---
title: "Pediatrics Clinical Research Feed | MedicHelpline"
specialty: "Pediatrics"
specialty_slug: "pediatrics"
canonical_url: "https://medichelpline.com/clinical-feed/pediatrics"
content_type: "clinical_feed_specialty"
page: 1
articles_in_batch: 30
generated_at: "2026-09-05T23:52:14.556Z"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Pediatrics — Clinical Research Feed
## Specialty Overview: Pediatrics
Latest peer-reviewed clinical trials, guidelines, and observational research in **Pediatrics**, indexed and structured for clinical intelligence and AI reasoning.
## Latest Pediatrics Publications
### 1. [FDA Issues Temporary Policies to Protect Newborn Access to Starter Parenteral Nutrition](https://medichelpline.com/clinical-feed/fda-news-releases-0-fda-takes-steps-to-maintain-newborn-access-to-life-saving-starter-nutrition.md)
- **Source:** FDA News Releases | **Published:** 2026-09-04
- **Detail Markdown URL:** [FDA Issues Temporary Policies to Protect Newborn Access to Starter Parenteral Nutrition](https://medichelpline.com/clinical-feed/fda-news-releases-0-fda-takes-steps-to-maintain-newborn-access-to-life-saving-starter-nutrition.md)

> **Executive GIST:** - The FDA announced immediate actions to address a potential supply gap in **neonatal starter parenteral nutrition (PN)** after children's hospitals reported concerns about continued access. - The concerns followed discontinuation of certain standardized neonatal starter PN products produced by two outsourcing facilities that are permanently closing. - The agency issued an immediately-in-effect guidance, Temporary Policies for Compounding Certain Starter Parenteral Nutrition Drug Products for Neonates, outlining temporary regulatory and enforcement priorities. - The guidance covers compounding by state-licensed pharmacies, federal facilities and outsourcing facilities under **sections 503A and 503B** of the Federal Food, Drug, and Cosmetic Act. - FDA leadership emphasized use of regulatory tools to prevent supply chain gaps affecting vulnerable patients; Acting FDA Commissioner Kyle Diamantas and Michael Davis, M.D., Ph.D., Acting CDER Center Director, are quoted in the release. - The temporary policies are intended to help hospitals maintain access to life-saving starter PN while longer-term solutions are pursued. - The FDA stated it will continue to monitor supply needs and consider additional actions if the situation changes. - Contact points for media and consumers were provided and the content is current as of September 4, 2026.

### 2. [Mother‑Child AI Agent (MoChiAgent) predicts maternal and infant outcomes from longitudinal EHRs](https://medichelpline.com/clinical-feed/nature-0-prediction-of-maternal-and-infant-outcomes-from-longitudinal-electronic-health.md)
- **Source:** Nature Medicine | **Published:** 2026-09-04
- **Detail Markdown URL:** [Mother‑Child AI Agent (MoChiAgent) predicts maternal and infant outcomes from longitudinal EHRs](https://medichelpline.com/clinical-feed/nature-0-prediction-of-maternal-and-infant-outcomes-from-longitudinal-electronic-health.md)

> **Executive GIST:** - Researchers developed the **Mother‑Child AI Agent (MoChiAgent)**, an LLM‑based clinical assistant that integrates longitudinal electronic health record (EHR) data to forecast maternal and infant diseases. - The core predictive engine, **MoChiFormer**, was trained on 4,401,599 longitudinal clinical visits and externally validated on independent maternal and infant cohorts with 263,452 and 23,192 visits, respectively. - MoChiFormer reconstructs missing laboratory values, mitigates batch effects and learns EHR representations to support gestational, fetal and infant age estimation, health‑trajectory modelling and risk stratification. - For maternal outcomes, MoChiFormer achieved high discrimination for key gestational conditions: **AUROC** 0.89 for placental abruption, 0.89 for premature rupture of membranes and 0.91 for preterm labour. - Paired mother–infant analyses identified transgenerational risk clusters; infants born to mothers in specific clusters had markedly increased risks of neonatal jaundice (hazard ratio **HR** 2.81, 95% CI 2.60–3.03) and haematological diseases (HR 2.83, 95% CI 2.62–3.05). - Integrating maternal gestational EHRs with infant records improved prediction of infant conditions including chromosomal abnormalities and respiratory disorders. - A separate Knowledge Search Tool uses MoChiAgent forecasts to retrieve intervention and treatment recommendations from curated literature and authoritative guidelines. - The article reports that MoChiAgent can provide clinically relevant, actionable decision‑support to enable risk‑stratified care for mothers and infants. Specific implementation details, prospective clinical utility testing and regulatory considerations were not reported in the source.

### 3. [Genetics of Childhood Eating Behaviors and Their Contribution to Obesity Risk](https://medichelpline.com/clinical-feed/medrxiv-8-genetic-and-behavioural-architecture-of-childhood-eating-behaviour-and-links-to.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-04
- **Detail Markdown URL:** [Genetics of Childhood Eating Behaviors and Their Contribution to Obesity Risk](https://medichelpline.com/clinical-feed/medrxiv-8-genetic-and-behavioural-architecture-of-childhood-eating-behaviour-and-links-to.md)

> **Executive GIST:** - The study analysed parent-reported childhood appetitive traits in up to **31,018** eight-year-old children from the Norwegian Mother, Father and Child Cohort Study (MoBa). - Six appetitive domains were derived from 18 items of the Children's Eating Behaviour Questionnaire and used for genome-wide association studies (GWAS). - Ten independent genome-wide significant loci for childhood eating behaviour were identified, mainly for **Food Responsiveness**, **Satiety Responsiveness**, and **Food Fussiness**. - Eight of the ten loci overlap known childhood or adult **BMI** loci, indicating shared genetic architecture between appetite traits and adiposity. - **Food Responsiveness** and **Satiety Responsiveness** showed both phenotypic and genetic correlations with BMI trajectories from early childhood through adolescence. - Mediation analyses estimated that aggregated genetic associations with BMI at age 8 could be decomposed through these traits by **22.1%** for one trait and **10.4%** for the other (values reported in the source); details on which correspond to each trait are provided in the manuscript. - Locus-specific results suggested mechanistic pathways: the **FTO** locus acts predominantly via Food Responsiveness, while the **ADCY3** locus acts via Satiety Responsiveness. - A trio-based design separated direct child genetic effects from indirect parental genetic effects: associations were predominantly explained by children's inherited alleles, with minimal indirect effects from parental adiposity. - Parental genetic liability did influence parental reporting of **Satiety Responsiveness**, indicating potential reporter bias or gene–environment correlation affecting that measure. - The authors conclude childhood appetitive traits capture a substantial portion of genetic susceptibility to adiposity and represent biologically plausible early targets for obesity prevention. - Data access is restricted: individual-level MoBa data are not public; summary results and supplementary information are reported in the manuscript and Supplementary Information. - Ethical approvals were obtained from the Regional Committees for Medical and Health Research Ethics (REK), Norway, and authors declared no competing interests.

### 4. [Human-Centered Design to Identify and Reach Zero-Dose and Under-Immunized Children in Kenya](https://medichelpline.com/clinical-feed/medrxiv-8-applying-human-centered-design-and-iterative-programming-to-identify-and-reach.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-04
- **Detail Markdown URL:** [Human-Centered Design to Identify and Reach Zero-Dose and Under-Immunized Children in Kenya](https://medichelpline.com/clinical-feed/medrxiv-8-applying-human-centered-design-and-iterative-programming-to-identify-and-reach.md)

> **Executive GIST:** - The Zero-Dose Learning Agenda applied **human-centered design (HCD)** and continuous learning in two Kenyan sub-counties—Turkana Central (rural, nomadic) and Rachuonyo North (semi-urban)—to diagnose and address drivers of zero-dose (ZD) and under-immunized (UI) status. - PATH’s Living Labs 4D HCD methodology (Discover, Define, Dream, Design) guided mixed-methods data collection: interviews, observations, focus group discussions, facilitated discussions, quantitative surveys, qualitative analysis, and data triangulation. - The project engaged 798 participants and produced six distinct caregiver archetypes per site to inform tailored interventions. - Key drivers differed by site: **gender norms** dominated in Rachuonyo North, while **geographic access and marginalization** dominated in Turkana Central. - Three iterative, co-designed interventions were prototyped and tested: Chanjo Talks Kazini, Quality Household Assessment and Sensitization, and Chanjo Mashinani. - Chanjo Talks Kazini (n=188 participants) achieved 60.1% completion, 92.5% satisfaction, and increased perceived spousal support from 37.1% to 74.4%. - Quality Household Assessment and Sensitization trained 68 community health promoters, reached 874 households, and identified 15 zero-dose and 39 under-immunized children; all identified children were subsequently vaccinated. - Chanjo Mashinani delivered 30 low-cost outreach events, reached 266 zero-dose children, and reduced costs by over 70% versus conventional outreach. - Iterative adaptation revealed barriers not captured by baseline instruments, including male caregivers’ fear of HIV testing. - The authors conclude that while children labeled ZD share that status, their exclusion pathways vary; addressing ZD/UI requires context-specific, tailored strategies, local voice engagement beyond problem identification, and resources to strengthen weaker health systems. - Ethics approval was obtained from the Ethics committee of Maseno University; funding was declared from the Gates Foundation. Data are available on reasonable request to the authors.

