Nitin Vidyasagar BS , Samuel R. Bunting MD, MSHA , Sarah Shapiro BS , Madan Kumar DO , Nicola M. Orlov MD, MPH , Maria A. Alkureishi MD
{"title":"Trends in Parallel Applications to Pediatrics Residency in the United States Between 2009-2023","authors":"Nitin Vidyasagar BS , Samuel R. Bunting MD, MSHA , Sarah Shapiro BS , Madan Kumar DO , Nicola M. Orlov MD, MPH , Maria A. Alkureishi MD","doi":"10.1016/j.jpeds.2025.114777","DOIUrl":"10.1016/j.jpeds.2025.114777","url":null,"abstract":"<div><h3>Objective</h3><div>We analyzed the trends in application to Pediatrics residency with concurrent application to one or more other specialties (parallel applications) between 2009 and 2023.</div></div><div><h3>Study design</h3><div>A retrospective analysis of custom Association of American Medical Colleges Electronic Residency Application Service data of applicants to Pediatrics residency between 2009 and 2023 was conducted. Descriptive statistics and linear regressions were used to identify trends of the percent parallel applying as well as the mean number of specialties and applications submitted. We used descriptive statistics to characterize common specialty combinations with Pediatrics.</div></div><div><h3>Results</h3><div>The present analysis examined data representing 81 138 unique Pediatrics applicants. The proportion of Pediatrics parallel applicants (65.9% vs 48.4%, <em>P</em> < .001) and the mean number of specialties applied to (4.1 to 3.9, <em>P</em> < .001) declined from 2009 to 2023. The proportion of international medical graduates (IMG) (88.9% [n = 4468] vs 76.5% [n = 1906]; B = −0.90, <em>P</em> < .001) parallel applying decreased while the proportion of MD applicants (17.3% [n = 370] vs 22.1% [n = 485]; B = 0.56, <em>P</em> = .03) parallel applying increased between 2009 and 2023. During that period, the proportion of DO (32.9% [n = 116] vs 34.0% [n = 291]; B = −0.06, <em>P</em> = .21) applicants parallel applying did not significantly increase. Internal medicine (66.9%) and family medicine (60.7%) were the most common specialty combinations for parallel applicants in 2023. Between 2009 and 2023, the mean applications increased for single-specialty (25.3 vs 51.0; <em>P</em> < .001) and parallel applicants (119.7 vs 146.3; <em>P</em> < .001). IMG (127.1 vs 164.6; <em>P <</em> .001), DO (43.5 vs 119.8; <em>P <</em> .001) and MD (53.4 vs 90.0; <em>P <</em> .001) parallel applicants all experienced significant increases in the mean number of applications submitted.</div></div><div><h3>Conclusions</h3><div>Although fewer applicants are applying to Pediatrics, around 50% of Pediatrics applicants parallel applied with the proportion of parallel applicants decreasing among IMG applicants and increasing among medical doctor applicants. Medical schools, residency programs, and application systems should revisit residency advising and application limits to reduce the strain of parallel application on applicants and residency programs.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"286 ","pages":"Article 114777"},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel G. Greenberg , Jason Lang , P. Brian Smith , Prem Shekhawat , Sherry E. Courtney , Mark L. Hudak , Fernando Moya , Anjali Iyengar , Alaa Eldemerdash , Barry Bloom , Mitzi Go , Mina Hanna , Lawrence Rhein , Sofia Aliaga , Tamorah Lewis , Aprille Febre , Autumn S. Kiefer , Varsha Bhatt-Mehta , Joseph A. Khoury , David Selewski , Matthew Laughon
{"title":"Corrigendum to “Furosemide Safety in Preterm Infants at Risk for Bronchopulmonary Dysplasia: A Randomized Clinical Trial” J Pediatr. 2025 Apr 28;283:114629","authors":"Rachel G. Greenberg , Jason Lang , P. Brian Smith , Prem Shekhawat , Sherry E. Courtney , Mark L. Hudak , Fernando Moya , Anjali Iyengar , Alaa Eldemerdash , Barry Bloom , Mitzi Go , Mina Hanna , Lawrence Rhein , Sofia Aliaga , Tamorah Lewis , Aprille Febre , Autumn S. Kiefer , Varsha Bhatt-Mehta , Joseph A. Khoury , David Selewski , Matthew Laughon","doi":"10.1016/j.jpeds.2025.114734","DOIUrl":"10.1016/j.jpeds.2025.114734","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"285 ","pages":"Article 114734"},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Information for Readers","authors":"","doi":"10.1016/S0022-3476(25)00281-1","DOIUrl":"10.1016/S0022-3476(25)00281-1","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"284 ","pages":"Article 114740"},"PeriodicalIF":3.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertension in Childhood Nephrotic Syndrome","authors":"Joseph T. Flynn MD, MS","doi":"10.1016/j.jpeds.2025.114746","DOIUrl":"10.1016/j.jpeds.2025.114746","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"284 ","pages":"Article 114746"},"PeriodicalIF":3.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly Quinn MD , Rachel Rosen MD , Rachel D'Anna MB , Suzanne E. Dahlberg PhD , Tregony Simoneau MD
