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Computer modeling of the cardiovascular system has potential to revolutionize personalized medical care. This is especially promising for congenital heart defects, such as ventricular septal defect (VSD), a hole between the two ventricles of the heart. However, relatively few studies have built computer models for VSD, nor have they considered how natural adaptation to the cardiovascular system with age might interact with the presence of a small, medium, or large size VSD. Here, we combine a lumped parameter model of the cardiovascular system with two key modeling components: a size-dependent resistance dictating shunt flow between the two ventricles and age-dependent scaling relationships for the systemic and pulmonary circulations. Our results provide insight into changes in hemodynamic conditions with various VSD sizes. We investigate the combined effects of VSD size, vascular parameters, and age, showing distinct differences with these three factors. This study lays the necessary foundation for studying VSD and towards building digital shadows and digital twins for managing VSD in pediatrics.

Artificial intelligence systems that record voice and video during pediatric emergencies are emerging as human-computer interaction (HCI) technologies with direct implications for clinical work, promising improvements in documentation, team performance, and post-event debriefing. Yet the perspectives of those most affected, including clinicians, parents, and child patients, remain largely absent from the design and governance of these technologies. This position paper argues that this has direct consequences for the legitimacy and effectiveness of these systems. We examine four areas where these missing perspectives prove consequential (consent, emotional impact, surveillance dynamics, and participatory governance) and propose four positions for reorienting AI recording in pediatric emergency care toward stakeholder-centered HCI inquiry.

Accurate diagnosis of pediatric brain tumors, starting with histopathology, presents unique challenges for deep learning, including severe data scarcity, class imbalance, and fine-grained morphologic overlap across diagnostically distinct subtypes. While pathology foundation models have advanced patch-level representation learning, their effective adaptation to weakly supervised pediatric brain tumor classification under limited data remains underexplored. In this work, we introduce an expert-guided contrastive fine-tuning framework for pediatric brain tumor diagnosis from whole-slide images (WSI). Our approach integrates contrastive learning into slide-level multiple instance learning (MIL) to explicitly regularize the geometry of slide-level representations during downstream fine-tuning. We propose both a general supervised contrastive setting and an expert-guided variant that incorporates clinically informed hard negatives targeting diagnostically confusable subtypes. Through comprehensive experiments on pediatric brain tumor WSI classification under realistic low-sample and class-imbalanced conditions, we demonstrate that contrastive fine-tuning yields measurable improvements i

Background: Pediatric dental disease remains one of the most prevalent and inequitable chronic health conditions worldwide. Although strong epidemiological evidence links oral health outcomes to socio-economic and demographic determinants, most artificial intelligence (AI) applications in dentistry rely on image-based diagnosis and black-box prediction models, limiting transparency and ethical applicability in pediatric populations. Objective: This study aimed to develop and evaluate an explainable machine learning framework for pediatric dental risk stratification that prioritizes interpretability, calibration, and ethical deployment over maximal predictive accuracy. Methods: A supervised machine learning model was trained using population-level pediatric data including age, income-to-poverty ratio, race/ethnicity, gender, and medical history. Model performance was assessed using receiver operating characteristic (ROC) analysis and calibration curves. Explainability was achieved using SHapley Additive exPlanations (SHAP) to provide global and individual-level interpretation of predictions. Results: The model achieved modest discrimination (AUC = 0.61) with conservative calibration

Pediatric liver tumors are one of the most common solid tumors in pediatrics, with differentiation of benign or malignant status and pathological classification critical for clinical treatment. While pathological examination is the gold standard, the invasive biopsy has notable limitations: the highly vascular pediatric liver and fragile tumor tissue raise complication risks such as bleeding; additionally, young children with poor compliance require anesthesia for biopsy, increasing medical costs or psychological trauma. Although many efforts have been made to utilize AI in clinical settings, most researchers have overlooked its importance in pediatric liver tumors. To establish a non-invasive examination procedure, we developed a multi-stage deep learning (DL) framework for automated pediatric liver tumor diagnosis using multi-phase contrast-enhanced CT. Two retrospective and prospective cohorts were enrolled. We established a novel PKCP-MixUp data augmentation method to address data scarcity and class imbalance. We also trained a tumor detection model to extract ROIs, and then set a two-stage diagnosis pipeline with three backbones with ROI-masked images. Our tumor detection mode

Pediatric medical imaging presents unique challenges due to significant anatomical and developmental differences compared to adults. Direct application of segmentation models trained on adult data often yields suboptimal performance, particularly for small or rapidly evolving structures. To address these challenges, several strategies leveraging the nnU-Net framework have been proposed, differing along four key axes: (i) the fingerprint dataset (adult, pediatric, or a combination thereof) from which the Training Plan -including the network architecture-is derived; (ii) the Learning Set (adult, pediatric, or mixed), (iii) Data Augmentation parameters, and (iv) the Transfer learning method (finetuning versus continual learning). In this work, we introduce PSAT (Pediatric Segmentation Approaches via Adult Augmentations and Transfer learning), a systematic study that investigates the impact of these axes on segmentation performance. We benchmark the derived strategies on two pediatric CT datasets and compare them with state-of-theart methods, including a commercial radiotherapy solution. PSAT highlights key pitfalls and provides actionable insights for improving pediatric segmentation.

