Translation and validation of the German version of the FACE-Q paralysis module in adult patients with unilateral peripheral facial palsy.

The aim was to develop and validate a German version of the FACE-Q paralysis module, a patient-reported outcome measure to assess health-related quality of life in adult patients with unilateral facial palsy. The FACE-Q craniofacial questionnaire, which includes the paralysis module, was translated. 213 patients with facial palsy completed the German FACE-Q paralysis along with the established FDI and FaCE questionnaires. Regression analyses were performed to examine the relationships between the different FACE-Q domains and patient and therapy characteristics. The FACE-Q scales had high internal consistency (Cronbach's alpha all > 0.6). High correlations were found between the FACE-Q and the FDI and FaCE (mean rho = 0.5), as well as within the FACE-Q (mean rho = 0.522). Unifactorial influences were found for all domains except Breathing (all p < 0.05). Multivariate independent predictors were found for some FACE-Q domains. Most influential predictors (> 8 subdomains): Patients who received physical therapy scored lower in ten subdomains than those who did not (all p < 0.05). Patients who had surgery scored lower in nine subdomains than patients without surgery (all p < 0.05). The German version of the FACE-Q Paralysis Module can now be used as a patient-reported outcome instrument in adult patients with facial nerve palsy.

Perceived naturalness of emotional voice morphs.

Research into voice perception benefits from manipulation software to gain experimental control over acoustic expression of social signals such as vocal emotions. Today, parameter-specific voice morphing allows a precise control of the emotional quality expressed by single vocal parameters, such as fundamental frequency (F0) and timbre. However, potential side effects, in particular reduced naturalness, could limit ecological validity of speech stimuli. To address this for the domain of emotion perception, we collected ratings of perceived naturalness and emotionality on voice morphs expressing different emotions either through F0 or Timbre only. In two experiments, we compared two different morphing approaches, using either neutral voices or emotional averages as emotionally non-informative reference stimuli. As expected, parameter-specific voice morphing reduced perceived naturalness. However, perceived naturalness of F0 and Timbre morphs were comparable with averaged emotions as reference, potentially making this approach more suitable for future research. Crucially, there was no relationship between ratings of emotionality and naturalness, suggesting that the perception of emotion was not substantially affected by a reduction of voice naturalness. We hold that while these findings advocate parameter-specific voice morphing as a suitable tool for research on vocal emotion perception, great care should be taken in producing ecologically valid stimuli.

Psychosocial and Behavioral Effects of the COVID-19 Pandemic on Children and Adolescents with Autism and Their Families: Overview of the Literature and Initial Data from a Multinational Online Survey.

Since COVID-19 has become a pandemic, everyday life has seen dramatic changes affecting individuals, families, and children with and without autism. Among other things, these changes entail more time at home, digital forms of communication, school closures, and reduced support and intervention. Here, we assess the effects of the pandemic on quality of life for school-age autistic and neurotypical children and adolescents. First, we provide a comprehensive review of the current relevant literature. Next, we report original data from a survey conducted in several countries, assessing activities, well-being, and social life in families with autism, and their changes over time. We focus on differences between children with and without autism from within the same families, and on different outcomes for children with high- or low-functioning autism. While individuals with autism scored lower in emotional and social functioning than their neurotypical siblings, both groups of children showed comparable decreases in well-being and increases in anxiety, compared to before the pandemic. By contrast, decreases in adaptability were significantly more pronounced in autistic children and adolescents compared to neurotypical children and adolescents. Overall, although individual families reported some positive effects of pandemic restrictions, our data provide no evidence that these generalize across children and adolescents with autism, or even just to individuals with high-functioning autism. We discuss the increased challenges that need to be addressed to protect children and adolescents' well-being under pandemic conditions, but also point out potentials in the present situation that could be used towards social participation and success in older children and young adults with autism.

Understanding and countering the spread of conspiracy theories in social networks: Evidence from epidemiological models of Twitter data.

