Processing causal structure sentences in Mandarin Chinese: an eye movements study.

It remains uncertain whether causal structure prediction can improve comprehension in Chinese sentences and whether the position of the headword mediates the prediction effect. We conducted an experiment to explore the effect of causal prediction and headword position in Chinese sentence reading. Participants were asked to read sentences containing causal connectives with their eye movements recorded. In the experiment, we manipulated the causal structure of the sentence and the position of the headword. We found a promoting effect of causal structure on first-pass reading time and a hindering impact on total reading time. However, the effect was not mediated by the headword position. The results show that causal syntactic prediction facilitated early-stage processing and increased the integration cost in the late stage of Chinese sentence processing. These findings also support the constraint-based approach, which suggests an isolation between semantic and syntactic processing.

Even laypeople use legalese.

Whereas principles of communicative efficiency and legal doctrine dictate that laws be comprehensible to the common world, empirical evidence suggests legal documents are largely incomprehensible to lawyers and laypeople alike. Here, a corpus analysis (n = 59) million words) first replicated and extended prior work revealing laws to contain strikingly higher rates of complex syntactic structures relative to six baseline genres of English. Next, two preregistered text generation experiments (n = 286) tested two leading hypotheses regarding how these complex structures enter into legal documents in the first place. In line with the magic spell hypothesis, we found people tasked with writing official laws wrote in a more convoluted manner than when tasked with writing unofficial legal texts of equivalent conceptual complexity. Contrary to the copy-and-edit hypothesis, we did not find evidence that people editing a legal document wrote in a more convoluted manner than when writing the same document from scratch. From a cognitive perspective, these results suggest law to be a rare exception to the general tendency in human language toward communicative efficiency. In particular, these findings indicate law's complexity to be derived from its performativity, whereby low-frequency structures may be inserted to signal law's authoritative, world-state-altering nature, at the cost of increased processing demands on readers. From a law and policy perspective, these results suggest that the tension between the ubiquity and impenetrability of the law is not an inherent one, and that laws can be simplified without a loss or distortion of communicative content.

Processing of Counterfactual Conditional Sentences with Differential Propositional Truth-Value in Mandarin Chinese: Evidence from ERP.

Although many studies document the role of propositional truth-value in human psychological reading behavior, there is a relative paucity of research examining the role of differential propositional truth-value in processing Chinese counterfactual conditionals. This study is to investigate the role of differential propositional value in processing Chinese counterfactual conditionals by means of ERPs (event-related potentials). The study is based on comprehending two types of Chinese counterfactual conditionals, which is propositional truth value introduced by two different markers of conditional conjunctions in the protasis and apodosis, such as true counterfactual conditional markers jiaru (if) & jiu (so) in the sentence wo xiang yu jiaru you tui jiu keyi zai shuixia zhixi (I think if fish had legs so they could stifle under water), and false counterfactual conditional markers ruguo (if) & namo (then) in the sentence wo xiang gou ruguo you lin namo keyi zai shuixia huxi (I think if dogs had scales, then they could breathe under water). Two counterfactual propositional values (i.e. true and false propositional values) are constructed through manipulating sentence counterfactuality between the true and false counterfactual conditional markers in the protasis and the apodosis. Twenty-four full-time Chinese college students participated in the ERP study. The results demonstrated that processing the true counterfactual propositional sentences with conditional markers jiaru (if) & jiu (so) elicited the N400 effect relative to false propositional sentences with conditional markers ruguo (if) & namo (then). Moreover, the counterfactual sentences with true propositional conditions varied from the elicitation of the N400 effect in the protasis and absence of the N400 effect in the apodosis, showing that semantic roles may gradually disappear under the impact of truth value of propositional counterfactual condition, and/or the roles of semantic anomaly was eliminated in the accumulated sentence processing. While for the false counterfactual conditional sentences, elicitations of P300 in the protasis and robust N400 effect in the apodosis were shown, indicating the increasing semantic role in the processing. Interestingly, there was the absence of the P600 effect for processing sentences with syntactic violation, suggesting little extra syntactic cost in processing sentences with false propositional condition.

Acoustic scene complexity affects motion behavior during speech perception in audio-visual multi-talker virtual environments.

