Gesture is the primary modality for language creation.

How language began is one of the oldest questions in science, but theories remain speculative due to a lack of direct evidence. Here, we report two experiments that generate empirical evidence to inform gesture-first and vocal-first theories of language origin; in each, we tested modern humans' ability to communicate a range of meanings (995 distinct words) using either gesture or non-linguistic vocalization. Experiment 1 is a cross-cultural study, with signal Producers sampled from Australia (n = 30, Mage = 32.63, s.d. = 12.42) and Vanuatu (n = 30, Mage = 32.40, s.d. = 11.76). Experiment 2 is a cross-experiential study in which Producers were either sighted (n = 10, Mage = 39.60, s.d. = 11.18) or severely vision-impaired (n = 10, Mage = 39.40, s.d. = 10.37). A group of undergraduate student Interpreters guessed the meaning of the signals created by the Producers (n = 140). Communication success was substantially higher in the gesture modality than the vocal modality (twice as high overall; 61.17% versus 29.04% success). This was true within cultures, across cultures and even for the signals produced by severely vision-impaired participants. The success of gesture is attributed in part to its greater universality (i.e. similarity in form across different Producers). Our results support the hypothesis that gesture is the primary modality for language creation.

Uncovering the acoustic vowel space of a previously undescribed language: The vowels of Nambo.

This study presents the first acoustic description of the vowel space of a Papuan language-Nambo, spoken in southern Papua New Guinea-based on duration and first and second formant measurements from 19 adult male and female speakers across three age groups (young, middle-aged, senior). Phonemically, Nambo has six full vowels /i, e, æ, ɑ, o, u/ and a reduced vowel tentatively labeled /ə/. Unlike the full vowels, the quality of /ə/ showed great variation: seniors' and young females' realizations tended to be more open and retracted than those by young males, while middle-aged speakers' productions fell between these two variants.

Cultural selection drives the evolution of human communication systems.

Human communication systems evolve culturally, but the evolutionary mechanisms that drive this evolution are not well understood. Against a baseline that communication variants spread in a population following neutral evolutionary dynamics (also known as drift models), we tested the role of two cultural selection models: coordination- and content-biased. We constructed a parametrized mixed probabilistic model of the spread of communicative variants in four 8-person laboratory micro-societies engaged in a simple communication game. We found that selectionist models, working in combination, explain the majority of the empirical data. The best-fitting parameter setting includes an egocentric bias and a content bias, suggesting that participants retained their own previously used communicative variants unless they encountered a superior (content-biased) variant, in which case it was adopted. This novel pattern of results suggests that (i) a theory of the cultural evolution of human communication systems must integrate selectionist models and (ii) human communication systems are functionally adaptive complex systems.

Creating a communication system from scratch: gesture beats vocalization hands down.

How does modality affect people's ability to create a communication system from scratch? The present study experimentally tests this question by having pairs of participants communicate a range of pre-specified items (emotions, actions, objects) over a series of trials to a partner using either non-linguistic vocalization, gesture or a combination of the two. Gesture-alone outperformed vocalization-alone, both in terms of successful communication and in terms of the creation of an inventory of sign-meaning mappings shared within a dyad (i.e., sign alignment). Combining vocalization with gesture did not improve performance beyond gesture-alone. In fact, for action items, gesture-alone was a more successful means of communication than the combined modalities. When people do not share a system for communication they can quickly create one, and gesture is the best means of doing so.

Probing the implicit suicidal mind: does the Death/Suicide Implicit Association Test reveal a desire to die, or a diminished desire to live?

