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Background In the USA, nirmatrelvir/ritonavir is authorized for the treatment of mild-to-moderate COVID-19 in patients at least 12 years of age, at high risk for progression to severe COVID-19. Objectives To estimate the impact of outpatient nirmatrelvir/ritonavir on COVID-19 hospitalization risk in a US healthcare system. Methods We conducted a cohort study using electronic health records among outpatients with a positive SARS-CoV-2 PCR test between January and August 2022. We evaluated the association of nirmatrelvir/ritonavir therapy with time to hospitalization by estimating adjusted HRs and assessed the impact of nirmatrelvir/ritonavir on predicted COVID-19 hospitalizations using machine-learning methods. Results Among 44 671 patients, 4948 (11%) received nirmatrelvir/ritonavir, and 201 (0.4%) were hospitalized within 28 days of COVID-19 diagnosis. Nirmatrelvir/ritonavir recipients were more likely to be older, white, vaccinated, have comorbidities and reside in areas with higher average socioeconomic status. The 28 day cumulative incidence of hospitalization was 0.06% (95% CI: 0.02%–0.17%) among nirmatrelvir/ritonavir recipients and 0.52% (95% CI: 0.46%–0.60%) among non-recipients. For nirmatrelvir/ritonavir versus no therapy, the age-adjusted HR was 0.08 (95% CI: 0.03–0.26); the fully adjusted HR was 0.16 (95% CI: 0.05–0.50). In the machine-learning model, the primary features reducing predicted hospitalization risk were nirmatrelvir/ritonavir, younger age, vaccination, female gender and residence in a higher socioeconomic status area. Conclusions COVID-19 hospitalization risk was reduced by 84% among nirmatrelvir/ritonavir recipients in a large, diverse healthcare system during the Omicron wave. These results suggest that nirmatrelvir/ritonavir remained highly effective in a setting substantially different than the original clinical trials. [ABSTRACT FROM AUTHOR]

It has been theorized that the contagion of behaviors may be related to social cognitive abilities, but empirical findings are inconsistent. We recorded young adults' behavioral expression of contagious yawning and contagious smiling to video stimuli and employed a multi-method assessment of sociocognitive abilities including self-reported internal experience of emotional contagion, self-reported trait empathy, accuracy on a theory of mind task, and observed helping behavior. Results revealed that contagious yawners reported increases in tiredness from pre- to post-video stimuli exposure, providing support for the internal experience of emotional contagion, and were more likely to provide help to the experimenter relative to non-contagious yawners. Contagious smilers showed stably high levels of self-reported happiness from pre- to post-video exposure, were more likely to provide help to the experimenter, and had increased accuracy on a theory of mind task relative to non-contagious smilers. There were no differences in self-reported trait empathy for contagious versus non-contagious yawners or smilers. Contagious yawning may be related to some basic (i.e., emotional contagion) and advanced (i.e., helping behavior) sociocognitive processes, whereas contagious smiling is related to some advanced sociocognitive processes (i.e., theory of mind and helping behavior). [ABSTRACT FROM AUTHOR]

Objective: This document is designed to outline the definition, pathogenesis, diagnostic modalities and therapeutic measures to treat antibody‐mediated rejection in children postheart transplant Methods: Literature review was conducted by a Pediatric Heart Transplant Society (PHTS) working group to identify existing pediatric and adult studies on antibody‐mediated rejection (AMR). In addition, the centers participating in PHTS were asked to submit their approach to diagnosis and management of pediatric AMR. This document synthesizes information gathered from both these sources to highlight a practical approach to diagnosing and managing a child with AMR postheart transplant. This document may not represent the practice at all centers in the PHTS and serves as a starting point to understand an approach to this clinical scenario. [ABSTRACT FROM AUTHOR]

Background Medically vulnerable individuals are at increased risk of acquiring multidrug-resistant Enterobacterales (MDR-E) infections. People with HIV (PWH) experience a greater burden of comorbidities and may be more susceptible to MDR-E due to HIV-specific factors. Methods We performed an observational study of PWH participating in an HIV clinical cohort and engaged in care at a tertiary care center in the Southeastern United States from 2000 to 2018. We evaluated demographic and clinical predictors of MDR-E by estimating prevalence ratios (PRs) and employing machine learning classification algorithms. In addition, we created a predictive model to estimate risk of MDR-E among PWH using a machine learning approach. Results Among 4734 study participants, MDR-E was isolated from 1.6% (95% CI, 1.2%–2.1%). In unadjusted analyses, MDR-E was strongly associated with nadir CD4 cell count ≤200 cells/mm3 (PR, 4.0; 95% CI, 2.3–7.4), history of an AIDS-defining clinical condition (PR, 3.7; 95% CI, 2.3–6.2), and hospital admission in the prior 12 months (PR, 5.0; 95% CI, 3.2–7.9). With all variables included in machine learning algorithms, the most important clinical predictors of MDR-E were hospitalization, history of renal disease, history of an AIDS-defining clinical condition, CD4 cell count nadir ≤200 cells/mm3, and current CD4 cell count 201–500 cells/mm3. Female gender was the most important demographic predictor. Conclusions PWH are at risk for MDR-E infection due to HIV-specific factors, in addition to established risk factors. Early HIV diagnosis, linkage to care, and antiretroviral therapy to prevent immunosuppression, comorbidities, and coinfections protect against antimicrobial-resistant bacterial infections. [ABSTRACT FROM AUTHOR]