In real-world listening situations, individuals typically utilize head and eye movements to receive and enhance sensory information while exploring acoustic scenes. However, the specific patterns of such movements have not yet been fully characterized. Here, we studied how movement behavior is influenced by scene complexity, varied in terms of reverberation and the number of concurrent talkers. Thirteen normal-hearing participants engaged in a speech comprehension and localization task, requiring them to indicate the spatial location of a spoken story in the presence of other stories in virtual audio-visual scenes. We observed delayed initial head movements when more simultaneous talkers were present in the scene. Both reverberation and a higher number of talkers extended the search period, increased the number of fixated source locations, and resulted in more gaze jumps. The period preceding the participants' responses was prolonged when more concurrent talkers were present, and listeners continued to move their eyes in the proximity of the target talker. In scenes with more reverberation, the final head position when making the decision was farther away from the target. These findings demonstrate that the complexity of the acoustic scene influences listener behavior during speech comprehension and localization in audio-visual scenes.

Towards an understanding of the ethics of electronic consent in clinical trials.

There are good practical reasons to use electronic consent (e-consent) in randomised trials, especially when conducting large-scale clinical trials to answer population-level health research questions. However, determining ethical reasons for e-consent is not so clear and depends on a proper understanding of what e-consent means when used in clinical trials and its ethical significance. Here we focus on four features of ethical significance which give rise to a range of ethical considerations relating to e-consent and merit further focused ethics research.

Brain and grammar: revealing electrophysiological basic structures with competing statistical models.

Acoustic, lexical, and syntactic information are simultaneously processed in the brain requiring complex strategies to distinguish their electrophysiological activity. Capitalizing on previous works that factor out acoustic information, we could concentrate on the lexical and syntactic contribution to language processing by testing competing statistical models. We exploited electroencephalographic recordings and compared different surprisal models selectively involving lexical information, part of speech, or syntactic structures in various combinations. Electroencephalographic responses were recorded in 32 participants during listening to affirmative active declarative sentences. We compared the activation corresponding to basic syntactic structures, such as noun phrases vs. verb phrases. Lexical and syntactic processing activates different frequency bands, partially different time windows, and different networks. Moreover, surprisal models based on part of speech inventory only do not explain well the electrophysiological data, while those including syntactic information do. By disentangling acoustic, lexical, and syntactic information, we demonstrated differential brain sensitivity to syntactic information. These results confirm and extend previous measures obtained with intracranial recordings, supporting our hypothesis that syntactic structures are crucial in neural language processing. This study provides a detailed understanding of how the brain processes syntactic information, highlighting the importance of syntactic surprisal in shaping neural responses during language comprehension.

Enhancing Patient Understanding of Laboratory Test Results: Systematic Review of Presentation Formats and Their Impact on Perception, Decision, Action, and Memory.

BACKGROUND: Direct access of patients to their web-based patient portal, including laboratory test results, has become increasingly common. Numeric laboratory results can be challenging to interpret for patients, which may lead to anxiety, confusion, and unnecessary doctor consultations. Laboratory results can be presented in different formats, but there is limited evidence regarding how these presentation formats impact patients' processing of the information. OBJECTIVE: This study aims to synthesize the evidence on effective formats for presenting numeric laboratory test results with a focus on outcomes related to patients' information processing, including affective perception, perceived magnitude, cognitive perception, perception of communication, decision, action, and memory. METHODS: The search was conducted in 3 databases (PubMed, Web of Science, and Embase) from inception until May 31, 2023. We included quantitative, qualitative, and mixed methods articles describing or comparing formats for presenting diagnostic laboratory test results to patients. Two reviewers independently extracted and synthesized the characteristics of the articles and presentation formats used. The quality of the included articles was assessed by 2 independent reviewers using the Mixed Methods Appraisal Tool. RESULTS: A total of 18 studies were included, which were heterogeneous in terms of study design and primary outcomes used. The quality of the articles ranged from poor to excellent. Most studies (n=16, 89%) used mock test results. The most frequently used presentation formats were numerical values with reference ranges (n=12), horizontal line bars with colored blocks (n=12), or a combination of horizontal line bars with numerical values (n=8). All studies examined perception as an outcome, while action and memory were studied in 1 and 3 articles, respectively. In general, participants' satisfaction and usability were the highest when test results were presented using horizontal line bars with colored blocks. Adding reference ranges or personalized information (eg, goal ranges) further increased participants' perception. Additionally, horizontal line bars significantly decreased participants' tendency to search for information or to contact their physician, compared with numerical values with reference ranges. CONCLUSIONS: In this review, we synthesized available evidence on effective presentation formats for laboratory test results. The use of horizontal line bars with reference ranges or personalized goal ranges increased participants' cognitive perception and perception of communication while decreasing participants' tendency to contact their physicians. Action and memory were less frequently studied, so no conclusion could be drawn about a single preferred format regarding these outcomes. Therefore, the use of horizontal line bars with reference ranges or personalized goal ranges is recommended to enhance patients' information processing of laboratory test results. Further research should focus on real-life settings and diverse presentation formats in combination with outcomes related to patients' information processing.

