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Further Considerations on Late Preterm Antenatal Corticosteroid Use. 对晚期早产儿使用皮质类固醇的进一步考虑。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-20 DOI: 10.1001/jamapediatrics.2025.5639
Jianguo Zhou
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引用次数: 0
Further Considerations on Late Preterm Antenatal Corticosteroid Use. 对晚期早产儿使用皮质类固醇的进一步考虑。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-20 DOI: 10.1001/jamapediatrics.2025.5636
Joseph W Kaempf,Ryan M McAdams,Michael Kuzniewicz
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引用次数: 0
Speed and Safety in Pediatric Artificial Intelligence-Child in the Loop. 儿童人工智能的速度和安全性——儿童在循环中。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-20 DOI: 10.1001/jamapediatrics.2025.5739
Ryan M McAdams,Wissam Shalish
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引用次数: 0
Parent-Led Early Intervention in Very Preterm Infants and Executive Function at School Age: Secondary Analysis of a Randomized Clinical Trial. 父母主导的极早产儿早期干预与学龄期执行功能:一项随机临床试验的二次分析。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-20 DOI: 10.1001/jamapediatrics.2025.5866
Mariana Lenz Tarouco,Renato S Procianoy,T Michael O'Shea,Rita C Silveira
ImportanceChildren born very preterm or with very low birth weight are at higher risk for executive function deficits, affecting attention, self-regulation, and problem-solving. Early developmental interventions have shown potential benefits, but their long-term effect on executive functioning remains uncertain.ObjectiveTo evaluate whether an enhanced developmental intervention (EDI) initiated in the neonatal intensive care unit (NICU) and continued at home through the first 2 years improves executive function at school age in very preterm children.Design, Setting, and ParticipantsThis secondary analysis assessed school-aged outcomes from a randomized clinical trial of infants born with fewer than 32 weeks of gestation or with birth weight less than 1500 g from January 2016 to February 2019. Follow-up assessments were conducted from July 7, 2023, to August 16, 2024, at a single center in Porto Alegre, Brazil. Data analyses were completed from August to December 2024.InterventionEDI compared with usual care.Main Outcomes and MeasuresThe primary outcomes were the scaled scores of Developmental Neuropsychological Assessment, Second Edition, subtests, which measures auditory attention, inhibition, design fluency, and motor persistence. The examiner was masked to group allocation. Medical records identified children with neurodevelopmental conditions that precluded formal assessment. The effect size for the Mann-Whitney U test comparisons was calculated using the rank-biserial correlation. Binary logistic regression was used to compare performance in the primary outcomes. Sensitivity analyses were used for those lost to follow-up.ResultsOf the original randomized clinical trial, 80 children (96% of those eligible) were assessed at a mean (SD) age of 7 (1) years; 34 children (43%) were female. Baseline characteristics were similar between groups. In the primary analysis of median scaled scores, children who received EDI demonstrated significantly better performance across all 4 executive function domains compared to usual care (median scores, 12-14 vs 2-9; r = 0.44-0.77; all P < .001). All results remained significant after Bonferroni correction (P < .0125), indicating medium to large effect sizes. In the secondary analysis of performance classification, EDI was associated with higher odds of expected performance in design fluency (odds ratio, 11.3; 95% CI, 4.08-31.7; P < .001). No statistically significant differences were observed for the remaining 3 domains.Conclusions and RelevanceIn this secondary analysis of a randomized clinical trial, early EDI, beginning in the NICU and extending through the first 2 years, contributed to sustained improvements in executive function in very preterm children. These findings support the long-term neurodevelopmental benefits of early intervention, with potential implications for academic and socioemotional outcomes in children from low- and middle-income settings.Trial RegistrationClinicalTrials.gov Identifier: NC
