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        <title>Frontiers in Pediatrics | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/pediatrics</link>
        <description>RSS Feed for Frontiers in Pediatrics | New and Recent Articles</description>
        <language>en-us</language>
        <generator>Frontiers Feed Generator,version:1</generator>
        <pubDate>2026-08-11T11:51:50.109+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1911388</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1911388</link>
        <title><![CDATA[Outcomes and predictors of respiratory morbidity in children with neuromuscular disorders requiring respiratory support: a cohort study from Vietnam]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hung Viet Dau</author><author>Tuoi Nguyen Thi</author><author>Lam Hoang Kim</author><author>Cuong Le Nhat</author><author>Canh Ngoc Hoang</author>
        <description><![CDATA[BackgroundRespiratory failure is a major cause of intensive care admission in children with neuromuscular disorders, but data on outcomes and prognostic factors in mixed pediatric neuromuscular cohorts remain limited. This study aimed to describe short-term outcomes and identify predictors of poor outcomes in children with neuromuscular disorders requiring respiratory support in a tertiary pediatric intensive care unit.MethodsWe conducted a single-center cohort study of children aged 1 month to 16 years with neuromuscular disorders requiring respiratory support admitted to a tertiary pediatric intensive care unit in Vietnam between January 2023 and June 2025. Poor outcome was defined as in-hospital mortality, invasive mechanical ventilation for ≥7 days, tracheostomy, or reintubation.ResultsSixty-three children were included. In-hospital mortality was 14.3% (9/63), and 33 children (52.4%) experienced a poor outcome. Nineteen children (30.2%) required invasive mechanical ventilation for ≥7 days, 10 (15.9%) underwent tracheostomy, and 20 (31.7%) required reintubation. Higher Pediatric Risk of Mortality III (PRISM III) score, shock, lower Glasgow Coma Scale score, and older age were independently associated with poor outcomes.ConclusionsRespiratory morbidity was substantial among children with neuromuscular disorders requiring respiratory support. Early illness severity and physiological instability at PICU admission were independently associated with poor outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1842381</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1842381</link>
        <title><![CDATA[Pulmonary function and risk factors in pediatric chest tightness variant asthma: a case-control study]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ruo-Yu Cao</author><author>Wei-Chao He</author><author>Ya-Bin Yu</author><author>Shan-Shan Tong</author>
        <description><![CDATA[ObjectiveTo investigate the pulmonary function characteristics and risk factors for pediatric chest tightness variant asthma (CTVA).MethodsA retrospective case-control study was conducted. Clinical data of 39 children diagnosed with CTVA in our outpatient department from February 2022 to February 2024 were analyzed. Fifty healthy children undergoing physical examinations during the same period were enrolled as controls. All participants underwent fractional exhaled nitric oxide (FeNO) measurement and pulmonary ventilation function tests at initial diagnosis or physical examination. FeNO levels and pulmonary function parameters were compared between groups. Baseline demographic and clinical data were recorded. Univariate logistic regression analyses were performed to explore factors associated with pediatric CTVA. Due to the limited sample size (39 cases) and an event-per-variable ratio below the recommended minimum of 10:1 for reliable multivariable modeling, multivariate analysis was not performed.ResultsFeNO levels were significantly higher in the CTVA group than in the healthy control group (p = 0.016). FEV1/FVC, PEF, FEF25, FEF50, and FEF75 were significantly lower in the CTVA group (all p < 0.05), whereas FEV1, FVC, and MMEF showed no significant differences (p > 0.05). Significant intergroup differences were observed for obesity, inhalant allergen sensitization, allergic rhinitis, atopic dermatitis, history of recurrent respiratory infections, and family history of allergic diseases (all p < 0.05). Univariate logistic regression analysis confirmed these six factors as significantly associated with pediatric CTVA (all p < 0.05).ntified these six factors as potential independent risk factors for pediatric CTVA (all p < 0.05)ConclusionChildren with CTVA have higher FeNO levels and lower FEV1/FVC, PEF, FEF25, FEF50, and FEF75 compared to healthy peers. Obesity, inhalant allergens, allergic rhinitis, atopic dermatitis, recurrent respiratory infections, and family history of allergic diseases showed significant univariate associations with pediatric CTVA in this exploratory cohort. Combined assessment of FeNO and small airway parameters may aid in the diagnostic evaluation of CTVA, although further diagnostic accuracy studies are needed.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1908967</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1908967</link>
        <title><![CDATA[A causal moderated mediation analysis of maternal prenatal bonding and daily infant engagement on postpartum bonding]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Caitlin Dressler</author><author>Stacy Tiemeyer</author><author>Karina M. Shreffler</author>
