Background: Simulation‐based training is increasingly used to enhance clinical competence in obstetric emergencies, yet evidence comparing high‐ and low‐fidelity simulation against standard training remains fragmented. Objectives: To systematically evaluate the effectiveness of high‐fidelity and low‐fidelity simulation‐based training compared with standard non‐simulation training in improving knowledge, clinical skills, confidence, teamwork and communication among healthcare professionals managing obstetric emergencies. Search Strategy: A comprehensive search of PubMed, Cochrane CENTRAL, Embase and Scopus was conducted from inception to 30 May 2025. Reference lists of relevant studies were also screened. Selection Criteria: Randomised controlled trials (RCTs) or quasi‐RCTs comparing high‐ or low‐fidelity simulation with standard training for obstetric emergencies were eligible. Studies had to report at least one quantitative outcome related to knowledge, skills, confidence, teamwork, communication or patient outcomes. Data Collection and Analysis: Two reviewers independently screened, extracted data and assessed risk of bias using the Cochrane RoB 2.0 tool. Due to substantial heterogeneity in study design, populations and outcomes, results were narratively synthesised. Main Results: Sixteen RCTs including 1453 participants met the inclusion criteria. Eleven studies evaluated high‐fidelity simulation; five examined low‐fidelity simulation. Most studies demonstrated significant improvements in knowledge acquisition, clinical skills, confidence and teamwork compared to standard training. High‐fidelity simulation was generally associated with greater improvements than low‐fidelity approaches. Risk of bias was predominantly low, with some concerns for selective reporting. Conclusions: Simulation‐based training, particularly high‐fidelity modalities, appears to enhance learning and performance in obstetric emergencies compared with standard training. Further research should address long‐term retention, patient‐centred outcomes and cost‐effectiveness. Trial Registration: CRD420251069240.

Objective: This study aimed to estimate the trends, projections, and determinants of standalone and coexisting forms of malnutrition (CFM) at the global, regional, national, and individual level among children under five in low- and middle-income countries (LMICs). It also assessed the projection trajectory towards the 2030 global nutrition targets (GNTs) for child growth including stunting, wasting, obesity, and CFM. Methods: Data from 48 LMICs were analyzed using the Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS). Children with complete anthropometry were included for national- and individual-level descriptive analyses. Projected prevalence of each form of malnutrition, including CFM, was calculated using the Annual Rate of Change. Inferential analyses employed generalized linear regression models with two-way interaction terms to identify determinants of each malnutrition type. Findings: By 2030, 22 of 48 LMICs are projected to achieve the GNT of stunting, wasting, and obesity, that is up from 10 countries currently, while Yemen and Zimbabwe are expected to remain off-track. Stunting is the most prevalent form, affecting 42 countries, with nine nations projected to have over 50% of children affected by a form of malnutrition. Wasting, obesity, and CFM are rising in several countries. Maternal education and household wealth were the strongest determinants, with children of uneducated mothers and from poorest households at the highest risk. Inequalities are narrowing slowly by 1–2% per year, and marked regional disparities persist. Conclusions: Many LMICs are off-track to meet child-growth targets when CFM is considered alongside standalone indicators. The government and global health partners must strengthen nutrition surveillance systems and equity-focused policies and programs to routinely capture CFM and prevent as well as manage all forms of malnutrition at the national and individual levels.

