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Pediatric abdominal ultrasound training program for pediatricians. 面向儿科医生的小儿腹部超声波培训计划。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-08-20 DOI: 10.3345/cep.2024.00451
Soon Chul Kim
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引用次数: 0
Neonatal risk factors associated with autism spectrum disorders: an umbrella review. 与自闭症谱系障碍相关的新生儿风险因素:综述。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-07-19 DOI: 10.3345/cep.2024.00136
Amir Mohammad Salehi, Erfan Ayubi, Salman Khazaei, Ensiyeh Jenabi, Saeid Bashirian, Zohreh Salimi

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe social communication deficits and stereotypical repetitive behaviors.

Purpose: This umbrella review assessed neonatal risk factors associated with ASD using meta-analyses and systematic reviews.

Methods: We conducted a systematic search of interna- tional databases including PubMed, Scopus, and Web of Science for studies published through April 2022 utilizing pertinent keywords. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Substantial heterogeneity was considered at values of I2≥50%. A quality assessment of the included studies was performed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) checklist.

Results: A total of 207,221 children with ASD and 22,993,128 neurotypical children were included. Six meta- analyses were included in this umbrella review. The factors of congenital heart disease (OR, 1.35; 95% CI, 1.17-1.52), macrosomia (OR, 1.11; 95% CI, 1.05-1.18), low birth weight (OR, 1.63; 95% CI, 1.48-1.81), very low birth weight (OR, 2.25; 95% CI, 1.79-2.83), small for gestational age (OR, 1.17; 95% CI, 1.09-1.24), jaundice (OR, 1.74; 95% CI, 1.42- 2.12), male sex (OR, 1.47; 95% CI, 1.39-1.55) and 1-minute Apgar score <7 (OR, 1.40; 95% CI, 1.26-1.55) were graded as suggestive evidence (class III). Only 3 studies reported heterogeneity (I2<50%). Based on the AMSTAR2 analysis, the methodological quality was critically low in 3 meta- analyses, low in 2, and moderate in 1.

Conclusion: Based on these results, clinicians should consider the risk factors for ASD and screen children in clinics.

背景:自闭症谱系障碍(ASD)是一种神经发育障碍,以严重的社会交流障碍和刻板重复行为为特征。目的:本综述使用荟萃分析和系统综述评估了与 ASD 相关的新生儿风险因素:我们利用相关关键词对国际数据库(包括 PubMed、Scopus 和 Web of Science)中 2022 年 4 月之前发表的研究进行了系统检索。采用随机效应模型计算几率比(OR)和 95% 置信区间(CI)。I2≥50%的值被认为具有实质性异质性。使用系统性综述评估工具(AmeaSurement Tool to Assess Systematic Reviews,AMSTAR2)核对表对纳入的研究进行了质量评估:共纳入 207221 名 ASD 儿童和 22993128 名神经畸形儿童。本综述共纳入六项荟萃分析。先天性心脏病(OR,1.35;95% CI,1.17-1.52)、巨大儿(OR,1.11;95% CI,1.05-1.18)、低出生体重(OR,1.63;95% CI,1.48-1.81)、极低出生体重(OR,2.25;95% CI,1.79-2.83)、胎龄小(OR,1.17;95% CI,1.09-1.24)、黄疸(OR,1.74;95% CI,1.42-2.12)、男性(OR,1.47;95% CI,1.39-1.55)和 1 分钟阿普加评分 结论:基于这些结果,临床医生应考虑 ASD 的风险因素,并在诊所对儿童进行筛查。
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引用次数: 0
Construction and validation of predictive models for intravenous immunoglobulin-resistant Kawasaki disease using an interpretable machine learning approach. 利用可解释的机器学习方法构建和验证静脉注射免疫球蛋白耐药川崎病的预测模型。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-07-23 DOI: 10.3345/cep.2024.00549
Linfan Deng, Jian Zhao, Ting Wang, Bin Liu, Jun Jiang, Peng Jia, Dong Liu, Gang Li

Background: Intravenous immunoglobulin (IVIG)-resistant Kawasaki disease is associated with coronary artery lesion development.

Purpose: This study aimed to explore the factors associated with IVIG-resistance and construct and validate an interpretable machine learning (ML) prediction model in clinical practice.

Methods: Between December 2014 and November 2022, 602 patients were screened and risk factors for IVIG-resistance investigated. Five ML models are used to establish an optimal prediction model. The SHapley Additive exPlanations (SHAP) method was used to interpret the ML model.

Results: Na+, hemoglobin (Hb), C-reactive protein (CRP), and globulin were independent risk factors for IVIG-resistance. A nonlinear relationship was identified between globulin level and IVIG-resistance. The XGBoost model exhibited excellent performance, with an area under the receiver operating characteristic curve of 0.821, accuracy of 0.748, sensitivity of 0.889, and specificity of 0.683 in the testing set. The XGBoost model was interpreted globally and locally using the SHAP method.

