Sevoflurane and propofol, the common anesthetic agents, have been under evaluation for emergence delirium in children. This pilot study examined how frontal cortex blood flow during sevoflurane and propofol anesthesia relates to emergence delirium in children aged 3-10 using functional near-infrared spectroscopy (fNIRS). Seventy-four children, undergoing urologic and orthopedic surgeries, were randomly assigned to either propofol (n = 37) or sevoflurane (n = 37) after obtaining approval from the institute ethics committee, written informed parental consent, assent, and registration in a clinical trial registry. Children with perinatal hypoxia, preterm birth, seizures, developmental disorders, psychiatric illness, or electrolyte imbalances were excluded. Anesthesia was induced and maintained per standard protocols, and pain was managed using paracetamol, ketorolac, and caudal analgesia. fNIRS readings were recorded at induction and reversal. Postoperatively, emergence delirium was assessed using the PAED and Cornell Assessment of Pediatric Delirium (CAPD) scales. Data were collected using a 20-channel fNIRS system and analyzed with NIRStar software. Frontal cortex fNIRS demonstrated agent-specific cortical patterns during anesthesia induction, with distinct neural activity differences related to ED. Under propofol, children without ED demonstrated greater left frontal activation (channel4; t = 2.30, p < 0.005), whereas those with ED showed deactivation; extubation showed no differences. Sevoflurane induction revealed that children without delirium showed greater deactivation in multiple frontal channels-channel 13 (right medial/superior frontal gyri; t = -2.252, p < 0.05), channel 2 (left middle/superior frontal gyri; t = -2.252, p < 0.05), and channel 17 (rightsuperior/middle frontal gyri; t = -3.15, p < 0.05), while no differences were observed during extubation. ED was more frequent with sevoflurane (18.9%) compared to propofol (5.4%). Sevoflurane was linked to significantly less deactivation (moreactivation) in frontal brain regions in children with emergence delirium, compared to propofol during both induction, notable in channel 4 (leftmiddle and superior frontal gyrus) (t = -5.756, p < 0.005) and extubation notable in channel 2 (left middle and superior frontal gyri) (t = -6.877, p < 0.05). The increased frontal cortical activation with sevoflurane may contribute to a higher incidence of emergence delirium in children compared to propofol. Clinical trial registry: CTRI/2022/04/041573; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NjQ3NTM.

This study evaluated eye movements (i.e., regressions, fixations, and saccades) in a variety of reading contexts in school-age children with and without reading disorders (RDs). This study used an experimental design with two groups: peers with RDs and typically developing (TD) peers. A Tobii Pro Spectrum system was used to capture eye movement data for all participants during the reading tasks under the following conditions: (a) single words without cognitive demand, (b) single-word reading with cognitive demand, and (c) grade-level paragraph reading text. The results indicated significant differences between the groups in the duration of fixation and number of regressions. In addition, participants in the RD group exhibited significantly more saccades while reading than their TD counterparts. Although reading is a language-based skill involving five areas of language (morphology, phonology, syntax, pragmatics, and semantics), this study offers a unique perspective and objective measurement while highlighting the role of eye movements in reading. The results of this study showed distinctive eye responses in school-age children with RDs. These findings underscore the value of eye tracking as a diagnostic and research tool, offering an objective window into the complex interplay among visual, linguistic, and cognitive processes that underlie reading.

This study examined how parent factors (i.e., permissive parenting, beliefs about the benefits of injuries) and child factors (i.e., risk-taking propensity, disclosure of information to parents about location and activities, secret keeping) predict the occurrence of injuries in pre-adolescents and adolescents. To garner a more comprehensive understanding of how parent gender and child gender each impact injury risk across developmental stages in later childhood, mothers' and fathers' perspectives were examined, and sons and daughters were considered separately. One hundred eighteen parent-child triads provided survey data (61 pre-adolescent, 57 adolescent). Children reported on disclosures about their activities and whereabouts to their parents and intentional secret keeping. Mothers and fathers each reported on their child's injury history and risk-taking propensity, as well as their permissiveness in parenting and beliefs about the benefits of their child sustaining minor injuries. Greater risk-taking propensity predicted injuries for sons but not daughters, across both pre-adolescence and adolescence, and based on both mothers' and fathers' reports. Parental belief in the benefits of injuries was associated with more frequent injuries among pre-adolescents. Parental knowledge about their children's activities and whereabouts significantly reduced injury risk for adolescents. Fathers' permissiveness and sons' keeping secrets from fathers both predicted higher injury risk in adolescence. Parent and child attributes both contribute to injury risk in later childhood, but the effects differ as a function of the developmental level of the child and the gender of the parent and child. Implications for injury prevention are discussed.