        <description><![CDATA[BackgroundThe early maternal-infant bond has profound impacts for infant development. Prior research indicates that higher self-reported maternal-fetal bonding predicts greater postpartum bonding, but additional research is needed on the mechanisms that may promote the early maternal-infant relationship. We explored daily engagement in caregiving behaviors as a potential non-pharmacological intervention to promote maternal and infant health.MethodsThis study utilizes a diverse and predominately low-income sample of 114 mothers of infants who were recruited at their first prenatal visit in 2017–2018 and followed through at least six months post-birth. We conducted a causal mediation analysis to examine whether daily engagement at two months postpartum functions as a mediator in the maternal prenatal and postpartum bonding relationship, and additionally tested whether this mediation was moderated by maternal prenatal bonding levels for postpartum bonding.ResultsMaternal prenatal bonding was associated with daily engagement (b = 0.03, SE = 0.01, p < .001) and postpartum bonding (b = 0.28, SE = 0.08, p = .001), controlling for covariates. We also found that daily engagement at two months postpartum was associated with bonding at six months postpartum (b = 3.88, SE = .95, p < .001). Causal mediation analyses indicated a significant indirect effect of prenatal bonding on postpartum bonding through daily engagement among mothers with lower levels of prenatal bonding. There was also evidence of moderation; daily engagement was a stronger predictor of postpartum bonding among mothers with lower prenatal bonding, whereas mothers with higher prenatal bonding showed consistently strong bonding regardless of engagement level (adjusted R2 = .378).ConclusionsThe results of this study indicate that maternal engagement activities may help to facilitate postpartum bonding and may explain the association between prenatal and postpartum bonding. Additionally, engaging in more caregiving activities may strengthen postpartum bonding, particularly among those with lower prenatal bonding. These findings suggest promoting maternal engagement in caregiving behaviors may promote a stronger postpartum bond.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1844281</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1844281</link>
        <title><![CDATA[Cleidocranial dysplasia with preserved function under conservative management: a case report]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Huijiao Xu</author><author>Junmei Ma</author><author>Xiaosong Huang</author><author>Siyu Pu</author><author>Fang Hou</author><author>Wenying Liu</author><author>Jiajun Chen</author>
        <description><![CDATA[IntroductionCleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal disorder caused by pathogenic variants in the RUNX2 gene and characterized by delayed closure of cranial sutures, clavicular hypoplasia, and dental abnormalities. The clinical phenotype is highly heterogeneous, and data on the long-term natural history of CCD with preserved function remain limited.MethodsWe reviewed the longitudinal clinical data of a male child with genetically confirmed CCD carrying a RUNX2 c.631C > T (p.R211W) variant. CCD-specific evaluation was initiated at approximately 4 years of age because of persistent delayed anterior fontanelle closure and clavicular abnormalities. Assessments included physical examination, cranial CT/MRI, chest imaging, panoramic dental radiography, whole-exome sequencing with parental validation, and endocrine follow-up.ConclusionThis case supports individualized conservative management for selected patients with CCD who have preserved function despite structural abnormalities. Longitudinal multidisciplinary follow-up is essential for guiding dental, endocrine, orthopedic, and functional management.DiscussionDespite typical skeletal and dental manifestations, the patient maintained preserved shoulder and upper limb function through 12 years of age, without recurrent fractures, persistent pain, functional limitation, or need for orthopedic or thoracic surgical intervention. A function-oriented conservative management strategy remained appropriate. Height SDS improved during rhGH-related follow-up; however, this observation should be interpreted cautiously because growth may also have been influenced by hypothyroidism, thyroid hormone replacement, normal development, and pubertal maturation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1725474</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1725474</link>
        <title><![CDATA[Using deep learning to monitor children’s nutritional status for child stunting identification]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shijia Luo</author><author>Yuan Wang</author><author>Rongrong Wu</author><author>Zhaoxin Yang</author><author>Hui Gao</author><author>Jing Yuan</author><author>Zhitao Wang</author>
        <description><![CDATA[IntroductionChildren's nutritional health remains a major public health concern, and accurate early identification of growth related risks is essential for timely screening and intervention. This study proposes a deep learning based framework for monitoring children's nutritional status for child stunting identification.MethodsThe task is formulated as a supervised binary classification problem, in which each child is represented by routinely available demographic and anthropometric variables, including age, sex, height, weight, and body mass index. Based on these structured inputs, the proposed Intelligent Nutritional Monitoring Model (INMM) learns discriminative latent representations and predicts whether a child is stunted. The model adopts a compact feature extraction architecture with feature fusion and hierarchical attention, enabling effective modeling of informative interactions among child level attributes while maintaining computational efficiency. To evaluate the proposed method, experiments are conducted on two public health survey datasets, NHANES and NFHS 5, under a unified preprocessing, training, and evaluation protocol.Results and DiscussionComparative results against traditional machine learning, mainstream deep learning, lightweight tabular modeling, and transformer based tabular baselines show that the proposed method achieves the strongest overall classification performance on both datasets while preserving a favorable effectiveness efficiency trade off. Additional ablation results further confirm the contribution of feature extraction, fusion, attention, and prediction design to the final performance. These findings indicate that the proposed framework provides an effective and scalable solution for data driven child stunting identification from structured health survey data.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1915085</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1915085</link>
