Problem-solving Domains Research Articles

Risk of Developmental Delay in Infants Born to Perinatal COVID-19-Positive Mothers at a Tertiary Care Hospital: A Cross-Sectional Study

Purpose: Prenatal and perinatal experiences of the mother are known to influence infant development. Maternal exposure to coronavirus disease 2019 (COVID-19) during pregnancy has been associated with increased morbidity and mother-baby separation. However, the developmental outcomes of infants born to COVID-19-positive mothers remain unclear. This study represents an initial exploratory effort to assess the developmental risks faced by infants born to mothers who tested positive for COVID-19. Methods: This cross-sectional study involved telephonic interviews and developmental screenings of 45 infants, aged 9 to 15 months, who were born to perinatal COVID-19-positive mothers between July 2020 and May 2021. The Ages & Stages Questionnaire was used for the developmental assessment. The impacts of maternal, infant and separation-related factors on development were analyzed. Results: Within the study population, 28.8% (13 of 45 infants) presented with a risk of developmental delay. The gross motor and problem-solving domains were the most frequently impacted. Among the factors studied, prolonged separation period (exceeding 7 days), advanced maternal age, and gestational age (preterm birth) were associated with higher proportions of infants at risk of developmental delay; however, these associations were not statistically significant.Conclusion: This study suggests that infants born to mothers who tested positive for COVID-19 during the perinatal period face a risk of developmental delay. Factors such as maternal age, gestational age at birth, metabolic disease during pregnancy, and infant-mother separation could exacerbate this risk. Future research should prioritize objective assessments of development and long-term follow-up to monitor developmental outcomes in this population.

Relationship of nutritional behaviors and parent–child interactions with developmental domains of Iranian toddlers: a cross-sectional study

BackgroundHealth service providers closely monitor the developmental state of toddlers to identify the factors affecting this process because any defect during this period will cause irreversible damage. Therefore, this study investigated the relationship of nutritional behaviors and parent–child interactions with the developmental domains of Iranian toddlers.MethodsThis cross-sectional, descriptive-analytical study was conducted on 341 toddlers aged 12–36 months covered by comprehensive health centers in the south of Tehran in 2021–2022. The participants were selected through single-stage cluster sampling. To this end, 16 comprehensive health centers were randomly selected, and then some of the clients from each center were randomly selected as the sample. The required data were collected through the Ages and Stages Questionnaire (ASQ), the Children’s Eating Behavior Questionnaire (CEBQ), the Child-Parent Relationship Scale (CPRS), and a demographics form. They were then analyzed statistically using descriptive and inferential statistics in SPSS-21, considering a significance level of p < 0.05.ResultsThe results showed that most participants were normal in all developmental domains (communication, gross motor, fine motor, personal-social, and problem-solving), with a mean developmental delay ranging from 1.8 to 7%. The most serious problem of participants requiring medical referral was related to gross motor (7%) with a mean of 54.35 ± 7.28 followed by communication (6.5%) with a mean of 49.41 ± 9.67. The mean nutritional behavior of participants was 77.9 ± 21.7. A significant relationship was found between the nutritional behaviors of participants and the problem-solving domain of development (p = 0.018). The results also indicated a mean parent-child interaction score of 94.26 ± 12.63. There was a significant relationship between parent-child interactions and the communication area of development (p = 0.04).ConclusionSince some areas of toddler development are influenced by children’s nutritional behavior and parent-child interactions, it is necessary to train families to identify, monitor, and correct the factors affecting the development of their children. Health system officials and planners are also recommended to develop interventions to improve the nutritional behaviors of children and parent-child interactions.

Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction during Pregnancy on Fetal Brain Development Detected by Neurosonography: A Secondary Analysis of a Randomized Clinical Trial (IMPACT BCN).

