Child sexual exploitation and abuse (CSEA) is prevalent worldwide. Yet, knowledge about potential perpetrators in the community is constrained by reliance on justice-involved and clinical samples, which limits external validity and obscures undetected behaviour. This study estimates population-level prevalence, demographic correlates, and co-endorsement patterns of men's self-reported sexual feelings, interests, and behaviours towards children. We analyse an anonymous online survey of 4,918 adult men quota-matched and weighted to national populations in Australia, the United Kingdom, and the United States. In pooled analyses, 8.0% reported sexual feelings towards children, 7.4% would likely have sexual contact with a child if undetected, 5.5% to 5.7% would watch child sexual abuse material or a webcam show, and 2.4% to 4.7% reporting engagement in online or contact offending. Prevalence estimates were consistently higher in the United States than in Australia and the United Kingdom. Age distributions generally showed peaks in early adulthood with subsequent decline, alongside later-life upticks for selected outcomes. Sociodemographic indicators linked to trust or access (higher income, being partnered, employment, university education, children in the household, and working with children) were consistently associated with multiple outcomes, with the largest effect sizes for men who live or work with children. Overlap analyses and a nodewise LASSO-based Ising network indicated coherent clusters (online behaviours, contact behaviour, and interest) with strong within-cluster and bridging connections. Findings support tiered prevention that distinguishes interest from behaviour, age-responsive strategies, and strengthened safeguards for child-contact roles, while providing cross-national baselines to inform surveillance, resource allocation, and targeted intervention.

BDP/FF/GB single-inhaler triple therapy in COPD: real-world effectiveness, safety, and adherence in a pooled analysis of 5,000 patients.

Healthy aging is a major public health priority, particularly for women, who have a longer life expectancy and a high prevalence of conditions associated with frailty, sarcopenia, and loss of functional independence. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effects of functional exercise on physical and psychosocial outcomes in women over 60 years of age. A systematic review and meta-analysis was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library up to September 2025. Only randomized controlled trials involving women aged 60 years and older who participated in functional exercise interventions were included. Methodological quality was assessed with the PEDro scale, and pooled analyses were conducted using standardized mean differences (SMD) with 95% confidence intervals. Seventeen randomized controlled trials with a total of 968 participants met the inclusion criteria. Meta-analyses showed that functional exercise significantly improved physical capacities, including functionality (SMD = 0.81; 95% CI = 0.62 to 0.99), strength (SMD = 0.51; 95% CI = 0.11 to 0.91), and power (SMD = 0.28; 95% CI = 0.10 to 0.46). Additional evidence suggested improvements in psychosocial outcomes and reductions in proinflammatory cytokines, although results were more heterogeneous. The overall methodological quality of the included studies was moderate to high. Functional exercise may be a beneficial strategy to enhance physical and psychosocial capacities in women over 60 years of age. It may also contribute to modulating inflammatory and immunosenescence-related responses; however, the evidence remains limited and should be interpreted with caution. Further high-quality studies are needed to support its integration into healthy aging and preventive care programs.

• High-frequency vertex MST rapidly reduces suicidal ideation in severe depression • Suicidality remission achieved in 76.5% of patients with treatment-resistant depression • MST reduces suicidal urge within hours, indicating rapid within-session effects • Reductions in suicidality correlate with improvements in depression and anxiety • MST is well tolerated and may serve as an alternative to ECT or ketamine Magnetic seizure therapy (MST) is novel treatment for severe depression, which is associated with fewer cognitive side effects than electroconvulsive therapy (ECT). Evidence suggests anti-suicidal effects; however, influence of stimulation parameters and patient characteristics remains unclear. Data of 38 patients with treatment-resistant depression (TRD) receiving high-frequency (100 Hz) MST over vertex in an open-label trial were pooled. Suicidality was assessed pre- versus post-treatment using suicide-specific items from Hamilton Rating Scale for Depression (HRSD-3), Montgomery–Åsberg Depression Rating Scale (MADRS-10), Beck Depression Inventory (BDI-9), and Inventory of Depressive Symptomatology–Self-Report (IDS-SR-18). Associations with anxiety (HAMA), anhedonia (SHAPS), and depressive response were examined. In 10 patients, within-session effects were measured using HRSD-3 and Depression and Anxiety Cognitive Scale item 6 (DACS-6). At baseline, 89.5% (34/38) reported suicidality; 76.5% (26/34) achieved remission after MST. HRSD-3 scores decreased from 1.71 ± 0.76 to 0.55 ± 0.68 (F(1,33) = 51.30, p < 0.001), with large effects for MADRS-10, BDI-9, and IDS-SR-18. In subsample, DACS-6 scores showed main effect of time (F(2, 18) = 5.12, p = 0.017), suggesting reduced suicidal urge within hours. These analyses were exploratory in nature and based on a small subsample; therefore, findings should be interpreted cautiously. High-frequency vertex MST produced robust reductions in suicidality in TRD, with high remission rates and with exploratory evidence of early within-session changes in suicidal ideation. Findings support further randomized trials to confirm efficacy and to evaluate MST alongside established interventions such as ECT or ketamine.