Conspiracy theories in social networks are considered to have adverse effects on individuals' compliance with public health measures in the context of a pandemic situation. A deeper understanding of how conspiracy theories propagate through social networks is critical for the development of countermeasures. The present work focuses on a novel approach to characterize the propagation of conspiracy theories through social networks by applying epidemiological models to Twitter data. A Twitter dataset was searched for tweets containing hashtags indicating belief in the "5GCoronavirus" conspiracy theory, which states that the COVID-19 pandemic is a result of, or enhanced by, the enrollment of the 5G mobile network. Despite the absence of any scientific evidence, the "5GCoronavirus" conspiracy theory propagated rapidly through Twitter, beginning at the end of January, followed by a peak at the beginning of April, and ceasing/disappearing approximately at the end of June 2020. An epidemic SIR (Susceptible-Infected-Removed) model was fitted to this time series with acceptable model fit, indicating parallels between the propagation of conspiracy theories in social networks and infectious diseases. Extended SIR models were used to simulate the effects that two specific countermeasures, fact-checking and tweet-deletion, could have had on the propagation of the conspiracy theory. Our simulations indicate that fact-checking is an effective mechanism in an early stage of conspiracy theory diffusion, while tweet-deletion shows only moderate efficacy but is less time-sensitive. More generally, an early response is critical to gain control over the spread of conspiracy theories through social networks. We conclude that an early response combined with strong fact-checking and a moderate level of deletion of problematic posts is a promising strategy to fight conspiracy theories in social networks. Results are discussed with respect to their theoretical validity and generalizability.

Eye Tracking During Visually Situated Language Comprehension: Flexibility and Limitations in Uncovering Visual Context Effects.

The present work is a description and an assessment of a methodology designed to quantify different aspects of the interaction between language processing and the perception of the visual world. The recording of eye-gaze patterns has provided good evidence for the contribution of both the visual context and linguistic/world knowledge to language comprehension. Initial research assessed object-context effects to test theories of modularity in language processing. In the introduction, we describe how subsequent investigations have taken the role of the wider visual context in language processing as a research topic in its own right, asking questions such as how our visual perception of events and of speakers contributes to comprehension informed by comprehenders' experience. Among the examined aspects of the visual context are actions, events, a speaker's gaze, and emotional facial expressions, as well as spatial object configurations. Following an overview of the eye-tracking method and its different applications, we list the key steps of the methodology in the protocol, illustrating how to successfully use it to study visually-situated language comprehension. A final section presents three sets of representative results and illustrates the benefits and limitations of eye tracking for investigating the interplay between the perception of the visual world and language comprehension.

Distinct effects of different visual cues on sentence comprehension and later recall: The case of speaker gaze versus depicted actions.

Language-processing accounts are beginning to accommodate different visual context effects, but they remain underspecified regarding differences between cues, both during sentence comprehension and subsequent recall. We monitored participants' eye movements to mentioned characters while they listened to transitive sentences. We varied whether speaker gaze, a depicted action, neither, or both of these visual cues were available, as well as whether both cues were deictic (Experiment 1) or only speaker gaze (Experiment 2). Speaker gaze affected eye movements during comprehension similarly early to a single deictic action depiction, but significantly earlier than non-deictic action depictions; conversely, depicted actions but not speaker gaze positively affected later recall of sentence content. Thus, cue type and cue-language relations must be accommodated in characterising real-time situated language comprehension and subsequent recall of sentence content.

Look before you speak: children's integration of visual information into informative referring expressions.

Children's ability to refer is underpinned by their developing cognitive skills. Using a production task (n = 57), we examined pre-articulatory visual fixations to contrast objects (e.g., to a large apple when the target was a small one) to investigate how visual scanning drives informativeness across development. Eye-movements reveal that although four-year-olds fixate contrast objects to a similar extent as seven-year-olds and adults, this does not result in explicit referential informativeness. Instead, four-year-olds frequently omit distinguishing information from their referring expressions regardless of the comprehensiveness of their visual scan. In contrast, older children make greater use of information gleaned from their visual inspections, like adults. Thus, we find a barrier not to the incidence of contrast fixations by younger children, but to their use of them in referential informativeness. We recommend that follow-up work investigates whether younger children's immature executive skills prevent them from describing referents in relation to contrast objects.

Looking at a contrast object before speaking boosts referential informativeness, but is not essential.

Variation in referential form has traditionally been accounted for by theoretical frameworks focusing on linguistic and discourse features. Despite the explosion of interest in eye tracking methods in psycholinguistics, the role of visual scanning behaviour in informative reference production is yet to be comprehensively investigated. Here we examine the relationship between speakers' fixations to relevant referents and the form of the referring expressions they produce. Overall, speakers were fully informative across simple and (to a lesser extent) more complex displays, providing appropriately modified referring expressions to enable their addressee to locate the target object. Analysis of contrast fixations revealed that looking at a contrast object boosts but is not essential for full informativeness. Contrast fixations which take place immediately before speaking provide the greatest boost. Informative referring expressions were also associated with later speech onsets than underinformative ones. Based on the finding that fixations during speech planning facilitate but do not fully predict informative referring, direct visual scanning is ruled out as a prerequisite for informativeness. Instead, pragmatic expectations of informativeness may play a more important role. Results are consistent with a goal-based link between eye movements and language processing, here applied for the first time to production processes.

