Multiple Milestones Research Articles

Noita

In this article, we present a case study where we used timelines as a structuring method for understanding the creative process of game development spanning several years. In the case study, an indie game, Noita, with over ten years of development time, was analyzed through a multitude of sources such as devlogs, prototypes, builds, interviews and fan engagement. As a result, we came up with a timeline with over 150 entries in seven distinct phases to showcase the richness of the design journey, with multiple milestones and influences on the development process. In this article, we reflect on the research process and suggest the use of the timeline method as a part of the multidisciplinary toolset for studying game design.

Abstract TP65: Mastering the Art of Herding Cats: Unraveling the Methods of Effective Communication in a Growing Stroke Program

Background: Since becoming a Comprehensive Stroke Center in 2008, our annual stroke patient volume doubled, and intervention volume grew nearly 6-fold. The program achieved multiple milestones over this time, transitioning from a combined ICU-progressive care unit to separate specialized units, and later relocating to a new facility with a dedicated Neuro ICU and two progressive care units. As the program expanded, innovative communication techniques and processes were adopted to accommodate the growing staff and infrastructure. Methods: The development and dissemination of intervention reports to stakeholders from each stroke case heightened awareness of time goals and fostered collaboration. Effective communication was further facilitated through the development of a SharePoint site, newsletter, and electronic handbook. Strategically designed dashboards provided crucial data on volumes, diversion, and treatment times. QR codes were introduced for convenient data and research request access. Moreover, detailed electronic follow-up reports facilitated external collaboration with referring facilities. Results: Embracing electronic communication enhanced information sharing, improving our team’s grasp of program data, outcomes, launches, and outreach initiatives. The monthly newsletter achieved a 60% open rate, contributing to nearly 5,000 SharePoint site visits. Monthly intervention reports to stroke team responders heightened time goal awareness, fostering collaboration, improving documentation, and reducing the need for case delay documentation clarification. Sending an average of 71 follow-up reports monthly to referring hospitals and EMS agencies strengthened external partnerships. Moreover, leveraging social media amplified community outreach for stroke education. Conclusion: We have found electronic communication to be successful for our growing program. To enhance engagement and accommodate diverse learners, we recommend utilizing a range of methods, including visuals, quizzes, and interactive content. Future plans involve expanding communication strategies with emerging techniques and conducting a formal analysis to assess stakeholders' comprehension of shared information in stroke care.

A branch‐and‐price algorithm for identical parallel machine scheduling with multiple milestones

AbstractThis article considers an identical parallel‐machine task scheduling problem motivated by operations management of online services. A task with an integer processing time can be split into sub‐tasks with integer processing times. Each task has multiple integer milestones and at each milestone a nonnegative penalty will occur. The penalty value of a task at a milestone is a convex nonincreasing function of the completed amount by this milestone. Our objective is to determine a feasible schedule for all the tasks on given identical parallel machines, such that the sum of all tasks' total penalty at all milestones is minimized. We prove the NP‐hardness of this problem in the ordinary sense and develop a branch‐and‐price algorithm. Computational experiments utilizing data from an online service operations survey show that this algorithm is singularly efficient and promising.

Using version control to document genuine effort in written assignments: a protocol with examples for universities

This conceptual report describes a novel assessment technique to evaluate written assignments in universities, such as literature reviews, essays or research proposals, over the course of the academic semester in multiple milestones. The method can be adapted to undergraduate and graduate courses in disciplines with a writing requirement. Key features of this method include encouraging student self-regulation and spacing of learning, rapid scoring using quantitative elements, improving the authenticity and transparency of the written work, and guiding students towards better writing and thinking skills. The method involves the implementation of a system called version control, which is a class of software to track and manage changes to textual data, often used by programmers to track code. This report describes a use case in two psychology courses describing the logistics and marking dynamics surrounding the assessment. This protocol has been seeded on a public repository on GitHub where educators can contribute and develop the technique further.

Unified semicompeting risks analysis of hepatitis natural history through mediation modeling.