Increasing inter-word spacing reduces migration errors and improves reading comprehension in students with dyslexia.

We report a small study in which we explored the effects of manipulating narrative text on levels of comprehension for students with and without dyslexia. Using two pieces of standardised narrative text deemed to be of similar difficulty and length, we manipulated the texts such that we could present two texts to each participant, one in each condition. The first condition was text using standard inter-word spacing; the second condition used increased inter-word spacing. Scores on standardised comprehension questions were significantly improved for participants with dyslexia. Additionally, given that there is evidence of delayed visual attention disengagement in individuals with specific forms of dyslexia, we hypothesised that the phenomena of migration of letters and words for some readers might be mitigated by increasing inter-word spacing. We did indeed find that incidence of migration was significantly reduced in this condition for all participants.

Patient education in the digital age: An analysis of quality and readability of online information on rhinoplasty.

This study aimed to investigate quality and readability of online rhinoplasty information provided on Turkish websites. We searched for the terms "rhinoplasty" (rinoplasti) and "nose job" (burun estetigi) in Turkish using the Google search engine in May 2023. The first 30 sites for each term were included in the evaluation. We used the DISCERN tool to evaluate quality and the Atesman and Cetinkaya-Uzun formulas to assess readability. According to the Atesman formula, the readability scores of all the websites were moderately difficult. According to the Cetinkaya-Uzun formula, the readability scores of websites were at the instructional reading level. The mean total DISCERN score was 2.33 ±â€…0.60, indicating poor quality. No statistically significant correlations were found between the Atesman or Cetinkaya-Uzun readability scores and the DISCERN scores across all websites (P > .05). Our analysis revealed key areas in which Turkish websites can improve the quality and readability of rhinoplasty information to support decision-making.

The role of general cognitive skills in integrating visual and linguistic information during sentence comprehension: individual differences across the lifespan.

Individuals exhibit massive variability in general cognitive skills that affect language processing. This variability is partly developmental. Here, we recruited a large sample of participants (N = 487), ranging from 9 to 90 years of age, and examined the involvement of nonverbal processing speed (assessed using visual and auditory reaction time tasks) and working memory (assessed using forward and backward Digit Span tasks) in a visual world task. Participants saw two objects on the screen and heard a sentence that referred to one of them. In half of the sentences, the target object could be predicted based on verb-selectional restrictions. We observed evidence for anticipatory processing on predictable compared to non-predictable trials. Visual and auditory processing speed had main effects on sentence comprehension and facilitated predictive processing, as evidenced by an interaction. We observed only weak evidence for the involvement of working memory in predictive sentence comprehension. Age had a nonlinear main effect (younger adults responded faster than children and older adults), but it did not differentially modulate predictive and non-predictive processing, nor did it modulate the involvement of processing speed and working memory. Our results contribute to delineating the cognitive skills that are involved in language-vision interactions.

Cortical cognitive processing during reading captured using functional-near infrared spectroscopy.

Neuroimaging studies using functional magnetic resonance imaging (fMRI) have provided unparalleled insights into the fundamental neural mechanisms underlying human cognitive processing, such as high-level linguistic processes during reading. Here, we build upon this prior work to capture sentence reading comprehension outside the MRI scanner using functional near infra-red spectroscopy (fNIRS) in a large sample of participants (n = 82). We observed increased task-related hemodynamic responses in prefrontal and temporal cortical regions during sentence-level reading relative to the control condition (a list of non-words), replicating prior fMRI work on cortical recruitment associated with high-level linguistic processing during reading comprehension. These results lay the groundwork towards developing adaptive systems to support novice readers and language learners by targeting the underlying cognitive processes. This work also contributes to bridging the gap between laboratory findings and more real-world applications in the realm of cognitive neuroscience.

