Clinical data gaps keeping life-saving antibiotics from children

Murdoch Childrens Research Institute

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Life-saving antibiotics that could treat severe infections in babies and children aren’t accessible due to a lack of data around safety and dosage, new research shows.

Two wide sweeping reviews, led by Murdoch Children’s Research Institute (MCRI) and the Australasian KIDS DOSE consortium, have discovered the barriers children are experiencing in Australia, New Zealand and the Pacific Islands when accessing treatment for the antimicrobial resistant (AMR) infections deemed the highest priority by the World Health Organization.

The findings, published in The Lancet Regional Health - Western Pacific, found of the 12 antibiotics recommended for serious bloodstream infections caused by a harmful bacteria, Gram-negative bacteria, only six were licensed in children aged under 12 and just three in babies. Standard antibiotic doses were also often too low for children under 12 years.

AMR is a growing public health problem, causing 1.27 million deaths globally every year, including 250,000 children under five years old. In Australia, one in five childhood infections caused by Gram-negative bacteria is antibiotic resistant with rates of infection much higher among First Nations children.

Associate Professor Amanda Gwee said more research was required to address significant equity and access gaps that prevent appropriate treatment for children. 

“Our review found limited treatment options for children who have life-threatening illnesses caused by MRSA (a drug-resistant staph infection) and VRE infections (caused by bacteria in the gut), especially those in the Pacific Islands,” she said.

“The KIDS DOSE network is building evidence to ensure children, the most vulnerable to serious infections, receive safe, effective antibiotic doses while supporting low resource countries to better detect and monitor AMR in their communities,” she said.

Associate Professor Gwee said while it had been challenging to get a full picture of antimicrobial resistance, the findings helped identify ongoing research priorities.

“The increase in AMR is making common infections untreatable, increasing severe illness, disability and death, and undermining modern medicine that relies on effective antimicrobials,” she said.

“To confront the challenge, we need coordinated action that improves AMR surveillance systems, supports more clinical trials involving children, removes licensing restrictions and upgrades laboratory infrastructure and technical expertise.”

Associate Professor Gwee said the KIDS DOSE Consortium would address the issue by trialling how newer antibiotics perform against bloodstream, bone and urinary tract infections in children, accelerating more effective treatments.

Publication: Daniel Yeoh, Alison Boast, Sophie Wen, Phoebe Williams, Lesley Voss, Brett Ritchie, Mona Mostaghim, Flora Lutui, Alice Lei, Tony Lai, Adam Irwin, Kiera Harwood, Thomas Ewin, Celia Cooper, Emma Best, Sarah Bannister and Amanda Gwee. ‘Drug-resistant gram-negative bacterial infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data, and key evidence gaps,’ Lancet Regional Health - Western Pacific. DOI: 10.1016/101735

Publication: Amanda Gwee, Sarah Bannister, Emma Best, Jeremy Carr, Kiera Harwood,Tony Lai, Alice Lei, Flora Lutui, Brendan McMullan, Mona Mostaghim, Lesley Voss, Heather Weerdenburg, Phoebe Williams, Amanda Wilkins, and Daniel Yeoh. ‘Methicillin-resistant Staphylococcus aureus and vancomycinresistant Enterococcus faecium infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data and key evidence gaps,’ Lancet Regional Health - Western Pacific. DOI: 10.1016/101754

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

About Murdoch Children’s Research Institute (MCRI):

Murdoch Children's Research Institute (MCRI) is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.

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Journal

The Lancet Regional Health - Western Pacific

DOI

10.1016/101735 

 

For people with traumatic brain injury and their caregivers, recovery of basic communication is an “acceptable” outcome

Mass General Brigham co-led surveys identify basic communication as the minimum acceptable outcome after TBI, despite the milestone being considered below the typical threshold for a “favorable” recovery outcome

Mass General Brigham

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A federally funded study of more than 500 people living with traumatic brain injury (TBI) and their caregivers, co-led by researchers at Mass General Brigham, found that survey participants viewed the ability to regain basic communication as the minimum acceptable outcome after severe brain injury. The study, published in Critical Care Medicine, shows that many individuals living with TBIs consider outcomes involving significant disability to be acceptable. These results challenge longstanding assumptions by TBI researchers and providers about what constitutes a “favorable” outcome after a severe brain injury, and should inform future care discussions and clinical trials, according to the authors. 