Assessment of implicit self-associations with death relative to life, measured by a death/suicide implicit association test (d/s-IAT), has shown promise in the prediction of suicide risk. The current study examined whether the d/s-IAT reflects an individual's desire to die or a diminished desire to live and whether the predictive utility of implicit cognition is mediated by life-oriented beliefs. Four hundred eight undergraduate students (285 female; Mage = 20.36 years, SD = 4.72) participated. Participants completed the d/s-IAT and self-report measures assessing 6 indicators of suicide risk (suicide ideation frequency and intensity, depression, nonsuicidal self-harm thoughts frequency and intensity, and nonsuicidal self-harm attempts), as well as survival and coping beliefs and history of prior suicide attempts. The d/s-IAT significantly predicted 5 out of the 6 indicators of suicide risk above and beyond the strongest traditional indicator of risk, history of prior suicide attempts. However, the effect of the d/s-IAT on each of the risk indicators was mediated by individuals' survival and coping beliefs. Moreover, the distribution of d/s-IAT scores primarily reflected variability in self-associations with life. Implicit suicide-related cognition appears to reflect a gradual diminishing of the desire to live, rather than a desire to die. Contemporary theories of suicide and risk assessment protocols need to account for the dynamic relationship between both risk and life-oriented resilience factors, and intervention strategies aimed at enhancing engagement with life should be a routine part of suicide risk management.

The cultural evolution of human communication systems in different sized populations: usability trumps learnability.

This study examines the intergenerational transfer of human communication systems. It tests if human communication systems evolve to be easy to learn or easy to use (or both), and how population size affects learnability and usability. Using an experimental-semiotic task, we find that human communication systems evolve to be easier to use (production efficiency and reproduction fidelity), but harder to learn (identification accuracy) for a second generation of naïve participants. Thus, usability trumps learnability. In addition, the communication systems that evolve in larger populations exhibit distinct advantages over those that evolve in smaller populations: the learnability loss (from the Initial signs) is more muted and the usability benefits are more pronounced. The usability benefits for human communication systems that evolve in a small and large population is explained through guided variation reducing sign complexity. The enhanced performance of the communication systems that evolve in larger populations is explained by the operation of a content bias acting on the larger pool of competing signs. The content bias selects for information-efficient iconic signs that aid learnability and enhance usability.

Lifestyle factors of smoking, BMI and alcohol on the risk of Non-Melanoma Skin Cancer in adults: a systematic review.

BACKGROUND: Non-melanoma skin cancer is the most common cancer in humans and the most important risk factors are thought to be age, skin type, and exposure to ultraviolet radiation. Lifestyle factors may also play a part. To date no systematic review has been performed to collate evidence of the effects of smoking, alcohol or body mass index. OBJECTIVES: We performed a systematic review and meta-analysis to assess the effects of smoking, alcohol and body mass index on the risk of non-melanoma skin cancer and its subtypes. INCLUSION CRITERIA: Adults (18+ years old) of either sex from any ethnicitySmoking, alcohol, or body mass index (including other anthropometric measurements, such as weight, waist to hip ratio, and the percentage body fat)Non-melanoma skin cancer, cutaneous squamous cell carcinoma, or basal cell carcinomaComparative observational epidemiological studies SEARCH STRATEGY: We performed a comprehensive search of MEDLINE, EMBASE, CINAHL, Cochrane Library and CAB Abstracts from inception to October 2010. We also scanned reference lists to identify further eligible studies. METHODOLOGICAL QUALITY: Data from eligible studies were extracted and quality assessed using the Newcastle Ottawa Scale independently by two reviewers. DATA COLLECTION: The titles, abstracts and full text identified from the search were assessed independently by two reviewers against pre-specified inclusion/exclusion criteria. Disagreements were resolved through discussion with a third reviewer. DATA SYNTHESIS: For studies with similar exposures, a meta-analysis was performed using a random effects model and results were expressed as pooled odds ratio with 95% confidence intervals. Heterogeneity was assessed using I. Publication bias was assessed using funnel plots. Data were analysed using Review Manager. RESULTS: Thirty studies were included of which 22 used a case control design and the remaining used a cohort design. The overall quality of the studies was variable with a Newcastle Ottawa Scale median score of 6 out of 9 stars. No evidence of asymmetry was detected in the funnel plots. Smoking was not significantly related to increased risks of non-melanoma skin cancer (Odds Ratio 0.62, 95% CI 0.21 to 1.79, I=34%, 2 studies) or basal cell carcinoma (Odds Ratio 0.95, 95% CI 0.82 to 1.09; I=59%, 14 studies). However, smoking was significantly associated with a 52% increase in the risk of cutaneous squamous cell carcinoma (95% CI 1.15 to 2.01; I=64%; 6 studies). Subgroup analysis found no significant difference in results based on the definition of smoking (current, former, or ever smoker) for basal cell carcinoma, cutaneous squamous cell carcinoma or non-melanoma skin cancer. Alcohol was not significantly related to increased risks of non-melanoma skin cancer (1 study), basal cell carcinoma (Odds Ratio 1.03, 95% CI 0.94 to 1.13, I=0%, 9 studies) or cutaneous squamous cell carcinoma (1 study). Similar results were found irrespective of the type of alcohol assessed (beer, wine, or spirits) for basal cell carcinoma and cutaneous squamous cell carcinoma. A pooled analysis of five studies found a non-significant decrease in the risk of basal cell carcinoma associated with a higher body mass index (Odds Ratio 0.94, 95% CI 0.84 to 1.04, I=40%). In a subgroup analysis based on sex, the potential reduction in risk of basal cell carcinoma appeared to be confined to males (Males: Odds Ratio 0.90, 95% CI 0.78 to 1.04, I=45%, 4 studies; Females: Odds Ratio 1.01, 95% CI 0.85 to 1.19, I=14%, 3 studies). CONCLUSION: It is unclear at present if smoking modifies the risk of basal cell carcinoma; however, smoking clearly increases the risk of cutaneous squamous cell carcinoma. Limited evidence has been published about the risk of non-melanoma skin cancer with alcohol and body mass index; however there is some suggestion a high body mass index may be slightly protective of basal cell carcinoma, particularly in males.This study highlights the importance for clinicians to actively survey high risk patients, including current smokers.The majority of studies included in this systematic review assessed the associations between basal cell carcinoma and smoking, alcohol or body mass index. However, more evidence is needed before conclusive recommendations can be formed regarding the relationship between cutaneous squamous cell carcinoma and alcohol or body mass index.