Severe Maternal Morbidity at the Intersection of Race and Disability: Evidence of Compounded Disparities in the U.S. Maternal Healthcare System.

What can a half-million saccades tell us about distractor suppression?

To evaluate the impact of automated feedback systems (AFS) on technical surgical skill acquisition in individuals undergoing surgical skills training. PRISMA-guided systematic review of studies published between May 2013 and December 2024. Four databases were searched. Eligible studies compared AFS with no feedback or assessed the impact of AFS on technical skill. Risk of bias was assessed using ROB-2 and ROBINS-I, and certainty of evidence with GRADE. The review was prospectively registered with PROSPERO (CRD420251058650). Simulation-based training environments, including bench models and virtual reality simulators. Fourteen studies involving 814 trainees were included. All studies reported improvement in technical skills with AFS; 9 demonstrated significant within-group gains, with a mean improvement of 38.1% (p = 0.0046). Six studies contributed to pooled analysis, showing a moderate-to-large benefit (Hedges' g = 0.81, 95% CI: 0.45-1.00, p < 0.0001). Secondary outcomes consistently favored AFS: learner satisfaction increased by 60% (MD = 1.16, 95% CI: 0.65-1.67, p < 0.01), path length decreased by 41% (95% CI: 10.3%-71.7%, p = 0.02), speed improved by 9.4% (MD = 3.1 mm/s, 95% CI: 0.4-5.8, p = 0.04), and applied force was reduced by 11.8% (95% CI: 4.5%-19.2%, p = 0.01). AFS are associated with moderate-to-large improvements in technical performance, particularly for foundational repetitive surgical tasks. While gains are often task-specific and largely confined to simulation settings, evidence supports AFS as a valuable adjunct to early surgical training. Integration into structured programmes, alongside expert oversight and contextual teaching, is essential to maximize benefit and ensure safe transferability to clinical practice. Small study numbers, task-specific designs, and heterogeneity limit interpretation.

Seven days versus extended duration antibiotic therapy for multidrug-resistant gram-negative bacterial infections in critically ill patients: A pooled analysis of the OPTIMISE and REGARD-VAP trials.

The benefit of IV thrombolysis (IVT) with alteplase before endovascular thrombectomy (EVT) compared with EVT alone has been shown to be limited and time dependent. Data on tenecteplase, its recommended alternative, are limited. We aimed to assess the efficacy and safety of IVT with tenecteplase plus mechanical thrombectomy (TNK + EVT) compared with EVT in patients with large vessel occlusion stroke and determine whether its potential benefit decreases with treatment time. We conducted a retrospective pooled analysis of 2 nationwide, real-world registries of patients with anterior circulation large vessel occlusion stroke within 4.5 hours of known symptom onset and with no contraindication to thrombolysis, treated with TNK + EVT (TETRIS) or EVT (ETIS). The efficacy outcome was the 3-month modified Rankin Scale (mRS) score, analyzed in ordinal and dichotomized (mRS score ≤2) approaches. We used propensity score-weighted logistic regression to assess associations between treatment groups and outcomes of interest. Among 1,890 patients who were analyzed (TNK + EVT: n = 798; EVT: n = 1,092; median age 73 years [interquartile range 61-82]; 49.6% women), the median expected onset-to-thrombolysis time was 146 minutes [interquartile range 119-180]. More than half of patients (n = 1,063; 56.2%) were admitted first to a primary stroke center. All baseline characteristics were balanced between treatment groups after overlap weighting. Overall, TNK + EVT was associated with better 3-month functional outcome over the full mRS (weighted common odds ratio [OR] 1.53 [95% CI 1.29-1.82]; p < 0.001) and regarding functional independence (propensity score overlap weighting [PSOW]-OR 1.50 [95% CI 1.23-1.84]; p < 0.001). This benefit did not differ statistically between patients admitted first to a primary or comprehensive stroke center (p-interaction = 0.12). There was no significant effect of the expected onset-to-thrombolysis time on the association between TNK + EVT and better functional outcome (p-interaction = 0.11). There were no significant differences in parenchymal hematoma (PSOW-OR 1.29 [95% CI 0.94-1.79]; p = 0.12) and symptomatic intracerebral hemorrhage (PSOW-OR 1.13 [95% CI 0.69-1.86]; p = 0.61) rates. Among patients treated within 4.5 hours of symptom onset, TNK + EVT was associated with better functional outcome than EVT, without safety concerns. This benefit does not seem to be time dependent. These findings support the routine use of tenecteplase before EVT in the early time window. This study provides Class II evidence that, in patients with stroke due to anterior circulation large vessel occlusion, IV tenecteplase plus thrombectomy is associated with better functional outcomes at 3 months compared with thrombectomy alone. NCT03776877 (ETIS registry) and NCT05534360 (TETRIS registry).

