Words have a weight: language as a source of inner grounding and flexibility in abstract concepts.

The role played by language in our cognitive lives is a topic at the centre of contemporary debates in cognitive (neuro)science. In this paper we illustrate and compare two theories that offer embodied explanations of this role: the WAT (words as social tools) and the LENS (language is an embodied neuroenhancement and scaffold) theories. WAT and LENS differ from other current proposals, because they connect the impact of the neurologically realized language system on our cognition to the ways in which language shapes our interaction with the physical and social environment. Examining these theories together, their tenets and supporting evidence, sharpens our understanding of each, but also contributes to a better understanding of the contribution that language might make to the acquisition, representation and use of abstract concepts. Here we focus on how language provides a source of inner grounding, especially metacognition and inner speech, and supports the flexibility of our thought. Overall, the paper outlines a promising research program focused on the importance of language to abstract concepts within the context of a flexible, multimodal, and multilevel conception of embodied cognition.

An interoceptive illusion of effort induced by false heart-rate feedback.

Interoception, or the sense of the internal state of the body, is key to the adaptive regulation of our physiological needs. Recent theories contextualize interception within a predictive coding framework, according to which the brain both estimates and controls homeostatic and physiological variables, such as hunger, thirst, and effort levels, by orchestrating sensory, proprioceptive, and interoceptive signals from inside the body. This framework suggests that providing false interoceptive feedback may induce misperceptions of physiological variables, or "interoceptive illusions." Here we ask whether it is possible to produce an illusory perception of effort by giving participants false acoustic feedback about their heart-rate frequency during an effortful cycling task. We found that participants reported higher levels of perceived effort when their heart-rate feedback was faster compared with when they cycled at the same level of intensity with a veridical feedback. However, participants did not report lower effort when their heart-rate feedback was slower, which is reassuring, given that failing to notice one's own effort is dangerous in ecologically valid conditions. Our results demonstrate that false cardiac feedback can produce interoceptive illusions. Furthermore, our results pave the way for novel experimental manipulations that use illusions to study interoceptive processing.

Suspicion of intraoperative left main coronary artery extrinsic compression with Perceval® sutureless bioprosthesis.

We present an uncommon case of intraoperative transient myocardial ischemia related to suspicion of left main stem artery extrinsic compression caused by the radial force of the stent of Perceval® bioprosthesis. No other cases have been described, but some similarities can be found with extrinsic coronary compression in percutaneous pulmonary valves. Surgeons should be aware of this complication in patients with coronary anomalies or with bicuspid anatomy.

Keep your interoceptive streams under control: An active inference perspective on anorexia nervosa.

Anorexia nervosa (AN) is a psychiatric disorder primarily characterized by "restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health" (DSM-5, n.d.). Here, we propose a novel interpretation of food restriction of AN, which elaborates on recent accounts of the brain as a predictive machine, continuously inferring and controling incoming signals, including bodily signals - i.e., interoceptive (active) inference. In this perspective, the extreme eating restrictions characterizing AN may serve the fundamental role of keeping under control (i.e., reducing excessively high levels of) interoceptive uncertainty, above and beyond controlling and mitigating concerns for body weight. In other words, noisy interoceptive streams may instantiate active strategies (i.e., eating restrictions) that amplify autonomic hunger signals, to minimize interoceptive uncertainty and maintain a more coherent sense of (interoceptive) self.

Social epistemic actions.

We consider the ways humans engage in social epistemic actions, to guide each other's attention, prediction, and learning processes towards salient information, at the timescale of online social interaction and joint action. This parallels the active guidance of other's attention, prediction, and learning processes at the longer timescale of niche construction and cultural practices, as discussed in the target article.

Overusing the pacifier during infancy sets a footprint on abstract words processing.