Risk of window period HIV infection in high infectious risk donors: systematic review and meta-analysis.

The OPTN defines high risk donors (HRDs), colloquially known as 'CDC high risk donors', as those thought to carry an increased risk of HIV window period (WP) infection prior to serologic detectability. However, the true risk of such infection remains unknown. To quantify the risk of WP infection in each HRD behavior category, we performed a systematic review and meta-analysis of studies of HIV prevalence and incidence. Of 3476 abstracts reviewed, 27 eligible studies of HIV infection in HRD populations were identified. Pooled HIV incidence estimates were calculated for each category of HRD behavior and used to calculate the risk of WP HIV infection. Risks ranged from 0.09-12.1 per 10 000 donors based on WP for ELISA and 0.04-4.9 based on nucleic acid testing (NAT), with NAT reducing WP risk by over 50% in each category. Injection drug users had the greatest risk of WP infection (4.9 per 10 000 donors by NAT WP), followed by men who have sex with men (4.2:10 000), commercial sex workers (2.7:10 000), incarcerated donors (0.9:10 000), donors exposed to HIV through blood (0.6:10 000), donors engaging in high-risk sex (0.3:10 000) and hemophiliacs (0.035:10 000). These estimates can help inform patient and provider decision making regarding HRDs.

Risk of window period hepatitis-C infection in high infectious risk donors: systematic review and meta-analysis.

The OPTN classifies high infectious risk donors (HRDs) based on criteria originally intended to identify people at risk for HIV infection. These donors are sometimes referred to as 'CDC high risk donors' in reference to the CDC-published guidelines adopted by the OPTN. However, these guidelines are also being used to identify deceased donors at increased risk of window period (WP) hepatitis C virus (HCV) infection, although not designed for this purpose. The actual risk of WP HCV infection in HRDs is unknown. We performed a systematic review of 3476 abstracts and identified 37 eligible estimates of HCV incidence in HRD populations in the United States/Canada. Pooled HCV incidence was derived and used to estimate the risk of WP infection for each HRD category. Risks ranged from 0.26 to 300.6 per 10,000 donors based on WP for ELISA and 0.027 to 32.4 based on nucleic acid testing (NAT). Injection drug users were at highest risk (32.4 per 10,000 donors by NAT WP), followed by commercial sex workers and donors exhibiting high risk sexual behavior (12.3 per 10,000), men who have sex with men (3.5 per 10,000), incarcerated donors (0.8 per 10,000), donors exposed to HIV infected blood (0.4 per 10,000) and hemophiliacs (0.027 per 10,000). NAT reduced WP risk by approximately 10-fold in each category.