CLARA-MeD Tool - A System to Help Patients Understand Clinical Trial Announcements and Consent Forms in Spanish.

We present an NLP web-based tool to help users understand consent forms (CFs) and clinical trial announcements (CTAs) in Spanish. For complex word identification, we collected: 1) a lexicon of technical terms and simplified synonyms (14 465 entries); and 2) a glossary (70 547 terms) with explanations from sources such as UMLS, the NCI dictionary, Orphadata or the FDA. For development, we extracted entities from 60 CTAs, 60 CFs and 60 patient information documents (PIDs). To prepare definitions for new terms, we used ChatGPT and experts validated them (28.99% needed to be fixed). We tested the system on 15 new CTAs, 15 CFs, and 15 PIDs, and we achieved an average F1 score of 82.91% (strict match) and of 94.65% (relaxed). The tool is available at: http://claramed.csic.es/demo.

Demystifying XAI: Requirements for Understandable XAI Explanations.

This paper establishes requirements for assessing the usability of Explainable Artificial Intelligence (XAI) methods, focusing on non-AI experts like healthcare professionals. Through a synthesis of literature and empirical findings, it emphasizes achieving optimal cognitive load, task performance, and task time in XAI explanations. Key components include tailoring explanations to user expertise, integrating domain knowledge, and using non-propositional representations for comprehension. The paper highlights the critical role of relevance, accuracy, and truthfulness in fostering user trust. Practical guidelines are provided for designing transparent and user-friendly XAI explanations, especially in high-stakes contexts like healthcare. Overall, the paper's primary contribution lies in delineating clear requirements for effective XAI explanations, facilitating human-AI collaboration across diverse domains.

A Comparison of Websites Offering Laboratory Test Information Targeted to Citizens.

Laboratory (lab) tests can assist diagnosis, treatment, and monitoring illness and health. Lab results are one of the most commonly accessible types of personal health information, yet they can be difficult for consumers (e.g., patients, laypeople, citizens) to understand. Consequently, many consumers turn to digital educational resources (e.g., websites, mobile applications) to make sense of their tests and results. In this study, we compared the understandability and readability of four different consumer targeted webpages with information about a commonly ordered blood test called the Complete Blood Count (CBC). The webpages varied in terms of understandability, and only one met the threshold. None of the web pages provided any information about how to respond to lab results. Although all four webpages were quite readable, some were much longer than others. The length of webpages may impact users' attention, ability to locate information, and determine what is most important. Future work is warranted to better understand users' information needs and the usability and user experience of these types of websites.

Reading books: The positive impact of print exposure on written word recognition.

Regular print exposure is thought to benefit reading and language processes: those who read more have a larger vocabulary and better spelling and comprehension skills. Yet, there is little or no direct evidence that exposure to print facilitates reading. Here, we used an ecologically valid design to test the impact of print exposure on the early stages of reading in skilled adult readers. Participants read a novel at their own pace. Reading was followed by a lexical decision task, in which the positive trials were words that were exposed in the novel, and matched controls not exposed in the novel. If exposure during reading had a positive impact on subsequent word recognition, exposed words would be processed more efficiently than not-exposed words (exposure effect). This effect was obtained in three experiments. In addition, the effect was not modulated by the amount of exposure (1 vs. 3 occurrences in the text; Experiment 1), or the timing between reading and the exposure test (immediately after reading vs. on the following day; Experiment 3). However, the effect was present only in low-frequency words (Experiment 3). Interpretations of the exposure effect in terms of activation threshold and lexical quality are discussed.

When social hierarchy matters grammatically: Investigation of the processing of honorifics in Korean.

Korean grammar encodes relative social hierarchies among interlocutors in various ways. This study utilized honorific subject-verb agreement in Korean to investigate how social hierarchies are processed during sentence comprehension. The experimental results showed that honorific violations elicited processing difficulties. The use of an honorific verb with an unhonorifiable subject resulted in lower naturalness ratings, longer reading times, and elicited a P600, similar to effects observed with number, person, and gender agreement in Spanish or English. These findings suggest that social hierarchies have become integrated into grammar, constraining how native Korean speakers process sentences. However, the agreement between honorific subjects and verbs seems asymmetrical; the mismatch effect was smaller or absent when an honorifiable subject was not accompanied by an honorific verb, suggesting that while an honorific verb requires an honorifiable subject, the reverse is not necessarily true. The results indicate that the -si agreement in Korean is a form of morpho-syntactic agreement, despite its asymmetrical nature.

