‘More work needed’ on children’s supervised toothbrushing programmes
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Ethical considerations in AI for child health and recommendations for child-centered medical AI
There does not exist any previous comprehensive review on AI ethics in child health or any guidelines for management, unlike in adult medicine. This review describes ethical principles in AI for child health and provides recommendations for child-centered medical AI. We also introduce the Pediatrics EthicAl Recommendations List for AI (PEARL-AI) framework for clinicians and AI developers to ensure ethical AI enabled systems in healthcare for children.
Assessing airline communication for voluntary carbon offsets
Airlines offer voluntary carbon offsetting (VCO) programmes in response to growing climate action demands. However, these programmes face scrutiny over potential greenwashing in communication. This study uses a two-step approach to examine the communication practices of 32 airlines across Asia, Europe, and North America. The content analysis assesses accessibility, transparency, and flexibility in communications, focusing on emphasizing not just the content but also how easily travellers can find, understand, and engage with VCO information. The interpretive analysis identifies misleading practices. Findings reveal diverse practices, regional variations, and differing transparency levels. While some airlines provide detailed communication, others use misleading tactics such as vagueness and selective disclosure. Notably, a third of the airlines did not offer VCO programmes, with many shifting towards sustainable aviation fuels. The results underscore the need for standardized regulations for VCO communication to enable travellers to make informed decisions in the evolving landscape of airline environmental responsibility.
Enhancing children’s numeracy and executive functions via their explicit integration
Executive functions (EF) are crucial to regulating learning and are predictors of emerging mathematics. However, interventions that leverage EF to improve mathematics remain poorly understood. 193 four-year-olds (mean age = 3 years; 11 months pre-intervention; 111 female, 69% White) were assessed 5 months apart, with 103 children randomised to an integrated EF and mathematics intervention. Our pre-registered hypotheses proposed that the intervention would improve mathematics more than practice as usual. Multi-level modelling and network analyses were applied to the data. The intervention group improved more than the control group in overall numeracy, even when controlling for differences across settings in EF and mathematics-enhancing practices. EF and mathematics measures showed greater interconnectedness post-intervention. In addition, disadvantaged children in the intervention group made greater gains than in the control group. Our findings emphasise the need to consider EFs in their integration with co-developing functions, and in their educational and socio-economic context.
The control of movement gradually transitions from feedback control to feedforward adaptation throughout childhood
The ability to adjust movements in response to perturbations is key for an efficient and mature nervous system, which relies on two complementary mechanisms — feedforward adaptation and feedback control. We examined the developmental trajectory of how children employ these two mechanisms using a previously validated visuomotor rotation task, conducted remotely in a large cross-sectional cohort of children aged 3–17 years and adults (n = 656; 353 males & 303 females). Results revealed a protracted developmental trajectory, with children up to ~13–14 years showing immature adaptation. Younger children relied more on feedback control to succeed. When adaptation was the only option, they struggled to succeed, highlighting a limited ability to adapt. Our results show a gradual shift from feedback control to adaptation learning throughout childhood. We also generated percentile curves for adaptation and overall performance, providing a reference for understanding the development of motor adaptation and its trade-off with feedback control.
Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia
X-linked hypophosphataemia (XLH) is a rare metabolic bone disorder caused by pathogenic variants in the PHEX gene, which is predominantly expressed in osteoblasts, osteocytes and odontoblasts. XLH is characterized by increased synthesis of the bone-derived phosphaturic hormone fibroblast growth factor 23 (FGF23), which results in renal phosphate wasting with consecutive hypophosphataemia, rickets, osteomalacia, disproportionate short stature, oral manifestations, pseudofractures, craniosynostosis, enthesopathies and osteoarthritis. Patients with XLH should be provided with multidisciplinary care organized by a metabolic bone expert. Historically, these patients were treated with frequent doses of oral phosphate supplements and active vitamin D, which was of limited efficiency and associated with adverse effects. However, the management of XLH has evolved in the past few years owing to the availability of burosumab, a fully humanized monoclonal antibody that neutralizes circulating FGF23. Here, we provide updated clinical practice recommendations for the diagnosis and management of XLH to improve outcomes and quality of life in these patients.
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