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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>
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        <pubDate>2026-08-13T14:23:52.680+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1915688</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1915688</link>
        <title><![CDATA[Real-world retrospective analysis of clinical outcomes in pediatric acquired aplastic anemia: a single-center 10-year cohort study]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shanshan Li</author><author>Kai Chen</author><author>Hui Jiang</author><author>Na Zhang</author><author>Jingwei Yang</author><author>Xuelian Liao</author><author>Ting Zhang</author><author>Shayi Jiang</author><author>Jingbo Shao</author>
        <description><![CDATA[IntroductionPediatric aplastic anemia (AA), a rare and potentially fatal disease, demonstrates significant heterogeneity in pathogenesis, disease severity, therapeutic regimens, and clinical outcomes.MethodsIn this study, clinical features and outcomes of 70 children with AA, including severe AA (SAA, n = 30), very severe AA (vSAA, n = 21) and nonsevere AA (nSAA, n = 19), were retrospectively analyzed, with a median follow-up of 60.7 months (range, 0.4-136.5 months).ResultsPatients with nSAA were mainly treated with cyclosporine A, whereas SAA/vSAA patients primarily received allogeneic hematopoietic stem cell transplantation (HSCT) followed by standard immunosuppressive therapy (IST). Ultimate therapy regimens differed significantly between patients with SAA/vSAA and nSAA (p = 0.001). SAA/vSAA group exhibited a higher overall response rate at the 2-year follow-up (85.5% vs. 55.6%, p = 0.019). The 2-year overall survival (OS) and event-free survival (EFS) for the entire cohort were 97.1% and 48.5%, respectively. In patients with SAA/vSAA, HSCT was associated with higher and faster cumulative complete response (CR) rate (p < 0.0001) and superior EFS (p = 0.0297) compared with IST. Two IST-resistant patients were observed to achieved CR with eltrombopag (EPAG) salvage therapy.Discussionpediatric AA carries excellent OS but suboptimal EFS. HSCT tends to yield more favorable EFS compared with IST in SAA/vSAA patients, and EPAG may act as an effective salvage option for appropriately selected IST-resistant individuals. Further multicenter prospective research is warranted prior to implementing these findings in routine clinical practice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1944386</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1944386</link>
        <title><![CDATA[Editorial: Advances and challenges in pediatric immune disorders: from pathogenesis to personalized therapy]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Yan Pan</author><author>Fuyong Jiao</author><author>Hong Wang</author><author>Weihua Zhang</author><author>Bilal Haider Shamsi</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1865167</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1865167</link>
        <title><![CDATA[Advances in the diagnosis and management of abdominoscrotal hydrocele: a narrative review]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Fangyuan Li</author><author>Lina Zhang</author><author>Yalong Ma</author><author>Jinsong Sun</author><author>Baohua Yu</author>
        <description><![CDATA[Abdominoscrotal hydrocele (ASH) is a rare variant of hydrocele characterized by contiguous scrotal and abdominal fluid collections communicating through the inguinal canal. Its pathogenesis remains poorly understood, and the available evidence is derived primarily from case reports and small retrospective case series, leaving continued uncertainty over its diagnosis, timing of intervention, and operative strategy. This narrative review summarizes and critically discusses the current literature on the pathogenesis, clinical presentation, imaging evaluation, differential diagnosis, and management of pediatric ASH. In children presenting with an apparently simple hydrocele, an unusually large, tense, or progressively enlarging inguinoscrotal swelling, ipsilateral lower abdominal fullness, or cross-fluctuation should prompt ultrasonographic assessment extending from the scrotum through the inguinal canal. Direct demonstration of continuity between the scrotal hydrocele and an abdominal fluid collection supports the diagnosis of ASH. Magnetic resonance imaging may be useful when the proximal extent or anatomical origin of the lesion remains unclear. Proposed mechanisms include pressure-driven cephalad extension of a scrotal hydrocele and persistent patency of the processus vaginalis, although neither mechanism fully accounts for all reported cases. Observation may be appropriate in carefully selected asymptomatic infants with close follow-up, whereas progressive, symptomatic, compressive, or diagnostically uncertain lesions generally warrant surgical intervention. Inguinal, scrotal, and laparoscopic approaches are all feasible, but the available evidence does not demonstrate the superiority of any single technique. Multicenter studies with standardized diagnostic criteria and long-term outcome reporting are needed to inform risk-stratified management.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1914065</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1914065</link>