Natural history of hepatitis B or C is comprised of multiple milestones such as liver cirrhosis and liver cancer. To fully characterize its natural course, semicompeting risks represent a common problem where liver cirrhosis and liver cancer are both of interest, but only the former may be censored by the latter. Copula, frailty and multistate models serve as well-established analytics for semicompeting risks. Here, we cast the semicompeting risks in a mediation framework, with liver cirrhosis as a mediator and liver cancer as an outcome. We define the indirect and direct effects as the effects of an exposure on the liver cancer incidence mediated and not mediated through liver cirrhosis, respectively. With the estimands derived as conditional probabilities, we derive respective expressions under the copula, frailty, and multistate models. Next, we propose estimators based on nonparametric maximum likelihood or U-statistics and establish their asymptotic results. Numerical studies demonstrate that the efficiency of copula models leads to potential bias due to model misspecification. Moreover, the robustness of frailty models is accompanied by a loss in efficiency, and multistate models balance the efficiency and robustness. We demonstrate the utility of the proposed methods by a hepatitis study, showing that hepatitis B and C lead to a higher incidence of liver cancer by increasing liver cirrhosis incidence. Thus, mediation modeling provides a unified framework that accommodates various semicompeting risks models.

Developmental Milestones of Infancy and Associations with Later Childhood Neurodevelopmental Outcomes in the Adolescent Brain Cognitive Development (ABCD) Study.

The age at attaining infancy developmental milestones has been associated with later neurodevelopmental outcomes, but evidence from large and diverse samples is lacking. We investigated this by analyzing data of 5360 singleton children aged 9–10 from 17 states in the US enrolled in the Adolescent Brain Cognitive Development (ABCD) study during 2016–2020. Delays in four milestones (first roll over, unaided sitting, unaided walking, and speaking first words) were defined using the 90th percentile of age at attainment reported by children’s biological mothers. Childhood neurocognitive function was measured by research assistants using the NIH toolbox, and children reported their behavioral problems using the Brief Problem Monitor. Linear mixed-effects models were employed to investigate the association between delays in single or multiple milestones and childhood neurobehavioral outcomes. Delays in first roll over, unaided sitting, or walking were associated with poorer childhood neurocognitive function, while delay in speaking first words was associated with both poorer neurocognitive function and behavioral problems. Children who had delays in both motor and language milestones had the worst neurocognitive function and behavioral outcomes. Our results suggest that delays in motor and language milestone attainment during infancy are predictive of childhood neurobehavioral outcomes.

Fluxonium: An Alternative Qubit Platform for High-Fidelity Operations

Superconducting qubits provide a promising path toward building large-scale quantum computers. The simple and robust transmon qubit has been the leading platform, achieving multiple milestones. However, fault-tolerant quantum computing calls for qubit operations at error rates significantly lower than those exhibited in the state of the art. Consequently, alternative superconducting qubits with better error protection have attracted increasing interest. Among them, fluxonium is a particularly promising candidate, featuring large anharmonicity and long coherence times. Here, we engineer a fluxonium-based quantum processor that integrates high qubit coherence, fast frequency tunability, and individual-qubit addressability for reset, readout, and gates. With simple and fast gate schemes, we achieve an average single-qubit gate fidelity of 99.97% and a two-qubit gate fidelity of up to 99.72%. This performance is comparable to the highest values reported in the literature of superconducting circuits. Thus our work, within the realm of superconducting qubits, reveals an alternative qubit platform that is competitive with the transmon system.

Novel vision restoration techniques: 3D bioprinting, gene and stem cell therapy, optogenetics, and the bionic eye.

Vision restoration has been one of the most sought-after goals of ophthalmology because of its inception. Despite these problems being tackled from numerous different perspectives, a concrete solution has not yet been achieved. An optimal solution will have significant implications on the patient's quality of life, socioeconomic status, and mental health. This article will explore new and innovative approaches with one common aim-to restore functional vision for the visually impaired. These novel techniques include 3D bioprinting, stem cell therapy, gene therapy, implantable devices, and optogenetics. While the techniques mentioned above show significant promise, they are currently in various stages of development ranging from clinical trials to commercial availability. Restoration of minimal vision in specific cases has already been achieved by the different methods but optimization of different parameters like biocompatibility, spatiotemporal resolution, and minimizing the costs are essential for widespread use. The developments over the past decade have resulted in multiple milestones in each of the techniques with many solutions getting approved by the FDA. This article will compare these novel techniques and highlight the major advantages and drawbacks of each of them.