### 5. [BMI Trajectories From Birth to Adolescence and Their Association With Asthma in the Leicester Coho](https://medichelpline.com/clinical-feed/medrxiv-18-body-mass-index-trajectories-from-birth-to-adolescence-and-their-association.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-04
- **Detail Markdown URL:** [BMI Trajectories From Birth to Adolescence and Their Association With Asthma in the Leicester Coho](https://medichelpline.com/clinical-feed/medrxiv-18-body-mass-index-trajectories-from-birth-to-adolescence-and-their-association.md)

> **Executive GIST:** - This longitudinal analysis used data from the **Leicester Respiratory Cohorts**, which recruited children aged 0–4 years in 1990 (N = 1,650) and 1998 (N = 8,700) and followed them up until 2010. - Body mass index (**BMI**) measures were obtained from birth records, well-child visits, questionnaires, and a clinical study visit and were modelled using group-based trajectory modelling to identify distinct **BMI trajectories** from birth to adolescence. - BMI trajectories were successfully modelled for 5,571 of 10,350 participants (54%). Outcome data for parent-reported **asthma** were available for 1,801 (17%) at 8–9 years, 1,269 (12%) at 12–13 years, and 575 (6%) at 16–17 years. - Five BMI trajectory groups were identified: **stable normal BMI** (47%), **persistent low BMI** (30%), **early overweight resolving** (8%), **childhood-onset obesity** (4%), and **adolescent-onset overweight** (11%). - The **persistent low BMI** trajectory was associated with lower odds of asthma at ages 8–9 (odds ratio 0.56; 95% CI 0.37–0.83) and 12–13 years (0.38; 95% CI 0.22–0.63) compared with the stable normal BMI group. - The **early overweight resolving** group had asthma risk similar to the reference stable normal BMI group. - The **childhood-onset obesity** trajectory was associated with substantially higher odds of asthma at 16–17 years (5.58; 95% CI 1.35–24.40). - The **adolescent-onset overweight** trajectory showed no significant association with asthma in the reported analyses. - Sex-stratified and ancestry-stratified analyses (boys vs girls; European vs South Asian ancestry) produced similar patterns of association. - The authors conclude the findings support **obesity** as a contributing factor to asthma development and suggest early prevention and management of childhood overweight/obesity to reduce secondary health impairments such as asthma. - Ethical approvals were obtained from the Leicestershire Health Authority Research Ethics Committee (multiple reference numbers) and written consent was obtained for clinical visits. Competing interests and funders are declared in the source.

### 6. [Reanalysis of Prenatal Acetaminophen and Neurodevelopmental Disorders Using Bias-Correction Methods](https://medichelpline.com/clinical-feed/medrxiv-0-testing-claimed-associations-of-prenatal-acetaminophen-with-neurodevelopmental.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-04
- **Detail Markdown URL:** [Reanalysis of Prenatal Acetaminophen and Neurodevelopmental Disorders Using Bias-Correction Methods](https://medichelpline.com/clinical-feed/medrxiv-0-testing-claimed-associations-of-prenatal-acetaminophen-with-neurodevelopmental.md)

> **Executive GIST:** - This preprint reanalysed studies included in a 2025 Navigation Guide systematic review that had claimed a link between prenatal **acetaminophen** exposure and neurodevelopmental disorders (NDDs). The original review reported “strong evidence” without quantitative meta-analysis or formal bias correction. - The authors selected 24 of 46 studies from the prior review that reported ratio measures (HR, OR, RR, IRR), collapsed estimates to a single study-level effect per outcome/design, and produced 30 study-level estimates. Reported sample sizes ranged from 307 to 2,480,797. - Analytical approach included random-effects **meta-analysis**, eight publication-bias-correction methods, a credibility-ceiling sensitivity analysis, five quality-filtered subsets, and harmonisation of effect measures to a common risk-ratio scale. - For **autism spectrum disorder (ASD)**, the pooled point estimate weakened from 1.14 (95% CI, 1.01–1.28) to 1.08 (95% CI, 0.97–1.19; P = .17) after weighting each study once rather than by number of sub-analyses, before bias correction. The harmonised ASD estimate crossed the null. - For **attention-deficit/hyperactivity disorder (ADHD)**, a modest positive association persisted across most bias-correction methods (range of estimates, 1.02–1.31), though the 95% CI crossed 1.00 under a 15% credibility ceiling sensitivity. - For aggregated other neurodevelopmental disorders (other-NDD), one bias-correction method produced a reversal (ratio 0.98; 95% CI, 0.65–1.19) and p-curve testing showed no right-skew (P = .71), calling selective-reporting explanations into consideration. - Overall conclusion: the prior claim of “strong evidence” for a prenatal acetaminophen–NDD link was not supported after standard meta-analytic pooling and multiple bias-correction procedures. A small ADHD signal remained but ASD and other-NDD estimates shifted toward the null. - The authors note this is a preprint not yet peer reviewed and provide open code and data at the supplied GitHub repository.

### 7. [Strategies to Improve Access to HIV Services for Children in Malawi: Study Protocol](https://medichelpline.com/clinical-feed/plos-one-23-investigating-strategies-to-enhance-access-to-hiv-services-among-children-in.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-03
- **Detail Markdown URL:** [Strategies to Improve Access to HIV Services for Children in Malawi: Study Protocol](https://medichelpline.com/clinical-feed/plos-one-23-investigating-strategies-to-enhance-access-to-hiv-services-among-children-in.md)

> **Executive GIST:** - This study protocol outlines a multifaceted research programme to identify and develop strategies to improve **HIV** service access for children (<15 years) in **Malawi**. It responds to persistent gaps in paediatric outcomes despite national progress toward UNAIDS targets. - National data show a marked disparity: about **55%** viral suppression among children versus **87%** among adults by the end of 2023. Children experience losses at every stage of the care continuum. - The study is guided by the **Socio-Ecological Model** and the **HIV care cascade** framework to examine determinants of access from individual to policy levels. - Four complementary sub-studies are planned: (1) secondary analysis of national HIV programme data and Spectrum estimates (2012–2023) to map trends and attrition points; (2) a scoping review of health-system interventions that improve paediatric HIV access in sub-Saharan Africa (2015–2025); (3) a modified e-Delphi with 15–30 experts to prioritise and adapt interventions into a context-appropriate package; and (4) a feasibility and acceptability assessment at Kabudula Community Hospital using questionnaires and qualitative interviews with healthcare workers, community health workers and caregivers. - The protocol emphasises pragmatic, context-specific intervention development that combines epidemiological evidence, published intervention evidence, and stakeholder prioritisation. - Ethical approval will be sought from Stellenbosch University HREC and the Malawi National Health Sciences Research Ethics Committee; written informed consent and confidentiality procedures will be followed. - The project aims to produce an evidence-informed, feasible intervention package to strengthen paediatric HIV service access and accelerate Malawi’s progress toward the **UNAIDS 95-95-95** targets for children. - No funding was reported for the work; data from the study will be made available upon study completion. The authors declared no competing interests.

