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Skin cancer is among the most frequent and fatal illnesses in the world, but early and correct diagnosis is one of the main challenges because of the complicated visual patterns of skin lesions and the absence of interpretable diagnostic devices. Conventional techniques are largely based on experienced dermatologists, but manual inspection is time-consuming, subjective, and liable to misinterpretation, with high false positive outputs. To address these issues, we present a unique DCNN architecture that employs the Swish activation function to effectively identify complex patterns in the skin lesion dataset. This model has remarkable performance in diagnosing skin cancer, as evidenced by a 98.31% accuracy rate, a 98.12% precision rate, a 98.01% recall rate, and an F1-score of 98.09%. Utilising several localised and global explainable artificial intelligence (XAI) approaches, we evaluate the model's predictions to ensure transparency and reliability in medical contexts. To reconcile the disparity between AI research and its use in healthcare, our findings underscore the necessity of integrating deep learning with explainability. These XAI solutions tackle critical concerns such as inclusiveness, transparency, and error control, providing medical practitioners with a comprehensible and reliable framework for assessing the model's reasoning process. The suggested technique establishes a reliable mechanism to assist physicians in the early and precise identification of skin cancer, while enhancing diagnostic accuracy. Future studies will focus on enhancing the model's computational efficiency and incorporating more datasets to ensure its durability and fairness across various demographic groupings.

Mycorrhizae play an important role in driving soil phosphorus (P) transformation, while intercropping or phosphate application influences rhizosphere mycorrhizal traits and enzyme activity. However, the mycorrhizal-mediated mechanism through which intercropping promotes P activation in red soil remains poorly understood. Based on a 7-year field experiment, we analyzed the effects of maize//soybean intercropping on maize yield, soil P fractions, mycorrhizal colonization, and the rhizosphere alkaline phosphatase activity (APA) with two plantation models, maize monoculture and maize//soybean intercropping under four phosphate application rates (0, 26.2, 39.3, and 52.4 kg P·hm-2). We further explored the mycorrhizal-mediated role of intercropping on