Pediatrics and Neonatology最新文献

英文中文

Automatic assessment of fine motor development in children through hand-drawn shape images 通过手绘形状图像自动评估儿童精细运动的发展。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.04.001

Nai-Hsuan Hwang , Sheng-Shan Chen , Tun-Wen Pai , Mary Hsin-Ju Ko , Ya-Lan Yu , Hui-Ju Chen

Background

Fine motor skills are closely related to neurological maturity among children and serve as critical indicators of developmental status. However, clinical assessments require significant human and material resources. This study proposes an automated evaluation mechanism designed to assess the development of children's fine motor skills, offering a streamlined and resource-efficient approach to developmental assessment.

Methods

The designed system evaluated the fine motor skills of 82 children aged 36–72 months. The children were asked to replicate five geometric shapes designed by the system: circles, crosses, squares, triangles, and rhombuses. The system automatically assessed 23 distinct features across the geometric shapes using an artificial intelligence-based model. A tailored scoring system then assigned a score that reflected the child's level of fine motor skill maturity.

Results

A total of 81 replicated drawings from the children in the test group were collected and automatically assessed using the assessment mechanism developed in this study. The results demonstrated a strong positive correlation between fine motor skill maturity and practical age. Additionally, the scores identified children with delayed fine motor development. The macro F1-score and accuracy of the automatic classification models for the five different geometric shapes in the validation dataset were 0.9236 and 0.9268, respectively. These evaluation outcomes can effectively support early intervention and treatment efforts.

Conclusion

The system's structured drawing tasks for varying geometric shapes have substantial practical value for the automatic assessment of children's fine motor maturity. The scoring method developed in this study provides a clear distinction between the different developmental stages of children's fine motor skills. This system offers an effective online tool for assessing fine motor development among children, thereby providing essential preliminary reference information for physicians in subsequent clinical evaluations and significantly reducing the burden on healthcare professionals.

背景：精细运动技能与儿童神经系统发育密切相关，是儿童发育状况的重要指标。然而，临床评估需要大量的人力和物力资源。本研究提出了一种评估儿童精细运动技能发展的自动化评估机制，为发展评估提供了一种精简和资源高效的方法。方法：采用设计的系统对82例36 ~ 72月龄儿童的精细运动技能进行评估。孩子们被要求复制系统设计的五种几何形状：圆形、十字形、正方形、三角形和菱形。该系统使用基于人工智能的模型自动评估几何形状中的23个不同特征。然后，一个量身定制的评分系统给出了一个反映孩子精细运动技能成熟程度的分数。结果：共收集了81张试验组儿童的重复图画，并采用本研究开发的评估机制进行了自动评估。结果表明，精细运动技能成熟度与实际年龄呈正相关。此外，分数确定了精细运动发育迟缓的儿童。验证数据集中5种不同几何形状的自动分类模型的宏观f1得分和准确率分别为0.9236和0.9268。这些评估结果可以有效地支持早期干预和治疗工作。结论：该系统对不同几何形状的结构化绘制任务对儿童精细运动成熟度的自动评估具有重要的实用价值。本研究开发的评分方法对儿童精细运动技能的不同发展阶段提供了清晰的区分。该系统为评估儿童精细运动发育提供了一个有效的在线工具，从而为医生在随后的临床评估中提供了必要的初步参考信息，并显著减轻了医疗保健专业人员的负担。

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引用次数: 0

Enhancing neonatal care through NAVA: A case study on optimizing respiratory support for a very low birth weight infant 通过NAVA加强新生儿护理：优化极低出生体重婴儿呼吸支持的案例研究。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.06.006

Daijiro Takahashi , Koko Goto , Kei Goto

引用次数: 0

Association of LEP rs7799039 and LEPR rs1137101 polymorphisms with obesity in Vietnamese preschool children 越南学龄前儿童肥胖与LEP rs7799039和LEPR rs1137101多态性的关系

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.09.007

Thi Tuyet Le , Bui Quang Minh Pham , Thi Trung Thu Nguyen , Thi Hong Hanh Nguyen , Thi Thuy Dung Le

Background

Single nucleotide polymorphisms (SNPs) in genes that regulate body weight and energy homeostasis, such as LEP and LEPR, may influence susceptibility to obesity. The present study aims to evaluate the association of LEP rs7799039 and LEPR rs1137101 polymorphisms with obesity in Vietnamese preschool children.