Exploring Generational Private Mobility Paradigm Shifts through Duration Modeling Analytics: A Greek Case Study

In this paper, we explore lifetime private mobility milestones in Greece and identify the factors that affect them, to explore the everchanging mobility landscape. In total, five archetypal private mobility milestones were examined: the age of getting a car driving license and the period until getting a car following that; the age of getting a motorbike driving license; the age of getting a first bicycle as an adult; and the age of first traveling by airplane. To this end, duration modeling and namely Kaplan-Meier and Cox Proportional Hazards models were developed. Results show that mobility paradigms are evolving and are affected by a wide array of factors. Generational differences are particularly highlighted, as younger travelers are less likely to get a car driving license or a car sooner but are more likely to get a bicycle as adults. Higher parents’ income diversely affects multiple mobility milestones. Growing up in rural locations and sustainable transport awareness also significantly affect mode choice related mobility milestones. Men were more likely to get both car and motorbike driving licenses at younger ages. The above results highlight the mobility profiles of Greek citizens and the factors that affect them, while offering insights into a future mobility landscape.

Gender Differences Among Milestone Assessments in a National Sample of Pediatric Emergency Medicine Fellowship Programs.

Understanding gender gaps in trainee evaluations is critical because these may ultimately determine the duration of training. Currently, no studies describe the influence of gender on the evaluation of pediatric emergency medicine (PEM) fellows. The objective of our study was to compare milestone scores of female versus male PEM fellows. This is a multicenter retrospective cohort study of a national sample of PEM fellows from July 2014 to June 2018. Accreditation Council for Medical Education (ACGME) subcompetencies are scored on a 5-point scale and span six domains: patient care (PC), medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills (ICS). Summative assessments of the 23 PEM subcompetencies are assigned by each program's clinical competency committee and submitted semiannually for each fellow. Program directors voluntarily provided deidentified ACGME milestone reports. Demographics including sex, program region, and type of residency were collected. Descriptive analysis of milestones was performed for each year of fellowship. Multivariate analyses evaluated the difference in scores by sex for each of the subcompetencies. Forty-eight geographically diverse programs participated, yielding data for 639 fellows (66% of all PEM fellows nationally); sex was recorded for 604 fellows, of whom 67% were female. When comparing the mean milestone scores in each of the six domains, there were no differences by sex in any year of training. When comparing scores within each of the 23 subcompetencies and correcting the significance level for comparison of multiple milestones, the scores for PC3 and ICS2 were significantly, albeit not meaningfully, higher for females. In a national sample of PEM fellows, we found no major differences in milestone scores between females and males.

Social Media Bridges the Training Gap Between Match Day and Internship With ACGME Milestone-based Clinical Case Curriculum.

The objective was to bridge the relative educational gap for newly matched emergency medicine preinterns between Match Day and the start of internship by implementing an Accreditation Council for Graduate Medical Education Milestone (ACGME)-based virtual case curriculum over the social media platform Slack. We designed a Milestone-based curriculum of 10 emergency department clinical cases and used Slack to implement it. An instructor was appointed for each participating institution to lead the discussion and encourage collaboration among preinterns. Pre- and postcurriculum surveys utilized 20 statements adapted from the eight applicable Milestones to measure the evolution of preintern self-reported perceived preparedness (PP) as well as actual clinical knowledge (CK) performance on a case-based examination. A total of 11 institutions collaborated and 151 preinterns were contacted, 127 of whom participated. After participating in the Slack intern curriculum (SIC), preinterns reported significant improvements in PP regarding multiple Milestone topics. They also showed improved CK regarding the airway management Milestone based on examination performance. Implementation of our SIC may ease the difficult transition between medical school and internship for emergency medicine preinterns. Residency leadership and medical school faculty will benefit from knowledge of preintern PP, specifically of their perceived strengths and weaknesses, because this information can guide curricular focus at the end of medical school and beginning of internship. Limitations of this study include variable participation and a high attrition rate. Further studies will address the utility of such a virtual curriculum for preinterns and for rotating medical students who have been displaced from clinical rotations during the novel coronavirus pandemic.

