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Question: Can adrenomedullin (ADM) or interleukin-6 (IL-6) detect late-onset neonatal sepsis (LOS) at admission (area under the curve [AUC]>0.90) as an early diagnostic marker? Finding: Only IL-6 consistently distinguished survivors from nonsurvivors (AUC>0.90) on admission and antibiotic treatment days 3 and 7. C-reactive protein level identified infections from day 3 but failed to predict outcomes (AUC<0.70). Meaning: IL-6 level can improve LOS diagnosis and prognosis. |
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Question: What is the acceptance rate for coronavirus disease 2019 vaccination among parents of children with systemic lupus erythematosus (SLE)? Finding: One-third of parents were hesitant to vaccinate their child. Parental willingness to vaccinate themselves, older patient age, and belief in the vaccine's potency were associated with vaccine acceptance. Meaning: These findings highlight the need for targeted interventions to improve vaccine acceptance among parents of children with SLE. |
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· Infection remains a leading cause of death in febrile neutropenia (FN). · Mid-regional pro-adrenomedullin (MR-ProADM) levels are higher among patients with FN and a bacterial infection. · A longer FN duration and hospital stay length as well as elevated C-reactive protein, procalcitonin, and MR-ProADM levels are significant risk factors for mortality. |
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Question: Does the T allele of Xmn1 polymorphism favorably influence hydroxyurea efficacy in children of Eastern descent with fetal hemoglobin (HbE)-β nontransfusion dependent thalassemia (NTDT)? Finding: Decrease in transfusion requirement and increase in height following hydroxyurea therapy was noted in both groups, however, change in CT was more critical than that in CC genotype. Meaning: T allele of Xmn1 polymorphism favorably influences hydroxyurea efficacy in children with HbE-β NTDT. |
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Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes. |
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Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible? Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected. Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea. |
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Question: How do dietary intake and physical activity affect body mass index (BMI) z scores and adiposity among children with obesity? Finding: Higher dietary protein and fiber intakes were significantly associated with a decrease in BMI z scores and adiposity among children with obesity. Meaning: Optimizing dietary interventions by focusing on protein and fiber intakes could be an effective strategy for managing childhood obesity. |
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Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics? Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative. Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations. |
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Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations? Finding: Preschool children with obesity exhibit impaired lung function characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of such changes. Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function. |
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Question: What are the clinicopathological features and outcomes of pediatric C3 glomerulopathy (C3G) in resource-limited settings? Finding: Children with C3G in resource-limited settings have significant morbidities, and most experience kidney sequelae despite treatment. Electron microscopy was performed in only 50% of our patients, while none received complement assays or genetic testing. Meaning: Pediatric C3G presentation, management, and kidney outcomes vary. Its thorough evaluation and management are challenging in resource-limited settings. |
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Question: What is the occurrence of pediatric stroke in Indonesia? Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%). Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims. |
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Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function? Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk. Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal. |
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Question: Short-term (1-year) follow-up data in pediatric patients with inflammatory bowel disease (IBD), especially in Southeast Asian countries, are limited. Finding/Meaning: Abdominal pain and pallor rates remained high at 1 year after IBD diagnosis. Three independent factors of 1-year clinical remission for Crohn disease were oral prednisolone, antibiotic, and immunomodulator use at 1-year follow-up. A history of weight loss at diagnosis was the only independent risk factor of IBD flare. |
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Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population? Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change. Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development. |
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Question: Do community members and health providers show different level of knowledge, attitude, and practice towards dengue vaccine? Finding: These 2 groups only differed in practice component, while the knowledge and attitude constituents were relatively low for both. Meaning: There is an urgent need to deliver educational interventions to raise awareness of community members and health providers regarding dengue vaccination. |
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Question: Can sigh breaths (Sighs) application during high-frequency oscillatory ventilation (HFOV) decrease partial pressure of carbon dioxide (PaCO2) levels? Finding: The mean PaCO2 level after Sighs during HFOV was significantly decreased compared to that after HFOV alone (mean difference, -3.6 mmHg). Meaning: HFOV plus Sighs functionality can reduce PaCO2 levels. However, further studies are required to conclusively determine the effects of Sighs. |
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Question: What are common tantrum behaviors in preschool children, and how frequently are problematic behaviors observed? Do problematic tantrums have a different emotional impact on caregivers compared to typical tantrums? Finding: Temper tantrums are common in preschool children, and verbal tantrums are the most common type. Meaning: Problematic tantrums, defined as tantrums exhibiting aggressive physical behavior, long duration (>15 minutes), or frequent occurrence (>3 days/wk), significantly affected caregivers’ emotions. |
