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.

Intuitive Data Visualization for Enhanced Patient Comprehension.

The pilot study explores how data visualization influences patient comprehension and engagement in understanding hyperlipidemia test results across diverse patient groups. Employing Gestalt theory and the Relational Information Display (RID) framework, intuitive visual tools were developed using Google Sheets, QlikView®, and Microsoft® Excel®. The survey conducted with patients used a Likert scale to evaluate six different line and bar graphs, each presenting the same LDL cholesterol data. The study emphasized the creation of graphs that were easily interpretable. The survey aimed to assess preferences for various data visualization formats. The survey results indicated that patients preferred stacked area charts, while healthcare providers favored line charts. The results highlight the importance of user-centric design and the effective application of theoretical frameworks in creating visualizations that enhance patient engagement and comprehension. The study highlights the role of tailored data visualizations in healthcare, emphasizing the need for such tools in user-centered health technology.

Reading acquisition among students in Grades 1-3 with intellectual disabilities in Sweden.

This study investigates the reading performance of younger students with intellectual disabilities to gain insight into their needs in reading education. Participants were 428 students in Grades 1 to 3 in Sweden. They performed LegiLexi tests measuring pre-reading skills, decoding and reading comprehension based on the model of Simple View of Reading. Results demonstrate a great variation in reading acquisition among students. Some students are able to decode single words and read shorter texts with comprehension already in Grade 1. Other students still struggle with learning letters and developing phonological awareness in Grade 3. According to their longitudinal data over grades, results show that most students progress in pre-reading skills, decoding, and reading comprehension. Hence, assessing reading skills among students with intellectual disabilities in Grades 1-3 using tools aligned with the Simple View of Reading seems applicable and informative for teachers. This study underscores the significance of informed instructional practices for empowering these students in reading education.

Do 14-17-month-old infants use iconic speech and gesture cues to interpret word meanings?a).

This experimental study investigated whether infants use iconicity in speech and gesture cues to interpret word meanings. Specifically, we tested infants' sensitivity to size sound symbolism and iconic gesture cues and asked whether combining these cues in a multimodal fashion would enhance infants' sensitivity in a superadditive manner. Thirty-six 14-17-month-old infants participated in a preferential looking task in which they heard a spoken nonword (e.g., "zudzud") while observing a small and large object (e.g., a small and large square). All infants were presented with an iconic cue for object size (small or large) (1) in the pitch of the spoken non-word (high vs low), (2) in gesture (small or large), or (3) congruently in pitch and gesture (e.g., a high pitch and small gesture indicating a small square). Infants did not show a preference for congruently sized objects in any iconic cue condition. Bayes factor analyses showed moderate to strong support for the null hypotheses. In conclusion, 14-17-month-old infants did not use iconic pitch cues, iconic gesture cues, or iconic multimodal cues (pitch and gesture) to associate speech sounds with their referents. These findings challenge theories that emphasize the role of iconicity in early language development.

Assessing the readability and quality of online patient information for laser tattooremoval.

Just as tattoos continue to increase in popularity, many people with tattoos also seek removal, often due to career concerns. Prospective clients interested in laser tattoo removal may do research about the procedure online, as the internet increasingly becomes a resource to get preliminary health information. However, it is important that the online health information on the topic be of high quality and be accessible to all patients. We analyzed 77 websites from a Google search query using the terms "Laser tattoo removal patient Information" and "Laser tattoo removal patient Instructions" to assess this. The websites were evaluated for their readability using multiple validated indices and comprehensiveness. We found that websites had a broad readability range, from elementary to college, though most were above the recommended eighth-grade reading level. Less than half of the websites adequately discussed the increased risk of pigmentary complications in the skin of color clients or emphasized the importance of consulting with a board-certified dermatologist/plastic surgeon before the procedure. Over 90% of the websites noted that multiple laser treatments are likely needed for complete clearance of tattoos. The findings from our study underscore a significant gap in the accessibility and quality of online information for patients considering laser tattoo removal, particularly in addressing specific risks for patients with darker skin tones and emphasizing the need for consulting a board-certified physician before undergoing the procedure. It is important that online resources for laser tattoo removal be appropriately written to allow better decision-making, expectations, and future satisfaction for potential clients interested in the procedure.

Cross-linguistic syntactic priming as rational expectation for syntactic repetition in the bilingual environment.

