Building language learning: Relations between infant attention and social contingency in the first year of life.

In Western societies, social contingency, or prompt and meaningful back-and-forth exchanges between infant and caregiver, is a powerful feature of the early language environment. Research suggests that infants with better attentional skills engage in more social contingency during interactions with adults and, in turn, social contingency supports infant attention. This reciprocity is theorized to build infant language skills as the adult capitalizes on and extends the infant's attention during socially contingent interactions. Using data from 104 infants and caregivers, this paper tests reciprocal relations between infant attention and social contingency at 6- and 12-months and the implications for infant vocabulary at 18-months. Infant attentional skills to social (women speaking) and nonsocial (objects dropping) events were assessed, and social contingency was examined during an 8-minute toy play interaction with a caregiver. Child receptive and expressive vocabulary was measured by caregiver-report. Both social and nonsocial attentional skills related to engagement in social contingency during caregiver-infant interaction, though only models that included social attention and social contingency predicted vocabulary. These findings provide empirical evidence for the proposed reciprocal relations between infant attention and social contingency as well as how they relate to later language.

Sevelamer-Induced Gastrointestinal Disease in 12 Patients with End-Stage Renal Disease: A Case Series.

INTRODUCTION: Isolated case reports and case series have linked the use of sevelamer to severe gastrointestinal (GI) inflammation and perforation among patients with end-stage renal disease. METHODS: In this study, we identified 12 cases of biopsy-proven sevelamer-induced gastrointestinal disease from a large urban community hospital over the course of 5 years. We described baseline characteristics, sites and types of injury, histological findings, timing and dosing of sevelamer initiation compared with symptom onset, and in a smaller subset, endoscopic resolution post drug cessation. We also reviewed preexisting conditions to identify trends in populations at risk. RESULTS: Several of the patients reviewed had preexisting conditions of decreased motility and/or impaired mucosal integrity. The presentation of disease was broad and included both upper-GI and lower-GI pathologies and in varying severity. DISCUSSION: There is a broad phenotypic range of sevelamer-induced gastrointestinal disease. As this becomes a more frequently recognized pathology, clinicians should be aware of how it may present and which populations may be more susceptible.

Using machine learning to mine mental health diagnostic groups from emergency department presentations before and during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic had a profound negative effect on mental health worldwide. The hospital emergency department plays a pivotal role in responding to mental health crises. Understanding data trends relating to hospital emergency department usage is beneficial for service planning, particularly around preparing for future pandemics. Machine learning has been used to mine large volumes of unstructured data to extract meaningful data in relation to mental health presentations. This study aims to analyse trends in five mental health-related presentations to an emergency department before and during, the COVID-19 pandemic. METHODS: Data from 690,514 presentations to two Australian, public hospital emergency departments between April 2019 to February 2022 were assessed. A machine learning-based framework, Mining Emergency Department Records, Evolutionary Algorithm Data Search (MEDREADS), was used to identify suicidality, psychosis, mania, eating disorder, and substance use. RESULTS: While the mental health-related presentations to the emergency department increased during the COVID-19 pandemic compared to pre-pandemic levels, the proportion of mental health presentations relative to the total emergency department presentations decreased. Several troughs in presentation frequency were identified across the pandemic period, which occurred consistently during the public health lockdown and restriction periods. CONCLUSION: This study implemented novel machine learning techniques to analyse mental health presentations to an emergency department during the COVID-19 pandemic. Results inform understanding of the use of emergency mental health services during the pandemic, and highlight opportunities to further investigate patterns in presentation.

Emergency presentations for older persons with low back pain: An increasing clinical and economic challenge.

OBJECTIVE: To determine whether differences exist for older persons presenting to Emergency Departments (EDs) with lower back pain (LBP) in terms of management, health service resource use and cost when compared to younger patients with LBP. METHODS: Retrospective analysis of routinely collected electronic medical record data from January 2015 to July 2021. Data from 11,098 adults presenting with LBP to two large regional Australian EDs were analysed over a 5-year period. Rates of presentation, investigation, medication use, spinal surgery and cost were assessed for all participants with respect to age groups (over or under 65 years of age), diagnosis and time. Multivariable logistic regression analysis was employed to assess the contribution of presentation characteristics to the risk of inpatient admission and to investigate the variable effect of patient age. RESULTS: Older people represented 23% (n = 2565) of all LBP presentations, with a growing proportion of presentations over time. More than 1 in 4 patients over 65 were admitted (n = 703, 27%), with CT imaging being proportionately three times more prevalent (24% vs. 6%), and average cost double (AU$3973 vs. $1671) that of the younger population. Consultation by an ED physiotherapist was associated with lower admission risk across all adult presentations (OR 0.52, 95% CI [0.40 to 0.67]). CONCLUSIONS: Older persons are over-represented amongst gradually increasing rates of LBP presentations to EDs and associated with escalating cost of care and hospital resource use. Older patients present a different clinical and economic profile to younger patients, supporting the provision of individualised management recommendations.