### 8. [CAMCAM program pilot: integrated oral health and nutrition education in community children’s cafet](https://medichelpline.com/clinical-feed/plos-one-22-development-and-implementation-of-an-integrated-oral-health-and-nutrition.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-03
- **Detail Markdown URL:** [CAMCAM program pilot: integrated oral health and nutrition education in community children’s cafet](https://medichelpline.com/clinical-feed/plos-one-22-development-and-implementation-of-an-integrated-oral-health-and-nutrition.md)

> **Executive GIST:** - This pilot study evaluated the adapted Comprehensive Awareness Modification of Mouth, Chewing, and Meal (**CAMCAM**) program for children (CAMCAM-P for kids) delivered monthly at two community children’s cafeterias in Tokyo over six months. - The single-group pre–post design enrolled 84 participants (52 children, 32 parents/guardians) who were regular cafeteria users and had no relevant food allergies. - Sessions included a 10-minute lecture on oral health, chewing, and nutrition plus a specially designed **CAMCAM bento** intended to increase chewing via texture, portion size, cutting, and cooking adjustments; weekly informational messages and recorded lectures were provided via a mobile app. - A bespoke child-specific CAMCAM Checklist questionnaire assessed oral-health behaviors, dietary habits, chewing-related behaviors, and food intake frequency before and after the intervention. - Median ages were 8.5 years (children) and 43.0 years (parents). Outcomes included increased self-observation of the oral cavity among children and increased daily fluoride use (from 61.5% to 76.9%, p = 0.020). - The proportion of children who reported not considering nutritional balance decreased (63.5% to 38.5%, p = 0.022); parental practice of nutritionally balanced diets rose non-significantly (56.2% to 75.0%). - Reported food intake frequency increased for caregivers (meat, dairy products, tubers) and for children (rice, tubers, fruits) after the program. - The number of participants who did not consider the number of chewing cycles decreased, indicating greater attention to chewing. - As a feasibility pilot without a control group, authors note findings are preliminary and recommend larger controlled studies to confirm effectiveness. - Ethical approval, registration (UMIN000048328), data availability, funding sources, and lack of competing interests were reported in the manuscript.

### 9. [Adolescent handgrip strength trends and reference values in Korea from KNHANES (2014–2022)](https://medichelpline.com/clinical-feed/plos-one-19-temporal-changes-and-reference-values-for-adolescent-handgrip-strength-in-the.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-03
- **Detail Markdown URL:** [Adolescent handgrip strength trends and reference values in Korea from KNHANES (2014–2022)](https://medichelpline.com/clinical-feed/plos-one-19-temporal-changes-and-reference-values-for-adolescent-handgrip-strength-in-the.md)

> **Executive GIST:** - This study analyzed **handgrip strength** in Korean adolescents aged 10–19 years using pooled KNHANES data from 2014–2019 and 2022 (n = 4,867). - Handgrip was measured with a digital dynamometer; maximum value across trials was used. Primary analyses used the first four attempts to harmonize methods across waves. - Participants were grouped into two‑year age bins (10–11, 12–13, 14–15, 16–17, 18–19) and analyses were sex‑stratified. - Absolute and body size–normalized handgrip (using height2 * mass0.333) were compared across survey years with Complex Samples General Linear Models accounting for KNHANES design and weights. - For males, significant year-to-year omnibus differences occurred for all age groups except 18–19 years; some years (notably 2016–2019) showed lower values by up to −4.1 kg, and 2014–2015 showed higher values by 2.6–3.5 kg compared with 2022. - For females, some age groups had lower handgrip in 2016–2019 (−1.6 to −2.6 kg) and higher values in 2014–2015 (~1.4 kg), compared with 2022. - Overall, over the 9‑year span **handgrip strength** remained fairly stable; observed year-to-year differences were generally small, inconsistent across ages and sexes, and absent in some groups. - Weighted percentiles (5th–95th) were calculated to produce **reference values** for absolute and normalized handgrip strength; lowest values were among 10–11‑year‑olds and increased with age, with sex differences. - Secondary analyses used all six attempts for earlier waves and produced consistent findings. - Data are publicly available via KNHANES; no specific funding or competing interests were reported.

### 10. [Childhood pneumonia after vaccines: shifting pathogen mix and the case for platform investments](https://medichelpline.com/clinical-feed/medrxiv-22-after-the-vaccine-era-sequencing-platform-investments-as-the-childhood.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-03
- **Detail Markdown URL:** [Childhood pneumonia after vaccines: shifting pathogen mix and the case for platform investments](https://medichelpline.com/clinical-feed/medrxiv-22-after-the-vaccine-era-sequencing-platform-investments-as-the-childhood.md)

> **Executive GIST:** - The historic reduction in childhood pneumonia deaths was driven largely by single-pathogen **vaccines** targeting Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae. - From 1990 to 2023 the effective number of pathogens underlying child pneumonia deaths rose from 5.57 to 9.94, indicating a diversified pathogen spectrum. - Using GBD 2023 deaths for 29 pathogens (ages 0–19) and WHO/UNICEF coverage data for PCV3 and Hib3, the authors classified pathogens into three intervention channels: **vaccine-reachable**, mixed, and **platform-sensitive**. - The vaccine-preventable group share declined from 54.0% to 40.2% (29-pathogen caliber, 1990–2023) while opportunistic/hospital-associated pathogens rose from 18.1% to 23.1%. - In 2023, estimated deaths: vaccine-reachable 441,410 (45.7%, channel includes COVID-19), mixed 126,926 (13.1%), and platform-sensitive 396,995 (41.1%). - Platform-sensitive deaths exceeded a computed scenario of residual vaccine-preventable deaths by 2.9–5.1-fold (scenario estimate 52,435–77,512 residual vaccine-preventable deaths). - Super-region vaccine coverage (PCV3, Hib3) showed no significant association with pathogen-share change (PCV3 rho = 0.108, p = 0.818; Hib3 rho = -0.036, p = 0.939); authors interpret this as evidence that simple coverage-burden correlations do not hold at the regional level. - Cross-classification found nine of 14 classifiable pathogens in the poverty-locked, infant-tropic cell (480,922 deaths), suggesting residual burden is concentrated among infants in poverty contexts. - The authors recommend that after continuing vaccine scale-up, marginal resources increasingly fund **platform investments** (oxygen systems, antimicrobial access and stewardship, infection prevention and control, referral systems, and nutrition) delivered as a package to populations where residual burden is locked. - Data sources are public (GBD 2023 Results Tool; WHO/UNICEF immunization coverage); analysis tables and a country-level dataset (204 countries, five time points 1990–2023) are available from the corresponding author or as additional files in the paper.

### 11. [Avoidable childhood respiratory-infection deaths: episode-fatality frontier analysis across 204 co](https://medichelpline.com/clinical-feed/medrxiv-20-avoidable-childhood-respiratory-infection-deaths-a-frontier-analysis-of-episode.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-03
- **Detail Markdown URL:** [Avoidable childhood respiratory-infection deaths: episode-fatality frontier analysis across 204 co](https://medichelpline.com/clinical-feed/medrxiv-20-avoidable-childhood-respiratory-infection-deaths-a-frontier-analysis-of-episode.md)

> **Executive GIST:** - The study applied an **episode-fatality-ratio (EFR)** frontier approach to quantify how many childhood deaths from respiratory infections could be averted using currently feasible care, using Global Burden of Disease (GBD) 2023 inputs for ages 0–19 years across 204 countries, 1990–2023. - EFR was calculated as deaths divided by incident episodes for each cause, country and year. The frontier was defined as the 10th-percentile country EFR within each GBD super-region, cause and year. - Avoidable deaths were computed deterministically as max(0, deaths − episodes × frontier EFR); uncertainty (95% UI) derived from 2,000 Monte Carlo draws. - Primary causes analysed were **lower respiratory infections (LRI)**, **whooping cough (pertussis)** and **upper respiratory infections (URI)**. The LRI avoidable-death estimate includes a 95% UI; pertussis and URI estimates are presented as deterministic point values with very wide underlying uncertainty. - In 2023, an estimated 333,803 childhood LRI deaths (95% UI 289,123–417,460; 46.9% of LRI deaths) were avoidable relative to within-region best practice. - Summing deterministically across the three causes yields 391,034 avoidable deaths in 2023 (46.5% of 840,444 total respiratory-infection deaths); UIs are available for the LRI component only. - Pertussis avoidable-death point estimate: 43,958 (39.0%); URI point estimate: 13,273 (81.0%), but both carry very wide uncertainty (global pertussis UI 12,545–321,874) and point values fall below their Monte Carlo intervals. - Avoidable deaths declined from 1,050,468 (44.9%) in 1990 to lower absolute numbers by 2023, but between 2019 and 2023 the avoidable share for LRI+URI changed little (48.7% to 47.7%) while absolute avoidable deaths fell 14.5%, indicating stalled convergence to the frontier. - Geographic concentration increased: Sub-Saharan Africa plus South Asia accounted for 73.1% of avoidable deaths in 2023 versus 41.8% in 1990; ten countries accounted for 59.1% of global avoidable deaths in 2023. - Sensitivity analyses varied frontier percentile, applied an aspirational global frontier, constructed pertussis counterfactuals, and repeated estimates for under-5 age band; the pertussis counterfactual suggested most countries kept pace with their regional frontier, implying further gains require improving the frontier itself. - All inputs are from public GBD 2023 results tools and GLOBOCAN 2022; reporting follows the GATHER statement. The authors declared no competing interests and appropriate ethical approvals and consents were confirmed.