This research is motivated by the importance of developing early childhood numeracy skills through concrete and sustainable media. The purpose of this study is to describe the implementation of ecobrick activities in stimulating children's numeracy skills, analyze their impact, and identify challenges and opportunities in their implementation. This study uses a descriptive qualitative approach. Data was collected through observations, interviews, and documentation of children's activities when processing plastic waste into ecobricks. The results of the study show that ecobrick activities significantly stimulate children's numeracy skills through three main aspects: 1) The use of numbers and symbols, where children learn to recognize and count the number of bottles and garbage concretely; 2) Contextual problem solving, through estimation of material needs and comparison of sizes (weight and length); and 3) Simple data-driven decision-making in project work. The main challenge found is the consistency of material availability, while the opportunity lies in the integration of environmental education in the PAUD curriculum. In conclusion, ecobricks are effective as an interactive numeracy learning medium while instilling the character of caring for the environment from an early age.

Physical activity (PA) is essential for the healthy development of children. However, the pervasive presence of digital technologies has made digital gaming (DG) a prominent part of children's everyday lives. As children grow up immersed in these digital environments, concerns about reduced PA have intensified. Given that adults, particularly parents and guardians, play a central role in guiding children's behavior, their understanding of children's motivational drivers for both PA and DG is of particular relevance. This study aimed to explore the motivational differences underlying children's engagement in either PA or DG. Specifically, the study investigated five distinct motivational scales (recreation, social interaction, coping, competition, and skill) to determine which motives primarily drive behavior in each context. Also, it assessed whether adults accurately perceive these motives in children. Data were collected during events using an on-site questionnaire based on the Videogaming Motives Questionnaire. Both children and their accompanying adults completed parallel assessments regarding motives for PA and DG. The final sample included 94 participants forming 49 parent-child pairs. A 3-way mixed ANOVA with group as a between-subjects factor and activity and motive as within-subjects factors was conducted to examine group, activity, and motive effects and their interactions. To further explore these effects, a series of 2 × 5 repeated measures ANOVAs were conducted to examine the interaction between activity type and motivational dimension across groups, followed by separate multivariate tests per motive. A significant interaction effect between activity type and motivational dimension emerged in the children's data (F4,45=3.93, P=.008, partial η²=.259). Further analyses showed that motive competition was rated significantly higher for DG than for PA (F1,48=4.38, P=.04, partial η²=.084). Among adults, separate multivariate tests for each motivational dimension revealed the largest difference in perceived motive coping (F1,48=4.72, P=.01, partial η²=.123), with PA rated higher than DG. Additionally, a significant difference emerged for motive competition (F1,48=4.10, P=.05, partial η²=.079), indicating higher ratings for DG compared to PA. The findings emphasize the complexity of children's motivational profiles, suggesting that engagement in DG is not necessarily a sign of diminished interest in PA but rather reflects alternative, equally compelling motivations. This nuanced understanding challenges simplistic dichotomies and supports the need for balanced perspectives on children's activity preferences. Importantly, no statistically significant differences were detected between children's self-reported motives and adults' perceptions of their children's motives, suggesting a general tendency toward similar ratings rather than clear evidence of alignment. These insights can inform the development of more tailored strategies for promoting both physical and digital engagement in a healthy and complementary manner.