The effects of socioeconomic status on working memory in childhood are partially mediated by intersensory processing of audiovisual events in infancy.

Socioeconomic status (SES) is a well-established predictor of individual differences in childhood language and cognitive functioning, including executive functions such as working memory. In infancy, intersensory processing-selectively attending to properties of events that are redundantly specified across the senses at the expense of non-redundant, irrelevant properties-also predicts language development. Our recent research demonstrates that individual differences in intersensory processing in infancy predict a variety of language outcomes in childhood, even after controlling for SES. However, relations among intersensory processing and cognitive outcomes such as working memory have not yet been investigated. Thus, the present study examines relations between intersensory processing in infancy and working memory in early childhood, and the role of SES in this relation. Children (N = 101) received the Multisensory Attention Assessment Protocol at 12-months to assess intersensory processing (face-voice and object-sound matching) and received the WPPSI at 36-months to assess working memory. SES was indexed by maternal education, paternal education, and income. A variety of novel findings emerged. 1) Individual differences in intersensory processing at 12-months predicted working memory at 36-months of age even after controlling for SES. 2) Individual differences in SES predicted intersensory processing at 12-months of age. 3) The well-established relation between SES and working memory was partially mediated by intersensory processing. Children from families of higher-SES have better intersensory processing skills at 12-months and this combination of factors predicts greater working memory two years later at 36-months. Together these findings reveal the role of intersensory processing in cognitive functioning.

Qualitative perception of 3D shape from patterns of luminance curvature.

A new source of information is proposed for the perception of three-dimensional (3D) shape from shading that identifies surface concavities from the curvature of the luminance field. Two experiments measured the abilities of human observers to identify concavities on smoothly curved shaded surfaces depicted with several different patterns of illumination and several different material properties. Observers were required to identify any apparent concavities along designated cross sections of the depicted objects and to mark each concavity with an adjustable dot. To analyze the results, we computed both the surface curvature and the luminance curvature along each image cross section. The results revealed that most responses were in concave regions of the luminance profiles, although they were often shifted in phase relative to the curvature of the depicted surfaces. This pattern of performance was surprisingly robust over large changes in the pattern of illumination or surface material properties. Our analysis predicts that observers should make false alarm responses in regions where a luminance concavity does not correspond to a surface concavity, and our empirical results confirm that prediction.

Effects of English versus Spanish language exposure on basic multisensory attention skills across 3 to 36 months of age.

Recent research has demonstrated that individual differences in infant attention to faces and voices of women speaking predict language outcomes in childhood. These findings have been generated using two new audiovisual attention assessments appropriate for infants and young children, the Multisensory Attention Assessment Protocol (MAAP) and the Intersensory Processing Efficiency Protocol (IPEP). The MAAP and IPEP assess three basic attention skills (sustaining attention, shifting/disengaging, intersensory matching), as well as distractibility, deployed in the context of naturalistic audiovisual social (women speaking English) and nonsocial events (objects impacting a surface). Might children with differential exposure to Spanish versus English show different patterns of attention to social events on these protocols as a function of language familiarity? We addressed this question in several ways using children (n = 81 dual-language learners; n = 23 monolingual-language learners) from South Florida, tested longitudinally across 3-36 months. Surprisingly, results indicated no significant English language advantage on any attention measure for children from monolingual English versus dual English-Spanish language environments. Second, for dual-language learners, exposure to English changed across age, decreasing slightly from 3-12 months and then increasing considerably by 36 months. Furthermore, for dual-language learners, structural equation modeling analyses revealed no English language advantage on the MAAP or IPEP as a function of degree of English language exposure. The few relations found were in the direction of greater performance for children with greater Spanish exposure. Together, findings indicate no English language advantage for basic multisensory attention skills assessed by the MAAP or IPEP between the ages of 3 to 36 months. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Infant distractibility from social events mediates the relation between maternal responsiveness and infant language outcomes.