        <title><![CDATA[Alberta family integrated careTM: a review of a family-integrated care model in neonatal intensive care]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Su Wang</author><author>Yuan Wang</author><author>Xi Kang</author><author>Jie Fu</author><author>Liwen Ding</author><author>Hong Zhou</author><author>Yiyong Fu</author>
        <description><![CDATA[Alberta Family Integrated CareTM (AB-FICareTM) is a standardized, theory-driven model that integrates parents as primary caregivers in neonatal intensive care units (NICUs); however, its clinical effectiveness, implementation determinants, and cross-setting applicability require systematic synthesis. This narrative review aims to evaluate the evidence on AB-FICareTM in Level II NICUs, focusing on neonatal and parental outcomes, implementation barriers and facilitators, and transferability to healthcare systems with distinct organizational and cultural contexts. Following SANRA guidelines, we systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies published between January 2020 and June 2026. Ten reports from a single Canadian cluster randomized controlled trial met the inclusion criteria. The findings demonstrate that AB-FICareTM significantly reduced the adjusted length of stay by 2.55 days (95% CI: −4.44 to −0.66, P = 0.02) without increasing readmissions or emergency visits, and improved parental experiences, specifically enhancing trust, engagement, and discharge readiness. However, exclusive human milk feeding at 2 months was lower in the AB-FICareTM group (aOR = 0.51, 95% CI: 0.31–0.83, P = 0.01). Neurodevelopmental outcomes were mixed; while there was a signal for reduced communication delay at 6–24 months, this was not replicated at 18 months, whereas maternal parenting stress consistently predicted developmental delay (aORs > 1.03, P < 0.01). Key implementation facilitators included receptive organizational culture and stakeholder engagement, whereas barriers encompassed training burden and competing institutional priorities. Based on these findings, we propose that AB-FICareTM implementation should move from one-size-fits-all adoption toward context-sensitive adaptation, integrating robust lactation support, post-discharge mental health services, and system-level coordination into a comprehensive framework covering NICU stay through community-based follow-up. Future research should prioritize long-term neurodevelopmental follow-up, formal cost-effectiveness analyses adhering to CHEERS standards, and multi-site validation across diverse healthcare settings to establish the generalizability and sustainability of AB-FICareTM benefits beyond the Canadian context.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1917680</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1917680</link>
        <title><![CDATA[Mediterranean diet adherence in pediatric familial Mediterranean fever: clinical and inflammatory correlates]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hande Ilgaz Tüzen</author><author>Tuncay Aydın</author><author>Zehra Kızıldağ</author><author>Rana İşgüder</author><author>Rüya Torun</author><author>Erbil Ünsal</author><author>Balahan Bora</author>
        <description><![CDATA[Familial Mediterranean fever is an autoinflammatory disease characterized by recurrent episodes of fever and serositis, with subclinical inflammation that may persist between attacks. Although the Mediterranean diet has recognized anti-inflammatory properties, its clinical relevance in pediatric familial Mediterranean fever remains unclear. In this cross-sectional observational study, children aged 7–18 years with a confirmed diagnosis of familial Mediterranean fever who were followed at the Pediatric Rheumatology Clinic of Dokuz Eylül University between June 2022 and February 2023 were evaluated using standardized dietary questionnaires during outpatient visits. A total of 91 patients met the inclusion criteria. Associations between Mediterranean diet adherence, eating behaviors, attack frequency, disease severity, and selected clinical and inflammatory parameters were analyzed using appropriate comparative statistical tests. Eating behavior showed nominal associations with body mass index and exertional leg pain. Leukocyte count differed across the KIDMED categories in the overall comparison; however, no pairwise comparison remained statistically significant after Bonferroni correction. Neither dietary measure was associated with attack frequency or disease severity. In pediatric familial Mediterranean fever, Mediterranean diet adherence and eating behaviors showed nominal exploratory associations with selected clinical and inflammatory parameters but were not associated with attack frequency or overall disease severity. These findings suggest that dietary patterns may be more closely related to inter-attack clinical and inflammatory expression than to acute disease activity and may help inform future prospective studies on modifiable lifestyle factors in pediatric autoinflammatory disease.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1871728</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1871728</link>
        <title><![CDATA[Diaphragmatic hernia after pediatric liver transplantation: graft-specific incidence, clinical characteristics, and outcomes]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Cansu Altuntaş</author><author>Alaaddin Aydın</author><author>Mey Talip</author><author>Gülden Özek</author><author>Taylan Şahin</author><author>Ali Koçyiğit</author><author>Eryiğit Eren</author><author>Mehmet Tokaç</author><author>Ayhan Dinçkan</author>