We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12 months old. This was a secondary analysis of a randomized clinical trial (2017-2020), including 1,221 singleton pregnancies at high risk for small-for-gestational age. Participants were randomized into three groups at 19-23 weeks' gestation: Mediterranean diet intervention, stress reduction program, or usual care. A detailed neurosonography was performed on 881 participants at mean (SD) 33.4 (1.1) weeks' gestation. Neurosonographic measurements were done offline. ASQ was performed on 276 infants at 1 year of corrected age. Biparietal diameter was similar among study groups. Mediterranean diet group fetuses had deeper insula (26.80 [1.68] versus 26.63 [1.75], mm, p = 0.02) and longer corpus callosum (42.98 [2.44] versus 42.62 [2.27], mm, p = 0.04), with a lower rate of suboptimal score infants in ASQ problem-solving domain (6.2 vs. 16.3%, p = 0.03). Stress reduction group fetuses had deeper insula (26.90 [1.75] versus 26.63 [1.75], mm, p = 0.04) and lower rates of suboptimal score infants in ASQ fine motor domain (4.3 vs. 12.8%, p = 0.04), compared to usual care group fetuses. Maternal structured intervention during pregnancy of the trial has the potential to modify offspring's neurodevelopment.

Toward Automated Knowledge Discovery in Case-Based Reasoning

Automated Case Elicitation (ACE) enables case-based reasoning (CBR) systems to automatically acquire knowledge through real-time exploration and interaction with environments. CBR is an explainable AI methodology, where decisions are based on previous encounters. ACE combined with CBR continues learning as it is being deployed, and produces specific cases that can be reviewed by humans, unlike pretrained large language models (LLMs) that learn by training offline on prior data. ACE and CBR may be useful methods to gather training data for use with generative AI, or to help them to adapt on the fly. This research explores ACE's potential by applying it to chess and conducting extensive experiments against Stockfish, the world's highest rated chess engine. An ACE agent was developed that combines random exploration with shallow alpha-beta search for novel game states. Results over 1000+ games showed the ACE player defeated Stockfish in nearly 10% of games—a notable achievement given Stockfish's extreme strength. Notably, the ACE agent required only 0.1 seconds per game compared an average of 8 minutes for Stockfish, while still gradually improving its win rate through accrued experience. Detailed analyses revealed how the relaxation of ACE's case matching criteria along with selective retention of useful cases enabled accumulation of strategic chess knowledge. The research provides valuable insights into ACE's proficiency for knowledge discovery in complex, adversarial domains. It lays groundwork for integrating ACE, an unsupervised CBR learner, with modern deep learning techniques like neural networks and large language models to combine the strengths of symbolic and subsymbolic AI. By demonstrating ACE's ability to extract strategic knowledge against world-class opponents, this work highlights its potential for impact across gaming, autonomous systems, and other complex problem-solving domains.

Bonobo Optimizer: A New Tool Toward the Global Optimization of Small Atomic Clusters.

In the realm of structural and bonding investigations within chemical systems, elucidating global minimum energy configurations stands as a paramount goal. As the systems increase in size and complexity, this pursuit becomes progressively challenging. Herein, we introduce Bonobo optimizer (BO), a metaheuristic algorithm inspired by the social and reproductive behaviors of bonobos, to the domain of chemical problem solving. Focusing on small carbon clusters, this study systematically evaluates BO's performance, showcasing its robustness and efficiency. Parametric studies highlight the algorithm's adaptability, consistently converging to global minimum structures. Rigorous statistical validation supports the results, and a comparative analysis against established global optimization algorithms underlines BO's superior efficiency. This exploration extends the applicability of BO to the optimization of atomic clusters, providing a promising avenue for future advancements in computational chemistry.

Examining Cognitive Disengagement Syndrome in Relation to Social Problem Solving in Young Adults

Objective: Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo (SCT), is characterized by symptoms such as excessive daydreaming, mental confusion, and hypoactivity. CDS symptoms are associated with emotional, social, and daily life impairments. The way in which one solves problems in their daily life is associated with experiences of further problems, such that maladaptive problem-solving can lead to further physical and psychological problems. However, there is limited information on how CDS symptoms are associated with problem solving. The current study examined CDS symptoms in relation to different social problem solving approaches. Method: A total of 280 college students (ages 18–23 years; 77.9% female) completed measures of psychopathology symptoms and social problem solving. Results: Above and beyond ADHD and internalizing symptoms, CDS symptoms were independently associated with negative problem orientation and avoidance style domains of maladaptive problem solving. Conclusion: Findings indicate that CDS symptoms are related to specific difficulties with social problem solving. CDS symptoms may lead to difficulties attending to problems or working through relevant steps needed to identify solutions for the problem, which may then lead to avoidance and social withdrawal. Longitudinal research is needed to evaluate maladaptive problem solving as a potential mechanism in the association between CDS, social withdrawal, and internalizing symptoms.

