation algorithm was validated on a dataset of 59 pediatric cases and evaluated using different classification metrics. Impedance telemetry data was combined with demographic data and morphological parameters of the cochlea and used as input data for the algorithm. The algorithm predictions were compared with ground truth labels derived from X-ray and CT scans.</p><p><strong>Results: </strong>The algorithm demonstrated a root mean squared error (RMSE) of 1.53mm for insertion depth prediction, compared to 1.01mm in the original report. In terms of classification, the algorithm successfully detected all cases with partially inserted electrodes, although three cases were detected as false positives.</p><p><strong>Conclusion: </strong>The results highlight the algorithm's potential for clinical decision support in assessing post-implantation outcomes, monitoring electrode migration, and detecting extracochlear electrodes. A larger dataset with more partial insertion cases would be required for additional training and validation of the algorithm. Assessing electrode placement through impedance measurements would eliminate the need for additional radiography, reducing radiation exposure for future patients while also saving the clinic significant cost and time.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"809"},"PeriodicalIF":2.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273700","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":"Takotsubo syndrome as initial presentation of pheochromocytoma in young children: case report and literature review.","authors":"Enfu Huang, Ting Zhang, Xiangming Yan, Ling Sun, Yun Zhou","doi":"10.1186/s12887-025-06187-2","DOIUrl":"10.1186/s12887-025-06187-2","url":null,"abstract":"","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"805"},"PeriodicalIF":2.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273769","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":"Clinical application and systematic review of waiting treatment for giant omphaloceles.","authors":"Rifang Pan, Zhaowei Zhou, Zhaopan Li, Jun Cen, Fengyu Pang, Yuansheng Luo, Kunlan Liang, Junzhong Li, Zhihua Xiao","doi":"10.1186/s12887-025-06206-2","DOIUrl":"10.1186/s12887-025-06206-2","url":null,"abstract":"","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"806"},"PeriodicalIF":2.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273731","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":"Modelling the determinants of uptake of complete immunization of children in Ghana.","authors":"Daudi Yeboah, Gideon Mensah Engmann, Dioggban Jakperik","doi":"10.1186/s12887-025-06224-0","DOIUrl":"10.1186/s12887-025-06224-0","url":null,"abstract":"<p><p>Immunization remains a vital public health initiative for children since it reduces the risk of morbidity, mortality, and long-term complications associated with vaccine-preventable diseases. The study sought to model the determinants of uptake of complete immunization among children in Ghana using data from the 2022 Ghana Demographic and Health Survey (GDHS). The study used a sample of 4,961 women with children under 5 years and employed Poisson regression, and Negative Binomial models. Results from the study showed that about 51.28% of the children had completely received all the childhood vaccines but 3.79% of the children had never received any of the vaccines in the country. The study found that Negative Binomial regression was the best-fitted model for modelling complete immunization of children under 5 years in Ghana. Respondents who have primary and secondary education were 3.20% and 4.00% times more likely to completely immunize their children as compared to those with no education. Respondents who are currently working are 7.20% more likely to completely immunize children as compared to those not currently working (IRR = 1.072; 95% CI: 1.042, 1.104). Women who have been exposed to mass media were 3.50% more likely to completely immunize their children as compared to those not exposed to mass media (IRR = 1.035; 95% CI: 1.000, 1.071). Women who made 8 or more number of ANC visits were 5.30% more likely to have children completely immunized compared to those made 1-3 ANC visits. We therefore encourage the use of mass media to educate women on the need to ensure complete immunization of their children. The study also recommends that women should be encouraged to improve their ANC visits (8 or more) to be fully made aware of childcare-related issues, such as the significance of immunizing children completely.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"808"},"PeriodicalIF":2.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273725","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":"Efficacy of physiotherapy with occupational and speech therapy for improving physical & behavioral status among children with autism spectrum disorder (ASD): an assessor blinded randomized clinical trial.","authors":"Md Sherajul Haque, Mohammad Mohinul Islam, Abid Hasan Khan, Nupur Akter, K M Amran Hossain","doi":"10.1186/s12887-025-05832-0","DOIUrl":"10.1186/s12887-025-05832-0","url":null,"abstract":"<p><strong>Background: </strong>Autism Spectrum Disorder (ASD) is characterized by physical, communication, and behavioral challenges that often require comprehensive interventions. This study aimed to evaluate the combined efficacy of physiotherapy, occupational and speech therapies in improving physical and behavioral outcomes among children with ASD.</p><p><strong>Materials and methods: </strong>This assessor-blinded randomized clinical trial was conducted at Proyash (Institute of Special Education), Jashore, Bangladesh, involving seventy children with ASD. Outcomes were assessed using the modified SF-36 for physical status and GARS-3 for behavioral status at baseline and after six weeks of intervention. Data were analyzed using SPSS version 25.0, with descriptive statistics (median and IQR) and inferential tests (Mann-Whitney U and Wilcoxon signed-rank), maintaining a 95% confidence level.</p><p><strong>Results: </strong>The average age of participants was 10.66 ± 3.28 years in Group A and 9.17 ± 2.83 years in Group B. Group A had a higher BMI of 21.86 ± 7.96 kg/m² compared to 19.53 ± 4.85 kg/m² in Group B. Post-intervention analysis revealed significant improvements in both physical and behavioral outcomes. Between-group comparisons yielded p-values < 0.01 for both measures. Within-group analysis showed significant improvements in Group A (p < 0.01), whereas changes in Group B were not statistically significant.