        <description><![CDATA[BackgroundDiaphragmatic hernia (DH) is a rare but clinically important complication following pediatric liver transplantation.MethodsThis retrospective single-center study evaluated consecutive pediatric liver transplant episodes. Clinical characteristics, timing, management, and outcomes of DH were assessed. Transplant episodes with and without subsequent DH were compared. The cumulative incidence of DH was estimated using a competing-risk approach, with death before DH diagnosis treated as a competing event.ResultsDiaphragmatic hernia occurred in 16 of 112 pediatric liver transplant episodes (14.3%). All cases occurred following left lateral segment (LLS) transplantation, corresponding to an incidence of 25.0% (16/64) among LLS transplant episodes, whereas no cases occurred after other graft types. Recipients who developed DH were younger at transplantation and had higher graft-to-recipient weight ratio (GRWR) values than those without DH. Approximately half of DH cases were diagnosed within the first 3 postoperative months, and most within the first year. In competing-risk analysis, the cumulative incidence of DH was 7.2% at 3 months, 10.0% at 6 months, and 11.9% at 12 months. Respiratory distress was the most common presentation. All patients underwent surgical repair, and dual mesh reinforcement was used in most cases. Severe postoperative complications were frequent, recurrence occurred in two patients, and no deaths were directly attributable to DH.ConclusionDiaphragmatic hernia is an unexpected and serious complication following pediatric liver transplantation. In our cohort, DH occurred exclusively after LLS transplantation, and affected recipients were younger and had higher GRWR values than those without DH; however, these characteristics are closely interrelated and their independent contributions could not be determined. Most cases were diagnosed early after transplantation, emphasizing the importance of clinical vigilance, timely diagnosis, and prompt surgical management.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1862244</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1862244</link>
        <title><![CDATA[Preschool children's sleep duration and parental depressive symptoms in western China: role of children's mental health and socioeconomic factors]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jiali Du</author><author>Xi Zhang</author><author>Wei He</author><author>Mingyue Duan</author>
        <description><![CDATA[BackgroundPreschool children's insufficient sleep is a public health concern in underdeveloped western China, yet its association with parental depressive symptoms remains unclear, particularly whether this relationship varies by socioeconomic context. This study aims to examine this association, explore whether child mental health may partly account for it, and identify vulnerable subgroups.MethodsThis cross-sectional study recruited 21,366 parent-child dyads from 189 preschools in western China. Parent-reported children's sleep duration was categorized into three groups: 10–13 h/d (reference), 8–9 h/d, and <8 h/d. Parental depressive symptoms and children's mental health outcomes (total difficulties) were assessed using the Center for Epidemiological Studies Depression Scale (CES-D) and the Strengths and Difficulties Questionnaire (SDQ), respectively. Multivariable logistic regression was used to examine the association between children's sleep duration and parental depressive symptoms, and subgroup analyses were performed to assess effect modification by demographic and socioeconomic factors. Indirect effect analysis was conducted to determine the extent to which children's total difficulties account for this association.ResultsIn fully adjusted model, a clear graded relationship was observed that parents of children sleeping 8–9 h/d had 43% higher odds of elevated parental depressive symptoms (OR = 1.43, 95% CI: 1.30–1.56, P < 0.001), while parents of children sleeping <8 h/d had 2.6-fold higher odds (OR = 2.61, 95% CI: 2.13–3.19, P < 0.001) compared with the 10–13 h/d reference group. Subgroup analyses revealed that the strongest associations were found among mortgaged homeowners (OR = 4.21, 95% CI: 2.52–7.04, P < 0.001), urban Hukou registrants (OR = 3.73, 95% CI: 2.62–5.32, P < 0.001), and ever-smokers (OR = 4.50, 95% CI: 2.84–7.12, P < 0.001) for the <8 h/d group. Indirect effect analyses showed that children's total difficulties accounted for 34.3% (95% CI: 25.1%–47.9%) of the association for children sleeping 8–9 h/d, and 39.4% (95% CI: 30.5%–52.9%) for those sleeping <8 h/d.ConclusionShorter sleep duration in preschool children is associated with an increased risk of parental depressive symptoms, and this association is partially accounted for by children's mental health. Future high-quality cohort studies are needed to explore this topic in greater detail.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1857511</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1857511</link>
        <title><![CDATA[Case Report: Ultra-early nusinersen initiation with pre-procedural spinal ultrasound-assisted intrathecal access in a symptomatic neonate with spinal muscular atrophy]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Ning Xie</author><author>Yan Sui</author><author>Yanyan Zhang</author><author>Leihong Zhang</author><author>Jiashan Li</author><author>Ying Sun</author><author>Xiuxiang Liu</author>
        <description><![CDATA[A full-term neonate presented at birth with generalized hypotonia, markedly reduced spontaneous movement, and tongue fasciculations. These findings raised early suspicion of an underlying severe neuromuscular disorder. Genetic testing confirmed homozygous deletion of SMN1 with two copies of SMN2 on day 5 of life, and intrathecal nusinersen was started on the same day. Because repeated lumbar puncture was required, spinal ultrasound was used before the first three intrathecal administrations during the neonatal period to evaluate lumbar anatomy and plan the puncture level and trajectory. This approach facilitated successful first-attempt intrathecal access during the early neonatal procedures. By day 68 of life, the infant had completed four loading doses without procedure-related complications. Motor function, assessed using the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND), increased from 6 before treatment to 21 before the third dose and 30 before the fourth dose. Given the short follow-up period, these early changes should be interpreted cautiously. They are more likely to reflect early disease stabilization and preservation of residual motor function than reversal of established motor neuron loss. This case provides an individual-level real-world description of symptomatic neonatal spinal muscular atrophy treated within the first days of life after postnatal diagnosis. It also supports the feasibility of a structured ultrasound-assisted approach for early repeated intrathecal administration during the neonatal period.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1889280</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1889280</link>