### 12. [Childhood respiratory pathogen spectra are diverging across countries, 1990–2023](https://medichelpline.com/clinical-feed/medrxiv-19-diversification-without-convergence-national-childhood-respiratory-pathogen.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-03
- **Detail Markdown URL:** [Childhood respiratory pathogen spectra are diverging across countries, 1990–2023](https://medichelpline.com/clinical-feed/medrxiv-19-diversification-without-convergence-national-childhood-respiratory-pathogen.md)

> **Executive GIST:** - Analysis of Global Burden of Disease 2023 etiologic attributions for lower respiratory infections in ages 0–19 across 204 countries evaluated national **childhood respiratory pathogen spectra** at five timepoints from 1990 to 2023. - National pathogen share vectors included 26 pathogens; between-country compositional distance was quantified primarily with **Jensen–Shannon divergence (JSD)** and secondarily with Bray–Curtis dissimilarity and decompositions (Baselga, Jaccard). - Mean pairwise JSD increased from 0.0084 in 1990 to 0.0283 in 2023 (+238%; trend p = 0.030), peaking in 2021 (+283%) with a partial pullback by 2023. Bray–Curtis rose +120%; a balanced 107-country panel showed a +423% rise. - The observed change reflects increased **diversification** (within-country richness rose from 18.5 to 21.1 of 26 pathogens) rather than nested loss or gain; Baselga decomposition indicated divergence was driven entirely by balanced variation (share reallocation). - Dispersion increased most for **influenza** (coefficient of variation 0.03 → 0.55) and **respiratory syncytial virus** (0.08 → 0.48). - Within-region compositional distance rose in every computable GBD super-region (five of seven), indicating divergence occurs inside regions rather than being driven solely by between-region differences. - Authors interpret the pattern as country-specific re-sorting of etiologic dominance as vaccine-preventable pathogens decline at different rates, producing asynchronous, path-dependent transitions with implications for empirical treatment and surveillance. - Data sources are public GBD 2023 estimates; derived panels and pairwise distances are included in supplementary data and analysis code is available from the corresponding author.

### 13. [How pediatricians build trust with vaccine-hesitant parents — a practice of last resort](https://medichelpline.com/clinical-feed/stat-news-3-the-pediatricians-who-take-in-vaccine-skeptical-parents-others-won-t.md)
- **Source:** STAT News | **Published:** 2026-09-03
- **Detail Markdown URL:** [How pediatricians build trust with vaccine-hesitant parents — a practice of last resort](https://medichelpline.com/clinical-feed/stat-news-3-the-pediatricians-who-take-in-vaccine-skeptical-parents-others-won-t.md)

> **Executive GIST:** - Reporting focused on pediatricians who accept **vaccine-hesitant parents** that other practices decline; the piece profiles a clinic described as a “practice of last resort.” - The reporter, Eric Boodman, interviewed nine pediatricians across six states and shadowed one physician, **Aaron Bornstein**, during a meet-and-greet with a vaccine-hesitant parent. - The visiting parent said she trusted her prior pediatricians for routine newborn care but objected to firm clinic policies that she felt pressured her to vaccinate on the standard schedule. - The parent described prior clinicians as kind and competent but worried about rigid statements such as “she needs them all by 2 or we can’t keep her as a patient,” which prompted her to seek an alternative practice. - At the appointment at **Middleboro Pediatrics**, the encounter was framed as mutual evaluation: the parent assessing the doctor’s willingness to listen without judgment and the physician assessing how open the parent might be to medical advice if her child became a patient. - The article situates these clinical interactions in reporting about the fallout from federal messaging on **vaccines**, which the reporter explored by interviewing clinicians and observing practice-level encounters. - The report emphasizes relational dynamics — listening, allaying concerns, and avoiding hardline dismissals — as central to how this clinic engages families who are wary of mainstream vaccine protocols. - Specific operational details about the clinic’s policies, longitudinal outcomes for patients, and broader statistical data were not reported in the provided source excerpt.

### 14. [Phase 3 Trial of Oral Infigratinib in Children with Achondroplasia — NEJM report](https://medichelpline.com/clinical-feed/pubmed-42370681.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-03 | DOI: [10.1056/NEJMoa2604565](https://doi.org/10.1056%2FNEJMoa2604565)
- **Detail Markdown URL:** [Phase 3 Trial of Oral Infigratinib in Children with Achondroplasia — NEJM report](https://medichelpline.com/clinical-feed/pubmed-42370681.md)

> **Executive GIST:** - The PubMed record documents a Phase 3 clinical trial titled "Phase 3 Trial of Oral Infigratinib in Children with Achondroplasia," published in the New England Journal of Medicine (N Engl J Med) in 2026. - The trial is identified as a clinical trial; the PubMed entry includes PMID **42370681** and DOI 10.1056/NEJMoa2604565. - The article lists a large, multi–author international team led by Ravi Savarirayan and including clinicians and researchers from multiple countries and institutions. - Multiple authors are affiliated with pediatric hospitals, university centers, and research institutes across Australia, the United States, Canada, the United Kingdom, France, Spain, Norway, Singapore, Argentina, and other locations. - Industry contributors from BridgeBio Pharma (San Francisco) are included among the authors. - The PubMed page links to the full-text provider (Atypon / NEJM) and reports the e-publication date (Epub 2026 Jun 28) and journal issue (2026 Sep 3;395(9):859-869). - The PubMed entry provides bibliographic metadata (title, authors, affiliations, publication details) but the displayed page does not include the article abstract or trial results in the clipped record provided here. - Specific trial design elements (sample size, inclusion criteria, randomization, dosing, endpoints, efficacy outcomes, safety profile, statistical results) are not reported in the PubMed excerpt shown; readers must consult the NEJM full text or the full PubMed abstract for those details. - The record confirms this is a Phase 3 interventional study of **Oral Infigratinib** in pediatric patients with **achondroplasia**, but further clinical details require access to the primary article or supplemental materials. - Clinicians and researchers seeking trial methods, outcomes, and implications should retrieve the NEJM full text via DOI or institutional access for the complete dataset and analysis.

### 15. [Balanced Fluid versus 0.9% Saline for Children With Septic Shock: NEJM Randomized Trial](https://medichelpline.com/clinical-feed/pubmed-42028918.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-03 | DOI: [10.1056/NEJMoa2601969](https://doi.org/10.1056%2FNEJMoa2601969)
- **Detail Markdown URL:** [Balanced Fluid versus 0.9% Saline for Children With Septic Shock: NEJM Randomized Trial](https://medichelpline.com/clinical-feed/pubmed-42028918.md)

> **Executive GIST:** - The source is a PubMed/NCBI entry for a randomized controlled trial titled “Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock,” published in the New England Journal of Medicine (NEJM), with doi 10.1056/NEJMoa2601969 and Epub date listed as 2026 Apr 24. - The article lists a large multi-author, multinational pediatric research collaboration with lead authors including Fran Balamuth and Scott L. Weiss and many coauthors from pediatric emergency, critical care, and research centers in North America, Australia, and New Zealand. - The trial is identified as a randomized controlled trial comparing **balanced fluid** to **0.9% saline** in children treated for **septic shock**. The NEJM and PubMed records and a free PMC full-text link are provided in the entry. - The JINA source text supplied here includes title, author list, affiliations, publication citation, DOI, and links but does not include the article abstract, trial methods, numerical results, primary or secondary endpoints, statistical findings, or conclusions. - Because the provided PubMed page excerpt does not contain the trial’s methods details, outcome data, or conclusions, those specific clinical results and recommendations are not reported in this source text and therefore are not available for summary here. - The entry indicates that full text is available via NEJM and PubMed Central; readers should consult the full article or the PMC copy for complete trial design, enrollment criteria, outcomes, and authors’ conclusions. - Key searchable identifiers from the source: NEJM, PMID 42028918 (PubMed page), DOI 10.1056/NEJMoa2601969, title referencing **balanced fluid** vs **0.9% saline** in pediatric **septic shock**.