promoting phosphorus activation. The results showed that maize//soybean intercropping significantly increased maize yield, the proportion and content of liable P pools, P activation, and mycorrhizal colonization. Under the four different P application levels, intercropping increased maize yield by 21.1%, 60.0%, 58.5%, and 44.3%, respectively. The proportion of liable phosphorus pools under intercropping increased significantly by 27.3%, 18.2%, 10.6%, and 9.2%, respectively. The Resin-P content increased by 13.7%, 31.3%, 22.9% and 18.4%. NaHCO3-Pi content increased by 15.9%, 28.8%, 16.1% and 6.9%. NaHCO3-Po content increased by 23.8%, 19.5%, 11.8% and 2.6%. The P activation coefficient (PAC) increased by 36.7%, 51.4%, 19.8% and 14.1%. Intercropping increased the colonization rate by 35.2%, 42.9%, 28.8% and 25.9%, hyphal density by 21.7%, 67.5%, 27.5% and 6.0%, spore density by 30.8%, 35.7%, 28.2% and 21.9%, total glomalin by 8.3%, 30.2%, 25.1%, and 17.3%, and rhizosphere APA by 20.6%, 24.6%, 16.8%, and 13.8%, respectively. Random forest analysis indicated that the liable phosphorus pools, Resin-P, NaHCO3-Po, NaHCO3-Pi, were the most important factors driving soil P activation. Key factors influencing P fractions, in descending order of importance, were total glomalin, alkaline phosphatase, hyphal density, mycorrhizal colonization rate, and spore density. Structural equation modeling further demonstrated that maize//soybean intercropping promoted P activation primarily by enhancing mycorrhizal colonization and rhizosphere alkaline phosphatase activity, which in turn increased the content and proportion of both liable organic and inorganic phosphorus. 菌根在介导土壤磷转化过程中发挥重要作用,间作和施磷影响菌根和根际酶活性,但间作下红壤磷活化的菌根介导作用尚不明确。本研究基于连续7年的红壤田间定位试验,设置玉米单作和玉米//大豆间作2种种植模式,在4个施磷水平(0、26.2、39.3、52.4 kg P·hm-2)下,分析玉米//大豆间作对玉米产量、红壤磷组分、菌根特征、根际碱性磷酸酶活性的影响,探究间作促进红壤磷活化的菌根介导作用。结果表明: 玉米//大豆间作显著提高了玉米产量、红壤活性磷库比例和含量,促进了红壤磷活化和菌根定殖。在4个施磷水平下,与对应单作相比,间作玉米产量分别提高了21.1%、60.0%、58.5%和44.3%,土壤活性磷库占比分别显著提高了27.3%、18.2%、10.6%和9.2%,其中树脂膜浸提态磷(Resin-P)含量分别增加13.7%、31.3%、22.9%和18.4%,碳酸氢钠提取态无机磷(NaHCO3-Pi)含量分别增加15.9%、28.8%、16.1%和6.9%,碳酸氢钠提取态有机磷(NaHCO3-Po)含量分别增加23.8%、19.5%、11.8%和2.6%,红壤磷活化系数(PAC)分别提高36.7%、51.4%、19.8%和14.1%。间作玉米菌根侵染率分别提高35.2%、42.9%、28.8%和25.9%,菌丝密度分别提高21.7%、67.5%、27.5%和6.0%,孢子密度分别提高30.8%、35.7%、28.2%和21.9%,总球囊酶素分别提高8.3%、30.2%、25.1%和17.3%,碱性磷酸酶活性分别提高20.6%、24.6%、16.8%和13.8%。随机森林模型分析表明,对红壤磷活化贡献最大的为活性磷库(Resin-P、NaHCO3-Po、NaHCO3-Pi),而影响红壤活性磷组分的重要贡献因子依次为总球囊酶素、碱性磷酸酶活性、菌丝密度、菌根侵染率、孢子密度。结构方程模型进一步揭示,玉米//大豆间作通过提高菌根定殖与根际碱性磷酸酶活性,提高了红壤活性磷含量和比例,从而促进了红壤磷活化。.