早产儿或出生体重过低的儿童有较高的执行功能缺陷风险,影响注意力、自我调节和解决问题。早期发育干预已显示出潜在的益处,但其对执行功能的长期影响仍不确定。目的评价在新生儿重症监护病房(NICU)开始并在家中持续2年的强化发育干预(EDI)是否能改善极早产儿学龄期的执行功能。设计、环境和参与者这项二级分析评估了2016年1月至2019年2月期间出生的小于32周妊娠或出生体重小于1500克的婴儿的随机临床试验的学龄结果。随访评估于2023年7月7日至2024年8月16日在巴西阿雷格里港的一个中心进行。数据分析于2024年8月至12月完成。干预与常规护理比较。主要结果和测量主要结果是发育神经心理学评估第二版子测试的量表得分,该子测试测量听觉注意、抑制、设计流畅性和运动持久性。考官被蒙面到小组分配。医疗记录表明,儿童患有神经发育疾病,无法进行正式评估。Mann-Whitney U检验比较的效应量采用秩-双列相关法计算。采用二元逻辑回归比较主要结局的表现。对未随访的患者进行敏感性分析。在最初的随机临床试验中,80名儿童(96%符合条件的儿童)在平均(SD)年龄为7(1)岁时进行了评估;34例(43%)为女性。各组间基线特征相似。在中位评分的初步分析中,与常规护理相比,接受EDI治疗的儿童在所有4个执行功能领域的表现明显更好(中位评分,12-14 vs 2-9; r = 0.44-0.77;均P < 0.001)。经Bonferroni校正后,所有结果仍然显著(P <。0125),表明中等到较大的效应大小。在性能分类的二次分析中,EDI与设计流畅性预期性能的较高几率相关(优势比,11.3;95% CI, 4.08-31.7; P < 0.001)。其余3个域差异无统计学意义。结论和相关性在一项随机临床试验的二级分析中,早期的EDI,从新生儿重症监护室开始,一直持续到前2年,有助于非常早产儿执行功能的持续改善。这些发现支持早期干预对神经发育的长期益处,并对中低收入儿童的学业和社会情感结果具有潜在影响。临床试验注册号:NCT02835612。
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引用次数: 0
GLP-1 Receptor Agonist Prescriptions for Adolescents With Obesity and Associated Disparities. GLP-1受体激动剂处方治疗青少年肥胖及相关差异
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-20 DOI: 10.1001/jamapediatrics.2025.5708
Chungsoo Kim,Mona Sharifi,Joseph S Ross,Yong Chen,Hua Xu,Harlan M Krumholz,Yuan Lu
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引用次数: 0
Intranasal Treatments for Children With Sleep-Disordered Breathing: The MIST+ Randomized Clinical Trial. 鼻内治疗睡眠呼吸障碍儿童:MIST+随机临床试验
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-20 DOI: 10.1001/jamapediatrics.2025.5717
Gillian M Nixon,Deborah Anderson,Alice Baker,Andrew Davidson,Amanda Griffiths,Anneke C Grobler,Gideon Pinczower,Joanne Rimmer,Elizabeth Rose,Chris J Selman,Catherine M Simpson,Moya Vandeleur,Kirsten P Perrett
ImportanceSymptoms of obstructive sleep apnea are common in childhood and associated with significant comorbidity. Surgical treatment with adenotonsillectomy is first-line treatment but medical treatments show potential to improve symptoms and reduce the need for surgery.ObjectiveTo determine the efficacy of 6 weeks of intranasal steroid (INS) compared with saline in children with obstructive sleep-disordered breathing (OSDB) with persistent symptoms after a 6-week intranasal saline run-in.Design, Setting, and ParticipantsThis was a double-blind, placebo-controlled, randomized clinical trial involving specialist clinic waitlists at 2 sites in Australia. Included were children aged 3 to 12 years. Study data were analyzed from January to June 2025.InterventionsAll children received once-daily intranasal saline for 6 weeks (run-in). Those with persisting symptoms (SDB score ≥-1) were randomized to either once-daily intranasal mometasone furoate, 50 µg, (INS) or continued saline for a further 6 weeks.Main Outcomes and MeasuresThe primary outcome was symptom resolution (SDB score <-1). Secondary outcomes included behavior, quality of life, and parental perception of need for surgery. Analyses were adjusted for site and baseline measures.ResultsA total of 150 children (mean [SD] age, 6.2 [2.3] years; 93 male [62%]) were recruited. Of 139 children who completed the run-in phase, 41 (29.5%) had symptom resolution after saline run-in. Among 93 children randomized to intervention groups (47 INS; 46 saline), symptom resolution occurred in 35.6% (95% CI, 22.9%-50.6%) and 36.4% (95% CI, 23.5%-51.6%) of the INS and saline group, respectively, with no evidence for a clinically significant difference between groups (risk difference, -0.9%; 95% CI, -20.7% to 19.0%; P = .93). No group differences were found in secondary outcomes. Subgroup analysis did not reveal a group more or less likely to respond to medical treatment.Conclusions and RelevanceResults of this randomized clinical trial show that 6 weeks of intranasal saline resolved OSDB symptoms in nearly one-third of children. An additional 6-week course of INS or saline led to resolution in another one-third (total resolution around 50%), with no added benefit from INS. Intranasal saline is an effective short-term first-line treatment for OSDB before consideration of polysomnography or surgical intervention. Results suggest that saline should be recommended for 3 months before assessing the need for specialist referral.Trial RegistrationClinicalTrials.gov Identifier: NCT05382494.