Prenatal organophosphate esters exposure and neurodevelopment trajectory in infancy: Evidence from the Shanghai Maternal-Child Pairs Cohort

BackgroundConcerns remain about the neurotoxic properties of the ubiquitous organophosphate esters (OPEs), the replacement of the toxicant polybrominated diphenyl ethers. ObjectivesWe examined the associations of prenatal exposure to OPEs and their mixtures with early-life neurodevelopment trajectories. MethodsTotally 1276 mother-child pairs were recruited from the Shanghai Maternal-Child Pairs Cohort. A high-performance liquid chromatography-triple quadrupole mass spectrometer was used to measure the levels of 7 OPEs in cord serum. Ages and Stages Questionnaires was used to examine children's neuropsychological development at 2, 6, 12, and 24 months of age. Group-based trajectory models were applied to derive the neurodevelopmental trajectories. Multiple linear regression and logistic regression model were performed to assess the relationships between OPEs exposure and neurodevelopment and trajectories. Mixtures for widely detected OPEs (n = 4) were investigated using quantile-based g-computation. ResultsTributyl phosphate (TBP), tris (2-butoxy ethyl) phosphate (TBEP), tris(1,3-dichloro-2-propyl) phosphate (TDCPP), and 2-ethylhexyl diphenyl phosphate (EHDPP), had detection rates >50 %. TDCPP had the highest median concentration (1.02 μg/L) in cord serum. EHDPP concentrations were negatively associated with scores in most domains at 12 months of age, with effect values (β) ranging from −1.89 to −0.57. EHDPP could negatively affect the total ASQ (OR = 1.07, 95 % CI: 1, 1.15) and gross-motor (OR = 1.09, 95 % CI: 1.02, 1.17) trajectory in infancy. Joint exposure to OPEs was associated with decreased scores in the total ASQ, gross-motor, fine-motor and problem-solving domain of 12-month-old infants, with β ranging from −5.93 to −1.25. In addition, the qgcomp models indicated significant positive associations between the concentrations of OPEs mixtures and risks of the persistently low group of the total ASQ, gross-motor and fine-motor development in early childhood. The impact of OPEs was more pronounced in boys. DiscussionOur findings suggested OPEs, especially EHDPP, had a persistently negative effect on neurodevelopment during the first 2 years.

IJCM_26A: Validation of Rashtriya Bal Swasthya Karyakram (RBSK) screening tool in Screening of Developmental Delay (DD) among under 3-year children in Bengaluru.

Background: Most DD tools available are designed in western countries which are lengthy, time consuming and need expertise to administer. RBSK has a simple tool to screen children aged 0-6 for developmental delays and disabilities. However, the psychometric properties are not published in public domain to understand its validity Objective: To study psychometric properties of RBSK screening tool for Screening of Developmental Delay among under 3 year children in Bengaluru. Methodology: A cross-sectional study was conducted among 262 children were screened in area covering five PHCs in Bengaluru. The children, categorized into eight strata based on age and underwent evaluation for developmental delay using both by the RBSK screening tool and the Ages and Stages questionnaire (ASQ) which is considered as gold standard. sensitivity, specificity, positive and negative predictive value along with kappa statistics was calculated readings of both the study tools. Results: The study encompassed a near-equal proportion of male (145,55.3%) and female (117,44.7%) children. Notably, the RBSK screening tool detected developmental delays in 13% of cases, slightly higher than the 10.7% identified by the ASQ tool. The RBSK tool exhibited a sensitivity of 97.01%, specificity of 96.43%, positive predictive value of 99.56% and negative predictive value of 79.41%. The calculated Kappa value of 0.854 signifies substantial agreement with the gold standard ASQ tool, reaffirming the RBSK tool’s validity in identifying developmental delays. Good psychometric properties was observed across gross motor, fine motor, communication, psychosocial and problem solving domains. Conclusion: This study demonstrates good psychometric properties of the RBSK screening tool in terms of sensitivity, specificity, and positive predictive value. Its user-friendly administration enables screening a larger population, effectively identifying more children with developmental delays, thereby facilitating early interventions crucial for their well-being

Early childhood development and nutritional status in urban Ethiopia.