Background Multidrug-resistant Enterobacterales (MDR-E) are important pathogens. People living with human immunodeficiency virus (HIV; PLWH) may be at greater risk for MDR-E infection given relatively high antibiotic exposure and burden of comorbidities. Methods We analyzed data from 36 521 patients in a healthcare system in North Carolina who had a clinical culture with growth of an Enterobacterales species from 2000 to 2018; 440 were PLWH. We used generalized linear models to estimate prevalence ratios and differences, contrasting PLWH and people not living with HIV (PNLWH) for resistance to individual antibiotic classes, as well as MDR-E. We assessed trends in prevalence over time by calculating the 5-year moving average and fitting restricted cubic spline models. Results The overall prevalence of MDR-E was higher among PLWH (21.5%; 95% confidence interval [CI], 18.2%–25.1%) vs PNLWH (16.5%; 95% CI, 16.2%–16.9%), with an adjusted prevalence ratio of 1.38 (95% CI, 1.14–1.65). PLWH had higher rates of antimicrobial resistance than PNLWH for all antibiotic classes analyzed, including penicillins, penicillin/beta lactamase inhibitor combinations, and sulfonamides. MDR-E prevalence was 3 to 10 percentage points higher among PLWH than PNLWH throughout the study period based on the 5-year moving average. Conclusions In a large clinical study population in the southeastern United States from 2000 to 2018, the prevalence of antibacterial resistance among Enterobacterales was consistently higher among PLWH than PNLWH. These data highlight the importance of identifying and mitigating the factors that contribute to antimicrobial resistance in PLWH, given the potential clinical consequences of these resistant pathogens. [ABSTRACT FROM AUTHOR]

Consequently, it is bequest us all to ensure health promotion and public health pedagogy is embedded in learning and teaching theories and frameworks. Teaching behavior change theory in Canada: Establishing consensus on behavior change theories that are recommended to Be taught to undergraduate students in courses addressing health behavior change. Advancing pedagogy in health promotion: Innovations in student participation, place-based pedagogy, and service learning. Historically, the work of Scholarship of Teaching and Learning (SoTL) scholars has been grounded in multi-disciplinary connections to educational psychology and pedagogical research. [Extracted from the article]

The current study examined the interplay between children's dispositional anger and susceptibility to peers' influence in increasing children's risk‐taking behaviors. Participants in the current study were children from a larger study of temperament and social–emotional development who were followed across 9, 24, 36, 48, and 60 months. Dispositional anger was measured using mothers' reports across 9 and 48 months. At 60 months, children played a risk‐taking computer game in presence of an unfamiliar peer who watched the child play. The child's risk‐taking was assessed during the game as the unfamiliar peers' reactions were coded based on comments that were peer directed, reflective of praising the target child's performance, or object directed, indicative of excitement toward the game. A latent profile analysis revealed three longitudinal anger profiles across infancy to early childhood: high stable, average stable, and low stable anger. Results suggested that as peers' object‐directed comments predicted risk‐taking independent of children's anger, the association between peer‐directed comments and risk‐taking was dependent on children's dispositional anger. Specifically, when peers praised the target child's performance, children in the high stable anger profile showed increased risk‐taking propensity. Findings are discussed based on the importance of considering both temperamental characteristics and aspects of the peer context in relation to children's risk‐taking. [ABSTRACT FROM AUTHOR]

Background Predicting mortality risk in patients is important in research settings. The Pitt bacteremia score (PBS) is commonly used as a predictor of early mortality risk in patients with bloodstream infections (BSIs). We determined whether the PBS predicts 14-day inpatient mortality in nonbacteremia carbapenem-resistant Enterobacteriaceae (CRE) infections. Methods Patients were selected from the Consortium on Resistance Against Carbapenems in Klebsiella and Other Enterobacteriaceae, a prospective, multicenter, observational study. We estimated risk ratios to analyze the predictive ability of the PBS overall and each of its components individually. We analyzed each component of the PBS in the prediction of mortality, assessed the appropriate cutoff value for the dichotomized score, and compared the predictive ability of the qPitt score to that of the PBS. Results In a cohort of 475 patients with CRE infections, a PBS ≥4 was associated with mortality in patients with nonbacteremia infections (risk ratio [RR], 21.9; 95% confidence interval [CI], 7.0, 68.8) and with BSIs (RR, 6.0; 95% CI, 2.5, 14.4). In multivariable analysis, the hypotension, mechanical ventilation, mental status, and cardiac arrest parameters of the PBS were independent risk factors for 14-day all-cause inpatient mortality. The temperature parameter as originally calculated for the PBS was not independently associated with mortality. However, a temperature <36.0°C vs ≥36°C was independently associated with mortality. A qPitt score ≥2 had similar discrimination as a PBS ≥4 in nonbacteremia infections. Conclusions Here, we validated that the PBS and qPitt score can be used as reliable predictors of mortality in nonbacteremia CRE infections. [ABSTRACT FROM AUTHOR]

To assess food safety program performance, the Tennessee Department of Health conducted food service surveys of randomly selected establishments and reviewed routine inspection reports by environmental health specialists (EHSs) of the same facilities. The individual restaurant sanitation scores, along with types and frequencies of violations noted by the survey team, were compared with records from the previous year. In addition, EHSs were observed as they each performed two routine inspections. Survey team staff consistently marked more critical violations than did field EHS staff. Differences between survey teams and field EHS staff in marking critical violations were statistically significant for all 10 critical violations in the first review cycle, 8 in the second cycle, and 7 in the third cycle. Over the course of the review period, there was a small but measurable improvement in scoring by field EHS staff. Marking of critical violations increased, sanitation scores decreased, and discrepancies with survey teams in both areas decreased. [ABSTRACT FROM AUTHOR]

Limited research has explored how specific elements of physical and social environments influence mental health indicators such as perceived stress, or whether such associations are moderated by gender. This study examined the relationship between selected neighborhood characteristics and perceived stress levels within a primarily low-income, older, African-American population in a mid-sized city in the Southeastern U.S. Residents ( n = 394; mean age=55.3 years, 70.9% female, 89.3% African American) from eight historically disadvantaged neighborhoods completed surveys measuring perceptions of neighborhood safety, social cohesion, aesthetics, and stress. Multivariate linear regression models examined the association between each of the three neighborhood characteristics and perceived stress. Greater perceived safety, improved neighborhood aesthetics, and social cohesion were significantly associated with lower perceived stress. These associations were not moderated by gender. These findings suggest that improving social attributes of neighborhoods may have positive impacts on stress and related benefits for population health. Future research should examine how neighborhood characteristics influence stress over time. [ABSTRACT FROM AUTHOR]