        <title><![CDATA[Modified Mitchell-Banks technique in pediatric inguinal hernia repair: a personalized surgical approach]]></title>
        <pubdate>2026-08-10T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sevgi Büyükbeşe Sarsu</author>
        <description><![CDATA[BackgroundThe classical Mitchell–Banks herniotomy (MBH) is widely employed in infants; however, its applicability in older pediatric populations remains incompletely defined. To address this limitation, we describe an external-oblique-sparing modification of MBH incorporating controlled aponeurotic stretching and the Axis-Directed Inguinal Alignment Maneuver (ADIAM), referred to in this study as the Büyükbeşe technique.ObjectiveTo evaluate the feasibility, short-term clinical outcomes, and early complication profile of the Büyükbeşe technique across different pediatric age groups and to descriptively examine relationships between internal inguinal ring (IIR) diameter, anatomical characteristics, and postoperative outcomes.MethodsThis single-center retrospective study included 110 pediatric patients aged 0–18 years who underwent hernia repair between October 1, 2024, and April 21, 2025. Patients were analyzed according to predefined age groups (0–2, 2–5, 5–10, and 10–18 years), ethnicity, and local surgical complication status.ResultsThe mean age was 4.79 ± 4.02 years, and 82.7% of patients were male. The mean IIR diameter was 8.59 ± 4.86 mm. Overall perioperative adverse events occurred in 20.0% of patients, including local surgical complications in 19.1%, predominantly scrotal edema (11.8%) and hematoma (4.5%). One systemic perioperative adverse event, postoperative respiratory failure, occurred in 0.9% of patients and was included in the overall perioperative adverse event count. Patients with local surgical complications were significantly younger (1.31 ± 1.05 vs. 5.61 ± 4.02 years), shorter (71.2 ± 14.2 vs. 98.6 ± 29.8 cm), and had larger IIR diameters than those without local surgical complications (10.88 ± 7.03 vs. 8.05 ± 4.06 mm; p = 0.034). Local surgical complication rates decreased with age (0–2 years: 45.7%; 10–18 years: 0.0%; p < 0.001). No early recurrence, surgical site infection, or clinically evident testicular complications were observed during the 30-day follow-up period, and all procedures were mesh-free.ConclusionIn this preliminary technical case series, the Büyükbeşe technique, an external-oblique-sparing modification of Mitchell–Banks herniotomy, was technically feasible in clinical practice, with short-term findings that should be interpreted cautiously because of the observed early local postoperative morbidity. Exploratory observations suggested that younger age, smaller body size, and relatively larger IIR diameters were more frequently observed among patients with local surgical complications; however, these findings remain hypothesis-generating and require prospective validation. The technique may offer preservation of the anterior inguinal wall, but this potential advantage should be considered alongside the technical challenges associated with limited operative exposure, increased traction, and deep tissue manipulation within a confined operative corridor, particularly in the youngest age group. Further evaluation in diverse clinical settings may help clarify the reproducibility and generalizability of this technique.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1837801</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1837801</link>
        <title><![CDATA[Translational insights into manufacturability and stability of broadly neutralizing antibodies for pediatric HIV prevention: lessons from plant-produced CAP256-VRC26.25]]></title>
        <pubdate>2026-08-10T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tsepo L. Tsekoa</author><author>Lusisizwe Kwezi</author><author>Priyen Pillay</author><author>Sibongile Mtimka</author><author>Maabo Moralo</author><author>Kabamba Alexandre</author><author>Joseph Nkolola</author><author>Dan H. Barouch</author><author>Rachel Chikwamba</author>
        <description><![CDATA[Monoclonal antibodies hold significant promise for preventing HIV infection in infants and children. However, global access remains constrained by the high production costs and infrastructure requirements associated with complex mammalian cell manufacturing platforms. Alternative expression systems, including plant-based production, have been proposed as scalable and potentially lower-cost approaches for antibody manufacturing. Here, we evaluated the in vivo performance of plant-produced CAP256-VRC26.25, a potent V2-apex HIV-1 broadly neutralizing antibody originally isolated from an HIV-infected individual in South Africa. Purified, endotoxin-free plant-produced CAP256-VRC26.25 was administered to cynomolgus macaques alongside a mammalian cell-produced CAP256-VRC26.25 control antibody prior to mucosal SHIV challenge. While the mammalian-derived antibody conferred protection, the plant-produced antibody did not. Pharmacokinetic analysis revealed approximately two orders of magnitude lower circulating antibody levels and rapid clearance of the plant-produced antibody, despite preserved in vitro neutralization potency. Electrophoretic analysis indicated evidence of partial proteolytic nicking of the plant-produced antibody, suggesting that structural instability may have contributed to reduced in vivo durability. Previous studies have shown that manufacturability liabilities within the CAP256-VRC26 lineage can occur across multiple expression platforms, highlighting the importance of integrating antibody engineering with manufacturing platform development. These findings have informed ongoing work combining host genome engineering to reduce endogenous plant protease activity with targeted modification of predicted protease-sensitive sites within CAP256-VRC26.25. Overall, this study provides translational insights into the engineering challenges associated with scalable production of broadly neutralizing antibodies and highlights key considerations for developing accessible antibody-based interventions for pediatric HIV prevention.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1918653</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1918653</link>