Even though immune checkpoint inhibitors (ICI) remain effective treatments for an increasing number of cancers, they are also liable to cause immune-related adverse events (irAE). Rheumatologic manifestations occur in 5-10 % of patients. The most common rheumatologic irAEs are immune checkpoint-induced inflammatory arthritis (ICI-IA) and immune checkpoint-induced polymyalgia rheumatica (ICI-PMR). While ICI-IA can mimic rheumatoid arthritis (RA), it is predominantly immuno-negative (absence of rheumatoid factor and anti-citrullinated peptide antibodies) and can persist subsequent to r ICI cessation. ICI-PMR is usually reversible. First-line treatments consist of corticosteroids at the lowest effective doses and are given for short periods. They are aimed at reducing symptoms such as joint swelling, with minimal (if any) disruption of ICI therapy. In patients with corticoid dependence at a dose > 10 mg/day, second-line treatments include methotrexate and biologic therapy: anti-IL6 and TNF inhibitors (TNFi). Management of these manifestations requires balancing the opposed perspectives of effective arthritis control and possible cancer progression. When possible, ICI cessation should be avoided, and immunomodulating therapies are to be applied cautiously. Co-management by patients, oncologists, and rheumatologists is of crucial importance when balancing the risks and benefits of treatment.

Antimicrobial resistance (AMR) is predicted to be liable for 10 million annual deaths worldwide by 2050, driven significantly by public cognitions and behaviours. Given the frequent social and economic interactions between people from Northern Ireland (NI) and Ireland (IRL), there is potential for cross-border spread of antibiotic-resistant bacteria. Little research compares public knowledge, awareness, beliefs and behaviours across the island of Ireland. This study aimed to address this gap in a post-COVID-19 era to inform targeted interventions. A cross-sectional, nationally representative online survey with adults in NI and IRL assessed public knowledge, awareness, behaviours and beliefs related to antibiotics and AMR. Questions were taken from the World Health Organization (WHO) multi-country public awareness survey and four relating to ESKAPE pathogens were derived from literature. Statistical analyses of difference compared results between NI and IRL. Among 811 respondents, 415 (51.2%) were from NI and 396 (48.8%) were from IRL. Those from NI showed better knowledge and understanding across most topics compared to those from IRL. However, effect sizes were small. Total knowledge of appropriate antibiotic use and antibiotic resistance was moderate in both countries. Nearly two fifths (37.9%) in both countries incorrectly identified ‘cold and flu’ as treatable with antibiotics. Awareness of AMR-related terms was consistent across countries and lowest for ‘ESKAPE pathogens’(11%), and ‘AMR’ (21.5%). The media (41.2%) and a doctor or nurse (27.1%) were the most frequent sources of awareness. Antibiotic use behaviours were consistent across countries, with over half (57%) having taken them within the last year. More respondents in IRL reported that there is not much they can do to stop antibiotic resistance (U = 74747.50, p = 0.02, r = 0.08). Knowledge, awareness, beliefs and behaviours around AMR and antibiotics are broadly consistent across the island of Ireland. Community-based initiatives could be used in both countries to educate the public on AMR and appropriate antibiotic use. Campaigns should refrain from using acronyms and employ multi-channel strategies to foster shared responsibility and encourage positive AMR-related behaviours across the island of Ireland. The online version contains supplementary material available at 10.1186/s12889-026-27024-w.

Nanocellulose separator is liable to trigger dendrite growth while being paired with lithium metal anodes due to the lack of functional species. This study introduces cationic lignin complex nanoparticles into nanocellulose separator via electrostatic interactions to stabilize lithium anodes for high-performance lithium metal batteries. The lignin complex nanoparticles, grafted on cellulose nanofibers, contribute to the enhancement in the porosity (76.2% vs 52.3%), electrolyte uptake (371.6% vs 174.1%), ionic conductivity (1.45 vs 0.76 mS cm-1) and lithium ion transference number (0.71 vs 0.34). More importantly, the composite separator promotes homogeneous lithium deposition to remarkably inhibit dendrite growth on lithium anodes with generation of a robust SEI layer. The assembled lithium metal battery shows long-life cycling with a low capacity decay (0.057% per cycle) as well as superior rate capability.

These guidelines are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing extracorporeal life support (ECLS)/ECMO and describe what are believed to be useful and safe practice for ECLS and ECMO. The aim of clinical guidelines was to help clinicians to make informed decisions about their patients. However, adherence to a guideline does not guarantee a successful outcome. Healthcare professionals must make their own treatment decisions about care on a case-by-case basis, after consultation with their patients, using their clinical judgment, knowledge, and expertise. These guidelines do not take the place of physicians' and other health professionals' judgment in diagnosing and treatment of patients. These guidelines are not intended to and should not be interpreted as setting a standard of care or being deemed inclusive of all proper methods of care nor exclusive of other methods of care directed at obtaining the same results. The ultimate judgment must be made by the physician and other health professionals and the patient considering all the circumstances presented by the individual patient, and the known variability and biologic behavior of the clinical condition. These guidelines reflect the data at the time the guidelines were prepared; the results of subsequent studies or other information may cause revisions to the recommendations in these guidelines to be prudent to reflect new data, but ELSO is under no obligation to provide updates. In no event will ELSO be liable for any decision made or action taken in reliance upon the information provided through these guidelines.

