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Question: Can deep learning models trained on expert-verified electroencephalography segments reliably detect seizures and be applied to single-channel wearable monitoring? Finding: This technique demonstrated 80.1%–100% sensitivity and low false-alarm rates. On 1,604 expert-labeled segments, the model outperformed previous studies in terms of latency and accuracy across unseen datasets. Meaning: Expert-labeled data are essential for achieving universal seizure detection. This channel-specific approach enabled efficient and continuous monitoring using wearable devices. |
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Question: Is a home-based fiberoptic phototherapy blanket as effective and safe as hospital-based overhead light-emitting diode phototherapy for the treatment of neonatal jaundice? Finding: Home phototherapy (HPT) resulted in a slower bilirubin reduction rate than inpatient phototherapy (IPT); however, both modalities achieved the therapeutic targets without phototherapy-related complications. Meaning: With careful patient selection, structured monitoring, and reliable follow-up, HPT is a safe and feasible alternative to IPT for neonatal jaundice. |
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Question: Do the loss of function (LOF) of ATP7B mutated variants affect the severity or outcomes of hepatic Wilson disease (WD)? Finding: LOF is associated with advanced liver disease, portal hypertension, and extrahepatic involvement. LOF did not determine hepatic or overall outcomes. ATP7B: c.813C>A (truncation variant) has an aggressive course with higher predisposition to acute liver failure. Lower serum exchangeable copper levels and higher disappearance of Kayser-Fleischer ring were observed in ATP7B: c.3809A>G (nontruncation variant) suggesting a better effect of chelation and lesser systemic copper. Meaning: Truncation of the ATP7B protein determines the severity of the phenotype in WD. |
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Question: Hyponatremia in Kawasaki disease is associated with inflammation and disease severity. Intravenous immunoglobulin (IVIG) formulations feature various sodium contents. What is the clinical impact of such variations? Finding: IVIG sodium content was associated with sodium, potassium, and protein level changes. Meaning: Coronary outcomes were similar but electrolyte changes differed: high-sodium IVIG caused hypokalemia, whereas low-sodium IVIG caused hyponatremia. IVIG preparation requires consideration when interpreting laboratory values. |
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Question: What are the pulmonary manifestations and clinical characteristics of telomere biology disorders in children with interstitial lung disease? Finding: Telomere biology disorders are an important but often underrecognized cause of childhood interstitial lung disease and are associated with variable pulmonary, radiologic, and histopathologic findings, frequent multisystem involvement, and often severe disease progression. Meaning: Early genetic testing and multidisciplinary evaluation are essential for timely diagnosis, optimized management, and improved outcomes in affected children. |
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Question: Do government-funded Specialized Public Medical Centers for Children (SPMCCs) improve the quality of care for pediatric patients requiring complex and intensive medical care? Finding: The SPMCC hospital designation reduced 30-day readmission rates among pediatric patients with severe conditions. Meaning: Government investments are associated with improved quality of care for children with complex chronic conditions. Therefore, sustained government funding is essential to enhancing pediatric care quality. |
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Question: As small for gestational age (SGA) neonates are more susceptible to infections, we hypothesized that their complete blood count and leukocyte differentiation might be affected. Finding: The counts of multiple blood cells of extreme SGA neonates were affected as illustrated by multivariate analyses, which showed significant decreases in neutrophil, monocyte, lymphocyte, and thrombocyte counts. Meaning: The mechanisms underlying this phenomenon and its clinical effects require further elucidation. |
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Question: What are the clinical phenotypes and pathogen associations of pediatric and adult Emergency Department visits for abnormal liver function tests? Finding: Pediatric visits showed fever-predominant profiles with temporal correlations with respiratory viruses, whereas adult visits revealed population-level temporal associations between enteric pathogens and infectious gastroenteritis, upper gastrointestinal disorders, and metabolic comorbidity clustering. Meaning: These findings provide novel population-level evidence of age-specific pathogen associations and support distinct age-stratified clinical diagnostics. |
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Question: Is metabolic acidosis at birth in very low birth weight infants (VLBWIs) associated with long-term clinical outcomes? Finding: Metabolic acidosis at birth was associated with increased mortality, adverse respiratory outcomes, neurological morbidities, and infection-related and gastrointestinal outcomes. Meaning: VLBWIs with metabolic acidosis are at high risk of systemic complications. This finding emphasizes the need for close monitoring and comprehensive care. |