梗阻性睡眠呼吸暂停的症状在儿童时期很常见,并伴有显著的合并症。手术治疗与腺扁桃体切除术是一线治疗,但药物治疗显示出改善症状和减少手术需要的潜力。目的比较6周鼻内类固醇(INS)与生理盐水对症状持续6周的阻塞性睡眠呼吸障碍(OSDB)患儿的疗效。设计、环境和参与者:这是一项双盲、安慰剂对照、随机临床试验,涉及澳大利亚2个地点的专科诊所候诊患者。研究对象为3至12岁的儿童。研究数据分析时间为2025年1月至6月。干预措施:所有儿童每天接受一次鼻内生理盐水,持续6周(磨合期)。那些持续症状(SDB评分≥-1)的患者被随机分为每日一次鼻内注射50µg糠酸莫米松(INS)或继续使用生理盐水6周。主要结局和测量方法主要结局为症状缓解(SDB评分<-1)。次要结果包括行为、生活质量和父母对手术需求的看法。根据现场和基线测量调整分析结果。结果共纳入儿童150例(平均[SD]年龄6.2[2.3]岁,男性93例(62%))。在139名完成磨合期的儿童中,41名(29.5%)在生理盐水磨合后症状缓解。在随机分配到干预组的93名儿童中(47名INS组,46名生理盐水组),INS组和生理盐水组的症状缓解率分别为35.6% (95% CI, 22.9%-50.6%)和36.4% (95% CI, 23.5%-51.6%),两组间无临床显著性差异(风险差异,-0.9%;95% CI, -20.7% - 19.0%; P = 0.93)。次要结果没有发现组间差异。亚组分析并没有显示出一组对药物治疗的反应更多或更少。结论和相关性这项随机临床试验的结果显示,6周鼻内生理盐水缓解了近三分之一儿童的OSDB症状。另外6周的INS或生理盐水治疗导致另外三分之一的患者缓解(总缓解约50%),INS没有额外的益处。在考虑多导睡眠检查或手术干预之前,鼻内生理盐水是OSDB有效的短期一线治疗方法。结果表明,在评估是否需要专家转诊之前,应建议使用生理盐水3个月。临床试验注册号:NCT05382494。
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引用次数: 0
Social Media Use and Well-Being Across Adolescent Development. 青少年发展过程中社交媒体的使用与幸福感。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-12 DOI: 10.1001/jamapediatrics.2025.5619
Ben Singh,Mason Zhou,Rachel Curtis,Carol Maher,Dorothea Dumuid
ImportanceSocial media's association with adolescent well-being remains debated. Heavy use has been associated with distress, while abstinence may cause missed connections.ObjectiveTo investigate 3-year longitudinal associations between after-school social media use and adolescent well-being using a large longitudinal cohort dataset modeled within a repeated cross-sectional framework.Design, Setting, and ParticipantsThis cohort study included Australian students in grades 4 through 12 (2019-2022). After-school social media use was self-reported and grouped as none, moderate, or highest. Well-being was assessed using 8 validated indicators (eg, happiness, life satisfaction, emotional regulation), dichotomized as high vs low. Well-being was assessed concurrently with social media use during the annual school-based survey in each year of data collection. Data analysis was conducted from June to July 2025.ExposuresSelf-reported after-school social media use between 3 pm and 6 pm (weekdays), classified into 3 categories: none (0 h/wk), moderate (>0 to <12.5 h/wk), and highest (≥12.5 h/wk).Main Outcomes and MeasuresThe primary outcome was overall well-being, measured as the mean score across 8 validated domains (happiness, optimism, life satisfaction, worry, sadness, perseverance, emotional regulation, and cognitive engagement), dichotomized as high vs low (<3 on a scale of 1-5). Secondary outcomes were each individual well-being indicator, similarly dichotomized. Mixed-effects logistic models were used for analyses, stratified by sex and adjusted for demographic covariates.ResultsThe analytic sample included 100 991 adolescents, contributing 173 533 observations (86 582 [49.9%] observations from female participants; mean [SD] age, 13.5 [2.2] years). A U-shaped association was observed between after-school social media use and well-being. Compared with moderate users, adolescents with the highest use had greater odds of low well-being (grades 7-9, girls: odds ratio [OR], 3.13 [95% CI, 2.88-3.39]; boys: OR, 2.25 [95% CI, 1.86-2.72]), while nonusers also had higher odds of low well-being in later adolescence (grades 10-12, girls: OR, 1.79 [95% CI, 1.41-2.27]; boys: OR, 3.00 [95% CI, 2.01-4.46]). These patterns were consistent across survey years and robust to sensitivity analyses.Conclusions and RelevanceIn this cohort study of students in grades 4 through 12, social media's association with adolescent well-being was complex and nonlinear, varying by age and sex. While heavy use was associated with poorer well-being and abstinence sometimes coincided with less favorable outcomes, these findings are observational and should be interpreted cautiously.