        <title><![CDATA[Feasibility, uptake, and exploratory outcomes of an individualized exercise program in pediatric oncology: a prospective single-center pilot study]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Christina Schuster</author><author>Elena Loos</author><author>Thomas Traunwieser</author><author>Michael C. Frühwald</author><author>Michaela Kuhlen</author>
        <description><![CDATA[IntroductionExercise interventions may help mitigate treatment-related physical impairment in pediatric oncology, but implementation in routine care remains challenging, particularly during active treatment and in heterogeneous patient cohorts.PatientsThis prospective single-center pilot study evaluated an individualized exercise program for children and adolescents aged 4–17 years undergoing cancer treatment during the COVID-19 pandemic.MethodThe program combined supervised in-hospital exercise, personalized home-based training, and an optional video-based SMART-Sport component introduced from month 3. The primary focus was feasibility, uptake, safety, and acceptability. Motor performance, six-minute walk distance, health-related quality of life (HRQoL), and neuropsychological functioning were assessed at baseline and six months as secondary exploratory outcomes.ResultsTwenty participants were enrolled; 15 completed at least one six-month follow-up assessment. Overall, 348 of 583 scheduled in-hospital exercise opportunities were attended, corresponding to a scheduled-session attendance of 59.7% using a conservative denominator. No serious program-related adverse event occurred. Movement diaries were available for 15 participants and documented 361 home-training sessions, of which 262 (72.6%) occurred during the first three months. Four participants documented use of SMART-Sport, completing 14 sessions. Exploratory complete-case analyses showed nominal within-participant improvements in hand-eye coordination, reaction time, six-minute walk distance, and selected HRQoL domains. Neuropsychological findings were inconclusive.DiscussionThe findings support the feasibility and safety of supervised individualized in-hospital exercise under the conditions of a specialized pediatric oncology center with a dedicated sports therapist. Feasibility was component-specific: home-training documentation decreased over time, and uptake of the optional video-based component was limited.ConclusionThis pilot study provides preliminary implementation data supporting further development of individualized exercise programs in pediatric oncology. Exploratory outcome findings should be interpreted as hypothesis-generating and require confirmation in larger controlled studies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1858985</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1858985</link>
        <title><![CDATA[Comparative analysis of infection-associated and non-infection-associated pulmonary embolism in children: a multicenter retrospective cohort study]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Fengqin Liu</author><author>Sixian Liu</author><author>Lejia Zhang</author><author>Zhilang Lin</author><author>Jing Zhang</author><author>Huijuan Xu</author><author>Bing Liu</author><author>Tian Shen</author><author>Yuan Wen</author><author>Mengze Hu</author><author>Lirong Sun</author><author>Gang Liu</author><author>Xiaochuan Wu</author><author>Yi Zhang</author><author>Rong Liu</author><author>Xiaoyun Jiang</author><author>Xing Chen</author><author>Juan Xiao</author>
        <description><![CDATA[BackgroundPediatric pulmonary embolism (PE) exhibits distinct risk factors, with respiratory infections playing a predominant yet understudied role in children.MethodsThis multicenter, retrospective study analyzed pediatric patients with PE from 8 Chinese tertiary hospitals between 2003 and 2023. Patients were stratified into infection-associated PE (I-PE) and non-infection-associated PE (NI-PE) groups based on systemic infection status for comparative analysis.ResultsAmong 196 pediatric patients diagnosed with PE, I-PE was predominant at 75.5%, vs. 24.5% for NI-PE. The vast majority of I-PE group (77.0%) were associated with respiratory infections, among which 20.3% were attributable to Mycoplasma pneumoniae. Clinically, the I-PE group had higher inflammatory markers (CRP: 45.1 mg/L, ESR: 41 mm/h; P < 0.05) and more frequent chest pain (31.8% vs. 16.7%) and hemoptysis (19.6% vs. 0%; P < 0.05 for both). Low-risk stratification predominated in both groups (91.2% vs. 89.6%). Anticoagulation safety profiles were comparable (bleeding events: 