Preliminary analysis of the resources in brachytherapy in Europe and its variability of use.

PURPOSE: The main objective of the program <> is to establish a group with detailed information on brachytherapy throughout Europe. METHODS: The data was compiled by the general coordinator, the ESTRO, and the <> through a website. RESULTS: A total of 32 countries reported data from at least 50% of their centres (criteria of inclusion). Countries were grouped in three categories based on the time of incorporation to the European Union. The majority of treatments belonged to gynaecological tumours. A large spread was found regarding workload of specialists depending on centre and group. CONCLUSION: Collection of information by a website is a feasible methodology. An increase in brachytherapy treatment was observed in all 3 groups by a rate of more than 20% (year 2002 versus year 1997). These results advocate for the continuation of the PCBE study to demonstrate the development in the field, such as an increase or decrease of patient numbers per tumour category.

Patterns of care for brachytherapy in Europe. Results in Spain.

INTRODUCTION: In 2003 ESTRO began a project whose primary objective, was to make a map in the European area of infrastructures in technology and personnel for brachytherapy. MATERIAL AND METHOD: A survey and a web site were elaborated. The survey was sent to the 76 Spanish Radiation Oncology departments in May 2003. RESULTS: By the end of 2003, 66 (86.8%) services had responded, 40 (71.4%) of which had brachytherapy. The services with brachytherapy treated 73.5% of the total patients, an average of 1,199 patients. The mean number of patients treated with brachytherapy by department was 135.5 and the number of applications was 265 annually. The average number of specialists was 7, 4 of them trained in brachytherapy. The average weekly work load of the radiation oncologists, physicists, and technicians was 22.6 h, 13.8 h and 21.0 h, respectively. The mean time dedicated to each patient by radiation oncologists, physicists and technicians was 9.2 h; 6.19 h; 7.2 h, respectively. The total number of afterloaders was 43 (22 HDR, 18 LDR, 3 PDR). The tumours most frequently treated with brachytherapy were gynaecological (56.24%), breast (14.2%) and prostate (11.7%). High dose rate was used in 47.46% of the patients and low dose rate in 47.24%. Between 1997 and 2002 there was an increase of 50.53% in patients treated with brachytherapy. CONCLUSIONS: The survey shows the brachytherapy resources and activity in Spain up to 2003. Increased use of brachytherapy in prostate tumours, prevalence of gynaecology brachytherapy and similar number of treatments with HDR and LDR are demonstrated in the Patterns of Care of Brachytherapy in Europe (PCBE) study in Spain.

A multicenter, open-label, prospective, randomized, dose-ranging pharmacokinetic study of the anti-TNF-alpha antibody afelimomab in patients with sepsis syndrome.

OBJECTIVE: To investigate the pharmacokinetics and safety of afelimomab, a murine antibody fragment against human tumor necrosis factor (TNF)-alpha in patients with sepsis. DESIGN: Multicenter, randomized, open-label, placebo-controlled phase I/II clinical trial. SETTING: Intensive care units of six academic medical centers in the United States. PATIENTS: Forty-eight patients with a clinical diagnosis of sepsis who received standard supportive care and antimicrobial therapy. INTERVENTIONS: Patients received 0.3, 1.0, or 3.0 mg/kg afelimomab or placebo intravenously over 20 min. Three patients in each dose group received single doses; the remaining nine patients in each group received multiple (nine) doses at 8-h intervals over 72 h. MEASUREMENTS AND MAIN RESULTS: Afelimomab appeared safe and well tolerated. Single- and multiple-dose kinetics were predictable and dose related. The elimination half-life was 44.7 h. Afelimomab treatment resulted in increased serum concentrations of TNF (includes TNF-antibody complexes) and decreased serum interleukin-6 concentrations, whereas no discernible trends were observed in placebo-treated patients. There was no significant treatment effect on 28-day mortality as was expected given the small number of patients. However, overall mortality was significantly (p = 0.001) associated with baseline interleukin-6 concentration. All patients experienced adverse events, but the vast majority were considered unrelated to the study drug and demonstrated no apparent relationship to afelimomab dose. Although 41% of patients developed human anti-murine antibodies, there were no clinical sequelae. CONCLUSIONS: Multidose therapy with afelimomab was safe, well tolerated, and had predictable linear kinetics. A large randomized trial comparing afelimomab to placebo in patients with well defined sepsis has recently been completed.

