The proximate regulation of prosocial behaviour: towards a conceptual framework for comparative research

Humans and many other animal species act in ways that benefit others. Such prosocial behaviour has been studied extensively across a range of disciplines over the last decades, but findings to date have led to conflicting conclusions about prosociality across and even within species. Here, we present a conceptual framework to study the proximate regulation of prosocial behaviour in humans, non-human primates and potentially other animals. We build on psychological definitions of prosociality and spell out three key features that need to be in place for behaviour to count as prosocial: benefitting others, intentionality, and voluntariness. We then apply this framework to review observational and experimental studies on sharing behaviour and targeted helping in human children and non-human primates. We show that behaviours that are usually subsumed under the same terminology (e.g. helping) can differ substantially across and within species and that some of them do not fulfil our criteria for prosociality. Our framework allows for precise mapping of prosocial behaviours when retrospectively evaluating studies and offers guidelines for future comparative work.

The theta-gamma code in predictive processing and mnemonic updating

Predictive processing has become a leading theory about how the brain works. Yet, it remains an open question how predictive processes are realized in the brain. Here I discuss theta-gamma coupling as one potential neural mechanism for prediction and model updating. Building on Lisman and colleagues SOCRATIC model, theta-gamma coupling has been associated with phase precession and learning phenomena in medio-temporal lobe of rodents, where it completes and retains a sequence of places or items (i.e., predictive models). These sequences may be updated upon prediction errors (i.e., model updating), signaled by dopaminergic inputs from prefrontal networks. This framework, spanning the molecular to the network level, matches excitingly well with recent findings on predictive processing, mnemonic updating, and perceptual foraging for the theta-gamma code in human cognition. In sum, I use the case of theta-gamma coupling to link the predictive processing account, a very general concept of how the brain works, to specific neural processes which may implement predictive processing and model updating at the cognitive, network, cellular and molecular level.

Mealtime conversations between parents and their 2-year-old children in five cultural contexts

Children all over the world learn language, yet the contexts in which they do so vary substantially. This variation needs to be systematically quantified to build robust and generalizable theories of language acquisition. We compared communicative interactions between parents and their 2-year-old children (N = 99 families) during mealtime across five cultural settings (Brazil, Ecuador, Argentina, Germany, and Japan) and coded the amount of talk and gestures as well as their conversational embedding (interlocutors, function, and themes). We found a comparable pattern of communicative interactions across cultural settings, which were modified in ways that are consistent with local norms and values. These results suggest that children encounter similarly structured communicative environments across diverse cultural contexts and will inform theories of language learning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Preverbal infants' understanding of social norms

Social norms are foundational to human cooperation and co-existence in social groups. A crucial marker of social norms is that a behavior is not only shared, but that the conformity to the behavior of others is a basis for social evaluation (i.e., reinforcement and sanctioning), taking the is, how individuals usually behave, to an ought, how individuals should behave to be socially approved by others. In this preregistered study, we show that 11-month-old infants grasp this fundamental aspect about social norms already in their first year. They showed a pupillary surprise response for unexpected social responses, namely the disapproval and exclusion of an individual who showed the same behavior like others or the approval and inclusion of an individual who behaved differently. That preverbal infants link the conformity with others' behavior to social evaluations, before they respond to norm violations themselves, indicates that the foundations of social norm understanding lie in early infancy.

Communicative signals during joint attention promote neural processes of infants and caregivers

Communicative signals such as eye contact increase infants' brain activation to visual stimuli and promote joint attention. Our study assessed whether communicative signals during joint attention enhance infant-caregiver dyads' neural responses to objects, and their neural synchrony. To track mutual attention processes, we applied rhythmic visual stimulation (RVS), presenting images of objects to 12-month-old infants and their mothers (n = 37 dyads), while we recorded dyads' brain activity (i.e., steady-state visual evoked potentials, SSVEPs) with electroencephalography (EEG) hyperscanning. Within dyads, mothers either communicatively showed the images to their infant or watched the images without communicative engagement. Communicative cues increased infants' and mothers' SSVEPs at central-occipital-parietal, and central electrode sites, respectively. Infants showed significantly more gaze behaviour to images during communicative engagement. Dyadic neural synchrony (SSVEP amplitude envelope correlations, AECs) was not modulated by communicative cues. Taken together, maternal communicative cues in joint attention increase infants' neural responses to objects, and shape mothers' own attention processes. We show that communicative cues enhance cortical visual processing, thus play an essential role in social learning. Future studies need to elucidate the effect of communicative cues on neural synchrony during joint attention. Finally, our study introduces RVS to study infant-caregiver neural dynamics in social contexts.