        <title><![CDATA[Case Report: Dorsal inlay labial mucosa graft urethroplasty for pediatric and adolescent long-segment urethral stricture after failed hypospadias repair]]></title>
        <pubdate>2026-08-10T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Ilaria Buconi</author><author>Lorna Spagnol</author><author>Leonardo Crescentini</author><author>Giovanni Rollo</author><author>Letizia Corbi</author><author>Massimiliano Silveri</author>
        <description><![CDATA[Long-segment urethral stricture represents a major and challenging complication after multiple failed hypospadias repairs. In pediatric and adolescent patients, reconstructive strategies for these complex cases remain non-standardized, and clinical evidence is limited. Oral mucosa graft urethroplasty is widely used for long and complex adult urethral strictures because of its favorable tissue characteristics. However, its role in pediatric reconstructive urology, particularly in complex post-hypospadias strictures associated with lichen sclerosus (LS), remains rarely reported. We report the case of a 15-year-old patient with severe recurrent anterior urethral stricture after multiple previous hypospadias repairs, complicated by repeated episodes of urinary retention requiring suprapubic catheterization. Histological examination of a urethral biopsy confirmed lichen sclerosus. A single-stage dorsal inlay labial mucosa graft urethroplasty was performed according to the Asopa technique. Intraoperatively, a long-segment anterior urethral stricture extending to the peno-bulbar junction was confirmed. Given the preserved urethral plate width of approximately 2 cm, a dorsal inlay approach was considered feasible. A 7 × 2 cm labial mucosa graft was harvested and quilted to the corporal bed, and the urethra was reconstructed over a 14 Ch Foley catheter with protective dartos flap coverage. The postoperative course was uneventful. At 18-month follow-up, the patient reported satisfactory voiding, no urinary tract infections, no filiform urinary stream, and no clinical evidence of recurrence. This case suggests that dorsal inlay labial mucosa graft urethroplasty may represent a feasible single-stage option in selected adolescents with complex post-hypospadias anterior urethral strictures, particularly when genital skin is unsuitable. Further pediatric experience and longer follow-up are needed to better define indications, durability, and functional outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1888442</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1888442</link>
        <title><![CDATA[Enteric duplication cyst as a lead point for intrauterine segmental volvulus resulting in type IIIa ileal atresia: a neonatal case report and focused literature review]]></title>
        <pubdate>2026-08-10T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Mariam Marzouki</author><author>Malek Mezni</author><author>Yosra Ben Ahmed</author><author>Wiem Hammouda</author><author>Rim Ben Aziza</author><author>Imen Ben Ismail</author><author>Said Jlidi</author><author>Aya Khemir</author><author>Imen Abess</author>
        <description><![CDATA[BackgroundJejunoileal atresia is most commonly attributed to intrauterine mesenteric vascular accidents. Both segmental volvulus and enteric duplication cysts are recognized yet uncommon causes of fetal vascular compromise capable of inducing intestinal ischemia. The simultaneous occurrence of ileal atresia, segmental volvulus, and enteric duplication cyst in a single neonate is exceedingly rare and offers valuable insight into the vascular pathogenesis of intestinal atresia.Case presentationWe report the case of a male term neonate admitted eleven hours after birth for bilious vomiting and progressive abdominal distension. Plain abdominal radiography revealed multiple air-fluid levels, and contrast enema demonstrated a microcolon with characteristic “string-of-beads” filling defects in the distal ileum consistent with meconium pellets. Exploratory laparotomy identified a type IIIa distal ileal atresia located 20 cm from the ileocecal valve, associated with a segmental volvulus twisting around a 3 cm cystic enteric duplication. The volvulated bowel segment, duplication cyst, and dilated proximal ileum were resected, and a primary end-to-end ileoileal anastomosis was performed. Histopathology confirmed cystic ileal duplication with bilateral ileal atresia at the resection margins. Despite an initially stable postoperative course, the infant developed severe bronchiolitis with respiratory failure and died on postoperative day 10.ConclusionThis rare neonatal triad supports the hypothesis that enteric duplication cysts may act as intrauterine lead points for segmental volvulus, triggering mesenteric vascular compromise and secondary ileal atresia. Any neonate presenting with distal bowel obstruction and microcolon should prompt consideration of complex intrauterine vascular events. Prompt surgical exploration remains essential to maximize intestinal preservation and improve outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1818320</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1818320</link>
        <title><![CDATA[Interleukin-6 in complications of prematurity: from biomarker to targeted therapy]]></title>
        <pubdate>2026-08-10T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Shuzhe Xiao</author><author>Qi Zheng</author><author>Lingling Wang</author><author>Zhiqiu Wang</author><author>Guangliang Bi</author><author>Jie Yang</author>
        <description><![CDATA[Prematurity is a major cause of neonatal morbidity and mortality. Inflammatory imbalance is critical in preterm complications, and interleukin-6 (IL-6) plays a pivotal role in this dysregulation. Currently, there is no comprehensive review focusing specifically on IL-6 in the context of neonatal complications of prematurity. Thus, we review the involvement of IL-6 in various prematurity complications, exploring its mechanisms and clinical implications. We also discuss current and emerging therapies targeting IL-6, its receptor, and the trans-signaling pathway, focusing on the potential of these cytokines as therapeutic targets for the development of safe and effective treatments for neonatal complications of prematurity. However, while IL-6 shows consistent value as an early predictive biomarker, its translation into targeted therapy for preterm infants remains preliminary, with substantial gaps in safety and pharmacokinetic data that require further investigation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1903927</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1903927</link>