Degenerative spondylolisthesis affects approximately 39million patients worldwide. While consensus supports decompression with fusion for single-level pathology, optimal surgical approaches for multi-level disease remain disputed. Despite the frequency of this clinical presentation, evidence comparing outcomes between Single-Level versus Multi-Level interbody fusion procedures is surprisingly scarce. This study aims to determine how the level of interbody fusion extent impacts outcomes in patients undergoing lumbar fusion for degenerative spondylolisthesis. Our systematic review methodology involved comprehensive database searches (Web of Science, Scopus, PubMed, and Cochrane Library) from inception through April 2025. Two independent reviewers performed article screening, data extraction, and quality assessment. Statistical analyses used R software (v4.4.2), with outcomes reported as risk ratios for categorical variables and mean differences for continuous measures (95% CI). The certainty of evidence was assessed using the GRADE approach. Our meta-analysis evaluated 10 studies (N = 1430 patients; 971 Single-Level, 366 Double-Level, 198 Multi-Level fusions). Single-Level procedures demonstrated 41% lower revision rates (RR = 0.59 [0.40-0.86], p = 0.007). Operative advantages included reduced surgical time (-60.73min [- 80.89 to - 40.57], p < 0.001), blood loss (-286.99mL [- 496.71 to - 77.27], p = 0.007), and hospitalization (-1.22 days [- 2.09 to - 0.34], p = 0.006). Oswestry Disability Index (ODI) scores showed borderline improvement (-3.90 [- 7.89 to 0.10], p = 0.06). Screw loosening decreased by 84% (RR = 0.16 [0.08-0.34], p < 0.001). We observed no significant differences in lumbar lordosis (-0.01 [- 1.75 to 1.72], p = 0.99), infection rates (RR = 0.49 [0.19-1.25], p = 0.13), adjacent segment deterioration, vascular injuries, or dural tears. The certainty of evidence ranged from low to very low, and high heterogeneity was observed in perioperative outcomes. Single-level fusion may offer a more favorable perioperative profile than double- or multi-level constructs, including lower revision risk, shorter operative time, reduced blood loss, shorter hospitalization, and fewer screw loosening events in pooled analyses. However, complications did not differ significantly between groups. Given substantial heterogeneity for perioperative outcomes and generally low to very low certainty of evidence, these findings should be interpreted cautiously and individualized to patient pathology and surgical context.

