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Although emotional mimicry is ubiquitous in social interactions, its mechanisms and roles remain disputed. A prevalent view is that imitating others' expressions facilitates emotional understanding, but the evidence is mixed and almost entirely based on facial emotions. In a preregistered study, we asked whether inhibiting orofacial mimicry affects authenticity perception in vocal emotions. Participants listened to authentic and posed laughs and cries, while holding a pen between the teeth and lips to inhibit orofacial responses ( n = 75), or while responding freely without a pen ( n = 75). They made authenticity judgments and rated how much they felt the conveyed emotions (emotional contagion). Mimicry inhibition decreased the accuracy of authenticity perception in laughter and crying, and in posed and authentic vocalizations. It did not affect contagion ratings, however, nor performance in a cognitive control task, ruling out the effort of holding the pen as an explanation for the decrements in authenticity perception. Laughter was more contagious than crying, and authentic vocalizations were more contagious than posed ones, regardless of whether mimicry was inhibited or not. These findings confirm the role of mimicry in emotional understanding and extend it to auditory emotions. They also imply that perceived emotional contagion can be unrelated to mimicry. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Infants' nonverbal expressions-a broad smile or a sharp cry-are powerful at eliciting reactions. Although parents' reactions to their own infants' expressions are relatively well understood, here we studied whether adults more generally exhibit behavioral and physiological reactions to unfamiliar infants producing various expressions. We recruited U.S. emerging adults (N = 84) prior to parenthood, 18-25 years old, 68% women, ethnically (20% Hispanic/Latino) and racially (7% Asian, 13% Black, 1% Middle Eastern, 70% White, 8% multiracial) diverse. They observed four 80-s audio-video clips of unfamiliar 2- to 6-month-olds crying, smiling, yawning, and sitting calmly (emotionally neutral control). Each compilation video depicted 9 different infants (36 clips total). We found adults mirrored behaviorally and physiologically: more positive facial expressions to infants smiling, and more negative facial expressions and pupil dilation-indicating increases in arousal-to infants crying. Adults also yawned more and had more pupil dilation when observing infants yawning. Together, these findings suggest that even nonparent emerging adults are highly sensitive to unfamiliar infants' expressions, which they naturally "catch" (i.e., behaviorally and physiologically mirror), even without instructions. Such sensitivity may have-over the course of humans' evolutionary history-been selected for, to facilitate adults' processing of preverbal infants' expressions to meet their needs., (© 2024 The Author(s). Developmental Psychobiology published by Wiley Periodicals LLC.)

The extent to which mother and infant sleep predict maternal sensitivity as (a) main effects and (b) moderate the association between social cognition about infant crying (i.e., cry processing) and maternal sensitivity was examined in a sample of 299 mother-infant dyads (43% of mothers non-White; 50.5% of infants female). Infant- and mother-oriented cry processing were assessed prenatally using a video recall procedure and mothers self-reported demographics and characteristics reflecting emotional risk. When infants were 2 months old, mothers reported their depressive symptoms and mother and infant sleep. Maternal sensitivity and infant negative mood were observed during free play and the still face. There were no main effects of mother or infant sleep on maternal sensitivity over and above covariates. However, infant total sleep duration across night and day and mother sleep disturbance moderated the effect of mother-oriented cry processing on sensitivity. Specifically, mother-oriented cry processing was associated with lower maternal sensitivity only among mothers whose infants had lower sleep duration and who reported more sleep disturbances. Moderating effects were not apparent for infant night wakings or time awake or mothers' total sleep problems. Constrained opportunities for sleep or respite across the entire day and the totality of mothers' nighttime sleep disturbances, not just those specific to infants' night wakings, undermine maternal sensitivity by exacerbating mothers' preexisting tendency to have self-focused and negative reactions to infant distress. The efficacy of interventions designed to facilitate maternal sensitivity and infant adjustment may be enhanced by adding targeted foci on maternal and infant sleep. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The purpose of this study is to describe the defecation pattern of healthy infants up to 17 weeks of age. We included 1052 healthy term infants from the prospective HELMi cohort (NCT03996304). Parents filled in recurring online questionnaires on feeding, gastrointestinal function, and crying weekly for the first 17 weeks of life. Defecation frequency was highest at the age of 3 weeks (a median of 4 times/day, interquartile range (IQR) 2.9-5). At each time point, the median defecation frequency of breastfed infants was higher than that of infants receiving formula (e.g., at week 17 a median of 2 times/day, IQR 0.9-3.6, and a median of 1.1, IQR 0.6-1.4, respectively). The dominant color of the stool was most often yellow or light brown. Nearly black stools were reported in the first week of life in 3.4%. Nearly half (47.4%) of the infants had green stool color dominating for at least 1 week, with comparable frequency among breastfed (47.7%) and formula-fed (45.2%) infants. Green stools were associated with a higher defecation frequency (linear mixed-effect model p < 0.0001). Occasional blood in stool was reported in 9.3% and recurrent blood in 5.2% of the infants with no difference in stool consistency. Hard stools were rare (≤ 1%).     Conclusion: This study enlightens the spectrum of defecation patterns in healthy term infants during the first 17 weeks of life. A better understanding of bowel function helps healthcare professionals distinguish normal from abnormal when addressing defecation, the color of stools, and the type of feeding. What is Known: • Breastfed infants have more frequent and more yellow-colored stools than formula-fed infants. • Stools with green color are often suggested by the parents or even by medical professionals to indicate disease or discomfort in early life. What is New: • Nearly half of the healthy term infants had green stool dominating for at least one week during the first 17 weeks and occasional blood was reported in almost 10% of the infants during this period. • Data on normal variation in bowel function and stool may serve primary health care professionals when educating the families and caretakers of infants., (© 2024. The Author(s).)

Background and Objective: Processing the newborns' cry audio signal (CAS) provides valuable information about the newborns' condition. This information can be used to diagnose the disease. This article analyzes the CASs of newborns under two months old using machine learning approaches to develop an automatic diagnostic system for identifying septic infants from healthy ones. Septic infants have not been studied in this context., Methodology: The proposed features include Mel frequency cepstral coefficients and the prosodic features of tilt, rhythm, and intensity. The performance of each feature set was evaluated using a collection of classifiers, including Support Vector Machine (SVM), decision tree, and discriminant analysis. We also examined the majority voting method for improving the classification results and feature manipulation and multiple classifier framework, which has not previously been reported in the literature on developing an automatic diagnostic system based on the infant's CAS. We tested our methodology on two datasets of expiration and inspiration episodes of newborns' CASs., Results and Conclusion: The framework of the concatenation of all feature sets using quadratic SVM resulted in the best F-score with 86% for the expiration dataset. Furthermore, the framework of tilt feature set with quadratic discriminant with 83.90% resulted in the best F-score for inspiration. We found out that septic infants cry differently than healthy infants through these experiments. Thus, our proposed method can be used as a noninvasive tool for identifying septic infants from healthy ones only based on their CAS., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

When patients fail symptom validity tests (SVTs) and/or performance validity tests (PVTs), their self-reported symptoms and test profiles are unreliable and cannot be taken for granted. There are many well-established causes of poor symptom validity and malingering is only of them. Some authors have proposed that a cry for help may underlie poor symptom validity. In this commentary, we argue that cry for help is a (1) metaphorical concept that is (2) difficult to operationalize and, at present, (3) impossible to falsify. We conclude that clinicians or forensic experts should not invoke cry for help as an explanation for poor symptom validity. To encourage conceptual clarity, we propose a tentative framework for explaining poor symptom validity.