        <title><![CDATA[Analysis of risk factors for severe acute poisoning in children]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jing Li</author><author>Wei Kai Wang</author>
        <description><![CDATA[ObjectiveTo identify independent risk factors for the progression of acute poisoning to severe cases in children, and to provide a basis for early clinical identification and intervention.MethodsA retrospective study was conducted to collect the clinical data of hospitalized children with acute poisoning at Tianshui First People's Hospital from January 1, 2018 to December 31, 2025. According to the Poisoning Severity Score (PSS), patients were divided into the severe group (≥3 points) and the non-severe group (<3 points). Variables that were statistically significant in univariate analysis were included in binary logistic regression analysis to identify independent risk factors for severe poisoning.ResultsA total of 726 children with acute poisoning were enrolled, including 79 (10.9%) severe cases and 647 (89.1%) non-severe cases. Two deaths occurred, with a case fatality rate of 0.3%. The difference across age groups was statistically significant (χ2 = 10.451, P = 0.015), with adolescents accounting for the highest proportion of severe cases (48.1%, 38/79). Multivariate logistic regression analysis revealed that gastric lavage was significantly associated with lower odds of severe poisoning (OR = 0.355, 95% CI: 0.157–0.800, P = 0.013); antidote use was associated with an increased risk of severe poisoning (OR = 3.156, 95% CI: 1.933–5.152, P < 0.001), while left-behind children (OR = 3.013, 95% CI: 1.558–5.828, P = 0.001) and self-poisoning (OR = 2.113, 95% CI: 1.283–3.481, P = 0.003) were independent risk factors. The ROC curve showed an area under the curve (AUC) of 0.710 (95% CI: 0.645–0.775).ConclusionsGastric lavage associated with a lower risk of severe poisoning in this pediatric cohort. When strictly indicated, it may remain a procedure of clinical value. Left-behind children and those with self-poisoning are high-risk populations requiring enhanced family supervision, early recognition, and psychological intervention. The association between antidote use and increased risk of severe poisoning likely reflects confounding by indication, and should not delay necessary antidotal therapy.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1902579</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1902579</link>
        <title><![CDATA[A stabilization device significantly improves measurement reliability and efficiency of Graf ultrasonography for developmental dysplasia of the hip: a retrospective cohort study]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yehui Lan</author><author>Liyu Tang</author><author>Miao Jin</author><author>Bin Du</author><author>Jianfei Yan</author><author>Quanzhou Wu</author><author>Chenying Lu</author><author>Yanhua Huang</author><author>Zhihui Chen</author>
        <description><![CDATA[ObjectivesTo compare the measurement reliability, procedural efficiency, and infant stress responses between device-assisted and manual restraint approaches in Graf hip ultrasonography for developmental dysplasia of the hip (DDH) screening.MethodsIn this retrospective cohort study, 238 infants (aged 0–6 months) underwent consecutive hip ultrasound examinations using both a Graf stabilization device and manual restraint during the same visit. Each examination included triple measurements of α and β angles by a single experienced sonographer. Primary outcomes included angle measurements and Graf classification. Examination time and infant crying incidence were also recorded. Intra-observer reliability for repeated measurements within each technique and inter-technique agreement between the two methods were evaluated separately using intraclass correlation coefficients (ICC) and Cohen's kappa.ResultsNo significant differences were observed in α angle (67.00° vs. 67.50°, P = 0.313), β angle (71.00° vs. 69.00°, P = 0.179), or Graf classification distribution (P = 0.832) between device-assisted and manual methods. However, the device-assisted approach showed significantly shorter examination time (P < 0.001) and a 13.5-fold reduction in crying incidence (0.84% vs. 11.34%, P < 0.001). Intra-observer reliability was excellent with device assistance (α angle: ICC = 0.95, β angle: ICC = 0.90) but poor with manual restraint (α angle: ICC = 0.49, β angle: ICC = 0.23). Inter-technique agreement was moderate for α angle (ICC = 0.71) and substantial for Graf classification (κ = 0.66), but poor with β angle (ICC = 0.36).ConclusionThe use of a stabilization device in Graf hip ultrasonography significantly improves measurement reliability and may enhance examination efficiency and infant comfort without altering diagnostic outcomes, supporting its integration into high-volume DDH screening programs.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1852266</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1852266</link>
        <title><![CDATA[Extraperitoneal repair using modified single-port mini-nephroscopy for pediatric hydrocele: surgical outcomes in 65 children]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Qianliang Wang</author><author>Qingling Liu</author>