Conclusion: Na+, Hb, CRP, and globulin levels were independently associated with IVIG-resistance. Our findings demonstrate that ML models can reliably predict IVIG-resistance. Moreover, use of the SHAP method to interpret the established XGBoost model's findings would provide evidence of IVIG-resistance and guide the individualized treatment of Kawasaki disease.

背景:目的:本研究旨在探索与IVIG耐药相关的因素,并构建和验证临床实践中可解释的机器学习(ML)预测模型:2014年12月至2022年11月期间,共筛查了602名患者,并调查了IVIG耐药的风险因素。采用五种 ML 模型建立最佳预测模型。采用SHAPLE Additive exPlanations(SHAP)方法解释ML模型:结果:Na+、血红蛋白(Hb)、C反应蛋白(CRP)和球蛋白是导致 IVIG 耐药的独立风险因素。球蛋白水平与 IVIG 耐药性之间存在非线性关系。XGBoost 模型表现出卓越的性能,在测试集中,接收者操作特征曲线下面积为 0.821,准确性为 0.748,灵敏度为 0.889,特异性为 0.683。采用 SHAP 方法对 XGBoost 模型进行了全局和局部解释:结论:Na+、Hb、CRP和球蛋白水平与IVIG耐药独立相关。我们的研究结果表明,ML 模型可以可靠地预测 IVIG 耐药性。此外,使用 SHAP 方法来解释已建立的 XGBoost 模型的结果将提供 IVIG 耐药性的证据,并指导川崎病的个体化治疗。
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引用次数: 0
Is it possible to provide palliative care to pediatric patients with neurological diseases? 能否为患有神经系统疾病的儿科患者提供姑息关怀?
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-02-15 DOI: 10.3345/cep.2023.01032
Young-Hoon Kim
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引用次数: 0
Effects of diethylene glycol contamination of pharmaceutical products on unexplained acute kidney injury in children: a systematic review. 药品中的二甘醇污染对儿童不明原因急性肾损伤的影响:系统综述。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-01-04 DOI: 10.3345/cep.2023.01039
Sani Rachman Soleman, Muhammad Luthfi Adnan, Hilmi Ardian Sudiarto, Satria Bintang Mahathma, Alya Ayu Tazkia, Hana Afifah Firdaus, Alfreda Amelia Khotijah, Miranti Dewi Pramaningtyas, Emi Azmi Choironi

Unexplained acute kidney injury (AKI) in children owing to diethylene glycol (DEG) contamination during drug production has gained attention in recent years. This qualitative study investigated the effects of DEG exposure on the incidence of unknown AKI in children. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines was proposed to search for studies using predefined search terms in the PubMed, EBSCO, and Web of Science data-bases without publication date restrictions. The inclusion criteria are observational study, case study, case report, and case series design; and having provided accurate data for DEG poisoning and AKI diagnosis in children. All authors performed the study screening, data extraction, and data synthesis processes. Consensus was reached by mutual agreement. The data synthesis was conducted according to the DEG and unexplained AKI in children by examining the statistical data using Microsoft Excel 2017 and storing the data using the cloud service of Universitas Islam Indonesia. Of the 115 included studies, 21 met the inclusion criteria, including 2 case-control studies, 1 cross-sectional study, 4 case studies, and 14 case reports. DEG-contaminated paracetamol caused unexplained AKI in children. Other drugs including cough expectorants, antihistamines, and sedatives were administered. Chemicals other than DEG, such as propylene glycol and ethylene glycol, also induce AKI owing to overprescription and unintentional exposure. A recent epidemic of unexplained AKI showed contaminated paracetamol as the poisoning agent regardless of formula.

