Communication Domain Research Articles

Impact of Residual Lesion Severity on Neurodevelopmental Outcomes Following Congenital Heart Surgery in Infancy and Childhood.

Children with congenital heart disease are at increased risk of neurodevelopmental delay throughout their lifespan. This risk is exacerbated following congenital heart surgery (CHS) in infancy. However, there are few modifiable risk factors for postoperative neurodevelopmental delay. In this study, weassessed the Residual Lesion Score (RLS), a quality assessment metric that evaluates residual lesion severity following CHS, as a predictor of neurodevelopmental delay. This was a single-center, retrospective review of patients who underwent CHS from 01/2011 to 03/2021 and post-discharge neurodevelopmental evaluation from 12 to 42months of age using the Bayley Scales of Infant Development, 3rd Edition (BSID-III). RLS was assigned per published criteria: RLS 1, no residua; RLS 2, minor residua; and RLS 3, major residua or pre-discharge reintervention. Associations between RLS and BSID-III scores, as well as trends in neurodevelopmental outcomes over time, were evaluated. Of 517 patients with median age at neurodevelopmental testing of 20.0 (IQR 18.0-22.7) months, 304 (58.8%), 146 (28.2%), and 67 (13.0%) were RLS 1, 2, and 3, respectively. RLS 3 patients had significantly lower scaled scores in the cognitive, receptive, and expressive communication, and fine and gross motor domains, compared with RLS 1 patients. Multivariable models accounted for 21.5%-31.5% of the variation in the scaled scores, with RLS explaining 1.4-7.3% of the variation. In a subgroup analysis, RLS 3 patients demonstrated relatively fewer gains in cognitive, expressive communication, and gross motor scores over time (all p < 0.05). In conclusion,RLS 3 patients are at increased risk for neurodevelopmental delay, warranting closer follow-up and greater developmental support for cognitive, language, and motor skills soon after surgery.

A robust and imperceptible n-Ary based image steganography in DCT domain for secure communication

A robust and imperceptible n-Ary based image steganography in DCT domain for secure communication

Risk for Developmental Delay Among Infants Born During the COVID-19 Pandemic.

Attempts by governments around the world to mitigate the spread of COVID-19 have substantially altered the early rearing environment, raising concerns about potential negative consequences for babies born during this time. The objective of this study was to determine whether infants born during the COVID-19 pandemic were at greater risk of screening positive for developmental delay compared with infants born before the pandemic. Participants were from 2 longitudinal cohorts. The prepandemic cohort, Impact of Maternal and Paternal Postpartum Depression, recruited postpartum individuals in the period between 2015 and 2018. Infant development milestone data (Ages and Stages Questionnaire [ASQ-3]) were collected at 1-year postpartum (n = 2903), between 2016 and 2019. The pandemic cohort, Pregnancy during the Pandemic, recruited pregnant individuals between April 2020 and April 2021. Infant development milestone data (ASQ-3) were collected at 1-year postpartum (n = 3742), between May 2021 and December 2022. Sociodemographic information, pregnancy outcomes, and depression symptom data were also collected. In covariate-adjusted analyses, pandemic-born infants had lower mean scores and higher odds of screening positive for delay on the Communication, Gross Motor, and Personal-Social domains of the ASQ-3 compared with prepandemic infants. Sex differences showed that males and females screened "at risk" in different domains. Most pandemic-born infants display typical development, and differences between prepandemic and pandemic-born infants were small. Nevertheless, an increased risk for delayed development among pandemic-born infants suggests the need for ongoing monitoring to determine what, if any, resources and interventions are needed to support healthy child development.

Effects of Expert Modeling Videos on the Development of Nursing Students' Clinical Competence.