        <description><![CDATA[ObjectiveThe purpose of the study is to introduce our experience of a modified single-port Mini-Nephroscopy technique for the treatment of pediatric hydrocele.MethodsIn this prospective study, 65 male children (age range: 1.5–8 years) with unilateral communicating hydrocele were enrolled between June 2019 and June 2022. The surgical procedure consisted of high ligation of the patent processus vaginalis performed extraperitoneally using a modified single-port nephroscope introduced through a single umbilical incision, facilitated by custom suture-guiding instruments. The primary outcome measures included testicular volume and testicular artery resistance index (RI), which were evaluated via scrotal ultrasonography preoperatively and at scheduled follow-ups of 1 and 6 months.ResultsThe novel technique was successfully employed in all 65 patients without conversion to open surgery. The mean operative time was remarkably brief (8–10 min), facilitating a 24-hour discharge for all children. Postoperative pain was well-controlled, with mean VAS scores decreasing from 2.1 ± 0.82.1 ± 0.8 at 6 h to 1.2 ± 0.51.2 ± 0.5 at 24 h, indicating only mild and transient discomfort. With a follow-up of 3–18 months, no instances of recurrence, testicular atrophy, or other complications (e.g., knot reactions, iatrogenic ascent) were observed.ConclusionSingle-port nephroscopic high ligation holds significant promise for pediatric communicating hydrocele, offering a compelling combination of minimal invasiveness, high operative efficiency, rapid recovery, and an excellent safety profile. These results strongly endorse its consideration as a first-line surgical treatment for this condition.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1730779</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1730779</link>
        <title><![CDATA[The global evaluation of nursing interventions on patient outcomes in children with pneumonia: a systematic review and meta-analysis]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Lijuan Zhou</author><author>Hui Meng</author><author>Liming Cao</author>
        <description><![CDATA[Background/objectivesPediatric patients diagnosed with pneumonia may experience a reduced incidence of complications when provided with appropriate nursing care. Numerous studies have investigated the impact of interventions on outcomes in children with pneumonia. However, the findings have been contradictory, and the effectiveness of these interventions on patient outcomes can differ. Therefore, it is crucial to compile and compare the results of these studies across various nursing intervention types. We conducted a systematic review and meta-analysis to evaluate the effectiveness of different interventions on patient outcomes in pediatric pneumonia cases.MethodsA comprehensive search was conducted across five reputable databases (Scopus, PubMed, Medline, Embase, and Web of Science) using three groups of keywords up to September 2025, following PRISMA guidelines. All types of studies were included if they involved nursing interventions in children with pneumonia. For the meta-analysis, nursing satisfaction, complication rates, and their 95% confidence intervals (CIs) in case-control studies were calculated using a random-effects model. The GRADE assessment was also performed. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tools.ResultsThis review analyzed a total of 40 studies encompassing 166,859 cases of pediatric pneumonia, including all study designs implemented in this field. Targeted nursing care, comprehensive nursing care, and hierarchical chain nursing care were identified as the most effective interventions. However, medication programs, educational nursing interventions, and positioning care programs, while cost-effective, can significantly enhance patient outcomes. Following these interventions, nursing satisfaction rates improved significantly, with a pooled standardized mean difference (SMD) of 1.79 (95% CI: 1.33–2.25), and complication rates decreased, also with an SMD of −3.81 (95% CI: −4.17–−3.45).ConclusionsNursing care interventions for children with pneumonia can significantly improve patient outcomes. It is crucial to develop effective and cost-efficient nursing strategies specifically tailored to pediatric pneumonia cases. The successful implementation of high-impact nursing interventions requires close collaboration among individual care providers, leadership, and policymakers. Policymakers and healthcare practitioners must carefully evaluate healthcare priorities alongside the effectiveness, benefits, and potential risks associated with these interventions.Systematic Review RegistrationPROSPERO CRD420251164790.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1896889</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1896889</link>
        <title><![CDATA[Impact of the neonatal intensive critical ultrasound workflow for managing neonatal acute pulmonary hypertension]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mingsheng Zheng</author><author>Wenwei Ling</author><author>Jingyi Zhang</author><author>Rong Ju</author><author>Tiantian Xiao</author><author>Yiyong Fu</author><author>Biao Li</author><author>Yi Zheng</author><author>Jun Wang</author><author>Xiaofeng Zhou</author><author>Gaoyang Qin</author><author>Lingping Zhong</author><author>Ling Zhu</author><author>Youning Hu</author><author>Xiaolong Zhang</author><author>Zhengwei Ye</author><author>Huaying Li</author><author>Yang Liu</author><author>Nana Wu</author><author>Shuqiang Gao</author><author>Xuhong Hu</author><author>Yan Jiang</author><author>Xiaohong Luo</author>
        <description><![CDATA[ObjectiveTo investigate the value of developed the Neonatal Intensive Critical Ultrasound (NICUltra) Examination workflow in the management of neonatal acute pulmonary hypertension (aPH).MethodsIn this retrospective cohort study, we assessed the effects of NICUltra-guided care on neonates with early aPH who underwent inhaled nitric oxide (iNO) therapy. The primary outcomes were the durations of iNO treatment and mechanical ventilation.ResultsOf the 77 enrolled neonates, 36 (46.7%) received NICUltra-guided care. Compared with non-NICUltra-guided patients, NICUltra-guided patients had significantly shorter durations of iNO treatment (P = 0.002) and mechanical ventilation (P = 0.003) and lower hospitalization costs, whereas no between-group differences were detected in mortality, the incidence of severe intraventricular hemorrhage, or extracorporeal membrane oxygenation therapy utilization.ConclusionAmong neonates >32 weeks with early aPH receiving iNO treatment and without structural cardiopulmonary anomalies in a single-center retrospective study, the implementation of the NICUltra workflow is associated with significantly improved clinical efficacy and may be useful for optimizing clinical strategies with no observed differences in short-term outcomes.]]></description>
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