Editor's Focus

Volume 87 No. 4 March 2020

Early Career Investigator

Congratulations to Pierluigi Marzuillo, the Early Career Investigator for March. Born and raised in the Sorrentine Peninsula in the province of Naples, Italy, Dr. Marzuillo knew at an early age that he would be a pediatrician. As proof, he has an essay he wrote at the age of 7 in which he expressed his desire to care for children, a desire that continues to increase. He was initially drawn to endocrinology and metabolism before focusing on pediatric urology and nephrology. In this issue, he and his team report that a difference in length between the two kidneys and dilated vesico-ureteral reflux are predictors of an abnormal Tc-99m dimercaptosuccinic acid renal scan, the gold standard for detecting renal parenchymal anomalies. His advice to other young investigators is to never give up and persist with passion. See https://doi.org/10.1038/s41390-019-0714-z and https://doi.org/10.1038/s41390-019-0676-1

The importance of sleep

Two studies reported in this issue used sleep patterns as important outcomes. Abramsky et al. describe the impact of mild and moderate hypoxic ischemic encephalopathy on the appearance of quiet sleep using amplitude-integrated electroencephalography (aEEG). Chan et al. found that at age 3–12 years, children who had been born preterm exhibited significant differences in their sleep micro-architecture as measured by EEG. They hypothesize that this evidence of sleep debt could be related to cognitive outcome. In a related Insights article, the mother of a preterm infant describes disruptions of her daughter’s sleep in a neonatal intensive care unit and the effects following discharge. See https://doi.org/10.1038/s41390-019-0560-z, https://doi.org/10.1038/s41390-019-0453-1, and https://doi.org/10.1038/s41390-019-0675-2

Global Pediatric Research Investigator

Congratulations to Rania A. El-Farrash, the Global Pediatric Research Investigator for March. Born and raised in Cairo, Egypt, she was heavily influenced by her father, a professor of nuclear physics, and spent time with him and other international academics on tours of Egypt. She has carried on this tradition with her own daughter. Following training in pediatrics, she rapidly rose through the academic ranks. In 2013, she became an international board-certified lactation consultant and an assessor for Baby Friendly Hospitals in Egypt. In 2015, she was named the representative from Egypt to the International Council for Respiratory Care and in 2019 became a full instructor for Neonatal Life Support. She encourages her more junior colleagues to exploit every chance to expand their knowledge and skills. In this issue, she and colleagues report that longer duration of kangaroo care is beneficial for several outcomes in preterm infants. See https://doi.org/10.1038/s41390-019-0670-7 and https://doi.org/10.1038/s41390-019-0558-6

Special considerations of treatment for T1D in children younger than 6

Nevo-Shenker et al. review the unique characteristics of type 1 diabetes (T1D) in children younger than 6. They examine the pros and cons of various T1D-treatment technologies in this age group and note that addressing the cons will improve treatment. In an accompanying policy commentary, the gaps in our knowledge are outlined, with a call for more research in this area. (Photo: FatCamera/Getty.) See https://doi.org/10.1038/s41390-019-0665-4 and https://doi.org/10.1038/s41390-020-0787-8

Maternal hyperoxygenation fails to improve outcomes in left heart hypoplasia

Rudolph reviews the literature on studies using maternal hyperoxygenation to improve outcomes of infants with left heart hypoplasia. The results of his analysis are discouraging, and he asks whether we should stop these studies.) See https://doi.org/10.1038/s41390-019-0604-4

Inter-rater reliability of the modified Sarnat score in preterm infants

One hundred two infants of 32–36 weeks gestation underwent two modified Sarnat examinations in a study by Pavageau et al. The authors note that, although inter-rater reliability was good, certain elements of the Sarnat could be modified for this patient population. In a related Comment, Sarnat discusses the merits of this study from both a historic and a current point of view. Maleki and Naderi point out the disadvantages of the kappa coefficient as a way to assess examiner agreement. See https://doi.org/10.1038/s41390-019-0562-x, https://doi.org/10.1038/s41390-019-0705-0, and https://doi.org/10.1038/s41390-019-0741-9

DEHP induces hypospadias that is prevented by TGF-β1

Hypospadias, a common birth defect associated with exposure to diethylhexyl phthalate (DEHP), is associated with morbidity in the boys it affects. Zhou et al. used DEHP to induce hypospadias in an in vitro rat model. In an effort to develop a preventive measure, they found that transforming growth factor-β1 (TGF-β1) could reduce the downstream impacts of DEHP. See https://doi.org/10.1038/s41390-019-0622-2