Emotional crying is a potent signal that can influence how social interactions unfold. Although the social signal function of crying has been mostly studied in experimental approaches involving hypothetical scenarios with strangers as targets, we propose that daily social interactions should be considered to address aspects of external validity. We conducted three retrospective studies (total N = 2,277; convenience samples; Studies 2 and 3 were preregistered; data were collected in 2022 and 2023) and found that individuals primarily observed close others crying in their daily lives; a boundary condition that was hardly reflected in former studies. Crying episodes were typically characterized by tears and changes in facial expression, vocalizations, and gestures, whereas isolated emotional tears, were rarely reported. Participants indicated that they frequently helped close others, but that helping strangers was the exception. The level of familiarity with the target also influenced the form of help provided. Furthermore, the crying person was rated as less warm and less competent when crying (vs. in general or in a neutral situation). Additional analyses suggest that question order effects and recall biases are no plausible alternative explanations of our findings. Taken together, these results call into question the validity of the experimental approaches used in this line of research. We discuss strategies for future study of the social signal function of crying in nonhypothetical scenarios with reference to the "generalizability crisis" of psychological science. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Porges' polyvagal theory (1991) proposes that the activity of the vagal nerve modulates moment-by-moment changes in adaptive behavior during stress. However, most work, including research with infants, has only examined vagal changes at low temporal resolutions, averaging 30+ s across phases of structured stressor paradigms. Thus, the true timescale of vagal regulation-and the extent to which it can be observed during unprompted crying-is unknown. The current study utilized a recently validated method to calculate respiratory sinus arrhythmia (RSA) dynamically at a high resolution of 5 Hz (updated every 200 ms) in a home-based infant study. Using an event-related analysis, we calculated the relative change in RSA around the onset of naturally occurring unprompted instances of n = 41 infants' 180 crying events. As predicted, RSA significantly decreased after the onset of crying compared to non-crying chance changes in RSA. Decreasing trends in RSA were driven by infants with higher pre-cry RSA values, infants rated lower in Negative Affectivity, and those rated both high and low in Orienting by their mothers. Our results display the timescale of RSA in spontaneous and naturalistic episodes of infant crying and that these dynamic RSA patterns are aligned with real-time levels of RSA and also caregiver-reported temperament., (© 2023 Wiley Periodicals LLC.)

Background: Bath is an external stimulus for preterm infants. Currently, three methods are used for preterm infants to bath. It is important to choose the best way for them. The objective of this meta-analysis is to evaluate the effectiveness of different bath methods on physiological indexes and behavioral status of preterm infants., Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines and was registered in PROSPERO(CRD42022377657). PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Sino Med, China National Knowledge Internet (CNKI) and Wan-Fang database were systematically searched for randomized controlled trials on the effects of different bath methods for preterm infants. The retrieval time was from the establishment of the database to February 2023. According to the inclusion and exclusion criteria, the literature was screened, quality evaluated and the data was extracted. Reman Version 5.4 was used for meta-analysis and Stata 16.0 software for publication bias Egger's test., Results: A total of 11 RCTs with 828 preterm infants were included. The results of meta-analysis showed that the body temperature and oxygen saturation of preterm infants in the sponge bath group were lower than those in conventional tub bath group (SMD = -0.34; 95%CI -0.56 to -0.12; I 2  = 0; p < 0.01), (MD = -0.39; 95%CI -0.76 to -0.02; I 2  = 39%; p = 0.04), while the heart rates were higher than those in conventional tub bath group(MD = 5.90; 95%CI 0.44 to 11.35; I 2  = 61%; p = 0.03). Preterm infant's body temperature and blood oxygen saturation of in swaddle bath group were higher than those in conventional tub bath group (MD = 0.18; 95%CI 0.05 to 0.30; I 2  = 88%; p < 0.01), (MD = 1.11; 95%CI 0.07 to 2.16; I 2  = 86%; p = 0.04), respiratory rates were more stable compared with infants in conventional tub bath group (MD = -2.73; 95%CI -3.43 to -2.03; I 2  = 0; p < 0.01). The crying duration, stress and pain scores of preterm infants in swaddle bath group were lower than those in conventional tub bath group (SMD = -1.64; 95CI -2.47 to -0.82; I 2  = 91%; p < 0.01), (SMD = -2.34; 95%CI -2.78 to -1.91; I 2  = 0; p < 0.01), (SMD = -1.01; 95%CI -1.40 to -0.62; I 2  = 49%; p < 0.01). Egger's test showed no publication bias in body temperature, respiratory rate, oxygen saturation, and crying duration., Conclusions: Swaddle bath is the best bathing method than conventional tub bath and sponge bath in maintaining the stability of preterm infant's body temperature, blood oxygen saturation and respiratory rate. In addition, swaddle bath also plays a role in reducing cry duration, stress scores, and pain levels of preterm infant compared with conventional tub bath and sponge bath. However, due to the important heterogeneity in some outcomes, future studies with larger sample size and more appropriately design are needed to conduct before recommendation., Trial Registration: Prospero CRD42022377657., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Depressive symptoms are common in the postpartum period and can affect mother-infant interaction. To better understand the role of depressive symptoms in the mother-infant interchange, this study examined whether maternal depressive symptoms are associated with self-reported, physiological, and facial expressive responses to infant crying and laughing sounds. A nonclinical sample was used, consisting of 101 mothers (Age M = 30.88 years, 33% scored 7 or higher on the Edinburgh Postnatal Depression Scale) with a young child. Mothers were exposed to standard infant crying and laughing sounds. Affect, perception of crying and laughing, intended caregiving responses, skin conductance level reactivity, and facial expressive responses to infant crying and laughing were measured. Higher levels of depressive symptoms were associated with more self-reported negative affect in general and a more negative perception of infant crying. Depressive symptoms were not associated with intended caregiving responses and physiological responses to infant crying. Infant laughing increased self-reported positive affect and happy facial expressions in mothers with all levels of depressive symptoms. Higher levels of depressive symptoms were associated with higher sad facial expressivity in general. Depressive symptoms were not related to positive perception of infant laughing, intended caregiving responses, and physiological responses to infant laughing. The findings suggest that mothers who score high on depressive symptoms send subtle facial cues showing sadness, which may overshadow happy facial expressions during infant laughing and may affect mother-infant interaction. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Laughter and crying are universal signals of prosociality and distress, respectively. Here we investigated the functional brain basis of perceiving laughter and crying using naturalistic functional magnetic resonance imaging (fMRI) approach. We measured haemodynamic brain activity evoked by laughter and crying in three experiments with 100 subjects in each. The subjects i) viewed a 20-minute medley of short video clips, and ii) 30 min of a full-length feature film, and iii) listened to 13.5 min of a radio play that all contained bursts of laughter and crying. Intensity of laughing and crying in the videos and radio play was annotated by independent observes, and the resulting time series were used to predict hemodynamic activity to laughter and crying episodes. Multivariate pattern analysis (MVPA) was used to test for regional selectivity in laughter and crying evoked activations. Laughter induced widespread activity in ventral visual cortex and superior and middle temporal and motor cortices. Crying activated thalamus, cingulate cortex along the anterior-posterior axis, insula and orbitofrontal cortex. Both laughter and crying could be decoded accurately (66-77% depending on the experiment) from the BOLD signal, and the voxels contributing most significantly to classification were in superior temporal cortex. These results suggest that perceiving laughter and crying engage distinct neural networks, whose activity suppresses each other to manage appropriate behavioral responses to others' bonding and distress signals., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest, (Copyright © 2023. Published by Elsevier Inc.)