Teleost species display a diverse range of reproductive strategies, consisting mainly of gonochorism and hermaphroditism, either sequentially or simultaneously. This leads to species-specific sex determination processes. Owing to the vast range of teleost species, sex determination and differentiation mechanisms vary in their sexual patterns; therefore, sexual plasticity in gonadal development is inevitable. Under certain environmental conditions, such as fluctuations in temperature, pH, density, social interaction, and hypoxia, gonadal fate is liable to change through a phenomenon referred to as gonadal transdifferentiation. This is a reprogrammable mechanism that can occur either naturally or be induced artificially in certain species at various life stages. Transdifferentiation results from the differential expression of steroidogenic enzyme genes or transcription factors that confer phenotypic, molecular, or morphological changes, such as sexual dimorphism. In addition, many endocrine disruptors manipulate the endocrine system of various fish species by interfering with their genetic pathways or with the profiles of endogenous steroid hormones, causing a shift in the sex ratio of a given population. In the current modern chemical environment that includes endocrine disrupting chemicals, fish can undergo gonadal transdifferentiation, which can lead to functional sex reversal. This review summarizes gonadal transdifferentiation and provides evidence of diverse strategies found in teleosts, from molecular-level changes to feminization or masculinization of gonads to sex reversal, induced either naturally or unnaturally. We end with a discussion of the adverse effects of endocrine disruptors and summarize areas for future research.

The landmark 1995 judgment by the Supreme Court of India included doctors within the purview of the Consumer Protection Act (CPA) 1986, hinting that other professions, including legal services, could also fall under its ambit. However, in 2024, the apex court ruled in 'Bar of Indian Lawyers Through its President vs DK Gandhi PS National Institute of Communicable Diseases and Anr.', that lawyers are not liable for professional deficiencies under the CPA, emphasising the lack of universal standards for assessing dereliction of duty in legal services. Although this landmark verdict let advocates off the hook, it calls into question the Court's 30-year-old decision. This ruling has reignited the debate on whether doctors should be equated with other service providers under the CPA 2019, particularly in light of the rise in defensive medicine practices, which increase healthcare costs and erode doctor-patient trust. In this commentary, we will discuss the analysis and observations of the apex court in the DK Gandhi case, contributing to the ongoing discourse on medical liability under the CPA in India.

Restrictive immigration policies limit maternity care access and exacerbate poverty and isolation among migrant women. In the UK, many migrant women face No Recourse to Public Funds (NRPF), restricting welfare access and making them liable for maternity care charges. Population-level evidence on perinatal outcomes remains limited. To examine perinatal outcomes among migrant women with NRPF compared with UK-born women, migrants with recourse to public funds, and migrants with unknown visa status in an ethnically diverse urban UK population. We conducted a retrospective analysis of linked maternity and neonatal electronic health records (eLIXIR -Born In South London) from 2018 to 2023, including 44,634 pregnancies. Multivariable regression estimated adjusted risk ratios (aRR) controlling for sociodemographic and clinical characteristics. Migrant women with NRPF had higher risks of adverse maternal outcomes (emergency caesarean aRR 1.74, 95% CI 1.55-1.95; severe maternal morbidity 1.49, 1.33-1.67). Their infants were more likely to have low Apgar scores (1.53, 1.07-2.16) and less likely to receive skin-to-skin contact (0.92, 0.88-0.97). Infants of women with NRPF did not show higher risk of neonatal death (1.44, 0.85-2.29), whereas infants of women with unknown visa status had the highest risks of preterm birth (1.24, 1.13-1.35), low birthweight (1.28, 1.17-1.39), and neonatal death (2.27, 1.81-2.86). Migrant women with NRPF and infants of women with unknown visa status face disproportionate risks of adverse outcomes. Addressing these inequities requires inclusive maternity care, accurate migration data collection, and reconsideration of NRPF and charging policies.