Research demonstrates that contingent and appropriate maternal responsiveness to infant requests and bids for attention leads to better language outcomes. Research also indicates that infants who are less distracted by irrelevant competing stimulation and attend efficiently to audiovisual social events (e.g., faces and voices) show better language outcomes. However, few studies have assessed relations between maternal responsiveness, infant attention to faces and voices, and distractibility, and how together these factors lead to early language outcomes. A newly developed audiovisual protocol, the Multisensory Attention Assessment Protocol (MAAP; Bahrick et al., 2018), allows researchers to examine individual differences in attention to faces and voices and distractibility, and to assess relations with other variables. At 12 months, infants (n = 79) in an ongoing longitudinal study participated in the MAAP to assess intersensory matching of synchronous faces and voices and attention to an irrelevant competing visual distractor event. They also were observed in a brief play interaction to assess infant bids for attention and maternal responsiveness (accept, redirect, or ignore). At 18 months, receptive and expressive language were assessed using the Mullen Scales of Early Learning. Several noteworthy findings emerged: 1) mothers were generally responsive, accepting 74% and redirecting 14% of infant bids, 2) infants who had a greater number of their bids redirected by mothers, and who had better intersensory matching of synchronous faces and voices, showed less attention to the distractor, and 3) infants who showed less attention to the distractor had better receptive language. Findings demonstrate that maternal redirecting of infant attention by mothers who are generally responsive may promote better infant attentional control (lower distractibility) which in turn predicts better receptive language in toddlers.

Intersensory processing of faces and voices at 6 months predicts language outcomes at 18, 24, and 36 months of age.

Intersensory processing of social events (e.g., matching sights and sounds of audiovisual speech) is a critical foundation for language development. Two recently developed protocols, the Multisensory Attention Assessment Protocol (MAAP) and the Intersensory Processing Efficiency Protocol (IPEP), assess individual differences in intersensory processing at a sufficiently fine-grained level for predicting developmental outcomes. Recent research using the MAAP demonstrates 12-month intersensory processing of face-voice synchrony predicts language outcomes at 18- and 24-months, holding traditional predictors (parent language input, SES) constant. Here, we build on these findings testing younger infants using the IPEP, a more comprehensive, fine-grained index of intersensory processing. Using a longitudinal sample of 103 infants, we tested whether intersensory processing (speed, accuracy) of faces and voices at 3- and 6-months predicts language outcomes at 12-, 18-, 24-, and 36-months, holding traditional predictors constant. Results demonstrate intersensory processing of faces and voices at 6-months (but not 3-months) accounted for significant unique variance in language outcomes at 18-, 24-, and 36-months, beyond that of traditional predictors. Findings highlight the importance of intersensory processing of face-voice synchrony as a foundation for language development as early as 6-months and reveal that individual differences assessed by the IPEP predict language outcomes even 2.5-years later.

Individual Differences in Multisensory Attention Skills in Children with Autism Spectrum Disorder Predict Language and Symptom Severity: Evidence from the Multisensory Attention Assessment Protocol (MAAP).

Children with autism spectrum disorders (ASD) show atypical attention, particularly for social events. The new Multisensory Attention Assessment Protocol (MAAP) assesses fine-grained individual differences in attention disengagement, maintenance, and audiovisual matching for social and nonsocial events. We investigated the role of competing stimulation on attention, and relations with language and symptomatology in children with ASD and typical controls. Findings revealed: (1) the MAAP differentiated children with ASD from controls, (2) greater attention to social events predicted better language for both groups and lower symptom severity in children with ASD, (3) different pathways from attention to language were evident in children with ASD versus controls. The MAAP provides an ideal attention assessment for revealing diagnostic group differences and relations with outcomes.

Improving communication at NHS Nightingale Hospital North West: Medical updates to next of kin.

BACKGROUND: The Nightingale North West (NNW) was a UK temporary field hospital set up during the COVID-19 pandemic. Policies and standard operating procedures were undeveloped. Visitors were permitted only in exceptional circumstances, resulting in heightened anxiety for patients and next of kin (NOK). OBJECTIVE: Recognising the importance of effective NOK communication, a quality improvement project (QIP) was undertaken to improve communication between doctors and NOK. METHOD: NOK satisfaction with communication received from doctors (scored 1-5) was the primary outcome measure and data was collected through standardised phone-calls.A wide four point (1-5) variability in satisfaction was identified.PDSA methodology was used to introduce interventions: (1) 'Gold standard' for frequency of NOK updates; (2) Record date of NOK update on the doctors' list. RESULTS: Early post-intervention data showed reduced variability in satisfaction with 82% of NOK scoring '4' or '5'. Process measures demonstrated excellent uptake of interventions. CONCLUSION: Conclusions are limited by the project's short time-frame but there is a promising role for these interventions in enhancing doctor-NOK communication.

Intersensory matching of faces and voices in infancy predicts language outcomes in young children.