Initial severity of motor and non-motor disabilities in patients with facial palsy: an assessment using patient-reported outcome measures.

Patients with facial palsy (FP) not only suffer from their facial movement disorder, but also from social and psychological disabilities. These can be assessed by patient-reported outcome measures (PROMs) like the quality-of-life Short-Form 36 Item Questionnaire (SF36) or FP-specific instruments like the Facial Clinimetric Evaluation Scale (FaCE) or the Facial Disability Index (FDI). Not much is known about factors influencing PROMs in patients with FP. We identified predictors for baseline SF36, FaCE, and FDI scoring in 256 patients with unilateral peripheral FP using univariate correlation and multivariate linear regression analyses. Mean age was 52 ± 18 years. 153 patients (60 %) were female. 90 patients (31 %) and 176 patients (69 %) were first seen <90 or >90 days after onset, respectively, i.e., with acute or chronic FP. House-Brackmann grading was 3.9 ± 1.4. FaCE subscores varied from 41 ± 28 to 71 ± 26, FDI scores from 65 ± 20 to 70 ± 22, and SF36 domains from 52 ± 20 to 80 ± 24. Older age, female gender, higher House-Brackmann grading, and initial assessment >90 days after onset were independent predictors for lower FaCE subscores and partly for lower FDI subscores (all p < 0.05). Older age and female gender were best predictors for lower results in SF36 domains. Comorbidity was associated with lower SF General health perception and lower SF36 Emotional role (all p < 0.05). Specific PROMs reveal that older and female patients and patients with chronic FP suffer particularly from motor and non-motor disabilities related to FP. Comorbidity unrelated to the FP could additionally impact the quality of life of patients with FP.

Direct Speaker Gaze Promotes Trust in Truth-Ambiguous Statements.

A speaker's gaze behaviour can provide perceivers with a multitude of cues which are relevant for communication, thus constituting an important non-verbal interaction channel. The present study investigated whether direct eye gaze of a speaker affects the likelihood of listeners believing truth-ambiguous statements. Participants were presented with videos in which a speaker produced such statements with either direct or averted gaze. The statements were selected through a rating study to ensure that participants were unlikely to know a-priori whether they were true or not (e.g., "sniffer dogs cannot smell the difference between identical twins"). Participants indicated in a forced-choice task whether or not they believed each statement. We found that participants were more likely to believe statements by a speaker looking at them directly, compared to a speaker with averted gaze. Moreover, when participants disagreed with a statement, they were slower to do so when the statement was uttered with direct (compared to averted) gaze, suggesting that the process of rejecting a statement as untrue may be inhibited when that statement is accompanied by direct gaze.

Nonmotor disabilities in patients with facial palsy measured by patient-reported outcome measures.

OBJECTIVES/HYPOTHESIS: To describe changes of motor and nonmotor disabilities in patient with peripheral facial palsy (FP) during treatment using the patient-reported outcome measures (PROMs) Facial Clinimetric Evaluation (FaCE), Facial Disability Index (FDI), and Short Form 36-Item Questionnaire (SF-36) and to analyze predictors for these changes STUDY DESIGN: Prospective, single-center longitudinal study. METHODS: One hundred twenty patients with FP underwent at least two PROMs between 2012 and 2015. Predictors for changes of the PROMs were analyzed univariately using Pearson's correlation and multivariately using linear regression models. RESULTS: The mean interval between onset of FP to first presentation was 29 ± 64 months and between first and final assessment 8.7 ± 7.2 months. Initial House-Brackmann grading was 4.0 ± 1.3 and final House-Brackmann grading was 2.8 ± 1.6 (P < .001). All mean FaCE and FDI but only some SF-36 subscores improved over time (all P < .05). Adjuvant treatment was an independent predictor for improvement of the FaCE Facial Comfort subscore (P = .015) and a malignant tumor as primary disease for improvement of the FaCE Oral Function subscore (P = .044). Unemployment was a predictor for improvement of the FDI Social/Well-Being Function (P = .035). First assessment <90 days after onset was a predictor for improvement of the SF-36 Bodily Pain subscore (P = .025), a primary malignant disease for improvement of the SF-36 General Health perception (P = .004), and idiopathic FP for improvement of the SF-36 Social Functioning subscore (P = .017). CONCLUSIONS: Changes of motor function revealed by classical grading systems mostly do not correlate with changes of nonmotor disabilities during treatment of FP. Many other factors are associated with changes of PROMs during the FP treatment. LEVEL OF EVIDENCE: 4. Laryngoscope, 126:1516-1523, 2016.