Rhythmic visual stimulation as a window into early brain development: A systematic review

Rhythmic visual stimulation (RVS), the periodic presentation of visual stimuli to elicit a rhythmic brain response, is increasingly applied to reveal insights into early neurocognitive development. Our systematic review identified 69 studies applying RVS in 0- to 6-year-olds. RVS has long been used to study the development of the visual system and applications have more recently been expanded to uncover higher cognitive functions in the developing brain, including overt and covert attention, face and object perception, numeral cognition, and predictive processing. These insights are owed to the unique benefits of RVS, such as the targeted frequency and stimulus-specific neural responses, as well as a remarkable signal-to-noise ratio. Yet, neural mechanisms underlying the RVS response are still poorly understood. We discuss critical challenges and avenues for future research, and the unique potentials the method holds. With this review, we provide a resource for researchers interested in the breadth of developmental RVS research and hope to inspire the future use of this cutting-edge method in developmental cognitive neuroscience.

Down and up! Does the mu rhythm index a gating mechanism in the developing motor system?

Developmental research on action processing in the motor cortex relies on a key neural marker - a decrease in 6-12 Hz activity (coined mu suppression). However, recent evidence points towards an increase in mu power, specific for the observation of others' actions. Complementing the findings on mu suppression, this raises the critical question for the functional role of the mu rhythm in the developing motor system. We here discuss a potential solution to this seeming controversy by suggesting a gating function of the mu rhythm: A decrease in mu power may index the facilitation, while an increase may index the inhibition of motor processes, which are critical during action observation. This account may advance our conception of action understanding in early brain development and points towards critical directions for future research.

Visual attention across cultures: Similarities and differences in child development and maternal attention styles

Previous cross-cultural research has described two different attention styles: a holistic style, characterized by context-sensitive processing, generally associated with interdependent cultural contexts, and an analytic style, a higher focus on salient objects, generally found in independent cultural contexts. Though a general assumption in the field is that attention styles are gradually socialized in culture-specific interactions in childhood, empirical evidence for the proximal mechanisms underlying this development is scarce. This study aimed to document the emergence of cross-cultural differences in attention styles in three cultural contexts differing in social orientations, namely in urban middle-class families from Münster, Germany (i.e., more independent context), and Kyoto, Japan, and Indigenous-heritage families from Cotacachi, Ecuador (i.e., more interdependent contexts). Furthermore, to test the assumption that caregivers' attention guidance is one of the forces driving differential development, we investigated how caregivers guide children's attention. In total, 270 children between 4 and 9 years of age and their mothers participated in three tasks: an eye-tracking task, a picture description task and a forced-choice recognition task. Results indicate a mixed pattern of findings: While some tasks revealed the expected cultural differences, namely a higher object focus in Münster compared to Kyoto and Cotacachi, others did not. Regarding caregivers' attention guidance, we found that mothers in Münster more strongly emphasized the focal object than mothers in Kyoto and Cotacachi. The results are discussed in terms of culture-specific developmental trajectories and the generalizability of attentional processes across tasks and cultural contexts. RESEARCH HIGHLIGHTS: We investigated visual attention styles in 4- to 9-year-old children and their mothers from urban Germany, urban Japan, and rural Ecuador in three different tasks. Special emphasis lied on mothers' verbal attention guidance toward their children as a proximal mechanism underlying the emergence of culture-specific attention styles. Mothers from urban Germany guided their children's attention in more analytic ways than mothers from urban Japan and rural Ecuador. The relevance of verbal attention guidance in the development of culture-specific attention styles has been demonstrated beyond the East-West dichotomy.

Visual category representations in the infant brain

Visual categorization is a human core cognitive capacity^1,2 that depends on the development of visual category representations in the infant brain.^3,4,5,6,7 However, the exact nature of infant visual category representations and their relationship to the corresponding adult form remains unknown.⁸ Our results clarify the nature of visual category representations from electroencephalography (EEG) data in 6- to 8-month-old infants and their developmental trajectory toward adult maturity in the key characteristics of temporal dynamics,^2,9 representational format,^10,11,12 and spectral properties.^13,14 Temporal dynamics change from slowly emerging, developing representations in infants to quickly emerging, complex representations in adults. Despite those differences, infants and adults already partly share visual category representations. The format of infants' representations is visual features of low to intermediate complexity, whereas adults' representations also encode high-complexity features. Theta band activity contributes to visual category representations in infants, and these representations are shifted to the alpha/beta band in adults. Together, we reveal the developmental neural basis of visual categorization in humans, show how information transmission channels change in development, and demonstrate the power of advanced multivariate analysis techniques in infant EEG research for theory building in developmental cognitive science.

