Provision of invasive mechanical ventilation (IMV) in the neonatal intensive care has seen a steady rise in low-esource settings (LRS). However, outcomes among those exposed to IMV remain under-reported, with the current evidence base being restricted to single-centre observational studies, thus limiting comparative analyses and effective healthcare planning. This study aims to estimate the pooled proportion of mortality and morbidity among neonates exposed to IMV in low-resource settings. Medline, Embase, and CENTRAL were searched until 22 August 2025. Randomised and non-randomised studies were included. Two reviewers, blinded to each other, extracted data independently. Proportion-based meta-analyses using random-effects model were performed. Risk of bias was assessed using ROBINS-E, and evidence-certainty was evaluated using the GRADE approach. One hundred of 117 studies were included, with most conducted in South Asia. In-hospital mortality was reported in 68 studies (7193 neonates), with a pooled estimate of 45
Artificial intelligence (AI) has potential to revolutionize radiology, yet current solutions and guidelines are predominantly focused on adult populations, often overlooking the specific requirements of children. This is important because children differ significantly from adults in terms of physiology, developmental stages, and clinical needs, necessitating tailored approaches for the safe and effective integration of AI tools. This multi-society position statement systematically addresses four critical pillars of AI adoption: (1) regulation and purchasing, (2) implementation and integration, (3) interpretation and post-market surveillance, and (4) education. We propose pediatric-specific safety ratings, inclusion of datasets from diverse pediatric populations, quantifiable transparency metrics, and explainability of models to mitigate biases and ensure AI systems are appropriate for use in children. Risk assessment, dataset diversity, transparency, and cybersecurity are important steps in regulation and purchasing. For successful implementation, a phased strategy is recommended, involving early pilot testing, stakeholder engagement, and comprehensive post-market surveillance with continuous monitoring of defined performance benchmarks. Clear protocols for managing discrepancies and adverse incident reporting are essential to maintain trust and safety. Moreover, we emphasize the need for foundational AI literacy courses for all healthcare professionals which include pediatric safety considerations, alongside specialized training for those directly involved in pediatric imaging. Public and patient engagement is crucial to foster understanding and acceptance of AI in pediatric radiology. Ultimately, we advocate for a child-centered framework for AI integration, ensuring that the distinct needs of children are prioritized and that their safety, accuracy, and overall well-being are safeguarded.
BACKGROUND:Innovative pedagogical approaches such as flipped classrooms, problem-based learning, simulation, and blended digital approaches are increasingly integrated into dental curricula worldwide, yet their comparative effectiveness over traditional lecture-based instruction remains unclear. This systematic review and meta-analysis sought to assess the effects of innovative pedagogical frameworks on the knowledge, competencies, and satisfaction levels of students within the realm of dental education. METHODS:An extensive search of PubMed, Web of Science, Scopus, and the Cochrane Library was performed for research articles published from January 2000 to August 2025, adhering to the PRISMA 2020 guidelines. Eligible randomized controlled, quasi-experimental, and cross-sectional studies comparing innovative and lecture-based instruction were screened and appraised using RoB 2, ROBINS-I, and JBI tools. RESULTS:Among the 61 studies included in this analysis, 31 fulfilled the criteria for quantitative synthesis, representing a total of 8742 students from 23 nations, while the remaining 30 studies were synthesized narratively. Pooled analysis of student performance outcomes (knowledge and clinical skill scores) using a random-effects model (inverse-variance method) demonstrated a significant moderate effect favoring innovative approaches (standardized mean difference = 0.42; 95% CI 0.27-0.57; p < 0.001) with substantial heterogeneity (I2 = 83%). Simulation-based, flipped-classroom, and blended formats showed the largest performance gains and were generally associated with higher student satisfaction and engagement, whereas digital learning was perceived as more flexible but required adequate technical support. CONCLUSIONS:Within the limitations of available data, innovative teaching strategies moderately improve dental students' performance and satisfaction compared with traditional lectures.
Objective: Tracheostomy in the pediatric population is a technical and demanding procedure due to the smaller, more pliable trachea and the limited exposure of the operating field. It has been documented to have higher morbidity and mortality, especially among low birth weight and pre-term infants. A review of the existing literature shows that indications, epidemiology, and complications are changing dynamically, and no definite guidelines have been established. Methods: A five-year retrospective observational study on pediatric tracheostomy was carried out at a pediatric tertiary care center. All children aged between 1 day and 18 years who had undergone tracheostomy were included. Case records of all children were analyzed meticulously for age, sex, indications, procedure, and complications of tracheostomy. Results: During the study period, 148 children underwent tracheostomy at our pediatric tertiary care center. The most common indication for tracheostomy was neurological causes, noted in 77 patients (52.02%). The most common early postoperative complication was tube obstruction in 13 patients (8.78%), and the most common delayed postoperative complication was suprastomal collapse in 52 patients (35.13%). In total, 104 patients (70.27%) underwent successful decannulation. Conclusion: Pediatric tracheostomy is a very demanding and challenging procedure owing to the alterations in the neck anatomy, variations in the airway, and several associated complications. There is a growing need to know the change in indications, complications, and overall outcome of pediatric tracheostomies for better care and efficient management of children requiring tracheostomies.
Autoinflammatory disorders (AIDs) are a clinically heterogeneous group of inborn errors of immunity primarily caused by dysregulation in the innate immune system. Clinical diagnosis is often challenging due to clinical heterogeneity and the overlapping phenotypes with other inborn errors of immunity and monogenic conditions that mimic AIDs. Worldwide, and especially in India, there is a lack of systematic large cohort studies employing genomic testing early in the course of evaluation for individuals with autoinflammatory disease. Herein, we describe our experience using exome sequencing as a first-tier investigation in evaluating 202 individuals from 196 unrelated families with possible monogenic AIDs. Consanguinity was noted in 19% of the families. Recurrent fever was the most common manifestation (90%), frequently associated with arthritis (54%), skin lesions (38%), hepatosplenomegaly (23%), oral ulcers (21%) and lymphadenopathy (21%). Exome sequencing could identify a molecular diagnosis in 50 of 196 (25%) families of whom 30 (60%) had variants in genes associated with monogenic AIDs, 10 (20%) had other distinct inborn errors of immunity and 10 (20%) had monogenic conditions with phenotypic overlap with AIDs. We identified 21 variants in genes associated with monogenic AIDs, of which 20 (95%) were single nucleotide variants and one (5%) was a copy number variant. Notably, seven (33%) of the 21 variants were novel. This study highlights the diagnostic challenges posed by phenotypic overlap in this group of disorders and demonstrates the utility of exome sequencing in enabling a timely diagnosis, including conditions that mimic AIDs thereby facilitating targeted therapy and genetic counseling.
