Isatou Sarr

The discussion around quality of life in adults born extremely preterm highlights one of the most important gaps in neonatal medicine: we now have increasing numbers of survivors, but our understanding of their lifelong outcomes remains incomplete. Much of the neonatal literature has traditionally focused on survival, short-term morbidity, and childhood neurodevelopment. Yet for families and former preterm infants themselves, the questions that matter often extend far beyond infancy: How do they function as adults? What are their educational, social, psychological, and occupational outcomes? How do they perceive their own quality of life? The encouraging news is that many adults born extremely preterm report good overall quality of life and demonstrate remarkable resilience despite facing higher risks of chronic health conditions, neurodevelopmental challenges, and mental health difficulties. However, outcomes are highly heterogeneous. Some individuals thrive with minimal limitations, while others continue to experience significant physical, cognitive, or social challenges that may not be fully captured by traditional clinical measures. A major challenge is that quality of life is multidimensional and deeply personal. Standardized assessments may not reflect what individuals themselves consider meaningful success or well-being. Furthermore, advances in neonatal care mean that outcomes observed in cohorts born decades ago may not accurately predict the experiences of infants receiving modern care today. This creates a substantial gap between what we know and what we need to know. We need more long-term, patient-centered follow-up studies that extend into adulthood, incorporate patient-reported outcomes, and examine participation in education, employment, relationships, and community life. We also need to better understand protective factors that promote resilience and positive adaptation. Ultimately, survival is only the beginning of the story. As neonatal care continues to advance, our responsibility extends beyond helping extremely preterm infants survive to ensuring that they have the opportunity to achieve the best possible quality of life throughout adulthood.

The question of whether a sub-1250 g infant can grow adequately on breast milk alone remains both clinically relevant and highly important, particularly in resource-limited settings where parenteral nutrition, human milk fortifiers, and specialized supplements may be unavailable. The answer is that some very low birth weight infants can achieve satisfactory growth on exclusive breast milk, but success depends on multiple factors including gestational age, illness severity, feeding tolerance, maternal milk volume, and the infant's individual nutrient requirements. Human milk remains the gold standard because of its immunological, developmental, and gastrointestinal benefits. However, the challenge is that the nutrient content of breast milk may not consistently meet the exceptionally high protein, mineral, and micronutrient demands of extremely small preterm infants. While energy needs can often be met with adequate milk volumes, protein, calcium, phosphorus, iron, zinc, and other micronutrients may become limiting factors over time, potentially affecting growth velocity and body composition. Defining optimal nutrition for preterm infants is itself a moving target. We are trying to replicate a rate of growth and tissue accretion that normally occurs in utero, yet our tools for measuring nutritional adequacy are imperfect. Growth is more than weight gain; it encompasses neurodevelopment, bone mineralization, immune competence, and long-term metabolic health. In many parts of the world, clinicians must balance these ideals against practical realities. Perhaps the most important lesson is that breast milk should not be viewed as inadequate, but rather as a remarkable biological foundation upon which additional nutritional support can be built when available. Where fortification is not possible, careful monitoring of growth, clinical status, and micronutrient deficiencies becomes even more critical. Resource constraints should not diminish our appreciation of breast milk's value, but they do highlight the need for innovative, affordable strategies to optimize nutrition for our smallest and most vulnerable patients.

The Future of Medicine and Medical Research: Artificial Intelligence, Precision Diagnostics, and the Transformation of Global Healthcare We are entering one of the most revolutionary periods in the history of medicine and biomedical science. The convergence of Artificial Intelligence (AI), machine learning, genomics, precision medicine, robotics, and advanced medical microbiology is rapidly transforming healthcare from a reactive system into a predictive, personalized, and data-driven discipline. From neonatal intensive care units to infectious disease surveillance and cancer therapeutics, emerging technologies are reshaping how diseases are diagnosed, monitored, prevented, and treated. As healthcare systems face increasing pressures from antimicrobial resistance, global pandemics, aging populations, and inequitable access to care, the integration of AI into biomedical research and clinical medicine may represent one of the most significant scientific turning points of the 21st century. In medical microbiology, AI-powered diagnostic platforms are already demonstrating the potential to detect pathogens faster than traditional laboratory methods through genomic sequencing, automated imaging, bioinformatics, and predictive analytics. Machine learning algorithms can analyze vast microbiological datasets to identify antimicrobial resistance patterns, forecast outbreaks, and support precision antimicrobial stewardship. Similarly, in neonatal and critical care medicine, AI-assisted monitoring systems are being explored for the early prediction of sepsis, respiratory compromise, and clinical deterioration before overt symptoms emerge. These innovations may dramatically reduce mortality while improving clinical decision-making and resource allocation in both high-income and resource-limited healthcare settings. Beyond diagnostics, the future of medicine is increasingly moving toward precision and individualized healthcare. Advances in molecular biology, omics technologies, immunology, and computational medicine now allow researchers to explore disease at genetic, cellular, and metabolic levels with unprecedented detail. The integration of AI with biomedical science may accelerate drug discovery, improve vaccine development, optimize clinical trials, and uncover novel therapeutic targets faster than ever before. Future healthcare systems may rely on real-time patient data, wearable biosensors, digital twins, and predictive models capable of identifying disease risk before clinical onset. This shift has the potential to redefine preventive medicine and transform patient outcomes globally. However, alongside these remarkable opportunities come major scientific, ethical, and public health questions. Can AI truly replace aspects of clinical reasoning, or should it remain a supportive tool for clinicians and scientists? How do we address algorithmic bias, patient privacy, and unequal technological access between healthcare systems? Will future biomedical scientists require computational and data science expertise alongside traditional laboratory training? Most importantly, how can the global scientific community ensure that these innovations benefit all populations rather than widening existing healthcare disparities? As biomedical science enters the era of intelligent medicine, interdisciplinary collaboration between clinicians, microbiologists, biomedical scientists, data scientists, engineers, and public health experts will become increasingly essential. The future of medical research may not depend solely on technological advancement, but on how effectively science, ethics, innovation, and equitable healthcare delivery can evolve together. The next generation of biomedical professionals will not only diagnose disease, they may help design the intelligent healthcare systems that redefine the future of humanity itself.