Early childhood development (ECD) is crucial for better health and well-being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem-solving and personal-social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community-based cross-sectional survey design, 627 mother-child (12-36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ-3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem-solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non-stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition.

Availability of STEAM Approach Requirements among Intermediate-Stage Mathematics Teachers and Their Attitudes towards It

The present research aimed at investigating the availability of the requirements of the STEAM approach among intermediate-stage teachers and their attitudes towards the STEAM approach in public schools of Amman city, Jordan. This was a cross-sectional study that recruited a sample of 294 intermediate-stage mathematics teachers. A researcher-developed questionnaire was used in this study. It comprised 46 items (30 items for the availability of the STEAM approach requirements and 16 items for teachers' attitudes towards the STEAM approach). The data gathered in this study was analyzed using the SPSS. The results showed that the requirements of the STEAM education approach were high. Exploring the domains of STEAM requirements revealed that the implementation domain was the highest available requirement (3.90±0.54), followed by the planning domain (3.81±0.68) was available at a high degree, and lastly the assessment domain (3.11±0.76) at a moderate degree. In addition, the results showed that the enrolled mathematics teachers had positive attitudes toward using the STEAM education approach in teaching mathematics. It was found the most positive attitudes were within the desire to apply the strategy domain (4.18±0.60), followed by the motivation and self-learning domain (4.06±0.83), thinking and problem-solving domain (3.66±1.08) and the last one was collaboration and communication domain (3.21±0.59). The study concluded that STEAM approach requirements are available to a high degree as perceived by intermediate-stage mathematics teachers and they had positive attitudes towards using the STEAM approach in teaching mathematics in the public schools in Amman city, Jordan. Keywords: STEAM, requirements, attitudes, intermediate stage, mathematics, Jordan

Screening for developmental delay in urban Rwandan children: a cross sectional study

BackgroundSystematic or targeted screening for developmental delay (DD) is critical to the early identification of developmental disabilities. With limited available information for urban Rwandan children, this study aimed to determine the prevalence of DD and associated risk factors in infants aged 9 to 16 months living in the urban Rwandan city of Kigali.MethodsA cross-sectional study was conducted in Rwanda from August to November 2019. A convenience sample of 376 Rwandan parents/caregivers and their children attending urban health centers for their routine immunization visits at 9 and 15 months of age was studied. Parents/caregivers completed the official Kinyarwandan version of the Ages and Stages Questionnaire (ASQ-3) and established cutoffs were used to identify DD. Frequency and percentages were used to summarise the data. Logistic regression analysis was used to identify factors associated with DD.ResultsOf the 358 children screened using the ASQ-3, the overall prevalence of DD was 24.6%, with a 27.2% prevalence among 9–10-month old children and 22.4% prevalence among 15–16-month old children. Delays in the combined group among the domains of gross motor, communication, fine motor, personal social, and problem solving were 12.8%, 2.5%, 8.4%, 1.7% and 7.5%, respectively. Gestational age at delivery and district of origin were most highly associated with DD, with preterm children at significantly higher risk of having DD compared to term children (Adjusted Odd Ratio AOR = 8.3; 95% CI = 2.5–27.4) and children from Nyarugenge District at high risk of DD compared to children from Gasabo district (AOR = 2.15; 95% CI = 1.2–3.9).ConclusionsThe prevalence of ASQ-detectable DD among urban Rwandan children between 9 and 16 months of age was 24.6%, with a high correlation to a history of prematurity and district of origin. This study demonstrates the need for thoughtful health planning regarding integrated developmental surveillance for children, particularly those at high risk, to allow for earlier identification and intervention in the urban area of Kigali, Rwanda.

