Body Part Structure Knowledge in Infancy

Human faces, bodies, and hands convey critical social information (e.g., emotions, goals, and desires). Infants, like adults, are sensitive to such social information. Unlike infants’ knowledge of the structure of the human face and body, not much is known about infants’ knowledge of hands and feet. The current study tested infants for their preference between intact hand images and ones in which the same hands were distorted (i.e., location of at least one finger was altered to distort the typical structure of the hand). Infants at 3.5 months of age had a preference for the reorganized hand image, demonstrating that 3.5-month-olds have sufficient knowledge of the configural properties of hands to discriminate between intact versus distorted images. Furthermore, when the same images were inverted, infants displayed no such preference, indicating that infants were not relying solely on low-level features to detect differences between intact versus reorganized hands. Contrastingly, when shown images of intact and reorganized feet, even 9-month-olds did not exhibit evidence of sensitivity to structural disruptions in images of feet. These results indicate that infants’ structural knowledge of hands, but not necessarily feet, develops along the same trajectory as their knowledge of faces and bodies

BODY PROCESSING AND ATTENTIONAL PATTERNS IN INFANCY

Bodies provide important social information, and adults benefit from this information by recognizing and responding appropriately to bodies. Body recognition is enabled by the fact that human bodies are defined by parts, such as the limbs, torso, and head, arranged in a particular configuration. To understand the development of social cognition, it is important to analyze and document how infants come to recognize bodies. Infants are sensitive to distortions to the global configurations of bodies by 3.5 months of age, suggesting an early onset of body knowledge. It was unclear, however, whether such sensitivity indicates knowledge of the location of specific body parts or solely reflects sensitivity to the overall gestalt or outline of bodies. The current study addressed this by examining whether infants attend to specific locations in which parts of the body have been reorganized. Results of Experiments 1 and 2 show that 5-month-olds, but not 3.5-month-olds, are sensitive to the location of specific body parts, as demonstrated by a difference in allocation of attention to the body joint areas that were normal (e.g., where the arm connects to the shoulder) versus ones that were reorganized. Furthermore, to examine whether this kind of processing is driven by information from the face/head, in Experiment 3 I tested infants on images in which the face/head was removed. Infants no longer exhibited differential scanning of normal versus reorganized bodies. To further assess whether infants were responding to critical information provided by the face/head or whether their processing was disrupted solely because the headless images were incomplete bodies, Experiment 4 examined infants’ performance on body images missing limbs. Once again, infants failed to exhibit differential scanning of typical versus reorganized bodies. Together, these results suggest that 5-month-olds are sensitive to the location of body parts. However, the presence of the face/head (Experiment 3) and limbs (Experiment 4) are necessary for 5-month-olds to exhibit differential scanning of reorganized versus intact body images. Overall, by 5 months of age, infants are sensitive to precise locations of body parts, and thus demonstrate a rather sophisticated level of knowledge about the structure of the human body. The role that the face/head and limbs play in body structure knowledge development is still unclear, and future studies need to address this question

Development of Body Emotion Perception in Infancy: From Discrimination to Recognition

Research suggests that infants progress from discrimination to recognition of emotions in faces during the first half year of life. It is unknown whether the perception of emotions from bodies develops in a similar manner. In the current study, when presented with happy and angry body videos and voices, 5-month-olds looked longer at the matching video when they were presented upright but not when they were inverted. In contrast, 3.5-month-olds failed to match even with upright videos. Thus, 5-month-olds but not 3.5-month-olds exhibited evidence of recognition of emotions from bodies by demonstrating intermodal matching. In a subsequent experiment, younger infants did discriminate between body emotion videos but failed to exhibit an inversion effect, suggesting that discrimination may be based on low-level stimulus features. These results document a developmental change from discrimination based on non-emotional information at 3.5 months to recognition of body emotions at 5 months. This pattern of development is similar to face emotion knowledge development and suggests that both the face and body emotion perception systems develop rapidly during the first half year of life

Further Evidence of Early Development of Attention to Dynamic Facial Emotions: Reply to Grossmann and Jessen

Adults exhibit enhanced attention to negative emotions like fear, which is thought to be an adaptive reaction to emotional information. Previous research, mostly conducted with static faces, suggests that infants exhibit an attentional bias toward fearful faces only at around 7 months of age. In a recent study (Journal of Experimental Child Psychology, 2016, Vol. 147, pp. 100–110), we found that 5-month-olds also exhibit heightened attention to fear when tested with dynamic face videos. This indication of an earlier development of an attention bias to fear raises questions about developmental mechanisms that have been proposed to underlie this function. However, Grossmann and Jessen (Journal of Experimental Child Psychology, 2016, Vol. 153, pp. 149–154) argued that this result may have been due to differences in the amount of movement in the videos rather than a response toemotional information. To examine this possibility, we tested a new sample of 5-month-olds exactly as in the original study (Heck, Hock, White, Jubran, & Bhatt, 2016) but with inverted faces. We found that the fear bias seen in our study was no longer apparent with inverted faces. Therefore, it is likely that infants’ enhanced attention to fear in our study was indeed a response to emotions rather than a reaction to arbitrary low-level stimulus features. This finding indicates enhanced attention to fear at 5 months and underscores the need to find mechanisms that engender the development of emotion knowledge early in life