Population-level physical activity surveillance is critical for informing research, practice, and policy efforts for supporting healthy development. The 2024 US Report Card on Physical Activity for Children and Youth synthesizes the most recent national data on physical activity levels and supports among US children and youth. A committee of experts evaluated 12 indicators related to physical activity in children and youth using the best available national data for each indicator. Based on established criteria from the Active Healthy Kids Global Alliance, letter grades (A-F) were assigned to the indicators to reflect how well the United States is succeeding at providing children and youth with opportunities for physical activity. Key metrics within select indicators were evaluated for differences among racial/ethnic and disability subgroups and trends over time since the first report card (2014) or earliest available data. Sufficient data were available to assign grades for 8 indicators. The grades ranged from B- to D-, with Overall Physical Activity earning a D-. Racial/ethnic disparities were observed for the Overall Physical Activity, Organized Sport, Sedentary Behavior, Sleep, and Community and Built Environment indicators. Key metrics for Overall Physical Activity and Active Transportation metrics decreased slightly over the past decade, whereas larger decreases were observed for Organized Sport and Sedentary Behavior metrics. Findings highlight opportunities to improve physical activity levels and supports among US children and youth. The 2024 Report Card can be a tool for informing research and practice at the local and national levels.

Children and adolescents with Down syndrome (DS) are at risk of obesity due to a reduced level of physical activity (PA). PA in children and adolescents with DS is a multifaceted phenomenon that includes personal, relationship, community and other social factors. Hence, a comprehensive understanding of how each component interacts with the others is required. Based on the socio-ecological model, this study aimed to identify the socio-ecological factors associated with PA in children and adolescents with DS through a mixed-methods systematic review. A systematic search was performed using PubMed, CINAHL, PsycINFO and Web of Science databases in February 2024. Inclusion criteria were studies investigating factors related to PA, involving at least one of the target populations (children and adolescents with DS or their parents), published in peer-reviewed journals and written in English. Studies assessing the effectiveness of PA, systematic reviews and unpublished studies were excluded. The methodology was appraised using the Mixed Methods Appraisal Tool. Data were extracted and synthesised in a sequential explanatory design using the socio-ecological model. Databases were searched for 1022 articles; 17 studies (10 quantitative and 7 qualitative) were included and synthesised in this review. Based on the socio-ecological model, the following factors were identified at four levels: (1) physical and cognitive ability to participate in PA at the personal level, (2) competing family responsibilities and overprotective parenting at the family level, (3) peer support and community programmes at the community level and (4) absence of state support for PA programmes at the policy level. To support the PA of children and adolescents with DS, factors affecting PA at the personal, family, community and policy levels must be considered. Community stakeholders and policymakers can use the findings of this review to develop and improve programmes for children and adolescents with DS.

This article conceptualizes active tourism as a strategy for promoting physical activity (PA) among children and adolescents and examines the literature that has analyzed its different modalities and their application across diverse settings and contexts. A systematic review (2015–2025) was conducted in accordance with PRISMA 2020, with searches performed in PubMed, Scopus, and Web of Science. Predefined inclusion and exclusion criteria were applied, alongside rigorous screening procedures and methodological quality assessment. Twelve studies were included, covering experiential and knowledge-oriented modalities implemented in curricular, extracurricular, family, and community contexts. The results show that active tourism increases PA frequency, duration, and intensity, and enhances physical fitness indicators as well as psychosocial variables (intrinsic motivation, enjoyment, autonomy, and competence). Experiential modalities and rural/natural environments predominate, generally yielding stronger effects than urban or mixed settings; however, these latter contexts broaden reach and equity by integrating activities into daily routines. Conceptual heterogeneity and the scarcity of longitudinal studies limit the estimation of sustained effects and the comparison across modalities. At present, active tourism emerges as a transversal approach to promoting meaningful PA in children and adolescents, integrating movement, learning, and well-being. Comparative and longitudinal designs capable of quantifying dose–response patterns by modality and setting are recommended, as well as policies that strengthen school–family–community linkages to enhance adherence and reduce inequalities in access to active opportunities.

