Upper limit of normal ALT levels in health and metabolic diseases: Pooled analysis of 423,355 individuals with bootstrap modelling.

INTRODUCTION: Given the global rise in obesity-related metabolic diseases, the upper limit of normal (ULN) alanine aminotransferase (ALT) in individuals with and without metabolic diseases may have changed. We performed a meta-analysis combined with bootstrap modelling to estimate the ALT ULN levels for individuals with and without metabolic diseases. METHODS AND RESULTS: Two separate searches of the PubMed, Embase and Cochrane databases were performed, one to identify healthy individuals which yielded 12 articles (349,367 individuals); another to include those with potential metabolic diseases but without known liver disease which yielded 35 articles (232,388 individuals). We estimated the mean ALT using a random-effects mixed model and the ULN level (95th-percentile value) via a bootstrap model with 10,000 resamples. In individuals without metabolic diseases and known liver disease, the ALT ULN levels were 32 U/L overall; 36 U/L in males and 28 U/L in females. In analyses that included individuals with metabolic diseases, the ALT ULN levels were 40 U/L among the overweight/obese (29 U/L if normal weight) and 36 U/L among those with type 2 diabetes mellitus (T2DM) (33 U/L if no T2DM). On meta-regression of study-level factors, body mass index (coefficient 1.49, 95% CI 0.11-2.86, p = 0.03), high-density lipoprotein (coefficient -0.47, 95% CI -0.85-(-0.08), p = 0.02) and triglycerides (coefficient 0.19, 95% CI 0.12-0.25, p < 0.0001) correlated with ALT. CONCLUSION: We provide expected ranges of ALT ULN levels for individuals without known liver disease without metabolic diseases and those with or without T2DM and/or are normal weight or overweight/obese. These data may have implications for clinical care and screening.

Development of infants' preferential looking toward native language speakers across distinct social contexts.

Presenting pictures of faces side by side is a common paradigm to assess infants' attentional biases according to social categories, such as gender, race, and language. However, seeing static faces does not represent infants' typical experience of the social world, which involves people in motion and performing actions. Here, we assessed infants' looking preferences for native over foreign language speakers in two social contexts: the presentation of static faces and the presentation of people performing instrumental actions. In addition, we tested infants' preferential looking at 5 and 9 months of age to assess whether their pattern of preferential looking changes across development. The results of 5-month-old infants replicated and extended previous findings by showing that, at this age, infants typically look longer at people who previously spoke their native language. As found for other social categories such as race and gender, this familiarity-based looking preference was not evident at 9 months of age when infants were presented with static faces. However, when presented with more informative dynamic events, 9-month-old infants showed a temporally aligned preference for the native over the foreign language speaker. Specifically, infants' looking preference was time-locked to the completion of the action goal: when speakers grasped and lifted a toy. These results suggest potentially a familiarity-based preference toward native language speakers around 5 months of age, which may later develop into a more strategic selective response in service of information-seeking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hypodescent or ingroup overexclusion?: Children's and adults' racial categorization of ambiguous black/white biracial faces.

Two processes describe racially ambiguous Black/White Biracial categorization-the one-drop rule, or hypodescent, whereby racially ambiguous people are categorized as members of their socially subordinated racial group (i.e., Black/White Biracial faces categorized as Black) and the ingroup overexclusion effect, whereby racially ambiguous people are categorized as members of a salient outgroup, regardless of the group's status. Without developmental research with racially diverse samples, it is unclear when these categorization patterns emerge. Study 1 included White, Black, and racially diverse Biracial children (aged 3- to 7-years) and their parents to test how racial group membership and social context influence face categorization biases. To provide the clearest test of hypodescent and ingroup overexclusion, White participants came from majority White neighborhoods and Black participants from majority Black neighborhoods (with Biracial participants from more racially diverse neighborhoods)-two samples with prominent racial ingroups. Study 2 aimed to replicate the parent findings with a separate sample of White, Black, Black/White Biracial, and Asian adults. Results suggest the ingroup overexclusion effect is present across populations early in development and persists into adulthood. Additionally, categorization was meaningfully related to parental context, pinpointing a pathway that potentially contributes to ingroup overexclusion. RESEARCH HIGHLIGHTS: White, Black, and racially diverse Biracial children and adults tended to categorize racially ambiguous Black/White Biracial faces as racial outgroup members, even if the outgroup was White. This contradicts most work arguing Black/White Biracial racially ambiguous people are more often seen as Black. Children and parents' categorizations were related, though children's categorizations were not related to socialization above and beyond parents' categorizations. Children showed similar categorization patterns across dichotomous and continuous measures.