5.4% vs. 4.2%), while the I-PE group without comorbidities demonstrated faster resolution of emboli (44 vs. 345 days). The PE-related mortality rate was 2.6% (below expected), with 10 (5.1%) cases developing late cardiopulmonary dysfunction.ConclusionsThis study revealed a predominance of school-age children within the identified PE cohort, whose actual prevalence exceeding prior estimates. The association between infection, particularly acute respiratory infection, and PE in this cohort supports consideration of PE in children with respiratory infection and concerning features. I-PE presents with marked inflammation, a higher proportion of markedly elevated D-dimer (≥5 μg/mL), and typical symptoms (chest pain/hemoptysis), yet demonstrates better short-term outcomes. NI-PE correlates with underlying diseases and warrants long-term complication monitoring. Recognizing these differences is vital for enhancing outcomes in children with respiratory diseases. PE should be considered in children with severe pneumonia who present with disproportionate inflammation or chest pain.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1838914</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1838914</link>
        <title><![CDATA[Development and validation of a machine learning-based risk prediction model for PICC-associated bloodstream infections in preterm infants: a retrospective multicenter study]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ruiqing Song</author><author>Zhirui Li</author><author>Denghui Ma</author><author>Xiaomin Yin</author><author>Lingxi Li</author><author>Junge Li</author><author>Kun Wang</author>
        <description><![CDATA[ObjectiveTo develop and validate a machine learning–based model for predicting the risk of peripherally inserted central catheter (PICC)–associated bloodstream infection (CRBSI) in preterm infants.MethodsThis retrospective multicenter study included 151 preterm infants with CRBSI and 302 matched controls from a tertiary hospital (2017–2024), randomly divided into a training set (n = 317) and an internal validation set (n = 136). An additional 96 cases from four tertiary hospitals were used for external validation. Eight significant predictors identified by univariate analysis were used to construct five models: Logistic Regression (LR), Extreme Gradient Boosting (XGBoost), Decision Tree (DT), Support Vector Machine (SVM), and Random Forest (RF). Model performance was evaluated using the area under the curve (AUC), accuracy, precision, recall, and F1 score. The Shapley Additive Explanations (SHAP) was applied for model interpretation.ResultsEight variables were identified as key predictors, including puncture duration, catheterized vein, duration and frequency of mechanical ventilation, catheter dwell time, fetal distress, hypoalbuminemia, and antibiotic use within 24 h after birth. Infection rates increased markedly with prolonged puncture duration (6% for < 30 min vs 78% for 30–60 min vs 93% for >60 min) and catheter dwell time (21% for <14 days vs 32% for 14–21 days vs 47% for >21 days). Femoral vein catheterization showed the highest infection rate (82%). In the internal validation set, the AUCs of LR, XGBoost, DT, SVM, and RF were 0.89, 0.86, 0.87, 0.88, and 0.95, respectively; in the external validation set, they were 0.89, 0.88, 0.87, 0.93, and 0.96. The RF model achieved the highest accuracy in both internal (0.91) and external (0.90) validation sets, while SVM showed the highest external accuracy (0.92). Precision ranged from 0.79 to 0.89, recall from 0.27 to 0.31, and F1 scores from 0.42 to 0.45. SHAP analysis showed that puncture duration was the most important predictor, followed by catheterized vein and mechanical ventilation–related variables.ConclusionsThe RF model demonstrated superior performance in predicting CRBSI risk in preterm infants with PICC placement. This model may facilitate early identification of high-risk patients and support clinical decision-making.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1866647</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1866647</link>
        <title><![CDATA[Clinical correlation of A2063G gene mutation in mycoplasma pneumoniae pneumonia in children: a retrospective analysis]]></title>
        <pubdate>2026-08-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jianshan Huang</author><author>Xiating Huang</author><author>Zhanpeng Qiu</author><author>Hui Li</author>
