{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:25:03Z","timestamp":1788830703247,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"DOI":"10.1038\/s41390-026-05049-6","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:29:45Z","timestamp":1778160585000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Machine learning and SHAP-based risk assessment of PICC-related bloodstream infections in premature infants at the time of clinical suspicion"],"prefix":"10.1038","author":[{"given":"Yongqin","family":"Guo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Dou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxia","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"5049_CR1","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1177\/0897190020932800","volume":"34","author":"H Teibel","year":"2021","unstructured":"Teibel, H., Hood, K., Manasco, K. & Bhatia, J. Antibiotic administration prior to central venous catheter removal in neonates. J. Pharm. Pract. 34, 894\u2013900 (2021).","journal-title":"J. Pharm. Pract."},{"key":"5049_CR2","doi-asserted-by":"publisher","first-page":"E36","DOI":"10.1097\/NCC.0000000000000873","volume":"45","author":"E Ponticelli","year":"2022","unstructured":"Ponticelli, E. et al. Complete blood count collected via venipuncture versus peripherally inserted central catheter in hematological patients: a comparison of 2 methods. Cancer Nurs. 45, E36\u2013e42 (2022).","journal-title":"Cancer Nurs."},{"key":"5049_CR3","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1002\/ca.23685","volume":"34","author":"DJ van Tonder","year":"2021","unstructured":"van Tonder, D. J., Keough, N., van Niekerk, M. L. & van Schoor, A. N. The position of the common facial vein in neonates: an alternate route for central venous catheter placement. Clin. Anat. 34, 644\u2013650 (2021).","journal-title":"Clin. Anat."},{"key":"5049_CR4","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.clnesp.2020.01.001","volume":"36","author":"R Brown","year":"2020","unstructured":"Brown, R. & Burke, D. The hidden cost of catheter related blood stream infections in patients on parenteral nutrition. Clin. Nutr. ESPEN 36, 146\u2013149 (2020).","journal-title":"Clin. Nutr. ESPEN"},{"key":"5049_CR5","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.987512","volume":"10","author":"Y Wu","year":"2022","unstructured":"Wu, Y. et al. A review of neonatal peripherally inserted central venous catheters in extremely or very low birthweight infants based on a 3-year clinical practice: complication incidences and risk factors. Front. Pediatr. 10, 987512 (2022).","journal-title":"Front. Pediatr."},{"key":"5049_CR6","doi-asserted-by":"crossref","unstructured":"Klinger, G. et al. Late-onset sepsis in very low birth weight infants. Pediatrics 152, e2023062223 (2023).","DOI":"10.1542\/peds.2023-062223"},{"key":"5049_CR7","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1007\/s00431-020-03844-9","volume":"180","author":"S Bierlaire","year":"2021","unstructured":"Bierlaire, S., Danhaive, O., Carkeek, K. & Piersigilli, F. How to minimize central line-associated bloodstream infections in a neonatal intensive care unit: a quality improvement intervention based on a retrospective analysis and the adoption of an evidence-based bundle. Eur. J. Pediatr. 180, 449\u2013460 (2021).","journal-title":"Eur. J. Pediatr."},{"key":"5049_CR8","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.1039\/D1LC00085C","volume":"21","author":"X Lu","year":"2021","unstructured":"Lu, X. et al. Sheathless and high-throughput elasto-inertial bacterial sorting for enhancing molecular diagnosis of bloodstream infection. Lab Chip 21, 2163\u20132177 (2021).","journal-title":"Lab Chip"},{"key":"5049_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.artmed.2020.101844","volume":"104","author":"A Triantafyllidis","year":"2020","unstructured":"Triantafyllidis, A. et al. Computerized decision support and machine learning applications for the prevention and treatment of childhood obesity: a systematic review of the literature. Artif. Intell. Med. 104, 101844 (2020).","journal-title":"Artif. Intell. Med."},{"key":"5049_CR10","doi-asserted-by":"publisher","first-page":"e0229331","DOI":"10.1371\/journal.pone.0229331","volume":"15","author":"M Fernandes","year":"2020","unstructured":"Fernandes, M. et al. Predicting intensive care unit admission among patients presenting to the emergency department using machine learning and natural language processing. PLoS ONE 15, e0229331 (2020).","journal-title":"PLoS ONE"},{"key":"5049_CR11","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12933-025-02577-z","volume":"24","author":"XH Li","year":"2025","unstructured":"Li, X. H., Yang, X. L., Dong, B. B. & Liu, Q. Predicting 28-day all-cause mortality in patients admitted to intensive care units with pre-existing chronic heart failure using the stress hyperglycemia ratio: a machine learning-driven retrospective cohort analysis. Cardiovasc. Diabetol. 