Nurse educators are called to develop innovative teaching strategies to build clinical competency. Expert modeling videos (EMVs) promote clinical competency by demonstrating exemplar nursing care. A quasiexperimental research study was conducted using a prebriefing intervention of a nursing process video for demonstration (experimental) and discussion (control) groups of nursing students. Simulation competency was measured using the Creighton Competency Evaluation Instrument (CCEI). Students in the experimental group demonstrated a statistically significant improvement in simulation competency (p = .001) and performed significantly better in the CCEI domains of communication (p = .009) and patient safety (p = .002). The use of EMVs in simulation prebriefing is an innovative teaching strategy to prepare undergraduate nursing students with the knowledge and skills required to enter the simulated environment. Through watching an exemplar demonstration of desired behaviors, students significantly improved their simulation performance and demonstrated clinically competent care of an acutely ill simulated patient. [J Nurs Educ. 2023;62(8):454-460.].

Design and Study of a Novel Regular Decagon Multilayer Photonic Crystal Fiber

This study introduces a unique regular decagon multilayer photonic crystal fiber and investigates its design and properties. Through extensive utilization of COMSOL Multiphysics optical module, the fiber's optical characteristics were thoroughly examined. The simulation outcomes indicate that, within the wavelength range of 1000-1500 nm, the photonic crystal fiber exhibits an effective mode field area ranging from 2.33*10-11 to 2.55*10-11 m2, a nonlinear coefficient between 4.96*10-3 and 8.08*10-3 s³/(kg·m³), a dispersion spanning from 1.46 to 1.54, and a loss varying from 3.76*10-3 to 1.29*10-2. This research presents novel approaches and concepts for the calculation, optimization, and design of photonic crystal fibers, ultimately fostering advancements in optical communication, optical sensing, and related domains. Furthermore, it bears significant implications for the practical implementation of innovative photonic crystal fibers in optical sensing and detection applications.

Black Lenses in Kaluza-Klein Matter.

We present the first examples of formally asymptotically flat black hole solutions with horizons of general lens space topology L(p,q). These five-dimensional static or stationary spacetimes are regular on and outside the event horizon for any choice of relatively prime integers 1≤q<p; in particular, conical singularities are absent. They are supported by Kaluza-Klein matter fields arising from higher dimensional vacuum solutions through reduction on tori. The technique is sufficiently robust that it leads to the explicit construction of regular solutions, in any dimension, realizing the full range of possible topologies for the horizon as well as the domain of outer communication, that are allowable with multi-axisymmetry. Lastly, as a by-product, we obtain new examples of regular gravitational instantons in higher dimensions.

Concurrent validity of the ages and stages questionnaires with Bayley Scales of Infant Development-III at 2 years – Singapore cohort study

With increasing acceptance of universal developmental screening in primary care, it is essential to evaluate the local validity and psychometric properties of commonly used questionnaires like the parent-completed Ages and Stages Questionnaires, 3rd Edition (ASQ-3) in identifying developmental delays. The aim of this study is to assess the convergent validity of the ASQ-3 with the Bayley Scales of Infant Development-3rd edition (Bayley-III) in identifying developmental delay in a low-risk term cohort in Singapore. ASQ-3 and Bayley-III data was collected prospectively with generation of ASQ-3 cut-off scores using three different criteria: 1-standard deviation (SD) (Criterion-I) or 2-SD (Criterion-II) below the mean, and using a Receiver Operator Curve (ROC) (Criterion-III). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. Correlations between the ASQ-3 and Bayley-III domains were evaluated using Pearson coefficients. With all three criteria across different domains ASQ-3 showed high specificity (72-99%) and NPV (69-98%), but lower sensitivity (19-74%) and PPV (11-59%). Criterion-I identified 11-21% of children as "at-risk of developmental delay," and was the most promising criterion measure, with high specificity (82-91%), NPV (69-74%) and overall agreement of 64-71%. Moderate-strong correlations were seen between ASQ-3 Communication and Bayley-III Language scales (r=0.44-0.59, p<0.01). The lowest sensitivities were seen in the motor domains. ASQ-3 is reliable in low-risk settings in identifying typically developing children not at risk of developmental delay, but it has modest sensitivity. Moderate-strong correlations seen in the communication domain are clinically important for early identification of language delay, which is one of the most prevalent areas of early childhood developmental delay.