Seafood consumption is a main source of human exposure to certain environmental contaminants. Therefore, it is valuable to assess the online health risk messages focused on this topic, as people in the US are increasingly accessing the Internet for health-related information. Previous research indicates that online health information tends to be written at a reading level that is more advanced than ability of the general population. The purpose of this research was to examine the content and readability of Internet resources targeted toward consumers in the US regarding the health risks from consumption of contaminated seafood. Sources for analysis were gathered through a targeted search of state and national government websites, as well as through a Google search. The overall mean readability level was Grade 9.21, which is slightly above the average reading level of US adults. Future research should evaluate the accuracy of the health risk messages, as well as consumer perceptions of risk. [ABSTRACT FROM AUTHOR]

Higher-functioning participants with and without autism spectrum disorder (ASD) viewed a series of face stimuli, made decisions regarding the affect of each face, and indicated their confidence in each decision. Confidence significantly predicted accuracy across all participants, but this relation was stronger for participants with typical development than participants with ASD. In the hierarchical linear modeling analysis, there were no differences in face processing accuracy between participants with and without ASD, but participants with ASD were more confident in their decisions. These results suggest that individuals with ASD have metacognitive impairments and are overconfident in face processing. Additionally, greater metacognitive awareness was predictive of better face processing accuracy, suggesting that metacognition may be a pivotal skill to teach in interventions. [ABSTRACT FROM AUTHOR]

Regulation of gene transcription in varicella-zoster virus (VZV), a ubiquitous human neurotropic alphaherpesvirus, requires coordinated binding of multiple host and virus proteins onto specific regions of the virus genome. Chromatin immunoprecipitation (ChIP) is widely used to determine the location of specific proteins along a genomic region. Since the size range of sheared virus DNA fragments governs the limit of accurate protein localization, particularly for compact herpesvirus genomes, we used a quantitative PCR (qPCR)-based assay to determine the efficiency of VZV DNA shearing before ChIP, after which the assay was used to determine the relationship between transcript abundance and the occupancy of phosphorylated RNA polymerase II (RNAP) on the gene promoter, body, and terminus of VZV genes 9, 51, and 66. The abundance of VZV gene 9, 51, and 66 transcripts in VZV-infected human fetal lung fibroblasts was determined by reverse transcription-linked quantitative PCR. Our results showed that the C-terminal domain of RNAP is hyperphosphorylated at serine 5 (S5P) on VZV genes 9, 51, and 66 independently of transcript abundance and the location within the virus gene at both 1 and 3 days postinfection (dpi). In contrast, phosphorylated serine 2 (S2P)-modified RNAP was not detected at any virus gene location at 3 dpi and was detected at levels only slightly above background levels at 1 dpi. [ABSTRACT FROM AUTHOR]

Error-monitoring, or the ability to recognize one's mistakes and implement behavioral changes to prevent further mistakes, may be impaired in individuals with Autism Spectrum Disorder ( ASD). Children and adolescents (ages 9-19) with ASD ( n = 42) and typical development ( n = 42) completed two face processing tasks that required discrimination of either the gender or affect of standardized face stimuli. Post-error slowing and the difference in Error-Related Negativity amplitude between correct and incorrect responses ( ERNdiff) were used to index error-monitoring ability. Overall, ERNdiff increased with age. On the Gender Task, individuals with ASD had a smaller ERNdiff than individuals with typical development; however, on the Affect Task, there were no significant diagnostic group differences on ERNdiff. Individuals with ASD may have ERN amplitudes similar to those observed in individuals with typical development in more social contexts compared to less social contexts due to greater consequences for errors, more effortful processing, and/or reduced processing efficiency in these contexts. Across all participants, more post-error slowing on the Affect Task was associated with better social cognitive skills. [ABSTRACT FROM AUTHOR]

The ability to regulate behaviors and emotions depends in part on the ability to flexibly monitor one's own progress toward a goal. Atypical patterns of response monitoring have been reported in individuals with autism spectrum disorders (ASD). In the current study we examined the error related negativity (ERN), an electrophysiological index of response monitoring, in relation to behavioral, social cognitive, and emotional presentation in higher functioning children (8-16 years) diagnosed with autism (HFA: N = 38) and an age- and IQ-matched sample of children without autism (COM: N = 36). Both HFA and COM participants displayed larger amplitude responses to error compared to correct response trials and these amplitudes did not differ by diagnostic group. For participants with HFA, larger ERN amplitudes were associated with more parent-reported autistic symptoms and more self-reported internalizing problems. However, across the full sample, larger ERN amplitudes were associated with better performance on theory of mind tasks. The results are discussed in terms of the utility of electrophysiological measures for understanding essential moderating processes that contribute to the spectrum of behavioral expression in the development of ASD. [ABSTRACT FROM AUTHOR]

Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and significantly increases the risk for later diagnosis of social anxiety disorder (SAD). Despite these general patterns, many children with high BI do not go on to develop clinical, or even subclinical, anxiety problems. Therefore, understanding the cognitive and neural bases of individual differences in developmental risk and resilience is of great importance. The present review is focused on the relation of BI to two types of information processing: automatic (novelty detection, attention biases to threat, and incentive processing) and controlled (attention shifting and inhibitory control). We propose three hypothetical models (Top-Down Model of Control; Risk Potentiation Model of Control; and Overgeneralized Control Model) linking these processes to variability in developmental outcomes for BI children. We argue that early BI is associated with an early bias to quickly and preferentially process information associated with motivationally salient cues. When this bias is strong and stable across development, the risk for SAD is increased. Later in development, children with a history of BI tend to display normative levels of performance on controlled attention tasks, but they demonstrate exaggerated neural responses in order to do so, which may further potentiate risk for anxiety-related problems. We conclude by discussing the reviewed studies with reference to the hypothetical models and make suggestions regarding future research and implications for treatment. [ABSTRACT FROM AUTHOR]