Background: Children with Autism Spectrum Disorders (ASDs) are generally more sedentary than their typically developing (TD) peers, resulting in a negative impact on their physical and cognitive development. Moreover, children with ASD are less involved in physical activity and sports. This systematic review aimed to investigate the effectiveness of physical activity in children with ASD. Methods: As data sources, PubMed (NML), Web of Science—Core Collection (Clarivate), Web of Science—MedLine (Clarivate), and Scopus were searched for relevant studies, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The literature search was performed in March 2024, and a supplementary search was conducted in October 2024. Eligibility criteria: The included studies were randomized controlled trials (RCTs) evaluating the effect of physical activity in children with ASD. Results: Sixteen studies were included following the PRISMA guidelines, involving a total of 465 participants. Intervention varied by type (land-based vs. aquatic), duration (7 weeks–one year), frequency (2–4 sessions/week) and session length (25–60 min). Evidence shows that physical activity interventions can positively influence motor coordination, with 81.2% of studies reporting beneficial effects, particularly in balance, motor coordination and overall motor proficiency. Land-based physical activity interventions may be an effective strategy for children with ASD, primarily due to their feasibility and accessibility. Conclusion: Physical activity intervention can improve motor coordination in children with ASD, with land-based programs generally being more accessible and aquatic program offering additional sensory–motor benefits for children with greater impairments. The current systematic review highlights the benefits of implementing physical activity in children with ASD, including extracurricular and school-based programs, to significantly enhance their functional outcomes, well-being, and overall quality of life.

Abstract Background Play provides an important foundation for a healthy childhood but longitudinal data exploring how play experiences relate to children's mental health over time is scarce. In this study, data on preschool‐aged children's activities and mental health during Covid‐19 related restrictions was used to explore how where (inside/outside) and with whom children played related to internalising and externalising problems over time. Methods UK based parents/carers ( n = 1028) of preschool‐aged children (2–5 years) completed an online survey at four time points between April and July 2020. The survey asked how much time in the previous week their child had spent: Playing inside; Playing outside; Playing alone; Playing with a parent; Playing with another child in their household; and their child's mental health (Strengths and Difficulties Questionnaire internalising and externalising scales). Four hierarchical linear regression analyses were conducted to examine associations between where children play (inside/outside) and (1) internalising and (2) externalising symptoms, and with whom children play (with parent, other child, alone) and (3) internalising and (4) externalising symptoms. Effects of linear and quadratic time, and interactions between play and time were examined. Parent mental health, parent education, contact with nature and physical activity were included as covariates. Results Both inside and outside play was associated with less severe internalising problems (beta = −0.23 [SE = 0.10]; beta −0.54 [SE = 0.19]) and, in statistical interaction with time, less time playing inside was associated with a stronger improvement in externalising problems over time (beta = 0.77 [SE = 0.23]). Further, more time playing with other children was associated with less severe internalising problems (beta = −0.50 [SE = 0.13]) whereas playing alone was associated with more severe internalising problems (beta = 0.28 [SE = 0.10]). Conclusion Varied play opportunities are related to young children's mental health. Even during a pandemic response, children should be given opportunity to play with other children and play outdoors wherever possible.

Accurately monitoring the screen exposure of young children is important for research related to screen use, such as childhood obesity, physical activity, and social interaction. Most existing studies rely upon self-report or manual measures from bulky wearable sensors, thus lacking efficiency and accuracy in capturing quantitative screen exposure data. In this work, we developed a novel screen detection framework that utilizes egocentric images from a wearable sensor, named the screen time tracker (STT), and a vision language model (VLM). In particular, we devised a multi-view VLM that takes multiple views from egocentric image streams and interprets screen exposure dynamically. We validated our approach by using a dataset of children's free-living activities, demonstrating significant improvement over existing methods in conventional vision language models and object detection models. The combination of a vision language model and a lightweight hardware design provides a novel solution in screen detection for children. The proposed framework has great potential to benefit children's behavioral study. The code is available at https://github.com/YGanLab/MV-VLM.