Design for Narrative Change. A Pedagogical Model for Interactive Digital Narratives

AbstractNarratives mirror shared interpretations of the world. Still, dominant narratives prevail, pushing non‐hegemonic narratives in the corner. A change in the creation, interaction and distribution of narratives can support the design of counter‐narratives able to feed social change. Interactive Digital Narrative (IDN) can be considered an emerging experimental context in which designers, researchers and practitioners from various domains operate to develop story‐based content addressing relevant social or societal issues. The IDN social constructivist role in encouraging or influencing individuals and collectivities towards social change is a relevant design issue especially from an educational perspective. Specifically, it features methodologies and praxis not yet systematised, in need of exploration and formalisation. Recognising the contribution of an approach combining transdisciplinary methods and tools, the article presents a pedagogical model for designing IDNs as complex interactive systems able to impact culture and society based on empirical study from a design course in the higher education context. Composed of theoretical and operational frameworks, the pedagogical model orients the multilayered design process for building engaging, interactive narrative artefacts systematising and operationalising knowledge from the domains of Communication for Social Change, storytelling and IDN in an iterative design process.

COMPARING THE EFFICACY OF EARLY INTERVENTION AND LATE INTERVENTION FOR AUTISM SPECTRUM DISORDER IN CHILDREN AND ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objective: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social interaction, communication, and repetitive behaviors. Early intervention is widely recognized as crucial for improving outcomes in individuals with ASD. However, there is ongoing debate regarding the optimal timing of intervention. This systematic review and meta-analysis aimed to compare the efficacy of early intervention and late intervention for individuals with ASD. The study aimed to synthesize existing evidence and provide a comprehensive analysis of the effectiveness of these two intervention approaches in improving outcomes for children and adults with ASD.&#x0D; Methods: A comprehensive search of electronic databases was conducted to identify relevant studies. The search terms included keywords related to ASD, early intervention, late intervention, children, adults, and outcome measures. Studies were selected based on predefined inclusion and exclusion criteria, focusing on randomized controlled trials and comparative studies with adequate sample sizes. The selected studies underwent rigorous quality assessment and data extraction. Meta-analysis was conducted using statistical software to determine the overall efficacy of early intervention and late intervention in improving outcomes related to social interaction, communication, adaptive functioning, and other relevant domains.&#x0D; Results: The distribution of cases according to expressive language and motor skills was analyzed in two groups: Group A (early intervention) and Group B (late intervention). The results showed no statistically significant differences in the distribution of cases according to expressive language and motor skills between the two groups. The findings suggested that the timing of intervention may not strongly influence the distribution of these skills in individuals with ASD.&#x0D; Conclusion: This study found no significant differences in the distribution of cases according to expressive language and motor skills between early and late intervention groups. These findings are consistent with previous research, indicating that the distribution of these skills may not be strongly influenced by the timing of intervention. However, further research with larger samples and standardized assessment methods is needed to gain a comprehensive understanding of the relationships between intervention timing and the distribution of these skills in individuals with ASD.

Integrating Narrative Medicine Through Story-Telling: A Feasibility Study in a Community Medicine Curriculum for Undergraduate and Postgraduate Students.