Comparison of in-plane and out-of-plane needle insertion with vs. without needle guidance.

PURPOSE: First comparison of two methods of needle insertion: long axis ("in-plane") versus short axis ("out-of-plane") approach, each with and without a prototype needle guidance system (NGS). MATERIALS AND METHODS: 24 medical students without prior experience punctured an ultrasound phantom (transparent except for the decklayer) in four conditions, with the goal of achieving as many accurate punctures as possible within a fixed time. RESULTS: Out-of-plane with NGS led to substantially more hits at first attempt than punctures without NGS (p < 0.001), as well as to a greater total number of hits (p = 0.004), and participants were faster to hit the target the first time (p = 0.009). CONCLUSIONS: Thus, navigation increases accuracy as well as efficiency of ultrasound guided punctures on the phantom. It could prove advantageous in clinical applications for fine needle biopsies, musculoskeletal injections, vascular access, and in regional anesthesia.

Preference for Well-Balanced Saliency in Details Cropped from Photographs.

Photographic cropping is the act of selecting part of a photograph to enhance its aesthetic appearance or visual impact. It is common practice with both professional (expert) and amateur (non-expert) photographers. In a psychometric study, McManus et al. (2011b) showed that participants cropped photographs confidently and reliably. Experts tended to select details from a wider range of positions than non-experts, but other croppers did not generally prefer details that were selected by experts. It remained unclear, however, on what grounds participants selected particular details from a photograph while avoiding other details. One of the factors contributing to cropping decision may be visual saliency. Indeed, various saliency-based computer algorithms are available for the automatic cropping of photographs. However, careful experimental studies on the relation between saliency and cropping are lacking to date. In the present study, we re-analyzed the data from the studies by McManus et al. (2011a,b), focusing on statistical image properties. We calculated saliency-based measures for details selected and details avoided during cropping. As expected, we found that selected details contain regions of higher saliency than avoided details on average. Moreover, the saliency center-of-mass was closer to the geometrical center in selected details than in avoided details. Results were confirmed in an eye tracking study with the same dataset of images. Interestingly, the observed regularities in cropping behavior were less pronounced for experts than for non-experts. In summary, our results suggest that, during cropping, participants tend to select salient regions and place them in an image composition that is well-balanced with respect to the distribution of saliency. Our study contributes to the knowledge of perceptual bottom-up features that are germane to aesthetic decisions in photography and their variability in non-experts and experts.

Preparing to be punched: prediction may not always require inference of intentions.

Pickering & Garrod's (P&G's) framework assumes an efference copy based on the interlocutor's intentions. Yet, elaborate attribution of intentions may not always be necessary for online prediction. Instead, contextual cues such as speaker gaze can provide similar information with a lower demand on processing resources.

Can Speaker Gaze Modulate Syntactic Structuring and Thematic Role Assignment during Spoken Sentence Comprehension?

During comprehension, a listener can rapidly follow a frontally seated speaker's gaze to an object before its mention, a behavior which can shorten latencies in speeded sentence verification. However, the robustness of gaze-following, its interaction with core comprehension processes such as syntactic structuring, and the persistence of its effects are unclear. In two "visual-world" eye-tracking experiments participants watched a video of a speaker, seated at an angle, describing transitive (non-depicted) actions between two of three Second Life characters on a computer screen. Sentences were in German and had either subject(NP1)-verb-object(NP2) or object(NP1)-verb-subject(NP2) structure; the speaker either shifted gaze to the NP2 character or was obscured. Several seconds later, participants verified either the sentence referents or their role relations. When participants had seen the speaker's gaze shift, they anticipated the NP2 character before its mention and earlier than when the speaker was obscured. This effect was more pronounced for SVO than OVS sentences in both tasks. Interactions of speaker gaze and sentence structure were more pervasive in role-relations verification: participants verified the role relations faster for SVO than OVS sentences, and faster when they had seen the speaker shift gaze than when the speaker was obscured. When sentence and template role-relations matched, gaze-following even eliminated the SVO-OVS response-time differences. Thus, gaze-following is robust even when the speaker is seated at an angle to the listener; it varies depending on the syntactic structure and thematic role relations conveyed by a sentence; and its effects can extend to delayed post-sentence comprehension processes. These results suggest that speaker gaze effects contribute pervasively to visual attention and comprehension processes and should thus be accommodated by accounts of situated language comprehension.