Recent research suggests that syntactic priming in language comprehension-the facilitated processing of repeated syntactic structures-arises from the expectation for syntactic repetition due to rational adaptation to the linguistic environment. To further evaluate the generalizability of this expectation adaptation account in cross-linguistic syntactic priming and explore the influence of second language (L2) proficiency, we conducted a self-paced reading study with Chinese L2 learners of English by utilizing the sentential complement-direct object (SC-DO) ambiguity. The results showed that participants exposed to clusters of SC structures subsequently processed repetitions of this structure more rapidly (i.e., larger priming effects) than those exposed to the same number of SC structures but spaced in time, despite the prime and target being in two different languages (Chinese and English). Furthermore, this difference in priming strength was more pronounced for participants with higher L2 (English) proficiency. These findings demonstrate that cross-linguistic syntactic priming is consistent with the expectation for syntactic repetition that rationally adapts to syntactic clustering properties in surrounding bilingual environments, and such adaptation is enhanced as L2 proficiency increases. Taken together, our study extends the expectation adaptation account to cross-linguistic syntactic priming and integrates the role of L2 proficiency, which can shed new light on the mechanisms underlying syntactic priming, bilingual shared syntactic representations and expectation-based sentence processing.

Duration of cochlear implant use in children with prelingual single-sided deafness is a predictor of word perception in the CI ear.

As part of a longitudinal study regarding the benefit of early cochlear implantation for children with single-sided deafness, the current work explored the children's daily device use, potential barriers to full-time device use, and the children's ability to understand speech with the cochlear implant (CI). Data were collected from 20 children with prelingual SSD who received a CI before the age of 2.5 years, from the initial activation of the sound processor until the children were 4.8 to 11.0 years old. Daily device use was extracted from the CI's data logging, while word perception in quiet was assessed using direct audio input to the children's sound processor. The children's caregivers completed a questionnaire about habits, motivations, and barriers to device use. The children with SSD and a CI used their device on average 8.3 h per day, corresponding to 63 % of their time spent awake. All children except one could understand speech through the CI, with an average score of 59 % on a closed-set test and 73 % on an open-set test. More device use was associated with higher speech perception scores. Parents were happy with their decision to pursue a CI for their child. Certain habits, like taking off the sound processor during illness, were associated with lower device use. Providing timely counselling to the children's parents, focused on SSD-specific challenges, may be helpful to improve daily device use in these children.

The jingle fallacy in comprehension tests for reading.

The Jingle fallacy is the false assumption that instruments which share the same name measure the same underlying construct. In this experiment, we focus on the comprehension subtests of the Nelson Denny Reading Test (NDRT) and the Wechsler Individual Achievement Test (WIAT-II). 91 university students read passages for comprehension whilst their eye movements were recorded. Participants took part in two experimental blocks of which the order was counterbalanced, one with higher comprehension demands and one with lower comprehension demands. We assumed that tests measuring comprehension would be able to predict differences observed in eye movement patterns as a function of varying comprehension demands. Overall, readers were able to adapt their reading strategy to read more slowly, making more and longer fixations, coupled with shorter saccades when comprehension demands were higher. Within an experimental block, high scorers on the NDRT were able to consistently increase their pace of reading over time for both higher and lower comprehension demands, whereas low scorers approached a threshold where they could not continue to increase their reading speed or further reduce the number of fixations to read a text, even when comprehension demands were low. Individual differences based on the WIAT-II did not explain similar patterns. The NDRT comprehension test was therefore more predictive of differences in the reading patterns of skilled adult readers in response to comprehension demands than the WIAT-II (which also suffered from low reliability). Our results revealed that these different comprehension measures should not be used interchangeably, and researchers should be cautious when choosing reading comprehension tests for research.

Early parafoveal semantic integration in natural reading.

Humans can read and comprehend text rapidly, implying that readers might process multiple words per fixation. However, the extent to which parafoveal words are previewed and integrated into the evolving sentence context remains disputed. We investigated parafoveal processing during natural reading by recording brain activity and eye movements using MEG and an eye tracker while participants silently read one-line sentences. The sentences contained an unpredictable target word that was either congruent or incongruent with the sentence context. To measure parafoveal processing, we flickered the target words at 60 Hz and measured the resulting brain responses (i.e. Rapid Invisible Frequency Tagging, RIFT) during fixations on the pre-target words. Our results revealed a significantly weaker tagging response for target words that were incongruent with the previous context compared to congruent ones, even within 100ms of fixating the word immediately preceding the target. This reduction in the RIFT response was also found to be predictive of individual reading speed. We conclude that semantic information is not only extracted from the parafovea but can also be integrated with the previous context before the word is fixated. This early and extensive parafoveal processing supports the rapid word processing required for natural reading. Our study suggests that theoretical frameworks of natural reading should incorporate the concept of deep parafoveal processing.

Multisensory integration of speech and gestures in a naturalistic paradigm.