Perturbations to the speech articulators induced by frequently using an interfering object during infancy (i.e., pacifier) might shape children's language experience and the building of conceptual representations. Seventy-one typically developing third graders performed a semantic categorization task with abstract, concrete and emotional words. Children who used the pacifier for a more extended period were slower than the others. Moreover, overusing the pacifier increased response time of abstract words, whereas emotional and (above all) concrete words were less affected. Results support the view that abstract words are grounded both in perception-action and in linguistic experience.

Correction to: Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis.

The original version of this article unfortunately contained a mistake.

Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis.

PURPOSE: There is a lack of consensus about which endocarditis-specific preoperative characteristics have an actual impact over postoperative mortality. Our objective was the identification and quantification of these factors. METHODS: We performed a systematic review of all the studies which reported factors related to in-hospital mortality after surgery for acute infective endocarditis, conducted according to PRISMA recommendations. A search string was constructed and applied on three different databases. Two investigators independently reviewed the retrieved references. Quality assessment was performed for identification of potential biases. All the variables that were included in at least two validated risk scores were meta-analyzed independently, and the pooled estimates were expressed as odds ratios (OR) with their confidence intervals (CI). RESULTS: The final sample consisted on 16 studies, comprising a total of 7484 patients. The overall pooled OR were statistically significant (p < 0.05) for: age (OR 1.03, 95% CI 1.00-1.05), female sex (OR 1.56, 95% CI 1.35-1.81), urgent or emergency surgery (OR 2.39 95% CI 1.91-3.00), previous cardiac surgery (OR 2.19, 95% CI 1.84-2.61), NYHA ≥ III (OR 1.84, 95% CI 1.33-2.55), cardiogenic shock (OR 4.15, 95% CI 3.06-5.64), prosthetic valve (OR 1.98, 95% CI 1.68-2.33), multivalvular affection (OR 1.35, 95% CI 1.01-1.82), renal failure (OR 2.57, 95% CI 2.15-3.06), paravalvular abscess (OR 2.39, 95% CI 1.77-3.22) and S. aureus infection (OR 2.27, 95% CI 1.89-2.73). CONCLUSIONS: After a systematic review, we identified 11 preoperative factors related to an increased postoperative mortality. The meta-analysis of each of these factors showed a significant association with an increased in-hospital mortality after surgery for active infective endocarditis. Graph summary of the Pooled Odds Ratios of the 11 preoperative factors analyzed after the systematic review and meta-analysis.

Septic Shock, Meningoencephalitis and Multiple Pulmonary Emboli: Case Report of an Uncommon Clinical Presentation of Ventricular Septal Defect Acute Infective Endocarditis.

The case is reported of a 55 year-old woman, with a previously known congenital septal defect, who was admitted to the emergency department with a diagnosis of meningoencephalitis, septic shock, and rapid clinical deterioration. Echocardiography revealed a vegetation occupying the right-side heart. Endocarditis affectation of the septal defect, aortic and tricuspid valves was noted and blood cultures were positive for Staphylococcus aureus. Urgent surgical treatment was performed whereby the ventricular septal defect was closed, a meticulous debridement of the affected area was conducted, and the aortic and tricuspid valves were replaced.

The influence of communication mode on written language processing and beyond.

Empirical evidence suggests a broad impact of communication mode on cognition at large, beyond language processing. Using a sign language since infancy might shape the representation of words and other linguistic stimuli - for example, incorporating in it the movements and signs used to express them. Once integrated into linguistic representations, this visuo-motor content can affect deaf signers' linguistic and cognitive processing.

Differential effects of visual uncertainty and contextual guidance on perceptual decisions: Evidence from eye and mouse tracking in visual search.

