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Repetitive Motor Behaviors in Non-Autistic Toddlers 非自闭症幼儿的重复性运动行为。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-17 DOI: 10.1016/j.jpeds.2026.114994
Monique Moore Hill MA , Devon Gangi PhD , Shy Maqbool BS , Rachel Ni MS , Chandni Parikh PhD , Sally Ozonoff PhD

Objective

To evaluate repetitive motor behaviors (RMBs) in non-autistic toddlers using direct observational methods.

Study design

This cohort study assessed RMBs in a community sample of 679 toddlers at 24 and 36 months of age. Initial analyses examined rates of RMBs in autistic (n = 65) vs nonautistic (n = 614) participants. Subsequent analyses focused on participants without autism, first examining clinical correlates of RMBs in the full non-autistic group and then comparing rates of RMBs in 2 non-autistic subgroups: 104 participants with other developmental concerns (ODC) and 510 participants with no developmental concerns.

Results

A total of 36% of non-autistic children demonstrated RMB at 24 and/or 36 months of age. RMBs were significantly more likely in the ODC (55%) than the no developmental concerns (33%) group. Non-autistic participants with RMBs had significantly lower communication scores at 24 months and, at both ages, significantly higher scores on 2 measures of autism-related symptomatology than those without RMBs; however, group means fell within the average range and effect sizes were small. There were no RMB differences based on sex.

Conclusions

RMBs are not uncommon in 24- to 36-month-old children who do not meet diagnostic criteria for autism. Among non-autistic children, RMBs are most likely to occur in those with other developmental challenges but are also present in some typically developing children. The presence of RMBs in toddlers should be evaluated within the context of Diagnostic and Statistical Manual of Mental Disorders, fifth edition ASD criteria, and RMBs alone without social communication challenges core to ASD should not be viewed as automatically indicative of autism.
目的:采用直接观察法评价非自闭症幼儿的重复性运动行为。研究设计:本队列研究评估了679名24和36个月大的幼儿的重复性运动行为(RMBs)。最初的分析检查了自闭症(n=65)和非自闭症(n=614)参与者的RMBs率。随后的分析集中在没有自闭症的参与者身上,首先检查了完全非自闭症组中RMBs的临床相关性,然后比较了两个非自闭症亚组中RMBs的发生率:104名有其他发展问题(ODC)的参与者和510名没有发展问题(NDC)的参与者。结果:36%的非自闭症儿童在24和/或36个月大时表现出重复性运动行为。人民币在ODC组(55%)的可能性明显高于NDC组(33%)。有RMBs的非自闭症参与者在24个月时的沟通得分显著低于没有RMBs的参与者,在两个年龄段,自闭症相关症状的两项测量得分均显著高于没有RMBs的参与者;然而,组均值落在平均范围内,效应量很小。性别之间没有人民币差异。结论:在不符合自闭症诊断标准的24-36月龄儿童中,RMBs并不罕见。在非自闭症儿童中,RMBs最有可能发生在那些有其他发育挑战的儿童中,但也存在于一些正常发育的儿童中。幼儿中存在的rmb应该在DSM-5 ASD标准的背景下进行评估,如果没有ASD核心的社会沟通挑战,那么单独的rmb不应该被视为自闭症的自动指示。
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引用次数: 0
The Silent Epidemic: Early Onset Ludopathy in Children and the Invisible Digital Threat. 无声的流行病:儿童早期Ludopathy和看不见的数字威胁。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.114987
Mehmet Vural, Georgios Konstantinidis, Maria Pastore, Tudor Lucian Pop, Esra Sevketoglu, Donjeta Bali, Ida Giardino, Massimo Pettoello-Mantovani
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引用次数: 0
Impact of the Supreme Court and State Legislation on Pediatric Diversity Initiatives. 最高法院和州立法对儿科多样性倡议的影响。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.114991
Michael D Cabana, Samantha R Levano, Pedro A de Alarcon, Xylina D Bean, Loretta Cordova de Ortega, Laura Degnon, Phyllis A Dennery, Lewis R First, Kersten Hildebrandt-Abdikarim, Charles Schleien, Lilia Parra-Roide, Glenn Flores
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引用次数: 0
Exception from Informed Consent in Neonatal Research 新生儿研究中知情同意的例外。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.114999
Jay R. Malone MD, PhD , Elizabeth E. Foglia MD, MSCE , Brian S. Carter MD , Sindhu Srinivas MD, MSCE , F. Sessions Cole MD
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引用次数: 0
Psychosocial Functioning of Youth with Hereditary Polyposis Syndromes and their Caregivers. 遗传性息肉病综合征青少年及其照顾者的社会心理功能。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.114988
Michele H Maddux, Caitlin Lawson, Nicole Stoecklein, Thomas M Attard