</p><p><strong>Conclusion: </strong>The combined rehabilitation program demonstrated significant improvements in physical and behavioral outcomes and showing greater effectiveness overall. These findings emphasize the importance of customized rehabilitation approaches in enhancing both physical and behavioral health, particularly when tailored to specific participant profiles.</p><p><strong>Trial registration: </strong>CTRI/2024/07/070209 (Prospectively Registered).</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"798"},"PeriodicalIF":2.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257371","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":"Growth and pubertal outcome of three-years medical treatment of peripheral precocious puberty in a boy with McCune-Albright Syndrome: a case report.","authors":"Rosario Ferrigno, Valeria Pellino, Maria Cristina Savanelli, Daniela Cioffi, Gioconda Argenziano, Francesco Esposito, Antonella Klain","doi":"10.1186/s12887-025-06157-8","DOIUrl":"10.1186/s12887-025-06157-8","url":null,"abstract":"","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"800"},"PeriodicalIF":2.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257330","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":"Determinants of early initiation of breastfeeding in Côte d'Ivoire: a hospital-based study.","authors":"Kouakou Kouamé Cyprien, Djivohessoun Augustine, Djoman Isabelle, Folquet Amorissani","doi":"10.1186/s12887-025-06190-7","DOIUrl":"10.1186/s12887-025-06190-7","url":null,"abstract":"<p><strong>Background: </strong>Early initiation of breastfeeding (EIBF), defined as putting the newborn to the breast within the first hour of life, is a cost-effective and evidence-based intervention to reduce neonatal morbidity and mortality. In Côte d'Ivoire, EIBF coverage remains suboptimal despite international recommendations.</p><p><strong>Methods: </strong>We conducted a cross-sectional analytical study from June to July 2022 at Abobo Houphouët-Boigny Regional Hospital in Abidjan. A total of 320 mother-infant dyads were consecutively enrolled. Data were collected using structured questionnaires and medical records. Associations between independent variables and EIBF were first explored using chi-square or Fisher's exact tests. Variables with p < 0.20 were included in a multivariate logistic regression model. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>The prevalence of EIBF was 61%. In bivariate analysis, maternal age < 20 years, maternal education, religion, unplanned pregnancy, vaginal delivery, and a 5-minute Apgar score ≥ 7 were significantly associated with EIBF. In the multivariate model, two independent predictors remained significant: higher maternal education increased the likelihood of EIBF (aOR = 2.20; 95% CI: 1.37-3.93; p = 0.005), whereas cesarean delivery markedly reduced it compared with vaginal delivery (aOR = 0.08; 95% CI: 0.04-0.14; p < 0.001).</p><p><strong>Conclusions: </strong>Although the prevalence of EIBF in this hospital was higher than the national estimate, it remains below international targets. Maternal education and mode of delivery are key determinants. Strengthening prenatal counseling and adapting post-cesarean protocols to promote immediate skin-to-skin contact are essential to increase EIBF coverage in Côte d'Ivoire.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"802"},"PeriodicalIF":2.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273710","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":"Performance of several large language models when answering common patient questions about type 1 diabetes in children: accuracy, comprehensibility and practicality.","authors":"Yasemin Denkboy Ongen, Ayla İrem Aydın, Meryem Atak, Erdal Eren","doi":"10.1186/s12887-025-05945-6","DOIUrl":"10.1186/s12887-025-05945-6","url":null,"abstract":"<p><strong>Background: </strong>The use of large language models (LLMs) in healthcare has expanded significantly with advances in natural language processing. Models, such as ChatGPT and Google Gemini, are increasingly used to generate human-like responses to questions, including those posed by patients and their families. With the rise in the incidence of type 1 diabetes (T1D) among children, families frequently seek reliable answers regarding the disease. Previous research has focused on type 2 diabetes, but studies on T1D in a pediatric population remain limited. This study aimed to evaluate and compare the performance and effectiveness of different LLMs when answering common questions about T1D.</p><p><strong>Methods: </strong>This cross-sectional, comparative study used questions frequently asked by children with T1D and their parents. Twenty questions were selected from inquiries made to pediatric endocrinologists via social media. The performance of ChatGPT-3.5 ChatGPT-4 ChatGPT-4o was assessed using a standard prompt for each model. The responses were evaluated by five pediatric endocrinologists interested in diabetes using the General Quality Scale (GQS), a 5-point Likert scale, assessing factors such as accuracy, language simplicity, and empathy.</p><p><strong>Results: </strong>All five LLMs responded to the 20 selected questions, with their performance evaluated by GQS scores. ChatGPT-4o had the highest mean score (3.78 ± 1.09), while Gemini had the lowest (3.40 ± 1.24). Despite these differences, no significant variation was observed between the models (p = 0.103). However, ChatGPT-4o, ChatGPT-4, and Gemini Advanced produced the highest-quality answers compared to ChatGPT-3.5 and Gemini, scoring consistently between 3 and 4 points. ChatGPT-3.5 had the smallest variation in response quality, indicating consistency but not reaching the higher performance levels of other models.</p><p><strong>Conclusions: </strong>This study demonstrated that all evaluated LLMs performed similarly in answering common questions about T1D. LLMs such as ChatGPT-4o and Gemini Advanced can provide above-average, accurate, and patient-friendly answers to common questions about T1D. Although no significant differences were observed, the latest versions of LLMs show promise for integration into healthcare, provided they continue to be evaluated and improved. Further research should focus on developing specialized LLMs tailored for pediatric diabetes care.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"799"},"PeriodicalIF":2.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257348","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}