In a previous paper, we showed in children 6-12 years old that a resting-state (RS) eyes-open dark room (DR) task provides RS parietal-occipital alpha measures similar to those obtained using the standard RS eyes-closed (EC) exam. Results provided initial evidence that theRS DR procedure is feasible and useful with populations often excluded from electrophysiology RS studies, such as participants who cannot remain awake with their eyes closed or cannot remain still for an extended period. The present study extended the DR and EC comparisons to a much larger sample of children spanning a wider age range and expanded the analysis strategy to examine RS aperiodic measures (offset and slope [exponent] of the power spectrum) and to evaluate 15 distinct brain regions rather than just the previously examined parieto-occipital RS periodic alpha activity. RS activity was recorded using MEG, here reporting on 147 DR and EC datasets obtained from children (including 23 with evaluable datasets at multiple timepoints) with typical development (TD; N = 69) and children with autism spectrum disorder (ASD; N = 53) 7.7-17.1 years old. Findings showed good reliability in both TD and ASD for the EC and DR parietal-occipital peak alpha frequency (frequency with highest alpha power; interclass correlation [ICC] = 0.84, p < 0.001). The ICC for periodic parieto-occipital PAF power was lower (ICC = 0.65). For offset and exponent, the two RS aperiodic measures, fair to good reliability for both groups was observed between DR and EC at all 15 brain regions (mean and median ICC values 0.77-0.80). Offset and exponent values differed significantly across the 15 brain regions, as did associations between age and both aperiodic measures. Findings confirm that the DR exam is a viable way to obtain RS periodic and aperiodic measures. The lack of TD/ASD differences in the EC and DR periodic and aperiodic ICCs supports the generalizability of the DR procedure. Finally, regional differences in aperiodic measures demonstrate the need to assess aperiodic activity in brain source space rather than scalp sensor space.

Developmental Coordination Disorder (DCD) is a multifactorial motor disorder that significantly impacts a child's activities of daily living and academic skills. Identifying signs of DCD early is essential to enable timely support and reduce the risk of long-term difficulties. This cross-sectional study aimed to further investigate the psychometric properties of the Greek version of the Little Developmental Coordination Disorder Questionnaire (LDCDQ) by carrying out appropriate analyses in a convenience sample of 3- to 5- year old children in Greece. A total of 362 preschool children aged 3-5 years old from 39 municipal kindergartens in Thessaloniki, Greece participated in this study. Parents filled out the Greek LDCDQ. Internal consistency of the LDCDQ-GR was determined by Cronbach's alpha. Construct validity was investigated using factor analysis RESULTS: Internal consistency of the LDCDQ-GR was 0.88. Factor analysis resulted in three factors (Locomotor, Fine motor and General Coordination skills). No effects of age (H(2) = 3.93, p = 0.14, η2 = 0.005) and gender (H(1) = 2.75, p = 0.09, η2 = 0.005) were depicted for the LDCDQ-GR final score. LDCDQ-GR appears to be a reliable and well-structured questionnaire for identifying preschool-aged (3-5 years old) children in Greece who may be at risk for DCD.

Pediatric delirium is a significant disorder which affects a child's psychomotor activity, sleep, emotions, perception, attention, and consciousness. It is commonly observed in pediatric intensive care units. The aim of this study is to investigate the knowledge, monitoring, and assessment practices related to delirium among nurses working in pediatric intensive care units. This descriptive and cross-sectional study was conducted between January 30, 2022, and April 15, 2024, with 71 nurses working in public hospitals in Ankara, Turkey. Data were collected using an online survey method with a "Descriptive Information Form" and a "Pediatric Delirium Knowledge Assessment Questionnaire." The majority of nurses had not received training on delirium (80.3%) and did not assess delirium in their clinical practice (88.3%). In all, 85.9% considered urinary catheters, 73.2% considered mechanical ventilators, and 53.5% considered congenital heart disease not to be risk factors for delirium. The majority believed that delirium is always hyperactive (90.1%), lasts for a few hours (77.5%), and that changes in the sleep-wake cycle are not a sign of delirium (50.7%). They thought that some nursing interventions that could be used to prevent delirium; such as wearing glasses (54.9%), early mobilization (77.5%), regularly assessing pain (54.9%), and not leaving the lights on for 24 hours. This study has revealed that nurses working in pediatric intensive care units in central Türkiye have significant knowledge gaps regarding the risk factors, symptoms, and management of delirium. It is recommended to organize training programs for intensive care nurses to facilitate the early detection and proper management of pediatric delirium, use validated and reliable pediatric delirium assessment tools in pediatric intensive care units, and develop evidence-based care guidelines.