Rhythms of human attention and memory: An embedded process perspective

It remains a dogma in cognitive neuroscience to separate human attention and memory into distinct modules and processes. Here we propose that brain rhythms reflect the embedded nature of these processes in the human brain, as evident from their shared neural signatures: gamma oscillations (30–90 Hz) reflect sensory information processing and activated neural representations (memory items). The theta rhythm (3–8 Hz) is a pacemaker of explicit control processes (central executive), structuring neural information processing, bit by bit, as reflected in the theta-gamma code. By representing memory items in a sequential and time-compressed manner the theta-gamma code is hypothesized to solve key problems of neural computation: (1) attentional sampling (integrating and segregating information processing), (2) mnemonic updating (implementing Hebbian learning), and (3) predictive coding (advancing information processing ahead of the real time to guide behavior). In this framework, reduced alpha oscillations (8–14 Hz) reflect activated semantic networks, involved in both explicit and implicit mnemonic processes. Linking recent theoretical accounts and empirical insights on neural rhythms to the embedded-process model advances our understanding of the integrated nature of attention and memory – as the bedrock of human cognition.

Cross-Cultural Differences in the Generation of Novel Ideas in Middle Childhood

Innovation and creativity have recently been in the center of the debate on human cultural evolution. Yet, we know very little about childrens’ developing capacity to generate novel ideas, as a key component of innovation and creativity, in different cultural contexts. Here, we assessed 8‐ to 9-year-old children from an autonomous and a relational cultural context, namely Münster (urban Germany; n = 29) and Banten (rural Cameroon; n = 29). These cultural contexts vary largely in their ecology, social structure, and educational system, as well as the cultural models on children’s individual development and thinking. Therefore, they provide an optimal contrast to investigate cultural similarities and differences in development of creative capacities. We applied classical divergent thinking tasks, namely an alternative uses task and a pattern association task. In these tasks, children are asked to generate as many ideas as possible what an object could be used for or what a pattern could be. First, our study revealed a good internal consistency and inter-task correlations for the assessment of children’s fluency and the generation of unique ideas in both cultures. Second, and most critically, we found significantly higher levels of creative capacities in children from Münster in contrast to Banten. This was reflected in both a higher number of ideas (fluency) and a higher number of unique ideas (uniqueness). Third, looking at the type of answers that children gave in the alternative uses task, we found that children from Münster and Banten uttered a similar number of conventional ideas, but that children from Münster uttered more ideas to manipulate an object, invent novel things with an object, and involve an object in play or pretend play, or in a fantasy story. This demonstrates that early creative development is strongly influenced by the cultural context and substantiates the cultural nature of human cognitive development.

The Development of Context-Sensitive Attention Across Cultures: The Impact of Stimulus Familiarity

Across cultures, there are marked differences in visual attention that gradually develop between 4 and 6 years of age. According to the social orientation hypothesis, people in interdependent cultures should show more pronounced context sensitivity than people in independent cultures. However, according to the differential familiarity hypothesis, the focus on the salient object should also depend on the familiarity of the stimulus; people will focus more on the focal object (i.e., less context sensitivity), if it is a less familiar stimulus. To examine the differences in visual attention between interdependent and independent cultures while taking into account stimulus familiarity, this study used an eye-tracking paradigm to assess visual attention of participants between 4 and 20 years who came from urban middle-class families from Germany (n = 53; independent culture) or from Nso families in a rural area in Cameroon (n = 50; interdependent culture). Each participant saw four sets of stimuli, which varied in terms of their familiarity: (1) standard stimuli, (2) non-semantic stimuli, both more familiar to participants from Germany, (3) culture-specific matched stimuli, and (4) simple stimuli, similarly familiar to the individuals of both cultures. Overall, the findings show that mean differences in visual attention between cultures were highly contingent on the stimuli sets: In support of the social orientation hypothesis, German participants showed a higher object focus for the culture-specific matched stimuli, while there were no cultural differences for the simple set. In support of the differential familiarity hypothesis, the Cameroonian participants showed a higher object focus for the less familiar sets, namely the standard and non-semantic sets. Furthermore, context sensitivity correlated across all the sets. In sum, these findings suggest that the familiarity of a stimulus strongly affects individuals’ visual attention, meaning that stimulus familiarity needs to be considered when investigating culture-specific differences in attentional styles.

The Development of Context-Sensitive Attention in Urban and Rural Brazil

Human perception differs profoundly between individuals from different cultures. In the present study, we investigated the development of context-sensitive attention (the relative focus on context elements of a visual scene) in a large sample (N = 297) of 5- to 15-year-olds and young adults from rural and urban Brazil, namely from agricultural villages in the Amazon region and the city of São Paulo. We applied several visual tasks which assess context-sensitive attention, including an optical illusion, a picture description, a picture recognition and a facial emotion judgment task. The results revealed that children and adults from the urban sample had a higher level of context-sensitive attention, when compared to children and adults from the rural sample. In particular, participants from São Paulo were more easily deceived by the context elements in an optical illusion task and remembered more context elements in a recognition task than participants from rural Amazon villages. In these two tasks, context-sensitivity increased with age. However, we did not find a cultural difference in the picture description and the facial emotion judgment task. These findings support the idea that visual information processing is highly dependent on the culture-specific learning environments from very early in development. Specifically, they are more consistent with accounts that emphasize the role of the visual environment, than with the social orientation account. However, they also highlight that further research is needed to disentangle the diverse factors that may influence the early development of visual attention, which underlie culture-specific developmental pathways.