### 16. [Secondhand Cannabis Smoke in US Adolescents: Prevalence, Personal Use, and Cognitive Trajectories](https://medichelpline.com/clinical-feed/medrxiv-9-secondhand-cannabis-smoke-exposure-prevalence-personal-use-and-neurocognitive.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Secondhand Cannabis Smoke in US Adolescents: Prevalence, Personal Use, and Cognitive Trajectories](https://medichelpline.com/clinical-feed/medrxiv-9-secondhand-cannabis-smoke-exposure-prevalence-personal-use-and-neurocognitive.md)

> **Executive GIST:** - Study used longitudinal data from the Adolescent Brain Cognitive Development (**ABCD Study**) to examine prevalence of **secondhand cannabis smoke (SCS)** exposure, personal cannabis use, and neurocognitive trajectories in US adolescents aged 11–17. - Full analytic sample with follow-up data included n=11,316 participants; n=776 (6.9%) reported family SCS exposure. - Among those reporting SCS exposure, 46% endorsed lifetime personal cannabis use by age 17, compared with 20% among non-SCS exposed youth (OR=3.83, 95% CI: 3.29–4.44). - A matched subsample compared youth exposed to SCS but with no personal cannabis use (n=419; 47% female) to non-exposed, non-using controls (n=838) matched 1:2 on prenatal substance exposure, family substance use history, and sociodemographics. - Cognitive assessment used the NIH Toolbox Cognitive battery at yearly visits; linear mixed-effects models tested SCS-by-age interactions with random effects for subject and family and covariates for sex and alcohol, nicotine, and other substance use. - In matched analyses, SCS*age showed a significant interaction on **attention and inhibitory control** (β = −0.32, p = .028), indicating reduced improvement over time in SCS-exposed youth. - Greater cumulative waves of reported SCS exposure showed a trend toward worse trajectories (β = −0.39, p = .057). - Authors conclude SCS exposure is associated with higher odds of personal cannabis use and domain-specific reduced cognitive improvement; they recommend public health measures to reduce youth SCS exposure. - Ethical approval was provided by University of California San Diego; funders included the National Institute on Drug Abuse (DA050779, DA062011, DA064409).

### 17. [Global patterns of optimal temperature for child respiratory survival and thermal variability effe](https://medichelpline.com/clinical-feed/medrxiv-5-thermal-variability-and-the-geography-of-optimal-temperature-for-child-survival.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Global patterns of optimal temperature for child respiratory survival and thermal variability effe](https://medichelpline.com/clinical-feed/medrxiv-5-thermal-variability-and-the-geography-of-optimal-temperature-for-child-survival.md)

> **Executive GIST:** - This study combined Global Burden of Disease 2023 mortality estimates for childhood respiratory infections (lower respiratory infection deaths ages 0–19 and asthma deaths ages 0–24) with the C-LSAT/C-LDTR high-resolution climate dataset to evaluate temperature associations across 171 countries from 1990–2023. - Four exposure dimensions were modelled: **annual mean temperature**, **diurnal temperature range (DTR)**, seasonal amplitude, and interannual variability; two-way fixed-effects regressions with Driscoll–Kraay standard errors were used. - A quadratic term in mean temperature was used to estimate the **minimum mortality temperature (MMT)**; percentile confidence intervals came from a 300-replication country-cluster bootstrap. - The estimated childhood LRI **MMT** was 17.1 °C (95% CI 14.7–19.8), corresponding to the 36th percentile of each country’s annual temperature distribution; tropical zones had MMT ≈ 24.7 °C and subtropical zones ≈ 15.8 °C; temperate and subarctic zones showed weak or no identification. - The quadratic term generating the MMT failed falsification checks: future-exposure leads reproduced the U-shaped relation and country-level detrending removed it, indicating the MMT reflects a trend-level geographic pattern rather than a contemporaneous dose–response. - Interannual temperature variability was positively associated with LRI mortality (+0.278 per 1 °C, 95% CI 0.102–0.454; p = 0.002) and asthma mortality (+0.836 per 1 °C, 95% CI 0.447–1.226; p = 2.6×10⁻⁵). However, future-exposure models produced similar coefficients and detrending removed significance, supporting only trend-level associations. - Annual mean temperature was inversely associated with both outcomes at the trend level; **DTR** and seasonal amplitude showed no independent within-country effects. - Adjustment for national **PCV3** coverage and ambient **PM2.5** did not materially change estimates for variability-associated effects. - Authors conclude this is the first multi-country, climate-zone-resolved geography of the optimal temperature for childhood respiratory survival, but emphasize that results are directional and that daily-scale, child-specific studies are needed to test contemporaneous causality of short-term thermal variability on pediatric respiratory mortality.

### 18. [Increasing non-receipt of vitamin K prophylaxis in newborns, 2019–June 2026](https://medichelpline.com/clinical-feed/medrxiv-20-rising-rate-of-non-receipt-of-vitamin-k-prophylaxis-for-newborns-january-2019.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Increasing non-receipt of vitamin K prophylaxis in newborns, 2019–June 2026](https://medichelpline.com/clinical-feed/medrxiv-20-rising-rate-of-non-receipt-of-vitamin-k-prophylaxis-for-newborns-january-2019.md)

> **Executive GIST:** - Study used de-identified Truveta electronic health record data linking mother-child dyads to evaluate documented receipt of **vitamin K** prophylaxis at birth from January 1, 2019 through June 30, 2026. - Cohort included 1,026,375 live births to mothers aged 15–49; 995,628 infants (96.97%) had documented vitamin K administration on the birth date or the following day. - Overall non-receipt rose from an average of 2.1% during 2019–2022 to 4.3% in 2025 and 6.1% in 2026, reaching 8.10% in June 2026. - Logistic regression identified higher odds of non-receipt associated with older maternal age, non-Hispanic or Latino ethnicity, Medicaid or unknown insurance, and year of delivery. - Interrupted time series analysis around January 2026 showed no immediate step change, but a monthly decline in odds of vitamin K receipt of 10% after that point (OR 0.90; 95% CI 0.88–0.91), indicating acceleration in the trend. - Authors note that vitamin K recommendations did not change with the January vaccine schedule, suggesting the pattern may reflect broader shifts in confidence in newborn preventive care rather than policy changes. - The report calls for future studies to investigate causal mechanisms, parental decision-making, and clinical outcomes associated with increasing non-receipt. - All authors are employees and equity holders of Truveta, Inc.; data are de-identified and available to Truveta subscribers at studio.truveta.com.

### 19. [Warming and thermal variability did not explain the 96% fall in childhood respiratory-infection mo](https://medichelpline.com/clinical-feed/medrxiv-12-warming-thermal-variability-and-the-96-decline-in-childhood-respiratory.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Warming and thermal variability did not explain the 96% fall in childhood respiratory-infection mo](https://medichelpline.com/clinical-feed/medrxiv-12-warming-thermal-variability-and-the-96-decline-in-childhood-respiratory.md)

> **Executive GIST:** - China experienced a 96.3% decline in lower respiratory infection (LRI) deaths among ages 0–19 from 1990 to 2021 (330,194 to 12,098; 95% UI 9,669–14,891) and a 94.9% decline in asthma deaths (3,287 to 167) over a comparable period. - The study linked GBD 2021 mortality estimates with the high-resolution C-LSAT temperature dataset (0.5° gridded, 1990–2019), aggregated nationally and across five climate zones. - Four annual thermal indicators were analyzed in log mortality regressions with Newey-West standard errors: **mean temperature**, diurnal temperature range (DTR), seasonal amplitude, and interannual variability. - Observed climate trends: mean temperature rose by 0.364 °C per decade and DTR narrowed by 0.092 °C per decade. - Baseline regression coefficients (per 1 °C change, on log rate) were substantial: mean temperature −1.696 (SE 0.174); DTR +2.408 (SE 0.336); seasonal amplitude −0.162 (SE 0.082); interannual variability +2.924 (SE 1.514). - A bootstrapped (500 resamples) quadratic model attempted to identify a minimum mortality temperature (MMT); national MMT was not identifiable within observed temperature support (6.66–8.13 °C). The quadratic model's nominal turning point (35.84 °C) is an extrapolation artifact (quadratic term p = 0.963). - Robustness checks including a future-exposure test failed, and detrending the series nullified all coefficients, indicating associations reflect long-term trends rather than identifiable short-cycle causal effects. - The authors conclude the dramatic decline in **childhood respiratory mortality** cannot be attributed to warming; within the observed temperature range, warming and declining mortality moved in the same direction but causal attribution is unsupported. - Data sources and analysis code availability are reported: GBD 2021 Results Tool for mortality, C-LSAT and C-LDTR datasets on Figshare (DOIs provided), population denominators from GLOBOCAN 2022, and analysis code available from the corresponding author on request.

