To study the clinical characteristics of rashes induced by trimethoprim-sulfamethoxazole (TMP-SMZ) in children treated for pertussis and to inform safe medication practices.

A retrospective analysis was conducted on 238 children diagnosed with pertussis and treated with TMP-SMZ at Wuhu First People's Hospital from January to August 2024. The incidence and clinical features of rashes were summarized.

Of 238 children, 34 (14.3%) developed rashes; 19 (55.9%) were boys, and the 5 to <10-year age group accounted for the highest proportion (70.6%, 24/34). A history of allergic disease was present in 50.0% (17/34). Rashes typically appeared on or after day 7 of therapy (82%, 28/34) and were predominantly erythematous or maculopapular eruptions (97%, 33/34); 71% (24/34) were pruritic. Fever occurred in 56% (19/34); among those who were tested for respiratory viruses, 77% (10/13) were positive for viruses such as rhinovirus and adenovirus. After discontinuation of TMP-SMZ, rashes resolved within 3 days in 97% (33/34) of patients (41% within 1 day; 56% within more than 1 but within 3 days). There was no significant difference in rash incidence between photoprotection and non-photoprotection groups (P>0.05).

TMP-SMZ for pertussis can induce rashes, particularly in children aged 5 to <10 years. The eruption is usually a pruritic erythematous or maculopapular rash, with over half of cases accompanied by fever and frequent concomitant viral infections. Most rashes resolve within 3 days after drug withdrawal. The potential association between the rash and sun exposure warrants further investigation.

To identify risk factors for recurrent plastic bronchitis (PB) among children with Mycoplasma pneumoniae pneumonia (MPP).

The clinical data of children with MPP complicated by PB who underwent bronchoscopy at Gansu Province Maternity and Child Health Hospital between July 2023 and January 2025 were retrospectively analyzed. Patients were grouped into a single-episode PB group and a recurrent PB group according to the number of PB episodes. Multivariable logistic regression was used to identify risk factors for recurrent PB. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of individual and combined predictors.

A total of 264 children were included; 188 (71.2%) had a single episode of PB and 76 (28.8%) had recurrent PB. Multivariable logistic regression analysis showed that decreased serum albumin, atelectasis, and fever persisting beyond 72 hours after the initial bronchoscopy were significantly associated with recurrent PB (all P<0.05). The combination of these predictors yielded a sensitivity of 82.9%, specificity of 61.7%, and an area under the ROC curve of 0.777 (95%CI: 0.714-0.839), outperforming any single predictor (P<0.05).

In children with MPP complicated by PB, decreased serum albumin, the presence of atelectasis, and fever persisting beyond 72 hours after the initial bronchoscopy are associated with an increased risk of PB recurrence. In such cases, early repeat or multiple bronchoscopic interventions should be considered.

To investigate the predictive factors for plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP) and to establish a nomogram prediction model for PB occurrence.

A retrospective analysis was conducted on children with MPP hospitalized at The Affiliated Hospital of Xuzhou Medical University from January 2023 to June 2024. The patients were randomly divided into a training set (n=562) and a validation set (n=240) at a ratio of 7:3 using simple random sampling. In the training set, patients were categorized into a PB group (n=70) and a non-PB group (n=492) based on the occurrence of PB. Spearman correlation analysis was performed to exclude collinearity among variables, followed by univariate analysis and LASSO regression to identify predictive factors. A nomogram prediction model for PB in children with MPP was constructed. The discriminative ability of the model was assessed using receiver operating characteristic (ROC) curve analysis, model calibration was evaluated with calibration curves, and clinical utility was appraised through decision curve analysis.

Compared with the non-PB group, the PB group exhibited significantly longer disease duration prior to bronchoscopy, prolonged fever duration, higher fever peaks, higher proportions of patients with a family history of allergy and personal allergy history, and a higher proportion of patients with pleural effusion, as well as significantly elevated levels of white blood cell count, neutrophil percentage, C-reactive protein, procalcitonin, fibrinogen, D-dimer, aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, immunoglobulin A, and interleukin-6, along with a significantly lower lymphocyte percentage (all P<0.05). LASSO regression analysis identified pleural effusion, procalcitonin, D-dimer, and lactate dehydrogenase as major predictive factors for PB occurrence in children with MPP. The nomogram model based on these factors demonstrated good discriminative ability (area under the ROC curve: 0.852 in the training set and 0.830 in the validation set), with satisfactory calibration and clinical benefit.