The increasing presence of autonomous and semi-autonomous technologies is raising challenging issues of law and policy. How society resolves these issues will likely depend in part on how its leaders and members conceptualize these technologies. While research indicates that people often draw anthropomorphic inferences about these technologies, we know little about how these inferences influence technology-related legal judgments and policy opinions. We report three studies in which participants read narratives about accidents involving autonomous machines, presented with or without anthropomorphic framing, then answered questions concerning their attributions to the machines, their experience of cognitive conflict, and their legal judgments and policy opinions. We found that participants were far more willing to attribute human-like agency than human-like experience to the machines, and these different types of attributions had distinct and sometimes opposing influences on participants' judgments. For instance, attributions of agency to machines were associated with decreased beliefs that the machines' owners or manufacturers should be liable for harms the machines cause, while attributions of experience were associated with increased beliefs. More broadly, we found that increases in participants' internal cognitive conflict predicted increases in their experience attributions, which, in turn, predicted (i) more autonomous-technology-friendly policy opinions and (ii) greater willingness to impose legal liability when those technologies cause harm. Finally, framing had minimal influence on participants' responses. Our findings illuminate ways in which anthropomorphic attributions can influence judgments in an important and socially relevant context.

BACKGROUND Pneumocystis jirovecii pneumonia (PJP) is a life-threatening opportunistic infection in kidney transplant recipients (KTRs). Early identification of patients liable to progress to severe disease is critical for improving prognosis. This study aimed to construct and validate a machine learning-based nomogram for predicting the risk of severe PJP in KTRs using routine clinical indicators. MATERIAL AND METHODS A retrospective cohort of 169 KTRs diagnosed with PJP was analyzed. Severe PJP was defined as cases requiring intensive care unit (ICU) admission or death. The cohort was randomized into training (n=120) and testing (n=49) sets. Three machine learning algorithms (Boruta, RFE, and LASSO) were utilized for feature selection. A multivariate logistic regression model was established and visualized as a nomogram. Model performance was evaluated via area under the ROC curve (AUC), calibration plots, and decision curve analysis (DCA). Kaplan-Meier analysis was performed to assess risk stratification. RESULTS Four key predictors were identified: procalcitonin (PCT), (1&#x2192;3)-&#xdf;-D-glucan (G_test), C-reactive protein (CRP), and the time from kidney transplantation to PJP onset (Time KT to PJP). Notably, shorter post-transplant time and elevated biomarkers were associated with greater severity. The nomogram demonstrated robust discrimination with AUCs of 0.935 (training) and 0.886 (testing), alongside excellent calibration. DCA confirmed a significant clinical net benefit. Furthermore, Kaplan-Meier analysis revealed that patients stratified as high-risk by the model had significantly lower survival rates compared to the low-risk group (P<0.0001). CONCLUSIONS We developed a practical nomogram incorporating 4 accessible indicators to accurately predict severe PJP in KTRs. This tool facilitates the early identification of high-risk patients, enabling timely, individualized interventions and the rational allocation of medical resources.

In view of recent interest in the regenerative powers of alpha-melanocyte-stimulating hormone (&#x3b1;-MSH), the effects of melanocortin receptor agonists and antagonists were reviewed in open-field, elevated plus-maze, hole-board, and light-box tests of exploratory activity. In the open-field, low doses of melanocortin receptor agonists increase ambulatory activity and rearing but decrease center zone activity and duration under some conditions. In the elevated plus-maze, MSH receptor agonists generally decrease open arm exploration while MSH receptor antagonists increase open arm exploration, possibly caused by effects in amygdala, medial preoptic area, and ventromedial hypothalamus. Hole-board and light-box test results are preliminary but indicate a similar pattern of an anxiogenic response to melanocortin receptor agonists and an anxiolytic response to antagonists. At low doses, melanocortin receptor agonists are liable to increase general activity, a factor that needs to be taken into account when examining its regenerating action. Melanocortin receptor antagonists decrease anxiety in the elevated plus-maze and thereby may serve a useful function while increasing appetite.