### 20. [Electronic Health Records for Paediatric Growth References: SwissPedGrowth Results](https://medichelpline.com/clinical-feed/medrxiv-11-towards-electronic-health-records-based-paediatric-growth-references-results.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Electronic Health Records for Paediatric Growth References: SwissPedGrowth Results](https://medichelpline.com/clinical-feed/medrxiv-11-towards-electronic-health-records-based-paediatric-growth-references-results.md)

> **Executive GIST:** - The SwissPedGrowth project analysed **electronic health records** (EHRs) from seven Swiss children’s hospitals to evaluate paediatric **growth references** and to estimate centile curves for height, weight, BMI, and head circumference. - Two analytic samples were used: (1) all children with at least one recording of height, weight, BMI, or head circumference; and (2) a subsample restricted to children without diseases potentially affecting growth, weighted to represent the general population. - Growth measures were compared with the World Health Organization references adopted for Switzerland in 2011 (**CH-WHO 2011**) and the current Swiss growth references (**Swiss 2026**); mean z-scores were calculated for each comparison. - Sample sizes: 213,868 children with height, 448,002 with weight, 209,244 with BMI, and 67,397 with head circumference recordings were included across the dataset. - Mean z-scores in the all-children sample (CH-WHO 2011; Swiss 2026): height 0.10; -0.19, weight 0.16; -0.09, BMI 0.04; -0.07, head circumference -0.28; -0.28. - Mean z-scores in the subsample (CH-WHO 2011; Swiss 2026): height 0.34; 0.00, weight 0.27; 0.01, BMI 0.18; 0.05, head circumference 0.04; 0.01. - In the subsample, sex-specific 50th centiles for height, weight, BMI, and head circumference closely followed **Swiss 2026**; the 3rd and 97th centiles were slightly wider in infancy and adolescence. - The authors conclude that hospital **EHRs** align well with current Swiss growth references and could contribute to future paediatric growth references. - Ethical approval was obtained from the cantonal ethics committee Bern (Kantonale Ethikkomission Bern 2023-00022). Data may be available on request from the corresponding author; metadata are in the Swiss Personalized Health Network catalogue. - Competing interests: OGJ, CEK, and CS are members of the commission for growth references of paediatrie schweiz; no other competing interests declared.

### 21. [Rising A&E attendances and long waits for children in mental health crisis, analysis shows](https://medichelpline.com/clinical-feed/bmj-0-children-as-young-as-6-are-increasingly-attending-a-e-in-mental-health-crisis.md)
- **Source:** BMJ | **Published:** 2026-09-02
- **Detail Markdown URL:** [Rising A&E attendances and long waits for children in mental health crisis, analysis shows](https://medichelpline.com/clinical-feed/bmj-0-children-as-young-as-6-are-increasingly-attending-a-e-in-mental-health-crisis.md)

> **Executive GIST:** - NHS England data obtained by the Royal College of Paediatrics and Child Health (**RCPCH**) show a substantial rise in children attending emergency departments with a recorded **mental health** concern: 75,491 attendances in 2025, a 36% increase since 2019. - The largest proportional increase was among 6–9 year olds (a 62% rise from 3,870 attendances in 2019 to 6,269 in 2025). Other increases included 41% for 9–15 year olds, 28% for 16 year olds, and 19% for 17 year olds. - Prolonged waits in emergency departments have increased: children staying more than 12 hours rose by 217%, from 1,964 in 2019 to 6,235 in 2025. The share of attendances exceeding 12 hours increased from 3.4% (1 in 29) in 2019 to 7.7% (1 in 13) in 2025. - The number of children aged 6–17 who were held in emergency departments for more than 72 hours rose from 55 in 2019 to 338 in 2025. - The RCPCH states that emergency departments were not designed to meet the needs of children with acute mental health problems and that many children end up there because of insufficient community support and difficulties securing onward care or safe discharge arrangements. - RCPCH officers (Ronny Cheung and Sam Jones) described the data as a “wake-up call,” emphasising risk to education, employment, and training if earlier support is not provided, and noting that some children do not require admission but cannot be safely discharged. - The Royal College of Emergency Medicine (Mark Buchanan) said patients arrive by “default” when needed services are unavailable, and long stays often reflect disputes between health, mental health, and social care. - A Department of Health and Social Care spokesperson highlighted policy actions: expanding mental health support in schools and colleges and opening more than 150 new mental health facilities, including community centres offering same-day, walk-in support, intended to provide earlier, local help for young people. - The RCPCH is calling on the government to use its forthcoming mental health strategy to address the crisis in children’s mental health, citing rising attendances and worsening waits as evidence of systemic pressure.

### 22. [Fever-related discomfort in children: international Delphi consensus definition](https://medichelpline.com/clinical-feed/pubmed-42680903.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-02 | DOI: [10.1007/s00431-026-07340-4](https://doi.org/10.1007%2Fs00431-026-07340-4)
- **Detail Markdown URL:** [Fever-related discomfort in children: international Delphi consensus definition](https://medichelpline.com/clinical-feed/pubmed-42680903.md)

> **Executive GIST:** - The article titled “Defining fever-related discomfort in children: an international Delphi consensus” reports an international expert consensus process (Delphi) addressing how to define **fever-related discomfort** in **children**. - Publication metadata: Eur J Pediatr, 2026 Sep 2;185(9):707. DOI 10.1007/s00431-026-07340-4. PubMed PMID 42680903. - Multi-author, multi-center work with numerous contributors from Europe, North America, and Oceania; several authors are noted as having contributed equally. - Participating institutions include university departments of pediatrics, pharmacy, family medicine, emergency departments, and pediatric specialty units across Italy, UK, Germany, France, New Zealand, USA, The Netherlands, Spain, Switzerland. - The corresponding lead and first-listed author is Gregorio P Milani (University of Calabria; Pediatric Unit, Annunziata Hospital). Multiple coauthors are listed including Edward Purssell, David Martin, François Corrard, Eunicia Tan, Janice E Sullivan, Eefje de Bont, Santiago Mintegi, Mario G Bianchetti, Sebastiano A G Lava, and Elena Chiappini. - The source excerpt does not include the study abstract, methods, Delphi rounds, panel composition, specific items or criteria agreed on, outcome measures, or detailed results. Those details were not reported in the provided source text. - Because the provided PubMed page excerpt contains primarily bibliographic and affiliation information, no clinical recommendations, specific consensus statements, or validated definition elements can be extracted from this text alone. - Readers should consult the full article (journal or DOI) for the complete methodology, panel membership, Delphi process details, consensus statements, and any proposed definition or clinical implications for assessing **fever-related discomfort** in pediatric patients.

### 23. [Physical activity, rumination, mindfulness, and reaction-time executive function in late adolescen](https://medichelpline.com/clinical-feed/plos-one-13-physical-activity-and-executive-function-in-adolescents-dual-rumination.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-01
- **Detail Markdown URL:** [Physical activity, rumination, mindfulness, and reaction-time executive function in late adolescen](https://medichelpline.com/clinical-feed/plos-one-13-physical-activity-and-executive-function-in-adolescents-dual-rumination.md)

> **Executive GIST:** - The study examined associations among **physical activity (PA_total)**, two forms of **rumination** (intrusive rumination [IR] and deliberate rumination [DR]), **mindfulness**, and a reaction-time-based executive-function composite (**EF_RT**) in late adolescents. - Cross-sectional sample: N = 450 late adolescents (266 males), aged 17–19 years, who completed self-report measures of PA, rumination, and mindfulness plus computerized cognitive tasks. - **EF_RT** was computed from standardized reaction-time indicators from Flanker, 2-back, and More–Odd Shifting tasks; lower EF_RT indicates better (faster) RT-based performance. - Structural equation models tested parallel indirect pathways from PA_total to EF_RT via IR and DR, with gender included as a covariate; bias-corrected bootstrapping (5,000 resamples) estimated indirect and conditional indirect effects. - Main finding: PA_total had significant positive total and direct associations with EF_RT—higher PA_total associated with higher EF_RT scores, meaning slower or less efficient RT-based task performance (an unexpected direction for RT-based measures). - Both **intrusive rumination (IR)** and **deliberate rumination (DR)** served as significant parallel indirect pathways linking PA_total to EF_RT. - **Mindfulness** moderated both the PA_total → IR path and the IR → EF_RT path; the conditional indirect effect via IR varied across mindfulness levels. - Authors emphasize these are cross-sectional associations involving RT-based executive-function performance; positive coefficients with EF_RT reflect longer reaction times or larger RT costs, not improved EF ability. - Data, figures, and tables supporting analyses are provided in the manuscript and supporting information; authors note caution in interpreting directional or causal implications.