Measuring Quantitative Cerebral Blood Flow in Healthy Children: A Systematic Review of Neuroimaging Techniques.

Cerebral blood flow (CBF) is an important hemodynamic parameter to evaluate brain health. It can be obtained quantitatively using medical imaging modalities such as magnetic resonance imaging and positron emission tomography (PET). Although CBF in adults has been widely studied and linked with cerebrovascular and neurodegenerative diseases, CBF data in healthy children are sparse due to the challenges in pediatric neuroimaging. An understanding of the factors affecting pediatric CBF and its normal range is crucial to determine the optimal CBF measuring techniques in pediatric neuroradiology. This review focuses on pediatric CBF studies using neuroimaging techniques in 32 articles including 2668 normal subjects ranging from birth to 18 years old. A systematic literature search was conducted in PubMed, Embase, and Scopus and reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We identified factors (such as age, gender, mood, sedation, and fitness) that have significant effects on pediatric CBF quantification. We also investigated factors influencing the CBF measurements in infants. Based on this review, we recommend best practices to improve CBF measurements in pediatric neuroimaging. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.

Children's language-based pedagogical preferences in a multilingual society.

A majority of the world's population is multilingual, yet children's language-based preferences have largely been studied in Western monolingual contexts. The present research investigated language-based preferences in 4- to 8-year-old children living in Hyderabad, India, a multilingual region with languages such as Telugu (official language of the state, and the native language of many children in the state) and English (medium of instruction in some schools). We presented to children novel objects and probed their selective preference to learn from different speakers (Telugu, British-accented English, or Indian-accented English). In addition, the current study assessed the flexibility of children's preferences by manipulating the learning goal (i.e., performance goal vs. enjoyment goal) and learning content (i.e., Science, Technology, Engineering and Mathematics [STEM] objects vs. cultural objects). Children showed a preference for both English speakers over Telugu speakers, a tendency that increased with age. This preference was especially pronounced for performance learning goals and for STEM learning content. Furthermore, children whose native language was Telugu showed a less pronounced English bias. The results of this study provide new insights into the development of language-based biases in multilingual environments. First, they highlight dual and intersecting considerations of speaker familiarity and speaker status in guiding children's choices about from whom to learn. Second, the results suggest that children's language-based preferences in a pedagogical setting are flexible, as children integrate social cues (e.g., language-based attitudes) as well as contextual cues (e.g., the learning goal) strategically. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Do preschoolers track and evaluate social includers and excluders?

Social exclusion is harmful and leads to negative consequences across the lifespan. Based on studies primarily with adults, psychologists have characterized a highly sensitive "ostracism detection system" that acts quickly and automatically to detect exclusion and mitigate its effects. However, research with children has not fully explored whether a system with similar characteristics is operational in early childhood, and prior work probing children's responses to exclusion has produced mixed findings. We investigated 4- to 6-year-old children's abilities to negatively evaluate those who have excluded them as well as to use these experiences for prosocial gossip. Children engaged one pair of play partners in an inclusive game and engaged another pair in an exclusive game. Nearly one third (n = 28 of 96) did not accurately recall who had excluded them. Yet those who did recall their game experiences evaluated excluders more negatively than includers, and they were less likely to recommend excluders as play partners to others. These findings indicate that not all children sensitively track their excluders' identities-but those who do so will evaluate excluders negatively. More work is needed to understand developments in how and when children recognize their own exclusion and whether the underlying processes should be viewed as homologous to adults' ostracism detection system.

Children's social wariness toward a different-race stranger relates to individual differences in temperament.