Aneurysmal subarachnoid hemorrhage (aSAH) in infants is exceptionally rare, posing unique diagnostic and therapeutic challenges due to nonspecific clinical features and lack of standardized management protocols. We report a 6-month-old male presenting with vomiting, decreased consciousness, and seizures. Neuroimaging revealed diffuse subarachnoid hemorrhage from a ruptured left middle cerebral artery (MCA) aneurysm. Despite aggressive stabilization, the patient suffered rebleeding and succumbed to catastrophic complications. A systematic review following PRISMA guidelines was conducted (CRD420251145008). PubMed, Embase, and Cochrane CENTRAL were searched (2005-2025) for aSAH cases in infants ≤ 12months. Extracted individual patient data were combined into a pooled individual-level analysis comparing survival and functional outcomes between intervention (endovascular/microsurgical) and conservative management using Fisher's exact test. Sixty cases were identified (median age 6months; 56% male). The MCA was the most frequently affected site (38%). Seizures (42%) and altered consciousness (38%) were common presentations. In the pooled analysis, 43 infants underwent intervention (37% endovascular, 33% microsurgical) while 8 received conservative management. Intervention was associated with a trend toward improved survival (88% vs. 63%; OR 4.50, 95% CI 0.73-28.9, p = 0.11). No significant difference in survival (OR 0.71, p > 0.99) or favorable functional outcome (OR 0.89, p > 0.99) was found between endovascular and microsurgical cohorts. Infantile aSAH is a devastating condition requiring early neuroimaging. Quantitative synthesis suggests active intervention may offer a survival advantage over conservative management, with both endovascular and microsurgical approaches demonstrating comparable efficacy in specialized centers.

Lung cancer (LC) and heart failure (HF) are being increasingly seen as related conditions, with rising concerns about the cardiotoxic effects of treatments. We conducted a bibliometric study on research related to LC and HF from 2014 to 2024 using the Web of Science Core Collection. To examine research trends and collaborations, data were analyzed and visualized using R, CiteSpace, and VOSviewer. The research encompassed 531 articles from 194 different journals, with contributions from 3963 authors. The United States and China have been the leading contributors to LC and HF research, with 146 and 120 publications, and 5307 and 1403 citations, respectively. Carmen Bergom from the United States, along with Aidan J. Cole, Suneil Jain, and Gerard M. Walls from the United Kingdom, are recognized leaders in this field due to their prolific publications. Lancet Oncology has consistently and significantly impacted the field, and an article in the Journal of Clinical Oncology, which is the most cited, examines cardiac toxicity after radiotherapy for Stage III non-small-cell lung cancer through a pooled analysis of dose-escalation trials delivering 70 to 90Gy. The focus of recent research is on immunotherapy (ICIs), cardiac toxicity associated with radiotherapy, and palliative care. This innovative mapping research highlights an increasing focus on the link between LC and HF, particularly concerning treatment-induced cardiotoxicity. Nonetheless, studies on their two-way interaction are still scarce, pointing to a promising yet under-researched area. Combining oncology and cardiology could reveal new insights to tailor personalized care and enhance results. Our research provides a foundation for future interdisciplinary investigations in the developing field of cardio-oncology.

The role of hyperthermic intraperitoneal chemotherapy in newly diagnosed and recurrent ovarian cancer: A time-to-event meta-analysis of randomized trials.

The association between occupational exposure to chlorinated solvents and lung cancer remains inconclusive. This study investigated this relationship using data from the internationally pooled SYNERGY study. Data from 14 case-control studies conducted in 13 European countries and Canada were pooled, including 28 048 participants (12 329 cases and 15 719 controls). Lifetime occupational exposure to chlorinated solvents was assessed using the ALOHA+job-exposure matrix. ORs and 95% CIs were estimated using unconditional logistic regression, adjusted for study centre, age, sex, smoking (pack-years and cessation), cumulative exposure to five occupational lung carcinogens (asbestos, hexavalent chromium, polycyclic aromatic hydrocarbons, respirable crystalline silica and diesel engine exhaust), cumulative benzene exposure and employment in high-risk occupations ('List A' jobs). Associations were estimated across categories of exposure levels, durations and analyses stratified by smoking status and lung cancer subtypes. We found no evidence of an association between ever exposure to chlorinated solvents and lung cancer risk (OR 1.03; 95% CI 0.96 to 1.10). Among exposed individuals, a positive trend with cumulative exposure was observed (p=0.031), but not when non-exposed individuals were included (p=0.173). Positive trends were found with exposure duration (p=0.005 for exposed; p=0.048 overall); risks were modestly elevated (OR 1.11) in those exposed for 20 or more years. No increased risk was observed across smoking strata or lung cancer subtypes. This pooled analysis provides limited evidence of an association between occupational exposure to chlorinated solvents and lung cancer, though exposure-response trends were noted among exposed individuals.

