Perception of visual and audiovisual trajectories toward and away from the body in the first postnatal year.

Perceiving motion in depth is important in everyday life, especially motion in relation to the body. Visual and auditory cues inform us about motion in space when presented in isolation from each other, but the most comprehensive information is obtained through the combination of both of these cues. We traced the development of infants' ability to discriminate between visual motion trajectories across peripersonal space and to match these with auditory cues specifying the same peripersonal motion. We measured 5-month-old (n = 20) and 9-month-old (n = 20) infants' visual preferences for visual motion toward or away from their body (presented simultaneously and side by side) across three conditions: (a) visual displays presented alone, (b) paired with a sound increasing in intensity, and (c) paired with a sound decreasing in intensity. Both groups preferred approaching motion in the visual-only condition. When the visual displays were paired with a sound increasing in intensity, neither group showed a visual preference. When a sound decreasing in intensity was played instead, the 5-month-olds preferred the receding (spatiotemporally congruent) visual stimulus, whereas the 9-month-olds preferred the approaching (spatiotemporally incongruent) visual stimulus. We speculate that in the approaching sound condition, the behavioral salience of the sound could have led infants to focus on the auditory information alone, in order to prepare a motor response, and to neglect the visual stimuli. In the receding sound condition, instead, the difference in response patterns in the two groups may have been driven by infants' emerging motor abilities and their developing predictive processing mechanisms supporting and influencing each other.

Touch and look: The role of affective touch in promoting infants' attention towards complex visual scenes.

In a complex social environment, stimuli from different sensory modalities need to be integrated to decode communicative meanings. From very early in life, infants have to combine a multitude of sensory features with social and affective attributes. Of all senses, touch constitutes a privileged channel to carry affective-motivational meanings and foster social connection. In the present study, we investigate whether sharing sensory stimulation that varies for its affective value differentially affects infants' attention towards visual stimuli. 6 to 11-month-old infants (N = 42) were familiarized with two characters respectively matched with tactile (affective or non-affective) and auditory stimulation; then repeatedly exposed to scenes where the two characters moved towards target objects. Our results showed a main effect of stimulation (sound vs. touch) on looking times during familiarization, with longer looking times when sound is provided. During scenes presentation, a main effect of the type of touch (affective vs. non affective) emerged, with longer looking times in infants that previously experienced affective touch, suggesting that this sensory experience may critically engage the self and modulate infant attention. Overall, these findings suggest that while sound acts as attention getter, affective touch supports sustained attention towards complex visual scenes beyond the stimulation period itself.

Ten years of a neonatal screening program for hemoglobinopathies in Friuli-Venezia Giulia: first regional experience in Italy.

BACKGROUND: Hemoglobinopathies are the commonest genetic defect worldwide (7% of the world's population has at least one hemoglobin mutation). Although prenatal screening for hemoglobinopathies is not obligatory during pregnancy in Italy, it is offered to women by the Italian National Health Service in the pre-conception phase. The screening of newborns is a valid alternative, and has been adopted in various European countries, albeit in a piecemeal fashion. Neonatal screening has the advantage of providing early diagnosis of a hemoglobinopathy. Here we report the findings from the experience with neonatal screening in Friuli-Venezia Giulia since 2010. MATERIALS AND METHODS: The hemoglobinopathy screening project in Friuli-Venezia Giulia, a Region in north Italy, began in November 2010. High-performance liquid chromatography was performed on dried blood spot samples collected by obstetric nurses from neonates within 5-8 days after birth. RESULTS: From 2010 to 2019, 11,956 newborns were screened, and abnormal hemoglobin was found in 519 of them (4.34%): the variants identified included HbS, HbC, HbD, HbE and HbX. More specifically, the HbS variant was observed in 347 (2.9%) newborns and the homozygous pattern was identified in 24 (0.2%) cases. The screening also detected two cases of ß-thalassemia major. DISCUSSION: We report our experience of 10 years of screening newborns for hemoglobinopathies in the Region of Friuli-Venezia Giulia, in which 7.7% of people come from malaria-endemic areas. Increased mobility and migratory flows bringing in hemoglobinopathy carriers from endemic areas have led to an increase in mutations in non-malarial countries, with a current incidence of around 4% in the newborns we tested. This means that hemoglobinopathies can be described as a rare condition. Our data show that incidence rates are comparable to those of other inherited disorders such as phenylketonuria, thereby justifying the inclusion of the test for hemoglobinopathies into screening programs for rare diseases.

Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020.

BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.

In Touch with the Heartbeat: Newborns' Cardiac Sensitivity to Affective and Non-Affective Touch.

The sense of touch is the first manner of contact with the external world, providing a foundation for the development of sensorimotor skills and socio-affective behaviors. In particular, affective touch is at the core of early interpersonal interactions and the developing bodily self, promoting the balance between internal physiological state and responsiveness to external environment. The aim of the present study is to investigate whether newborns are able to discriminate between affective touch and non-affective somatosensory stimulations and whether affective touch promotes a positive physiological state. We recorded full-term newborns' (N = 30) heart rate variability (HRV)-which reflects oscillations of heart rate associated with autonomic cardio-respiratory regulation-while newborns were presented with two minutes of affective (stroking) and non-affective (tapping) touch alternated with two minutes of resting in a within-subject design. The results revealed that non-affective touch elicits a decrease in HRV, whereas affective touch does not result in a change of HRV possibly indicating maintenance of calm physiological state. Thus, newborns showed cardiac sensitivity to different types of touch, suggesting that early somatosensory stimulation represents scaffolding for development of autonomic self-regulation with important implications on infant's ability to adaptively respond to the surrounding social and physical environment.

Psychophysiological and Visual Behavioral Responses to Faces Associated with Affective and Non-affective Touch in Four-month-old Infants.

Affective touch (gentle, caress-like touch) carries a rewarding meaning, which may represent a neurophysiological foundation for the development of social interactions from the earliest stages of life. Developmental studies have shown evidence of infants' sensitivity to affective touch as reflected by a decrease in heart rate and activation of the insular cortex. Moreover, affective touch has been shown to regulate infants' emotional state, reinforce eye contact and facilitate learning of facial information, suggesting that affective touch may promote social functioning from the earliest stages of development. The present study aims to investigate the role of affective touch in enhancing engagement with social stimuli, exploring sustained attention and cardiac responses to faces as signatures of the underlying psychophysiological mechanism. Four-months-old infants (N = 40) were repeatedly presented with a female face paired with touch (hand stroking vs tapping with a brush in two different blocks) alternating with a face presented without tactile stimulation (familiarization phase), followed by a visual preference test between the two faces. Our results revealed an attenuated cardiac response in the affective compared to the non-affective condition during the familiarization phase. During the test phase infants looked longer at both the faces presented in the affective touch condition, compared to the faces in the non-affective condition. These findings suggest that affective touch might promote engagement in social interactions by facilitating physiological state regulation during processing of multisensory social information.

Identifying peripersonal space boundaries in newborns.

Peripersonal space immediately surrounds the body and can be represented in the brain as a multisensory and sensorimotor interface mediating physical and social interactions between body and environment. Very little consideration has been given to the ontogeny of peripersonal spatial representations in early postnatal life, despite the crucial roles of peripersonal space and its adaptive relevance as the space where infants' earliest interactions take place. Here, we investigated whether peripersonal space could be considered a delimited portion of space with defined boundaries soon after birth. Our findings showed for the first time that newborns' saccadic reaction times to a tactile stimulus simultaneous to sounds with different intensities changed based on the sound intensity. In particular, they were significantly faster when the sound was lounder than a critical intensity, in a pattern that closely resembled that showed by adults. Therefore, provided that sound intensity on its own can cue newborns' sound distance perception, we speculate that this critical distance could be considered the boundary of newborns' rudimentary peripersonal space. Altogether, our findings suggest that soon after birth peripersonal space may be already considered as a bounded portion of space, perhaps instrumental to drive newborns' attention towards events and people within it.