24, 10 (2025).","journal-title":"Cardiovasc. Diabetol."},{"key":"5049_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-10854-1","volume":"25","author":"E Albu","year":"2025","unstructured":"Albu, E. et al. Hospital-wide, dynamic, individualized prediction of central line-associated bloodstream infections-development and temporal evaluation of six prediction models. BMC Infect. Dis. 25, 597 (2025).","journal-title":"BMC Infect. Dis."},{"key":"5049_CR13","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jclinepi.2023.07.019","volume":"161","author":"S Gao","year":"2023","unstructured":"Gao, S. et al. Systematic review finds risk of bias and applicability concerns for models predicting central line-associated bloodstream infection. J. Clin. Epidemiol. 161, 127\u2013139 (2023).","journal-title":"J. Clin. Epidemiol."},{"key":"5049_CR14","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1038\/jp.2012.7","volume":"32","author":"K Colacchio","year":"2012","unstructured":"Colacchio, K., Deng, Y., Northrup, V. & Bizzarro, M. J. Complications associated with central and non-central venous catheters in a neonatal intensive care unit. J. Perinatol. 32, 941\u2013946 (2012).","journal-title":"J. Perinatol."},{"key":"5049_CR15","first-page":"32","volume":"31","author":"ZJ Bu","year":"2024","unstructured":"Bu, Z. J. et al. Introduction and example analysis of common sample size estimation methods in clinical prediction model construction. Mod. Chin. Med. Clin. 31, 32\u201337 (2024).","journal-title":"Mod. Chin. Med. Clin."},{"key":"5049_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1086\/599376","volume":"49","author":"LA Mermel","year":"2009","unstructured":"Mermel, L. A. et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the infectious diseases society of America. Clin. Infect. Dis. 49, 1\u201345 (2009).","journal-title":"Clin. Infect. Dis."},{"key":"5049_CR17","first-page":"Cd012141","volume":"6","author":"A Gordon","year":"2018","unstructured":"Gordon, A., Greenhalgh, M. & McGuire, W. Early planned removal versus expectant management of peripherally inserted central catheters to prevent infection in newborn infants. Cochrane Database Syst. Rev. 6, Cd012141 (2018).","journal-title":"Cochrane Database Syst. Rev."},{"key":"5049_CR18","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/j.ajic.2019.08.023","volume":"48","author":"VD Rosenthal","year":"2020","unstructured":"Rosenthal, V. D. et al. International nosocomial infection control consortium (Inicc) report, data summary of 45 Countries for 2012-2017: device-associated module. Am. J. Infect. Control 48, 423\u2013432 (2020).","journal-title":"Am. J. Infect. Control"},{"key":"5049_CR19","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1055\/s-0039-1694760","volume":"38","author":"XL Ren","year":"2021","unstructured":"Ren, X. L. et al. Ultrasound to localize the peripherally inserted central catheter tip position in newborn infants. Am. J. Perinatol. 38, 122\u2013125 (2021).","journal-title":"Am. J. Perinatol."},{"key":"5049_CR20","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.jhin.2023.11.020","volume":"144","author":"SJ Jansen","year":"2024","unstructured":"Jansen, S. J. et al. Central-line-associated bloodstream infection burden among Dutch neonatal intensive care units. J. Hosp. Infect. 144, 20\u201327 (2024).","journal-title":"J. Hosp. Infect."},{"key":"5049_CR21","doi-asserted-by":"publisher","first-page":"e43815","DOI":"10.2196\/43815","volume":"25","author":"J Wang","year":"2023","unstructured":"Wang, J. et al. A risk prediction model for physical restraints among older chinese adults in long-term care facilities: machine learning study. J. Med. Internet Res. 25, e43815 (2023).","journal-title":"J. Med. Internet Res."},{"key":"5049_CR22","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s10096-019-03803-9","volume":"39","author":"M Papadimitriou-Olivgeris","year":"2020","unstructured":"Papadimitriou-Olivgeris, M. et al. Molecular characteristics and predictors of mortality among gram-positive bacteria isolated from bloodstream infections in critically Ill patients during a 5-year period (2012-2016). Eur. J. Clin. Microbiol Infect. Dis. 39, 863\u2013869 (2020).","journal-title":"Eur. J. Clin. Microbiol Infect. Dis."