Methods

A case-control study was conducted on 1146 preschool children aged 3–6 years (360 obese children and 786 normal-weight children). Genotypes at rs7799039 and rs1137101 loci were identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.

Results

After adjusting for age and sex, single SNP analysis indicated an association of LEP rs7799039 with obesity (OR∗ = 1.41, P∗ = 0.01 in the recessive model), but no association between LEPR rs1137101 and obesity was found. In SNP-SNP interaction analysis, the combination of LEP rs7799039 AA and LEPR rs1137101 GG genotypes conferred a greater risk of obesity (OR∗ = 1.48, P∗ = 0.015).

Conclusions

This study implies a synergistic effect of LEP rs7799039 and LEPR rs1137101 on obesity susceptibility. Therefore, these two polymorphisms are potential genetic markers to predict childhood obesity in the Vietnamese population.

背景：调节体重和能量稳态的基因（如LEP和LEPR）中的单核苷酸多态性（snp）可能影响肥胖的易感性。本研究旨在评估越南学龄前儿童LEP rs7799039和LEPR rs1137101多态性与肥胖的关系。方法：对1146例3 ~ 6岁学龄前儿童（其中肥胖儿童360例，正常体重儿童786例）进行病例对照研究。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）技术鉴定rs7799039和rs1137101位点的基因型。结果：在调整年龄和性别后，单SNP分析显示LEP rs7799039与肥胖相关（OR∗= 1.41，在隐性模型中P∗= 0.01），而LEPR rs1137101与肥胖无关。在SNP-SNP互作分析中，LEP rs7799039 AA和LEPR rs1137101 GG基因型的组合会增加肥胖的风险（OR∗= 1.48,P∗= 0.015）。结论：本研究提示LEP rs7799039和LEPR rs1137101在肥胖易感性中具有协同作用。因此，这两种多态性是预测越南人群儿童肥胖的潜在遗传标记。

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引用次数: 0

Exploring stickler syndrome through a familial case: Beyond Robin sequence 通过家族病例探索stickler综合征：超越Robin序列。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.03.011

Hsin-Ru Wu , Fuu-Jen Tsai

引用次数: 0

A simple biochemical marker for biliary atresia-promise and prudence 一种简便的胆道闭锁生化指标——希望与谨慎。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.10.001

Ming-Wei Lai

引用次数: 0

Evaluating treatment efficacy in attention-deficit/hyperactivity disorder by analyzing the movement-induced deformation of load cells under a chair in a simulated classroom: A pilot study 通过分析模拟教室中椅子下测压元件的运动诱导变形来评估对注意力缺陷/多动障碍的治疗效果：一项试点研究。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.08.008

Rong-Ching Wu , Yi-Hung Chiu , Chen-Sen Ouyang , Rei-Cheng Yang , Lung-Chang Lin

Background

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Several tools are available for evaluating the efficacy of ADHD treatment, such as, for example, the Swanson, Nolan, and Pelham (SNAP-IV) questionnaire; and the Vanderbilt ADHD Diagnostic Rating Scale. However, these scales are subjective. In this study, we developed an objective method by using load cells for evaluating the efficacy of ADHD treatment.

Methods

A situational classroom was prepared to simulate a real classroom. The setup included a desk, a chair, and a large screen. The four legs of the chair were equipped with load cells—materials that deform under force. These cells are used to detect the activity of patients with ADHD. This study included 13 patients with ADHD (12 boys and 1 girl). Before and after 1-month treatment with methylphenidate 10 mg p.o. QD, the patients were instructed to watch an age-appropriate educational video on Mathematics while sitting. Their movements were indicated by data gathered from the load cells under the chair. The average trajectory length (ATL) was measured to analyze the signal from the load cells. SNAP-IV questionnaires were completed by parents and teachers before and after treatment.