Parent language input is a well-established predictor of child language development. Multisensory attention skills (MASks; intersensory matching, shifting and sustaining attention to audiovisual speech) are also known to be foundations for language development. However, due to a lack of appropriate measures, individual differences in these skills have received little research focus. A newly established measure, the Multisensory Attention Assessment Protocol (MAAP), allows researchers to examine predictive relations between early MASks and later outcomes. We hypothesized that, along with parent language input, multisensory attention to social events (faces and voices) in infancy would predict later language outcomes. We collected data from 97 children (predominantly White and Hispanic, 48 males) participating in an ongoing longitudinal study assessing 12-, 18-, and 24-month MASks (MAAP) and parent language input (quality, quantity), and 18- and 24-month language outcomes (child speech production, vocabulary size). Results revealed 12-month intersensory matching (but not maintaining or shifting attention) of faces and voices in the presence of a distractor was a strong predictor of language. It predicted a variety of 18- and 24-month child language outcomes (expressive vocabulary, child speech production), even when holding traditional predictors constant: parent language input and SES (maternal education: 52% bachelor's degree or higher). Further, at each age, parent language input predicted just one outcome, expressive vocabulary, and SES predicted child speech production. These novel findings reveal infant intersensory matching of faces and voices in the presence of a distractor can predict which children might benefit most from parent language input and show better language outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Are mirror-symmetric objects of special importance for 3D shape perception? A reply to Sawada and Pizlo (2022).

Yu, Todd, and Petrov (2021) and Yu, Petrov, and Todd (2021) investigated failures of shape constancy that occur when objects are viewed stereoscopically at different distances. Although this result has been reported previously with simple objects such as pyramids or cylinders, we examined more complex objects with bilateral symmetry to test the claim by Li, Sawada, Shi, Kwon, and Pizlo (2011) that the perception of those objects is veridical. Sawada and Pizlo (2022) offer several criticisms of our experiments, but they seem to suggest that the concept of shape is defined by what is computable by their model. If stimuli are used that cannot be discriminated by their model, they are dismissed as degenerate, and tasks that cannot be performed by their model are assumed to be based on something other than shape. This allows them to disregard empirical evidence that is inconsistent with their model. We argue, in contrast, that all reliable aspects of shape perception are deserving of explanation. We also argue that there are many different attributes of shape and many different sources of information about shape that may be relevant in different contexts. It is unlikely that all of them can be explained by a single model.

The many facets of shape.

Shape is an interesting property of objects because it is used in ordinary discourse in ways that seem to have little connection to how it is typically defined in mathematics. The present article describes how the concept of shape can be grounded within Euclidean and non-Euclidean geometry and also to human perception. It considers the formal methods that have been proposed for measuring the differences among shapes and how the performance of those methods compares with shape difference thresholds of human observers. It discusses how different types of shape change can be perceptually categorized. It also evaluates the specific data structures that have been used to represent shape in models of both human and machine vision, and it reviews the psychophysical evidence about the extent to which those models are consistent with human perception. Based on this review of the literature, we argue that shape is not one thing but rather a collection of many object attributes, some of which are more perceptually salient than others. Because the relative importance of these attributes can be context dependent, there is no obvious single definition of shape that is universally applicable in all situations.

Office "Phone First" Systems Reduce Emergency Department/Urgent Care Utilization by Medicaid-Enrolled Children.

BACKGROUND: Emergency department and urgent care (ED/UC) visits for common conditions can be more expensive with less continuity than office care provided by primary care physicians. METHODS: We used quality-improvement methods to enhance telephone triage for pediatric patients by adding additional "Phone First" services including: 1) enhanced office-hours telephone triage and advice with available same-day appointments, 2) follow-up calls to parents of children self-referred to an ED/UC, and 3) parent education to telephone the office for advice prior to seeking acute care. We hypothesized that enhanced office services would reduce ED/UC utilization and cost. We compared changes in ED/UC encounter rates between intervention and regional practices for 4 years (2014-2017) using general linear models, and evaluated balancing measures (after-hour phone calls, acute care phone calls, acute care visits, well child visits) for Medicaid-enrolled and commercially-insured children. RESULTS: The study practices dramatically increased office-hours acute care phone triage and advice which correlated with 23.8% to 80.5% (P < 0.001) reductions in ED/UC rates for Medicaid-enrolled children. Office acute care visits decreased modestly. ED/UC visits did not decrease for children in the comparison region. In phone surveys, 94% of parents indicated satisfaction with the ED/UC follow-up call. The decrease in ED/UC visits resulted in an estimated annual cost of care savings for Medicaid-enrolled children in 2017 of $12.61 per member per month which projected to $169 million cost of care savings in Colorado and $6.8 billion in the United States. CONCLUSION: "Phone First" services in pediatric practices during office-hours reduced ED/UC encounters and cost of care for Medicaid-enrolled children.