社交媒体与青少年健康之间的关系仍存在争议。过度使用与痛苦有关,而戒断可能会导致错过连接。目的利用一个重复横截面框架的大型纵向队列数据集,调查3年的课后社交媒体使用与青少年幸福感之间的纵向关联。设计、环境和参与者本队列研究包括4至12年级(2019-2022)的澳大利亚学生。课后社交媒体使用情况是自我报告的,分为无、中等和最高。幸福感是用8个有效的指标来评估的(例如,幸福,生活满意度,情绪调节),分为高和低。在每年的数据收集中,在以学校为基础的年度调查中,幸福感与社交媒体使用情况同时进行评估。数据分析时间为2025年6月至7月。自我报告的放学后(工作日)下午3点至6点之间的社交媒体使用情况,分为3类:无(0小时/周)、中度(0小时至<12.5小时/周)和最高(≥12.5小时/周)。主要结果和测量主要结果是整体幸福感,以8个有效领域(快乐、乐观、生活满意度、担忧、悲伤、毅力、情绪调节和认知参与)的平均分来衡量,分为高和低(在1-5的范围内<3)。次要结果是每个个体的幸福指标,类似地分为两类。使用混合效应逻辑模型进行分析,按性别分层并根据人口统计学协变量进行调整。结果分析样本包括100 991名青少年,173 533条观察结果(女性参与者86 582条[49.9%]观察结果,平均[SD]年龄为13.5[2.2]岁)。课后社交媒体使用与幸福感之间呈u型关系。与适度使用者相比,使用率最高的青少年幸福感较低的几率更大(7-9年级,女孩:比值比[OR], 3.13 [95% CI, 2.88-3.39];男孩:OR, 2.25 [95% CI, 1.86-2.72]),而不使用者在青春期后期幸福感较低的几率也更高(10-12年级,女孩:OR, 1.79 [95% CI, 1.41-2.27];男孩:OR, 3.00 [95% CI, 2.01-4.46])。这些模式在调查年份中是一致的,并且对敏感性分析具有稳健性。结论和相关性在这项对4年级到12年级学生的队列研究中,社交媒体与青少年幸福感的关系是复杂的、非线性的,因年龄和性别而异。虽然大量使用与较差的幸福感和戒断有关,但这些发现是观察性的,应谨慎解释。
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引用次数: 0
The Politics and Policies Against US Children. 针对美国儿童的政治和政策。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-12 DOI: 10.1001/jamapediatrics.2025.5627
Yael Cannon,Julie M Linton,Del Ivey,Shaquita Bell
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引用次数: 0
Error in Table, Text, and Figure. 表、文本和图中的错误。
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-12 DOI: 10.1001/jamapediatrics.2025.5980
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引用次数: 0
Child Poverty Trends by Race and Ethnicity in the US From 2022 to 2025. 2022 - 2025年美国各种族儿童贫困趋势
IF 26.1 1区 医学 Q1 PEDIATRICS Pub Date : 2026-01-12 DOI: 10.1001/jamapediatrics.2025.5630
Haris Majeed,Carmen H Logie,Daniyal Zuberi
{"title":"Child Poverty Trends by Race and Ethnicity in the US From 2022 to 2025.","authors":"Haris Majeed,Carmen H Logie,Daniyal Zuberi","doi":"10.1001/jamapediatrics.2025.5630","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5630","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"48 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
JAMA Pediatrics
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