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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>2026-08-10T17:31:43.583+00:00</pubDate>
        <ttl>60</ttl>
        <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.2026.1889280</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.2026.1918653</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.2026.1837801</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.2026.1888442</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.2026.1902579</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.2026.1730779</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>
      </item><item>
        <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>
      </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.2026.1903927</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>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1859038</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1859038</link>
        <title><![CDATA[Geographical inequalities in skin-to-skin contact after birth among women in Somaliland: a multilevel and spatial analysis of the 2020 survey]]></title>
        <pubdate>2026-08-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Abdiasis Aden Omer</author><author>Hamda Jama Yousuf</author><author>Mohamed Hussein Egeh</author><author>Ahmed Abdirahman Farah</author><author>Ali Ahmed Hussein</author><author>Fatima Nouh Ismail</author><author>Bashir Mohamed Mohamoud</author>
        <description><![CDATA[BackgroundSkin-to-skin contact (SSC) after birth is a proven, low-cost intervention that improves neonatal survival and promotes early breastfeeding. This study aimed to assess the prevalence, determinants, and geographical inequalities of SSC after birth among women in Somaliland.MethodsA cross-sectional study was conducted using data from the 2020 Somaliland Demographic and Health Survey. A nationally representative sample of women aged 15–49 years who had a live birth within five years preceding the survey was included. Multilevel mixed-effects logistic regression analysis was employed to identify individual- and community-level factors associated with SSC. Model fitness was assessed using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Spatial analysis was performed using R software to examine geographic variation, including hotspot analysis (Getis-Ord Gi*) and Local Moran's I to identify clustering patterns.ResultsThe prevalence of skin-to-skin contact after birth was 24.81%. Significant regional variation was observed, with higher prevalence in western regions and lower prevalence in eastern regions. In the multilevel analysis, women residing in Marodijeh (AOR = 0.36; 95% CI: 0.23–0.56), Sool (AOR = 0.48; 95% CI: 0.34–0.68), and Sanaag (AOR = 0.54; 95% CI: 0.34–0.86) had lower odds of practicing SSC compared to Awdal. At the individual level, wealth index, antenatal care utilization, place of delivery, pregnancy wantedness, and child size at birth were significantly associated with SSC. Women who delivered in health institutions had significantly higher odds of practicing SSC (AOR = 6.09; 95% CI: 4.39–8.45). Spatial analysis revealed significant clustering of low SSC practice in eastern regions, indicating clear geographic inequalities.ConclusionThe prevalence of skin-to-skin contact in Somaliland remains low, with substantial socioeconomic and geographic disparities. Both individual and community-level factors influence its practice, with institutional delivery emerging as the strongest predictor. Targeted interventions focusing on improving antenatal care utilization, promoting facility-based delivery, and addressing regional inequalities are essential to enhance the uptake of SSC and improve neonatal health outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1874110</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1874110</link>
        <title><![CDATA[Case Report: Synchronous ALK-positive laryngeal inflammatory myofibroblastic tumor and EGFR-mutant lung adenocarcinoma in a child]]></title>
        <pubdate>2026-08-06T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Guodun Zheng</author><author>Dengke Luo</author><author>Taozhen He</author><author>Miao Yuan</author><author>Gang Yang</author><author>Shiyi Dai</author><author>Chang Xu</author>
        <description><![CDATA[The concurrent occurrence of two histogenetically distinct tumors in a child is exceptionally uncommon and may create substantial diagnostic uncertainty. To the best of our knowledge, this is the first reported case of synchronous diagnosis of an ALK-rearranged inflammatory myofibroblastic tumor (IMT) of the larynx and EGFR-mutant lung adenocarcinoma. A 7-year-old boy presented with dyspnea and hoarseness. A laryngeal mass was resected and confirmed to be ALK-positive IMT harboring a THBS1-ALK rearrangement. PET-CT also detected a solitary lung nodule in the right lower lobe, which was initially considered possible metastatic IMT. However, serial chest CT over 22 months demonstrated only minimal, indolent enlargement, a pattern that was inconsistent with the expected behavior of metastatic disease. Because of this clinicoradiologic discrepancy, thoracoscopic wedge resection was performed for definitive diagnosis. Histopathology revealed acinar-predominant invasive adenocarcinoma of the lung that was positive for TTF-1, and Napsin A, and negative for ALK. Next-generation sequencing identified an EGFR exon 20 insertion (p.N771_P772insG) and a low tumor mutational burden. The discordant clinical behavior, isolated and indolent radiologic evolution, divergent histopathologic and immunophenotypic profiles, and distinct oncogenic drivers collectively supported a diagnosis of synchronous primary tumors rather than metastatic IMT. Because sequencing was limited to the DICER1 hotspot region, other hereditary cancer-predisposition mechanisms could not be definitively excluded. This case underscores the importance of longitudinal imaging, integrated pathology, and molecular profiling when presumed metastatic disease follows an atypical course pediatric oncology.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1869213</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1869213</link>