Artificial intelligence (AI) is applied in numerous areas of society and has also led to significant changes in the field of medicine. Medicine is a branch of science of exceptional importance, and it is therefore necessary to ensure a high level of patient protection. The quality of healthcare has significantly improved through the use of artificial intelligence in various stages of the medical process, from the analysis of medical data and diagnostics, through therapy planning, to patient monitoring and the management of healthcare systems. The aim of this paper is to analyze the civil law aspects of artificial intelligence in medicine, with a particular focus on questions of liability for damage resulting from the use of such systems. The paper will first present the basic characteristics and areas of application of artificial intelligence in medicine, and then examine potential sources of damage and the legal basis for the liability of various stakeholders, including AI system manufacturers, software developers and data providers, healthcare institutions, and healthcare professionals. Special attention will be given to the challenges of proving causation and allocating liability in situations where decisions are made or supported by autonomous algorithmic systems. However, at the same time, numerous legal issues arise, particularly in the field of civil liability in cases where the application of artificial intelligence results in harm to a patient. Given the great importance of medicine and the need to ensure a high level of patient protection, the application of artificial intelligence must be accompanied by appropriate legal protection. The paper gives answers to a number of questions, with particular emphasis on the question of who may be held liable for damage caused by the use of artificial intelligence in medicine, as well as under which regulations and in what manner such liability is determined. Artificial intelligence has the potential to significantly enhance medical practice, its application must be accompanied by appropriate legal mechanisms that ensure patient protection and clearly define the responsibility of all participants in the system. Future legal development in this area will likely focus on further adapting existing civil law institutions to the specificities of artificial intelligence, while simultaneously strengthening preventive risk management mechanisms and transparency of AI systems in medicine.

This article examines a recent Canadian case in which a chiropractor is found liable after a patient experienced cervical artery dissection and stroke allegedly linked to cervical spinal manipulation. Two questions dominate: whether informed consent is valid and whether the final treatment caused the injury. Using a clinician-oriented lens applied to the trial reasons, the review maps the courts' reasoning against epidemiology, biomechanics, and contemporary clinical guidance. The trial court finds that the consent disclosure minimizes material risk, and the court of appeal upholds that informed-consent ruling. On causation, the trial court places determinative weight on clinical opinion, treats population-level evidence as "controversial," and frames causation as a binary choice (traumatic or "spontaneous") rather than considering interaction models (latent arterial susceptibility plus trigger). These choices risk oversimplifying a medically complex problem and accepting legal causation where scientific probability remains uncertain. On appeal, the defendant did not seek review of the causation finding.

This is a stage 1 registered report submission that seeks to examine whether religious belief and a range of other individual differences variables are associated with youth justice preferences. As this is a stage 1 registered report, these are liable to change. As this is a stage 1 registered report, we have no results. As this is a stage 1 registered report, we have no results. Consequently, we have no conclusions.

The Society of Vascular and Interventional Neurology (SVIN) Guidelines and Practice Standards Committee issues Brief Practice Updates to provide concise, evidence-based recommendations and suggestions on focused topics relevant to vascular and interventional neurology. Currently, there is limited published guidance on the technical performance and interpretative parameters of cerebral digital subtraction angiography for the determination of cerebral circulatory arrest in patients being evaluated for brain death/death by neurological criteria. In this Brief Practice Update, we present consensus-based suggestions for standardizing the performance, interpretation, and application of digital subtraction angiography in this context. This Brief Practice Update was developed using the SVIN Standards and Parameters for Guideline Development in the classification of evidence and Class of Recommendation when evidence is available and Expert Opinion recommendation when evidence is lacking. The Guidelines and Practice Standards committee convened a multidisciplinary writing group to establish key clinical questions and develop a survey assessing Expert Opinion on the role of digital subtraction angiography in cerebral circulatory arrest determination. Survey items addressed technical considerations, interpretation criteria, and clinical integration. Iterative refinement was achieved through group consensus, and the final survey was distributed to a panel of experts in neurointervention and neurocritical care. The SVIN Guidelines and Practice Standards Quality Committee reviewed the findings for adherence to SVIN's internal evidence evaluation guidelines before submission to the SVIN board for societal endorsement. Evidence was evaluated by the writing group when available, and Expert Opinion was assessed using survey results. Suggested recommendations follow the established SVIN guideline framework for Class of Recommendation and Level of Evidence, with an Expert Opinion endorsement category for areas lacking high-quality evidence at the time of publication. This update standardizes how to perform, interpret, and report digital subtraction angiography when used to assess cerebral circulatory arrest in brain death/death by neurological criteria evaluations, aiming to improve reproducibility across centers. It provides a structured framework to improve consistency and reliability among practitioners performing and interpreting cerebral angiography in this setting.