The purpose of this research is to identify 1) how the implementation of facility and infrastructure management at SDN 5 Sindangsari Cimerak is, 2) how the learning outcomes at SDN 5 Sindangsari Cimerak are, 3) what are the supporting and inhibiting factors in the implementation of facility and infrastructure management at SDN 5 Sindangsari Cimerak. This study employs a qualitative approach with a descriptive method. Data collection techniques include observation, interviews, and documentation. The obtained data were analyzed using data reduction techniques, data presentation, and conclusion drawing. The results of the study indicate that the implementation of facilities and infrastructure management at SDN 5 Sindangsari Cimerak has been carried out through the stages of planning, procurement, inventory, utilization, maintenance, and disposal. However, challenges remain, such as budget constraints, low awareness of facility maintenance, and inadequate learning facilities. Nevertheless, supporting factors such as assistance from the school administration and the Department of Education contribute to enhancing the effectiveness of facilities and infrastructure management. the improvement in student learning outcomes at SDN 5 Sindangsari Cimerak shows positive results. The main factor supporting the achievement of improved student learning outcomes is teacher competence. Other supporting factors include the management of school facilities and infrastructure, as well as the active role of parents in motivating and monitoring their children's learning activities at home.

Background. Physical inactivity among children has risen globally, driven by sedentary behaviors and technology-mediated lifestyles. Emerging research suggests that virtual reality (VR) and gamification may serve as effective digital interventions for promoting physical activity (PA) and improving children’s health outcomes. Objectives. This systematic review aimed to synthesize and critically evaluate the current evidence on VR- and gamification-based interventions designed to promote PA among children, with a focus on intervention characteristics, theoretical mechanisms, effectiveness, and implementation considerations. Methods. Peer-reviewed studies were retrieved from Scopus, ERIC, and the ACM Digital Library. Eligible studies included intervention research involving children and adolescents aged 5–18 years that applied VR, exergaming, or gamified digital interventions to promote PA or related health outcomes. Data were extracted and synthesized according to intervention typology, theoretical underpinnings, outcomes, and implementation features. Results. The review included 11 intervention studies published between 2021 and 2025. Overall, VR- and gamification-based interventions demonstrated positive effects on PA engagement, motor outcomes, and selected psychosocial indicators. Effective designs commonly integrated goal setting, feedback, social comparison, and reward mechanisms, often aligned with Self-Determination Theory and Social Cognitive Theory. Key implementation barriers included cost, accessibility, and staffing requirements, while facilitators involved remote delivery models, stakeholder engagement, and the use of consumer-level hardware. Conclusions. VR and gamification hold significant potential for promoting children’s PA when interventions are theoretically grounded and well implemented. However, evidence for long-term effectiveness, sustainability, and equitable access remains limited, underscoring the need for longitudinal research and scalable, inclusive intervention models.