Introduction The routine curriculum of community medicine includes clinico-social case-taking with a focus on the physical, biological, and psychosocial determinants of health. There is an opportunity to integrate narrative medicine with this for undergraduate and postgraduate medical students using story-telling. The objective of the current study was to assess its feasibility, challenges, and opportunities. Methods We conducted a need assessment cross-sectional survey of the teaching faculty of community medicine across India using Google Forms. Considering an 80% positive response in a pilot within the department, a relative error of 10%, and a 20% non-response rate, the sample size was 120. The questionnaire included closed-ended questions with a Likert scale that dealt with affective, cognitive, and communication domains and open-ended questions for insights into opportunities and challenges. The results of the former were expressed as descriptive statistics, in frequencies and proportions. Open-ended questions were summarized to guide the refinement of further implementation. Results Of the 120 participants, 92 (77%) quoted low/medium empathy quotient in students, and 107 (89.2%) felt that the listening skills of students can improve with the introduction of story-telling. A hundred and twelve (93.4%) participants felt that their history-taking skills can improve with story-telling, and all agreed that the language of medicine can be improved. One hundred nine (90.8%) felt that it will lead to better student-patient interaction. Opportunities included a better understanding of social determinants, patient-/family-centered care, improved communication skills, and better mental health. The key challenges included time, motivation, the need for training/capacity building, and streamlining of assessment metrics. Conclusion We conclude that story-telling may help medical students investigate various social determinants of health, disease, and lived environments that createvulnerabilities.

Association of Preventive Care Attitudes and Beliefs with Colorectal Cancer Screening History among African American Patients of Community Health Centers.

Colorectal cancer (CRC) is the third most common cancer and third leading cause of cancer-related death among African Americans in the United States. However, when detected early, CRC is treatable and survival rates are high. CRC health disparities for African Americans compared with other groups may be due in part to lower screening adherence and later stage diagnosis. The objective of this research phase was to test predictors of ever having received CRC screening (i.e., self-report of lifetime receipt of CRC screening) using survey measures in the domains of healthcare communication, trust in doctors, CRC perceived susceptibility, CRC worry, negative cancer beliefs, CRC screening self-efficacy, and cultural constructs for CRC screening in a sample of African American community health center patients. The study recruited 115 African American patients between the ages of 45 to 64years old from community health centers in north Florida to complete the baseline survey. Our results show significant differences in CRC screening history by age, marital status, level of mistrust of healthcare providers, and level of empowerment toward cancer screening. To increase CRC screening in this population, the study findings suggest development of intervention programs that focus on priority populations of younger, unmarried African Americans, especially given the current trend of early onset CRC. Moreover, survival rates are lower for unmarried and younger African Americans relative to older and married individuals. Such interventions should also aim to increase trust in healthcare providers and increase empowerment for CRC screening decision making to increase screening participation.

Shadows of quintessential dark energy black holes in the domain of outer communication

The rotating black holes in the quintessential dark energy correspond to three horizons: inner, outer, and quintessential horizon. The domain of outer communication is the region between outer and quintessential horizon. Here in this work, we study the photon region and shadows of the quintessential dark energy black holes when the observer stays statically in the domain of outer communication. The quintessential dark energy black holes shadow characterizes by its mass (M), spin parameter (a), quintessential dark energy parameter (ωq), and normalization factor (γ). The dark energy parameter ωq can take values between −1.1<ωq<−1/3 and follows the equation of state ωq = pressure(p)/energy density(ρq). This state parameter significantly affects the shape and the size of the black hole shadow. We generalize all the geodesic equations of motion for ωq and obtain relation to visualizing the black hole shadow by a static observer at any arbitrary distance in the domain of outer communication. We estimate the black hole shadow observables: radius Rs, distortion parameter δs, and the shadow area A. Using the numerical values of shadow radius Rs and area A, we obtain the angular diameter (θd) of the black hole shadow. The angular diameter of the M87 and Sgr A∗ black holes shadow are 42±3μas and 48.7±7μas respectively as observe by Event Horizon Telescope (EHT). In this case, the angular diameter of the black hole shadow varies from θd≈21o±4 with γ from 0.08/M to 0.12/M for the state parameter ωq=−2/3 when the static observer at ro=5M in the domain of outer communication.

The Proposed Intrusion Detection System using Support Vector Machine by IOT Enabled WSN

Abstract: Detecting intruders in computer networks is very important because it affects multiple communication and security domains finding network intruders can be difficult furthermore network intrusion detection remains a challenging undertaking due to the large amount of data required to train modern machine learning models to detect network intrusion risks recently many methods have been published for detecting network intruders however they face significant challenges as new threats continue to emerge that are undetectable by older systems this study evaluates different approaches to creating network intrusion detection systems the best features of the dataset are selected based on the correlations between features in addition we provide a complete functional and performance overview of an adaboost-based network attack detection solution based on these selected characteristics.