Objective: To evaluate psychosocial functioning among youth with hereditary polyposis syndromes (HPS) and their caregivers.

Study design: Data on health-related quality of life (HRQOL), illness uncertainty (CIUS/PIUS), caregiver psychological distress, and caregiver-perceived blame/fault were collected as part of standard care visits to a multidisciplinary polyposis clinic.

Results: Psychosocial data were obtained from 33 youth ages 8-18 and 63 caregivers. About 15% of youth and 13% of caregivers endorsed elevated illness uncertainty. HRQOL was poorest in emotional and school functioning. Mean (± SD) caregiver distress scores were 1.03 ± 1.59 and mean blame/fault scores were 2.56 ± 2.53, with 21% of caregivers feeling at fault for their child's HPS. Significant correlations were found between child- and caregiver-reported illness uncertainty (r = 0.52, p < 0.01) and caregiver perceived fault was significantly correlated with caregiver distress (r = 0.26, p = 0.04). Caregivers with a shared diagnosis endorsed feeling at fault for their child's HPS diagnosis and endorsed significantly greater distress. Caregivers of youth with minority status endorsed significantly greater distress (H(4) = 10.54, p = 0.03) and caregiver perceived fault was higher for male youth.

Conclusions: Findings suggest that youth with HPS are at risk of poor HRQOL and elevated illness uncertainty, and caregivers similarly show elevated risk for psychological distress, perceived fault for the youth's HPS diagnosis, and elevated illness uncertainty. Some socioeconomic factors also have significant implications for caregiver's overall functioning. These findings highlight the need for psychosocial functioning to be a primary target and consideration in HPS care.

目的:评价遗传性息肉病综合征(HPS)青少年及其照顾者的社会心理功能。研究设计:收集与健康相关的生活质量(HRQOL)、疾病不确定性(CIUS/PIUS)、护理者心理困扰和护理者感知的责备/过失等数据,作为多学科息肉病诊所标准护理就诊的一部分。结果:获得了33名8-18岁青少年和63名照顾者的心理社会数据。大约15%的年轻人和13%的护理人员认为疾病不确定性增加。HRQOL在情绪和学习功能方面最差。平均(±SD)照顾者痛苦得分为1.03±1.59,平均责备/过错得分为2.56±2.53,21%的照顾者对孩子的HPS有过错。儿童和照顾者报告的疾病不确定性之间存在显著相关(r = 0.52, p < 0.01),照顾者感知错误与照顾者痛苦之间存在显著相关(r = 0.26, p = 0.04)。有共同诊断的照顾者赞同对他们孩子的HPS诊断有过错,并赞同明显更大的痛苦。少数民族青少年照顾者的痛苦程度显著高于男性青少年(H(4) = 10.54, p = 0.03),男性青少年照顾者感知错误更高。结论:研究结果表明,患有HPS的青少年存在HRQOL差和疾病不确定性升高的风险,护理者同样表现出心理困扰、对青少年HPS诊断的感知错误和疾病不确定性升高的风险。一些社会经济因素也对照顾者的整体功能有重要影响。这些发现强调了心理社会功能作为HPS护理的主要目标和考虑的必要性。
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引用次数: 0
Feeding Infants Born Moderate-to-Late Preterm: 2-Year Follow-Up of the DIAMOND Randomized Trial. 喂养中度至晚期早产儿:DIAMOND随机试验的2年随访。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.114989
Subhasish Das, Frank H Bloomfield, Tanith Alexander, Yannan Jiang, Greg Gamble, Luling Lin, Jane E Harding

Objective: To determine the impact of different feeding strategies in children born moderate-and-late preterm (MLPT) on later neurosensory impairment.