Making Sense of the World: Infant Learning From a Predictive Processing Perspective

For human infants, the first years after birth are a period of intense exploration-getting to understand their own competencies in interaction with a complex physical and social environment. In contemporary neuroscience, the predictive-processing framework has been proposed as a general working principle of the human brain, the optimization of predictions about the consequences of one's own actions, and sensory inputs from the environment. However, the predictive-processing framework has rarely been applied to infancy research. We argue that a predictive-processing framework may provide a unifying perspective on several phenomena of infant development and learning that may seem unrelated at first sight. These phenomena include statistical learning principles, infants' motor and proprioceptive learning, and infants' basic understanding of their physical and social environment. We discuss how a predictive-processing perspective can advance the understanding of infants' early learning processes in theory, research, and application.

Young Children Respond to Moral Dilemmas Like Their Mothers

There is a large scientific interest in human moral judgments. However, little is known about the developmental origins and the specific role of the primary caregivers in the early development of inter-individual differences in human morality. Here, we assess the moral intuitions of 3- to 6-year-old children and their mothers (N = 56), using child-friendly versions of five trolley dilemmas and two control scenarios. We found that children responded to moral dilemmas similar to their mothers, revealed by correlations between the responses of mothers and their children in all five moral dilemmas and a highly similar overall response pattern between mother and child across all judgments. This was revealed by a high agreement in the response pattern of children and their mothers. Furthermore, children’s overall response tendencies were similar to the response tendencies of adults. Thus, similar moral principles (e.g., the Doctrine of the Double Effect) which have been identified in adults, and describes as a universal moral grammar, may guide the moral intuitions in early childhood already. Taken together, the present findings provide the first evidence that children’s moral intuitions are closely associated with the moral intuitions of their mother.

Visually Entrained Theta Oscillations Increase for Unexpected Events in the Infant Brain

Infants form basic expectations about their physical and social environment, as indicated by their attention toward events that violate their expectations. Yet little is known about the neuronal processing of unexpected events in the infant brain. Here, we used rhythmic visual brain stimulation in 9-month-olds (N = 38) to elicit oscillations of the theta (4 Hz) and the alpha (6 Hz) rhythms while presenting events with unexpected or expected outcomes. We found that visually entrained theta oscillations sharply increased for unexpected outcomes, in contrast to expected outcomes, in the scalp-recorded electroencephalogram. Visually entrained alpha oscillations did not differ between conditions. The processing of unexpected events at the theta rhythm may reflect learning processes such as the refinement of infants’ basic representations. Visual brain-stimulation techniques provide new ways to investigate the functional relevance of neuronal oscillatory dynamics in early brain development.

From understanding others' needs to prosocial action: Motor and social abilities promote infants' helping

In the present study, we test the main hypothesis that infants' understanding of others' needs translates into helping behavior, when critical motor and social competencies have emerged, early in the second year. We assessed the understanding of others' needs in an eye-tracking paradigm and the helping behavior of 10- (n = 41) and 16-month-olds (n = 37). Furthermore, we assessed the motor and social abilities of 16-month-olds. Critically, while infants understood others' needs already at 10 months, fine motor and social interaction skills moderated the link between infants' prosocial understanding and helping behavior at 16 months. This provides first evidence that infants' helping behavior relates to their understanding of others' needs. Furthermore, we found that fine motor, gross motor, and social interaction skills predicted early helping behavior by themselves. These findings highlight that the emergence of infants' helping behavior is the result of a developmental system that includes infants' understanding of others' needs and also their motor and social competencies. The link between infants' understanding of others' needs and their early helpful actions provide further support for the prosocial nature of early helping behavior.

Theta-gamma coupling binds visual perceptual features in an associative memory task

It is an integral function of the human brain to sample novel information from the environment and to integrate them into existing representations. Recent evidence suggests a specific role for the theta rhythm (4-8 Hz) in mnemonic processes and the coupling between the theta and the gamma rhythm (40-120 Hz) in ordering and binding perceptual features during encoding. Furthermore, decreases in the alpha rhythm (8-12 Hz) are assumed to gate perceptual information processes in semantic networks. In the present study, we used an associative memory task (object-color combinations) with pictures versus words as stimuli (high versus low visual information) to separate associative memory from visual perceptual processes during memory formation. We found increased theta power for later remembered versus later forgotten items (independent of the color judgement) and an increase in phase-amplitude coupling between frontal theta and fronto-temporal gamma oscillations, specific for the formation of picture-color associations. Furthermore, parietal alpha suppression and gamma power were higher for pictures compared to words. These findings support the idea of a theta-gamma code in binding visual perceptual features during encoding. Furthermore, alpha suppression likely reflects perceptual gating processes in semantic networks and is insensitive to mnemonic and associative binding processes. Gamma oscillations may promote visual perceptual information in visual cortical networks, which is integrated into existing representations by prefrontal control processes, working at a theta pace.