Historically associated with aversion, the lateral habenula has a poorly characterized role in parenting. In this issue of Neuron, Lecca and colleagues 1 show that these seemingly opposing roles converge in a subnucleus where aversion to pup cries may drive motivation for caregiving., Competing Interests: Declaration of interests The authors declare no competing interests., (Published by Elsevier Inc.)

Background: Stimulating infants to elicit a cry at birth is common but could result in unnecessary handling. We evaluated heart rate in infants who were crying versus non-crying but breathing immediately after birth., Methods: This was single-centre observational study of singleton, vaginally born infants at ≥33 weeks of gestation. Infants who were crying or non-crying but breathing within 30 s after birth were included. Background demographic data and delivery room events were recorded using tablet-based applications and synchronised with continuous heart rate data recorded by a dry-electrode electrocardiographic monitor. Heart rate centile curves for the first 3 min of life were generated with piecewise regression analysis. Odds of bradycardia and tachycardia were compared using multiple logistic regression., Results: 1155 crying and 54 non-crying but breathing neonates were included in the final analyses. There were no significant differences in the demographic and obstetric factors between the cohorts. Non-crying but breathing infants had higher rates of early cord clamping <60 s after birth (75.9% vs 46.5%) and admission to the neonatal intensive care unit (13.0% vs 4.3%). There were no significant differences in median heart rates between the cohorts. Non-crying but breathing infants had higher odds of bradycardia (heart rate <100 beats/min, adjusted OR 2.64, 95% CI 1.34 to 5.17) and tachycardia (heart rate ≥200 beats/min, adjusted OR 2.86, 95% CI 1.50 to 5.47)., Conclusion: Infants who are quietly breathing but do not cry after birth have an increased risk of both bradycardia and tachycardia, and admission to the neonatal intensive care unit., Trial Registration Number: ISRCTN18148368., Competing Interests: Competing interests: JE is employed at Laerdal Medical. AJK received PhD salary from Laerdal Foundation through a grant paid to Uppsala University., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Objective: This study aimed to determine the effect of palmar grasp reflex stimulation during a neonatal bath on the physiological parameters and crying time of the newborn., Design, Setting, and Participants: This study was designed as a parallel randomized clinical trial. Parents fully understood the study procedure at the Neonatal Intensive Care Unit in Turkey ( N = 82). Both written and verbal consent was obtained from the parents. Newborns who were ineligible for tub bathing were excluded from the study. The babies in the control group were given baths according to the tub bathing standards. Babies in the experimental group were given palmar grasp reflex stimulation during the baths. The variables examined included body temperature, respiratory rate, pulse, oxygen saturation levels, and crying time. In all analyses, p < 0.05 was accepted as statistically significant., Results: The heart rate of the experimental group was 5.2 beats per minute slower than the control group (χ2 = 12.272; p < 0.001). The respiratory rate of the experimental group was 1.3 lower per minute compared to the control group (χ2 = 43.219; p < 0.001). In addition, the oxygen saturation level (%) of the experimental group was 0.4 higher than the control group (χ2 = 5.793; p < 0.016). Crying time was higher in the control group during bathing ( p < 0.001)., Conclusion: The results showed that the palmar grasp reflex in newborn bathing helps to maintain the stability of physiological parameters and shortens the crying time of babies. Palmar grasp reflex stimulation is recommended in interventions that may cause stress.

Background: Whereas previous studies revealed positive effects of emotional expressions such as swearing and laughing on acute pain, systematic research on the effects of crying on pain is missing. The rationale for the current study is that either a mere emotional distraction or changes in oxytocin and opioid levels represent a mechanism through which crying modulates pain, with the timing of mood changes as crucial information for distinguishing between potential mechanisms., Methods: In two studies, we exposed participants (Study 1: n = 57; Study 2: n = 70) to a sad movie and measured their mood, and exposed them to pain induction procedures (electric shock and cold-pressor test, respectively) before and after the film. Dependent variables were pain threshold, tolerance, and intensity. In addition to baseline and one immediate post-crying mood and pain response measurement in both studies, in Study 2, we repeated these procedures 20 and 50 min later to discern between the potential role of neurobiological substances and distraction., Results: Crying was elicited in 28 participants in Study 1 (49.1%) and 49 (70%) in Study 2. We found no systematic differences in pain and mood changes between criers and non-criers and no systematic dose-response relationship between crying and pain responses and mood. The only significant effects ran contrary to our hypotheses, showing detrimental effects of the occurrence (Study 1) and frequency of crying (both studies) on pain threshold., Conclusions: Results do not support the idea that crying has pain-alleviating effects, either via distraction or direct biological mechanisms., Significance: Despite previous findings on pain alleviating effects of emotional expression and the widespread idea about the generally beneficial consequences of emotional crying, research on the possible pain alleviating effects of crying is largely missing. Two quasi-experimental studies demonstrated that crying induced in laboratory conditions does not alleviate acute pain responses, suggesting that role of crying in pain interventions is doubtful. Less directly, results cast light on the role of emotional distraction from acute pain and possible crying-related neurochemical changes., (© 2022 European Pain Federation - EFIC®.)

