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Abstract Objectives The social representation (SR) of pediatric surgeons (PSs) can influence the attractiveness of a specialty and the interaction between PSs and other physicians. This study aims to describe and understand the stereotypes and social representations (SRs) associated with PSs among medical students, residents, and physicians in France. Methods This anonymous nationwide web-based survey was posted on social networks and disseminated by e-mail by medical students and residents’ associations. It used hierarchical evocation methods. Qualitative analyses were performed using the Reinert method with factorial analyses. SR was graded from 1 to 5. Results A total of 278 people responded to the survey. Pediatric surgery holds a rather neutral social representation (median 3/5 [IQR 3–4]) but only 3.6% of medical peers strongly considered practicing PS, ranking it 10th out of 12 surgical specialties. The specialty is considered as wide, intense, meticulous, and demanding surgical specialty but also as hyperspecialized and confined to academic centers with a unique parent–child–surgeon relationship, embodying traits such as “empathy”, “humanity”, “passion”, “beautiful[ness]” and “honorab[ility]”. The willingness to pursue a carreer in a PS was positively influenced not only by its social representation (p

Background: The major drivers of carbon dioxide (CO2eq) emissions of external beam radiation therapy (EBRT) are not well known and limit our ability to initiate mitigation strategies. Material and methods: We describe the carbon footprint of four typical centers. We explore direct EBRT associated factors such as the impact of fractionation and use of MRI-LINAC, as well as indirect factors (e.g. patient rides). Treatment strategy related CO2eq emissions are included in a health technology assessment analysis that takes into account CO2eq emissions. Results: A typical EBRT treatment emits from 185 kgCO2eq to 2066 kgCO2eq. CO2eq emissions are mostly driven by (i) accelerator acquisition and maintenance (37.8 %), (ii) patients and workers rides (32.7 %), (iii) drugs and medical devices (7.3 %), (iv) direct energy consumption (6.1 %), and (v) building and bunker construction (5.6 %) with a substantial heterogeneity among centers. Hypofractionation has a strong impact to mitigate emissions. MRI-LINAC is associated with a substantial increase in CO2eq emissions per fraction and requires ultra hypofractionation in 5 fractions to achieve a similar carbon footprint compared to 20 fractions treatment schemes. The expected limited small increase in toxicities due to hypofractionation (when existing) are in the same range as avoided detrimental effects to future people’s health thanks to CO2eq mitigation. Conclusion: Carbon footprint of EBRT is not neglectable and could be mitigated. When safely feasible, hypofractionation is one of the main factors to decrease this impact. Taking into account CO2eq emissions has a substantial impact on the health technology assessment of EBRT, favoring hypofractionated regimens.