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.
The European Paediatric Surgeons' Association (EUPSA) and the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA) conducted a survey to assess the current surgical management and care practices for esophageal atresia (EA) in order to assess changes over the past decade.An online survey consisting of 56 questions was administered to EUPSA members and ERNICA representatives between March and September 2025. The questionnaire covered seven domains: center structure, preoperative assessment, surgical management of esophageal atresia and tracheoesophageal fistula (EA-TEF) patients and long-gap EA, postoperative care, long-term follow-up, and the management of complications. Results were compared to practices reported in a previous EUPSA Network Office survey in 2013.There were a total of 202 respondents from 41 countries with 60% from European Union countries. Compared with previous surveys, the routine use of preoperative bronchoscopy and the use of trans-anastomotic tubes were found to be significantly more common (both p < 0.001). A marked increase in preference for thoracoscopic techniques for EA-TEF was observed (p < 0.001). The routine use of chest drains, elective paralysis, and contrast studies prior to feeding initiation also rose significantly over the decade (p ≤ 0.004). Yet for many areas of care, there remains variation between surgeons, and structured long-term follow-up arrangements are not universal.The findings demonstrate increased standardization and suggest increased adherence to recommendations in the management of EA-TEF. However, significant variation persists in long-term follow-up, transition-to-adult-care programs, and structured quality-of-life assessment, highlighting areas for future harmonization across European centers.
The effectiveness and uptake of financial incentives can differ substantially between reward- and deposit-based incentives. Therefore, it is unclear to whom and how different incentives should be assigned. In this study, the effect of different modes of assigning reward- and deposit-based financial incentives on effort is explored in a two-session experiment. First, students’ ( n = 228, recruited online) discounting, loss aversion and willingness to pay a deposit were elicited. Second, an incentivized real-effort task was completed ( n = 171, 25% drop-out). Two modes of assigning reward- or deposit-based financial incentives were compared: random assignment and ‘nudged’ assignment – assignment based on respondent characteristics allowing opting out. Our results show that respondents receiving nudged assignment earned more and persisted longer on the real-effort task than respondents randomly assigned to incentives. We find no differences in effectiveness between reward-based or deposit-based incentives. Overall, 39% of respondents in the nudged assignment mode followed-up the advice to take deposit-based incentives. The effect of deposit-based incentives was larger for the respondents who followed-up the advice than for respondents that randomly received deposit-based incentives. Overall, these findings suggest that nudged assignment may increase incentives’ effect on effort. Future work should extend this approach to other contexts (e.g., behaviour change).
Despite the increasing availability of IV analgesics, perioperative pain management remains a challenge, especially in pediatric care where most IV NSAIDs do not have labelled indications. NSAIDs are consistently identified as essential for multimodal analgesia protocols. This document summarizes key discussions of a 2023 Medical Advisory Board Meeting (Frankfurt, Germany) on Ready-to-use (RTU) IV Ibuprofen, complemented by follow-up clinician questionnaires describing institutional clinical protocols, perceived benefits and safety considerations. Ready-to-use IV ibuprofen has become available in Europe in the last few years, prior to its worldwide launching. This paper aims to provide valuable insights and serve as a reference point for the introduction of this new formulation by colleagues in other countries. Ibuprofen inhibits COX-1 and COX-2 enzymes with a favorable COX-1/COX-2 ratio, reducing side effects. Its pharmacokinetics are consistent across age groups, and it is considered safe for pediatric and elderly populations. Experts reported broad adoption of RTU IV Ibuprofen across multiple surgical settings, with consistent analgesic efficacy and evident opioid-sparing effects. Protocols referred by the authors included mainly preemptive analgesia and multimodal strategies tailored to patient needs. Reported advantages for IV Ibuprofen included rapid onset of action, accurate dosing, faster recovery, and workflow benefits from a premixed preparation, making it suitable for hospitalized patients. Contraindications include allergies, active bleeding, and severe renal failure. Board members reported no increased bleeding risk in their experience with IV Ibuprofen.
Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are inflammatory disorders of the CNS with distinct immunopathologic mechanisms and treatment responses and partially overlapping clinical phenotypes. The identification of aquaporin-4 (AQP4)-IgG and MOG-IgG has transformed disease classification and diagnosis, enabled a classification of antibody-defined subgroups, and facilitated the development of targeted therapies. However, optimal use of these biomarkers in clinical practice requires careful interpretation within the appropriate clinical and radiologic context. This review synthesizes current evidence on established and emerging fluid biomarkers in NMOSD and MOGAD, with emphasis on analytical performance, biological relevance, and clinical utility. We review antibody detection using cell-based assays, highlighting differences between live and fixed platforms and the impact of antigen conformation on sensitivity and specificity, particularly for MOG-IgG. Common causes of false-positive and false-negative results are discussed, including low-titer reactivity, testing in low pretest probability populations, treatment-related antibody titer reduction, and assay-specific limitations. The diagnostic challenges posed by indiscriminate testing in adult cohorts with multiple sclerosis, in whom disease prevalence markedly exceeds that of MOGAD, are emphasized. We also discuss the role of repeat testing during acute attacks and paired serum-CSF analysis in improving diagnostic confidence when results are equivocal or discordant. Beyond disease-defining antibodies, we examine biomarkers of tissue injury and immune activation. Serum and CSF neurofilament light chain and glial fibrillary acidic protein provide complementary measures of neuroaxonal and astrocytic damage and show associations with attack severity, disease activity, relapse risk, and long-term disability. Cytokines, chemokines, and complement components reflect inflammatory pathways, including IL-6-driven immune activation in NMOSD and MOGAD and complement-mediated astrocytopathy in NMOSD, and may support mechanistic stratification and treatment monitoring in both conditions. We further review the contribution of CSF analysis, neuropathology, genetics, and antigen discovery platforms to refine disease classification, particularly in seronegative or atypical presentations. Finally, we outline priorities for future research, including assay harmonization, standardized sampling protocols, longitudinal biomarker profiling, and integrative multiomic approaches. Collectively, advances in biomarker science have the potential to improve diagnostic precision, guide individualized therapeutic strategies, and support de-escalation decisions in NMOSD and MOGAD.
