Background: The options for severely disabled children with intact cognition to interact with their environment are extremely limited. A brain computer interface (BCI) has the potential to allow such persons to gain meaningful function, communication, and independence. While the pediatric population might benefit most from BCI technology, research to date has been predominantly in adults. Methods: In this prospective, cross-over study, we quantified the ability of healthy school-aged children to perform simple tasks using a basic, commercially available, EEG-based BCI. Typically developing children aged 6–18 years were recruited from the community. BCI training consisted of a brief set-up and EEG recording while performing specific tasks using an inexpensive, commercially available BCI system (EMOTIV EPOC). Two tasks were trained (driving a remote-control car and moving a computer cursor) each using two strategies (sensorimotor and visual imagery). Primary outcome was the kappa coefficient between requested and achieved performance. Effects of task, strategy, age, and learning were also explored. Results: Twenty-six of thirty children completed the study (mean age 13.2 ± 3.6 years, 27% female). Tolerability was excellent with >90% reporting the experience as neutral or pleasant. Older children achieved performance comparable to adult studies, but younger age was associated with lesser though still good performance. The car task demonstrated higher performance compared to the cursor task (p = 0.027). Thought strategy was also associated with performance with visual imagery strategies outperforming sensorimotor approaches (p = 0.031). Conclusion: Children can quickly achieve control and execute multiple tasks using simple EEG-based BCI systems. Performance depends on strategy, task and age. Such success in the developing brain mandates exploration of such practical systems in severely disabled children.

Wrist trauma is common in children, typically requiring radiography for diagnosis and treatment planning. However, many children do not have fractures and are unnecessarily exposed to radiation. Ultrasound performed at bedside could detect fractures prior to radiography. Modern tools including three-dimensional ultrasound (3DUS) and artificial intelligence (AI) have not yet been applied to this task. Our purpose was to assess (1) feasibility, reliability, and accuracy of 3DUS for detection of pediatric wrist fractures, and (2) accuracy of automated fracture detection via AI from 3DUS sweeps. Children presenting to an emergency department with unilateral upper extremity injury to the wrist region were scanned on both the affected and unaffected limb. Radiographs of the symptomatic limb were obtained for comparison. Ultrasound scans were read by three individuals to determine reliability. An AI network was trained and compared against the human readers. Thirty participants were enrolled, resulting in scans from fifty-five wrists. Readers had a combined sensitivity of 1.00 and specificity of 0.90 for fractures. AI interpretation was indistinguishable from human interpretation, with all fractures detected in the test set of 36 images (sensitivity = 1.0). The high sensitivity of 3D ultrasound and automated AI ultrasound interpretation suggests that ultrasound could potentially rule out fractures in the emergency department.

Events typically occur in a specific context and the ability to assign importance to this occurrence plays a significant role in memory formation and recall. When the scent of a crayfish predator (CE) is encountered in Lymnaea strains known to be predator-experienced (e.g. the W-strain), enhancement of memory formation and depression of feeding occurs, which are part of a suite of anti-predator behaviours. We hypothesized that Lymnaea possess a form of higher-order conditioning, namely configural learning. We tested this by simultaneously exposing W-strain Lymnaea to a carrot food-odour (CO) and predator scent (CE). Two hours later we operantly conditioned these snails with a single 0.5h training session in CO to determine whether training in CO results in long-term memory (LTM). In W-strain snails two 0.5h training sessions are required to cause LTM formation. A series of control experiments followed and demonstrated that only the CO+CE snails trained in CO had acquired enhanced memory forming ability. Additionally, following CE+CO pairing, CO no longer elicited an increased feeding response. Hence, snails have the ability to undergo configural learning. Following configural learning, CO becomes risk-signaling and evokes behavioural responses phenotypically similar to those elicited by exposure to CE.

A flavonoid, (-)-epicatechi (Epi), enhances long-term memory (LTM) formation in Lymnaea and reverses memory obstruction caused by stress. Many foods contain substantial amounts of Epi, (e.g. green tea and cocoa). In humans eating such foods may directly or indirectly enhance cognition. We directly test whether operant conditioning training Lymnaea in these natural foods result in the same effects as training snails in pure Epi. We found that exposure to products containing high concentrations of Epi (e.g. green tea and cocoa) during training enhanced memory formation and could even reverse a learning and memory deficit brought about by stress. Epi can be photo-inactivated by exposure to ultraviolet light. We found that following photo-inactivation of Epi, memory enhancement did not occur. Photo-inactivation of foods containing Epi (e,g. green tea) blocked their ability to enhance LTM. Our data are thus consistent with the hypothesis that dietary sources of Epi can have positive benefits on cognitive ability and be able to reverse memory aversive states.