Pediatric brain tumor segmentation presents unique challenges due to the rarity and heterogeneity of these malignancies, yet remains critical for clinical diagnosis and treatment planning. We propose an ensemble approach integrating nnU-Net, Swin UNETR, and HFF-Net for the BraTS-PED 2025 challenge. Our method incorporates three key extensions: adjustable initialization scales for optimal nnU-Net complexity control, transfer learning from BraTS 2021 pre-trained models to enhance Swin UNETR's generalization on pediatric dataset, and frequency domain decomposition for HFF-Net to separate low-frequency tissue contours from high-frequency texture details. Our final ensemble framework combines nnU-Net ($γ=0.7$), fine-tuned Swin UNETR, and HFF-Net, achieving Dice scores of 62.7% (CC), 83.2% (ED), 72.9% (ET), 85.7% (NET), 91.8% (TC), and 92.6% (WT) on the unseen test dataset, respectively. Our proposed method achieves first place (rank 1st) in the BraTS 2025 Pediatric Brain Tumor Segmentation Challenge.

The emergence of Large Language Models (LLMs) in the medical domain has stressed a compelling need for standard datasets to evaluate their question-answering (QA) performance. Although there have been several benchmark datasets for medical QA, they either cover common knowledge across different departments or are specific to another department rather than pediatrics. Moreover, some of them are limited to objective questions and do not measure the generation capacity of LLMs. Therefore, they cannot comprehensively assess the QA ability of LLMs in pediatrics. To fill this gap, we construct PediaBench, the first Chinese pediatric dataset for LLM evaluation. Specifically, it contains 4,117 objective questions and 1,632 subjective questions spanning 12 pediatric disease groups. It adopts an integrated scoring criterion based on different difficulty levels to thoroughly assess the proficiency of an LLM in instruction following, knowledge understanding, clinical case analysis, etc. Finally, we validate the effectiveness of PediaBench with extensive experiments on 20 open-source and commercial LLMs. Through an in-depth analysis of experimental results, we offer insights into the ability of

Pulmonary arterial hypertension (PAH) is a progressive cardiopulmonary disease that leads to increased pulmonary pressures, vascular remodeling, and eventual right ventricular (RV) failure. Pediatric PAH remains understudied due to limited data and the lack of targeted diagnostic and therapeutic strategies. In this study, we developed and calibrated multi-scale, patient-specific cardiovascular models for four pediatric PAH patients using longitudinal MRI and catheterization data collected approximately two years apart. Using the CRIMSON simulation framework, we coupled three-dimensional fluid-structure interaction (FSI) models of the pulmonary arteries with zero-dimensional (0D) lumped-parameter heart and Windkessel models to simulate patient hemodynamics. An automated Python-based optimizer was developed to calibrate boundary conditions by minimizing discrepancies between simulated and clinical metrics, reducing calibration time from weeks to days. Model-derived metrics such as arterial stiffness, pulse wave velocity, resistance, and compliance were found to align with clinical indicators of disease severity and progression. Our findings demonstrate that computational modeling can

Pediatric chest X-ray imaging is essential for early diagnosis, particularly in low-resource settings where advanced imaging modalities are often inaccessible. Low-dose protocols reduce radiation exposure in children but introduce substantial noise that can obscure critical anatomical details. Conventional denoising methods often degrade fine details, compromising diagnostic accuracy. In this paper, we present SharpXR, a structure-aware dual-decoder U-Net designed to denoise low-dose pediatric X-rays while preserving diagnostically relevant features. SharpXR combines a Laplacian-guided edge-preserving decoder with a learnable fusion module that adaptively balances noise suppression and structural detail retention. To address the scarcity of paired training data, we simulate realistic Poisson-Gaussian noise on the Pediatric Pneumonia Chest X-ray dataset. SharpXR outperforms state-of-the-art baselines across all evaluation metrics while maintaining computational efficiency suitable for resource-constrained settings. SharpXR-denoised images improved downstream pneumonia classification accuracy from 88.8% to 92.5%, underscoring its diagnostic value in low-resource pediatric care.