Eye-fixation behavior, lexical storage, and visual word recognition in a split processing model.

Some of the implications of a model of visual word recognition in which processing is conditioned by the anatomical splitting of the visual field between the two hemispheres of the brain are explored. The authors investigate the optimal processing of visually presented words within such an architecture, and, for a realistically sized lexicon of English, characterize a computationally optimal fixation point in reading. They demonstrate that this approach motivates a range of behavior observed in reading isolated words and text, including the optimal viewing position and its relationship with the preferred viewing location, the failure to fixate smaller words, asymmetries in hemisphere-specific processing, and the priority given to the exterior letters of words. The authors also show that split architectures facilitate the uptake of all the letter-position information necessary for efficient word recognition and that this information may be less specific than is normally assumed. A split model of word recognition captures a range of behavior in reading that is greater than that covered by existing models of visual word recognition.

Cytochrome P450 CYP2D6 genotypes: association with hair colour, Breslow thickness and melanocyte stimulating hormone receptor alleles in patients with malignant melanoma.

We previously identified associations between polymorphism in the cytochrome P450 CYP2D6 gene and outcome in several cancers. We have now examined the hypothesis that homozygosity for the mutant alleles, CYP2D6*4 and CYP2D6*3, is associated with susceptibility and outcome in malignant melanoma. Outcome was assessed by Breslow thickness. We first confirmed previous reports that these mutant alleles are associated with increased susceptibility to malignant melanoma. For example, the frequency of homozygosity for CYP2D6*4 was significantly greater (P = 0.006, chi-squared 1 d.f. = 7.4, odds ratio 2.2, 95% confidence interval 1.2, 3.9) in cases (9.1%) than in control individuals (4.3%). The frequency of homozygosity for the mutant alleles was next examined in the malignant melanoma cases grouped on the basis of characteristics associated with malignant melanoma risk. Homozygosity was significantly more common (P = 0.038) in cases with red/blonde hair than in those with brown/black hair. We found no associations between the CYP2D6 genotype and sex, skin type or eye colour. The possible association of CYP2D6 with outcome was assessed by comparing genotype frequencies in patients with tumours of Breslow thickness < 1.5 mm with those whose tumours were > or = 1.5 mm. In patients with red/blonde, but not brown or black hair, homozygosity for CYP2D6*4 was significantly associated with thicker lesions in a multivariate model (P = 0.036). We further examined the association of CYP2D6*4 homozygosity with red/blonde hair by classifying patients on the basis of homo- or heterozygosity for wild-type or val92met, asp294his or asp84glu melanocyte stimulating hormone receptor (MC1R) alleles. None of the nine patients with brown/black hair with the asp294his allele were homozygotes for CYP2D6*4. By contrast, in the patients with red/blonde hair, three of five cases with asp294his were homozygotes for the mutant CYP2D6 allele. The difference in the frequency of CYP2D6*4 homozygotes in the red/blonde cases with wild-type MC1R alleles compared with those with asp294his was significant (exact P = 0.029). No associations between val92his or asp84glu and CYP2D6 alleles were identified.

Cocaine-induced behavioral sensitization: effects of haloperidol and SCH 23390 treatments.

The objective of this study was to determine whether the development of behavioral sensitization to cocaine could be prevented by high doses of the dopamine receptor antagonists haloperidol and SCH 23390. In two experiments, male Wistar rats were injected daily for 4 days with either cocaine (15 mg/kg, IP) or vehicle in combination with haloperidol (1.0 mg/kg, IP), SCH 23390 (0.5 mg/kg, SC), or vehicle. After the daily injections, the rats were tested for locomotor activity in photocell arenas. At 24 h after the last preexposure test session, all rats were given a challenge injection of cocaine (15 mg/kg, IP) and tested for activity. Cocaine treatments produced a greater relative increase in locomotor activity with repeated exposure compared to vehicle treatments (i.e., sensitization). Moreover, the acute activating effects of cocaine over days were blocked by both haloperidol and SCH 23390. The coadministration of haloperidol, but not SCH 23390, blocked the development of behavioral sensitization to cocaine. That is, after the cocaine challenge injection, rats pretreated with SCH 23390 and cocaine did not differ from rats preexposed only to cocaine, whereas rats pretreated with haloperidol and cocaine did not differ from rats pretreated only with vehicle. Pretreatment with haloperidol or SCH 23390 without cocaine enhanced the locomotor-activating effects of the subsequent cocaine challenge injection. These findings suggest that cocaine-induced behavioral sensitization may develop as a result of repeated dopamine D1- or D2-type receptor stimulation, and that brief dopamine antagonist treatments enhance subsequent behavioral sensitivity to cocaine.