{"title":"The Impact of Inhaled Corticosteroids on Lung Inflammation and Clinical Outcomes in Children with Oropharyngeal Dysphagia","authors":"Kelly Quinn MD , Rachel Rosen MD , Rachel D'Anna MB , Suzanne E. Dahlberg PhD , Tregony Simoneau MD","doi":"10.1016/j.jpeds.2025.114764","DOIUrl":"10.1016/j.jpeds.2025.114764","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether inhaled corticosteroids (ICS) decrease airway inflammation and hospitalization risk in children with laryngeal penetration or aspiration inferior to the vocal cords.</div></div><div><h3>Study design</h3><div>We performed a retrospective cohort study of 103 children younger than 24 months who had penetration/aspiration determined by initial videofluoroscopic swallowing study (VFSS) between July 2021 and July 2022 and subsequently had a flexible bronchoscopic examination performed at our quaternary care center. Patients were grouped based on exposure to ICS for at least two weeks at the time of bronchoscopy. We compared bronchoalveolar lavage (BAL) neutrophil percentage, qualitative BAL bacterial cultures, and time to first hospitalization after VFSS between groups, using regression analyses. Cox proportional hazards model was performed for analyses of time to hospitalization.</div></div><div><h3>Results</h3><div>Patients prescribed ICS were more likely to have elevated BAL neutrophil percentage (33% vs 15%, OR 2.95; 95% CI 1.08-8.35) and positive bacterial cultures (57% vs 30%, OR 3.41; 95% CI 1.30-9.50), after adjusting for comorbidities. After multivariable analyses, treatment with ICS did not appear to reduce time to hospitalization (hazard ratio 1.06, 95% CI 0.42-2.67), although the number of hospitalizations in both groups was small.</div></div><div><h3>Conclusions</h3><div>In this single-center, retrospective study, ICS was associated with elevated percentage of BAL neutrophils and positive BAL bacterial cultures in children with penetration/aspiration as determined by VFSS. The practice of using of ICS in this population is not supported.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114764"},"PeriodicalIF":3.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brijesh Sathian PhD, Javed Iqbal RN, MHA, Syed Muhammad Ali MBBS, FCPS
{"title":"Acute Mastoiditis in the Postpandemic Era: A Re-Emerging Threat to Children","authors":"Brijesh Sathian PhD, Javed Iqbal RN, MHA, Syed Muhammad Ali MBBS, FCPS","doi":"10.1016/j.jpeds.2025.114767","DOIUrl":"10.1016/j.jpeds.2025.114767","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"286 ","pages":"Article 114767"},"PeriodicalIF":3.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Mukerji MD , Brooke Read RRT , Yi-Chen Su MSc , Caio Barbosa de Oliveira MD , Deepak Louis MD , Hala Makary MD , Jill Zwicker OT, PhD , Karen Thomas MD , Michael Dunn MD , Prakesh S. Shah MD
{"title":"Severity of Bronchopulmonary Dysplasia Using a Contemporary Canadian Definition and Early Childhood Outcomes: A Population-Based Cohort Study","authors":"Amit Mukerji MD , Brooke Read RRT , Yi-Chen Su MSc , Caio Barbosa de Oliveira MD , Deepak Louis MD , Hala Makary MD , Jill Zwicker OT, PhD , Karen Thomas MD , Michael Dunn MD , Prakesh S. Shah MD","doi":"10.1016/j.jpeds.2025.114763","DOIUrl":"10.1016/j.jpeds.2025.114763","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the association between a bronchopulmonary dysplasia (BPD) definition used by the Canadian Neonatal Network (CNN) for grading and childhood outcomes and to compare that with the Neonatal Research Network (NRN) 2019 BPD definition.</div></div><div><h3>Study design</h3><div>We conducted a population-level, retrospective cohort study of neonates born at <29 weeks’ gestational age and admitted to Canadian tertiary neonatal intensive care units within the CNN for whom follow-up data were available. Eligible neonates admitted between 2016 and 2020 were categorized as having no, mild, moderate, or severe BPD. The primary outcomes were significant respiratory morbidity during early childhood and significant neurodevelopmental impairment (sNDI), both with and without mortality, by age 18-24 months.</div></div><div><h3>Results</h3><div>Of 5511 eligible neonates, 3816 were included in this study after excluding 1695 without follow-up data. The CNN BPD definition was associated with a significant increase in respiratory morbidity (±mortality) for both moderate and severe BPD (vs no BPD), and the definition was associated with an increase in sNDI (±mortality) for severe BPD (vs no BPD) only. Using the NRN 2019 BPD definition, significant respiratory morbidity (±mortality) was associated with all grades of BPD (vs no BPD), and an increase in sNDI (±mortality) was associated only with grade 3 BPD (vs no BPD).</div></div><div><h3>Conclusions</h3><div>There is a graded association between BPD and long-term childhood outcomes. With use of the CNN definition of BPD, both moderate and severe BPD were associated with respiratory morbidity, whereas only severe BPD was associated with sNDI.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114763"},"PeriodicalIF":3.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ria Pal MD , Gabrielle Russo Barsh MD, PhD , Ingrid Luo MS , Hisham Dahmoush MBBCh , Sarah Lee MD , Elizabeth Mayne MD, PhD