Pediatric dental segmentation is critical in dental diagnostics, presenting unique challenges due to variations in dental structures and the lower number of pediatric X-ray images. This study proposes a custom SegUNet model with a VGG19 backbone, designed explicitly for pediatric dental segmentation and applied to the Children's Dental Panoramic Radiographs dataset. The SegUNet architecture with a VGG19 backbone has been employed on this dataset for the first time, achieving state-of-the-art performance. The model reached an accuracy of 97.53%, a dice coefficient of 92.49%, and an intersection over union (IOU) of 91.46%, setting a new benchmark for this dataset. These results demonstrate the effectiveness of the VGG19 backbone in enhancing feature extraction and improving segmentation precision. Comprehensive evaluations across metrics, including precision, recall, and specificity, indicate the robustness of this approach. The model's ability to generalize across diverse dental structures makes it a valuable tool for clinical applications in pediatric dental care. It offers a reliable and efficient solution for automated dental diagnostics.

This study explores the integration of artificial intelligence (AI) or large language models (LLMs) into pediatric rehabilitation clinical documentation, focusing on the generation of SOAP (Subjective, Objective, Assessment, Plan) notes, which are essential for patient care. Creating complex documentation is time-consuming in pediatric settings. We evaluate the effectiveness of two AI tools; Copilot, a commercial LLM, and KAUWbot, a fine-tuned LLM developed for KidsAbility Centre for Child Development (an Ontario pediatric rehabilitation facility), in simplifying and automating this process. We focus on two key questions: (i) How does the quality of AI-generated SOAP notes based on short clinician summaries compare to human-authored notes, and (ii) To what extent is human editing necessary for improving AI-generated SOAP notes? We found no evidence of prior work assessing the quality of AI-generated clinical notes in pediatric rehabilitation. We used a sample of 432 SOAP notes, evenly divided among human-authored, Copilot-generated, and KAUWbot-generated notes. We employ a blind evaluation by experienced clinicians based on a custom rubric. Statistical analysis is conducted to asse

Neuroblastoma, is a highly heterogeneous pediatric tumour and is responsible for 15% of pediatric cancer-related deaths. The clinical outcomes can vary from spontaneous regression to high metastatic disease. This extracranial tumour arises from a neural crest-derived cell and can harbor different phenotypes. Its heterogeneity may result from variations in differentiation states influenced by genetic and epigenetic factors and individual patient characteristics. This leads downstream to disruption of homeostasis and a metabolic shift in response to the tumour needs. Nutrition can play a key role in influencing various aspects of a tumour behaviour. This review provides an in-depth exploration of the aetiology of neuroblastoma and the different avenues of disease progression, which can be targeted with individualized nutrition intervention strategies to improve the well-being of children and optimize clinical outcomes.

Objectives: Magnetic resonance elastography (MRE) is a noninvasive technique for assessing the viscoelastic properties of soft biological tissues in vivo, with potential relevance for pediatric tumor evaluation. This study aimed to evaluate the feasibility of multifrequency MRE in children with solid tumors and to report initial findings on stiffness and fluidity across rare pediatric tumor entities. Additionally, the potential of viscoelastic properties as biomarkers of tumor malignancy was explored. Materials and Methods: Ten pediatric patients (mean age, 5.7 +/- 4.8 years; four female) with extracranial solid tumors underwent multifrequency MRE. Shear waves at 30 - 70 Hz were subsequently generated and measured with a phase-sensitive single-shot spin-echo planar imaging sequence. The obtained shear wave fields were processed by wavenumber (k-)based multi-frequency inversion to reconstruct tumor stiffness and fluidity. The viscoelastic properties within the tumors were quantified and correlated with the apparent diffusion coefficient (ADC). In addition, differences in stiffness and fluidity were assessed across the histopathologically confirmed tumor entities, which were stratifi

Artificial intelligence-enhanced electrocardiogram (AI-ECG) has shown promise as an inexpensive, ubiquitous, and non-invasive screening tool to detect left ventricular systolic dysfunction in pediatric congenital heart disease. However, current approaches rely heavily on large-scale labeled datasets, which poses a major obstacle to the democratization of AI in hospitals where only limited pediatric ECG data are available. In this work, we propose a robust training framework to improve AI-ECG performance under low-resource conditions. Specifically, we introduce an on-manifold adversarial perturbation strategy for pediatric ECGs to generate synthetic noise samples that better reflect real-world signal variations. Building on this, we develop an uncertainty-aware adversarial training algorithm that is architecture-agnostic and enhances model robustness. Evaluation on the real-world pediatric dataset demonstrates that our method enables low-cost and reliable detection of left ventricular systolic dysfunction, highlighting its potential for deployment in resource-limited clinical settings.