        <title><![CDATA[A novel double-lumen tracheal tube-assisted InSurE versus LISA in preterm infants with RDS: a multicenter randomized trial]]></title>
        <pubdate>2026-08-06T00:00:00Z</pubdate>
        <category>Clinical Trial</category>
        <author>Jin Gao</author><author>Hanmei Xiong</author><author>Chuanfeng Li</author><author>Weihong Yu</author><author>Jie Yang</author><author>Panrong Nie</author><author>Lingyun Bao</author><author>Hong Yang</author><author>Yuan Shi</author>
        <description><![CDATA[BackgroundNeonatal respiratory distress syndrome (NRDS) is a leading cause of mortality and long-term morbidity in preterm infants; however, safe and effective surfactant delivery to the neonatal lung remains challenging. We developed a novel dual-lumen tracheal tube (NDT) enabling surfactant administration without interrupting ventilation. This study aimed to evaluate the non-inferiority of the novel NDT-based technique compared with the Less Invasive Surfactant Administration (LISA) technique in reducing the need for early invasive mechanical ventilation.MethodsThe NDT, designed for a modified Intubation–Surfactant–Extubation (InSurE) technique (NDT-InSurE), features an embedded 0.2 mm channel. A multicenter, randomized controlled trial was conducted across six tertiary neonatal intensive care units (NICUs) in China. Preterm infants ≤ 32 weeks’ gestation with NRDS were randomly assigned to the NDT-InSurE group (n = 69) or the LISA group (n = 69). The primary outcome was the requirement for mechanical ventilation within 72 h of treatment initiation due to non-invasive ventilation failure. Secondary outcomes included key clinical outcomes and major complications associated with NRDS.ResultsBaseline characteristics were comparable between the two groups. The primary outcome occurred in 10 infants (14.5%) in the NDT-InSurE group and 13 (18.8%) in the LISA group (P = 0.493; 95% CI, −12.5% to 4.0%). The upper bound of the 95% confidence interval was below the prespecified non-inferiority margin of 20%, indicating that the NDT-InSurE technique met the prespecified criterion for non-inferiority. Secondary outcomes, including total procedure duration, intubation time, duration of invasive ventilation, non-invasive ventilation, oxygen therapy, and total hospitalization time, showed no significant differences between the two groups (all P > 0.05). However, post-intubation arterial pH was lower in the NDT-InSurE group than in the LISA group (7.27 [7.25–7.35] vs. 7.38 [7.32–7.42], P = 0.004). Moreover, the incidence of major complications, including bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity, and necrotizing enterocolitis, did not differ significantly between groups.ConclusionsNDT-InSurE may serve as a practical alternative to LISA, particularly in settings where LISA expertise or resources are limited. Further large-scale, multicenter studies with long-term follow-up are warranted to confirm these findings and further evaluate the efficacy and safety of this technique.Clinical Trial RegistrationThis study was registered at the China Clinical Trial Registry (https://www.chictr.org.cn/), Registration Number: ChiCTR2300076354.The registration date is October 7th, 2023.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1880763</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1880763</link>
        <title><![CDATA[The risk of developing severe bronchopulmonary dysplasia: evaluating associations with the nucleated red blood cell count at birth and volume of transfusions received]]></title>
        <pubdate>2026-08-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Bailey B. Zeiler</author><author>Timothy M. Bahr</author><author>Khanh V. Lai</author><author>Joel L. Addams</author><author>Elizabeth F. Stone</author><author>Erica A. Swenson</author><author>Robin K. Ohls</author><author>Robert D. Christensen</author>
        <description><![CDATA[IntroductionThe nucleated red blood cell (NRBC) count at birth and blood transfusions received prior to 36 weeks postmenstrual age (PMA) are both associated with the risk of developing retinopathy of prematurity (ROP). We examined the association of these two factors with the risk of developing bronchopulmonary dysplasia (BPD).MethodsWe retrospectively analyzed records of infants in five Intermountain Health Neonatal Intensive Care Units during the past four years who were born <32 weeks gestation, had an NRBC count at birth, and BPD scoring. We expressed NRBC counts as multiples of the control mean (MoM), with the control mean determined by the refineR algorithm. We report red blood cell (RBC) and platelet transfusions received before 36 weeks PMA.ResultsThe NRBC count of 896 infants was not independently associated with BPD risk. However, RBC transfusions received before 36 weeks were associated with BPD risk (p < 0.01). All 39 infants who developed severe BPD received multiple RBC transfusions (volume range 36–501 mL/kg) and 15 (38%) also received platelet transfusions (range 16–489 mL/kg).ConclusionsAn elevated NRBC count at birth is not an independent risk factor for developing severe BPD, but the number and volume of RBC transfusions received are associated factors.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1880157</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1880157</link>