Context-sensitive attention is socialized via a verbal route in the parent-child interaction

The way humans perceive and attend to visual scenes differs profoundly between individuals. This is most compellingly demonstrated for context-sensitivity, the relative attentional focus on focal objects and background elements of a scene, in cross-cultural comparisons. Differences in context-sensitivity have been reported in verbal accounts (e.g. picture descriptions) and in visual attention (e.g., eye-tracking paradigms). The present study investigates (1) if the way parents verbally guide the attention of their children in visual scenes is associated with differences in children’s context-sensitivity and (2) if verbal descriptions of scenes are related to early visual attention (i.e., gaze behavior) in 5-year-old children and their parents. Importantly, the way parents verbally described visual scenes to their children was related to children’s context-sensitivity, when describing these scenes themselves. This is, we found a correlation in the number of references made to the object versus the background as well as the number of relations made between different elements of a scene. Furthermore, verbal descriptions were closely related to visual attention in adults, but not in children. These findings support our hypotheses that context-sensitivity is socialized via a verbal route and that visual attention processes align with acquired narrative structures only later in development, after the preschool years.

Maternal socialization goals and the spontaneous prosocial behavior of children in rural contexts

The purpose of this descriptive-correlational study was to investigate possible associations between maternal socialization goals and prosocial behavior (spontaneous helping) among children living in a rural context. This study involved 39 dyads of mothers, aged 17 to 48 years (M = 24.28 years, SD = 5.97), and their children, with a mean age of 24 months. The data collection included a Sociocultural Sociodemographic Characterization Questionnaire (SSCQ), a Socialization Goals Questionnaire (SGQ), and a Spontaneous Prosocial Behavior Task (SPBT). Most importantly, we found that the maternal socialization goal to "Learning to support others" exhibited a significant correlation (r = 0.40, p < 0.05) with the helping task performed by the children. This finding sustains the hypothesis that maternal goals, which emphasize the importance of their children in learning to help others, are correlated with an increased frequency of prosocial behavior in young children, around their second birthday.

Visual attention in 5-year-olds from three different cultures

Cognitive processes differ markedly between children from different cultures, with best evidence for attention to visual scenes and the activities of others. Children from urban Western cultures tend to focus on focal objects, whereas children from urban East-Asian cultures rather attend to contextual elements of a visual scene. Regarding the attention to others' activities, children from subsistence-based farming communities often observe several activities simultaneously, while children from urban Western contexts focus on activities sequentially. Here we assessed 144 5-year-old children from three prototypical cultural contexts (urban Germany, rural Cameroon, urban Japan) to investigate variations in attention across a variety of tasks. Attention to the elements of a visual scene was assessed in an optical illusion task, in picture descriptions and an eye-tracking paradigm. Attention to and learning from others' activities was assessed in a parallel action task and a rule-based game. Some tasks indicated higher context-sensitive attention in urban Japan, while other findings indicated higher context-sensitive attention in urban Germany. Levels of parallel attention and learning from others' activities were lower in rural Cameroonian children compared to the urban samples. Across tasks, the visual attention measures were unrelated. These findings substantiate that culture has a profound influence on early cognitive development, already in the preschool years. Furthermore, they raise critical questions about the early origins of cultural specificities in attention and the generalizability of attention phenomena beyond specific tasks and populations.

Neuronal oscillations reveal the processes underlying intentional compared to incidental learning in children and young adults

This EEG study investigated the neuronal processes during intentional compared to incidental learning in young adults and two groups of children aged 10 and 7 years. Theta (3–8 Hz) and alpha (10–16 Hz) neuronal oscillations were analyzed to compare encoding processes during an intentional and an incidental encoding task. In all three age groups, both encoding conditions were associated with an increase in event-related theta activity. Encoding-related alpha suppression increased with age. Memory performance was higher in the intentional compared to the incidental task in all age groups. Furthermore, intentional learning was associated with an improved encoding of perceptual features, which were relevant for the retrieval phase. Theta activity increased from incidental to intentional encoding. Specifically, frontal theta increased in all age groups, while parietal theta increased only in adults and older children. In younger children, parietal theta was similarly high in both encoding phases. While alpha suppression may reflect semantic processes during encoding, increased theta activity during intentional encoding may indicate perceptual binding processes, in accordance with the demands of the encoding task. Higher encoding-related alpha suppression in the older age groups, together with age differences in parietal theta activity during incidental learning in young children, is in line with recent theoretical accounts, emphasizing the role of perceptual processes in mnemonic processing in young children, whereas semantic encoding processes continue to mature throughout middle childhood.