Results

The ATL values before and after treatment were 0.0316 ± 0.0139 and 0.0208 ± 0.0127 (p = 0.0055), respectively. The patients’ SNAP-IV scores assigned by parents before and after treatment were 38.89 ± 8.07 and 23.67 ± 16.87 (p = 0.0167) and those provided by teachers were 44.11 ± 11.47 and 22.22 ± 13.50 (p = 0.0048), respectively. The coefficients of the correlations between ATL values and SNAP-IV hyperactivity-impulsivity scores from parents and from teachers were 0.109 and 0.200, respectively.

Conclusion

In conclusion, the smart chair equipped with load cells is an effective tool for objectively evaluating the efficacy of ADHD treatment on hyperactivity of children with ADHD.

背景：注意缺陷/多动障碍（ADHD）是儿童常见的神经发育障碍。有几种工具可用于评估ADHD治疗的效果，例如Swanson， Nolan, and Pelham （SNAP-IV）问卷；以及范德比尔特多动症诊断评定量表。然而，这些量表是主观的。在这项研究中，我们开发了一种客观的方法，使用称重传感器来评估ADHD治疗的效果。方法：模拟真实课堂，制作情境教室。设备包括一张桌子、一把椅子和一个大屏幕。椅子的四条腿都装有测压元件，这种材料在外力作用下会变形。这些细胞被用来检测多动症患者的活动。本研究纳入13例ADHD患者（12名男孩和1名女孩）。在用哌醋甲酯治疗1个月前后，患者被要求坐着观看适合年龄的数学教育视频。他们的运动是由椅子下面的测压元件收集的数据指示的。测量平均轨迹长度（ATL）来分析来自称重传感器的信号。治疗前后由家长和老师填写SNAP-IV问卷。结果：治疗前后ATL值分别为0.0316±0.0139和0.0208±0.0127 （p = 0.0055）。患者治疗前后家长评分为38.89±8.07分、23.67±16.87分（p = 0.0167），教师评分为44.11±11.47分、22.22±13.50分（p = 0.0048）。ATL值与家长和教师的SNAP-IV多动冲动得分的相关系数分别为0.109和0.200。结论：综上所述，配备称重传感器的智能椅是客观评价ADHD治疗对ADHD患儿多动效果的有效工具。

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引用次数: 0

The newborn with abnormal platelets aggregation who survived spontaneous splenic rupture: a case report 自发性脾破裂新生儿血小板聚集异常存活1例。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.06.004

Tal Golan Lagziel , Michal Eisenstadt , Liran Tamir Hostovsky

引用次数: 0

The impact of therapeutic hypothermia on developmental outcomes in lower-middle income countries: A systematic review and meta-analysis with a health equity lens 治疗性低温对中低收入国家发育结局的影响：一项基于健康公平视角的系统综述和荟萃分析

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.09.010

Cheryl C. Hawkins , Elizabeth Spiegel , Diane D. Allen , Kathryn Nesbit

Hypoxic-ischemic encephalopathy (HIE) from birth asphyxia is particularly burdensome on lower-middle income countries (LMICs). Our systematic review examined early and late developmental outcomes related to neonatal therapeutic hypothermia (TH) without disability thresholds or cut-offs pre-determined by high-income countries. A search of PubMed, Web of Science, and Embase databases yielded 364 articles; 11 studies met eligibility criteria. According to published standards for reporting of studies, 3 of the 11 studies were good quality and 8 studies were excellent. Within-group changes in early and late developmental outcomes showed large, significant effect sizes (d = -2.07; CI = −0.77, −3.36; d = 3.17; CI = 2.14, 4.21). Between-group differences showed significant effect sizes in late but not early developmental outcomes (d = 0.85; CI = 0.62, 1.07; d = −0.16; CI = −0.58, 0.25). The evidence indicates that TH improves developmental outcomes prior to hospital discharge and after 6 months, and surpasses standard of care for 6-month and later developmental outcomes.