“Medical decisions such as withdrawal of life support often rely on research-guided predictions of whether a patient will achieve a ‘favorable’ outcome after TBI,” said senior study author Joseph Giacino, PhD, director of the Spaulding-Harvard Traumatic Brain Injury Model System at Mass General Brigham. “Our findings show that recovery of basic yes/no communication can hold profound value for people living with TBIs and their caregivers.” 

The study highlights a gap between assumptions held by TBI clinicians and researchers and what patients and families actually find meaningful.Among measures used most frequently to assess TBI outcome, none evaluate recovery of basic communication.    

The study surveyed 252 individuals with TBI and 256 caregivers. They rated 11 TBI outcomes on a five-point scale ranging from “unacceptable to acceptable,” and then selected one minimally acceptable outcome. Respondents also rated the importance of 29 personal values that might influence decision-making after severe TBI.  

The survey revealed 65% of individuals with TBI and 72% of caregivers rated recovery of basic communication as being “acceptable” or “somewhat acceptable”. Outcomes ranging from “alive, but permanently unconscious” to partially independent in the home” were selected significantly more frequently as the minimally acceptable outcome than “completely independent in the home,” which is a common cut-off for a “favorable” outcome in TBI research studies. 

Study limitations include the inability to confirm TBI injury severity and level of disability of the respondents due to the survey methodology. In addition, the study did not include individuals who could not respond to surveys.  

The authors call for more person-centered approaches to TBI outcome research and say these findings should be considered in the design of future TBI clinical trials. 

“Our field has historically relied on outcome measures that don’t capture the full spectrum of TBI recovery or the milestones that matter most to patients and families,” said first study author Yelena Bodien, PhD, a clinical neuroscientist at Vanderbilt University Medical Center, formerly of Spaulding Rehabilitation. “These findings should guide the development of new outcome measures that better reflect the priorities of individuals with lived experience.” 

Authorship: In addition to Bodien and Giacino, study co-authors include Lydia Borsi, Ellyn Pier, Samantha Kanny, Lillian Droscha, William Choi, Ryan Filoramo, Danielle Burnetta, Kathleen McColgan, Bhumi Patel, Mallory Spring, Jean Paul Vazquez Rivera, Jessica Wolfe, Enrico Quilico, Tiffany Campbell, Amanda R. Merner, Gabriel Lázaro-Muñoz, and Lindsay Wilson.  

Disclosures: The authors declare no competing interests. 

Funding: This research was funded by a National Institute on Disability, Independent Living, and Rehabilitation Research grant (90DPTB0027) to Spaulding-Harvard TBI Model System. 

Paper cited: Bodien Y, et al. “Perspectives of persons with lived experience on acceptable outcome after severe acute traumatic brain injury.” Critical Care Medicine, DOI:10.1097/CCM.0000000000007017 

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About Mass General Brigham 

Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org. 

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Journal

Critical Care Medicine

DOI

10.1097/CCM.0000000000007017 

Method of Research

Survey

Subject of Research

People

Article Title

Perspectives of persons with lived experience on acceptable outcome after severe acute traumatic brain injury.

 

“I see a rubber duck” – neuroscientists use AI to discover babies categorize objects in the brain at just two months old

Trinity College Dublin

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video: 

Baby Eli attentively watches the Foundcog pictures at his 2-month scan. 

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Credit: Cusack Lab. © 2026. Licensed under CC BY-NC-ND 4.0.

Babies as young as two months old are able to categorise distinct objects in their brains – much earlier than previously thought – according to new research from neuroscientists in Trinity College Dublin. 

The research, which combined brain imaging with artificial intelligence models, enriches our understanding of what babies are thinking and how they learn in the earliest months of life.

The study has been just published in the journal Nature Neuroscience by a team from Trinity College Institute of Neuroscience (TCIN) and the School of Psychology. 

“Parents and scientists have long wondered what goes on in a baby’s mind and what they actually see when they view the world around them. This research highlights the richness of brain function in the first year of life,” explains Dr. Cliona O’Doherty, lead author on the study who conducted the research while in Trinity’s Cusack Lab. 