Visual search can be seen as a decision-making process that aims to assess whether a target is present or absent from a scene. In this perspective, eye movements collect evidence related to target detection and verification to guide the decision. We investigated whether, in real-world scenes, target detection and verification are differentially recruited in the decision-making process in the presence of prior information (expectations about target location) and perceptual uncertainty (noise). We used a mouse-tracking methodology with which mouse trajectories unveil components of decision-making and eye-tracking measures reflect target detection and verification. Indoor scenes were presented, including a target in usual or unusual locations or no target, and were degraded with additive noise (or no noise). Participants had to respond to the target's presence or absence. Degrading the scene delayed the decision due to increased verification times and reduced mouse velocity. Targets in unusual locations delayed the decision and deviated mouse trajectories toward the target-absent response. Detection times played a major role in these effects. Thus, target detection and verification processes influence decision-making by integrating the available sources of information differently and lead to an accumulation of evidence toward both the presence of a target and its absence.

How do you hold your mouse? Tracking the compatibility effect between hand posture and stimulus size.

In keeping with the idea that observing objects activates possible motor responses, several experiments revealed compatibility effects between the hand postures used to report a choice and some characteristics of the stimuli. The real-time dynamics of such compatibility effects are currently unknown. We tracked the time course of a categorization experiment requiring subjects to categorize as natural or artifact figures of big and small objects. Participants reported their choice using either a big mouse (requiring a power grip: a hand posture compatible with the grasping of big objects) or a small mouse (requiring a precision grip: a hand posture compatible with the grasping of small objects). We found a compatibility effect between the grip required by the mouse and the grip elicited by objects, even if it was irrelevant to the task. In a following experiment with the same paradigm, lexical stimuli failed to reproduce the same effect. Nevertheless, a compatibility effect mediated by the target-word category (artificial vs. natural) was observed. We discuss the results in the context of affordance effects literature and grounded theories of cognition.

Active inference and cognitive-emotional interactions in the brain.

All organisms must integrate cognition, emotion, and motivation to guide action toward valuable (goal) states, as described by active inference. Within this framework, cognition, emotion, and motivation interact through the (Bayesian) fusion of exteroceptive, proprioceptive, and interoceptive signals, the precision-weighting of prediction errors, and the "affective tuning" of neuronal representations. Crucially, misregulation of these processes may have profound psychopathological consequences.

Combined effects of expectations and visual uncertainty upon detection and identification of a target in the fog.

Detecting a pedestrian while driving in the fog is one situation where the prior expectation about the target presence is integrated with the noisy visual input. We focus on how these sources of information influence the oculomotor behavior and are integrated within an underlying decision-making process. The participants had to judge whether high-/low-density fog scenes displayed on a computer screen contained a pedestrian or a deer by executing a mouse movement toward the response button (mouse-tracking). A variable road sign was added on the scene to manipulate expectations about target identity. We then analyzed the timing and amplitude of the deviation of mouse trajectories toward the incorrect response and, using an eye tracker, the detection time (before fixating the target) and the identification time (fixations on the target). Results revealed that expectation of the correct target results in earlier decisions with less deviation toward the alternative response, this effect being partially explained by the facilitation of target identification.

Interactions between visual and semantic processing during object recognition revealed by modulatory effects of age of acquisition.

The age of acquisition (AoA) of objects and their names is a powerful determinant of processing speed in adulthood, with early-acquired objects being recognized and named faster than late-acquired objects. Previous research using fMRI (Ellis et al., 2006. Traces of vocabulary acquisition in the brain: evidence from covert object naming. NeuroImage 33, 958-968) found that AoA modulated the strength of BOLD responses in both occipital and left anterior temporal cortex during object naming. We used magnetoencephalography (MEG) to explore in more detail the nature of the influence of AoA on activity in those two regions. Covert object naming recruited a network within the left hemisphere that is familiar from previous research, including visual, left occipito-temporal, anterior temporal and inferior frontal regions. Region of interest (ROI) analyses found that occipital cortex generated a rapid evoked response (~75-200 ms at 0-40 Hz) that peaked at 95 ms but was not modulated by AoA. That response was followed by a complex of later occipital responses that extended from ~300 to 850 ms and were stronger to early- than late-acquired items from ~325 to 675 ms at 10-20 Hz in the induced rather than the evoked component. Left anterior temporal cortex showed an evoked response that occurred significantly later than the first occipital response (~100-400 ms at 0-10 Hz with a peak at 191 ms) and was stronger to early- than late-acquired items from ~100 to 300 ms at 2-12 Hz. A later anterior temporal response from ~550 to 1050 ms at 5-20 Hz was not modulated by AoA. The results indicate that the initial analysis of object forms in visual cortex is not influenced by AoA. A fastforward sweep of activation from occipital and left anterior temporal cortex then results in stronger activation of semantic representations for early- than late-acquired objects. Top-down re-activation of occipital cortex by semantic representations is then greater for early than late acquired objects resulting in delayed modulation of the visual response.