        <description><![CDATA[ObjectiveTo investigate the correlation between the A2063G point mutation in the 23S rRNA resistance gene and the clinical features of Mycoplasma pneumoniae pneumonia (MPP) in children.MethodsA retrospective analysis was conducted on 279 children diagnosed with MPP and hospitalized at Xiamen Hospital of Traditional Chinese Medicine from 2023. Based on the results of drug resistance gene sequencing, the patients were divided into a non-mutation group and a mutation group, and their clinical data were compared.ResultsNo significant differences were observed between the two groups regarding symptoms of productive cough and wheezing, or in laboratory indicators including white blood cell count (WBC), creatine kinase (CK), creatine kinase-MB (CK-MB), alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), and serum creatinine (Scr) (P > 0.05). The total fever duration and hospital stay were significantly longer in the mutation group than in the non-mutation group (P < 0.05). Levels of C-reactive protein (CRP), D-dimer (D-D), and lactate dehydrogenase (LDH) were significantly higher in the mutation group (P < 0.05). No significant differences between the two groups of children regarding antibiotic regimen selection and the use of fiberoptic bronchoscopy (P > 0.05). The usage rate of glucocorticoids in the mutation group was significantly higher than that in the non-mutation group, and the difference was statistically significant (P < 0.05). Multivariate analysis indicated that elevated levels of CRP, D-D, LDH and Glucocorticoid Therapy were independently associated with the A2063G mutation.ConclusionThe A2063G mutation may be associated with prolonged hospital stay, total fever duration, glucocorticoid use, and elevated serum CRP, D-D, and LDH levels. Furthermore, certain independent correlations are present between these clinical parameters. Early identification of this mutation during the initial stages of the disease could provide crucial guidance for adjusting clinical management strategies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1912583</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1912583</link>
        <title><![CDATA[Herlyn-Werner-Wunderlich syndrome in three infants: a case report of surgical treatment]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jiarong Chen</author><author>Youcai Feng</author><author>Jiabo Chen</author><author>Danping Zeng</author><author>Hua Li</author><author>Hongjun Gao</author>
        <description><![CDATA[Oblique vaginal septum syndrome (Herlyn-Werner-Wunderlich syndrome) is a congenital reproductive tract malformation frequently accompanied by ipsilateral renal dysplasia. During infancy, it can lead to urinary tract infections, dysuria, and abdominal masses. Delayed intervention predisposes patients to hydronephrosis and even renal failure. Current treatment primarily involves incision and drainage; however, traditional transvaginal surgery in infants is limited by a restricted surgical field and a lack of standardized protocols. This case report presents the clinical data of three affected infants (age range: 5 days to 4 months and 15 days) treated at our institution, evaluating the efficacy of two minimally invasive surgical approaches. During a follow-up period of 1–12 months postoperatively, all patients achieved complete recovery of normal voiding function, with no recurrence of urinary tract infections, and no instances of intestinal injury, hemorrhage, or restenosis were observed. Transvaginal direct incision is considered suitable for patients presenting with vulvar masses caused by a low-positioned oblique septum, whereas a laparoscopy-assisted approach effectively optimizes surgical conditions for cases involving a high-positioned oblique septum or those with significant inflammation following repeated punctures. Both techniques resulted in symptom relief without major complications. We emphasize the importance of early and precise intervention, as well as the avoidance of blind puncture, to preserve renal function.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1947631</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1947631</link>
        <title><![CDATA[Correction: Birth weight, ototoxic medication, and surgical history predict individual hearing loss risks: a systematic review and meta-analysis]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Hanwen Luo</author><author>Jianghua He</author><author>Dapeng Chen</author><author>Xiaoming Xu</author><author>Jing Zhao</author><author>Xiaoyan Yang</author><author>Jing Shi</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1907180</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1907180</link>
        <title><![CDATA[Periventricular leukomalacia-related litigation in Japan: a qualitative analysis of causation under clinical uncertainty]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shigeo Iijima</author>