Misophonia is the adverse emotional reaction to everyday sounds (e.g., chewing or pen clicking). Since atypical sensory experiences are a key feature of autism, we investigated whether autistic individuals are more liable for experiencing misophonia symptoms. In addition, we explore the contribution of sensory sensitivity to misophonia symptoms in autism. Autistic adults (N&#x2009;=&#x2009;1050) filled out the Amsterdam Misophonia Scale-Revised (AMISOS-R), the Autism Spectrum Quotient (AQ-28), and the Sensory Processing Questionnaire (SPQ). Chi-square tests were applied to compare proportion of moderate or higher AMISOS-R scores over 20 to previously reported values in the extant literature. Next we modelled the quantitative level of AMISOS-R scores as function of AQ-28 with age, sex, and co-occurring disorders. Finally, we ran a mediation model adding SPQ as a mediator. Autistic people reported moderate to extreme levels of AMISOS-R in higher proportion than the general population. In particular autistic females and those with co-occurring disorders scored higher. In quantitative models, we found that autistic traits strongly predicted misophonia symptoms after correcting for multiple covariates. Both the hearing and vision subscales of the SPQ significantly mediated the effect. The increased level of misophonia symptoms in autism and the mediation analyses suggest that autistic traits and sensory sensitivity are factors to consider for a subset of misophonia sufferers, with possible consequences for their clinical interventions.

Complicated community-acquired pneumonia (CCAP) in children can result in severe morbidities. While computed tomography (CT) is the gold standard for diagnosis, its radiation exposure has led to the increased use of lung ultrasound (LUS) as a safer radiation-free alternative. This study aimed to evaluate the diagnostic accuracy of LUS in detecting complications in pediatric patients with CCAP and determine its value in their follow up as well as its value in determining patients liable for surgical intervention as pleural decortication comparing its efficacy with chest CT. This is a prospective observational cohort study that was conducted on 56 pediatric patients with CCAP at our tertiary-level referral pediatric hospital. Patients underwent clinical evaluation, laboratory investigations, chest X-ray, CT, and LUS. The sensitivity, specificity, and accuracy of LUS were compared with CT for detecting consolidations, pleural thickening, effusions, lung abscesses, and hydropneumothorax. Compared to CT chest, LUS showed high sensitivity (92.6% for the right lung and 94.1% for the left lung) and specificity (88% and 100%, respectively) in detecting pleural effusions and consolidations, with substantial agreement with CT (p&#x2009;<&#x2009;0.001). However, it had lower sensitivity in detecting lung abscesses (33.3% for the right lung, 0% for the left lung) and hydropneumothorax. Pleural thickness measured by LUS was a predictor for surgical intervention (cut-off >&#x2009;2.2&#xa0;mm). Follow-up LUS indicated significant improvement in lung lesions after one month. LUS is a reliable tool for detecting pleural effusions and consolidations in pediatric CCAP, reducing the need for CT in many cases. However, its limitations in identifying abscesses and hydropneumothorax highlight the need for combined diagnostic approaches.