When children first meet a stranger, there is great variation in how much they will approach and engage with the stranger. While individual differences in this type of behavior-called social wariness-are well-documented in temperament research, surprisingly little attention has been paid to the social groups (such as race) of the stranger and how these characteristics might influence children's social wariness. In contrast, research on children's social bias and interracial friendships rarely examines individual differences in temperament and how temperament might influence cross-group interactions. The current study bridges the gap across these different fields of research by examining whether the racial group of an unfamiliar peer or adult moderates the association between temperament and the social wariness that children display. Utilizing a longitudinal dataset that collected multiple measurements of children's temperament and behaviors (including parent-reported shyness and social wariness toward unfamiliar adults and peers) across early childhood, we found that 2- to 7-year-old children with high parent-reported shyness showed greater social wariness toward a different-race stranger compared to a same-race stranger, whereas children with low parent-reported shyness did not. These results point to the importance of considering racial group membership in temperament research and the potential role that temperament might play in children's cross-race interactions. RESEARCH HIGHLIGHTS: Previous research on temperament has not considered how the race of strangers could influence children's social wariness. We find evidence that 2- to 7-year-old children with high parent-reported shyness show greater social wariness toward a different-race stranger compared to a same-race stranger. These results point to the importance of considering racial group membership in temperament research. Our findings also suggest temperament may play a role in children's cross-race interactions.

Toddlers' action learning and memory from active and observed instructions.

From early in life, children learn to perform actions on the objects in their environments. Although children learn from observing others' actions, actively engaging with the material to be learned can be important for learning. This study tested whether instruction that included opportunities for children to be active supported toddlers' action learning. In a within-participants design, 46 22- to 26-month-old toddlers (average age = 23.3 months; 21 male) were introduced to target actions for which instruction was either active or observed (instruction order counterbalanced across children). During active instruction, toddlers were coached to perform a set of target actions. During observed instruction, toddlers saw a teacher perform the actions. Toddlers were then tested on their action learning and generalization. Surprisingly, action learning and generalization did not differ between instruction conditions. However, toddlers' cognitive maturity supported their learning from both types of instruction. One year later, children from the original sample were tested on their long-term memory for information learned from active and observed instructions. Of this sample, 26 children provided usable data for the follow-up memory task (average age = 36.7 months, range = 33-41; 12 male). Children demonstrated better memory for information learned from active instruction than for information learned from observed instruction (odds ratio = 5.23) 1 year after instruction. Active experience during instruction appears to be pivotal for supporting children's long-term memory.

Responder analysis confirms results of a stroke transitional care trial but provides more interpretable results.

OBJECTIVES: Interpreting between-group differences in patient-reported outcome measures can be challenging. Responder analyses, which compare the proportions of patients who achieve a meaningful clinical change, represent a more interpretable approach. We conducted a secondary responder analysis of the Michigan Stroke Transitions Trial (MISTT). STUDY DESIGN AND SETTING: The MISTT randomized 265 patients with stroke to three treatment groups: usual care [UC], social work case management [SWCM], or social work case management plus access to a patient-oriented website [SWCM + website]. Two Patient-Reported Outcomes Measurement and Information System (PROMIS) Global-10 subscales (representing physical and mental health) and 5 additional patient-reported outcomes were collected at baseline and 90-days. Responder analyses were conducted using modified Poisson and linear regression using published minimal important differences. Multiple imputation was used to address missing data. RESULTS: For the PROMIS-10 global physical health subscale, responders were 80% more common in the SWCM + website group compared to the UC group (relative risk = 1.8, 95% confidence interval [CI]: 1.0, 3.1), with a number needed to treat of 7 (95% CI: 3, 112). No significant treatment effects were observed for the PROMIS-10 global mental health subscale. CONCLUSION: Results of this responder analysis were largely consistent with the original trial analysis but have the advantage of presenting treatment effects using more clinically interpretable number needed to treat metrics.

Action experience in infancy predicts visual-motor functional connectivity during action anticipation.