CD4 lymphocytes in women with invasive and preinvasive cervical neoplasia.

OBJECTIVE: To assess the relationship between CD4 lymphocyte population and stage of disease in cervical neoplasia. METHODS: Study population was 107 women with invasive cervical cancer, 116 women with cervical intraepithelial neoplasia (CIN), and 32 women without neoplasia diagnosed in 1988-1994. All women under age 50 were seronegative for the human immunodeficiency virus (HIV). All women over age 50 with CD4:CD8 ratio below normal were HIV-negative. Stage was defined by FIGO criteria using clinical findings. CD4 and CD8 lymphocyte populations were enumerated by flow cytometry prior to treatment. The normal range of CD4 counts was defined as 537-1571 cells/mm3. RESULTS: Distribution of CD4 count was similar in stages I (n = 40), II (n = 24), and III (n = 32), with 31% below normal and 9% above normal (mean CD4 count = 881). However, in stage IV (n = 11), 64% were below normal and 18% above normal (mean CD4 = 591). The difference in distribution between stages I-III and stage IV was statistically significant. Among 116 CIN patients, 10% had CD4 counts below normal and 3% above normal (mean CD4 = 910). Among 32 women without cervical neoplasia, 0% had CD4 counts below normal and 3% above normal. The difference between CIN and invasive cancer in the distribution of CD4 counts and CD8 counts was significant (P < 0.01). There was no difference in the CD4 count distribution by CIN severity. Forty-five percent of patients with below-normal CD4 counts at diagnosis developed recurrent cancer compared to 43% of patients with normal or above-normal CD4 counts. CONCLUSION: Women with invasive cervical cancer have lower CD4 counts and a broader distribution compared to women with preinvasive or no neoplasia. Metastatic cancer at diagnosis was associated with severely depressed CD4 count.

Attention deficit hyperactivity disorder and whole-blood serotonin levels: effects of comorbidity.

Whole-blood serotonin (5-hydroxytryptamine, 5-HT) levels were measured in children with attention deficit hyperactivity disorder (ADHD) with and without comorbid conduct disorder (CD) or oppositional-defiant disorder (ODD). It was hypothesized that the whole-blood 5-HT levels of ADHD probands would be significantly correlated with the whole-blood 5-HT levels of their mothers. Fifty-two children who met DSM-III-R criteria for ADHD were selected consecutively from an ADHD clinic (47 males--35 Caucasians, 10 African-Americans, and 2 Hispanics; 10 females--all Caucasians). Whole-blood 5-HT was assayed by high performance liquid chromatography and compared between ADHD children with and without comorbid CD or ODD. The familiality of whole-blood 5-HT levels was studied by Spearman's rank-order correlation. There were no significant age, race, or sex effects. There was no significant difference in whole-blood 5-HT levels between children with ADHD only (n = 22; 190 +/- 45 ng/ml) and ADHD with CD or ODD (n = 30; 212 +/- 67). However, 7 out of 30 (23%) children with ADHD+CD/ODD had whole-blood 5-HT levels > 270 ng/ml, while none of the ADHD-only children had whole-blood 5-HT levels > 270 ng/ml, a statistically significant difference. Whole-blood 5-HT levels showed significant positive correlations between 36 children with disruptive behavior disorders and their biological mothers (rs = 0.47). There was no difference in mean levels of whole-blood 5-HT between subgroups of children with ADHD with or without comorbid CD or ODD.(ABSTRACT TRUNCATED AT 250 WORDS)