Purpose: Whole system approaches to public health challenges such as low physical activity levels have the potential to create sustained behaviour change at a population level and tackle health inequalities. However, there is currently little evidence of the nature or effectiveness of adopting whole system approaches. This study evaluated whether a whole system physical activity intervention (JU:MP) was effective at improving physical activity in five- to eleven-year-olds. Methods: A before and after controlled study with two-arms (JU:MP intervention and control), was conducted in Bradford, United Kingdom with data collected at baseline and 24-months follow-up. Habitual physical activity was measured via accelerometry. The primary outcome was difference in moderate-to-vigorous intensity physical activity (MVPA) between groups at 24-months. Secondary outcomes included: sedentary time (ST), counts per minute (CPM), BMI z-score, waist circumference, social, emotional, and behavioural health, and quality-of-life. An exploratory analysis compared intervention effects between sub-groups. Results: 1,453 children were recruited. 330 children with valid wear-time at baseline and 24-months (JU:MP group n = 175, control group n = 155) were included in the final analysis of physical activity outcomes. The JU:MP group improved levels of MVPA (+4.99 minutes/day, confidence interval (CI) = 1.01, 8.96, standardised mean difference (SMD) = 0.29), ST (–8.69 minutes/day, CI = –16.76, –0.61, SMD = –0.20), and CPM (+32.72, CI = 5.93, 59.53, SMD = 0.28) compared to controls. There were minor differences between groups in all secondary outcomes, favouring the JU:MP group. Exploratory sub-group analysis revealed that MVPA improved for boys (+7.34 minutes/day, CI = 0.70, 13.99, SMD = 0.36) and South Asian heritage children (+7.20 minutes/day, CI = 1.67, 12.72, SMD = 0.52) in the JU:MP group compared to the control group. Conclusions: Whole system approaches hold considerable promise for addressing children’s levels of physical activity at scale, whilst also tackling inequalities. Support/Funding Source: This study was supported by Sport England’s Local Delivery Pilot – Bradford; weblink: https://www.sportengland.org/campaigns-and-our-work/local-delivery. Sport England is a non-departmental public body under the Department for Digital, Culture, Media and Sport. Keywords: Physical activity, whole system, children, inequalities, before and after trial

The construction of the Shu Culture Curriculum in kindergarten is grounded in the demands of the times and the inheritance of local culture, with policy orientation, practical challenges, and the developmental patterns of young children serving as its three foundational logics. The overarching goal of the curriculum is to promote the holistic development of children's moral, intellectual, physical, and aesthetic capacities, with each developmental domain further refined into specific objectives. The selection of curriculum content emphasizes authenticity, experientiality, age-appropriateness, and integration, prioritizing elements of Shu culture that align with children's lived experiences and can be directly perceived. Curriculum implementation primarily revolves around children's daily activities, with teachers employing games, situational creation, and intuitive demonstration methods. Curriculum evaluation focuses on the life-relevance of assessment content, the diversity of evaluators, the variety of evaluation methods, and the continuity of the evaluation process. Through systematic assessment, the curriculum is continuously optimized to effectively support children's growth, ultimately achieving the organic unity of regional cultural inheritance and the comprehensive development of young children.

Optimizing hybrid closed-loop (HCL) performance around exercise in children with type 1 diabetes (T1D) is challenging. In this prospective, randomized, controlled pilot study conducted during a 7-day holiday camp, participants using Medtronic MiniMed 780 G and continuous glucose monitoring (CGM) were randomized to two strategies of HCL use for physical activity (1-2 sessions/day): pump kept connected in auto-mode versus suspended and disconnected. Meal boluses before exercise were not reduced, and all participants used 90-min pre-exercise temporary glucose target 150 mg/dL. Of 20, 8 and 7 participants from connected and disconnected arms were eligible for analysis. Median age was 11 (10-11) years, diabetes duration was 1.6 (0.7-6.0) years, HbA1c was 6.4 (6.05-7.3)% (46, 43-56 mmol/mol), and BMI z-score was -0.25 (-0.53-1.36). HCL exercise disconnection resulted in lower time below range <70 mg/dL [3.9 mmol/L] during camp (-2.91 ± 1.3%point difference, P = 0.0250), with no difference in time in range 70-180 mg/dL [3.9-10.0 mmol/L] (+0.3 ± 4.8%point, P = 0.1677). Temporary HCL disconnection for exercise significantly reduces hypoglycemia risk without compromising glucose control.

Robot-Assisted Gait Training and Changes In Motor Function and Brain Activation In Children With Cerebral Palsy: Preliminary Findings From A Pilot Study.