This study aims to compare the efficiencies of three noninvasive technologies in monitoring the perioperative hemodynamics of children with congenital heart disease (CHD) including ventricular septal defects with or without atrial septal defects. Three noninvasive technologies included transthoracic echocardiography (TTE), electrical cardiometry (EC), and vasoactive inotropic score (VIS). Parameters included left ventricular ejection fraction (LVEF) and cardiac index (cardiac index monitored by ultrasound, uCI) in TTE, cardiac index (cardiac index monitored by electrical cardiometry, eCI) and systemic vascular resistance index (SVRI) in EC, and VIS. Seventy-four children were eligible. Three types of adverse events (AEs) related to disease activity and prognosis were observed, including cardio-pulmonary resuscitation in five cases (5/74, 6.76%), hypoxic-ischemic brain damage in four cases (4/74, 5.41%) and hemopurification in four cases (4/74, 5.41%). Except for LVEF, eight parameters (VISmax [maximum VIS], VISmea [mean VIS], uCImea [mean uCI], uCImin [minimum uCI], eCImea [mean eCI], eCImin [minimum eCI], SVRImea [mean SVRI], and SVRImin [minimum SVRI]) showed predictive value for any AE (p < 0.05). VISmea, uCImea, and eCImea demonstrated the highest accuracy and linear associations (AUROC > 0.9, p = 0.00). Linear associations also existed between the three groups of parameters and the duration of mechanical ventilation (MV) and the length of stay (LOS) in the intensive care unit (ICU). The duration of MV and the LOS in the ICU increased as VISmea rose, or uCImea and eCImea fell (p < 0.05). LVEF in TTE could not predict any AE (p > 0.05) and not fully reflect the cardiovascular function. Therefore, most parameters obtained in TTE, EC, and VIS can reflect the perioperative hemodynamics of children with CHD, with VISmea, uCImea, and eCImea being most accurate.

To assess the beneficial effects of delivery room continuous positive airway pressure (DRCPAP) in extremely preterm infants, a single-center retrospective study was performed at the Women and Children's Hospital of Chongqing Medical University in China. Infants born between January 2016 and December 2018 were regarded as the control group, and those born between January 2019 and August 2022 were considered as the observation group (DRCPAP group). The primary outcome was tracheal intubation within 72 h after birth. Six hundred and seven patients were included in the study (control: 232; DRCPAP: 375). Compared with the control group, DRCPAP reduced the intubation rate (56.8% vs. 62.9%, OR 0.57, 95% CI 0.34–0.96, p = 0.035), including <28 weeks gestational age (GA) subgroup (61.5% vs. 84.7%, OR 0.12, 95% CI 0.02–0.78, p = 0.027). One-to-one propensity score matching (195:195) was used to match the baseline characteristics of patients in DRCPAP and control group. After matching, no significant differences were observed in intubation rate within 72 h between the two groups (20.5% [40 of 195] vs. 22.1% [43 of 195]; p = 0.711). Whether DRCPAP can reduce intubation rate within 72 h requires further investigation.

Spina bifida is a birth defect resulting from abnormal embryonic development of the neural tube. Though spina bifida is divided into several subtypes, myelomeningocele—the most severe form of spina bifida often associated with a markedly diminished quality of life—accounts for a significant portion of cases. A broad range of genetic and environmental factors, many of which are still unknown, influence spina bifida, making it difficult to provide a comprehensive etiology for the disorder. Folic acid supplementation aided by the mandatory fortification of food is preventive; still, spina bifida persists due to numerous other confounding factors that affect risk. This article reviews the latest studies pertaining to the risk factors and genetics involved in spina bifida in an attempt to elucidate the complex background of the congenital malformation. Additionally, this review highlights the significant impact of environmental pollutants, adverse medication effects, and maternal health conditions such as diabetes and obesity on the prevalence of spina bifida. Emerging research on gene-environment interactions provides insight into how specific genetic variants may influence susceptibility to these environmental factors. We also discuss new technologies in genetic sequencing that show promise for the large-scale discovery of genes associated with spina bifida risk. Understanding these intricate interactions is crucial for developing effective prevention and intervention strategies.

To retrospectively analyze the clinical characteristics of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, this study involved 739 children with SARS-CoV-2 infection who were admitted to multiple medical institutions in Zhuhai City from December 15, 2022 to January 24, 2023. Epidemiological and clinical data were collected and analyzed using statistical methods to understand the disease characteristics. The onset and progression of SARS-CoV-2 infection in children were significantly associated with age distribution, basic illness, vaccination status, exposure history, and family clustering. The most common clinical symptoms were fever (91.7%) and cough (81.6%). Laboratory findings indicated elevated neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prothrombin time, and procalcitonin, creatine kinase, D-dimer, and IL-6 levels, along with decreased lymphocyte count, platelet count, and lymphocyte-to-monocyte ratio. Lung computed tomography (CT) showed imaging changes strongly linked to severe infection. After receiving anti-inflammatory, symptomatic, supportive, and antipathogen therapies, 74% of the children displayed clinical symptomatic relief, 26% of the children were cured and discharged, and there were no fatalities. In Zhuhai, children infected with SARS-CoV-2 commonly exhibit family-based transmission, with fever and cough as the predominant symptoms. Factors, such as young age, basic illness, specific laboratory markers, and patchy exudative changes on lung CT scans, served as critical indicators of severe infection. Early detection and monitoring of these factors, along with timely vaccination against novel coronavirus, can mitigate disease severity and prevent progression.