Despite substantial evidence indicating a close link between action production and perception in early child development, less is known about how action experience shapes the processes of perceiving and anticipating others' actions. Here, we developed a novel approach to capture functional connectivity specific to certain brain areas to investigate how action experience changes the networks involved in action perception and anticipation. Nine- and-12-month-old infants observed familiar (grasping) and novel (tool-use) actions while their brain activity was measured using EEG. Infants' motor competence of both actions was assessed. A link between action experience and connectivity patterns was found, particularly during the anticipation period. During action anticipation, greater motor competence in grasping predicted greater functional connectivity between visual (occipital alpha) and motor (central alpha) regions relative to global levels of whole-brain EEG connectivity. Furthermore, visual and motor regions tended to be more coordinated in response to familiar versus novel actions and for older than younger participants. Critically, these effects were not found in the control networks (frontal-central; frontal-occipital; parietal-central; parietal-occipital), suggesting a unique role of visual-motor networks on the link between motor skills and action encoding. HIGHLIGHTS: Infants' motor development predicted functional connectivity patterns during action anticipation. Faster graspers, and older infants, showed a stronger ratio of visual-motor neural coherence. Overall whole-brain connectivity was modulated by age and familiarity with the actions. Measuring inter-site relative to whole-brain connectivity can capture specific brain-behavior links. Measures of phase-based connectivity over time are sensitive to anticipatory action.

Should I learn from you? Seeing expectancy violations about action efficiency hinders social learning in infancy.

Infants generate basic expectations about their physical and social environment. This early knowledge allows them to identify opportunities for learning, preferring to explore and learn about objects that violate their prior expectations. However, less is known about how expectancy violations about people's actions influence infants' subsequent learning from others and about others. Here, we presented 18-month-old infants with an agent who acted either efficiently (expected action) or inefficiently (unexpected action) and then labeled an object. We hypothesized that infants would prefer to learn from the agent (label-object association) if she previously acted efficiently, but they would prefer to learn about the agent (voice-speaker association) if she previously acted inefficiently. As expected, infants who previously saw the agent acting efficiently showed greater attention to the demonstrated object and learned the new label-object association, but infants presented with the inefficient agent did not. However, there was no evidence that infants learned the voice-speaker association in any of the conditions. In summary, expectancy violations about people's actions may signal a situation to avoid learning from them. We discussed the results in relation to studies on surprise-induced learning, motionese, and selective social learning, and we proposed other experimental paradigms to investigate how expectancy violations influence infants' learning about others.

Children's social networks in developmental psychology: A network approach to capture and describe early social environments.

Psychologists are interested in understanding how early social environments impact children's behavior and cognition. Early social environments are comprised of social relationships; however, there have been relatively few tools available to quantify the depth and breadth of children's social relationships. We harnessed the power of social networks to demonstrate that networks can be used to describe children's early social environments. Descriptive data from American children aged 6 months-5 years (n = 280; 47% female, 56% White) demonstrates that network properties can be used to provide a quantitative analysis of children's early social environments and highlights how these environments vary across development. Social network methodology will provide researchers with a comprehensive picture of children's early social experiences and improve studies exploring individual differences.

A Scoping Review and Appraisal of Extracorporeal Membrane Oxygenation Education Literature.

Background: Despite a recent rise in publications describing extracorporeal membrane oxygenation (ECMO) education, the scope and quality of ECMO educational research and curricular assessments have not previously been evaluated. Objective: The purposes of this study are 1) to categorize published ECMO educational scholarship according to Bloom's educational domains, learner groups, and content delivery methods; 2) to assess ECMO educational scholarship quality; and 3) to identify areas of focus for future curricular development and educational research. Methods: A multidisciplinary research team conducted a scoping review of ECMO literature published between January 2009 and October 2021 using established frameworks. The Medical Education Research Study Quality Instrument (MERSQI) was applied to assess quality. Results: A total of 1,028 references were retrieved; 36 were selected for review. ECMO education studies frequently targeted the cognitive domain (78%), with 17% of studies targeting the psychomotor domain alone and 33% of studies targeting combinations of the cognitive, psychomotor, and affective domains. Thirty-three studies qualified for MERSQI scoring, with a median score of 11 (interquartile range, 4; possible range, 5-18). Simulation-based training was used in 97%, with 50% of studies targeting physicians and one other discipline. Conclusion: ECMO education frequently incorporates simulation and spans all domains of Bloom's taxonomy. Overall, MERSQI scores for ECMO education studies are similar to those for other simulation-based medical education studies. However, developing assessment tools with multisource validity evidence and conducting multienvironment studies would strengthen future work. The creation of a collaborative ECMO educational network would increase standardization and reproducibility in ECMO training, ultimately improving patient outcomes.