A - 153 Differing Impacts of Divided Auditory and Visual Attention on Abstract Reasoning among Patients with Mild Traumatic Brain Injury.

Although not all mild traumatic brain injuries (mTBIs) lead to long-term effects, they can still have significant cognitive and emotional impacts. One of the common lasting symptoms of mTBI is attentional deficit, with divided attention being specifically negatively impacted by mTBIs. This study investigated the impacts of divided auditory attention and divided visual attention on executive functioning among patients with mTBI. Participants were 98 mTBI patients. Ethnicity was self-identified as 77.5% White, 6.3%, Asian, 2.7% Hispanic, and 13.5% Mixed/Other, gender was 68% women. Tests included the Neuropsychological Assessment Battery (NAB) Numbers & Letters Test to assess divided visual attention, Paced Auditory Serial Addition Task (PASAT) for divided auditory attention, and the Halstead Category Test (HCT) to assess the abstract reasoning domain of executive functioning as part of a full neuropsychological evaluation at a private outpatient clinic. Multiple linear regression was used to analyze the data. The overall model was statistically significant (F(3,94) = 3.23, p = 0.03, R2 = 0.09). Results indicated a significant positive relationship between abstract reasoning and auditory divided attention (β= 2.42, p = 0.03), but no significant relationship between abstract reasoning and visual divided attention (β= 1.5, p = 0.2). The findings of this study suggest that divided auditory and visual attention may impact the abstract reasoning and problem-solving domain of executive functioning differently among those who have sustained mild traumatic brain injury. Specifically, divided auditory attention may play a more significant role in abstract reasoning abilities than visual divided attention.

Metacognition and self-control: An integrative framework.

Self-control describes the processes by which individuals control their habits, desires, and impulses in the service of long-term goals. Research has identified important components of self-control and proposed theoretical frameworks integrating these components (e.g., Inzlicht et al., 2021; Kotabe & Hofmann, 2015). In our perspective, these frameworks, however, do not yet fully incorporate important metacognitive aspects of self-control. We therefore introduce a framework explicating the role of metacognition for self-control. This framework extends existing frameworks, primarily from the domains of self-regulated learning and problem-solving (e.g., Schraw & Moshman, 1995; Zimmerman, 2000), and integrates past and contemporary research and theorizing on self-control that involves aspects of metacognition. It considers two groups of metacognitive components, namely, (a) individual metacognitive characteristics, that is a person's declarative, procedural, and conditional metacognitive knowledge about self-control, as well as their self-awareness (or metacognitive awareness), and (b) metacognitive regulatory processes that unfold before a self-control conflict (forethought and prevention), when a self-control conflict is identified, during a self-control conflict (regulation and monitoring), and after a self-control conflict (reflection and evaluation). The proposed framework integrates existing research and will be useful for highlighting new directions for research on the role of metacognition for self-control success and failure. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Birth Cohort Follow-Up Study on Congenital Zika Virus Infection in Vietnam.

We assessed the development, sensory status, and brain structure of children with congenital Zika virus (ZIKV) infection (CZI) at two years and preschool age. CZI was defined as either ZIKV RNA detection or positive ZIKV IgM and neutralization test in the cord or neonatal blood. Twelve children with CZI born in 2017-2018 in Vietnam, including one with Down syndrome, were assessed at 23-25.5 months of age, using Ages and Stages Questionnaire (ASQ-3), ASQ:Social-Emotional (ASQ:SE-2), Modified Checklist for Autism in Toddlers, automated auditory brainstem response (AABR), and Spot Vision Screener (SVS). They underwent brain CT and MRI. They had detailed ophthalmological examinations, ASQ-3, and ASQ:SE-2 at 51-62 months of age. None had birthweight or head circumference z-score < -3 except for the one with Down syndrome. All tests passed AABR (n = 10). No ophthalmological problems were detected by SVS (n = 10) and detailed examinations (n = 6), except for a girl's astigmatism. Communication and problem-solving domains in a boy at 24 months, gross-motor area in a boy, and gross-motor and fine-motor areas in another boy at 59-61 months were in the referral zone. Brain CT (n = 8) and MRI (n = 6) revealed no abnormalities in the cerebrum, cerebellum, or brainstem other than cerebellar hypoplasia with Down syndrome. The CZI children were almost age-appropriately developed with no brain or eye abnormalities. Careful and longer follow-up is necessary for children with CZI.