Cultural Environment Impact on Corporate Management

The swift evolution of China's foreign trade, has introduced a multitude of intricate challenges to its external commerce. National policies, societal norms, economic conditions, and cultural factors exert various degrees of influence over a firm's international operations. Notably, cultural disparities emerge as a significant influence on enterprises' cross-border conduct, particularly in the domain of cross-cultural communication. In sum, an examination of cross-cultural disparities in the business context is crucial for the contemporary globalized economy. By acquiring a nuanced understanding of cultural norms and practices, businesses can devise effective strategies for navigating various cultural contexts, preclude misunderstandings and conflicts, enhance communication, and exploit the advantages of cultural diversity. This study aims to examine Starbucks' internationalization as a representative instance. The intention is to unravel the mechanisms by which varying national cultures and cultural types influence internationalization, while also suggesting appropriate adaptive strategies. By doing so, the research aspires to provide a robust foundation for the creation and execution of China's internationalization strategies. The emphasis is placed on rendering pragmatic and implementable insights to facilitate the global expansion efforts of Chinese enterprises.

Towards Universally Designed Communication: Opportunities and Challenges in the Use of Automatic Speech Recognition Systems to Support Access, Understanding and Use of Information in Communicative Settings.

Unlike physical barriers, communication barriers do not have an easy solution: people speak or sign in different languages and may have wide-ranging proficiency levels in the languages they understand and produce. Universal Design (UD) principles in the domain of language and communication have guided the production of multimodal (audio, visual, written) information. For example, UD guidelines encourage websites to provide information in alternative formats (for example, a video with captions; a sign language version). The same UD for Learning principles apply in the classroom, and instructors are encouraged to prepare content to be presented multimodally, making use of increasingly available technology. In this chapter, I will address some of the opportunities and challenges offered by automatic speech recognition (ASR) systems. These systems have many strengths, and the most evident is the time they employ to convert speech sounds into a written form, faster than the time human transcribers need to perform the same process. These systems also present weaknesses, for example, a higher rate of errors when compared to human-generated transcriptions. It is essential to weigh the strengths and weaknesses of technology when choosing which device(s) to use in a universally designed environment to enhance access to information and communication. It is equally imperative to understand which tools are most appropriate for diverse populations. Therefore, researchers should continue investigating how people process information in a multimodal format, and how technology can be improved based on this knowledge and users' needs and feedback.

Developmental and behavioural outcomes at 2 years in babies born during the COVID-19 pandemic: communication concerns in a pandemic birth cohort

IntroductionThe CORAL (Impact of Corona Virus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born During Lockdown) study reported a reduction in social communication milestones in 12-month-old infants born into...

Conditional Minimal Detectable Change for the Cochlear Implant Quality of Life-35 Profile Associated With Improved Functional Abilities 12 Months After Cochlear Implantation