        <description><![CDATA[IntroductionPeriventricular leukomalacia (PVL) is a leading cause of cerebral palsy in preterm infants. However, its multifactorial pathogenesis and uncertainty regarding the timing of brain injury make causal attribution in medical litigation inherently complex. Despite its clinical significance, little is known about how courts evaluate causation and responsibility in PVL-related cases. This study aimed to clarify the clinical and judicial characteristics of PVL-related medical litigations in Japan.MethodsCases were identified using a nationwide legal database. A qualitative analysis of judicial decisions was performed, focusing on obstetric and neonatal management, breach of duty, causation, and informed consent. Seven litigation cases involving preterm infants were included.ResultsDespite substantial heterogeneity in clinical presentation and perinatal course, cross-case analysis identified several recurring patterns in judicial reasoning regarding causation and responsibility. Disputed issues arose across multiple phases of perinatal care, including the timing of delivery, fetal monitoring, maternal transfer, postnatal care systems, and respiratory management. Although judicial decisions showed considerable variability, the recognition of causation emerged as the pivotal determinant of liability. In some cases, causation was acknowledged only partially, despite persistent clinical uncertainty regarding the timing and mechanisms of injury. In contrast, in cases involving clearly identifiable intrapartum hypoxic events, courts were more likely to affirm causation by linking clinical events in a coherent temporal sequence despite the underlying medical uncertainty.DiscussionThese findings demonstrate that PVL-related litigation may involve disputes across multiple phases of perinatal care because of the multifactorial nature of PVL and the uncertainty regarding the timing and etiologies of injury. Under such conditions of clinical uncertainty, legal responsibility is assessed not only through isolated medical acts but also through broader clinical decision-making processes involving critical decisions across multiple phases of perinatal care. Moreover, the results highlight a fundamental divergence between medical reasoning based on scientific evidence and legal reasoning. The findings underscore the importance of transdisciplinary decision-making, careful documentation, and effective communication in managing medico-legal risk in perinatal practice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1911394</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1911394</link>
        <title><![CDATA[Association of early oxygen therapy parameters with retinopathy of prematurity stages in preterm infants with respiratory distress syndrome: a gestational age-stratified analysis]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shanshan Chen</author><author>Rong Li</author><author>Na Shi</author><author>Qinxing Xie</author><author>Wenqiang Liu</author>
        <description><![CDATA[ObjectiveTo investigate the associations between early oxygen-related parameters and ROP severity in preterm infants with respiratory distress syndrome (RDS), and to evaluate their discriminative performance for severe ROP.MethodsThis retrospective study included 825 preterm infants (24–<37 weeks) with RDS stratified by gestational age (32–<37, 28–<32, and 24–<28 weeks). Early oxygen parameters during the first 7 days after birth included cumulative oxygen duration, mean and maximum FiO2, SpO2 target range time proportion (91%–95%), and intermittent hypoxia frequency. Correlation analysis, multivariable logistic regression, and ROC analyses were performed.ResultsROP incidence was 12.97% (107/825) and increased with decreasing gestational age (1.21%, 25.80%, and 59.57%, respectively; P < 0.001). Compared with mild ROP, severe ROP showed longer oxygen duration, higher FiO2 exposure, more intermittent hypoxia episodes, and lower SpO2 target range time proportion (all P < 0.05). After adjustment for gestational age, birth weight, and surfactant use, none of the oxygen-related parameters remained independently associated with severe ROP. ROC analysis among infants with ROP showed moderate discrimination for individual oxygen parameters (AUC: 0.705–0.761), whereas models incorporating oxygen parameters showed limited improvement beyond gestational age and birth weight.ConclusionEarly oxygen-related parameters were associated with ROP severity but showed limited independent discriminative value beyond gestational age and birth weight. They may represent candidate markers for risk characterization, although prospective validation is required before clinical application.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1886291</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1886291</link>
        <title><![CDATA[Sensory afferent electrical stimulation to improve upper limb function in children with hemiparesis – a randomised controlled trial (SenseUp study protocol)]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Alisa Gschaidmeier</author><author>Kim Lory</author><author>Kevin Möri</author><author>André Moser</author><author>Tobias Nef</author><author>Kathleen Seidel</author><author>Cristina Simon-Martinez</author><author>Miriam Von Gunten</author><author>Jonathan Wermelinger</author><author>Roland Wiest</author><author>Regula Everts</author><author>Sebastian Grunt</author>