The study investigated autonomic regulation during feeding in six-month old infants with a history of excessive crying (EC) and social-behavioral development at 12 and 24 months. When contrasted with non-EC infants (NEC), EC infants had atypical autonomic responses observed as dampened reductions in respiratory sinus arrhythmia (RSA) and decreases in heart period (HP) during feeding. EC infants demonstrated atypical autonomic regulation only if they were bottle-fed, while breastfed EC infants had patterns of autonomic regulation similar to NEC infants. Behavioral data suggest that while a history of EC was related to social-emotional behaviors at 12 and 24 months, breastfeeding may buffer the behavioral effects of EC on sociability at 24 months., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Research on the effect of emotional tears on perceived competence has yielded an inconsistent pattern of findings, with some studies showing that tearful individuals may be perceived as less competent, while others report no such effect. These mixed results point to the likely existence of third variables influencing the link between tears and perceived competence and suggest that crying may affect competence only in specific circumstances. In the current project, we reexamine this link using a large, openly available dataset of responses to tearful faces collected across 41 countries and 7,007 participants (Zickfeld et al., 2021). Our results show that tears have no general effect on perceptions of competence but do reduce competence when crying is regarded as inappropriate (e.g., there is no clear reason for shedding tears) or when the target is perceived as helpless. Moreover, shedding tears increases competence when the target is perceived as honest. As emotional tears have been found to signal both helplessness and honesty, the interplay of these effects might result in no overall effect of tears on perceptions of competence. The present findings suggest that the link between emotional tears and perceived competence is highly context dependent. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The study of pathological laughter and crying (PLC) allows insights into the neural basis of laughter and crying, two hallmarks of human nature. PLC is defined by brief, intense and frequent episodes of uncontrollable laughter or crying provoked by trivial stimuli. It occurs secondary to CNS disorders such as stroke, tumours or neurodegenerative diseases. Based on case studies reporting various lesions locations, PLC has been conceptualized as dysfunction in a cortico-limbic-subcortico-thalamo-ponto-cerebellar network. To test whether the heterogeneous lesion locations are indeed linked in a common network, we applied 'lesion network-symptom-mapping' to 70 focal lesions identified in a systematic literature search for case reports of PLC. In lesion network-symptom-mapping normative connectome data (resting state functional MRI, n = 100) is used to identify the brain regions that are likely affected by diaschisis based on the lesion locations. With lesion network-symptom-mapping we were able to identify a common network specific for PLC when compared with a control cohort (n = 270). This bilateral network is characterized by positive connectivity to the cingulate and temporomesial cortices, striatum, hypothalamus, mesencephalon and pons, and negative connectivity to the primary motor and sensory cortices. In the most influential pathophysiological model of PLC, a centre for the control and coordination of facial expressions, respiration and vocalization in the periaqueductal grey is assumed, which is controlled via two pathways: an emotional system that exerts excitatory control of the periaqueductal grey descending from the temporal and frontal lobes, basal ganglia and hypothalamus; and a volitional system descending from the lateral premotor cortices that can suppress laughter or crying. To test whether the positive and negative PLC subnetworks identified in our analyses can indeed be related to an emotional system and a volitional system, we identified lesions causing emotional (n = 15) or volitional facial paresis (n = 46) in a second literature search. Patients with emotional facial paresis show preserved volitional movements but cannot trigger emotional movements in the affected hemiface, while the reverse is true for volitional facial paresis. Importantly, these lesions map differentially onto the PLC subnetworks: the 'positive PLC subnetwork' is part of the emotional system and the 'negative PLC subnetwork' overlaps with the volitional system for the control of facial movements. Based on this network analysis we propose a two-hit model of PLC: a combination of direct lesion and indirect diaschisis effects cause PLC through the loss of inhibitory cortical control of a dysfunctional emotional system., (© The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Human fathers often form strong attachments to their infants that contribute to positive developmental outcomes. However, fathers are also the most common perpetrators of infant abuse, and infant crying is a known trigger. Research on parental brain responses to infant crying have typically employed passive listening paradigms. However, parents usually engage with crying infants. Therefore, we examined the neural responses of 20 new fathers to infant cries both while passively listening, and while actively attempting to console the infant by selecting soothing strategies in a video game format. Compared with passive listening, active responding robustly activated brain regions involved in movement, empathy and approach motivation, and deactivated regions involved in stress and anxiety. Fathers reporting more frustration had less activation in basal forebrain areas and in brain areas involved with emotion regulation (e.g., prefrontal cortex and the supplementary motor area). Successful consolation of infant crying activated regions involved in both action-outcome learning and parental caregiving (anterior and posterior cingulate cortex). Overall, results suggest that active responding to infant cries amplifies activation in many brain areas typically activated during passive listening. Additionally, paternal frustration during active responding may involve a combination of low approach motivation and low engagement of emotion regulation., (© 2021 Wiley Periodicals LLC.)

The aim of the study was to determine effects of administration of simethicone and a multi-strain synbiotic on the crying behaviour of colicky babies. The study design consisted of an open-label, two parallel treatment group study involving 87 infants aged 3-6 weeks with infantile colic (defined as crying episodes lasting 3 or more hours per day and occurring at least 3 days per week within 3 weeks prior to enrolment) randomly, unequally [1:1.5] assigned to receive simethicone (n=33) or a multi-strain synbiotic (n=54) orally for 4 weeks. The multi-strain synbiotic contained Lactobacillus acidophilus LA-14, Lacticaseibacillus casei R0215, Lacticaseibacillus paracasei Lp-115, Lacticaseibacillus rhamnosus GG, Ligilactobacillus salivarius Ls-33, Bifidobacterium lactis Bl-04, Bifidobacterium bifidum R0071, Bifidobacterium longum R0175 and fructooligosaccharides). Primary outcome measures were the responder rates (effect ≥50% reduction from baseline) of the measures 'crying days last 3 weeks', 'average evening crying duration last 3 weeks' and 'reduction of average number of crying phases per day last three weeks' at the end of treatment. The study is registered at ClinicalTrials.gov under NCT04487834. Significantly higher responder rates (effect ≥50% reduction from baseline) of the multi-strain synbiotic compared to simethicone were found for the measures 'crying days last 3 weeks' (72% vs 18%, P <0.0001) and 'average evening crying duration last 3 weeks' (85% vs 39%, P =0.0001). No significant difference was found for the measure 'reduction of average number of crying phases per day last three weeks' (50% vs 42%, P =0.4852). No adverse effects were reported for the two treatment groups. Based on these results, the multi-strain synbiotic can be considered as an interesting therapeutic possibility for the treatment of infantile colic, worthwhile to be investigated further in non-clinical and clinical studies.

Objective: To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants., Study Design: Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years., Results: Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63)., Conclusions: Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years., (Copyright © 2021 Elsevier Inc. All rights reserved.)

BACKGROUND Regulation disorders are already apparent in infancy. The For Healthy Offspring Project was the first Hungarian study aimed at building an effective model for screening and examining the prevalence and complex (medical and psychosocial) background of classic behavior regulation disorders (excessive crying, feeding, and sleep problems) in infancy. MATERIAL AND METHODS Data were collected from families of 0- to 3-year-old children in a pediatric hospital and its neighboring areas through questionnaires, medical examinations, and individual and small-group consultations. RESULTS In the questionnaire study about their children's behavior (n=1133), 15% of mothers reported excessive crying, 16% reported feeding problems, and 10% reported sleep problems. In a subsample (n=619) in which medical examinations were also conducted, the prevalence of medical diagnoses was 15.0% for excessive crying, 15.2% for sleep disorders, 10.3% for breastfeeding difficulties, and 14.8% for feeding disorders. Children who were referred to the screening program (n=183) had significantly more behavior regulation disorders than the other children in our study. Regulation disorders were found to be comorbid with other health conditions in some cases. CONCLUSIONS We developed a complex model to screen for regulatory problems in early childhood. This study adds more information about the relationship between regulation problems and other health conditions. The general incidence (5-15%) of early childhood regulation disorders in other countries is likely similar to that found in Hungary. In order to effectively recognize early regulation disorders, diagnostic instruments widely used in the international field should be adapted in general Hungarian pediatric care.

Infant colic is a condition of unknown cause which can result in carer distress and attachment difficulties. Recent studies have implicated the gut microbiota in infant colic, and certain probiotics have demonstrated possible efficacy. We aim to investigate whether the intestinal microbiota composition in infants with colic is associated with cry/fuss time at baseline, persistence of cry/fuss at 4-week follow-up, or child behavior at 2 years of age. Fecal samples from infants with colic (n = 118, 53% male) were analyzed using 16S rRNA sequencing. After examining the alpha and beta diversity of the clinical samples, we performed a differential abundance analysis of the 16S data to look for taxa that associate with baseline and future behavior, while adjusting for potential confounding variables. In addition, we used random forest classifiers to evaluate how well baseline gut microbiota can predict future crying time. Alpha diversity of the fecal microbiota was strongly influenced by birth mode, feed type, and child gender, but did not significantly associate with crying or behavioral outcomes. Several taxa within the microbiota (including Bifidobacterium, Clostridium, Lactobacillus, and Klebsiella) associate with colic severity, and the baseline microbiota composition can predict further crying at 4 weeks with up to 65% accuracy. The combination of machine learning findings with associative relationships demonstrates the potential prognostic utility of the infant fecal microbiota in predicting subsequent infant crying problems.