近年来,药物生产过程中的二甘醇(DEG)污染导致的儿童不明原因急性肾损伤(AKI)已引起人们的关注。本定性研究调查了二甘醇暴露对儿童不明原因急性肾损伤发病率的影响。本研究按照 PRISMA(系统综述和荟萃分析的首选报告项目)指南提出了一项系统综述,使用预先定义的搜索条件在 PubMed、EBSCO 和 Web of Science 数据库中搜索研究,没有出版日期限制。纳入标准包括观察性研究、病例研究、病例报告和病例系列设计;以及提供了准确的儿童 DEG 中毒和 AKI 诊断数据。所有作者均参与了研究筛选、数据提取和数据综合过程。通过相互协商达成共识。数据综合根据儿童 DEG 和不明原因 AKI 进行,使用 Microsoft Excel 2017 检查统计数据,并使用印度尼西亚伊斯兰大学的云服务存储数据。在纳入的115项研究中,21项符合纳入标准,包括2项病例对照研究、1项横断面研究、4项病例研究和14项病例报告。受DEG污染的扑热息痛会导致儿童不明原因的AKI。其他药物包括止咳祛痰药、抗组胺药和镇静剂。除二乙二醇外,丙二醇和乙二醇等化学品也会因过量使用和无意接触而诱发急性肾损伤。最近流行的不明原因 AKI 显示,无论配方如何,受污染的扑热息痛都是中毒原因。
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引用次数: 0
Neutropenia following metamizole use in pediatric patients: a multicenter retrospective study. 儿科患者使用甲硝唑后出现的中性粒细胞减少症:一项多中心回顾性研究。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-07-23 DOI: 10.3345/cep.2024.00262
Meraj Alam Siddiqui, Arzu Akyay, Fatma Burcu Belen Apak, Özgür Carti, Canan Albayrak, Melek İşik, Zühre Kaya, Sevgi Yetgin, Lale Olcay
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引用次数: 0
Comorbidities of allergic rhinitis in children. 儿童过敏性鼻炎的并发症。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-07-31 DOI: 10.3345/cep.2024.00164
Yong Ju Lee
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引用次数: 0
Advancements in food allergen immunotherapy: improving quality of life and reducing risks. 食物过敏原免疫疗法的进展:提高生活质量,降低风险。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-07-31 DOI: 10.3345/cep.2023.01718
Jihyun Kim
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引用次数: 0
Association between pre- and postnatal exposure to endocrine-disrupting chemicals and birth and neurodevelopmental outcomes: an extensive review. 产前和产后暴露于某些内分泌干扰化学物质与出生和神经发育结果的关系:一项广泛的综述。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-07-01 Epub Date: 2023-11-16 DOI: 10.3345/cep.2023.00941
Ozge Yesildemir, Mensure Nur Celik

Endocrine-disrupting chemicals (EDCs) are natural or synthetic chemicals that mimic, block, or interfere with the hormones in the body. The most common and well- studied EDCs are bisphenol A, phthalates, and persistent organic pollutants including polychlorinated biphenyls, polybrominated diphenyl ethers, per- and polyfluoroalkyl substances, other brominated flame retardants, organochlorine pesticides, dioxins, and furans. Starting in embryonic life, humans are constantly exposed to EDCs through air, diet, skin, and water. Fetuses and newborns undergo crucial developmental processes that allow adaptation to the environment throughout life. As developing organisms, they are extremely sensitive to low doses of EDCs. Many EDCs can cross the placental barrier and reach the developing fetal organs. In addition, newborns can be exposed to EDCs through breastfeeding or formula feeding. Pre- and postnatal exposure to EDCs may increase the risk of childhood diseases by disrupting the hormone-mediated processes critical for growth and development during gestation and infancy. This review discusses evidence of the relationship between pre- and postnatal exposure to several EDCs, childbirth, and neurodevelopmental outcomes. Available evidence suggests that pre- and postnatal exposure to certain EDCs causes fetal growth restriction, preterm birth, low birth weight, and neurodevelopmental problems through various mechanisms of action. Given the adverse effects of EDCs on child development, further studies are required to clarify the overall associations.

内分泌干扰化学物质(EDCs)是一种天然或人造的化学物质,可以模仿、阻止或干扰人体的激素。最常见和研究最充分的EDCs是双酚A、邻苯二甲酸酯和持久性有机污染物,包括多氯联苯、多溴联苯醚、全氟和多氟烷基物质、其他溴化阻燃剂、有机氯农药、二恶英和呋喃。人类从胚胎开始就不断地通过空气、饮食、皮肤和水接触到EDCs。胎儿和新生儿建立了关键的发育过程,使其能够在一生中适应环境。它们对极低剂量的EDCs极为敏感,因为它们正在发育。在产前,许多EDCs可以穿过胎盘屏障到达胎儿正在发育的内脏器官。此外,新生儿在产后可能通过母乳喂养或婴儿配方奶粉喂养接触到EDCs。产前和产后暴露于EDCs可能会破坏对妊娠期和婴儿期生长发育至关重要的激素介导的过程,从而增加儿童疾病的风险。本综述讨论了产前和产后暴露于几种EDCs与儿童出生和神经发育结局之间关系的证据。现有证据表明,产前和产后暴露于某些EDCs可通过多种作用机制导致胎儿生长受限、早产、低出生体重和神经发育问题。考虑到EDCs对儿童发育的不良影响,需要进一步的研究来阐明两者之间的整体关系。
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引用次数: 0
Efficacy of social skills group intervention among children with mild autism spectrum disorder. 社交技能小组对轻度自闭症谱系障碍儿童的效果。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-07-01 Epub Date: 2024-05-31 DOI: 10.3345/cep.2024.00122
Lee Ling Low, Ker Yang Chua, Bih Hwa Ching
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引用次数: 0
期刊
Clinical and Experimental Pediatrics
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