        <description><![CDATA[BackgroundChildren with hemiparesis present with sensory and motor deficits, which negatively affect quality of life. Sensory Afferent Electrical Stimulation (SAES) triggers action potentials in afferent nerve fibers, leading to increased sensorimotor afferent input. While proven effective in adults after stroke and safe in children with cerebral palsy through small studies, a systematic and large-scale investigation in the pediatric population is still missing. This protocol describes a study designed to investigate the efficacy and mechanisms of SAES.MethodsWe will recruit 34 children and adolescents with spastic hemiparesis to participate in the prospective, single center, randomized controlled Bayesian phase II trial with a 5-week intervention period and a follow-up examination after 12 weeks. Participants will be randomly assigned to a 5-week SAES intervention or a control group consisting of treatment as usual. Before and after the SAES as well as at 12-week follow-up, clinical measures will be used to assess bimanual and unimanual hand functions (primary outcome: Assisting Hand Assessment AHA). Accelerometry and contactless motion tracking will be applied to evaluate everyday life upper limb functions. Neurophysiological methods such as structural and functional Magnetic Resonance Imaging and Transcranial Magnetic Stimulation will be performed to gain insight into neuroplastic mechanisms underlying SAES and are considered secondary outcomes.DiscussionPrevious studies were limited by small cohorts and narrow outcome measures. Our study addresses these gaps while additionally investigating underlying neurophysiological mechanisms in children using MRI and TMS, providing a scientific basis for implementing such stimulation in practice.Clinical Trial Registrationclinicaltrials.gov, identifier (NCT06536634); kofam.ch, identifier (SNCTP000005950).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1894739</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1894739</link>
        <title><![CDATA[Thumb posterior rotation deformity: a neglected deformity in children with thumb polydactyly]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>ZiHua Lin</author><author>Lin Ye</author><author>LiuQing Liao</author><author>DiHao Tang</author><author>XueMei Lin</author><author>WeiZhe Shi</author><author>JianQun Wang</author><author>YiQiang Li</author>
        <description><![CDATA[PurposeTo investigate the incidence and risk factors of thumb posterior rotation deformity in children with thumb polydactyly.MethodsA retrospective analysis was conducted on the clinical data of 479 patients (521 thumbs, mean age 13.1 ± 12.7 months) with thumb polydactyly. Clinical data including gender, age, and affected side were collected. Clinical appearance photographs and x-ray images of all patients were obtained. Thumb posterior rotation deformity was determined on clinical appearance photographs. The ulnar deviation angle of the thumb was measured on anteroposterior thumb radiographs.ResultsAccording to the Wassel classification, 13 thumbs (2.5%) were Type I, 55 thumbs (10.6%) Type II, 92 thumbs (17.7%) Type III, 186 thumbs (35.7%) Type IV, 138 thumbs (26.5%) Type V, 34 thumbs (6.5%) Type VI, and 3 thumbs (0.6%) Type VII. According to the Wu classification, 222 thumbs (42.6%) were type A, 27 thumbs (5.2%) were type B, 121 thumbs (23.2%) were type C, and 151 thumbs (29%) were type D. A total of 35 hands (6.7%) presented with varying degrees of thumb posterior rotation deformity, with a mean rotational angle of 14.1°±9.0° (range, 5°–30°). Wassel classification and Wu classification were correlated with the incidence of thumb posterior rotation deformity. Patients with thumb posterior rotation deformity had a significantly larger ulnar deviation angle of the thumb (19.3°±17.5°) than those without (11.4°±15.7°). Logistic regression analysis demonstrated that both the level and the type of the bifurcation of the duplicated thumb and ulnar deviation angle of the thumb were independent risk factors for the occurrence of thumb posterior rotation deformity (P < 0.05).ConclusionsThumb posterior rotation deformity is a common malformation in pediatric thumb polydactyly. The incidence of thumb posterior rotation deformity is significantly increased in patients with Wassel types IV, V, and VI thumb polydactyly, and thumb ulnar deviation also significantly elevates the risk of thumb posterior rotation deformity.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1887012</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1887012</link>
        <title><![CDATA[Prognostic implications of CD123 in pediatric B-cell acute lymphoblastic leukemia: a single-center retrospective analysis]]></title>
        <pubdate>2026-08-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Zheng Li</author><author>Qinfa Chen</author><author>Zhiyong Zhou</author><author>Fei He</author>