Bilateral Symmetry Has No Effect on Stereoscopic Shape Judgments.

A single experiment is reported that measured the apparent stereoscopic shapes of symmetric and asymmetric objects at different viewing distances. The symmetric stimuli were specifically designed to satisfy the minimal conditions for computing veridical shape from symmetry. That is to say, they depicted complex, bilaterally symmetric, plane-faced polyhedra whose symmetry planes were oriented at an angle of 45° relative to the line of sight. The asymmetric stimuli were distorted versions of the symmetric ones in which the 3D position of each vertex was randomly displaced. Prior theoretical analyses have shown that it is mathematically possible to compute the 3D shapes of symmetric stimuli under these conditions, but those algorithms are useless for asymmetric objects. The results revealed that the apparent shapes of both types of objects were expanded or compressed in depth as a function of viewing distance, in exactly the same way as has been reported in many other studies, and that the presence or absence of symmetry had no detectable effect on performance.

Experimental evaluation of genomic selection prediction for rust resistance in sugarcane.

The total sugarcane (Saccharum L.) production has increased worldwide; however, the rate of growth is lower compared with other major crops, mainly due to a plateauing of genetic gain. Genomic selection (GS) has proven to substantially increase the rate of genetic gain in many crops. To investigate the utility of GS in future sugarcane breeding, a field trial was conducted using 432 sugarcane clones using an augmented design with two replications. Two major diseases in sugarcane, brown and orange rust (BR and OR), were screened artificially using whorl inoculation method in the field over two crop cycles. The genotypic data were generated through target enrichment sequencing technologies. After filtering, a set of 8,825 single nucleotide polymorphic markers were used to assess the prediction accuracy of multiple GS models. Using fivefold cross-validation, we observed GS prediction accuracies for BR and OR that ranged from 0.28 to 0.43 and 0.13 to 0.29, respectively, across two crop cycles and combined cycles. The prediction ability further improved by including a known major gene for resistance to BR as a fixed effect in the GS model. It also substantially reduced the minimum number of markers and training population size required for GS. The nonparametric GS models outperformed the parametric GS suggesting that nonadditive genetic effects could contribute genomic sources underlying BR and OR. This study demonstrated that GS could potentially predict the genomic estimated breeding value for selecting the desired germplasm for sugarcane breeding for disease resistance.

Failures of stereoscopic shape constancy over changes of viewing distance and size for bilaterally symmetric polyhedra.

Two shape matching experiments examined the effects of viewing distance and object size on observers' judgments of 3D metric shape under binocular viewing. Unlike previous studies on this topic, the stimuli were specifically designed to satisfy the minimal conditions for computing veridical shape from symmetry. Concretely, the stimuli were complex, mirror-symmetric polyhedra whose symmetry planes were oriented at an angle of 45o relative to the line of sight in a shape-matching task. Although it is mathematically possible to accurately compute the 3D shapes of these stimuli using relatively simple algorithms, the results indicated that human observers are unable to do so. Indeed, the apparent shapes of the objects were systematically expanded or compressed in depth as a function of viewing distance, in exactly the same way as has been reported for simpler stimuli that do not satisfy the minimal conditions for an accurate computational analysis. For objects presented at near distances, we also obtained statistically significant effects of object size on observers' shape judgments.

Barriers and Facilitators to Effective Implementation of the NAMWEZA Intervention in Dar es Salaam, Tanzania.

The NAMWEZA intervention was implemented, using a ten-session group format, to build skills targeting psychosocial vulnerabilities and enhancing HIV prevention among people living with HIV (PLH) and their social networks. The overall goal of this intervention is to improve psychological wellbeing and reduce HIV risk behaviours. These analyses aim to describe the barriers and facilitators of implementing the NAMWEZA intervention from the perspective of participants and trained peer group facilitators. Twenty-four in-depth interviews were conducted with NAMWEZA participants, and 50 pooled peer facilitator self-assessment reports were obtained from 16 trained peers. Participants identified personal and structural barriers, including fear of inadvertent HIV status disclosure, time constraints, level of participant reimbursements, and limited space available for group sessions. Factors facilitating effective implementation included perceived benefits of the program, such as reduction in HIV-related risk behaviours, increased self-esteem, and improvement in confidence in HIV prevention communications. Scaling up the NAMWEZA intervention to other areas of Tanzania or regionally should take into account these facilitators and barriers to implementation.