Study design: Children born MLPT (32+0-35+6 weeks) recruited to the DIAMOND factorial randomized trial from New Zealand neonatal units were randomized to intravenous amino acids vs intravenous dextrose, exclusive maternal breastmilk vs milk supplement, and taste/smell of milk before gastric tube feeds or not. Neurosensory impairment (blindness, deafness, cerebral palsy or developmental delay [Bayley III composite cognitive/language/motor scores < 85]) was assessed at 2 years of corrected age. Outcomes were compared using generalized linear mixed models.

Results: Of 529 eligible children, 425 were assessed at mean (SD) 25.6 (1.9) months. Rates of neurosensory impairment or developmental delay were similar in amino acids vs dextrose and in milk supplement vs maternal breastmilk only groups, but impairments were less frequent in children randomized to taste/smell of milk (43/203 [21%] vs 68/220 [31%]; aRR 0·7; 95% CI 0·5 to 0·9; P=0·02). This difference was primarily due to mild developmental delay, particularly language delay (35/199 [18%] vs 61/218 [28%]; aRR 0.6; 95% CI 0.4 to 0.9; P=0.01). Growth, general health and behavior were similar between groups.

Conclusions: Early parenteral and enteral nutrition strategies in children born MLPT did not alter outcomes at 2 years. However, exposure to taste/smell of milk before gastric tube feeds was associated with a lower risk of neurosensory impairment. Further investigation to confirm these findings is necessary.

目的:探讨不同喂养策略对中晚期早产儿神经感觉功能障碍的影响。研究设计:从新西兰新生儿单位招募的MLPT(32+0-35+6周)出生的儿童(32+0-35+6周)随机分配到静脉注射氨基酸vs静脉注射葡萄糖,纯母乳vs母乳补充剂,胃管喂养前或不胃管喂养前的牛奶味道/气味。在矫正年龄2岁时评估神经感觉障碍(失明、耳聋、脑瘫或发育迟缓[Bayley III复合认知/语言/运动评分< 85])。结果采用广义线性混合模型进行比较。结果:在529名符合条件的儿童中,425名儿童在平均(SD) 25.6(1.9)个月时接受评估。氨基酸组与葡萄糖组、母乳补充剂组与纯母乳组的神经感觉障碍或发育迟缓率相似,但随机分配到品尝/嗅觉组的儿童的神经感觉障碍发生率较低(43/203[21%]对68/220 [31%];aRR为0.7;95% CI为0.05 ~ 0.9;P= 0.02)。这种差异主要是由于轻度发育迟缓,特别是语言迟缓(35/199 [18%]vs 61/218 [28%]; aRR 0.6; 95% CI 0.4 ~ 0.9; P=0.01)。两组之间的生长、总体健康和行为相似。结论:早期肠外和肠内营养策略对先天性MLPT患儿2岁时的预后没有影响。然而,在胃管喂养前接触牛奶的味道/气味与神经感觉损伤的风险较低有关。有必要进一步调查以证实这些发现。
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引用次数: 0
Invasive Haemophilus influenzae Disease in Children: Continued Challenges and the Work ahead 儿童侵袭性流感嗜血杆菌疾病:持续的挑战和未来的工作。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.115001
Kathryn Como-Sabetti MPH, Ruth Lynfield MD
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引用次数: 0
Necrotizing Enterocolitis and Shunt Survival in Premature Infants with Posthemorrhagic Hydrocephalus: A Hydrocephalus Clinical Research Network Study 出血后脑积水早产儿坏死性小肠结肠炎和分流生存:脑积水临床研究网络研究。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-16 DOI: 10.1016/j.jpeds.2026.114985
Vijay M. Ravindra MD, MSPH , John R.W. Kestle MD , Hailey Jensen MStat , Abhaya V. Kulkarni MD, PhD , David D. Limbrick Jr. MD, PhD , Amanda Stanton MD , John C. Wellons III MD, MSPH , Robert P. Naftel MD , Curtis J. Rozzelle MD , Brandon G. Rocque MD, MS , Ian F. Pollack MD , Mandeep S. Tamber MD, PhD , Samuel R. Browd MD, PhD , Jonathan Pindrik MD , Albert M. Isaacs MD, PhD , Patrick J. McDonald MD, MHSc , Todd C. Hankinson MD , Eric M. Jackson MD , Mark D. Krieger MD , Tamara D. Simon MD, MSPH , R. Holubkov