Men's Involvement in Sexual and Reproductive Health Care and Decision Making in the Philippines: A Systematic Review of the Literature.

Sexual and reproductive health care (SRH) and family planning (FP) services have been primarily female centered. In recent decades, international groups have advocated for men's involvement in SRH and FP, yet related research remains limited and implementation not fully realized in many countries. This systematic review of literature seeks to summarize the barriers and facilitators to men's involvement in SRH/FP services in the Philippines. It is limited to publications in English from 1994 to 2021 regarding studies conducted in the Philippines whose research questions focused on men's involvement in SRH/FP. Eligible studies were assessed for methodological quality using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Evidence Rating Scale. The Ecological Model for Health Promotion was used as the guiding theoretical framework for analysis and to report findings. Barriers and facilitators were identified at every ecological level except that of policy. The most common barrier identified was men's deficit in knowledge about SRH/FP; the most common facilitator was the positive influence of their social network on men's attitudes, beliefs, and practices pertaining to SRH/FP. A range of factors from the individual to the community level influenced men's involvement, including religious beliefs, economic means, and cultural gender roles. More studies are needed to provide a fuller understanding of the multilevel ecological factors influencing men's involvement in SRH/FP and inform interventions with men that can positively affect their behavior related to SRH/FP decision making.

"It's Kind of Like Code-Switching": Black Older Adults' Experiences with a Voice Assistant for Health Information Seeking.

Black older adults from lower socioeconomic environments are often neglected in health technology interventions. Voice assistants have a potential to make healthcare more accessible to older adults, yet, little is known about their experiences with this type of health information seeking, especially Black older adults. Through a three-phase exploratory study, we explored health information seeking with 30 Black older adults in lower-income environments to understand how they ask health-related questions, and their perceptions of the Google Home being used for that purpose. Through our analysis, we identified the health information needs and common search topics, and discussed the communication breakdowns and types of repair performed. We contribute an understanding of cultural code-switching that has to be done by these older adults when interacting with voice assistants, and the importance of such phenomenon when designing for historically excluded groups.

Children's developing views of social excluders: A dissociation between social evaluation and partner preference.

When facing social exclusion, children seek to strengthen existing social connections and form new ones. This study asked whether they also make strategic choices about the targets of their affiliative goals. Three- to six-year-olds (N = 69; 36 female; mostly non-Hispanic White) observed characters acting inclusively or exclusively. All ages viewed excluders more negatively than includers, but only five- and six-year-olds preferred includers as play partners. Despite easily detecting and remembering exclusion events, younger children expressed no play partner preference. Children's verbal justifications revealed that older children choose partners more carefully and draw on a richer understanding of exclusion. More generally, the initial dissociation between social evaluation and preference formation underscores that these are distinct processes with different developmental trajectories.

Neural correlates of familiar and unfamiliar action in infancy.

Behavioral evidence shows that experience with an action shapes action perception. Neural mirroring has been suggested as a mechanism underlying this behavioral phenomenon. Suppression of electroencephalogram (EEG) power in the mu frequency band, an index of motor activation, typically reflects neural mirroring. However, contradictory findings exist regarding the association between mu suppression and motor familiarity in infant EEG studies. In this study, we investigated the neural underpinnings reflecting the role of familiarity in action perception. We measured neural processing of familiar (grasp) and novel (tool-use) actions in 9- and 12-month-old infants. Specifically, we measured infants' distinct motor/visual activity and explored functional connectivity associated with these processes. Mu suppression was stronger for grasping than for tool use, whereas significant mu and occipital alpha (indexing visual activity) suppression were evident for both actions. Interestingly, selective motor-visual functional connectivity was found during observation of familiar action, a pattern not observed for novel action. Thus, the neural correlates of perception of familiar actions may be best understood in terms of a functional neural network rather than isolated regional activity. Our findings provide novel insights on analytic approaches for identifying motor-specific neural activity while also considering neural networks involved in observing motorically familiar versus unfamiliar actions.