The nomogram prediction model based on pleural effusion, procalcitonin, D-dimer, and lactate dehydrogenase provides effective predictive performance for the occurrence of PB in children with MPP.

To investigate the epidemiological characteristics of human metapneumovirus (hMPV) and the risk factors for severe pneumonia in hospitalized children.

The epidemiological characteristics of hMPV in hospitalized children at Hebei Children's Hospital from January 2019 to December 2023 were retrospectively analyzed. The clinical data of hospitalized children with hMPV infection from April to December 2023 were included, and independent risk factors for severe pneumonia were identified through logistic regression.

A total of 44 092 children were tested, with an hMPV positive rate of 7.30% (3 220/44 092). Children aged 3-6 years constituted the largest proportion (40.93%, 1 318/3 220) among hMPV-positive cases. The detection rate varied significantly by year (P<0.001), peaking in 2022 (12.35%, 978/7 919). The peak season of the epidemic was winter and spring from 2019 to 2021, but shifted to spring and summer from 2022 to 2023. The proportion of co-infection was 38.70% (1 246/3 220), primarily with rhinovirus (600/1 246, 48.15%), Mycoplasma pneumoniae (217/1 246, 17.42%), and respiratory syncytial virus (182/1 246, 14.61%). The main manifestations of hMPV pneumonia were cough, expectoration, and fever. Children with severe pneumonia were significantly younger (P<0.05). Wheezing, underlying diseases, co-infection, and younger age were identified as independent risk factors for severe pneumonia (P<0.05).

There are significant annual and seasonal differences in the epidemiological characteristics of hMPV in hospitalized children. Young age, underlying diseases, wheezing, and co-infection are independent risk factors for severe pneumonia.

To investigate the application value of targeted next-generation sequencing (tNGS) in the etiological diagnosis of moderate to severe respiratory distress syndrome (RDS) in neonates.

A prospective randomized controlled trial was conducted, enrolling 81 term and late-preterm neonates with moderate to severe RDS admitted to Fujian Children's Hospital between December 2023 and December 2024. Patients were randomly assigned to the conventional microbiological test (CMT) group (n=42) or the tNGS group (n=39). For routine pathogen detection, bronchoalveolar lavage fluid was obtained via bronchoscopy, and lower respiratory tract specimens were collected via the endotracheal tube; all specimens underwent culture, and some specimens additionally underwent polymerase chain reaction or antigen testing. In the tNGS group, tNGS was performed in addition to routine pathogen detection on the same specimen types. The detection rate of pathogens, the detection rate of co-infections, and the duration of antibiotic use were compared between the two groups.

The pathogen detection rate in the tNGS group (18/39, 46%) was significantly higher than that in the CMT group (8/42, 19%) (P=0.009). The co-infection detection rate was 13% (5/39) in the tNGS group, while no co-infections were identified in the CMT group (P=0.024). Regarding treatment, the duration of antibiotic use in the tNGS group was shorter than that in the CMT group [(12±4) days vs (15±5) days, P=0.003].

tNGS significantly improves the pathogen detection rate in neonates with moderate to severe RDS and offers advantages in the rapid identification of co-infections and reduction of antibiotic treatment duration, suggesting it has clinical utility and potential for wider adoption.

Despite being essential for protecting public health, the restrictions imposed during the coronavirus pandemic have negatively affected the physical and mental well-being of medical students. Furthermore, most students had negative perceptions of full-time online courses. The COVID-19 vaccine plays a vital role in preventing the collapse of healthcare systems and mitigating stress-related illnesses. The objective of this study was to explore medical students' self-reported feelings, symptoms, and daily routines across two key phases: the period of social isolation and the subsequent return to face-to-face learning after coronavirus vaccination.