Neonatal sepsis continues to represent one of the most critical challenges in neonatal and pediatric care despite major advances in medicine, intensive care technologies, and antimicrobial therapy. The persistent burden of morbidity and mortality associated with neonatal sepsis especially in low- and middle-income countries raises important questions regarding our current diagnostic approaches, treatment strategies, and preventive interventions. Delayed diagnosis, nonspecific clinical presentation, antimicrobial resistance, and limited access to advanced laboratory support remain significant barriers to improved neonatal outcomes. As emerging research continues to explore novel biomarkers, molecular diagnostics, immune profiling, and precision medicine, there is increasing interest in how Artificial Intelligence (AI) and machine learning may transform neonatal care. AI-driven predictive models, electronic health record analytics, real-time monitoring systems, and early warning algorithms may offer opportunities for earlier recognition of sepsis, improved risk stratification, optimized antibiotic stewardship, and ultimately reduced neonatal mortality. However, important concerns also remain regarding data quality, ethical implications, implementation feasibility, and healthcare inequities, particularly in resource-limited settings. Thus, the aim to stimulate an interdisciplinary scientific discussion on the future of neonatal sepsis research and management in the era of digital health and AI innovation. Can AI truly enhance clinical decision-making in neonatal intensive care units, or are we overestimating its current capabilities? Are current biomarkers sufficient for early and accurate diagnosis, or should future research focus more on genomics and precision medicine? How can we balance the urgent need for empirical antibiotic treatment with the growing threat of antimicrobial resistance? Additionally, what practical strategies can be adopted to ensure equitable implementation of AI technologies across different healthcare systems globally? I would be very interested to hear perspectives on the most pressing research gaps, emerging innovations, and future directions in neonatal sepsis care. particularly in the era of AI and Machine Learning. Many thanks, Isatou

This represents a deeply important and timely initiative in global health. There is still much to learn about rapid diagnostics, antimicrobial resistance, neonatal immune responses, and low-cost technologies for early detection in resource-limited settings. By creating a platform dedicated to these challenges, the society may help stimulate interdisciplinary research and support the translation of scientific discoveries into practical clinical solutions.

The expansion of point-of-care ultrasound (POCUS) into critical care, emergency medicine, and neonatology has intensified concerns about it as a potential vector for healthcare-associated infections (HAIs). In the post-COVID era marked by heightened awareness of fomite transmission, environmental persistence of pathogens, and increasing antimicrobial resistance (AMR), POCUS devices represent a uniquely mobile, high-contact interface between patients and clinicians. Surfaces such as probes, gel containers, touchscreens, and cables may facilitate cross-transmission of multidrug-resistant organisms (MDROs) if disinfection practices are inconsistent or suboptimal. This raises urgent questions about microbial ecology in clinical environments and the adequacy of current infection prevention frameworks. Can plasmid-mediated resistance spread be linked epidemiologically to contaminated medical equipment interfaces such as ultrasound probes? Did pandemic-driven PPE and disinfection changes inadvertently select for more resilient environmental organisms on reusable medical equipment? Can single-use probe covers or antimicrobial-coated ultrasound surfaces significantly reduce MDRO transmission risk without compromising image quality? Should infection risk classification for POCUS be upgraded in hospital infection control guidelines to reflect its cross-patient mobility? Can single-use probe covers or antimicrobial-coated ultrasound surfaces significantly reduce MDRO transmission risk without compromising image quality? Are hospital wastewater systems and environmental reservoirs contributing to re-contamination of disinfected ultrasound equipment? What behavioral and cognitive barriers contribute most to inconsistent POCUS disinfection compliance among healthcare workers? Many thanks, Isatou

This initiative by EBNEO plays an important role in advancing evidence-based practice by disseminating concise and critical #NeoEBM summaries of high-quality original research articles. Such efforts contribute significantly to knowledge translation, support clinical decision-making, and promote continuous professional development within the neonatal and pediatric research community. Given the emerging evidence that infants with mild HIE may experience significant neurodevelopmental impairment, should therapeutic hypothermia and advanced MRI assessment become standard practice for all cases of mild HIE, or should treatment remain selective until stronger randomized controlled trial evidence becomes available?