Neuronal Oscillations Indicate Sleep-dependent Changes in the Cortical Memory Trace

Sleep promotes the consolidation of newly acquired associative memories. Here we used neuronal oscillations in the human EEG to investigate sleep-dependent changes in the cortical memory trace. The retrieval activity for object–color associations was assessed immediately after encoding and after 3 hr of sleep or wakefulness. Sleep had beneficial effects on memory performance and led to reduced event-related theta and gamma power during the retrieval of associative memories. Furthermore, event-related alpha suppression was attenuated in the wake group for memorized and novel stimuli. There were no sleep-dependent changes in retrieval activity for missed items or items retrieved without color. Thus, the sleep-dependent reduction in theta and gamma oscillations was specific for the retrieval of associative memories. In line with theoretical accounts on sleep-dependent memory consolidation, decreased theta may indicate reduced mediotemporal activity because of a transfer of information into neocortical networks during sleep, whereas reduced parietal gamma may reflect effects of synaptic downscaling. Changes in alpha suppression in the wake group possibly index reduced attentional resources that may also contribute to a lower memory performance in this group. These findings indicate that the consolidation of associative memories during sleep is associated with profound changes in the cortical memory trace and relies on multiple neuronal processes working in concert.

Cumulative changes in weight but not fluid volume balances reflect fluid accumulation in ICU patients

BACKGROUND

The cumulative fluid balance of critically ill patients seems to be an outcome-relevant variable. However, there are no validated data for their reliability calculated for longer (> 5 days) periods of time.

METHODS

All ICU patients ≥ 18 years, with an ICU stay ≥ 5 days and a body weight ≤ 195 kg were evaluated from 1 January 2013 to 31 December 2013. Daily standardized weighing was performed using bed-integrated scales simultaneously with the daily 24-h fluid balance. Simultaneously, a fluid balance without and with insensible perspiration (10 ml/kg/day) was calculated for each 24 h. Primary endpoint: difference between cumulative fluid balance and body weight changes at the day of transfer to the normal ward or the day of death in the ICU, respectively, in each patient. All data are presented as medians with interquartile ranges (IQR) with 25 and 75 percentiles (IQR/25/75) unless otherwise noted.

RESULTS

One hundred and six critically ill patients were evaluated; 82 survivors and 24 nonsurvivors. Cumulative 24-h fluid balances rose continuously while body weight decreased over time. Correction of cumulative fluid balances for insensible perspiration (10 ml/kg/day) also did not match with body weight changes. Only survivors had a significant loss in body weight -1.8 (27.5/-6.1/1.0) kg.

CONCLUSIONS

Assuming that changes in body weight reflect changes in whole body water content cumulative daily fluid volume balances without or with correction for insensible water loss are not useful for estimating cumulative fluid balance of ICU patients. Survivors but not nonsurvivors had a significant loss of weight over time.

Infants Understand Others’ Needs

Infants begin to help other individuals in the second year of life. However, it is still unclear whether early helping behavior is based on an understanding of other individuals’ needs and is thus motivated prosocially. In the present eye-tracking study, 9- to 18-month-old infants ( N = 71) saw a character in need of help, unable to reach its goal because of an obstacle, and a second character that was able to achieve a goal on its own. When a third individual (a helper) initiated an action, the infants expected the helper to help the character in need (as indicated during the anticipatory-looking and violation-of-expectation phases). Their prosocial understanding did not differ between age groups and was not related to their helping behavior (measured in two behavioral tasks). Thus, infants understand other individuals’ needs even before they start to help others themselves. This indicates that early helping may indeed be motivated prosocially and raises the question of which other competences underlie the ontogeny of helping behavior.

Review of 103 Swedish Healthcare Quality Registries

BACKGROUND AND OBJECTIVES

In the past two decades, an increasing number of nationwide, Swedish Healthcare Quality Registries (QRs) focusing on specific disorders have been initiated, mostly by physicians. Here, we describe the purpose, organization, variables, coverage and completeness of 103 Swedish QRs.

METHODS

From March to September 2013, we examined the 2012 applications of 103 QRs to the Swedish Association of Local Authorities and Regions (SALAR) and also studied the annual reports from the same QRs. After initial data abstraction, the coordinator of each QR was contacted at least twice between June and October 2013 and asked to confirm the accuracy of the data retrieved from the applications and reports.