Sire contribution to pregnancy loss in different periods of embryonic and fetal development of beef cows

The objective was to evaluate the effect of service sire on pregnancy results during different periods of embryonic and fetal development. Angus cows (n = 658) were timed artificially inseminated (TAI) on day 0 after synchronization of estrus using one of eight Angus sires. Estrus expression prior to TAI was evaluated using estrus breeding indicators. Blood samples were collected on days 0, 24 and 31 for quantification of circulating pregnancy-associated glycoprotein (PAG). Pregnancy was diagnosed at day 24 based on blood-based test, and on days 31 and 60 by transrectal ultrasonography to determine early embryonic mortality (EEM; between days 24 and 31) and late embryonic/early fetal mortality (LEM; between days 31 and 60). Sires were retrospectively classified according to the amount of pregnancy loss in each evaluated interval. Overall EEM was 5.54%, with values ranging from 1.8 to 11.7% among sires, whereas LEM was 6.7% with values ranging from 2.3 to 12.6% among sires. Individual sires had different phenotypes in regard to pregnancy loss during different developmental periods, indicating the importance of evaluating multiple milestones of embryonic development when classifying sire fertility. No difference (P ≥ 0.05) was observed in serum concentrations of PAG in cows bred with sires of different phenotypes. Pregnancy rate by sire was also influenced by estrus expression. Sires with a greater number of cows pregnant without estrus expression, had similar incidence of early (P = 0.71) but greater incidence of late embryonic mortality (P = 0.05). These results are significant to characterize sire contribution to pregnancy maintenance and establishment in beef cows and to serve as basis of studies to identify markers to improve sire fertility evaluation.

Transient States and Barriers from Molecular Simulations and the Milestoning Theory: Kinetics in Ligand-Protein Recognition and Compound Design.

This study presents a novel computational approach to study molecular recognition and binding kinetics for drug-like compounds dissociating from a flexible protein system. The intermediates and their free energy profile during ligand association and dissociation processes control ligand-protein binding kinetics and bring a more complete picture of ligand-protein binding. The method applied the milestoning theory to extract kinetics and thermodynamics information from running short classical molecular dynamics (MD) simulations for frames from a given dissociation path. High-dimensional ligand-protein motions (3N-6 degrees of freedom) during ligand dissociation were reduced by use of principal component modes for assigning more than 100 milestones, and classical MD runs were allowed to travel multiple milestones to efficiently obtain ensemble distribution of initial structures for MD simulations and estimate the transition time and rate during ligand traveling between milestones. We used five pyrazolourea ligands and cyclin-dependent kinase 8 with cyclin C (CDK8/CycC) as our model system as well as metadynamics and a pathway search method to sample dissociation pathways. With our strategy, we constructed the free energy profile for highly mobile biomolecular systems. The computed binding free energy and residence time correctly ranked the pyrazolourea ligand series, in agreement with experimental data. Guided by a barrier of a ligand passing an αC helix and activation loop, we introduced one hydroxyl group to parent compounds to design our ligands with increased residence time and validated our prediction by experiments. This work provides a novel and robust approach to investigate dissociation kinetics of large and flexible systems for understanding unbinding mechanisms and designing new small-molecule drugs with desired binding kinetics.

Progress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder.

Buprenorphine (BUP) can safely and effectively reduce craving, overdose, and mortality rates in people with opioid use disorder (OUD). However, adoption of ED-initiation of BUP has been slow partly due to physician perception this practice is too complex and disruptive. We report progress of the ongoing EMBED (EMergency department-initiated BuprenorphinE for opioid use Disorder) project. This project is a five-year collaboration across five healthcare systems with the goal to develop, integrate, study, and disseminate user-centered Clinical Decision Support (CDS) to promote the adoption of Emergency Department (ED)-initiation of buprenorphine/naloxone (BUP) into routine emergency care. Soon to enter its third year, the project has already completed multiple milestones to achieve its goals including (1) user-centered design of the CDS prototype, (2) integration of the CDS into an automated electronic health record (EHR) workflow, (3) data coordination including derivation and validation of an EHR-based computable phenotype, (4) meeting all ethical and regulatory requirements to achieve a waiver of informed consent, (5) pilot testing of the intervention at a single site, and (6) launching a parallel group-randomized 18-month pragmatic trial in 20 EDs across 5 healthcare systems. Pilot testing of the intervention in a single ED was associated with increased rates of ED-initiated BUP and naloxone prescribing and a doubling of the number of unique physicians adopting the practice. The ongoing multi-center pragmatic trial will assess the intervention’s effectiveness, scalability, and generalizability with a goal to shift the emergency care paradigm for OUD towards early identification and treatment.Trial Registration:Clinicaltrials.gov # NCT03658642.