The sensorimotor and social sides of the architecture of speech.

Speech is a complex skill to master. In addition to sophisticated phono-articulatory abilities, speech acquisition requires neuronal systems configured for vocal learning, with adaptable sensorimotor maps that couple heard speech sounds with motor programs for speech production; imitation and self-imitation mechanisms that can train the sensorimotor maps to reproduce heard speech sounds; and a "pedagogical" learning environment that supports tutor learning.

Perioperative risk stratification scores in infective endocarditis and its usefulness.

Infective endocarditis continues to represent a serious disease worldwide with high morbidity and mortality rates despite advances in diagnosis and treatment. Risk assessment plays a pivotal role in determining the appropriate course of treatment for patients diagnosed with infective endocarditis. In this context, specific endocarditis risk scores have been developed trying to help in the risk assessment process. During the last 15 years, 19 specific endocarditis scores have been published. These newly created scores are very heterogenous in their characteristics, factors included, and validation strategies. The purpose of this review is to analyze the published specific infective endocarditis risk scores and discuss their advantages, limitations, and usefulness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12055-023-01644-y.

Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications.

Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.

Mapping the mental space of emotional concepts through kinematic measures of decision uncertainty.

Emotional concepts and their mental representations have been extensively studied. Yet, some ecologically relevant aspects, such as how they are processed in ambiguous contexts (e.g., in relation to other emotional stimuli that share similar characteristics), are incompletely known. We employed a similarity judgement of emotional concepts and manipulated the contextual congruency of the responses along the two main affective dimensions of hedonic valence and physiological activation, respectively. Behavioural and kinematics (mouse-tracking) measures were combined to gather a novel 'similarity index' between emotional concepts, to derive topographical maps of their mental representations. Self-report (interoceptive sensibility, positive-negative affectivity, depression) and physiological measures (heart rate variability, HRV) have been collected to explore their possible association with emotional conceptual representation. Results indicate that emotional concepts typically associated with low arousal profit by contextual congruency, with faster responses and reduced uncertainty when contextual ambiguity decreases. The emotional maps recreate two almost orthogonal axes of valence and arousal, and the similarity measure captures the smooth boundaries between emotions. The emotional map of a subgroup of individuals with low positive affectivity reveals a narrower conceptual distribution, with variations in positive emotions and in individuals with reduced arousal (such as those with reduced HRV). Our work introduces a novel methodology to study emotional conceptual representations, bringing the behavioural dynamics of decision-making processes and choice uncertainty into the affective domain. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.

Treatment For Infected Frozen Elephant Trunk Prosthesis Caused by Propionibacterium acnes: A Surgical Challenge.

In this article, we present the case of a 47-year-old man who underwent Bentall-Bono procedure and frozen elephant trunk prosthesis implantation due to severe aortic regurgitation and aortic dilatation with a second-time endovascular stent-graft repair in descending aorta. Over eight years, a subacute graft infection by Propionibacterium acnes was developed, culminating in cardiogenic shock secondary to severe aortic regurgitation due to a complete aortic root dehiscence because of multiple aortic pseudoaneurysms. The patient underwent emergency surgery in which the replacement of the graft by a biological valve tube was performed accompanied by a complete debranching of the three supra-aortic vessels.