RESULTS

About 60% of the QRs covered ≥80% of their target population (completeness). Data recorded in Swedish QRs include aspects of disease management (diagnosis, clinical characteristics, treatment and lead times). In addition, some QRs retrieve data on self-reported quality of life (EQ5D, SF-36 and disease-specific measures), lifestyle (smoking) and general health status (World Health Organization performance status, body mass index and blood pressure).

CONCLUSION

Detailed clinical data available in Swedish QRs complement information from government-administered registries and provide an important source not only for assessment and development of quality of care but also for research.

[Information on early detection of colorectal cancer: development of an information module for the women's health portal of the Federal Center for Health Education (BZgA)]

Colorectal cancer is the second most prevalent cancer in Germany. The governmental program for early detection of colorectal cancer intends to increase the chances of recovery by identifying colorectal cancer in an early, more treatable stage. Citizens need quality-assured, balanced, and target-group-specific information to be able to make an informed decision. On the basis of the current state of research, of extensive studies, and of expert and user interviews, the Federal Center for Health Education (BZgA) developed an information module on"early detection of colorectal cancer" for the women's health portal of the BZgA. The information module contains information on colorectal cancer, on the governmental program for early detection, as well as on the program's benefits and risks. The information offered is intended to be up to date and is approved by experts. The BZgA approves the quality of this information using methods of process and outcome evaluation.

Seizures during antidepressant treatment in psychiatric inpatients--results from the transnational pharmacovigilance project "Arzneimittelsicherheit in der Psychiatrie" (AMSP) 1993-2008

RATIONALE

There is little clinical data available about seizure rates in psychiatric inpatients, and there are no studies with reference data to the frequencies of antidepressant (AD) use for this important clinical population.

OBJECTIVE

This study investigates seizure rates during AD treatment in psychiatric inpatient settings, drawn from the transnational pharmacovigilance programme Arzneimittelsicherheit in der Psychiatrie (AMSP) in relation to the known frequencies of ADs used in the participating clinics. Comparisons are made to former publications and their limitations.

RESULTS

Seventy-seven cases were identified with grand mal seizures (GMS) during AD treatment between 1993 and 2008, with a total number of 142,090 inpatients under surveillance treated with ADs in the participating hospitals. The calculated overall rate of reported seizures of patients during AD treatment in this collective is 0.05 % for ADs imputed alone or in combination with other psychotropic drug groups and 0.02 % when only ADs were given and held responsible for GMS. The patients receiving tri- or tetracyclic ADs (TCAs) had a 2-fold risk to develop a seizure as compared to the overall average rate in this sample. In 11 cases, there was only one AD imputed--the majority of these cases (9/11) were TCA. Monotherapy with selective serotonin reuptake inhibitors (SSRI) or dual serotonin and noradrenaline reuptake inhibitors (SNRI) were never imputed alone in this sample.

CONCLUSIONS

The results of the study favour the assumption that SSRIs, noradrenergic and specific serotonergic antidepressants (NaSSA) and dual SNRI might be more appropriate than TCAs for the treatment of psychiatric patients with an enhanced seizure risk.

Successful memory encoding is associated with increased cross-frequency coupling between frontal theta and posterior gamma oscillations in human scalp-recorded EEG

Although previous studies have established that successful memory encoding is associated with increased synchronization of theta-band and gamma-band oscillations, it is unclear if there is a functional relationship between oscillations in these frequency bands. Using scalp-recorded EEG in healthy human participants, we demonstrate that cross-frequency coupling between frontal theta phase and posterior gamma power is enhanced during the encoding of visual stimuli which participants later on remember versus items which participants subsequently forget ("subsequent memory effect," SME). Conventional wavelet analyses and source localizations revealed SMEs in spectral power of theta-, alpha-, and gamma-band. Successful compared to unsuccessful encoding was reflected in increased theta-band activity in right frontal cortex as well as increased gamma-band activity in parietal-occipital regions. Moreover, decreased alpha-band activity in prefrontal and occipital cortex was also related to successful encoding. Overall, these findings support the idea that during the formation of new memories frontal cortex regions interact with cortical representations in posterior areas.

Oocyte zona birefringence intensity is associated with embryonic implantation potential in ICSI cycles

A retrospective study recently showed that oocytes presenting with a high birefringence of the inner zona layer were more often associated with conception cycles. To further investigate these findings, a prospective study was conducted between September 2005 and September 2006 including intracytoplasmic sperm injection (ICSI) cycles presenting with at least two embryos for transfer. Using a polarization imaging system, oocytes were classified prior to ICSI treatment as having either a high zona birefringence (HZB) or a low zona birefringence (LZB) of the zona pellucida. Using zona birefringence as the only selection criterion, two fertilized oocytes, preferably derived from HZB oocytes, were selected for further culture and transfer. The required criteria were met by 135 ICSI cycles (124 patients; 34.9 +/- 4.1 years of age). Embryos for transfer were used in 20 cycles derived from HZB/HZB oocytes, in 50 cycles from HZB/LZB oocytes and in 65 from LZB/LZB oocytes. The corresponding implantation (P < 0.025), pregnancy (P < 0.005) and live birth (P < 0.025) rates were significantly different between HZB/HZB and HZB/LZB versus LZB/LZB group. Embryo development was superior in embryos derived from HZB oocytes. This study concludes that oocyte zona birefringence is a good selection criterion and a good predictive criterion for embryo implantation potential.