A prospective qualitative study was conducted online with medical students in their 1st to 6th years at a university in São Paulo, Brazil, from 2020 to 2021 before and after in-person activities and coronavirus vaccination; focus groups and content analysis were used.

In total, 200 students participated in the initial focus groups, whereas 60 participated in the follow-up sessions in groups of five to ten students. The discussions highlighted recurring negative emotions such as anxiety, depression, loneliness, sleep disorders and time management losses. Coping strategies were explored, and a return to in-person activities and vaccination were significant factors for improvement, particularly with the support of peers and faculty. However, challenges related to time management and sleep quality persist.

Negative feelings recurred in medical students' reports during social isolation. However, coping strategies have been cited. The return to in-person activities and coronavirus vaccination were positive factors in students' personal and academic routines. Despite this, most students reported changes in their physical, mental, or behavioral state.

It is unclear whether postoperative pulmonary complications (PPC) can be early predicted by lung ultrasound (LUS) score in older adults undergoing thoracoscopic lobectomy. This study aimed to evaluate the validity of lung ultrasound application.

Two physicians performed lung ultrasonography on patients preoperatively, 30 min postoperatively and 72 h postoperatively to obtain LUS score. Pulmonary complications occurred within 10 days postoperatively were recorded. The correlation between lung ultrasound results and PPC was analyzed using logistic regression model. ROC curve were applied to assess the prediction accuracy.

PPC occurred in 115 of 292 patients (39.38%) in this study. Independent risk factors for PPC included higher age (OR 1.16, 95% CI 1.04-1.29, p = 0.007), COPD comorbidity (OR 5.03, 95% CI 1.29-19.59, p = 0.020), lower preoperative hemoglobin level (OR 0.96, 95% CI 0.93-1.00, p = 0.043), and higher postoperative 30 min LUS score (OR 1.32, 95% CI 1.22-1.43, p < 0.001). Postoperative 30 min lung ultrasound score (AUC: 0.811, cut-off: 14) shown in the ROC curve analysis was effective in predicting postoperative outcomes.

Postoperative 30 min lung ultrasound score is a risk factor for PPC in older adults undergoing thoracoscopic lobectomy in this study. The value of lung ultrasound as a predictive tool for PPC is warranted.

This study was registered in China Clinical Trial Registry (ChiCTR2100053449).

Asthma is one of the diseases that pose a serious threat to human health globally. The Global Burden of Disease (GBD) study from 1990 to 2021 conducted a comprehensive assessment of the prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALY) of asthma. This study particularly focuses on the integration of prevalence data with other indicators and carries out stratified analyses at the global, regional, and national levels based on gender, age, and Socio-Demographic Index (SDI).

The data for this study is drawn from the 2021 Global Burden of Disease (GBD) study, which provides comprehensive data on diseases, injuries, and risk factors. This study aims to explore the temporal trends of asthma and assess the dynamics of age-standardized prevalence rates (ASPR), incidence rates (ASIR), death rates (ASDR), and disability-adjusted life years (DALYs) for asthma, with the goal achieved by estimating the annual percentage change (EAPC) over the study period. The study conducted a detailed stratification based on gender, 20 age groups, 21 GBD regions, 204 countries and territories, and 5 SDI quintiles.

In 2021, asthma continued to impose a substantial burden on the global health landscape, with a total of 260479186.9 (227209547.5-297967236.9) cases and an ASPR of 3340.1 (2905.2-3832.2 per 100,000 people. The ASIR was 37864175.4 (31381241-46919993.7), translating to 516.7 (425.4-646.1) per 100,000 people. In 2021, the number of disability-adjusted life years (DALYs) attributed to asthma was 21422859.9 (16956877.7-26887091.7), and the ASDR was 264.6 (208.3-333.4) per 100,000 people. Analyzing regional disparities, it was observed that High SDI regions had the highest ASPR, and ASIR, while Low SDI regions had the lowest ASDR and Age-standardized DALY rates. Geographically, Kazakstan and Pakistan stood out with the high ASPR, and Papua New Guinea stood out with the highest ASDR, and Age-standardized DALY rates. Asthma primarily affects minors, with no significant difference between males and females. High BMI has emerged as the most important risk factor for asthma-related DALYs globally.