In early infancy, melody provides the most salient prosodic element for language acquisition and there is huge evidence for infants' precocious aptitudes for musical and speech melody perception. Yet, a lack of knowledge remains with respect to melody patterns of infants' vocalisations. In a search for developmental regularities of cry and non-cry vocalisations and for building blocks of prosody (intonation) over the first 6 months of life, more than 67,500 melodies (fundamental frequency contours) of 277 healthy infants from monolingual German families were quantitatively analysed. Based on objective criteria, vocalisations with well-identifiable melodies were grouped into those exhibiting a simple (single-arc) or complex (multiple-arc) melody pattern. Longitudinal analysis using fractional polynomial multi-level mixed effects logistic regression models were applied to these patterns. A significant age (but not sex) dependent developmental pattern towards more complexity was demonstrated in both vocalisation types over the observation period. The theoretical concept of melody development (MD-Model) contends that melody complexification is an important building block on the path towards language. Recognition of this developmental process will considerably improve not only our understanding of early preparatory processes for language acquisition, but most importantly also allow for the creation of clinically robust risk markers for developmental language disorders.

Major depressive disorder (MDD) is characterized by pervasive mood disturbance as well as deficits in emotional processing, reactivity, and regulation. There is accumulating evidence that MDD is characterized by emotional patterns consistent with environmental disengagement, as reflected in attenuated positive and negative emotional reactivity, consistent with Emotion Context Insensitivity (ECI) theory. However, MDD individuals vary considerably in the extent to which they exhibit specific alterations in patterns of emotional responding. Emotions are complex, multicomponent processes that invoke responses across multiple functional domains and levels of analysis, including subjective experience, behavior, autonomic regulation, cognition, and neural processing. In this article, I review the current state of the literature on emotional responding and MDD from the lens of ECI. I focus on the importance of assessing emotional indices from multiple levels of analysis across development and contexts. I also discuss methodological and measurement issues that may contribute to inconsistent findings. In particular, I emphasize how psychophysiological measures can help elucidate emotional processes that underlie the pathophysiology of MDD as part of an integrated and contextualized approach., (© 2020 Society for Psychophysiological Research.)

The increase in the number of children with autism and the importance of early autism intervention has prompted researchers to perform automatic and early autism screening. Consequently, in the present paper, a cry-based screening approach for children with Autism Spectrum Disorder (ASD) is introduced which would provide both early and automatic screening. During the study, we realized that ASD specific features are not necessarily observable in all children with ASD and in all instances collected from each child. Therefore, we proposed a new classification approach to be able to determine such features and their corresponding instances. To test the proposed approach a set of data relating to children between 18 to 53 months which had been recorded using high-quality voice recording devices and typical smartphones at various locations such as homes and daycares was studied. Then, after preprocessing, the approach was used to train a classifier, using data for 10 boys with ASD and 10 Typically Developed (TD) boys. The trained classifier was tested on the data of 14 boys and 7 girls with ASD and 14 TD boys and 7 TD girls. The sensitivity, specificity, and precision of the proposed approach for boys were 85.71%, 100%, and 92.85%, respectively. These measures were 71.42%, 100%, and 85.71% for girls, respectively. It was shown that the proposed approach outperforms the common classification methods. Furthermore, it demonstrated better results than the studies which used voice features for screening ASD. To pilot the practicality of the proposed approach for early autism screening, the trained classifier was tested on 57 participants between 10 to 18 months. These 57 participants consisted of 28 boys and 29 girls and the results were very encouraging for the use of the approach in early ASD screening., Competing Interests: The authors have declared that no competing interests exist.

Purpose: This study was carried out to assess the effect of the odor of breast milk and formula milk on reducing the acute pain of newborn infants during the heel-prick blood sampling. Methods: Eighty-four newborn were randomly assigned into two groups (formula milk group and breast milk group) with 42 infant searches. The pain that the newborn felt before, during, and after heel-prick blood sampling was assessed using Neonatal Infant Pain Scale; their heart rate and blood oxygen saturation were measured with a pulse oximeter. Saliva samples were taken from newborns before and after sampling, and their salivary cortisol level was measured. During sampling, the crying duration of newborn was recorded with a chronometer. Results: The pain threshold and heart rates of the newborn in the breast milk group were significantly lower than those in the formula milk group ( p  < 0.001). Salivary cortisol in the formula milk group increased and oxygen saturation levels in these infants decreased significantly more as compared to the breast milk group ( p  < 0.05). Conclusions: The odor of breast milk may be helpful in reducing the pain of newborn during heel-prick blood sampling.

This randomized trial compared the analgesic effect of 4 nonpharmacologic interventions (breastfeeding, oral sucrose, nonnutritive sucking, and skin-to-skin contact) on term newborns between 24 and 48 hours of age who underwent a heel lance. The Neonatal Pain, Agitation, and Sedation Scale was used to evaluate pain. The newborns (N = 226) were assigned to one of 4 intervention groups (n = 176) or a control group without pain intervention (n = 50). The results indicate that all intervention groups showed decreased pain levels when compared with the control group (P < .01). The oral sucrose group experienced a superior analgesic effect when compared with the skin-to-skin contact group (P < .01), but no difference was observed when compared with the breastfeeding group (P > .05) or the nonnutritive sucking group (P > .05). All intervention groups showed a shortened crying time (P < .01) and reduced procedural duration (P < .01) compared with the control group. All of these interventions are clinically applicable and acceptable when caring for a newborn during a minor painful procedure.

Background: Behavioral Indicators of Infant Pain scale (BIIP) has been shown to be a good tool to assess pain in infants., Aims: This paper aimed to translate BIIP into Chinese and evaluate its reliability and validity for neonates in China., Design: A prospective observational study. SETTING AND PARTICIPANTS: A convenience sample of 396 neonates (preterm and term infants) were recruited from neonatal intensive care units in China from July to October 2016., Methods: The BIIP was translated and adjusted for semantic adaption.396 neonates were assessed during 3 phases of blood collection from an artery/vein. A video camera was positioned for a close-up view of the face and body. The neonates' pain was rated independently by 2 nurses who were trained and familiar with the Chinese version of BIIP (C-BIIP)and FLACC (Facial expression, Legs, Activity, Crying and Consolability)., Results: The internal consistency were 0.904 (preterm) and 0.895 (term). The test-retest reliability were 0.947 (preterm) and 0.938 (term) and the interclass correlation coefficients were 0.921 to 0.959 (preterm) and 0.921 to 0.959 (term). The correlations between the C-BIIP and FLACC were high (preterm: r = 0.948, term: r = 0.896). Using the C-BIIP, the 3 phases of blood collection were found to be statistically different (preterm: F = 635.76, term: F = 675.54; P < 0.001), which showed that the construct validity of C-BIIP was good., Conclusion: The BIIP is a reliable and valid tool to assess pain in term and preterm neonates in China., (Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