The differential associative relationship between early risk factors, neonatal morbidities and early neurodevelopmental outcome in preterm infants

BackgroundVery preterm infants of <29 weeks' gestation are at high risk for adverse neurodevelopment due to multiple risk factors in the early stages of life. There is little information regarding the associative effects of risk factors in early life, neonatal morbidities and subsequent neurodevelopmental outcomes. AimsInvestigate the association of early neurodevelopmental outcomes, neonatal complications and the risk factors in the early hours of life in a cohort of preterm infants <29 weeks' gestational age. MethodsWe enrolled all surviving preterm neonates born at gestation <29 weeks between January 2015 and June 2021 in the University of Hong Kong–Shenzhen Hospital. Demographic and clinical characteristics were collected from a database of the neonatal intensive care unit. Neurodevelopmental outcomes of the survivors were evaluated using the Ages and Stages Questionnaire (ASQ-3) which were measured at the adjusted age of 12 to 18 months. The multivariate linear regression model was used to determine correlation presented as β coefficient (β) with 95 % confidence intervals (CI). ResultsIn this cohort of 56 survivors <29 weeks' gestation, urine output within the first 12 h of life and Apgar score at 5 min were positively associated with different domains of ASQ-3 score, however male sex and highest fraction of inspired oxygen (FiO2) in the first 12 h of life were negatively related with at least one of neurocognitive domains of ASQ-3 at adjusted age of 12 to 18 months. During hospitalization, in addition to the frequency of packed red cell transfusions, the development of severe necrotizing enterocolitis was inversely associated with both neuromotor and neurocognitive skills (gross motor domain: β = −16.93, CI: −32.04, −1.82; fine motor domain: β = −16.42, CI: −28.82, −4.02; problem solving domain: β = −13.14, CI: −24.45, −1.83; all P < 0.05), whereas severe intraventricular hemorrhage had adverse effects on gross motor only (β = −13.04, CI: −24.42, −1.65; P = 0.03). Bronchopulmonary dysplasia and retinopathy of prematurity were not related with ASQ-3. ConclusionsIn this small cohort study of very preterm neonates born at <29 weeks' gestation, risk factors in the early hours of life and neonatal morbidities during hospitalization had differential associative relationships with ASQ-3 at 12–18 months adjusted age. This information may be important for parental counseling and management including early diagnosis and intervention.

Sex difference in association between cognitive and P50 deficits in patients with chronic schizophrenia.

A large number of studies have reported that sensory gating disorders represented by P50 inhibition may be involved in the pathophysiological process of schizophrenia. However, few studies have explored the relationship between sensory gating disorders and cognitive dysfunction in patients with schizophrenia. This study aimed to explore sex differences in the relationship between cognitive and P50 deficits in patients with chronic schizophrenia, which has not been reported. A total of 183 chronic schizophrenia patients (128 males and 55 females) and 166 healthy controls (76 males and 90 females) participated in this study. The MATRICS Consensus Cognitive Battery (MCCB) was measured for cognitive function and P50 components for the sensory gating in all participants. The Positive and Negative Syndrome Scales (PANSS) was used to assess the psychopathological symptoms in patients. Female patients performed significantly better than male patients in several cognitive domains of MCCB (all p < 0.01). There were no significant differences in P50 components between male and female patients (all p > 0.05). Further analysis showed that in female patients, latency of S2 was negatively correlated with reasoning and problem-solving domain of MCCB (p < 0.05), and P50 ratio was negatively correlated with social cognition domain of MCCB (p < 0.05). In male patients, there was no any correlation between P50 and cognitive domains of MCCB. Our results suggest that there is a sex difference in the association between P50 deficiency and cognitive impairment in Chinese Han patients with schizophrenia.