### 24. [Maternal BMI in Early Pregnancy and Offspring Mortality up to Early Adulthood](https://medichelpline.com/clinical-feed/plos-medicine-1-maternal-body-mass-index-in-early-pregnancy-and-offspring-mortality-up-to-early.md)
- **Source:** PLOS Medicine | **Published:** 2026-09-01
- **Detail Markdown URL:** [Maternal BMI in Early Pregnancy and Offspring Mortality up to Early Adulthood](https://medichelpline.com/clinical-feed/plos-medicine-1-maternal-body-mass-index-in-early-pregnancy-and-offspring-mortality-up-to-early.md)

> **Executive GIST:** - This nationwide Swedish cohort study included 2,606,684 live births (1982–2014, excluding 1990–1991) with a median follow-up of 22.4 years to assess associations between **maternal BMI** in early pregnancy and offspring mortality up to early adulthood. - Maternal BMI was categorized as underweight (<18.5 kg/m2), normal (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), obesity grade I (30.0–34.9 kg/m2), grade II (35.0–39.9 kg/m2) and grade III (≥40.0 kg/m2); mortality data came from the national Cause of Death Register. - During follow-up 21,981 offspring (0.8%) died. Higher maternal BMI was associated with higher offspring all-cause mortality: HR 1.03 per 1 unit BMI increase (95% CI 1.02–1.03). - Compared with maternal normal BMI, offspring risks were increased for maternal overweight (HR 1.11, 95% CI 1.07–1.15) and for obesity grades I–III with progressively larger HRs: 1.27, 1.68, and 1.92, respectively; all p < 0.001. - Similar positive associations were observed for several common causes of death in the young, including **respiratory diseases**, **cardiovascular diseases**, and **congenital anomalies**. - Analyses adjusted for maternal age, education, income, marital status, country of birth, smoking in early pregnancy, psychiatric disorders and cardiovascular disease before childbirth; adverse pregnancy outcomes were also considered. - A cousin comparison analysis attenuated but did not eliminate the associations, suggesting partial influence of shared familial factors but not complete confounding. - The authors caution that residual confounding remains possible and the findings should not be taken as proof of causality; mechanisms remain to be elucidated. - The study underscores the potential public health importance of achieving a healthy maternal BMI prior to conception given the rising obesity prevalence among women of childbearing age.

### 25. [Persistent psychotic experiences in adolescents at familial high risk of schizophrenia or bipolar](https://medichelpline.com/clinical-feed/medrxiv-2-persistence-of-psychotic-experiences-and-clinical-outcomes-in-adolescents-at.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-01
- **Detail Markdown URL:** [Persistent psychotic experiences in adolescents at familial high risk of schizophrenia or bipolar](https://medichelpline.com/clinical-feed/medrxiv-2-persistence-of-psychotic-experiences-and-clinical-outcomes-in-adolescents-at.md)

> **Executive GIST:** - This nationwide follow-up examined **psychotic experiences (PE)** and clinical outcomes in 522 adolescents drawn from three groups: familial high risk for schizophrenia (FHR-SZ, n=202), familial high risk for bipolar disorder (FHR-BP, n=120), and a population-based control group (PBC, n=200). - Assessments using a semi-structured interview occurred at ages 7, 11, and 15 to evaluate occurrence and persistence of PE and presence of mental disorders. - At age 15, adolescents at FHR-SZ reported more **current** PE (past six months) and more PE over the preceding four years than PBC; adolescents at FHR-BP reported more **current** PE but not increased PE over the past four years compared with PBC. - **Persistent PE** (PE present at two or three assessment timepoints) was associated with substantially increased risk of any **Axis I disorder** in mid-adolescence: PE at two timepoints predicted ~3-fold greater odds (OR 2.9, 95% CI 1.5–5.7) and PE at three timepoints predicted much larger odds (OR 21.4, 95% CI 2.8–162.3). - Persistent PE also predicted greater **multimorbidity**: PE at two timepoints had about 2.8-fold increased odds (95% CI 1.0–7.6) and at three timepoints about 4.1-fold increased odds (95% CI 1.2–14.1). - These associations remained after adjusting for sex, early mental disorders, and familial risk status. - The study underscores that early-onset, enduring PE are important risk markers for mid-adolescent mental disorder and supports monitoring children with PE before age 7 who go on to have persistent symptoms. - Ethical approval was obtained from the Danish Committee on Health Research Ethics (H-20067908). Individual-level data are not publicly available due to GDPR, but collaboration requests can be made.

### 26. [PCGS: Explainable GNN platform for biomarker and risk-group identification in pediatric cancers](https://medichelpline.com/clinical-feed/medrxiv-17-pcgs-biomarker-and-risk-group-identification-for-pediatric-cancers-via.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-01
- **Detail Markdown URL:** [PCGS: Explainable GNN platform for biomarker and risk-group identification in pediatric cancers](https://medichelpline.com/clinical-feed/medrxiv-17-pcgs-biomarker-and-risk-group-identification-for-pediatric-cancers-via.md)

> **Executive GIST:** - The study presents PCGS, an end-to-end multi-modality framework developed for **pediatric cancer** research that combines omics-specific representation learning with graph neural network (GNN) architectures and multi-objective learning for classification, clustering, and survival tasks. - PCGS is built on a scalable AI platform called **GAIPO** (Graph Artificial Intelligence for Pediatric Oncology) that integrates bulk and single-cell omics with clinical data, leveraging pediatric-focused data resources such as the Childhood Cancer Data Initiative (**CCDI**). - The framework uses cross-attention fusion to combine modality-specific GNN representations and supports downstream supervised tasks, reportedly outperforming prior supervised multi-omics integration baseline approaches on **glioma** and **Wilms tumor** cohorts. - Explainability is provided by Shapley value–based feature attribution to estimate and rank the contribution of gene-level features across omics modalities for different biomedical tasks, enabling identification of background-specific key features when using background samples defined by age, sex, or grade. - PCGS can identify biomarkers, stratify risk groups, and support survival analysis in pediatric glioma and Wilms tumor, with potential applicability to other pediatric cancers. - The study used only openly available human data from cbioPortal, PedCBioPortal (Kids First), and the CCDI Clinical Commons. IRB and ethical statements indicate use of open datasets and adherence to reporting guidelines; authors declared no competing interests. - Funding support was declared from the National Cancer Institute (3P30CA082709-25S1). Full data sources and links are provided in the manuscript for reproducibility.