出生窒息引起的缺氧缺血性脑病（HIE）对中低收入国家（LMICs）来说尤其沉重。我们的系统综述检查了与新生儿治疗性低温（TH）相关的早期和晚期发育结局，没有高收入国家预先确定的残疾阈值或截止值。在PubMed、Web of Science和Embase数据库中搜索得到364篇文章；11项研究符合资格标准。根据已公布的研究报告标准，11项研究中有3项为优质研究，8项为优秀研究。早期和晚期发育结局的组内变化显示出巨大的显著效应量(d = -2.07；Ci = -0.77, -3.36；d = 3.17；Ci = 2.14, 4.21)。组间差异在发育晚期而非早期表现出显著效应(d = 0.85；Ci = 0.62, 1.07；d = -0.16；Ci = -0.58, 0.25)。有证据表明，TH可改善出院前和出院后6个月的发育结果，并在6个月及以后的发育结果中优于标准护理。

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引用次数: 0

Heart rate variability as an early predictor for children with SARS-CoV-2-associated encephalopathy 心率变异性作为sars - cov -2相关脑病儿童的早期预测指标

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.09.009

Yu-Shin Lee , Hung-Tao Chung , Shao-Hsuan Hsia , Oi-Wa Chan , En-Pei Lee , Kuang-Lin Lin , Jainn-Jim Lin , Han-Ping Wu

Background

Although encephalopathy and encephalitis are uncommon complications of SARS-CoV-2 infection in children, they can lead to significant morbidity and mortality. Therefore, the aim of the study is to assess heart rate variability in children with SARS-CoV-2 infection and determine those at risk of progressing to SARS-CoV-2-associated encephalopathy.

Methods

Children with confirmed SARS-CoV-2 infection between September 1, 2022 and December 8, 2023 were prospectively enrolled and divided into encephalopathic and non-encephalopathic groups. The non-encephalopathic group was further classified into mild, moderate, and severe/critical disease groups. One-minute electrocardiography was recorded on the first day of admission. Heart rate variability indices were compared between the encephalopathic and non-encephalopathic groups.

Results

A total of 72 children (30 girls [41.7 %] and 42 boys [58.3 %]) with SARS-CoV-2 infection were enrolled, with age ranging from 1 month to 18 years. Of these children, 15 (20.8 %) were classified into the encephalopathic group, and 57 (79.2 %) were classified into the non-encephalopathic group. We compared heart rate variability indices and found that both time domain analysis (SDNNc and RMSSDc) and nonlinear Poincaré plot analysis (SD1/SD2 ratio) were lower in the encephalopathic group and severe/critical disease group than in the mild and moderate severity non-encephalopathic groups.

Conclusions

Heart rate variability parameters were significantly lower in the severe/critical disease group and the encephalopathic group compared to the mild to moderate severity groups. The implications of heart rate variability, particularly when considering neurological symptoms, as a predictor of disease progression to encephalopathy require further evaluation.

背景：虽然脑病和脑炎是儿童SARS-CoV-2感染的罕见并发症，但它们可导致显著的发病率和死亡率。因此，本研究的目的是评估感染SARS-CoV-2的儿童的心率变异性，并确定那些有发展为SARS-CoV-2相关脑病风险的儿童。方法：前瞻性纳入2022年9月1日至2023年12月8日确诊的SARS-CoV-2感染患儿，分为脑病组和非脑病组。非脑病组进一步分为轻度、中度和重度/危重症组。入院第一天记录1分钟心电图。比较脑病组和非脑病组的心率变异性指数。结果：共纳入72例SARS-CoV-2感染患儿，其中女孩30例（41.7%），男孩42例（58.3%），年龄1个月~ 18岁。其中脑病组15例（20.8%），非脑病组57例（79.2%）。我们比较了心率变异性指标，发现脑病组和重/危重疾病组的时域分析（SDNNc和RMSSDc）和非线性poincar图分析（SD1/SD2比值）均低于轻度和中度非脑病组。结论：重/危重症组和脑病组的心率变异性参数明显低于轻至中度严重程度组。心率变异性的含义，特别是当考虑到神经系统症状时，作为疾病进展为脑病的预测指标需要进一步评估。