        <title><![CDATA[Factors associated with delayed decannulation within 180 days after pediatric tracheostomy in the PICU: a retrospective cohort study]]></title>
        <pubdate>2026-08-05T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Wenmiao Xu</author><author>Jingya Sun</author><author>Jian Ji</author><author>Jiansheng Zeng</author><author>Zheng Li</author><author>Quan Wang</author><author>Chaonan Fan</author><author>Suyun Qian</author>
        <description><![CDATA[IntroductionLong-term decannulation outcomes after pediatric tracheostomy, particularly among children discharged from the pediatric intensive care unit (PICU), remain poorly described. This study aimed to describe the long-term decannulation outcomes and factors associated with delayed decannulation within 180 days after hospital discharge.MethodsWe retrospectively reviewed children aged 29 days to 18 years who underwent first-time tracheostomy in the PICU of Beijing Children's Hospital between January 2016 and December 2020. Follow-up data were obtained from medical records and standardized telephone interviews through August 31, 2025. The cumulative decannulation rate was estimated using the Kaplan–Meier analysis. Factors associated with delayed decannulation were analyzed using Cox regression. The discriminative ability of the independently associated factors in combination was assessed using receiver operating characteristic (ROC) curve analysis.ResultsAmong 234 children who underwent tracheostomy, 121 survivors with complete follow-up data were included in the final analysis. The median age at tracheostomy was 60 months (IQR, 15–111 months), and 30 patients (24.8%) were aged ≤1 year. At least one post-tracheostomy complication occurred in 66 children (54.5%), with late complications occurring in 62 children (51.2%). During final follow-up, 106 patients (87.6%) achieved successful decannulation, with a median time to decannulation of 126 days (IQR, 68–332). Within 180 days after discharge, 62 children (51.2%) achieved successful decannulation. Multivariable Cox regression analysis showed that age ≤1 year, obstructive airway disease, and poor cough reflex were independently associated with delayed decannulation within 180 days. The combination of these factors showed good discriminatory ability for 180-day decannulation status (AUC, 0.854; 95% CI, 0.783–0.926).ConclusionsProlonged tracheostomy dependence was common after PICU discharge, with approximately half of children remaining cannulated at 180 days. Infancy, obstructive airway disease, and poor cough reflex were independently associated with delayed decannulation. Ventilator dependence and late complications were also associated with delayed decannulation. These late complications included respiratory infections, tube-related events, swallowing or phonation disorders, granulation tissue formation, tracheocutaneous fistula, and tracheal stenosis or malacia. These findings highlight the importance of individualized airway assessment, effective secretion management, surveillance for late complications, and continued multidisciplinary follow-up after discharge.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1827163</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1827163</link>
        <title><![CDATA[Multimodal quantitative characterization and mechanistic exploration of paraspinal muscle groups in adolescent idiopathic scoliosis]]></title>
        <pubdate>2026-08-05T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ruibao Yang</author><author>ShangShang Ren</author><author>Jie Lin</author><author>Man Sun</author><author>Guangliang Jiang</author>
        <description><![CDATA[BackgroundThe mechanical properties of muscles and their interactions with three-dimensional spinal deformities are difficult to quantify with a single method. This study aimed to quantitatively characterize the paraspinal muscle groups in adolescent idiopathic scoliosis (AIS) using multimodal methods.MethodsThe patients with AIS who received corrective surgery at our hospital from June 1, 2025, to August 31, 2025 were enrolled in this prospective study. Two independent evaluators used 3.0T magnetic resonance imaging (MRI) and digital radiography (DR) to analyze parameters in the bilateral paraspinal muscle groups.ResultsThis study enrolled 25 patients with AIS, including 15 cases with lumbar curvature and 10 with thoracic curvature. There were significant differences in the multimodal quantitative characterization of the convex and concave sides of scoliosis in AIS patients (p < 0.05). On the concave sides of the lumbar curvature, the erector spinae, multifidus muscles and psoas major muscles showed a higher fat fraction, higher signal intensity, and smaller volume than those on the convex sides. The erector spinae muscle was significantly thicker on the concave side in lumbar curvature, and on the convex side in thoracic curvature. Two evaluators showed good intra- and inter-observer consistency, with intraclass correlation coefficients (ICC) ranging from 0.75 to 0.85. The Cobb angle showed almost no correlation with the flexibility index on the concave side. For cases of thoracic curvature, the maximum vertebral inclination angle showed a strong positive correlation with the erector spinae thickness ratio on the convex side (r = 0.85).ConclusionThe quantitative assessment results of this exploratory study using MRI and DR methods showed that muscle asymmetry in the paraspinal muscles may interact with three-dimensional spinal deformity in patients with AIS.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1900675</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1900675</link>