This research tested the hypothesis that emotional crying facilitates coping and recovery, specifically through physiological changes that occur during crying. Female undergraduate students (N = 197) were randomly assigned to either a sad or neutral condition using short videos. Sad videos were selected for their extreme emotion elicitation. We predicted that compared to those who did not cry to the stimuli and those who were exposed to neutral videos, people who cried would (a) be able to withstand a stressful task for longer; (b) show lower levels of cortisol following crying and exposure to the stressor; and (c) have faster recovery (i.e., return to baseline levels of affect). The final groups consisted of the neutral group (n = 65), sad criers (n = 71), and sad noncriers (n = 61). After a 5-min baseline period, participants watched either the sad or neutral videos for 17 min and then completed a physical stressor (cold pressor test). Heart rate and respiration were continuously recorded, whereas salivary samples for cortisol were taken at 4 separate time points during testing. Analyses revealed no differences between the 3 groups in time withstanding the stressor or cortisol changes. Respiration rate, however, increased in the neutral group and noncriers while watching the videos, with criers' respiration remaining stable. Furthermore, heart rate was found to decelerate just before crying, with a return to baseline during the first crying period. These results suggest that crying may assist in generally maintaining biological homeostasis, perhaps consciously through self-soothing via purposeful breathing and unconsciously through regulation of heart rate. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Infants communicate their emotions to their caregivers through cries and laughter. Recent work suggests that adaptive parenting requires cognitive regulation of intuitive behaviors toward infants' signals. In this study, we examined the effects of cognitive regulation on mothers' unconscious behavioral and cardiac responses to infant cries and laughs. In all, 55 mothers took part in this study. To manipulate cognitive load, mothers were asked to memorize alphabet characters (two letters in the low cognitive load condition and eight in the high cognitive load condition). Then, they heard infant vocalizations (cries or laughs) for 6 s. During this time, we measured mothers' behavioral (center of pressure, an index of approach-avoidance behavior) and physiological (heart rate) responses. Regardless of vocalization type (infant cries or laughs), high cognitive load increased mothers' forward movement toward the infant sounds as well as mothers' heart rate. These findings advance our understanding of the link between executive function and maternal response to infant signals by utilizing postural and physiological measures of maternal response during memory tasks that require cognitive resources., (© 2020 Wiley Periodicals, Inc.)

Presence of teeth at birth or within a month post-delivery is a rare condition. We report here 2 cases to highlight their clinical features and discuss their possible treatment. A 7- days old female newborn with two mandibular central incisors, noticed by the parents at birth, with complaint of continuous crying, inability to suck milk and causing discomfort to the mother. The left incisor was highly mobile justifying its extraction. The second case was a female newborn referred 2 hours after delivery, for a brownish highly mobile mandibular incisor noticed by the pediatrician. Extraction was immediately made to avoid the danger of aspiration. This phenomenon can lead to complications either local such as pain on suckling or general such as undernutrition or asphyxia by aspiration. The decision to maintain or remove these teeth should be assessed in each case independently, based on degree of mobility and interference with breastfeeding., Competing Interests: The authors declare no competing interests., (Copyright: Salma Aboulouidad et al.)

We investigated infants' capacities to express themselves orally at very early developmental stages. Most reports focus on crying when in pain or hungry. We evaluated young preterm infants' spontaneous vocal production in non-painful contexts. We identified a vocal repertoire composed of nine types of vocalisations. High-pitched sounds were associated with relaxed postures, implying a positive valence, whereas long low-pitched vocalisations, associated more with grimaces and muscle tensions, appeared to have a more negative valence. Infants' vocalisations were useful indicators of their internal state in two situations (when exposed to clothing constraints and environmental noises)., (Copyright © 2020 Elsevier Inc. All rights reserved.)

During the early period of hypothesis building and empirical testing of attachment theory, a major emphasis was placed on mother-infant physical contact. In spite of this, mother-infant contact has received scant attention amongst attachment and child development researchers in the past decades. Here, a brief theoretical framework for mother-infant contact is presented, drawing on animal studies as well as human studies of preterm infants and neonates. Salient mechanisms may include an extended sensitive period during early infancy, requiring specific somatosensory stimuli for bio-behavioral homeorhesis; oxytocinergic and epigenetic pathways; kinesthetic stimuli and face-to-face proximity allowing for increased social interaction. Studies of extended human mother-full-term infant physical contact have demonstrated positive effects in multiple domains. For infants, these include sleep organization, temperature and heart rate regulation, behavioral response, crying/colic, socio-emotional development, attachment quality, speech development opportunities and mother-child interactions. For mothers, studies demonstrate improved depressive symptomatology, physiological stress regulation, contingent responsivity, breastfeeding and mother-child interactions. Parent-infant attachment quality has gained prominence as a trauma-resilience factor as well as a predictor of adult physical health. The potential role of mother-infant contact as an attachment promoting intervention as well as future research subjects are discussed. Current evidence supports the original attachment research that early maternal touch provision may influence infant socio-emotional development and attachment quality, with positive implications for mother-child relationship functioning., (Copyright © 2020. Published by Elsevier Inc.)

Chest radiographs should be obtained at the peak of inspiration so that radiological findings can be precisely interpreted. However, this is not easily achieved, particularly in young children who do not follow the instruction to hold their breath. We developed a sensor that detects the breathing movements and conducted a randomized controlled study to determine whether the sensor would increase the proportion of chest radiographs obtained in the inspiration phase. We recruited 124 infants and children aged less than 3 years, who visited the pediatric department of a general hospital in Tokyo, Japan, and allocated them into one of two groups: with-sensor and without-sensor groups. Overall, 81% of all images were obtained during inspiration. The proportion of chest radiographs taken during inspiration was not statistically different between the two groups (81% vs. 82%). In the with-sensor group, radiologic technologists were able to obtain chest radiographs of the same quality while not observing the chest movement, but the sensor. The use of the sensor did not increase the proportion of chest radiographs taken in the inspiration phase in this study. However, this null result may indicate the possibility of utilizing the sensor for automatizing chest radiography in the future.