Visual Scanning of Males and Females in Infancy

This study addressed the development of attention to information that is socially relevant to adults by examining infants\u27 (n = 64) scanning patterns of male and female bodies. Infants exhibited systematic attention to regions associated with sex-related scanning by adults, with 3.5-and 6.5-month-olds looking longer at the torso of females than males and longer at the legs of males than females. However, this pattern of looking was not found when infants were tested on headless bodies in Experiment 2, which suggests that infants\u27 differential gaze pattern in Experiment 1 was not due to low-level stimulus features, such as clothing, and also indicates that facial/head information is necessary for infants to exhibit sex-specific scanning. We discuss implications for models of face and body knowledge development

Retinoblastoma seeds: Impact on American Joint Committee on Cancer clinical staging

Aim To investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding. Methods Multicentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method. Results Clinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; p<0.001). There was insufficient evidence to prove or disprove an association between vitreous seed type and local treatment failure risk(p=0.06). Conclusion This international, multicentre, registry-based analysis of RB eyes affirmed that eyes with diffuse intraocular distribution of RB seeds at diagnosis had a higher risk of local treatment failure when compared with focal seeds. Subclassification of AJCC RB category cT2b into focal vs diffuse seeds will improve prognostication for eye salvage.Fil: Tomar, Ankit Singh. New York Eye Cancer Center; Estados UnidosFil: Finger, Paul T.. New York Eye Cancer Center; Estados UnidosFil: Gallie, Brenda. University Of Toronto. Hospital For Sick Children; CanadáFil: Kivelä, Tero. University of Helsinki; Finlandia. Helsinki University Hospital; FinlandiaFil: Mallipatna, Ashwin. University Of Toronto. Hospital For Sick Children; Canadá. Narayana Nethralaya; IndiaFil: Zhang, Chengyue. Beijing Children's Hospital; ChinaFil: Zhao, Junyang. Beijing Children's Hospital; ChinaFil: Wilson, Matthew. University of Tennessee; Estados UnidosFil: Brennan, Rachel. St Jude Children's Research Hospital; Estados UnidosFil: Burges, Michala. University of Tennessee; Estados UnidosFil: Kim, Jonathan. Keck Medical School of the University of Southern California; Estados UnidosFil: Berry, Jesse L.. Children's Hospital Los Angeles; Estados UnidosFil: Jubran, Rima. Childrens Hospital Society of Los Angeles; Estados UnidosFil: Khetan, Vikas. Vitreo Retinal Services; IndiaFil: Ganeshan, Suganeswari. Vitreo Retinal Services; IndiaFil: Yarovoy, Andrey. Fyodorov Eye Microsurgery Federal State Institution; RusiaFil: Yarovaya, Vera. Fyodorov Eye Microsurgery Federal State Institution; RusiaFil: Kotova, Elena. Fyodorov Eye Microsurgery Federal State Institution; RusiaFil: Volodin, Denis. Fyodorov Eye Microsurgery Federal State Institution; RusiaFil: Yousef, Yacoub. King Hussein Cancer Center; JordaniaFil: Nummi, Kalle. University of Helsinki; Finlandia. Helsinki University Hospital; FinlandiaFil: Ushakova, Tatiana L.. N.N. Blokhin Russian Cancer Research Center; Rusia. Russian Academy of Postgraduate Medical Education; RusiaFil: Yugay, Olga V.. N.N. Blokhin Russian Cancer Research Center; RusiaFil: Polyakov, Vladimir G. N.N. Blokhin Russian Cancer Research Center; Rusia. Russian Academy of Sciences; RusiaFil: Ramirez Ortiz, Marco Antonio. Hospital Infantil de Mexico Federico Gomez; MéxicoFil: Esparza Aguiar, Elizabeth. Hospital Infantil de Mexico Federico Gomez; MéxicoFil: Chantada, Guillermo Luis. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Schaiquevich, Paula Susana. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fandiño, Adriana Cristina. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Yam, Jason C.. The Chinese University of Hong Kong Faculty of Medicine; Hong Kon

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Whole Picture: Holistic Body Posture Recognition in Infancy

Holistic processing is tied to expertise and is characteristic of face and body perception by adults. Infants process faces holistically, but it is unknown whether they process body information holistically. In the present study, infants were tested for discrimination between body postures that differed in limb orientations in three conditions: in the context of the whole body, with just the isolated limbs that changed orientation, or with the limbs in the context of scrambled body parts. Five- and 9-month-olds discriminated between whole-body postures, but failed in the isolated-part and scrambled-body conditions, demonstrating holistic processing of information from bodies. These results indicate that at least some level of expertise in body processing develops quite early in life

The Development of Attention to Dynamic Facial Emotions

Appropriate processing of emotions is paramount for successful social functioning. Adults’ enhanced attention to negative emotions such as fear is thought to be a critical aspect of this adaptive functioning. Prior studies indicate that increased attention to fear relative to positive or neutral emotions begins at around 7 months of age, and it has been suggested that this negativity bias is related to self-locomotion. However, these studies mostly used static faces, potentially limiting information available to the infants. In the current study, 3.5-month-olds (n = 24) and 5-month-olds (n = 24) were exposed to dynamic faces expressing fear, happy, or neutral emotions and a distracting peripheral checkerboard. The 5-month-olds looked proportionally longer at the face compared with the checkerboard when the face was fearful than when it was happy or neutral. Conversely, the 3.5-month-olds did not differentiate their attention as a function of emotion. These results indicate that the onset of enhanced attention to fear occurs between 3.5 and 5 months of age. This finding raises questions about the developmental mechanisms that drive attentional bias given that the idea of the onset of self-locomotion being a catalyst for the development of negativity bias might no longer hold