        <description><![CDATA[IntroductionAcute lymphoblastic leukemia (ALL) is the most common pediatric hematologic malignancy, with the majority of cases being of B-cell origin. While many patients respond favorably to therapy, a subset experiences early relapse or poor outcomes, underscoring the critical need for reliable prognostic biomarkers. This study investigated the significance of CD123 expression in diagnosing the disease, evaluating therapeutic efficacy, and predicting prognosis in pediatric B-cell ALL (B-ALL).MethodsThis retrospective study included 305 pediatric patients with B-ALL admitted to our hematology department from January 2016 to December 2021. All patients were treated following the CCCG-ALL-2015 protocol. Based on flow cytometric evaluation, patients with ≥20% or <20% CD123-expressing blasts were stratified into CD123-positive (CD123+) and CD123-negative (CD123−) groups, respectively.ResultsCD123 was expressed on the leukemic blasts of 60.3% of patients, exhibiting a strong positive correlation with CD34 expression (P < 0.001). CD123 positivity was substantially associated with specific genetic abnormalities. Specifically, the frequencies of the ETV6::RUNX1 and TCF3::PBX1 fusion genes were significantly lower in the CD123+ group than in the CD123− group. The 5-year event-free survival (EFS) rate was significantly higher in the CD123+ group than in the CD123− group (P = 0.027). This favorable prognostic impact was particularly pronounced in patients exhibiting minimal residual disease (MRD) positivity on day 19 (P = 0.006). Furthermore, combining CD123 status with day 19 MRD enabled more accurate identification of patients with a poor prognosis.DiscussionCD123 positivity on leukemic blasts correlates with distinct genetic profiles and favorable clinical outcomes in pediatric B-ALL. Ultimately, integrating CD123 status with early treatment response facilitates accurate risk stratification and guides personalized therapeutic strategies.]]></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.2026.1871728</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.2026.1857511</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.2026.1921366</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1921366</link>
        <title><![CDATA[A scoping review exploring the health impact and sustainability of collaborative paediatric heart disease treatment programmes in developing countries]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>S. K. Sulaiman</author><author>N. Hamza</author><author>M. Martin-Khan</author>
        <description><![CDATA[IntroductionThe global burden of paediatric heart disease is increasing with widening disparities between developed countries and developing economies. In the last two decades, mortality and morbidity rates have markedly improved in developed nations, however they continue to rise in developing countries. Collaborative treatment programmes are crucial for bridging this gap where the necessary healthcare infrastructure is lacking. This scoping review aims to map the health impact, economic outcomes, and capacity building initiatives of collaborative paediatric heath disease treatment programmes in developing countries.MethodsA comprehensive search was conducted across MEDLINE, Embase and Global Health from inception to May 5th, 2024. Studies were screened by title and abstract, followed by full-text review, applying predefined inclusion and exclusion criteria. Data on patient and programme characteristics, mortality rates, economic impact and capacity-building initiatives were extracted and analysed.ResultsThe review included 35 studies. Thirty studies reported on mortality rates which ranged from 0% to 12.4%. Nine studies reported on mortality pre and post programme with a 4% to 41% reduction in mortality. Many studies included capacity building initiatives within their programmes. This included: Training and Education (n = 26); Infrastructure Development (n = 13); and Systems Strengthening (n = 18). Long-term programmes placed more than double the emphasis on systems strengthening approaches compared to short-term missions.ConclusionOur review extensively maps the various characteristics and approaches of collaborative paediatric heart disease programmes. Overall, the findings suggests that these initiatives have the potential to provide favourable clinical outcomes and if setup appropriately they can support development of local expertise, improve healthcare infrastructure, and promote self-sustaining services in developing countries. A multi-faceted approach is required to improve paediatric cardiac care globally. Evidence evaluating long term impact and sustainability remains limited and further research is required to better understand how collaborative models can be optimised to support equitable and sustainable paediatric cardiac care globally.]]></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.2026.1911388</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>
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