The association between maternal urinary Bisphenol A levels and neurodevelopment at age 2 years in Chinese boys and girls: A prospective cohort study

The impact of maternal exposure to Bisphenol A on child cognitive development as well as its sex dimorphism remains uncertain. This study used data of 215 mothers and their children from a birth cohort in Shanghai. Urinary BPA were measured in spot urine samples of mothers at late pregnancy and children at age 2 years. Cognitive development was evaluated by Ages & Stages Questionnaires, Third Edition (ASQ-3) at age 2 years. Urinary BPA was detectable in 98.9% of mothers (geometric mean, GM: 2.6 μg/g. creatinine) and 99.8% children (GM: 3.4 μg/g. creatinine). Relative to the low and medium BPA tertiles, high tertile of maternal urinary BPA concentrations were associated with 4.8 points lower (95% CI: −8.3, −1.2) in gross motor and 3.7 points lower (95% CI: −7.4, −0.1) in problem-solving domain in girls only, with adjustment for maternal age, maternal education, pre-pregnancy BMI, passive smoking during pregnancy, parity, delivery mode, birth-weight for gestational age, child age at ASQ-3 test. This negative association remained with additional adjustment for child urinary BPA concentrations at age 2 years. No association was observed in boys. These results suggested the sex-dimorphism on the associations of maternal BPA exposure with gross motor and problem-solving domains in children at age 2 years. This study also indicated that optimal early child development should start with a healthy BPA-free “in utero” environment.

Association of Maternal and Paternal Education and Developmental Domains in 2–36 Months Old Children in Primary Care Setting in Cairo Egypt

Abstract Background Developmental delays (DDs) in children are increasing in prevalence and necessitate routine screening of young children for early recognition and management. Objective To determine the association of Maternal and Paternal education and developmental delays among children 2-36 months of age and determine the associated factors in Saraya El Koba primary care center in Cairo, Egypt. Methods This crosssectional study that enrolled a total of 193 children at the ages 2 to 36 months. Data were collected using the official Arabic version of the Ages and Stages Questionnaires, third edition (ASQ-3) to assess five domains of development (Gross Motor, Fine Motor, Language and Communication, Problem-Solving, and Personal and Social Skills). Sociodemographic data and risk factors related to DDs of children and parents were asked for. Results The overall prevalence of children with DDs was 9. 3%. The most developmental domain with delayed children were the communication and gross motor (3.1%each). Lower rates of DDs were identified for fine motor (1.04%). Girls scored higher than boys in problem solving domain (p &amp;lt; 0.05). Maternal and Paternal education is associated with developmental domains in this group of children. Mothers with university education and above had children with higher fine motor and total developmental scores (p &amp;lt; 0.05). Fathers with university education and above had children with higher communication scores (p &amp;lt; 0.001). Conclusion The study recognized a high prevalence (9.3%) of DDs especially for communication and gross motor skills. Maternal and Paternal education was associated with DDs. Creating a standardized developmental screening program for prompt recognition and timely intervention is recommended.

Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years

Whether some domains of child development are specifically associated with screen time and whether the association continues with age remain unknown. To examine the association between screen time exposure among children aged 1 year and 5 domains of developmental delay (communication, gross motor, fine motor, problem-solving, and personal and social skills) at age 2 and 4 years. This cohort study was conducted under the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Pregnant women at 50 obstetric clinics and hospitals in the Miyagi and Iwate prefectures in Japan were recruited into the study between July 2013 and March 2017. The information was collected prospectively, and 7097 mother-child pairs were included in the analysis. Data analysis was performed on March 20, 2023. Four categories of screen time exposure were identified for children aged 1 year (<1, 1 to <2, 2 to <4, or ≥4 h/d). Developmental delays in the 5 domains for children aged 2 and 4 years were assessed using the Japanese version of the Ages & Stages Questionnaires, Third Edition. Each domain ranged from 0 to 60 points. Developmental delay was defined if the total score for each domain was less than 2 SDs from its mean score. Of the 7097 children in this study, 3674 were boys (51.8%) and 3423 were girls (48.2%). With regard to screen time exposure per day, 3440 children (48.5%) had less than 1 hour, 2095 (29.5%) had 1 to less than 2 hours, 1272 (17.9%) had 2 to less than 4 hours, and 290 (4.1%) had 4 or more hours. Children's screen time was associated with a higher risk of developmental delay at age 2 years in the communication (odds ratio [OR], 1.61 [95% CI, 1.23-2.10] for 1 to <2 h/d; 2.04 [1.52-2.74] for 2 to <4 h/d; 4.78 [3.24-7.06] for ≥4 vs <1 h/d), fine motor (1.74 [1.09-2.79] for ≥4 vs <1 h/d), problem-solving (1.40 [1.02-1.92] for 2 to <4 h/d; 2.67 [1.72-4.14] for ≥4 vs <1 h/d), and personal and social skills (2.10 [1.39-3.18] for ≥4 vs <1 h/d) domains. Regarding risk of developmental delay at age 4 years, associations were identified in the communication (OR, 1.64 [95% CI, 1.20-2.25] for 2 to <4 h/d; 2.68 [1.68-4.27] for ≥4 vs <1 h/d) and problem-solving (1.91 [1.17-3.14] for ≥4 vs <1 h/d) domains. In this study, greater screen time for children aged 1 year was associated with developmental delays in communication and problem-solving at ages 2 and 4 years. These findings suggest that domains of developmental delay should be considered separately in future discussions on screen time and child development.

Cognitive Training With Head-Mounted Display Virtual Reality in Neurorehabilitation: Pilot Randomized Controlled Trial.

Neurological rehabilitation is technologically evolving rapidly, resulting in new treatments for patients. Stroke, one of the most prevalent conditions in neurorehabilitation, has been a particular focus in recent years. However, patients often need help with physical and cognitive constraints, whereby the cognitive domain in neurorehabilitation does not technologically exploit existing potential. Usually, cognitive rehabilitation is performed with pen and paper or on a computer, which leads to limitations in preparation for activities of daily living. Technologies such as virtual reality (VR) can bridge this gap. This pilot study investigated the use of immersive VR in cognitive rehabilitation for patients undergoing inpatient neurorehabilitation. The goal was to determine the difference in rehabilitation effectiveness between a VR serious game that combines everyday activities with cognitive paradigms and conventional computerized cognitive training. We hypothesized the superiority of the VR serious game regarding cognitive abilities and patient-reported outcomes as well as transfer to daily life. We recruited 42 patients with acute brain affection from a German neurorehabilitation clinic in inpatient care with a Mini Mental Status Test score >20 to participate in this randomized controlled trial. Participants were randomly assigned to 2 groups, with 1 receiving the experimental VR treatment (n=21). VR training consisted of daily life scenarios, for example, in a kitchen, focusing on treating executive functions such as planning and problem-solving. The control group (n=21) received conventional computerized cognitive training. Each participant received a minimum of 18 treatment sessions in their respective group. Patients were tested for cognitive status, subjective health, and quality of life before and after the intervention (Alters-Konzentrations-Test, Wechsler Memory Scale-Revised, Trail Making Test A and B, Tower of London-German version, Short Form 36, European Quality of Life 5 Dimensions visual analog scale, and Fragebogen zur Erfassung der Performance in VR). Repeated-measures ANOVA revealed several significant main effects in the cognitive tests: Tower of London-German version (P=.046), Trail Making Test A (P=.01), and Wechsler Memory Scale-Revised (P=.006). However, post hoc tests revealed that the VR group showed significant improvement in the planning, executive control, and problem-solving domains (P=.046, Bonferroni P=.02). In contrast, no significant improvement in the control group between t0 and t1 was detected (all P>.05). Furthermore, a nonsignificant trend was observed in visual speed in the VR group (P=.09, Bonferroni P=.02). The results of this pilot randomized controlled trial showed that immersive VR training in cognitive rehabilitation had greater effectiveness than the standard of care in treating patients experiencing stroke in some cognitive domains . These findings support the further use and study of VR training incorporating activities of daily living in other neurological disorders involving cognitive dysfunction. Federal Registry of Clinical Trials of Germany (DRKS) DRKS00023605; https://drks.de/search/de/trial/DRKS00023605.