Background: Worldwide, every year, 6 to 10 million infants require resuscitation at birth according to estimates based on limited data regarding "nonbreathing" infants. In this article, we aim to describe the incidence of "noncrying" and nonbreathing infants after birth, the need for basic resuscitation with bag-and-mask ventilation, and death before discharge., Methods: We conducted an observational study of 19 977 infants in 4 hospitals in Nepal. We analyzed the incidence of noncrying or nonbreathing infants after birth. The sensitivity of noncrying infants with nonbreathing after birth was analyzed, and the risk of predischarge mortality between the 2 groups was calculated., Results: The incidence of noncrying infants immediately after birth was 11.1%, and the incidence of noncrying and nonbreathing infants was 5.2%. Noncrying after birth had 100% sensitivity for nonbreathing infants after birth. Among the "noncrying but breathing" infants, 9.5% of infants did not breathe at 1 minute and 2% did not to breathe at 5 minutes. Noncrying but breathing infants after birth had almost 12-fold odds of predischarge mortality (adjusted odds ratio 12.3; 95% confidence interval, 5.8-26.1)., Conclusions: All nonbreathing infants after birth do not cry at birth. A proportion of noncrying but breathing infants at birth are not breathing by 1 and 5 minutes and have a risk for predischarge mortality. With this study, we provide evidence of an association between noncrying and nonbreathing. This study revealed that noncrying but breathing infants require additional care. We suggest noncrying as a clinical sign for initiating resuscitation and a possible denominator for measuring coverage of resuscitation., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Numerous event-related potential (ERP) studies have examined adults' neural responses to child emotional expressions to understand the neurobiological mechanisms contributing to caregiving. It is unclear, however, whether one emotion evokes an enhanced response across components, and whether this pattern differs based on parent status or other sample characteristics. This meta-analysis quantified adult responses to child emotional expressions at the N170 and the late positive potential (LPP) components. Cohen's d reflected the difference between crying and neutral (CN), crying and laughing (CL), and laughing and neutral (LN) N170 and LPP amplitudes. Crying expressions elicited slightly enhanced N170 and LPP amplitudes relative to neutral and laughing expressions (N170 CN: k = 24, d = -0.09, p < 0.001; N170 CL: k = 30, d = -0.07, p = .004; LPP CN: k = 20, d = 0.12, p = .027; LPP CL: k = 27, d = 0.10, p < .001), and laughing expressions elicited slightly enhanced N170 amplitudes relative to neutral expressions (N170 LN : k = 21, d = -0.05, p = .02). Parental status, child age, risk factors for insensitive caregiving, and measurement characteristics moderated some effect sizes, with reference electrode emerging as the most consistent moderator. Results shed light on the typical pattern of neural response to child emotions and characteristics that may moderate this response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Aim: In this narrative review we aimed to describe how stroke affects emotions and update the readers on the emotional disturbances that occur after stroke., Methods: We searched Medline from 1.1.2013 to 1.7.2019, personal files and references of selected publications. All retrieved systematic reviews and randomized controlled trials were included. Other references were selected by relevance., Summary of Review: The emotional response includes a reactive behavior with arousal, somatic, motivational and motor components, and a distinctive cognitive and subjective affective experience. Emotional category responses and experiences after stroke can show dissociations between the behavioral response and the cognitive and affective experiences. Emotional disturbances that often occur after stroke include fear, anger, emotional indifference, lack of understanding of other emotions, and lack of control of emotional expression. Emotional disturbances limit social reintegration of the persons with stroke and are a source of caregiver burnout. The evidence to support the management of the majority of emotional disorders in stroke survivors is currently weak and of low or very low methodologic quality. An exception are the disorders of emotional expression control where antidepressants can have a strong beneficial effect, by reducing the number and duration of the uncontrollable episodes of crying or laughing., Conclusion: Our current knowledge of the emotional disorders that occurs in acute stroke patients and in stroke survivors is heterogeneous and limited. Joint efforts of different research approaches, methodologies and disciplines will improve our current understanding on emotional disorder after stroke and indicate rational pathways to manage them.

Objective: We investigated the nature and neural foundations of pathologic tearfulness in a uniquely large cohort of patients who had presented with autoimmune limbic encephalitis (aLE)., Methods: We recruited 38 patients (26 men, 12 women; median age 63.06 years; interquartile range [IQR] 16.06 years) in the postacute phase of aLE who completed questionnaires probing emotion regulation. All patients underwent structural/functional MRI postacutely, along with 67 age- and sex-matched healthy controls (40 men, 27 women; median age 64.70 years; IQR 19.87 years). We investigated correlations of questionnaire scores with demographic, clinical, neuropsychological, and brain imaging data across patients. We also compared patients diagnosed with pathologic tearfulness and those without, along with healthy controls, on gray matter volume, resting-state functional connectivity, and activity., Results: Pathologic tearfulness was reported by 50% of the patients, while no patient reported pathologic laughing. It was not associated with depression, impulsiveness, memory impairment, executive dysfunction in the postacute phase, or amygdalar abnormalities in the acute phase. It correlated with changes in specific emotional brain networks: volume reduction in the right anterior hippocampus, left fusiform gyrus, and cerebellum, abnormal hippocampal resting-state functional connectivity with the posteromedial cortex and right middle frontal gyrus, and abnormal hemodynamic activity in the left fusiform gyrus, right inferior parietal lobule, and ventral pons., Conclusions: Pathologic tearfulness is common following aLE, is not a manifestation of other neuropsychiatric features, and reflects abnormalities in networks of emotion regulation beyond the acute hippocampal focus. The condition, which may also be present in other neurologic disorders, provides novel insights into the neural basis of affective control and its dysfunction in disease., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Adult attachment is particularly known for the modulating role of caregiving motivation and behavior. Although most studies consider attachment style relatively stable, it may also be affected by various situational factors, and these temporary fluctuations are related to meaningful behaviors. Using functional magnetic resonance imaging, the present study aims to examine whether neural responses to infant faces are moderated by participants' state attachment. The results indicated that state attachment security was positively associated with increased inferior orbitofrontal cortex (OFC) and insula activation to infant crying. State attachment anxiety was positively associated with increased insula and anterior cingulate cortex (ACC) activation to infant crying as well as enhanced cuneus activation to infant joy. In contrast, state attachment avoidance was negatively associated with amygdala activity in response to both infant joy and crying as well as insula and ACC activation in response to infant joy. Moderation analysis found that the relationship between the prediction effect of state attachment avoidance on ACC activity was gradually weakened with the attenuation of participants' trait attachment avoidance. These results demonstrate that neural responses to infant faces are moderated by individual differences in state attachment, thereby demonstrating that state attachment is an effective measure to capture the variation in maternal ability., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Purpose Instances of laryngeal constriction have been noted as a feature of infant vocal development. The purpose of this study was to directly evaluate the developmental occurrence of laryngeal constriction phenomena in infant crying, cooing, and babbling vocalizations. Method The cry and noncry vocalizations of 20 healthy term-born infants between the ages of 1 and 7 months were examined for instances of laryngeal constriction. Approximately 20,000 vocalization samples were acoustically evaluated, applying a combined visual (frequency spectra and melody curves) and auditory analysis; the occurrence of instances of different constriction phenomena was analyzed. Results Laryngeal constrictions were found during the production of cry and noncry vocalizations. The developmental pattern of constrictions for both vocalizations was charac-terized by an increase in constrictions followed by a decrease. During the age period of 3-5 months, when cry and noncry vocalizations were co-occurring, laryngeal constrictions were observed in 14%-22% of both types of vocalizations. An equal percentage of constrictions was found for both vocalizations at 5 months of age. Conclusions The findings confirm that the production of laryngeal constriction is a regularly occurring phenomenon in healthy, normally developing infants' spontaneous crying, cooing, and marginal babbling. The occurrence of constriction in both cry and noncry vocalizations suggests that an infant is exploiting physiological constraints of the sound-generating system for articulatory development during vocal exploration. These results lend support to the notion that the laryngeal articulator is the principal articulator that infants 1st start to control as they test and practice their phonetic production skills from birth through the 1st several months of life.

Background and objectives : The objective of this study was to contribute to the evaluation of the newborn (NB) cry as a means of communication and diagnosis. Materials and Methods : The study implied the recording of the spontaneous cry of 101 NBs with no intrapartum events (control sample), and of 72 NBs with nuchal cord (study sample) from the "Bega" University Clinic of Obstetrics-Gynecology and Neonatology of Timisoara, Romania. The sound analysis was based upon: Imagistic highlighting methods, descriptive statistics, and data mining techniques. Results : The differences between the cry of NBs with no intrapartum events and that of NBs affected by nuchal cord are statistically significant regarding the volume unit meter (VUM) ( p = 0.0021) and the peak point meter (PPM) ( p = 0.041). Conclusions: While clinically there are no differences between the two groups, the cry recorded from the study group (nuchal cord group) shows distinctive characteristics compared to the cry recorded from the control group (eventless intrapartum NBs group)., Competing Interests: The authors declare no conflict of interest.