},{"key":"5049_CR23","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.21873\/invivo.13788","volume":"38","author":"A Futamura","year":"2024","unstructured":"Futamura, A. et al. Factors associated with mortality in patients with catheter-related bloodstream infection: a multicenter retrospective study. Vivo 38, 3041\u20133049 (2024).","journal-title":"Vivo"},{"key":"5049_CR24","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1001\/jamapediatrics.2022.1647","volume":"176","author":"C Poggi","year":"2022","unstructured":"Poggi, C., Lucenteforte, E., Petri, D., De Masi, S. & Dani, C. Presepsin for the diagnosis of neonatal early-onset sepsis: a systematic review and meta-analysis. JAMA Pediatr. 176, 750\u2013758 (2022).","journal-title":"JAMA Pediatr."},{"key":"5049_CR25","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.earlhumdev.2016.12.002","volume":"105","author":"M Gilfillan","year":"2017","unstructured":"Gilfillan, M. & Bhandari, V. Biomarkers for the diagnosis of neonatal sepsis and necrotizing enterocolitis: clinical practice guidelines. Early Hum. Dev. 105, 25\u201333 (2017).","journal-title":"Early Hum. Dev."},{"key":"5049_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-023-01361-7","volume":"28","author":"Y Jin","year":"2023","unstructured":"Jin, Y., Lan, A., Dai, Y., Jiang, L. & Liu, S. Development and testing of a random forest-based machine learning model for predicting events among breast cancer patients with a poor response to neoadjuvant chemotherapy. Eur. J. Med. Res. 28, 394 (2023).","journal-title":"Eur. J. Med. Res."},{"key":"5049_CR27","doi-asserted-by":"crossref","unstructured":"Al-Matary, A. et al. Correlation between Bronchopulmonary Dysplasia and cerebral palsy in children: a comprehensive analysis using the national inpatient sample dataset. Children 11, 1129 (2024).","DOI":"10.3390\/children11091129"},{"key":"5049_CR28","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1097\/PCC.0000000000003147","volume":"24","author":"G Emeriaud","year":"2023","unstructured":"Emeriaud, G. et al. Executive summary of the second international guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (Palicc-2). Pediatr. Crit. Care Med. 24, 143\u2013168 (2023).","journal-title":"Pediatr. Crit. Care Med."},{"key":"5049_CR29","doi-asserted-by":"publisher","first-page":"2611","DOI":"10.1002\/ppul.25439","volume":"56","author":"P Papoff","year":"2021","unstructured":"Papoff, P. et al. The starting rate for high-flow nasal cannula oxygen therapy in infants with bronchiolitis: is clinical judgment enough?. Pediatr. Pulmonol. 56, 2611\u20132620 (2021).","journal-title":"Pediatr. Pulmonol."},{"key":"5049_CR30","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1093\/milmed\/usad059","volume":"188","author":"AF Cruz","year":"2023","unstructured":"Cruz, A. F. et al. Sustained vs. intratidal recruitment in the injured lung during airway pressure release ventilation: a computational modeling perspective. Mil. Med. 188, 141\u2013148 (2023).","journal-title":"Mil. Med."},{"key":"5049_CR31","doi-asserted-by":"publisher","first-page":"274","DOI":"10.3389\/fped.2017.00274","volume":"5","author":"JM Bliss","year":"2017","unstructured":"Bliss, J. M. & Wynn, J. L. Editorial: the neonatal immune system: a unique host-microbial interface. Front. Pediatr. 5, 274 (2017).","journal-title":"Front. Pediatr."}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05049-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05049-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05049-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:29:50Z","timestamp":1778160590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05049-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":31,"alternative-id":["5049"],"URL":"https:\/\/doi.org\/10.1038\/s41390-026-05049-6","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"assertion":[{"value":"20 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was reviewed and approved by the Medical Ethics Committee of Changzhi Maternal and Child Health Hospital (Ethics Approval No: CZSFYLL2024.026) and complies with the ethical principles of the Declaration of Helsinki. As a prospective study, informed consent was obtained from all participants. During data collection and processing, all personal information was anonymized using coded identifiers to protect participant privacy.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}