This pattern indicates a complex relationship between socio-economic development and health outcomes. Regions with higher Socio-Demographic Index (SDI), which typically represent more developed areas, tend to have a higher prevalence of asthma but lower mortality rates and disease burden. These patterns highlight the necessity for low-income regions to learn from the targeted public health measures of high-income areas in developing asthma management plans, in order to address the inequalities in asthma outcomes.

Universal, healthy school meal programs can address poor nutrition, improve educational outcomes and job and life opportunities, and support environmental sustainability. While many countries have extensive experience with such programs, New Zealand's initiative (Ka Ora, Ka Ako) was launched in 2020 as part of the COVID-19 recovery strategy and, by 2024, reached over 236,000 (~ 27%) school students.

This study aimed to assess the value generated from the investment (~ NZD320 million/year) in Ka Ora, Ka Ako and its potential for further value creation.

The study employed the participatory Value for Investment framework to assess the program across five economic domains: effectiveness, efficiency, economy, equity, and cost-effectiveness. Four workshops with key community, government, and research stakeholders co-developed 21 evaluation criteria and rated the program's performance based on evidence from program monitoring data, national research and international studies.

Ka Ora, Ka Ako rated very well overall, with seven criteria rated as excellent, 12 as good, two as adequate, and none as poor. All six primary outcomes set as the original purpose of the program, relating to alleviating hunger, improving nutrition, improving health and wellbeing, reducing financial burdens on families, reducing barriers to education and supporting local economies, were rated good (4) or excellent (2). The program's continuity was rated only as adequate due to announced major budget cuts and uncertainty about future funding. Although enhancing environmental sustainability was not part of the program's original purpose, some sustainability criteria-packaging and food waste management-were rated as good. However, the criterion for sustainable food procurement systems was rated only as adequate. In light of these findings, the study assessed Ka Ora, Ka Ako as providing very good value for investment overall.

The use of the Value for Investment approach was key because school lunch programs have many dimensions and the participatory research processes of the approach enabled stakeholders to emphasize the program's wide-ranging social and health benefits while identifying areas for improvement. While Ka Ora, Ka Ako rated very well across most of the 21 value dimensions, there are major concerns that this level of quality will not be upheld under the program's budget cuts from 2025 onwards.

While the COVID-19 pandemic has been burdensome globally, it has fostered extensive data collection at various spatiotemporal resolutions. These data heightened researchers' interest in investigating multiple facets of the pandemic. In Europe, key factors shaping disease transmission vary among countries, leading to a gap in understanding how the epidemic evolved and spread across countries as a whole. We endeavor to understand the similarities and differences in the spatiotemporal spread of the COVID-19 pandemic across 27 European Union (EU) countries and 3 European Economic Area (EEA) countries between March 2020 and December 2022.

We utilized a multivariate endemic-epidemic model to conduct a space-time analysis across 30 countries, using weekly aggregated COVID-19 case counts from week 13-2020 to week 50-2022. Our analysis considered the discrepancies in population size, the primary course and three booster vaccine doses - taking into account waning immunity, the Stringency Index as a surrogate for non-pharmaceutical interventions adopted in each country, and the circulation of various viral variants. We employed a power law approximation for spatial interactions between countries.

We found that within-country transmission was dominant across all countries over almost three years of observation. This work also underscored a basic transmission mechanism, whereby infections introduced by between-country transmission could be of great importance in subsequent local transmission. Furthermore, there were indications of the transition to endemicity since the beginning of 2022, particularly in light of the evolving variants of concern.

Our study highlighted the benefit of the endemic-epidemic framework to elucidate the COVID-19 disease spread over a large spatial and temporal scale, using a wide range of epidemiological information. Insights derived from this study are beneficial for those interested in seeking an overview of the emergency phase of the COVID-19 pandemic in the EU/EEA region.