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Question: Can the potential metabolites/pathways involved in the pathogenesis of sepsis-associated acute kidney injury (SA-AKI) be identified using metabolomics? Finding: We identified 18 novel metabolites involved in the pathogenesis of SA-AKI as well as 31 metabolites that were altered in severe AKI. Linoleic acid, linolenic acid, and phospholipid pathways were altered in SA-AKI. Meaning: Once validated, these markers may be used to diagnose SA-AKI at an early stage before sufficient kidney injury occurs. |
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Question: Did the intramuscular (IM) and subcutaneous (SC) administration of gonadotropin-releasing hormone (GnRH) agonists have comparable timing and diagnostic utility for evaluating central precocious puberty in girls? Finding: Both the IM and SC GnRH stimulation tests demonstrated comparable times to peak luteinizing hormone levels. Meaning: Clinicians may consider the IM route as a time-efficient alternative, as it offers similar diagnostic utility for central precocious puberty without compromising the detection of hypothalamic-pituitary-gonadal axis activation. |
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Question: How do body mass index (BMI) and metabolic markers change over time in severely obese Korean children and adolescents receiving only lifestyle modifications? Finding: Among 124 participants, BMI z scores decreased modestly over 2.6 years, primarily in younger prepubertal boys. However, most remained severely obese, with minimal improvement in body composition or metabolic markers. Meaning: Lifestyle interventions alone have limited efficacy for severe pediatric obesity. Early and more intensive treatments are required. |
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Question: Are the predominant circulating strains of Mycoplasma pneumoniae associated with disease severity and clinical indicators? Finding: The common cluster label 14 (CCL14) lineage was a high-risk clone circulating in central China that demonstrated a strong association between severe pediatric pneumonia and a distinct hyperinflammatory profile. Meaning: Targeted molecular surveillance of the CCL14 lineage may facilitate early risk stratification and guide clinical management to reduce the burden of severe disease. |
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Question: Which factors influence pediatric thyroid disorder susceptibility and severity? Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg386His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels. Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg386His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management. |
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Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy? Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients. Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects. |
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Question: The clinical relevance of impaired renal function (IRF), based on the rate of serum creatinine level decline during the week after birth, in neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy need further investigation. Finding: In this study, neonates with IRF had 2-fold higher risk of early death or severe brain injury. Meaning: IRF can be used as a marker of adverse neonatal outcomes. |
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Question: Is macronutrient intake, particularly that from human milk, distinctly associated with the growth of preterm infants? Finding: Total protein and fat intake derived from human milk and fortifiers showed distinct positive associations with weight gain velocity. Meaning: Particular attention to protein and fat composition during individualized human milk fortification can optimize weight gain in preterm infants. |
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Question: What is the diagnostic utility of whole exome sequencing (WES) and whole genome sequencing (WGS) in unexplained neurodevelopmental disorders (NDDs)? Finding: WES and WGS achieved a combined diagnostic yield of 39.1% in children with NDDs. Novel variants accounted for over half the pathogenic findings, and trio-based or phenotype-driven testing improved the diagnostic rate. Meaning: Comprehensive genomic sequencing integrated with clinical phenotyping enhances diagnostic yield among children with NDDs. |
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Question: In pediatric acute lymphoblastic leukemia (ALL), what are the incidence and causes of induction-phase acute kidney injury (AKI), and which factors predict chronic kidney disease (CKD)? Finding: Induction AKI occurred in 43% of patients, while CKD developed in 1 of 8 patients. The 5-year CKD-free survival rate was 94%. Older age at diagnosis was a continuous independent determinant of CKD risk. Meaning: Induction AKI is common and clinically relevant. Older children warrant closer kidney monitoring during and after therapy. |
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Question: What genes are commonly altered in mother-neonate dyads immediately after shared exposure to preeclampsia? Finding: Perinatal/peripartum gene expression in preeclampsia is context-dependent, involves diverse signaling pathways, and is associated with some perinatal features. Meaning: Our results may help build the fundamentals for managing future cardiometabolic risks in these populations. Further investigation of the long-term influence of these candidate genes on cardiometabolic phenotypes is required. |