The current study examined the associations between the early childhood temperament of behavioral inhibition and children's displays of social problem-solving ( SPS) behavior during social exclusion. During toddlerhood (the ages of two to three), maternal report and behavioral observations of behavioral inhibition were collected. At the age of seven, children's SPS behaviors were observed during a laboratory social exclusion task based on the commonly used Cyberball game. Results showed that behavioral inhibition was positively associated with displayed social withdrawal and negatively associated with assertive behavior during the observed social exclusion task at seven years of age. These results add to our understanding of inhibited children's SPS behaviors during social exclusion and provide evidence for the associations between toddler temperament and children's social behavior during middle childhood. [ABSTRACT FROM AUTHOR]

• Behavioral mimicry serves interpersonal functions during social interactions. • We examined relations among shyness, self-focussed attention (SFA), and mimicry. • Shyness was indirectly related to lower behavioral mimicry through higher SFA. Behavioral mimicry is the copying of another person's actions and serves interpersonal functions such as facilitating social reciprocity. Although behavioral mimicry is a ubiquitous phenomenon, there are individual differences in the susceptibility to mimic. Participants engaged in an online interaction with an experimenter who performed planned target behaviors. We coded participants' mimicking behavior, and participants self-reported their trait shyness and focus of attention during the interaction. We found an indirect effect of shyness predicting behavioral mimicry through self-focused attention. Specifically, higher shyness predicted heightened self-focused attention, which in turn was related to a lower likelihood of mimicking. We speculate that shy individuals may experience internally-focused attention during interactions which may impede their likelihood of perceiving and mimicking their partner's behavior. [ABSTRACT FROM AUTHOR]

MircoRNAs (miRNAs) are small non-coding RNAs that govern the gene expression and, play significant role in the pathogenesis of heart failure. The detection of miRNAs in circulation of pulmonary hypertensive (PH) human subjects remains elusive. In the current study, we determined the pattern of miRNAs of mild-to-severe human PH subjects and, compared them with the control subjects by miRNA array. Blood was obtained using fluoroscopic and waveform guided catheterization from the distal (pulmonary artery) port of the catheter. A total 40 human subjects were included in the study and, the degree of PH was determined by mean pulmonary arterial pressure. Among several miRNAs in the array, we validated 14 miRNAs and, the data were consistent with the array profile. We identified several novel downregulated miRNAs (miR-451, miR-1246) and upregulated miRNAs (miR-23b, miR-130a and miR-191) in the circulation of PH subjects. Our study showed novel set of miRNAs which are dysregulated in PH and, are directly proportional to the degree of PH. These miRNAs may be considered as potential biomarker for early detection of PH. [ABSTRACT FROM AUTHOR]

The goals of the current study were to examine whether children's social problem solving (SPS) skills are a mechanism through which temperament influences later academic achievement and whether sex moderates these associations. The participants included 1117 children enrolled in the National Institute of Child Health and Human Development Study of Early Child Care. During preschool, mothers and childcare providers rated children's temperamental shyness and inhibitory control, and SPS was assessed using a hypothetical-reflective measure during a laboratory visit. During kindergarten and first grade, teacher-report of math and language skills was collected. The results indicated that high ratings of inhibitory control in preschool, but not shyness, predicted better kindergarten and first-grade academic skills. Furthermore, children's SPS competence mediated the relations between both shyness and inhibitory control on later academic skills. The child's sex did not moderate these associations. The results suggest that preventative efforts targeting early SPS skills may buffer against later academic adjustment problems among temperamentally extreme children. [ABSTRACT FROM AUTHOR]

Temperament works in combination with a child's environment to influence early socioemotional development. We examined whether maternal caregiving behavior at infant age 9 months moderated the relation between infant temperamental fear (9 months) and observations of children's social behavior with an unfamiliar peer at age 2 in a typically developing sample of 155 children. When infants received lower quality maternal caregiving, temperamental fear was inversely related to observed social engagement and aggression. These relations were nonsignificant when infants received higher quality maternal caregiving. Findings indicate that variations in temperamental fear may predict individual differences in future peer interactions, but sensitive, nonintrusive caregiving behaviors can attenuate these associations. [ABSTRACT FROM AUTHOR]

Background: ABO incompatible (ABOi) heart transplantation is an accepted approach to increasing organ availability for young patients. Previous studies have suggested that early survival for ABOi transplants is similar to ABO compatible (ABOc) transplants. We analyzed the Pediatric Heart Transplant Study (PHTS) database from 1/96 to 12/08 to further assess this strategy. Methods: We analyzed the numbers of ABOi and ABOc done at the PHTS centers. We then compared the clinical characteristics, and short-term freedom from death, rejection and infection in the ABOi patients with the patients that had an ABOc heart transplant during the same period. All patients were less than or equal to 15 months of age at listing (the age of the oldest ABOi patient). We adjusted for co-variates shown to increase risk for mortality (age less than 1 month, extracorporeal membrane oxygenation (ECMO), ventilator, previous sternotomy, and congenital heart disease). Results: There were 931 total transplants done at 34 PHTS centers during the 12 year time period in patients ≤15 months of age. Of these, 502 transplants were performed at 20 PHTS centers that did at least one ABOi heart transplant. Eighty-five of the 502 (17%) were ABOi. At time of transplant, ABOi recipients compared with ABOc were more likely to be on a ventilator (49.4% vs 36.5%, p=0.025), and more often supported with ECMO (23.5% vs 13.4%, p=0.018). There was similar survival at 12 months (82% vs 84%, p=0.7). In risk adjusted analysis ABOi status was not associated with 1 year mortality (HR 0.85, 95% CI 0.45–1.6, p=0.61). The ABOi patients had greater freedom from rejection when compared with ABOc patients for all 34 centers (75% vs 62%, p=0.016), but the difference was not significant when limited only to the 20 centers doing ABOi transplants (75% vs 69%, p=0.4). The ABOi cohort had lower infection rates (23.5% vs 37.9%, p = 0.013). This difference remained after adjusting for center and other covariates. Conclusions: In center and risk adjusted analysis, young children who received an ABOi transplant had equivalent one-year survival and freedom from rejection compared with those who received an ABOc transplant. In spite of the favorable outcome for ABOi recipients, many centers appear to reserve ABOi transplantation for sicker patients. These data mandate reexamination of the current United Network for Organ Sharing (UNOS) policy that gives priority to ABOc over ABOi transplantation in the United States. [ABSTRACT FROM AUTHOR]

Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. ), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific modifier processes that affect the social and emotional development of all people. One study supporting this model found that measures of resting anterior EEG asymmetry, a measure reflecting complex brain processes associated with generic individual differences in approach and avoidance motivation, may help explain differences in the expression of autism in children without intellectual disabilities (Sutton et al. ). In the current study, we partially replicated the observation that children with autism who exhibited a pattern of left frontal EEG asymmetry tended to display milder levels of social symptoms, although in the current sample this pattern applied only to HFA children with relatively lower verbal IQs. New observations indicated that left frontal EEG asymmetry was also associated with retrospective parent reports of significantly later age of onset of symptoms, but also higher levels of self-reported outward expressions of anger as well as symptoms of obsessive compulsive disorder in school-age higher functioning children with ASD. Therefore, the results of this study provide a new and fully independent set of observations, which indicate that individual differences in anterior EEG asymmetry may significantly moderate the expression and developmental course of autism. This observation may have clinical implications for identifying meaningful diagnostic sub-groups among children with autism. [ABSTRACT FROM AUTHOR]

The P1 and N170 components, two event-related potentials sensitive to face processing, were examined in response to faces and vehicles for children with autism and typical development. P1 amplitude decreased, P1 latency decreased, and N170 amplitude became more negative with age. Children with typical development had larger P1 amplitudes for inverted faces than upright faces, but children with autism did not show this pattern. Children with autism had longer N170 latencies than children with typical development. Smaller P1 amplitudes and more negative N170 amplitudes for upright faces were associated with better social skills for children with typical development. [ABSTRACT FROM AUTHOR]

Abstract: Oral vaccination is an important part of wildlife rabies control programs. Currently, the vaccinia-rabies glycoprotein recombinant virus is the only oral rabies vaccine licensed in the United States, and it is not effective in skunks. In the current study, captive raccoons and skunks were used to evaluate a vaccine developed by incorporating the rabies virus glycoprotein gene into a canine adenovirus serotype 2 vector (CAV2-RVG). Seven of 7 raccoons orally vaccinated with CAV2-RVG developed virus neutralizing antibodies and survived lethal challenge. Five of 5 and 6 of 6 skunks in 2 experimental groups receiving 10-fold different dilutions of CAV2-RVG developed neutralizing antibodies and survived challenge. The results of this preliminary study suggest that CAV2-RVG stimulates protective immunity against rabies in raccoons and skunks. [Copyright &y& Elsevier]

Background: We examined performance on a self-referenced memory (SRM) task for higher-functioning children with autism (HFA) and a matched comparison group. SRM performance was examined in relation to symptom severity and social cognitive tests of mentalizing. Method: Sixty-two children (31 HFA, 31 comparison; 8–16 years) completed a SRM task in which they read a list of words and decided whether the word described something about them, something about Harry Potter, or contained a certain number of letters. They then identified words that were familiar from a longer list. Dependent measures were memory performance (d′) in each of the three encoding conditions as well as a self-memory bias score (d′ self–d′ other). Children completed The Strange Stories Task and The Children’s Eyes Test as measures of social cognition. Parents completed the SCQ and ASSQ as measures of symptom severity. Results: Children in the comparison sample showed the standard SRM effect in which they recognized significantly more self-referenced words relative to words in the other-referenced and letter conditions. In contrast, HFA children showed comparable rates of recognition for self- and other-referenced words. For all children, SRM performance improved with age and enhanced SRM performance was related to lower levels of social problems. These associations were not accounted for by performance on the mentalizing tasks. Conclusions: Children with HFA did not show the standard enhanced processing of self- vs. other-relevant information. Individual differences in the tendency to preferentially process self-relevant information may be associated with social cognitive processes that serve to modify the expression of social symptoms in children with autism. [ABSTRACT FROM AUTHOR]

Variation in temperament is characteristic of all people but is rarely studied as a predictor of individual differences among individuals with autism. Relative to a matched comparison sample, adolescents with High-Functioning Autism (HFA) reported lower levels of Surgency and higher levels of Negative Affectivity. Variability in temperament predicted symptomotology, social skills, and social-emotional outcomes differently for individuals with HFA than for the comparison sample. This study is unique in that temperament was measured by self-report, while all outcome measures were reported by parents. The broader implications of this study suggest that by identifying individual variability in constructs, such as temperament, that may influence adaptive functioning, interventions may be developed to target these constructs and increase the likelihood that individuals with HFA will achieve more adaptive life outcomes. [ABSTRACT FROM AUTHOR]

The following interview of Dr. Ron Iannone was conducted by heather henderson over the period of several weeks. Dr. Ron Iannone has written quite extensively on humanizing education. His major works include, "Alternatives to the Coming Death of Schooling," "School Ain't No Way/Appalachian," and several other articles, poems, and plays. His responses to heather henderson's inquiry give the reader an opportunity to seek new possibilities for curriculum and teaching. [ABSTRACT FROM AUTHOR]

Children with behavioral inhibition, a temperamental style characterized by infant distress to novelty and childhood social reticence, exhibit both continuity and discontinuity of this behavioral trait over the course of development. However, few researchers have identified factors that might be responsible for these different patterns. In the current study, childcare history, maternal personality, and maternal behavior were examined as moderators of the relations between infant temperament, preschool social reticence, and childhood social wariness. Seventy-seven children participated in this longitudinal study that began in infancy and continued into middle childhood. Maternal negative personality moderated the relation between infant temperament and childhood social wariness. In addition, maternal behavior moderated the relation between preschool social reticence and childhood social wariness. The findings suggest that a complex interplay of within-child and maternal factors affect the development of internalizing behavior in the early school years. [ABSTRACT FROM AUTHOR]

The article discusses the direct and indirect zoonotic transmission of Shiga toxin-producing Escherichia coli (STEC). The outbreak of STEC infections was traced to cattle and goats in open farms where about 6 million humans are at potential risk of infection from animal contact at petting zoos each week. The risk factors for the environmental transmission of STEC include visits to farms and zoos, exposure to animal feces and contact with farm animals.