        <title><![CDATA[Inverted insulin to C-Peptide ratios in neonatal intensive care: is there something we don't know?]]></title>
        <pubdate>2026-08-05T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>J. Geoffrey Chase</author><author>Helen D. Shannon</author>
        <description><![CDATA[BackgroundInsulin (I) and C-Peptide (C) are secreted in equimolar amounts, but insulin clears more rapidly. Typical Insulin to C-Peptide ratios (I/C) are therefore <0.05–0.2 (1/20–1/5). Except in relatively rare cases, I/C > 1.0 are interpreted as evidence of exogenous or factitious insulin dosing. However, recently published data from pre-term neonates with no insulin dosing or family history of diabetes show far higher ratios. How can these “inverted” ratios happen without factitious insulin poisoning?HypothesisInsulin binding antibodies explain the incidence and magnitude of “inverted” I/C ratios in this NICU cohort?MethodA secondary analysis integrating three independent evidence streams with mechanistic modelling study. Three “siloed” areas of neonatal research were integrated: (1) paired insulin and C-Peptide measurements from two NICU cohorts (227 and 75 matched samples) from infants not receiving insulin and with no immediate family history of diabetes or insulin use illustrates the incidence of unexpected I/C > 0.1–0.2; (2) Analysis of direct measurements of affinity, displacement and binding-site capacity across 5 independent studies constrain neonatal binding affinity and concentration; and (3) Analysis of binding kinetics of reversible insulin-binding reactions. Results of #2–3 are combined with a clinically validated neonatal metabolic model to assess whether they could account for observed I/C > 1.0 from #1.ResultsFor #1, over 80% of NICU infants had I/C > 0.1 and 40% had I/C > 1.0 consistent with circulating bound insulin measured by some immunoassays. #2, Independent affinity measurements, displacement studies, direct concentration measurements, and reconstruction from I/C data converged on a dominant high-affinity, low-nanomolar binding regime. #3, Model-based analysis of antibody binding reactions reproduced the observed I/C ratios and high apparent insulin concentrations without requiring extreme assumptions.ConclusionHigh I/C ratios are not uncommon in NICU neonates and can be explained by high-affinity insulin-binding activity rather than insulin administration. Multiple independent quantitative analyses converge on a common high-affinity, low-nanomolar binding regime which reproduces observed I/C ratios. Critical illness, such as sepsis, significantly increases the levels and likelihood of unexpected high I/C ratios.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1902619</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1902619</link>
        <title><![CDATA[The applications, complications, and management of neonatal peripherally inserted central catheters (n-PICCs): a narrative review]]></title>
        <pubdate>2026-08-05T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Lei Yang</author><author>Qiaoling Fan</author><author>Lingyan Fan</author><author>Jiayu Qiu</author>
        <description><![CDATA[The neonatal peripherally inserted central catheters (n-PICCs) is a commonly used vascular access device in neonatal intensive care, yet its associated complications significantly affect patient outcomes. This narrative review aims to summarize current status of n-PICCs, major complications and risk factors, and evidence-based preventive strategies. A literature search was conducted in PubMed, Web of Science, and Embase for articles published between January 2000 and February 2026, and relevant studies were synthesized and discussed. The findings demonstrate that the incidence of n-PICCs-related complications ranges from 10% to 40%, encompassing catheter-related bloodstream infection, thrombosis, cardiac tamponade, and mechanical failure. Key risk factors include low birth weight, small gestational age, prolonged catheter dwell time, malposition of the catheter tip, and improper insertion site selection. In terms of preventive strategies, interventions such as ultrasound guidance, intracavitary electrocardiography, antimicrobial-impregnated catheters, tissue adhesive securement, and bundle care strategies have been associated with reductions in specific complications in observational and quasi-experimental studies, although the evidence quality varies, while specialized vascular access teams and standardized training serve as important foundations for ensuring procedural quality and patient safety. Based on these findings, this review proposes that neonatal vascular access management should shift from single-intervention approaches toward system-based frameworks. Integrating technical optimization, material selection, standardized procedures, and organizational management into a comprehensive safety system covering the full process-assessment, insertion, maintenance, removal, and monitoring-represents a key pathway for reducing complications and ensuring patient safety. Future research should focus on multicenter randomized controlled trials, improving risk prediction models, and advancing the clinical application of intelligent monitoring technologies and evidence-based practice dissemination.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1847049</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1847049</link>
