This review summarizes considerations within the existing recent literature that guide the practice of interval appendectomy (IA) after initial non-operative management (NOM) of complicated appendicitis (CA) in children. A systematic review of English language articles published from 2000 to 2025 was conducted in Medline, Embase, and Cochrane Central Register of Controlled Trials to address four elements which could impact the decision for IA after NOM of CA: (1) the incidence of recurrent appendicitis; (2) the time period in which recurrence occurs; (3) the patient or disease-related risk factors which increase recurrence; and (4) the incidence of appendiceal neoplasms identified by IA. Of the 3,022 articles initially reviewed, 46 met inclusion criteria. Recurrence was reported in 2–50
Intelligence testing is an important tool for clinicians to help in diagnosis and treatment planning for children with neurodevelopmental disabilities. Although interpreting IQ profiles is a common clinical practice, there are concerns regarding the validity and reliability of such scores. Previous research has shown relatively stable global measures of IQ, but less stable scores within index or subtest score. More research is needed to better understand the long-term stability of IQ scores within autistic and other neurodevelopmental populations who may have more instability in their scores over time. We tested the long-term stability of IQ scores using the same test over time (Stanford-Binet, Fifth Edition; SB-5) in a large clinical sample of 650 youth with autism (n = 236) or other neurodevelopmental disabilities (n = 414), over a period of 4 months to 11 years. In addition to IQ scores, we also tested consistency of scatter scores, overall profiles, and strengths and weaknesses using linear mixed effects models. Results indicated overall consistency of FSIQ scores (ICC = 0.86), slightly less stability for VIQ and NVIQ, and low stability for abbreviated IQ as well as index and subtest scores. The consistency of cognitive profiles, scatter scores, and strengths and weaknesses was poor. Younger age was the best predictor of higher FSIQ instability. Long-term stability of IQ in neurodevelopmental disabilities appears similar to results from other studies with different clinical and nonclinical groups. Implications and recommendations are discussed.
There are few prospective studies of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) for pediatric lupus nephritis (pLN) and none evaluating rituximab (RTX). The Prospective Pediatric Lupus Nephritis Registry (ProPeL-R) enrolled patients < 21 years within 4 weeks of an initial kidney biopsy diagnostic of pLN. Demographic, clinical, and laboratory data were collected prospectively at enrollment, 3 months, 6 months, and then every 6 months thereafter for up to 5 years of follow-up. For this study, we compared patients receiving initial therapy with corticosteroids (CS) and either MMF (n = 33) vs. CYC (n = 18), and those treated with CS, either MMF or CYC, with RTX (n = 20) vs. without RTX (n = 51). Histology consisted of 18
Background:Atypical teratoid rhabdoid tumor (ATRT) is a rare pediatric central nervous system tumor with little data on the efficacy of upfront treatment strategies. This study reports prognostic factors and survival of children with newly diagnosed ATRT at high-volume centers treated as per the Children's Oncology Group trial ACNS0333. Methods:Data were collected retrospectively from 13 institutions. Included subjects were children with newly diagnosed ATRT, treated as per ACNS0333, a single-arm phase III trial of intensive chemotherapy and radiation therapy (RT). Data were analyzed to assess the prognostication of clinical variables and estimates of event-free survival (EFS) and overall survival (OS). Results:Eighty subjects were included, with a median age at diagnosis of 18 months, 70% had localized disease, and 53% underwent complete tumor resection at the time of diagnosis. Fifty patients (63%) completed all therapy phases, while 12 patients (15%) experienced progression during treatment. Fifty-three patients (66%) received post-induction consolidation with high-dose chemotherapy and stem cell rescue (HDC/SCR), and 55 (69%) received RT. The 4-year EFS and OS for the entire cohort were 49% and 53%, respectively. Patients completing all therapy phases had superior outcomes (4-year EFS: 63%; OS: 67%). Absence of disease post-induction correlated with improved outcomes (4-year EFS: 64%; OS: 70%), and patients with primary spinal cord tumors had poor outcomes despite intensive therapy. Conclusions:Children with ATRT treated as per ACNS0333 with multi-modal therapy, including HDC/SCR and RT, have improved survival compared to those treated without RT and is higher than previously reported on study.
Biomedical research is rapidly adopting artificial intelligence (AI). Yet the inherent complexity of biomedical data preparation requires implementing actionable, robust criteria for ethical and explainable AI (XAI) at the "pre-model" stage, encompassing data acquisition, detailed transformations, and ethical governance. Simple conformance to FAIR (Findable, Accessible, Interoperable, Reusable) Principles is insufficient. Here, we define criteria and practices for reliable AI-readiness of biomedical data, developed by the NIH Bridge to Artificial Intelligence (Bridge2AI) Standards Working Group across seven core dimensions of dataset AI-readiness: FAIRness, Provenance, Characterization, Ethics, Pre-model Explainability, Sustainability, and Computability. Conformance to these criteria provides a basis for pre-model scientific rigor and ethical integrity, mitigating downstream risks of bias and error prior to AI modeling. We apply and evaluate these standards across all four Bridge2AI flagship datasets, spanning functional genomics to clinical medicine, and encode them in machine-actionable metadata bound to the datasets. This framework sets a benchmark for preparing ethical, reusable datasets in biomedical AI and provides standardized methods for reliable pre-model data evaluation.