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引用次数: 0

The impact and outcome of the presence of ductus arteriosus in neonatal peripheral extracorporeal membrane oxygenation. 动脉导管的存在对新生儿外周体外膜氧合的影响和结果。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-10-31 DOI: 10.1016/j.pedneo.2025.06.007

Hsi-Yun Liu, Ming-Chou Cheng, Shao-Ju Chien, Ying-Jui Lin, Hsuan-Chang Kuo, Mei-Hsin Hsu, Chien-Te Lee, Jiunn-Jye Sheu

Background: This study aimed to investigate the impact of the patent ductus arteriosus (DA) on pulmonary conditions and to evaluate the outcomes during neonatal extracorporeal membrane oxygenation (ECMO).

Methods: Thirteen neonates who received ECMO support at Kaohsiung Chang Gung Memorial Hospital from June 2009 to June 2021 were retrospectively reviewed. Clinical data including diagnosis, duration of ECMO support, serial chest X-rays, echocardiography findings, and outcomes were recorded. The study population underwent peripheral ECMO placement, and echocardiography was performed to assess the DA condition. Chest X-rays were evaluated using the Radiographic Assessment of Lung Edema (RALE) score to assess pulmonary edema. Statistical analyses were conducted to compare pre- and post-ECMO pulmonary conditions and outcomes.

Results: The study population consisted of neonates diagnosed with congenital diaphragmatic hernia (CDH), acute respiratory distress syndrome (ARDS), or meconium aspiration syndrome (MAS). All neonates presented with pulmonary hypertension and patent DA before ECMO initiation, which DA spontaneously closed in surviving neonates after ECMO. The RALE score showed no significant differences in pulmonary edema between pre-ECMO and post-ECMO setup. The overall survival rate of neonates undergoing ECMO support with DA was 53.8 %. The ECMO weaning success rates and survival-to-discharge rates were 62.5 % and 50.0 % in the CDH group, compared to 80 % and 60 % in the non-CDH group, respectively.

Conclusion: The presence of DA during neonatal ECMO may not deteriorate the condition of pulmonary hypertension and pulmonary edema. Additionally, all surviving neonates showed spontaneous closure of the DA during follow-up. These findings suggest that peripheral ECMO without routine PDA ligation may be feasible in newborns.

背景：本研究旨在探讨动脉导管未闭（DA）对新生儿肺状况的影响，并评价新生儿体外膜氧合（ECMO）的预后。方法：对2009年6月至2021年6月在高雄长庚纪念医院接受ECMO支持的13例新生儿进行回顾性分析。记录临床资料，包括诊断、ECMO支持时间、连续胸部x线、超声心动图结果和结果。研究人群接受外周ECMO放置，并进行超声心动图评估DA状况。胸片采用肺水肿放射学评估（RALE）评分来评估肺水肿。统计分析比较ecmo前后肺部状况和结果。结果：研究人群包括诊断为先天性膈疝（CDH）、急性呼吸窘迫综合征（ARDS）或胎粪吸入综合征（MAS）的新生儿。所有新生儿在ECMO开始前均出现肺动脉高压和DA未闭，存活的新生儿在ECMO后DA自行关闭。RALE评分显示ecmo前和ecmo后肺水肿无显著差异。采用DA的ECMO支持新生儿的总生存率为53.8%。CDH组的ECMO断奶成功率和存活至出院率分别为62.5%和50.0%，而非CDH组分别为80%和60%。结论：新生儿ECMO时DA的存在不会加重肺动脉高压和肺水肿的病情。此外，所有存活的新生儿在随访期间都表现出DA的自发关闭。这些结果表明，不进行常规PDA结扎的外周ECMO在新生儿中是可行的。

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