Sickness behavior of rats with abdominal sepsis can be improved by antibiotic and G-CSF prophylaxis in clinic modeling randomized trials

BACKGROUND AND AIM

In clinical sepsis research nearly all immune-modulators have demonstrated no benefit in regard to the 28-day mortality rate. Other endpoints such as quality of life have become more attractive, but clinically relevant animal models analyzing an equivalent to quality of life by measurement of sickness behavior are extremely rare. The concept of clinic modeling randomized trials was used in an animal trial to model clinical complexity and conditions of a randomized clinical trial.

METHODS

80 adult male Wistar rats were randomly assigned to (1) control: anesthesia and sham operation, (2) sepsis: laparotomy and peritoneal infection with human stool bacteria, (3) sepsis with antibiotic prophylaxis: cefuroxime/metronidazole and (4) sepsis with antibiotic plus a cytokine prophylaxis with granulocyte-colony stimulating factor (GCSF). Endpoints were physiological and behavioral parameters.

RESULTS

The combination of antibiotics plus G-CSF was most effective in reducing mortality. All infected animals showed reduced open field activity acutely after infection, and recovery was improved during the 9 day follow-up in rats with prophylactic treatments. In the social interaction test, but not in the elevated plus-maze anxiety test, prophylaxis was also efficient, especially with antibiotics and G-CSF.

CONCLUSIONS

The results show that improving sickness behavior in septic rats with G-CSF plus antibiotics may be a promising approach.

165RE-EXPANSION AND QUALITY OF SPLIT BOVINE EMBRYOS IN VITRO

Transferring split bovine embryos results in a higher number of calves born per embryo. In addition to generating genetically identical progeny, biopsies can be made for molecular biological analyses. We aimed to determine the effect of splitting ratio on the in vitro development of Day 7 (164 to 168h post insemination) IVP bovine embryos. The inner cell mass (ICM) and trophoblast cells were split in three ratios (50:50, 60:40 and 70:30) with a Beaver microblade (Becton Dickinson, N.J., USA.) fixed to a micromanipulator under an inverse microscope at 100 X (Leica, Bensheim, Germany). Split blastocysts were cultured singly in 50μL drops of CR1aa medium at 39°C under 5% CO2 in a moisture-saturated atmosphere. After 1 and 2h culture, the morphology was assessed by judging the shape of the embryos and re-development of the blastocoel. On Day 8 (after 22h culture), the shape of the blastocysts, development of the ICM, blastocoel, proportion of degenerated cells and embryos and re-expanded blastocysts were recorded. Embryos were stained with propidium iodide and Hoechst 33258 for cell counting. The re-expansion status of Group A (50, 60 and 70%) and B (50, 40 and 30%) embryos after 1 and 2h and their quality after 22h culture (1: excellent=&lt;10% degenerated cells, well-defined ICM; 2: fair=&lt;20% degenerated cells) are shown in Table 1. With regards to Group A split blastocysts, a higher (P&lt;0.05) percentage of embryos that re-expanded after 1 and 2h and which yielded Quality 1 and 2 embryos suitable for embryo transfer was observed with the 60% and 70% than with demi-embryos. There were significant differences (P&lt;0.05) between all split blastocysts in Group B after 1h culture. The 30% split embryos showed the lowest re-expansion rate and quality of embryos after 2h and 22h culture, respectively. No differences (P&lt;0.05) were seen in the ratio of the ICM to the total number of cells in both Group A and B. This study showed that the ratio in which blastocysts were split had a significant effect on re-expansion and quality but not on the number of cells. Table 1

[Concepts in early planning for vocational rehabilitation in schizophrenia patients during acute care]

The particular relevance of employment for financial independence, acquisition of social skills and, hence, an increase in self-confidence is undeniable, and has for several years now been increasingly considered an essential component of care notably in psychiatric disorders. Vice versa, unemployment is deemed a potential risk factor with regard to poorer therapeutic response and social integration as well as a higher incidence of crises in persons with mental illness. Schizophrenia is among the psychiatric disorders very often resulting in unemployment and subsequent early pensioning. Planning for vocational rehabilitation early-on during acute care therefore is considered of greatest importance especially in this patient group. This article gives a brief overview of the main concepts drawn on in preparing the vocational rehabilitation of patients with Schizophrenia, focussing in particular on their relevance for daily practice and the possibilities for evaluating their effectiveness.