Screen time, defined as the amount of time spent engaging with electronic screens, has become inevitable in modern life. The rise in screen time among children under 5 years old has raised concerns about its association with motor development including gross and fine motor skills. Conflicting evidence on the association of screen time requires more investigation and the planning of targeted interventions. This systematic review aims to explore the relationship between screen time and motor development in children aged 0–7 years, considering various influencing factors like screen type, exposure duration, and context. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) and assessing the methodological quality of systematic reviews (AMSTAR) guidelines, a literature search was conducted in May 2024 in databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ScienceDirect. Eligible studies were observational or experimental, involved children aged 0–7 years, and assessed the outcomes between screen time and motor development. The quality of the included studies was assessed through Joanna Briggs Institute's (JBI) critical appraisal checklist. Out of 1490 records initially identified, 24 studies met the inclusion criteria for this review. Among these, 17 studies reported a significant negative correlation between screen time and motor development in children, while 5 studies found no statistically significant association. Two studies presented mixed findings, indicating both negative and positive associations between screen time and motor development. Excessive screen time in early childhood is mainly linked to negative effects on motor development. The association varies with screen content and environment, highlighting the need for balanced screen time and early interventions.

Neuroblastoma (NB) is a common pediatric solid malignancy characterized by heterogeneous clinical outcomes. The identification of predictive and interpretable prognostic biomarkers is critical for advancing precision medicine in NB. We proposed an integrative network-based machine learning method for biomarker discovery, which employed a network smoothed t-statistic support vector machine to select prognostic related biomarkers, and then we performed network analysis on these biomarkers to find hub genes. Later, we conducted a comprehensive analysis to integrate bulk and single-cell RNA sequencing data to character the tumor microenvironment of prognostic state and correlated them to the discovered hub genes. This analysis identified 528 prognostic biomarkers associated with NB. Network-based analysis further refined this set to 11 hub prognostic biomarkers for NB: AURKA, BLM, BRCA1, BRCA2, CCNA2, CHEK1, E2F1, MAD2L1, PLK1, RAD51, and RFC3. Among these genes, high RFC3 expression was significantly associated with poor prognosis, highlighting its potential as a novel prognostic biomarker in NB. Additionally, our findings revealed that these biomarkers are correlated to chemotherapy drugs, such as vincristine and cyclophosphamide. Furthermore, drug sensitivity analyses identified several candidate drugs, such as dactinomycin, bortezomib, docetaxel, and sepantronium bromide, that may hold therapeutic potential for NB treatment. This study offers novel insights to underlying NB prognosis and therapeutic targets and provides a foundation for developing personalized treatment strategies to improve clinical outcomes.

Off-label use of biologic therapies in patients with pediatric inflammatory bowel disease (IBD) has seen an increase in utilization. In this paper, we review the current state of off-label therapies in the pediatric IBD population. Real-world use of ustekinumab (UST), vedolizumab (VDZ), upadacitinib (UPA), tofacitinib, and ozanimod in the adult population could prove positive outcomes in the pediatric population. Established off-label therapies inch closer to comparable safety, efficacy, and outcomes in pediatric IBD use. Outcomes and use of newer biologic therapies in patients with pediatric IBD have improved with increased rates of steroid-free clinical remission (SFCR). Novel therapies, including Janus kinase (JAK) inhibitors and sphingosine-1-phosphate receptor (S1Pr) modulators, require further studies but could also prove effective.

Epilepsy is a chronic neurological disorder characterized by abnormal synchronized neuronal discharges, leading to cognitive dysfunction. The ketogenic diet (KD) has shown promise as an effective treatment for drug-resistant epilepsy (DRE), reducing seizures and improving cognitive and behavioral outcomes in patients. However, the precise neuroprotective mechanisms are not fully understood. This study aimed to investigate the effects of KD on cognitive impairment and hippocampal neurocircuit damage in rats with status epilepticus (SE), with a focus on a nuclear factor-kappa B (NF-κB) signaling. SE was induced using pilocarpine, and rats were assigned to KD and control groups. After 7 and 20 days of KD treatment, cognitive function was assessed using the elevated plus-maze, Morris water maze, novel object recognition, and Y-maze tests. Hippocampal tissue was analyzed for structural damage of neurocircuit. NF-κB pathway activation was evaluated by western blot and immunofluorescence. Results indicated that KD significantly improved cognitive performance and reduced hippocampal damage. Additionally, KD inhibited NF-κB pathway activation, evidenced by decreased levels of NF-κB, p-IκB, and proinflammatory cytokines. These findings suggest that KD may alleviate cognitive deficits and hippocampal damage by modulating the NF-κB signaling, providing insights into its neuroprotective mechanisms and potential as an alternative treatment for epilepsy.