Children’s math learning (N = 217; Mage = 4.87 years; 63% European American, 96% college‐educated families) from an intelligent character game was examined via social meaningfulness (parasocial relationships [PSRs]) and social contingency (parasocial interactions, e.g., math talk). In three studies (data collected in the DC area: 12/2015–10/2017), children’s parasocial relationships and math talk with the intelligent character predicted quicker, more accurate math responses during virtual game play. Children performed better on a math transfer task with physical objects when exposed to an embodied character (Study 2), and when the character used socially contingent replies, which was mediated by math talk (Study 3). Results suggest that children’s parasocial relationships and parasocial interactions with intelligent characters provide new frontiers for 21st century learning.

Background Perfusion mapping with indocyanine green angiography (ICGA) in breast reconstruction can change intraoperative plans and reduce the risk of flap necrosis. We evaluated the utility of ICGA in the decision to delay reconstruction postmastectomy and its predictive power for necrosis. Methods Single-institution retrospective study of implant-based breast reconstructions following mastectomy using ICGA from 2015 to 2021. A decision was made to proceed with immediate reconstruction or delay reconstruction based on clinical assessment and perfusion analysis. Incidence of complications in the immediate and delayed cohorts were assessed. Intraoperative ICGA perfusion values were correlated with postoperative outcomes to calculate diagnostic accuracy. Results Three hundred twenty breast reconstructions were performed. Two hundred fifty-nine of these underwent immediate reconstruction, while 61 underwent delayed reconstruction due to poor perfusion. Median time between mastectomy and delayed reconstruction was 7.3 days (range, 4–21 days). All 8 cases (3.1%) of necrosis were in the immediate cohort. Cases of necrosis had significantly lower intraoperative ICGA perfusion values compared to cases without necrosis (absolute values 13.1 versus 27.1 units, p = 0.017). Increasing our ICGA cut-off score for necrosis from 14 to 22 units would have increased sensitivity from 63 to 100% but reduced specificity from 70 to 48%. Conclusions Delayed breast reconstruction due to poor perfusion on ICGA resulted in no cases of necrosis. A higher ICGA cut-off score for predicting necrosis is more sensitive but less specific. ICGA is useful as a supplement rather than a substitute for clinical assessment in flap perfusion evaluation. Level of Evidence Level III, Risk / Diagnostic Study.