Synchrony of Caresses: Does Affective Touch Help Infants to Detect Body-Related Visual-Tactile Synchrony?

Bodily self-awareness, that is the ability to sense and recognize our body as our own, involves the encoding and integration of a wide range of multisensory and motor signals. Infants' abilities to detect synchrony and bind together sensory information in time and space critically contribute to the process of gradual bodily self-awareness. In particular, early tactile experiences may have a crucial role in promoting self-other differentiation and developing bodily self-awareness. More specifically affective touch, slow and gentle touch linked to the neurophysiologically specialized system of C-tactile afferents, provides both information about the body from within (interoception) and outside (exteroception), suggesting it may be a key component contributing to the experience of bodily self-awareness. The present study aimed to investigate the role of affective touch in the formation and modulation of body perception from the earliest stages of life. Using a preferential looking task, 5-month-old infants were presented with synchronous and asynchronous visuo-tactile body-related stimuli. The socio-affective valence of the tactile stimuli was manipulated by means of the velocity [CT-optimal (slow) touch vs. CT-suboptimal (fast) touch] and the source of touch (human hand vs. brush). For the first time, we show that only infants that were stroked using a brush at slow velocity displayed a preference for the visual-tactile synchronous video, suggesting that CT-optimal touch might help infants to detect body-related visual-tactile synchrony, independently from the source of touch. Our results are in line with findings from adults and indicate that affective touch might have a critical role in the early development of bodily self-awareness.

Trajectory Discrimination and Peripersonal Space Perception in Newborns.

The ability to discriminate the trajectories of moving objects is highly adaptive and fundamental for physical and social interactions. Therefore, we could reasonably expect sensitivity to different trajectories already at birth, as a precursor of later communicative and defensive abilities. To investigate this possibility, we measured newborns' looking behavior to evaluate their ability to discriminate between visual stimuli depicting motion along different trajectories happening within the space surrounding their body. Differently from previous studies, we did not take into account defensive reactions, which may not be elicited by impending collision as newborns might not categorize approaching stimuli as possible dangers. In two experiments, we showed that newborns display a spontaneous visual preference for trajectories directed toward their body. We found this visual preference when visual stimuli depicted motion in opposite directions (approaching vs. receding) as well as when they both moved toward the peripersonal space and differed only in their specific target (i.e., the body vs. the space around it). These findings suggest that at birth human infants seem to be already equipped with visual mechanisms predisposing them to perceive their presence in the environment and to adaptively focus their attention on the peripersonal space and their bodily self.

An asymptomatic multiple magnet ingestion with transmesenteric entero-enteric fistula.

Ingestion of foreign bodies is a common presenting complaint in the pediatric emergency department. We present a case of a child in whom disc battery ingestion was suspected initially. The immobility of the foreign body on few days of conservative management raised the suspicion of two magnets. At operation, two magnets were found in the bowel causing a transmesenteric entero-enteric fistula.

Body perception in newborns.

Body ownership and awareness has recently become an active topic of research in adults using paradigms such as the "rubber hand illusion" and "enfacement" [1-11]. These studies show that visual, tactile, postural, and anatomical information all contribute to the sense of body ownership in adults [12]. While some hypothesize body perception from birth [13], others have speculated on the importance of postnatal experience [14, 15]. Through studying body perception in newborns, we can directly investigate the factors involved prior to significant postnatal experience. To address this issue, we measured the looking behavior of newborns presented with visual-tactile synchronous and asynchronous cues, under conditions in which the visual information was either an upright (body-related stimulus; experiment 1) or inverted (non-body-related stimulus; experiment 2) infant face. We found that newborns preferred to look at the synchronous condition compared to the asynchronous condition, but only when the visual stimulus was body related. These results are in line with findings from adults and demonstrate that human newborns detect intersensory synchrony when related to their own bodies, consistent with the basic processes underlying body perception being present at birth.