Background: Simulation-based training is increasingly used to enhance clinical competence in obstetric emergencies, yet evidence comparing high- and low-fidelity simulation against standard training remains fragmented. Objectives: To systematically evaluate the effectiveness of high-fidelity and low-fidelity simulation-based training compared with standard non-simulation training in improving knowledge, clinical skills, confidence, teamwork and communication among healthcare professionals managing obstetric emergencies. Search strategy: A comprehensive search of PubMed, Cochrane CENTRAL, Embase and Scopus was conducted from inception to 30 May 2025. Reference lists of relevant studies were also screened. Selection criteria: Randomised controlled trials (RCTs) or quasi-RCTs comparing high- or low-fidelity simulation with standard training for obstetric emergencies were eligible. Studies had to report at least one quantitative outcome related to knowledge, skills, confidence, teamwork, communication or patient outcomes. Data collection and analysis: Two reviewers independently screened, extracted data and assessed risk of bias using the Cochrane RoB 2.0 tool. Due to substantial heterogeneity in study design, populations and outcomes, results were narratively synthesised. Main results: Sixteen RCTs including 1,453 participants met the inclusion criteria. Eleven studies evaluated high-fidelity simulation; five examined low-fidelity simulation. Most studies demonstrated significant improvements in knowledge acquisition, clinical skills, confidence and teamwork compared to standard training. High-fidelity simulation was generally associated with greater improvements than low-fidelity approaches. Risk of bias was predominantly low, with some concerns for selective reporting. Conclusions: Simulation-based training, particularly high-fidelity modalities, appears to enhance learning and performance in obstetric emergencies compared with standard training. Further research should address long-term retention, patient-centred outcomes and cost-effectiveness.

Background: Perioperative atrial fibrillation (AF) is a frequent surgical complication associated with increased morbidity, mortality and healthcare utilization. While landiolol, an ultra–short-acting and β₁-selective beta-blocker, has demonstrated efficacy in reducing AF in cardiac surgical populations, its role in non-cardiac surgery remains uncertain. This systematic review and meta-analysis aim to evaluate the effectiveness and safety of prophylactic landiolol for preventing perioperative AF in patients undergoing non-cardiac surgery. Methods: This systematic review and meta-analysis protocol follows Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and is registered with the international systematic review registry PROSPERO (CRD420261281111). We will do a literature search using MEDLINE, Embase, Scopus and Cochrane CENTRAL from inception to 10 January 2026, including terms related to ‘landiolol’, ‘atrial fibrillation’ and ‘thoracic surgery’. Eligible studies include randomized controlled trials and observational studies comparing prophylactic intravenous landiolol to placebo or no treatment in adult patients. The primary outcome is the incidence of perioperative AF. Secondary outcomes include serious adverse events, intraoperative blood loss, duration of surgery and length of hospital stay. Risk of bias will be assessed using Cochrane RoB2 and Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) and the overall certainty of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation approach. Data will be synthesized using a random-effects model with risk ratios and mean differences. Subgroup analyses will explore the effect of landiolol by timing, duration and surgical procedure. Conclusions: This review will provide a comprehensive synthesis of evidence on landiolol for AF prevention in high-risk thoracic surgical settings. Findings will guide optimal prophylactic strategies and inform future research on landiolol use in thoracic surgeries.

Simulation-based training is increasingly used to address the challenges of neonatal tracheal intubation, a high-risk and infrequent procedure associated with low first-pass success and significant complications, particularly among trainees with limited opportunities for hands-on practice. This systematic review and meta-analysis aimed to synthesize current evidence on whether simulation-based training improves intubation outcomes compared with conventional or non-simulation-based approaches. Following PRISMA and Cochrane guidelines and registered with PROSPERO (CRD420251081086), reviewers searched PubMed, Cochrane CENTRAL, and Embase up to 6 June, 2025, identifying thirteen eligible randomized and prospective observational studies including 910 participants. Pooled analyses revealed that simulation-based training showed a trend toward higher first-attempt success (RR 1.10, 95% CI 0.99–1.22) and overall success rates (RR 1.04, 95% CI 0.97–1.11) compared to controls, though neither reached statistical significance. Time to intubation was slightly shorter in the simulation group but with wide confidence intervals (mean difference − 2.62 seconds, 95% CI -10.12 to 4.48). While the evidence suggests a possible benefit of simulation for achieving successful neonatal intubation on the first attempt, larger and better-standardized trials are needed to confirm its impact on clinical practice and to guide its optimal integration into neonatal airway training programs.