“Although at two months, infants’ communication is limited by a lack of language and fine motor control, their minds were already not only representing to how things look, but figuring out to which category they belonged. This shows that the foundations of visual cognition are already in place from very early on and much earlier than expected.”

With the assistance of the Coombe and Rotunda Hospitals in Dublin, the FOUNDCOG team recruited 130 two-month-old infants. Lying on a comfy beanbag and wearing sound-cancelling headphones, the babies were shown bright, colourful images which kept them engaged for 15-20 minutes. This provided the team with enough time to use functional MRI (fMRI) to measure their patterns of brain activity in response to pictures representing 12 common visual categories such as cat, bird, rubber duck, shopping cart and tree.

Artificial intelligence models were then used to characterise how the babies’ brains represented different visual categories by comparing activity patterns along the pathways for visual recognition between the models and the brains.

“This study represents the largest longitudinal study with functional magnetic resonance imaging  (fMRI) of awake infants. The rich dataset capturing brain activity opens up a whole new way to measure what babies are thinking at a very early age. It also highlights the potential for neuroimaging and computational models to be used as a diagnostic tool in very young infants,” explains team lead Rhodri Cusack, the Thomas Mitchell Professor of Cognitive Neuroscience at Trinity’s School of Psychology and Trinity College Institute of Neuroscience. 

“Babies learn much more quickly than today’s AI models and by studying how they do this, we hope to inspire a new generation of AI models that learn more efficiently, so reducing their economic and environmental costs.”

Dr. Anna Truzzi, who now works at Queen’s University Belfast, is also a co-author on the paper. She added: “Until recently, we could not reliably measure how specific areas of the infant brain interpreted visual information. By combining AI and neuroimaging, our study offers a very unique insight, which helps us to understand much more about how babies learn in their first year of life.

“The first year is a period of rapid and intricate brain development. This study provides new foundational knowledge which will help guide early-years education, inform clinical support for neurodevelopmental conditions and inspire more biologically-grounded approaches in artificial intelligence.”

Professor Eleanor Molloy, a neonatologist from Children’s Health Ireland and co-author emphasised the potential of the study’s high success rates for awake neuroimaging: “There is a pressing need for greater understanding of how neurodevelopmental disorders change early brain development, and awake fMRI has considerable potential to address this.”

Dr. O’Doherty is now based in Stanford University and Dr. Anna Truzzi is a Senior Lecturer at the School of Psychology of Queen’s University Belfast.

Art work was produced by artist Cian McLoughlin inspired by this research while he was Artist in Residence at the Trinity College Institute of Neuroscience in 2024, as well as an exhibition essay.

 

Baby Sadie attends her 2-month Foundcog scan with her mum, Donna.

Credit

Cusack Lab. © 2026. Licensed under CC BY-NC-ND 4.0.

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Journal

Nature Neuroscience

DOI

10.1038/s41593-025-02187-8 

 

Pink noise reduces REM sleep and may harm sleep quality

Earplugs were found more effective than pink noise for protecting sleep quality

University of Pennsylvania School of Medicine

PHILADELPHIA—Pink noise—often used to promote sleep—may reduce restorative REM sleep and interfere with sleep recovery. In contrast, earplugs were found to be significantly more effective in protecting sleep against traffic noise, according to new study published in the journal Sleep from the University of Pennsylvania Perelman School of Medicine.  

The findings challenge the widespread use of ambient sound machines and apps marketed as sleep aids. 

“REM sleep is important for memory consolidation, emotional regulation and brain development, so our findings suggest that playing pink noise and other types of broadband noise during sleep could be harmful—especially for children whose brains are still developing and who spend much more time in REM sleep than adults,” said study lead author Mathias Basner, MD, PhD, professor of Sleep and Chronobiology in Psychiatry.  

What was tested 

Researchers observed 25 healthy adults, ages 21 to 41, in a sleep laboratory during eight-hour sleep opportunities over seven consecutive nights. The participants reported not previously using noise to help them sleep or having any sleep disorders. Participants slept under different conditions, including being exposed to aircraft noise, pink noise, aircraft noise with pink noise and aircraft noise with earplugs. Each morning, they completed tests and surveys to measure sleep quality, alertness, and other health effects. 