It is essential to measure an individual patient's baseline and follow-up abilities to demonstrate changes in clinical outcomes over time. Inherent in this strategy is interpreting whether the measured change is clinically significant and beyond measurement error. Conditional minimal detectable change (cMDC) values are widely used in many disciplines but have rarely been established for outcome measures in otolaryngology or hearing research, and never in cochlear implantation. To determine cMDC values for the Cochlear Implant Quality of Life-35 (CIQOL-35) Profile instrument to enhance our understanding of the initial and ongoing changes in functional abilities from cochlear implants (CIs). Item response theory analyses of responses from a multi-institutional cohort of 705 CI users at a tertiary CI center were used to derive standard error (SE) values for each possible CIQOL-35 domain score. Using an iterative approach, these SE values were used to calculate cMDC values for every possible pre-CI and post-CI domain score combination. We then compared pre-CI to 12-month post-CI CIQOL-35 domains scores in an independent cohort of 65 adult CI users to determine whether the measured change exceeded error to be clinically significant. The analysis took place on December 14, 2022. The CIQOL-35 Profile instrument and cochlear implantation. The cMDC values were smaller for the communication domain, and global measure and cMDC values for all domains were larger at the extremes of the measurement scale. Overall, 60 CI users (92.3%) demonstrated improvement beyond cMDC at 12 months post-CI for at least 1 CIQOL-35 domain, and no patients' scores declined beyond cMDC for any domain. The percentage of CI users demonstrating improvement beyond cMDC varied by domain, with communication (53 [81.5%]) showing the largest number of CI users improving, followed by global (42 [64.6%]) and entertainment (40 [60.9%]). In general, CI users who demonstrated improvement in CIQOL-35 domains had greater improvement in speech recognition scores than patients who did not, but the strength and significance of these associations greatly varied by domain and speech material. This multistep cohort study found that cMDC values for the CIQOL-35 Profile provided personalized thresholds for detecting real changes in patient self-reported functional abilities over time across multiple domains, which may inform clinical decision-making. Moreover, these longitudinal results reveal the domains with more or less improvement, which may aid in patient counseling.

#3102 LIMITED PHARMACEUTICAL LITERACY IN PATIENTS ON HEMODIALYSIS IN THE NETHERLANDS AS ASSESSED WITH THE RALPH INTERVIEW GUIDE

Abstract Background and Aims Patients with advanced chronic kidney disease typically use 15 or more different drugs. Proper use of these drugs requires sufficient pharmaceutical literacy, which is defined as health literacy in the context of medication use. Until now, no data are available on the prevalence of limited pharmaceutical literacy in patients with CKD or on hemodialysis. Recently, the RALPH (Recognizing and Addressing Limited Pharmaceutical Literacy) interview guide was developed in the Netherlands to assess pharmaceutical literacy skills. The current study aims to provide data on the prevalence of limited pharmaceutical literacy, associated problems, and the domains in which these problems occur, in hemodialysis patients using phosphate-binding drugs in the Netherlands. Method This study was part of a prospective observational study in a teaching hospital in Rotterdam, investigating a complex adherence-improving intervention in hemodialysis patients using phosphate-binding drugs. One of the aims of the original study was to explore pharmaceutical literacy at baseline, using the RALPH interview guide. The RALPH consists of eleven multiple-choice questions and several open-ended questions in three health literacy domains. The functional domain assesses the basic skills of reading, writing, and calculating. The communicative domain assesses more advanced skills, namely finding and understanding information and applying this information to the own situation. The critical domain assesses the even more advanced skills of critically analyzing information and applying this information to different situations. Limited pharmaceutical literacy was defined as the presence of at least one problem in one or more of the domains of the RALPH. The primary outcome was the prevalence of limited pharmaceutical literacy. Secondary outcomes were the prevalence of one or more problems in the domains. Data were analyzed using descriptive statistics (SPSS version 28.0). Results A total of 63 patients were included in the study. Mean age was 66 years, 65% were male. The main primary renal diagnoses were hypertensive nephropathy (31%) and diabetic nephropathy (19.1%). Seventy-three percent of patients received their drugs in a weekly drug dispensing system. The prevalence of limited pharmaceutical literacy was 79%. Fifty-two percent of patients had at least one problem in the communicative domain, 46% in the functional domain, and 78% in the critical domain. Around 90% of patients could correctly reproduce user instructions for phosphate-binding drugs. The most prevalent problems were lack of knowledge about the indication (40%) in the functional domain and finding understandable information (51%) in the communicative domain. In the critical domain, the most frequently encountered problems were a lack of adequate judgment of both reliability and applicability of information (62% and 65%, respectively). Almost half of the patients did not search for information. Furthermore, 32% of patients did not engage in shared-decision making or found this difficult to do. Reasons for this were a profound trust in the nephrologist and the patient's conviction that the nephrologist knew what was best. Conclusion Limited pharmaceutical literacy is frequent in patients on hemodialysis: the majority of patients have problems with finding understandable information and judging its applicability and reliability. The results of this study are in line with earlier findings studying pharmaceutical literacy in Dutch community pharmacies in the Netherlands. However, the current study found slightly higher percentages for problems with finding understandable information and judging the applicability of information. This was expected, as our population generally uses more drugs and has a more vulnerable health status. Recent data show that limited health literacy in general negatively affects certain aspects of self-management, such as adherence, communication, and knowledge. This is also apparent in our study. These data together underline the need for dialysis healthcare providers to individualize their communication and support to meet their patients’ needs.