Anastomotic leaks in colorectal surgery increase mortality, local cancer recurrence, and hospital readmission rate. The Echelon Circular Powered Stapler (PCS) is marketed to reduce anastomotic leaks by minimizing operator errors through powered systems. We reviewed current evidence on the use of PCS in left-sided colorectal anastomoses to determine if there is a reduction in anastomotic leak rates versus manual circular staplers (MCS). This study followed PRISMA guidelines. MEDLINE, EMBASE, CINAHL, and OVID review databases were searched to January 2024. A broad search strategy for PCS versus MCS in colorectal surgery was used. Abstracts were reviewed for the primary outcome of anastomotic leaks, and data were extracted from full-text review. Statistical analysis was performed using RevMan 5.4 software. 109 articles were screened, 9 studies with 3110 patients were included. No randomized control trials (RCTs) were found. In pooled and sensitivity analysis excluding studies that used historic comparators, there was no significant difference in the rates of anastomotic leak (pooled RR 0.56, 95% CI [0.27-1.18], p = 0.13; sensitivity analysis RR 0.75, 95% CI [0.32-1.77], p = 0.52). Similarly, there was no significant difference in morbidity between PCS and MCS on pooled analysis (RR 0.84, 95% [CI 0.65-1.08], p = 0.17). However, on pooled analysis, there was a significantly lower rate of post-operative bleeding with the use of PCS (RR 0.2, 95% CI [0.08-0.51], p < 0.001). The current systematic review and meta-analysis is unable to support the claim of lower leak rate with the use of PCS; however, there is preliminary evidence to indicate that powered staplers may decrease the rate of post-operative bleeding. Further evidence from RCTs investigating anastomotic leaks and bleeding rate with PCS and assessments of environmental impact should be conducted prior to the widespread use of powered staplers.

Recently, drug-coated balloons (DCB) have emerged as a promising alternative for side branch treatment in coronary bifurcation lesions, in combination with drug-eluting stent (DES) implantation in the main vessel, the hybrid DCB approach. We aimed to evaluate clinical outcomes in patients treated with the hybrid DCB approach and to compare this strategy with other bifurcation techniques. A systematic review and meta-analysis. MEDLINE and EMBASE were searched up until January 2025. We included randomised controlled trials and observational studies investigating clinical outcomes in patients treated with the hybrid DCB approach for coronary bifurcation lesions. Two independent reviewers extracted data and assessed the risk of bias. The outcome of interest was the combined endpoint of cardiac death, myocardial infarction (MI) or target lesion revascularisation (TLR) at the longest available follow-up. Crude event rates, stratified by treatment strategy, were provided for the overall incidence of the primary endpoint. Furthermore, we conducted meta-analyses on the combined endpoint, comparing different bifurcation percutaneous coronary intervention (PCI) strategies. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. 13 studies, consisting of 2393 patients, were included in our systematic review. Investigated techniques were the hybrid DCB approach in all studies, and a two-stent strategy or the combination of DES in main vessel and balloon angioplasty (BA) in the side branch as potential comparators. Median follow-up duration was 12 months (IQR 7.5-12). The combined endpoint of cardiac death, MI or TLR was found in 5.6% in the hybrid DCB group, 15.4% in the two-stent group and in 10.0% in the BA group. The pooled analyses, including three and two studies, respectively, showed that the hybrid DCB approach was associated with a lower risk of the composite endpoint of cardiac death, MI or TLR when compared with a two-stent strategy (7.9% vs 15.4%; risk ratio (RR): 0.53; 95% CI 0.33 to 0.85) and compared with BA in the side branch (5.6% vs 10.0%; RR: 0.57; 95% CI 0.37 to 0.88). The certainty of the evidence was graded as very low. The results of this systematic review and meta-analysis suggest that the hybrid DCB approach is a feasible and promising treatment approach for bifurcation lesions, when compared with other bifurcation PCI strategies. However, the results should be interpreted cautiously as the certainty of evidence was graded as very low, underlining the importance of larger trials to confirm these findings. CRD420250651469.

Relevance of more stringent discharge standards for acute malnutrition treatment: A pooled analysis of post-treatment relapse in 21 studies.