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Question: What are the primary triggers for pediatric migraines, and how do they impact clinical management? Finding: Common triggers for pediatric migraines include sleep disturbances, academic stress, and motion sickness, with academic stress identified as the most intense. Meaning: Recognizing and addressing specific triggers like sleep disturbance and academic stress is crucial to effectively managing pediatric migraines with emphasis on personalized care to improve outcomes. |
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· The mortality rate of acute necrotizing encephalopathy was high. · Laboratory tests revealed that the fatal group had higher creatinine, lactate, activated partial thromboplastin time, thrombin time, interleukin (IL)-6, IL-10, creatine kinase, and D-dimer than survivors. · The fatal group displayed lower Glasgow Coma Scale scores and arterial pH. |
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Question: Is there a difference in immune cells in human breast milk by parity? Finding: There were higher proportions of monocytes and T/B cells in the primiparous and multiparous group, respectively. The expression of genes with a direct role in the infant immune system and immune response-related genes were highest in the primiparous group Meaning: There were parity-dependent differences in the expression of genes between innate and adaptive immune cells. |
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Question: How stable are the revised Korean Developmental Screening Test score classifications in early infancy? Finding: A significant number of infants improved into the peer and high-level group (≥-1 standard deviations), especially in the gross motor area. Meaning: The early detection of developmental delay requires a comprehensive medical history, physical and neurological examinations, and repeated developmental screenings. |
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Question: What are the differences in efficacy between leuprolide acetate and triptorelin pamoate administered every 3 months for the treatment of central precocious puberty (CPP)? Finding: There were no significant intergroup differences in luteinizing hormone suppression or predicted adult height at the end of treatment in girls with CPP. Meaning: Leuprolide acetate and triptorelin pamoate have comparable efficacy for treating CPP. |
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Question: How Common is obstructive sleep apnea (OSA) in obese children? OSA is common in obese children, even without habitual snoring. Finding: Among the subjects, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, 59.8% had desaturation, 20.5% had sleep-related hypoventilation, and 5.0% had obesity hypoventilation syndrome. Body mass index (BMI) and neck and waist circumferences were significantly associated with severe OSA. Meaning: We recommend screening obese children (BMI > 29.2 kg/m2) for OSA. |
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Question: What are the short-term outcomes of oropharyngeal administration of colostrum (OAC) in preterm neonates? Finding: This study demonstrated the significantly lower rates of necrotizing enterocolitis, clinically suspected sepsis, shorter hospital stay, period to full enteral feeding, and antibiotic therapy period in the OAC group. Meaning: This trial may further expand the clinical application of OAC in premature infants to reduce their length of hospital stay and complications. |
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Question: What is the prevalence of carbapenem resistance in gram-negative bacteria and associated carbapenemase genes? Findings: This study identified a notable prevalence of carbapenem-resistant gram-negative isolates, with Escherichia coli being the predominant contributor, follow ed by Klebsiella pneumoniae, Acinetobacter baumannii, while bla OXA48 was the most prevalent carbapenemase gene. Meaning: These findings highlight the urgent need for proactive measures including the rapid detection of carbapenemase- producing isolates and effective infection control. |
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Question: Can a balance task with narrowed base of support indicate overall functional balance control in children with disabilities? Finding: While single-limb standing could explain overall balance control for children with disabilities, it was unrelated with balance control for typically developing children. Meaning: One balance task with narrowed base of support can be used as practical assessment of balance abilities for children with disabilities when allocated session time is of concern. |
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Question: Is the tumor necrosis factor (TNF) signaling pathway (TNF-α-converting enzyme [TACE]/TNF-α/angiotensin converting enzyme [ACE]) involved in pediatric coronavirus disease 2019 (COVID-19) infection? Finding: Significantly increased circulating TACE/TNF-α and decreased ACE2 levels were noted. TNF-α-308G/A plays a significant role in susceptibility to COVID-19 infection among children. The ACE (I/D) (rs4646994) and ACE2 (rs2285666) single nucleotide polymorphisms lack significant associations with pediatric COVID-19 infection. Meaning: The TNF signaling pathway participates in pediatric COVID-19 infection. |
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Question: What is the prevalence of HTN among adolescents enrolled in the TLGS according to 3 different accepted definitions (4th report, ESH, and AAP-CPG). Also, what is the ability of each of these definitions in predicting early adulthood CIMT, as a surrogate for cardiovascular disease events? Finding: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. The highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively. Meaning: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG. |
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Question: Is proper postnatal care (PNC) associated with exclusive breastfeeding (EBF) practice among young Indonesian mothers? Finding: Proper PNC elevates the likelihood of EBF among Indonesian adolescent mothers aged 15–19 years. Meaning: Breastfeeding services should be provided during the early postnatal period to support EBF practice among adolescent mothers. High-quality PNC is a tailored intervention for vulnerable populations. |
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Question: What is the effect of nonpharmacological interventions on postoperative pain and anxiety among children. Finding: Nurse-provided distraction interventions reduce pain and anxiety among pediatric surgical patients. Meaning: The findings suggest that nonpharmacological interventions provided postoperatively to children reduce their pain and anxiety levels. |
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