Using Technology to Measure Older Adults' Social Networks for Health and Well-Being: A Scoping Review.

BACKGROUND AND OBJECTIVES: Social networks affect the health and well-being of older adults. Advancements in technology (e.g., digital devices and mHealth) enrich our ability to collect social networks and health data. The purpose of this scoping review was to identify and map the use of technology in measuring older adults' social networks for health and social care. RESEARCH DESIGN AND METHODS: The Joanna Briggs Institute methodology was followed. PubMed (MEDLINE), Sociological Abstracts, SocINDEX, CINAHL, and Web of Science were searched for relevant articles. Conference abstracts and proceedings were searched via Conference Papers Index, the American Sociological Society, and The Gerontological Society of America. Studies published in English from January 2004 to March 2020 that aimed to improve health or social care for older adults and used technology to measure social networks were included. Data were extracted by 2 independent reviewers using an a priori extraction tool. RESULTS: The majority of the 18 reviewed studies were pilot or simulation research conducted in Europe that focused on older adults living in the community. The various types of technologies used can be categorized as environment-based, person-based, and data-based. DISCUSSION AND IMPLICATIONS: Technology facilitates objective and longitudinal data collection on the social interactions and activities of older adults. The use of technology to measure older adults' social networks, however, is primarily in an exploratory phase. Multidisciplinary collaborations are needed to overcome operational, analytical, and implementation challenges. Future studies should leverage technologies for addressing social isolation and care for older adults, especially during the coronavirus disease 2019 pandemic.

Social context shapes neural processing of others' actions in 9-month-old infants.

From infancy, neural processes for perceiving others' actions and producing one's own actions overlap (neural mirroring). Adults and children show enhanced mirroring in social interactions. Yet, whether social context affects mirroring in infancy, a time when processing others' actions is crucial for action learning, remains unclear. We examined whether turn-taking, an early form of social interaction, enhanced 9-month-olds' neural mirroring. We recorded electroencephalography while 9-month-olds were grasping (execution) and observing live grasps (observation). In this design, half of the infants observed and acted in alternation (turn-taking condition), whereas the other half observed several times in a row before acting (blocked condition). Replicating previous findings, infants showed significant 6- to 9-Hz mu suppression (indicating motor activation) during execution and observation (n = 24). In addition, a condition (turn-taking or blocked) by time (action start or end) interaction indicated that infants engaged in turn-taking (n = 9), but not in the blocked context (n = 15), showed more mirroring when observing the action start compared with the action end. Exploratory analyses further suggest that (a) there is higher visual-motor functional connectivity in turn-taking toward the action's end, (b) mirroring relates to later visual-motor connectivity, and (c) visual attention as indexed by occipital alpha is enhanced in turn-taking compared with the blocked context. Together, this suggests that the neural processing of others' actions is modulated by the social context in infancy and that turn-taking may be particularly effective in engaging infants' action perception system.

Reproducibility of cerebrovascular reactivity measurements: A systematic review of neuroimaging techniques.

Cerebrovascular reactivity (CVR), the capacity of the brain to increase cerebral blood flow (CBF) to meet changes in physiological demand, is an important biomarker to evaluate brain health. Typically, this brain "stress test" is performed by using a medical imaging modality to measure the CBF change between two states: at baseline and after vasodilation. However, since there are many imaging modalities and many ways to augment CBF, a wide range of CVR values have been reported. An understanding of CVR reproducibility is critical to determine the most reliable methods to measure CVR as a clinical biomarker. This review focuses on CVR reproducibility studies using neuroimaging techniques in 32 articles comprising 427 total subjects. The literature search was performed in PubMed, Embase, and Scopus. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified 5 factors of the experimental subjects (such as sex, blood characteristics, and smoking) and 9 factors of the measuring technique (such as the imaging modality, the type of the vasodilator, and the quantification method) that have strong effects on CVR reproducibility. Based on this review, we recommend several best practices to improve the reproducibility of CVR quantification in neuroimaging studies.