Abstract: In this paper we review current definitions and measurement approaches used to assess individual differences in children’s temperament. We review the neural bases of temperamental reactivity and self-regulation and propose that these constructs provide a framework for examining individual differences and developmental change in emotion–cognition interactions across development. Studies are reviewed in which some well-documented contextual effects on the expression of temperament can be interpreted in terms of the influence of biological and non-biological factors on CNS functioning. We conclude with ideas regarding future directions for the study of individual differences and developmental change in cognition–emotion interactions as they are shaped throughout development. [Copyright &y& Elsevier]

The study of phenotypic variability in social impairments and comorbid emotional disorders in autism is important because it provides information on phenotypic differences that currently complicate diagnosis, research, and treatment of this disorder. Currently, though, relatively little is known about the processes that contribute to individual differences in social impairments and comorbidity in autism. In this paper, we present a model that suggests modifier processes (MPs), which are not necessarily specific to the syndrome, refract or alter the expression of autism and contribute to fundamental behavioral and psychological differences in children diagnosed with this disorder. One MPs involves the somewhat surprising tendency of some children with higher functioning autism (HFA) to make attributions about other peoples thoughts, although they have social cognitive deficits. Just as in other children, the attributions of children with HFA are linked to some of their behavioral problems. Another MP involves the influence of differences in motivation associated with the behavioral activation and inhibition systems that can be assessed with measures of anterior EEG asymmetry. This dimension of motivation may be linked to how active but inappropriate and withdrawn children with HFA may appear. Third, differences in the self-monitoring of errors among children with HFA appear to be related to individual differences in IQ and social symptom severity in these children. The possible role of these MPs in diagnostic subgroups and differences in treatment responses among children with HFA are discussed. In addition, the role of MPs in understanding the effects associated with specific genetic functions in autism, such as those associated with the serotonin transporter gene (5-HTTLPR), is discussed. A conclusion of this paper is that the varied expression of autism may require that we understand how autism interacts with other non-syndrome-specific processes that are related to individual differences in all people. [ABSTRACT FROM AUTHOR]

Abstract: Children with autism not only display social impairments but also significant individual differences in social development. Understanding the source of these differences, as well as the nature of social impairments, is important for improved diagnosis and treatments for these children. Current theory and research suggests that individual differences in response monitoring, a specific function of the anterior cingulate cortex (ACC), may contribute to social-emotional and social-cognitive impairments and individual differences in autism. To examine this hypothesis, we used a modified flanker task to assess an ERP index of response monitoring, the error-related negativity (ERN), in a sample of higher function children with autism (HFA) and an IQ-matched control sample. The results revealed a significant Diagnostic group by Verbal IQ interaction on ERN amplitude indicating that the most verbally capable HFA children displayed significantly larger ERN amplitudes than did the control children. Within the HFA sample, greater ERN amplitude was also related to parent reports of fewer symptoms of social interaction impairments, fewer internalizing problems, but more externalizing problems, although these associations were reduced to nonsignificance when medication status was controlled. The latter results complement previous observations from imaging studies of a significant association between ACC activity and social symptoms and impairments in autism. The implications of these results for future research on brain-behavior relations, as well as treatment related research with children with autism are discussed. [Copyright &y& Elsevier]

Behavioral inhibition refers to a temperament or style of reacting that some infants and young children exhibit when confronted with novel situations or unfamiliar adults or peers. Research on behavioral inhibition has examined the link between this set of behaviors to the neural systems involved in the experience and expression of fear. There are strong parallels between the physiology of behaviorally inhibited children and the activation of physiological systems associated with conditioned and unconditioned fear. Research has examined which caregiving behaviors support the frequency of behavioral inhibition across development, and work on the interface of cognitive processes and behavioral inhibition reveal both how certain cognitive processes moderate behavioral inhibition and how this temperament affects the development of cognition. This research has taken place within a context of the possibility that stable behavioral inhibition may be a risk factor for psychopathology, particularly anxiety disorders in older children. The current chapter reviews these areas of research and provides an integrative account of the broad impact of behavioral inhibition research. [ABSTRACT FROM AUTHOR]

Four-year-old children showing low levels of social behavior in a laboratory play session with unfamiliar peers were classified as reticent (unoccupied or onlooking behaviors) or solitary-passive (solitary constructive or exploratory play). Compared with a group of more social children, the children in both low-social groups were rated high on maternal reports of shyness and displayed a pattern of right frontal EEG asymmetry. However, only the reticent group was elevated on measures indicative of a fearful temperament, both concurrently and retrospectively. A subset of children in the solitary-passive group showed increasing levels of reticent behavior over the course of the visit, suggesting that for some children solitary-passive behaviors provide a means for coping with feelings of unease. [ABSTRACT FROM AUTHOR]

Four-month-old infants were screened (N = 433) for temperamental patterns thought to predict behavioral inhibition, including motor reactivity and the expression of negative affect. Those selected (N = 153) were assessed at multiple age points across the first 4 years of life for behavioral signs of inhibition as well as psychophysiological markers of frontal electroencephalogram (EEG) asymmetry. Four-month temperament was modestly predictive of behavioral inhibition over the first 2 years of life and of behavioral reticence at age 4. Those infants who remained continuously inhibited displayed right frontal EEG asymmetry as early as 9 months of age while those who changed from inhibited to noninhibited did not. Change in behavioral inhibition was related to experience of nonparental care. A second group of infants, selected at 4 months of age for patterns of behavior thought to predict temperamental exuberance, displayed a high degree of continuity over time in these behaviors. [ABSTRACT FROM AUTHOR]

Presents a study which examined the influence of maternal reports of negative reactivity in the first year of life on measures of sociability and social wariness taken at four years of age. Gender differences in social wariness; Methodology and results; Limitations of the study; Clinical implications.