Improving diagnostic accuracy of multiple system atrophy: a clinicopathological study.

Clinical diagnosis of multiple system atrophy is challenging and many patients with Lewy body disease (i.e. Parkinson's disease or dementia with Lewy bodies) or progressive supranuclear palsy are misdiagnosed as having multiple system atrophy in life. The clinical records of 203 patients with a clinical diagnosis of multiple system atrophy were reviewed to identify diagnostic pitfalls. We also examined 12 features supporting a diagnosis of multiple system atrophy (red flag features: orofacial dystonia, disproportionate antecollis, camptocormia and/or Pisa syndrome, contractures of hands or feet, inspiratory sighs, severe dysphonia, severe dysarthria, snoring, cold hands and feet, pathological laughter and crying, jerky myoclonic postural/action tremor and polyminimyoclonus) and seven disability milestones (frequent falls, use of urinary catheters, wheelchair dependent, unintelligible speech, cognitive impairment, severe dysphagia, residential care). Of 203 cases, 160 (78.8%) were correctly diagnosed in life and had pathologically confirmed multiple system atrophy. The remaining 21.2% (43/203) had alternative pathological diagnoses including Lewy body disease (12.8%; n = 26), progressive supranuclear palsy (6.4%; n = 13), cerebrovascular diseases (1%; n = 2), amyotrophic lateral sclerosis (0.5%; n = 1) and cerebellar degeneration (0.5%; n = 1). More patients with multiple system atrophy developed ataxia, stridor, dysphagia and falls than patients with Lewy body disease; resting tremor, pill-rolling tremor and hallucinations were more frequent in Lewy body disease. Although patients with multiple system atrophy and progressive supranuclear palsy shared several symptoms and signs, ataxia and stridor were more common in multiple system atrophy. Multiple logistic regression analysis revealed increased likelihood of multiple system atrophy versus Lewy body disease and progressive supranuclear palsy if a patient developed orthostatic hypotension or urinary incontinence with the requirement for urinary catheters [multiple system atrophy versus Lewy body disease: odds ratio (OR): 2.0, 95% confidence interval (CI): 1.1-3.7, P = 0.021; multiple system atrophy versus progressive supranuclear palsy: OR: 11.2, 95% CI: 3.2-39.2, P < 0.01]. Furthermore, autonomic dysfunction within the first 3 years from onset can differentiate multiple system atrophy from progressive supranuclear palsy (multiple system atrophy versus progressive supranuclear palsy: OR: 3.4, 95% CI: 1.2-9.7, P = 0.023). Multiple system atrophy patients with predominant parkinsonian signs had a higher number of red flag features than patients with Lewy body disease (OR: 8.8, 95% CI: 3.2-24.2, P < 0.01) and progressive supranuclear palsy (OR: 4.8, 95% CI: 1.7-13.6, P < 0.01). The number of red flag features in multiple system atrophy with predominant cerebellar signs was also higher than in Lewy body disease (OR: 7.0, 95% CI: 2.5-19.5, P < 0.01) and progressive supranuclear palsy (OR: 3.1, 95% CI: 1.1-8.9, P = 0.032). Patients with multiple system atrophy had shorter latency to reach use of urinary catheter and longer latency to residential care than progressive supranuclear palsy patients, whereas patients with Lewy body disease took longer to reach multiple milestones than patients with multiple system atrophy. The present study has highlighted features which should improve the ante-mortem diagnostic accuracy of multiple system atrophy.

A linear time–cost tradeoff problem with multiple milestones under a comb graph

We consider a linear time–cost tradeoff problem (LTCTP) with multiple milestones under a comb graph. A time–cost tradeoff problem decides whether and how much to spend a cost to compress processing time of a job in order to meet promised due dates. This is common in managing a project because additional labors or resources are expensive. It is called linear where the compression cost linearly increases with reduced time. An objective of the LTCTP that this study addresses is to minimize the weighted number of tardy milestones plus the total compression cost. This study considers a special precedence structure, which is called a comb graph. A chain of jobs that sequentially precede each other forms a main process of a project, and other chains of jobs, corresponding to sub processes, precede each job in the main process. For this structure, we developed a strongly-polynomial-time algorithm. This is the first result of unveiling complexity of the multi-milestone LTCTP under a non-chain structure.