Associations of father absence and limited access to books and toys with early childhood development among children aged 0-6years in a rural county lifted out of poverty in China.

This study aimed to understand the early development and nurturing care environment of children aged 0-6years in rural China and to evaluate the sex- and age-specific associations of nurturing care environment with child developmental outcomes. A cross-sectional survey involving 2078 children aged 0-6years was conducted using a stratified cluster sampling strategy. We used face-to-face interviews to collect information on child, family and nurturing care. The Ages & Stages Questionnaires-Chinese version and ASQ: Social-Emotional were applied to assess children's neuro- and social-emotional development, respectively. Lower neurodevelopmental scores indicate an increased risk for neurodevelopmental delay, and higher social-emotional scores are indicative to a risk of social-emotional problems. The multiple linear regression model examined the associations of nurturing care environments with childhood development. Among the investigated children, the average age was (42.9 ± 19.8) months and 55.8% were boys; 67.9% of the children had absent fathers because of labour migration and 54.0% had limited access to books and toys. Overall, boys had a lower total neurodevelopmental score than girls; similar gender patterns were also found in the domains of communication, fine motor, problem-solving and person-social. Concurrent absent fathers and limited access to books and toys were significantly associated with reduced neurodevelopmental scores [β - 11.44, 95% CI (-18.20, -4.68)] and increased social-emotional developmental scores [β 5.88, 95%CI (1.35, 10.41)] after controlling for confounding factors. Sex-specific analysis only echoed the results in boys. Additionally, having an absent father and limited access to books and toys was associated with lower neurodevelopmental scores [β - 14.58, 95%CI (-25.41, -3.75)] in children under 3 years of age and higher social-emotional developmental scores among children aged 3-6years [β 10.66, 95%CI (5.09, 16.24)]. Children, especially boys, with absent fathers due to labour migration have poorer neuro- and social-emotional development. Limited access to books and toys and father absence are linked to the children's developmental delay, especially for those under 3 years of age. Our findings suggest that intervention programs in resource-constrained rural areas are desirable; more importantly, such programs should begin before 3 years of age to achieve a benefit-cost outcome.

The gradual coevolution of syntactic combinatorics and categorization under the effects of human self-domestication: a proposal

The gradual emergence of syntax has been claimed to be engaged in a feedback loop with Human Self-Domestication (HSD), both processes resulting from, and contributing to, enhanced connectivity in selected cortico-striatal networks, which is the mechanism for attenuating reactive aggression, the hallmark of HSD, but also the mechanism of cross-modality, relevant for syntax. Here, we aim to bridge the gap between these brain changes and further changes facilitated by the gradual complexification of grammars. We propose that increased cross-modality would have enabled and supported, more specifically, a feedback loop between categorization abilities relevant for vocabulary building and the gradual emergence of syntactic structure, including Merge. In brief, an enhanced categorization ability not only brings about more distinct categories, but also a critical number of tokens in each category necessary for Merge to take off in a systematic and productive fashion; in turn, the benefits of expressive capabilities brought about by productive Merge encourage more items to be categorized, and more categories to be formed, thus further potentiating categorization abilities, and with it, syntax again. We support our hypothesis with evidence from the domains of language development and animal communication, but also from biology, neuroscience, paleoanthropology, and clinical linguistics.