### 27. [WHO expands access to lifesaving sickle cell treatment and child-friendly medicines](https://medichelpline.com/clinical-feed/who-0-0-who-moves-to-expand-access-to-lifesaving-sickle-cell-treatment-and-care-for.md)
- **Source:** World Health Organization | **Published:** 2026-09-01
- **Detail Markdown URL:** [WHO expands access to lifesaving sickle cell treatment and child-friendly medicines](https://medichelpline.com/clinical-feed/who-0-0-who-moves-to-expand-access-to-lifesaving-sickle-cell-treatment-and-care-for.md)

> **Executive GIST:** - Sickle cell disease (SCD) remains a leading cause of preventable childhood death and disability; an estimated **81,100** deaths occurred among children under five in 2021. - The WHO published its first normative guideline for diagnosis, prevention and clinical management of SCD in children and adolescents (0–19 years) in May 2026, with 15 recommendations across seven priority areas. - WHO issues a strong recommendation for the use of **hydroxyurea** for all children and adolescents with sickle cell anaemia aged 9 months to 19 years, irrespective of clinical severity. - WHO paired clinical guidance with efforts to improve availability of **quality-assured, child-friendly medicines**, prioritizing sub-Saharan Africa where nearly 80% of SCD cases occur. - The WHO Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing collaborated with the Global Accelerator for Paediatric Formulations (GAP-f) to bridge guidance and medicine access. - The Paediatric Drug Optimization for sickle cell disease (PADO-SCD) exercise convened in September 2025 identified priority medicines and formulations, set a watch list of investigational therapies, and informed research priorities. - A **Target Product Profile (TPP) for paediatric hydroxyurea** published July 2026 defines preferred and minimum characteristics for age-appropriate formulations (dosage form, strengths, dosing flexibility, administration, stability, packaging and affordability) with emphasis on weight-based dosing and resource-limited settings. - The TPP underpins the first-ever **WHO Prequalification Expression of Interest (EOI)** for SCD therapeutics, making certain hydroxyurea formulations, including paediatric forms and 500 mg capsules, eligible for prequalification evaluation. - WHO encourages manufacturers to engage with the Prequalification of Medicines Team about eligibility, development requirements and submission pathways. - WHO is monitoring and preparing for a changing therapeutic landscape, including new medicines, biologics and gene therapies; PADO-SCD developed a watch list of promising investigational therapies and paediatric evidence priorities. - WHO stresses that effective medicines must be affordable, accessible and presented in child-appropriate formulations to translate recommendations into lives saved.

### 28. [Catheter-lock therapy for preventing and treating neonatal catheter-related bloodstream infections](https://medichelpline.com/clinical-feed/bmj-open-4-lock-solutions-for-the-prevention-and-treatment-of-catheter-related-bloodstream.md)
- **Source:** BMJ Open | **Published:** 2026-09-01
- **Detail Markdown URL:** [Catheter-lock therapy for preventing and treating neonatal catheter-related bloodstream infections](https://medichelpline.com/clinical-feed/bmj-open-4-lock-solutions-for-the-prevention-and-treatment-of-catheter-related-bloodstream.md)

> **Executive GIST:** - Neonatal bloodstream infections are a leading cause of morbidity and mortality in NICUs, with central venous catheters a primary risk factor. A focused evidence synthesis is needed on catheter-lock therapy (CLT) in newborns. - **Catheter-lock therapy (CLT)** involves instilling antimicrobial or antibiotic solutions into the catheter lumen and leaving them in place for a defined period. CLT has shown promise in adult and paediatric populations, but data specific to newborns are limited and fragmented. - This document is a protocol for a systematic review and meta-analysis following Cochrane methods and PRISMA reporting standards to evaluate CLT efficacy and safety in newborns. - The primary outcome is frequency of **CRBSI/CLABSI** in newborns receiving CLT versus placebo or no lock therapy. Secondary outcomes include mortality, NICU length of stay, catheter survival and dwell time, antibiotic exposure, and safety profiles. - A PICOS framework will guide inclusion. Searches of major electronic databases and grey literature have been developed, with tailored queries and backward/forward citation checking. No language or publication period limits. The systematic search date is 1 May 2026. - All primary-study designs with original data are eligible: randomized controlled trials, cohort studies, case-control studies, case reports, and surveys. Studies without original data will be excluded, though review reference lists will be screened manually. - Two independent reviewers will screen, extract data, and assess risk of bias using standardized tools; a third reviewer will adjudicate disagreements. - Quantitative synthesis will aggregate comparable data; CLT effects will be analyzed separately for prophylactic versus therapeutic use. Subgroup analyses will examine different locking-solution types. Meta-analysis will be performed when at least two sufficiently homogeneous studies are available. - Certainty of evidence will be appraised using the GRADE approach for clinically relevant outcomes. - No formal ethics approval is required because the review uses published secondary data. The authors expect to complete the systematic review within six months and submit findings to peer-reviewed journals indexed in PubMed. - The protocol is registered in PROSPERO: CRD420251176308.

### 29. [Norwegian Triple-S Cohort: Longitudinal Study of Children Exposed to Maltreatment](https://medichelpline.com/clinical-feed/bmj-open-2-norwegian-triple-s-cohort-study-a-large-longitudinal-study-of-children-and.md)
- **Source:** BMJ Open | **Published:** 2026-09-01
- **Detail Markdown URL:** [Norwegian Triple-S Cohort: Longitudinal Study of Children Exposed to Maltreatment](https://medichelpline.com/clinical-feed/bmj-open-2-norwegian-triple-s-cohort-study-a-large-longitudinal-study-of-children-and.md)

> **Executive GIST:** - The Norwegian **Triple-S Cohort Study** is a large longitudinal study recruiting children and adolescents aged 5–18 years with substantiated **childhood maltreatment** and their non-offending caregivers through the Stine Sofie Centre in Norway. - The study aims to identify risk and resilience factors and to understand long-term health, functioning and service needs after maltreatment by following participants at roughly 2-year intervals and linking survey data, with consent, to national registries. - As of June 2026, baseline questionnaires were completed by 733 caregivers and 325 adolescents aged 12–18; recruitment will continue until about 1,500 child/adolescent participants are enrolled. - Child/adolescent data include maltreatment type, mental and somatic health, behavioural and neurodevelopmental symptoms, self-harm and suicidality, sleep, social relationships, school functioning, health behaviours and service use. - Caregiver data cover mental and physical health, self-harm and suicidality, lifetime interpersonal victimisation, socioeconomic and lifestyle factors, parenting practices, family dynamics, relationship quality and perceived service needs. - Published analyses have reported high rates of mental health and sleep problems, impaired school functioning and elevated non-suicidal self-harm among exposed children and adolescents; studies also show variable service use and barriers to disclosure. - Caregiver analyses reveal both relational strengths and parenting difficulties, and socioeconomic vulnerability among mothers with cumulative interpersonal violence exposure. - Future plans include continued follow-up to examine trajectories of mental health, education, work participation and service use, registry linkages for life-course data and additional qualitative interviews to deepen understanding of lived experiences and inform prevention and service delivery.

### 30. [mHealth-Supported Perioperative Care for Caregivers of Children Undergoing Tonsillectomy: TONAPP R](https://medichelpline.com/clinical-feed/pubmed-42678982.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.2196/93989](https://doi.org/10.2196%2F93989)
- **Detail Markdown URL:** [mHealth-Supported Perioperative Care for Caregivers of Children Undergoing Tonsillectomy: TONAPP R](https://medichelpline.com/clinical-feed/pubmed-42678982.md)

> **Executive GIST:** - Pediatric ENT surgery (tonsillectomy, adenoidectomy, tympanostomy tube insertion) commonly causes perioperative distress in children and anxiety among family caregivers. Limited time for perioperative education and reliance on unverified online sources can reduce family preparedness and increase stress. - The TONAPP study is a 2-arm, parallel-group, open-label **randomized controlled trial** comparing an **mHealth** app–supported pathway versus standard supportive and educational care alone for caregivers of children undergoing ENT surgery. - The trial enrolled caregivers at the hospital during the presurgery visit; a health care provider introduced the study and provided instructions for app use. No additional human support was scheduled after enrollment. - The **mHealth** app was co-designed with users through a participatory, user-centered approach and developed following Schnall and colleagues' Information Systems Research Framework; content was informed by caregivers' informational needs. - A planned sample size of 180 participants (90 per arm) was calculated to detect the expected between-group difference in caregiver anxiety. Randomization was 1:1 to app use or standard care. - The primary outcome was caregiver state anxiety measured with the State-Trait Anxiety Inventory (STAI-Y). Secondary outcomes included caregiver anxiety at follow-up, child distress measured with a modified Yale Preoperative Anxiety Scale (mYPAS), child preparation for surgery, family preparation for hospital admission and surgery, and social-impact indicators. - Recruitment and baseline procedures were performed at the presurgery visit; the study design included no scheduled additional human support beyond initial app introduction. - The abstract and available source text describe study design, intervention development, planned sample size, and outcome measures, but the source document provided here is incomplete and does not report trial results, numerical outcomes, statistical analyses, or conclusions. - Details not reported in the provided source text include primary and secondary outcome results, measures of effect size, statistical significance, participant flow, adherence or engagement metrics for the app, adverse events, and final conclusions about efficacy or implementation. - For interpretation or clinical application, the missing outcome data must be obtained from the full publication or trial report; the present summary should be considered a design and methods overview only.

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