        <title><![CDATA[A nomogram for predicting emergence agitation after laparoscopic high ligation of the hernia sac in children]]></title>
        <pubdate>2026-08-05T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Chun Liang</author><author>Xifeng Zhang</author><author>Lian Zhao</author>
        <description><![CDATA[BackgroundEmergence agitation (EA) is a frequent recovery complication in children and may compromise postoperative safety. This study aimed to develop and internally validate an exploratory model for predicting Pediatric Anesthesia Emergence Delirium (PAED)-defined EA after laparoscopic high ligation of the hernia sac.MethodsThis single-center retrospective prediction-model study screened 342 consecutive procedures performed from January 2022 to December 2024. Complete-case analysis included 287 children. The prediction time was immediately before planned tracheal extubation and before the first PAED assessment. After review of the original data-driven selection results, a post hoc four-predictor logistic model was constructed using age, baseline preoperative anxiety, sedative premedication, and intraoperative regional block. Conditional internal validation was performed using 1,000 bootstrap resamples.ResultsPAED-defined EA occurred in 93 children (32.4%). Increasing age was associated with lower odds of EA, whereas baseline preoperative anxiety was associated with higher odds; sedative premedication and intraoperative regional block were associated with lower odds. The model showed an apparent area under the receiver operating characteristic curve of 0.768 (95% confidence interval, 0.710–0.826) and an optimism-corrected value of 0.755. The optimism-corrected calibration slope and intercept were 0.943 and −0.028, respectively, and the corrected Brier score was 0.185.ConclusionsThe post hoc four-predictor nomogram showed moderate discrimination and acceptable internal calibration for estimating PAED-defined EA risk. Independent external validation and prospective clinical impact assessment are required before implementation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1862189</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1862189</link>
        <title><![CDATA[Efficacy and safety of ERAS protocols in pediatric laparoscopic appendectomy: a systematic review and meta-analysis]]></title>
        <pubdate>2026-08-05T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Di Wang</author><author>Rongkun Zhu</author><author>Xiaoxuan Ma</author><author>Jing Zhao</author><author>Cong Shang</author><author>Xiwei Hao</author>
        <description><![CDATA[BackgroundAcute appendicitis is the most common surgical emergency in children, and laparoscopic appendectomy has become the standard of care. Enhanced recovery after surgery (ERAS) protocols have demonstrated significant benefits in adult populations, but their application in pediatric emergency surgery remains less established.ObjectiveTo systematically evaluate the efficacy and safety of ERAS protocols compared with traditional perioperative care in children undergoing laparoscopic appendectomy for acute appendicitis.MethodsA systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI) from inception to March 2026. Randomized controlled trials (RCTs) comparing ERAS protocols with traditional perioperative care in pediatric patients undergoing laparoscopic appendectomy were included. The primary outcomes were postoperative hospital stay and time to first flatus; secondary outcomes included postoperative pain scores and total complications. Meta-analysis was performed using RevMan 5.4, with mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. Heterogeneity was assessed using the I2 statistic.ResultsEight RCTs comprising 1,135 pediatric patients were included. ERAS protocols significantly reduced postoperative hospital stay (MD: −2.04 days, 95% CI: −2.74 to −1.34, P < 0.00001, I2 = 96%), accelerated time to first flatus (MD: −7.51 h, 95% CI: −11.00 to −4.03, P < 0.0001, I2 = 99%), alleviated postoperative pain (MD: −1.70 on VAS 0–10, 95% CI: −2.72 to −0.68, P = 0.001, I2 = 99%), and reduced the risk of total postoperative complications (RR: 0.29, 95% CI: 0.15 to 0.58, P = 0.03, I2 = 54%). Sensitivity analyses confirmed the robustness of the findings.ConclusionsERAS protocols are effective and safe for children undergoing laparoscopic appendectomy, significantly reducing hospital stay, accelerating gastrointestinal recovery, alleviating postoperative pain, and lowering complication risk. These findings support broader adoption of ERAS in pediatric emergency surgical practice, while acknowledging that some components may already be integrated into routine care in certain settings, and that further optimization through day-surgery pathways is warranted for uncomplicated cases.]]></description>
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