Objective To understand the risk factors associated with adverse events during exchange transfusion (ET) in severe neonatal hyperbilirubinemia. Study design We conducted a retrospective study of infants with hyperbilirubinemia who underwent ET within 30 days of birth from 2015 to 2020 in a children’s hospital. Both traditional statistical analysis and state-of-the-art explainable artificial intelligence (XAI) were used to identify the risk factors. Results A total of 188 ET cases were included; 7 major adverse events, including hyperglycemia (86.2%), top-up transfusion after ET (50.5%), hypocalcemia (42.6%), hyponatremia (42.6%), thrombocytopenia (38.3%), metabolic acidosis (25.5%), and hypokalemia (25.5%), and their risk factors were identified. Some novel and interesting findings were identified by XAI. Conclusions XAI not only achieved better performance in predicting adverse events during ET but also helped clinicians to more deeply understand nonlinear relationships and generate actionable knowledge for practice.
ObjectivesThis study aimed to investigate the seasonality of paediatric intussusception and the associations between meteorological factors and paediatric intussusception in Hangzhou, as well as aimed to compare the variance in sex and disease type.DesignAn 8-year retrospective study was conducted from January 2014 to December 2021 in the Children’s Hospital of Zhejiang University, Hangzhou, China.SettingThis was a single-centre retrospective study review of intussusception cases in a large Children’s Hospital in Hangzhou.ParticipantsThere were 17 674 patients with intussusception in this study.MethodsA Spearman correlation analysis and Poisson regression analysis were used to determine the association between weekly intussusception cases and meteorological factors. The seasonality of paediatric intussusception was demonstrated via the t-test and visualised.ResultIn January, May and December, there were relatively more intussusception patients. In February, there was a trough in the number of intussusception patients. Both the Spearman correlation analysis and Poisson regression analysis proved that weekly intussusception cases had significant associations with temperature (λ=−0.205, p<0.01; β=−0.080, p<0.01), feels-like temperature (λ=−0.214, p<0.01; β=−0.012, p<0.01), dew (λ=−0.249, p<0.01; β=0.095, p<0.01), humidity (λ=−0.230, p<0.01; β=−0.037, p<0.01), precipitation (λ=−0.148, p<0.01; β=−0.001, p<0.01), windspeed (λ=−0.135, p<0.01; β=0.005, p<0.01), visibility (λ=−0.206, p<0.01; β=−0.066, p<0.01), sea level pressure (λ=0.171, p<0.01; β=−0.004, p<0.01) and a total of 20 of 25 dynamic meteorological factors (p<0.05). These associations reflected gender differences but showed stronger associations in groups that were prone to recurrence.ConclusionsPaediatric intussusception in Hangzhou showed a seasonal tendency. Additionally, intussusception was significantly associated with certain meteorological factors in all of the cases. These findings suggest that parents and paediatricians should be more vigilant about the occurrence of intussusception in children regarding seasonal change times and climate change times.
Background Eczema is the most common form of dermatitis and also the starting point of atopic march. Although many eczema‐associated allergic and immunologic disorders have been studied, there remains a gap in the systematic quantitative knowledge regarding the relationships between all childhood disorders and eczema. This study aimed to systematically explore eczema‐associated childhood diseases using a real‐world, long‐term clinical dataset generated from millions of children in China. Methods Data were collected at 8,907,735 outpatient healthcare visits from 2,592,147 children between January 1, 2013, and August 15, 2019, at the largest comprehensive pediatric medical center in Zhejiang Province of China. The period prevalence differences in various pediatric diseases between children with and without eczema were used to test the independence of various pediatric disorders and eczema using Fisher's exact test. Bonferroni correction was used to adjust the p value in multiple testing. Odds ratio >2 with 95% confidence interval not including 1 and adjusted p < 0.05 was used to identify eczema‐associated diseases. Results Overall, 234 pediatric disorders were identified from more than 6000 different pediatric disorders. An interactive eczema‐associated disease map that has related quantitative epidemiological features called ADmap was published at http://pedmap.nbscn.org/admap . Thirty‐six of these disease associations have not been reported in previous studies. Conclusion This systematic exploratory study confirmed the associations of many well‐known diseases with eczema in Chinese children and also identified some novel and interesting associations. These results are valuable for the development of a comprehensive approach to the management of eczema in childhood.
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