Studies the reactions of inhibited and uninhibited children to unfamiliar challenges in school settings. Role of temperament in predicting children's academic, social and personal adaptation; Link of social and emotional adjustment on reactions to unfamiliar; Approaches for assessment and classroom modifications for needs of temperamentally diverse students.

The professionalization of the fields of health education and health promotion has largely coincided with the completion of job task analysis conducted by major organizations in the field (e.g., the National Commission for Health Education Credentialing, Society for Public Health Education). The process through which these job task analyses and skill-based competencies are implemented in professional preparation programs poses a risk to stifle advancement and innovation in health education and promotion. In this perspective, we discuss Competency Focused Practice (the current state of the field) to a goal of Philosophically Grounded Practice. We provide comparisons of the implications of these two schools of thought with respect to ethics, social determinants of health, and practical methods in health education and promotion. [ABSTRACT FROM AUTHOR]

• Children faster and more accurate at identifying global than local level targets. • Better performance when target remained at same level across subsequent trials. • As shyness increased, children slower in social relative to non-social condition. • However, shyness did not predict differences in accuracy between conditions. • Shyness relates to variable attentional task performance under social conditions. To engage effectively in a dynamic social world, children must be prepared to process incoming information quickly and efficiently. For some, the perception that one may be evaluated by peers may directly affect how they attend to and engage with the world around them. The current study examined how children's performance on a hierarchical figures task varies under perceived social and nonsocial conditions as a function of temperamental shyness. A total of 78 8-year-olds completed a self-report measure of shyness and two blocks of a divided attention task in which they identified targets appearing at the global or local level of a hierarchical figure. Children completed one block under standard laboratory conditions (Baseline condition) and completed the other block under the impression that their performance was being recorded and would be shown to other children of the same age (Social Monitoring condition). Results showed that children were faster and more accurate when targets appeared at the global level and when targets remained at the same level across trials. Furthermore, as shyness increased, children responded slower in the Social Monitoring condition relative to the Baseline condition. Notably, these changes in response time were not reflected by commensurate increases in accuracy. Potential processes and motivations underlying these differences in performance, as well as implications for children in real-world situations, are discussed. [ABSTRACT FROM AUTHOR]

To be a desirable social partner and develop healthy relationships with peers, a child must be able to engage with peers across a variety of contexts. Understanding the factors supporting high levels of social engagement with peers is thereby essential, requiring the development of nuanced and ecologically valid indices of social engagement. Building on recent adult work, the current study explores conversational response time as a novel index of children's social engagement with peers in a dyadic context. This study further explores relationship between conversational response time and children's shyness. Fifty‐six 9‐ to 11‐year‐old children interacted with an unfamiliar peer in an unstructured setting and completed a self‐report measure of shyness. Children's behaviour was coded for their conversational RTs and overall social engagement. Faster conversational RTs were significantly related to children's own social engagement and marginally related to their partners' engagement. Moreover, higher shyness in children's partners predicted faster conversational RTs in children themselves. New directions for using conversational RT as an index of children's social engagement and implications for accounts children's social development are discussed. [ABSTRACT FROM AUTHOR]

Background: Among ambulatory people with incomplete spinal cord injury (iSCI), balance deficits are a primary factor limiting participation in walking activities. There is broad recognition that effective interventions are needed to enhance walking balance following iSCI. Interventions that amplify self-generated movements (e.g., error augmentation) can accelerate motor learning by intensifying sensorimotor feedback and facilitating exploration of motor control strategies. These features may be beneficial for retraining walking balance after iSCI. We have developed a cable-driven robot that creates a movement amplification environment during treadmill walking. The robot applies a continuous, laterally-directed, force to the pelvis that is proportional in magnitude to real-time lateral velocity. Our purpose is to investigate the effects of locomotor training in this movement amplification environment on walking balance. We hypothesize that for ambulatory people with iSCI, locomotor training in a movement amplification environment will be more effective for improving walking balance and participation in walking activities than locomotor training in a natural environment (no applied external forces). Methods: We are conducting a two-arm parallel-assignment intervention. We will enroll 36 ambulatory participants with chronic iSCI. Participants will be randomized into either a control or experimental group. Each group will receive 20 locomotor training sessions. Training will be performed in either a traditional treadmill environment (control) or in a movement amplification environment (experimental). We will assess changes using measures that span the International Classification of Functioning, Disability and Health (ICF) framework including 1) clinical outcome measures of gait, balance, and quality of life, 2) biomechanical assessments of walking balance, and 3) participation in walking activities quantified by number of steps taken per day. Discussion: Training walking balance in people with iSCI by amplifying the individual's own movement during walking is a radical departure from current practice and may result in new strategies for addressing balance impairments. Knowledge gained from this study will expand our understanding of how people with iSCI improve walking balance and how an intervention targeting walking balance affects participation in walking activities. Successful outcomes could motivate development of clinically feasible tools to replicate the movement amplification environment within clinical settings. Trial registration: NCT04340063. [ABSTRACT FROM AUTHOR]