When we sleep, we cycle multiple times through periods of deep sleep and REM sleep. Deep sleep is important for physical restoration, for memory consolidation, and for clearing toxins from the brain. REM sleep, also called dream sleep, is important for emotional regulation, for motor skills, and for brain development. 

This way, deep and REM sleep complement each other, and collectively guarantee that we wake up restored in the morning, ready for the next day. 

What is pink noise? 

Pink noise is a type of broadband noise—a continuous sound spread across a wide range of frequencies—that sounds uniform and static-like. Broadband noise also includes the well-known white noise and other noise colors like brown and blue noise.  

The different noise colors differ in their energy content across the audible spectrum which determines whether they sound high-pitched or low-pitched. Nature sounds like ocean or rainfall sounds are also broadband sounds, and many household appliances like air conditioning units and fans produce broadband sounds. 

Eye-opening results 

Exposure to aircraft noise—compared to none—was associated with about 23 fewer minutes per night spent in “N3,” the deepest sleep stage. Earplugs prevented this drop in deep sleep to a large extent. Pink noise alone at 50 decibels (often compared to the sound of a “moderate rainfall”) was associated with a nearly 19-minute decrease in REM sleep.  

If pink noise was combined with aircraft noise, both deep sleep and REM sleep were significantly shorter compared to noise-free control nights, and time spent awake was now also 15 minutes longer, which had not been observed in aircraft noise only or pink noise only nights.  

Participants also reported that their sleep felt lighter, they woke up more frequently, and their overall sleep quality was worse when exposed to aircraft noise or pink noise, compared to nights without noise—unless they used earplugs. 

Habits of millions may lead to bad sleep 

The results, the researchers said, suggest not only that earplugs—which are used by as many as 16 percent of Americans to sleep—are likely effective, but also that the overall health effects of pink noise and other types of broadband noise “sleep aids” need to be studied more thoroughly. 

Millions of people play back broadband noise during sleep every night. For example, white noise and ambient podcasts accounted for three million daily hours on the Spotify platform, and the top five videos on YouTube to the prompt “white noise” have been watched more than 700 million times. Even so, research on the effects of broadband noise on sleep remains scarce and inconclusive, according to a recent review by Basner and colleagues.  

REM sleep disruption is a common feature of disorders such as depression, anxiety, and Parkinson’s disease. Basner noted that young children, compared to adults, spend much more time in REM sleep—and thus may be particularly vulnerable to the ill effects of pink noise. Yet, it is common that parents place sound machines next to the bed of their newborns or toddlers, with the good intention to help them fall and stay asleep.  

“Overall, our results caution against the use of broadband noise, especially for newborns and toddlers, and indicate that we need more research in vulnerable populations, on long-term use, on the different colors of broadband noise, and on safe broadband noise levels in relation to sleep,” Basner said.  

This research was funded by the U.S. Federal Aviation Administration Office of Environment and Energy through ASCENT, the FAA Center of Excellence for Alternative Jet Fuels and the Environment, project 86 through FAA Award Number 13-C-AJFE-UPENN under the supervision of Susumu Shirayama. Any opinions, findings, conclusions or recommendations expressed in this material are those of the investigators and do not necessarily reflect the views of the FAA. 

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school. 

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System (UPHS) and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school. 

The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $580 million awarded in the 2023 fiscal year. Home to a proud history of “firsts,” Penn Medicine teams have pioneered discoveries that have shaped modern medicine, including CAR T cell therapy for cancer and the Nobel Prize-winning mRNA technology used in COVID-19 vaccines. 

The University of Pennsylvania Health System cares for patients in facilities and their homes stretching from the Susquehanna River in Pennsylvania to the New Jersey shore. UPHS facilities include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Doylestown Health, Lancaster General Health, Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, chartered in 1751. Additional facilities and enterprises include Penn Medicine at Home, GSPP Rehabilitation, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others. 

Penn Medicine is an $11.9 billion enterprise powered by nearly 49,000 talented faculty and staff. 

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Journal

SLEEP

DOI

10.1093/sleep/zsag001 

Article Title

Efficacyofpinknoiseandearplugsformitigatingtheeffectsofintermittentenvironmentalnoiseexposureonsleep

Article Publication Date

2-Feb-2026