Infant signals, including infant sounds and facial expressions, play a critical role in eliciting parental proximity and care. Processing of infant signals in the adulthood brain is likely to recruit emotional empathy neural circuits, including the inferior frontal gyrus (IFG). Here, we used transcranial magnetic stimulation (TMS) to test the role of right IFG (rIFG) in behavioral responses to infant signals. Specifically, a group of nulliparous women were asked to perform a handgrip dynamometer task and an Approach-Avoidance Task (AAT) after receiving TMS over the right IFG or over a control site (vertex). Suppressing activity in the rIFG affected the modulation of handgrip force in response to infant crying. Moreover, the AAT showed that participants tend to avoid the sad infant face after Vertex stimulation, and this bias was counteracted by rIFG stimulation. Our results suggest a causal role of rIFG in sensitive responding towards sad infants and point to the rIFG as a critical node in the neural network underlying the innate releasing mechanism for feelings of love, affection and caring of sad infants.

Speakers can make inferences about the meaning of new words appearing in an utterance based on the lexical semantics of other words that co-occur with them. Previous work has revealed that infants at 19 and 24 months of age can recruit the semantic selectional restrictions of known verbs (e.g., eating) to deduce that a noun appearing in the subject position maps onto an animate referent. We asked whether this ability to capitalize on the semantics of familiar words to identify the referent of a novel noun in subject position extends to adjectives, which also denote properties, and which also have animacy constraints (e.g., hungry). We found that unlike in the previous studies with verbs, neither 24- nor 36-month-olds could successfully recruit known adjectival semantics in an online task to home in on an animate nominal referent. However, 36-month-olds were successful in a more interactive, forced-choice version of the task without such strict time limitations. We discuss multiple non-mutually-exclusive hypotheses for this pattern of results, focusing on the role of the morphosyntactic cues, the (lack of) perceptual cues for the target property in context of the utterance, truth conditions, and cross-linguistic implications. These possibilities raise fundamental questions about the infant's developing lexicon and the linguistic and conceptual mechanisms at play in the process of word learning., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Distress vocalizations are fundamental for survival, and both sonic and ultrasonic components of such vocalizations are preserved phylogenetically among many mammals. On this basis, we hypothesized that ultrasonic inaudible components of the acoustic signal might play a heretofore hidden role in humans as well. By investigating the human distress vocalization (infant cry), here we show that, similar to other species, the human infant cry contains ultrasonic components that modulate haemodynamic responses in mothers, without the mother being consciously aware of those modulations. In two studies, we measured the haemodynamic activity in the breasts of mothers while they were exposed to the ultrasonic components of infant cries. Although mothers were not aware of ultrasounds, the presence of the ultrasounds in combination with the audible components increased oxygenated haemoglobin concentration in the mothers' breast region. This modulation was observed only when the body surface was exposed to the ultrasonic components. These findings provide the first evidence indicating that the ultrasonic components of the acoustic signal play a role in human mother-infant interaction.

Purpose : To evaluate the refractive outcome and influencing factors following atropine 0.5% eye-drops applied twice daily during 2 ½ days at home and two drops of cyclopentolate 1% (C+C) and one drop of cyclopentolate 1% and one drop of tropicamide 1% (C+T) applied in an outpatient clinic, in hypermetropic children with a dark iris. Methods : Double-blind randomized study including 67 3-6-year-old children receiving C+C in one eye and C+T in the other eye. Two weeks later followed by atropine 0.5% in both eyes. Primary outcome measures were: spherical equivalent (SEQ) following C+C, C+T and atropine, and secondarily SEQ with respect to sex, ethnicity, skin pigmentation (light, medium, dark) and crying. Data on atropine are divided in those with C+C (CC) or C+T (CT) as a first intervention. Results : Mean SEQ±SD for C+C, C+T, atropine-(CC) and atropine-(CT) was +1.74 ± 1.35, +1.77 ± 1.34, +2.15 ± 1.43 and +2.10 ± 1.38 diopter (D). Atropine 0.5% revealed significantly more hypermetropia than C+C and C+T; +0.41 ± 0.43, 95%CI +0.31 to +0.52D and +0.33 ± 0.39, 95%CI +0.24 to +0.34D. No significant difference was present between C+C and C+T; -0.03 ± 0.56, 95%CI -0.16 to +0.11D. Ethnicity and skin-color were strongly associated (r = 0.84, p < .001). Sex was not affecting outcomes ( p = .101). Ethnicity was borderline significant ( p = .049). Skin-color was a highly significant factor ( p = .002). A statistical model combining intervention and skin-color, with light-pigmented subjects receiving atropine-(CC) as reference group (mean SEQ +2.61 ± 1.46D), indicated borderline significantly less hypermetropia in atropine-(CC)-dark: mean decrease (95%CI): -0.81 (-1.66 to +0.05)D and atropine-(CT)-dark -0.87 (-1.70 to -0.03)D, furthermore significantly less hypermetropia in C+C-dark: -1.15 (-1.97 to -0.32)D; C+T-dark: -1.21 (-2.03 to -0.39)D, C+C-medium: -1.02 (-1.81 to -0.24)D and C+T-medium: -0.86 (-1.64 to -0.08)D. Adding crying to the model significantly less hypermetropia was found for subjects crying in all interventions; -0.53 (-0.98 to -0.09)D. Within the interventions, with light-pigmented non-crying subjects as reference group (mean SEQ in atropine, C+C, respectively, C+T: +2.62 ± 1.41, +2.33 ± 1.20 and +2.32 ± 1.20D), showed significantly less hypermetropia in dark-pigmented crying subjects in each individual intervention: atropine -1.10 (-2.01 to -0.19), C+C -1.28 (-2.14 to -0.42) and C+T -1.34 (-2.20 to -0.48)D. For medium pigmented crying subjects this was present in atropine: -0.82 (-1.61 to -0.03)D and C+C: -0.86 (-1.68 to -0.04)D, but not in C+T: -0.58 (-1.25 to +0.09)D. Conclusions : Atropine 0.5% revealed a slight significantly higher hypermetropia. A dark-pigmented skin, especially when crying upon application, resulted in lower hypermetropia in all interventions. C+T provided clinically better results in medium pigmented crying subjects compared to C+C, and equal results compared to atropine 0.5%.

Several studies have shown that mothers and fathers have significant lower levels of testosterone (T) than non-mothers and non-fathers, and that in men caregiving is related to a decrease in T. To date, only a few studies have examined T in women. We examined T reactivity to a crying infant simulator in 160 women. Use of oral contraceptives (OC), basal cortisol (CORT) levels and childhood experiences of maternal love withdrawal were taken into account. T levels were consistently significantly higher in women not using OC. In women not using OC, high basal CORT was related to higher initial T levels and larger decreases of T during caregiving. No effect of basal CORT was found in women with OC use. Childhood experiences of maternal love withdrawal did not affect T levels. This is the first study to show support for a decrease of T in women while taking care of a crying infant, supporting the Challenge hypothesis and the Steroid/Peptide Theory of Social Bonds., (Copyright © 2017 Elsevier Inc. All rights reserved.)