{"title":"Radiographic Severity of Neonatal Deep Medullary Venous Thrombosis is Associated with Neurodevelopmental Impairment","authors":"Ria Pal MD , Gabrielle Russo Barsh MD, PhD , Ingrid Luo MS , Hisham Dahmoush MBBCh , Sarah Lee MD , Elizabeth Mayne MD, PhD","doi":"10.1016/j.jpeds.2025.114769","DOIUrl":"10.1016/j.jpeds.2025.114769","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between severity of brain magnetic resonance imaging (MRI) findings and neurodevelopmental impairment (NDI) among neonates with radiographically identified deep medullary vein thrombosis (DMVT) and to develop an MRI grading system to help predict clinical outcomes.</div></div><div><h3>Study design</h3><div>We conducted a retrospective cohort study of infants admitted to a single, tertiary care hospital and diagnosed as having DMVT identified by brain MRI from January 1990 to March 2023. Clinical characteristics, MRI features, and neurodevelopmental assessments were analyzed. An MRI grading system was created to categorize the severity of radiographic injury as mild, moderate, or severe.</div></div><div><h3>Results</h3><div>Among 63 neonates diagnosed with DMVT, 41 exhibited moderate to severe MRI lesions. These patients were more likely to experience NDI than those with mild lesions (adjusted OR 24.3, 95% CI 4.7-180.2, <em>P</em> < .001). Follow-up data were available for 52 infants, of whom 40.4% developed NDI. MRI severity emerged as the strongest predictor of impaired outcomes, independent of other clinical factors such as gestational age, Apgar score, or seizures at presentation.</div></div><div><h3>Conclusions</h3><div>Neonates with moderate or severe DMVT on MRI are at risk for NDI. The proposed MRI grading system may be a valuable classification and prognostication tool for clinicians and researchers managing DMVT in neonates.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114769"},"PeriodicalIF":3.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nasopharyngeal Prongs versus RAM Cannula for Delivering Noninvasive Positive Pressure Ventilation: An Open-Label, Randomized Controlled Trial","authors":"Mahima Rajan MD, Supreet Khurana DM, Suksham Jain DM, Deepak Chawla DM","doi":"10.1016/j.jpeds.2025.114762","DOIUrl":"10.1016/j.jpeds.2025.114762","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of nasopharyngeal (NP) prongs and RAM cannula in preventing the need for invasive ventilation among preterm neonates receiving noninvasive positive pressure ventilation (NIPPV).</div></div><div><h3>Study design</h3><div>This was an open-label, randomized controlled trial conducted in the neonatal intensive care unit of a tertiary care hospital in India. A total of 150 neonates born at 28<sup>0/7</sup> to 36<sup>6/7</sup> weeks of gestation who required NIPPV were randomized to receive NIPPV via either NP prongs or a RAM cannula. Randomization was stratified by gestation at birth and timing of support (primary or postextubation). The primary outcome was the proportion of neonates requiring invasive ventilation within 72 hours of randomization. Secondary outcomes included the need for invasive ventilation from 72 hours to 7 days after NIPPV initiation, as well as the incidence of nasal trauma.</div></div><div><h3>Results</h3><div>Baseline characteristics, including birth weight, gestational age, and respiratory morbidities, were comparable between groups. Invasive ventilation within 72 hours of NIPPV initiation was required in 33% of neonates in the NP prongs group and 28% in the RAM cannula group (relative risk: 1.17, 95% CI: 0.72-1.89; <em>P</em> = .44). No significant interaction was observed between the primary outcome and the stratification variables. The incidence and severity of nasal injury, duration of respiratory support, and other secondary outcomes were also similar across groups.</div></div><div><h3>Conclusions</h3><div>Among preterm neonates receiving NIPPV, NP prongs and a RAM cannula showed comparable efficacy in preventing the need for invasive ventilation. Further research is warranted to confirm these findings in larger and more diverse populations.</div></div><div><h3>Trial registration</h3><div>Clinical Trial Registry of India (CTRI/2023/07/055835).</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114762"},"PeriodicalIF":3.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}