Assessment of readability, reliability, and quality of ChatGPT®, BARD®, Gemini®, Copilot®, Perplexity® responses on palliative care.

There is no study that comprehensively evaluates data on the readability and quality of "palliative care" information provided by artificial intelligence (AI) chatbots ChatGPT®, Bard®, Gemini®, Copilot®, Perplexity®. Our study is an observational and cross-sectional original research study. In our study, AI chatbots ChatGPT®, Bard®, Gemini®, Copilot®, and Perplexity® were asked to present the answers of the 100 questions most frequently asked by patients about palliative care. Responses from each 5 AI chatbots were analyzed separately. This study did not involve any human participants. Study results revealed significant differences between the readability assessments of responses from all 5 AI chatbots (P < .05). According to the results of our study, when different readability indexes were evaluated holistically, the readability of AI chatbot responses was evaluated as Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini®, from easy to difficult (P < .05). In our study, the median readability indexes of each of the 5 AI chatbots Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini® responses were compared to the "recommended" 6th grade reading level. According to the results of our study answers of all 5 AI chatbots were compared with the 6th grade reading level, statistically significant differences were observed in the all formulas (P < .001). The answers of all 5 artificial intelligence robots were determined to be at an educational level well above the 6th grade level. The modified DISCERN and Journal of American Medical Association scores was found to be the highest in Perplexity® (P < .001). Gemini® responses were found to have the highest Global Quality Scale score (P < .001). It is emphasized that patient education materials should have a readability level of 6th grade level. Of the 5 AI chatbots whose answers about palliative care were evaluated, Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini®, their current answers were found to be well above the recommended levels in terms of readability of text content. Text content quality assessment scores are also low. Both the quality and readability of texts should be brought to appropriate recommended limits.

Neural semantic effects of tone accents.

This study investigated whether the brain utilizes morphologically induced tones for semantic processing during online speech perception. An auditory comprehension task was conducted while measuring event-related potentials (ERPs). The study tested whether a discrepancy between contextual expectations and the tonal realizations of the target word would yield an N400 effect, indicative of semantic processing difficulty. An N400 effect was observed, reflecting integration difficulty due to semantic anomalies caused by incongruent tones. Additionally, the ERPs in the congruent conditions were modulated by the cohort entropy of the target word indicating lexical competition. The late negativity observed in this study encompasses both the N400 and preactivation negativity. This overlap underscores the brain's potential for rapidly connecting form and meaning from different sources within the word, relying on statistically based prediction in semantic processing.

Can ChatGPT help patients understand their andrological diseases?

We aimed to assess the reliability of Chat Generative Pre-training Transformer (ChatGPT)'s andrology information and its suitability for informing patients and medical students accurately about andrology topics. We presented a series of systematically organized frequently asked questions on andrology topics and sentences containing strong recommendations from the European Association of Urology (EAU) Guideline to ChatGPT-3.5 and 4.0 as questions. These questions encompassed Male Hypogonadism, Erectile Dysfunction and Sexual Desire Disorder, Disorders of Ejaculation, Penile Curvature and Penile Size Abnormalities, Priapism, and Male Infertility. Two expert urologists independently evaluated and assigned scores ranging from 1 to 4 to each response based on its accuracy, with the following ratings: (1) Completely true, (2) Accurate but insufficient, (3) A mixture of accurate and misleading information, and (4) Completely false. A total of 120 questions were included in the study. Among these questions, 50.0% received a grade of 1 (completely correct) (55.4% for 4.0 version). The combined rate of correct answers (grades 1 and 2) was 85.2% for frequently asked questions (88.8% for 4.0 version) and 81.5% for questions obtained from the guideline. The rate of completely incorrect answers (grade 4) was 1.8% for frequently asked questions (0% for 4.0 version) and 5.2% for questions based on strong recommendations. The response rate of version 4.0 to questions created from sentences containing strong recommendations from the EAU guideline was the same as version 3.5. ChatGPT provided satisfactory answers to the questions asked, although some responses lacked completeness. It may be beneficial to utilize ChatGPT under the guidance of a urologist to enhance patients' comprehension of their andrology issues.