Accelerating Venture Milestone Achievement: Examining the Impact of Resource Acquisition Timing

This study examines how resource acquisition timing affects a venture's ability to accelerate milestone achievement. We examine acquisition timing decisions for three types of resources: material resources, facilities and equipment resources, and human resources. Two venture milestones are examined: accomplishment of the first sale and achievement of positive cash flows. We theorize that resource acquisition timing can impact the degree of resource availability delays and the rate of resource-driven cash outflows/inflows, which, in turn, determine the time to first sale and the time to positive cash flows, respectively. Our results demonstrate that decisions concerning resource acquisition timing could have contradictory effects vis-à-vis shortening the time to first sale versus shortening the time to positive cash flows. These findings highlight the difficult tradeoffs that ventures have to navigate when making resource acquisition decisions, which have implications for multiple milestones across a venture's lifecycle. Finally, the paper demonstrates how technological novelty moderates, and, in fact, radically alters, the relationship between the timing of resource acquisitions and the time to venture milestone achievement.

A New Networking Technique—The Beeline Diagramming Method

The Critical Path Method (CPM) has gradually increased in importance in the construction industry since the Arrow Diagramming Method (ADM) and the Precedence Diagramming Method (PDM) were introduced in 1956 and 1961, respectively. In an improvement over the ADM, the PDM is able to represent overlapping relationships between consecutive activities. It is limited to representing overlapping relationships only as four combinations that connect the starting and finishing points of two consecutive activities, however; it cannot express the relationships at the exact point of interrelation if that point is in the middle of the activity’s duration. Further, when two consecutive activities have respective multiple milestones that should be connected independently, the PDM cannot represent the multiple overlapping relationships precisely. This research proposes the Beeline Diagramming Method (BDM) as a new networking technique that can represent all kinds of overlapping relationships between activities. The basic concept, principle, interpretation methods, and schedule computation methods of the BDM are defined in this paper.

Task scheduling with progress control

ABSTRACTTasks with long durations often face the requirement of having to periodically report their progress to process controllers. Under this requirement, working teams that simultaneously process multiple tasks need to schedule their work carefully in order to demonstrate satisfactory progress on each unfinished task. We present a single-machine scheduling model that reflects this requirement. Our model has multiple milestones at which the tasks are penalized if their progress is below a satisfactory level. We develop polynomial solution methods for the general case with convex nonlinear penalty functions and for the special case with linear penalty functions. Extensions of our model are also discussed.

Large-Scale Behavior-Change Initiative for Infant and Young Child Feeding Advanced Language and Motor Development in a Cluster-Randomized Program Evaluation in Bangladesh

Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development. We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding. A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts were randomly assigned to receive either the intensive or the nonintensive intervention. Household surveys were conducted at baseline (2010) and at endline (2014) in the same communities (n = ∼4000 children aged 0-47.9 mo for each round). Child development was measured by asking mothers if their child had reached each of multiple milestones, with some observed. Linear regression accounting for clustering was used to derive difference-in-differences (DID) impact estimates, and path analysis was used to examine developmental advancement through indicators of improved IYCF and other factors. The DID in language development between intensive and nonintensive groups was 1.05 milestones (P = 0.001) among children aged 6-23.9 mo and 0.76 milestones (P = 0.038) among children aged 24-47.9 mo. For gross motor development, the DID was 0.85 milestones (P = 0.035) among children aged 6-23.9 mo. The differences observed corresponded to age- and sex-adjusted effect sizes of 0.35 for language and 0.23 for gross motor development. Developmental advancement at 6-23.9 mo was partially explained through improved minimum dietary diversity and the consumption of iron-rich food. Intensive IYCF intervention differentially advanced language and gross motor development, which was partially explained through improved complementary feeding. Measuring a diverse set of child outcomes, including functional outcomes such as child development, is important when evaluating integrated nutrition programs. This trial was registered at clinicaltrials.gov as NCT01678716.