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Question: How have epilepsy and cognitive outcomes of children with infantile epileptic spasms syndrome (IESS) evolved over the past 20 years? Finding: Approximately 78% of children developed chronic epilepsy, and one-third progressed to drug-resistant epilepsy, while 90% of them exhibited intellectual disabilities. Meaning: Given the poor outcomes associated with IESS, consensus guidelines tailored to Korean clinical practice are required to ensure timely treatment and improve outcomes. |
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Question: Can demographic factors identify pediatric malignant vasovagal syncope pre-head-up tilt test (HUTT)? Finding: Age/body mass index are independent protectors; <12.9 years age cuts risk 20%/yr. Meaning: Enables early risk stratification to optimize HUTT safety for children. |
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Question: Can hematopoietic stem cell transplantation (HSCT) cure pediatric transfusion-dependent thalassemia in Thailand? What influences its outcomes? Finding: Among 266 HSCT procedures, 5-year overall survival and event-free survival rates were 91.3% and 81.0%, respectively. Outcomes were comparable between related and unrelated donors. Pre-HSCT ferritin >2,500 ng/mL, low CD34+ cell dose, and oral busulfan conditioning were associated with unfavorable survival. Longterm complications affected 22.7% of survivors. Meaning: Optimizing pre-HSCT care, ensuring adequate grafting, and long-term surveillance are crucial. |
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Question: How is arterial blood pressure related to cerebral oxygenation during the immediate postnatal transition in neonates? Finding: Among preterm infants requiring respiratory support, cerebral oxygenation was associated with diastolic and mean arterial pressures, indicating passive pressure perfusion. Meaning: Compromised preterm infants are vulnerable to impaired autoregulation with cerebral oxygenation fluctuations, highlighting the need for hemodynamic and cerebral monitoring plus routine monitoring of arterial oxygen saturation and heart rate. |
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Question: Does atrial septal defect (ASD) physiology affect postrepair mitral valve growth in patients with coarctation of the aorta or an interrupted aortic arch? Finding: Mitral valve growth occurred after biventricular repair but not single-ventricle palliation, particularly in patients with small valves and low ASD pressure gradients. Meaning: The ASD pressure gradient determines mitral valve growth and should guide surgical strategies in patients with borderline hypoplastic left heart syndrome. |
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Question: What perinatal factors influence patent ductus arteriosus (PDA) in and improve outcomes of preterm infants? Finding: Lower birth weight, frequent surfactant treatment, and maternal hypertension increased hemodynamically significant PDA risk in very low birth weight infants, whereas chorioamnionitis and premature rupture of membranes protected against it. A lower birth weight and incomplete antenatal steroid use increased the risk of surgical ligation, whereas small for gestational age reduced it. Meaning: Recognizing these factors may enable early, targeted intervention and reduce the need for surgical management. |
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Question: Is prolonged monitoring of regional cerebral oxygen saturation (rcSO2) and hemodynamic parameters a feasible approach? Can these measures predict the neurological outcomes in extremely preterm infants? Finding: We used a neurocritical care bundle from birth to discharge or term-equivalent age. Infants with poor outcomes had significantly lower rcSO2 values. Meaning: Understanding rcSO2 and hemodynamic parameters may help manage cerebral hypoxia and reduce neurological complications in extremely preterm infants. |
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Question: Can the revised Japanese classification predict severe bronchopulmonary dysplasia (BPD) early in preterm infants? Finding: Small for gestational age and bubbly/cystic chest radiographic patterns were independently associated with severe BPD, and subtypes I and III showed particularly strong associations. Meaning: This classification may facilitate early risk stratification and guide timely supportive strategies to prevent progression to severe BPD. |
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Question: What are the characteristics and clinical implications of thrombocytopenia in preterm neonates born to mothers with systemic lupus erythematosus? Finding: Nearly one-third of preterm infants developed thrombocytopenia. Key modulators of this risk included gestational age, maternal hypertensive disorders of pregnancy, and hydroxychloroquine use. Thrombocytopenia may be associated with neonatal morbidity. Meaning: Platelet count should be monitored during the first week of life, and infants should be assessed for potential complications. |
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Question: Can a basophil activation test (BAT) of cord blood predict a cow's milk allergy? Finding: Infants with a high casein-BAT value were more likely to develop food allergy symptoms in the first year, whereas cow’s milk BAT showed no predictive association. Meaning: Cord blood casein BAT may help identify newborns at increased risk for early-life food allergies, enabling closer monitoring and preventive strategies, although larger studies are needed for validation. |
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