Children with a history of behaviorally inhibited (BI) temperament face a heightened risk for anxiety disorders and often use control strategies that are less planful. Although these relations have been observed concurrently in early childhood, middle childhood, and adolescence, few studies leverage longitudinal data to examine long-term prospective relations between cognitive control and anxiety. Using longitudinal data from 149 adolescents (55% female; from predominantly White middle-class families), we assessed temperament in toddlerhood and cognitive control and anxiety at 4, 12, 15, and 18 years of age. At age 4, separate measures of task switching and inhibitory control were obtained via the Dimensional Change Card Sort and Stroop tasks, respectively. At 12, 15, and 18 years of age, planful control was assessed with the AX-Continuous Performance Test, and anxiety symptoms were assessed via self-report. Growth curve models revealed that children with greater inhibitory control at age 4, regardless of BI status, experienced a sharper increase in anxiety symptoms across adolescence. Children with heightened BI during early childhood displayed lower levels of planful control at age 12, but experienced a more rapid improvement in these skills across adolescence. Children with greater task switching ability at age 4 displayed higher levels of planful control at age 12, but experienced a smaller increase in these skills across adolescence. Finally, children's growth rate for anxiety was unrelated to their growth rate for planful control. These findings reveal that early-life temperament, cognitive control, and anxiety remain interconnected across development, from toddlerhood to at least late adolescence. Public Significance Statement: This study indicates that temperament and executive function in early childhood predict the future development of anxiety and executive function across adolescence. However, changes in anxiety across adolescence did not relate to changes in executive function across the same period. Together, results suggest that early interventions may have the best chance of improving adolescents' anxiety trajectories. [ABSTRACT FROM AUTHOR]

Background: Routine surveillance protocols rely heavily on endomyocardial biopsy (EMB) for detection of rejection in pediatric heart transplant recipients. More sensitive echocardiographic tools to assess rejection may help limit the number of EMBs. This study compared changes in left ventricular (LV) strain in patients who had rejection versus those who did not. Methods: A single center retrospective review was conducted between 2013 and 2020. Patients were categorized based on rejection history. Echocardiograms were evaluated at the time of 2 consecutive EMBs; in the rejection group, the second echocardiogram was collected at the time of a rejection episode. Conventional measures of LV function and speckle‐tracking echocardiography‐derived longitudinal (LS) and circumferential strain (CS) were measured. Results: 17 patients were in the non‐rejection group and 17 were in the rejection group (30 total rejection episodes). The rejection group was older at the time of transplant (12.5 vs. 1.3 years, p =.01). A decline in CS was seen in the rejection group at the second echocardiogram [−18.5 (IQR −21.5, −14.6) to −15.7 (IQR −19.8, −13.2)] while CS improved in the non‐rejection group [−20.8 (IQR −23.9, −17.8) to −23.9 (IQR −24.9, −20.1)]. This difference in change reached significance (p =.02). A similar pattern was seen in LS that neared significance (p =.06). There was no significant difference in ejection fraction change (p =.24). Conclusions: Patients in the non‐rejection group displayed improvement in CS between echocardiograms while patients in the rejection group showed subsequent decline. Worsening of LV CS may help identify acute rejection in the early post‐transplant period. [ABSTRACT FROM AUTHOR]

Background Urinary tract infection (UTI) is the most common clinical manifestation of carbapenem-resistant Klebsiella pneumoniae (CR Kp). Persistent CR Kp bacteriuria is associated with the spread of CR Kp and antibiotic overuse. Risk factors for persistent CR Kp bacteriuria are uncertain. Methods CRACKLE-1 was a multicenter, prospective study that included 960 patients with at least one carbapenem-resistant Enterobacteriaceae (CRE)-positive culture from December 2011 to June 2016 collected from 18 hospitals encompassing 8 healthcare systems in the Midwestern US and North Carolina. Patients with CR Kp bacteriuria who were discharged alive from index hospitalization were included in the current study, and sporadic (single positive CR Kp urine culture) and persistent (≥2 CR Kp urine cultures during independent hospital admissions occurring at least 2 days apart) cases were compared. Antibiotic susceptibility testing was performed by local laboratories. Amikacin, gentamicin (GENT), and trimethoprim/sulfamethoxazole were included in the analysis based on variance and frequency of testing. The CDC/National Healthcare Safety Network criteria for UTI were used. Results CR Kp was the most common CRE isolate (n = 869, prevalence 91%). In patients with CR Kp , 527 had CR Kp isolated from the urine (prevalence 61%, 95% CI 0.57, 0.64). Of these, 486 patients, of whom 129 (27%) were diagnosed with a UTI, were discharged alive. Notably, 135/486 (28%) patients with CR Kp bacteriuria were readmitted and yielded a second urine culture of CR Kp. Most patients with persistent bacteriuria, 99/135 (73%), were asymptomatic at initial admission. Of these patients, 20/99 (20%) were diagnosed with a UTI at second admission. In multivariable analysis, only GENT non-susceptibility was associated with an increased risk (adjusted OR 1.66, 95% CI 1.10–2.49) of persistent bacteriuria. Persistent bacteriuria was independent of GENT treatment during index hospitalization (GENT was used in 15% of patients). Conclusion Bacteriuria with GENT non-susceptible CR Kp strains was associated with persistent bacteriuria. As this was independent of GENT treatment, GENT resistance determinants may be co-transmitted along with traits that promote bacterial persistence in CR Kp. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Heart failure results in significant morbidity and mortality for young children with hypoplastic left heart syndrome (HLHS) following the Norwood procedure. The trajectory in later childhood is not well described. We studied the outcome into adolescence of participants enrolled in the Single Ventricle Reconstruction trial who underwent the Fontan procedure or survived to 6 years without having undergone Fontan procedure. The primary outcome was heart failure events, defined as heart transplant listing or death attributable to heart failure. Symptomatic heart failure for participants surviving 10 or more years was also assessed utilizing the Pediatric Quality of Life Inventory (PedsQL). Of the 345 participants who underwent a Fontan operation or survived to 6 years without Fontan, 25 (7.2%) had a heart failure event before the age of 12 years. Among these, 21 were listed for heart transplant, and 4 died from heart failure. Nineteen participants underwent heart transplant, all of whom survived to age 12 years. Factors associated with a heart failure event included longer Norwood hospital length of stay, aortic atresia, and no Fontan operation by age 6 years. Assessment of heart failure symptoms at 12 years of age revealed that 24 (12.2%) of 196 PedsQL respondents "often" or "almost always" had difficulty walking more than one block. Heart failure events occur in over 5% of children with palliated HLHS between preschool age and adolescence. Outcomes for children listed for transplant are excellent. However, a substantial portion of palliated HLHS children have significant symptoms of heart failure at 12 years of age. [ABSTRACT FROM AUTHOR]