Objective

To examine whether necrotizing enterocolitis (NEC) is associated with time to shunt failure (revision or infection) in infants born premature who have posthemorrhagic hydrocephalus (PHH) and cerebrospinal fluid ventriculoperitoneal shunting.

Study design

In this retrospective, case-control study using the Hydrocephalus Clinical Research Network Core Data Project registry, we identified children <6 months of age who underwent shunt placement for PHH. The outcomes were time to shunt failure, frequency of shunt failure at 6, 12, and 24 months, and reasons for failure.

Results

Among the 412 patients identified, 76 were diagnosed with NEC (18%). NEC was not associated with time to shunt failure (P = .353) and was not an independent predictor of shunt failure (P = .68). Similar percentages of children experienced shunt failure at 6 (P = .12), 12 (P = .26), and 24 (P = .35) months. The reasons for shunt failure did not differ between cohorts.

Conclusions

Our study did not demonstrate differences in shunt survival between children <6 months of age requiring cerebrospinal fluid diversion secondary to PHH who had NEC and those who did not. Thus, peritoneal shunt placement may be suitable for children with NEC despite having abdominal interventions.
目的:探讨出血性脑积水(PHH)和脑脊液(CSF)脑室-腹膜分流的早产儿坏死性小肠结肠炎(NEC)是否与分流失败(翻修或感染)的时间有关。研究设计:在这项使用脑积水临床研究网络核心数据项目登记处的回顾性病例对照研究中,我们确定了儿童。结果:在确定的412例患者中,76例被诊断为NEC(18%)。NEC与分流失效时间无关(P=0.353),也不是分流失效的独立预测因子(P= 0.68)。在6个月(P=0.12)、12个月(P= 0.26)和24个月(P= 0.35)时发生分流失败的儿童比例相似。分流失败的原因在队列之间没有差异。结论:我们的研究没有证明儿童在分流存活率上的差异
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引用次数: 0
Missing School Matters for Children's Health: Multidisciplinary Approaches to Chronic Absenteeism and its Socioeconomic Drivers. 缺课对儿童健康的影响:慢性缺课及其社会经济驱动因素的多学科方法。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-15 DOI: 10.1016/j.jpeds.2026.114986
Rachel Lee, Nicholas Wilson, Austin D Le, Courtney Lubaczewski, Jared Boyce, Daniel Resnick, Crystal C Uwazie, Shaminy Manoranjithan, Riddhi Modi, Kyle Smith, Adrienne Nguyen, Heidi Schumacher, Danielle G Dooley, Elliott Attisha
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引用次数: 0
Reassessing the Evidence and Opportunities Ahead for Pediatric Iron Deficiency Anemia. 重新评估儿童缺铁性贫血的证据和机会。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2026-01-14 DOI: 10.1016/j.jpeds.2026.114984
Luisanna M Sánchez, Jacquelyn M Powers
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引用次数: 0
期刊
Journal of Pediatrics
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