Fentanyl overdose deaths are a critical public health issue in the United States. Rhode Island, an early epicenter of the fentanyl crisis, has seen fentanyl overdose deaths increase 30-fold since 2009. In response, harm reduction tools such as fentanyl test strips (FTSs) have been introduced to help people who use drugs (PWUD) detect fentanyl in their substances. We analyzed FTS use among PWUD in Rhode Island from 2021 through 2023 and identified characteristics associated with their use. We conducted a pooled cross-sectional analysis using aggregate data from the Rhode Island Harm Reduction Surveillance System. We used bivariate Pearson χ2 tests to assess the relationship between past-month FTS use and demographic and behavioral characteristics. Because analyses were limited to unadjusted comparisons, these findings are exploratory and hypothesis generating. Of 498 survey respondents, most identified as male (n = 328; 65.9%), non-Hispanic White (n = 204; 41.0%), straight (n = 400; 80.3%), and aged 25 to 44 years (n = 288; 57.8%). The most frequently reported substances used were crack (n = 355; 71.3%), cocaine (n = 219; 44.0%), and fentanyl/heroin (n = 196; 39.4%). Only 31.7% of individuals reported FTS use in the past 30 days. FTS use was significantly associated with age, race and ethnicity, witnessing an overdose, possessing naloxone, and recent fentanyl/heroin use (all P < .05). Despite FTS distribution efforts and overdose risk, FTS uptake in Rhode Island was low. Future research should assess barriers to FTS adoption and consider integrating FTS distribution within naloxone programs.

Chronic pain resulting from postoperative adhesions represents a significant clinical concern due to its substantial impact on patient quality of life; however, optimal therapeutic management remains contentious. This systematic review and meta-analysis aimed to evaluate the efficacy of laparoscopic adhesiolysis in alleviating chronic pain attributable to postoperative adhesions, and to assess the influence of adhesion barriers on treatment outcomes. A comprehensive systematic review was conducted by searching PubMed, Embase, and Web of Science from database inception through August 2025. Studies reporting pain improvement as the primary outcome, along with safety outcomes (including complication incidence and mortality), were eligible for inclusion. Pooled estimates were calculated using a random-effects model, and heterogeneity was quantified employing the I2 statistic.. A total of 30 studies involving 1,450 patients were included in the systematic review. In 27 single-arm observational studies (n = 1,150), laparoscopic adhesiolysis was associated with a pooled pain improvement rate of 67.3% (95% CI 57.5-76.2%), with substantial heterogeneity (I2 = 91%). In contrast, pooled analysis of four randomized controlled trials (n = 271) demonstrated no statistically significant difference in pain improvement between laparoscopic adhesiolysis and diagnostic laparoscopy alone (38.9% vs 36.2%; risk ratio 1.05, 95% CI 0.61-1.83). Although observational studies report relatively high rates of pain improvement, these findings should be interpreted as descriptive and hypothesis-generating. The highest level of available evidence from randomized controlled trials does not demonstrate a clinically meaningful benefit of laparoscopic adhesiolysis over diagnostic laparoscopy alone. PROSPERO CRD42023478049.

We conducted a systematic review and meta-analysis to compare effectiveness and safety of 9 months of isoniazid (9H) versus shorter rifamycin-containing regimens for treating latent tuberculosis infection (TBI) in children. We systematically searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials to June 2025 for randomized, controlled trials (RCTs) and cohort studies that compared regimens that were shorter than 9 months of isoniazid in children aged 1-18 years. Outcomes were development of TB disease, treatment completion, and adverse events. Risk of bias was assessed using RoB 2.0 and the Risk Of Bias In Non-Randomized Studies - of Interventions (ROBINS-I) tool; certainty of evidence was graded using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Five RCTs and 7 nonrandomized studies that enrolled approximately 2950 children in trials and >25 000 in observational cohorts were included. In pooled analysis of 3 RCTs, shorter rifamycin-containing regimens resulted in little to no difference in development of TB disease compared with 9H (odds ratio [OR], 0.19; 95% confidence interval [CI], .03-1.12; moderate-certainty evidence). Treatment completion was probably higher with shorter regimens (OR, 0.51; 95% CI, .42-0.62; moderate-certainty evidence). Adverse events were similar between groups, but evidence is uncertain (low-certainty evidence). Observational data were consistent with these findings, showing higher completion rates and lower hepatotoxicity with shorter treatments. Shorter rifamycin-containing regimens for pediatric TBI probably increase treatment completion and have similar safety outcomes, with no important difference in development of TB disease compared with the standard regimen. These findings support current guideline recommendations that favor shorter regimens in children.