Speech comprehension is crucial for human social interaction, relying on the integration of auditory and visual cues across various levels of representation. While research has extensively studied multisensory integration (MSI) using idealised, well-controlled stimuli, there is a need to understand this process in response to complex, naturalistic stimuli encountered in everyday life. This study investigated behavioural and neural MSI in neurotypical adults experiencing audio-visual speech within a naturalistic, social context. Our novel paradigm incorporated a broader social situational context, complete words, and speech-supporting iconic gestures, allowing for context-based pragmatics and semantic priors. We investigated MSI in the presence of unimodal (auditory or visual) or complementary, bimodal speech signals. During audio-visual speech trials, compared to unimodal trials, participants more accurately recognised spoken words and showed a more pronounced suppression of alpha power-an indicator of heightened integration load. Importantly, on the neural level, these effects surpassed mere summation of unimodal responses, suggesting non-linear MSI mechanisms. Overall, our findings demonstrate that typically developing adults integrate audio-visual speech and gesture information to facilitate speech comprehension in noisy environments, highlighting the importance of studying MSI in ecologically valid contexts.

Assessing ChatGPT Ability to Answer Frequently Asked Questions About Essential Tremor.

Background: Large-language models (LLMs) driven by artificial intelligence allow people to engage in direct conversations about their health. The accuracy and readability of the answers provided by ChatGPT, the most famous LLM, about Essential Tremor (ET), one of the commonest movement disorders, have not yet been evaluated. Methods: Answers given by ChatGPT to 10 questions about ET were evaluated by 5 professionals and 15 laypeople with a score ranging from 1 (poor) to 5 (excellent) in terms of clarity, relevance, accuracy (only for professionals), comprehensiveness, and overall value of the response. We further calculated the readability of the answers. Results: ChatGPT answers received relatively positive evaluations, with median scores ranging between 4 and 5, by both groups and independently from the type of question. However, there was only moderate agreement between raters, especially in the group of professionals. Moreover, readability levels were poor for all examined answers. Discussion: ChatGPT provided relatively accurate and relevant answers, with some variability as judged by the group of professionals suggesting that the degree of literacy about ET has influenced the ratings and, indirectly, that the quality of information provided in clinical practice is also variable. Moreover, the readability of the answer provided by ChatGPT was found to be poor. LLMs will likely play a significant role in the future; therefore, health-related content generated by these tools should be monitored.

Readability analysis of ChatGPT's responses on lung cancer.

For common diseases such as lung cancer, patients often use the internet to obtain medical information. As a result of advances in artificial intelligence and large language models such as ChatGPT, patients and health professionals use these tools to obtain medical information. The aim of this study was to evaluate the readability of ChatGPT-generated responses with different readability scales in the context of lung cancer. The most common questions in the lung cancer section of Medscape® were reviewed, and questions on the definition, etiology, risk factors, diagnosis, treatment, and prognosis of lung cancer (both NSCLC and SCLC) were selected. A set of 80 questions were asked 10 times to ChatGPT via the OpenAI API. ChatGPT's responses were tested using various readability formulas. The mean Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning FOG Scale, SMOG Index, Automated Readability Index, Coleman-Liau Index, Linsear Write Formula, Dale-Chall Readability Score, and Spache Readability Formula scores are at a moderate level (mean and standard deviation: 40.52 ± 9.81, 12.56 ± 1.66, 13.63 ± 1.54, 14.61 ± 1.45, 15.04 ± 1.97, 14.24 ± 1.90, 11.96 ± 2.55, 10.03 ± 0.63 and 5.93 ± 0.50, respectively). The readability levels of the answers generated by ChatGPT are "collage" and above and are difficult to read. Perhaps in the near future, the ChatGPT can be programmed to produce responses that are appropriate for people of different educational and age groups.

Assessing readability of online patient educational material on concussion and return to play.

OBJECTIVE: Concussions are self-limited forms of mild traumatic brain injury (TBI). Gradual return to play (RTP) is crucial to minimizing the risk of second impact syndrome. Online patient educational materials (OPEM) are often used to guide decision-making. Previous literature has reported that grade-level readability of OPEM is higher than recommended by the American Medical Association and the National Institutes of Health. The authors evaluated the readability of OPEM on concussion and RTP. METHODS: An online search engine was used to identify websites providing OPEM on concussion and RTP. Text specific to concussion and RTP was extracted from each website and readability was assessed using the following six standardized indices: Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook Index, and Automated Readability Index. One-way ANOVA and Tukey's post hoc test were used to compare readability across sources of information. RESULTS: There were 59 concussion and RTP articles, and readability levels exceeded the recommended 6th grade level, irrespective of the source of information. Academic institutions published OPEM at simpler readability levels (higher FRE scores). Private organizations published OPEM at more complex (higher) grade-level readability levels in comparison with academic and nonprofit institutions (p < 0.05). CONCLUSIONS: The readability of OPEM on RTP after concussions exceeds the literacy of the average American. There is a critical need to modify the concussion and RTP OPEM to improve comprehension by a broad audience.

Semantic encoding during language comprehension at single-cell resolution.

From sequences of speech sounds1,2 or letters3, humans can extract rich and nuanced meaning through language. This capacity is essential for human communication. Yet, despite a growing understanding of the brain areas that support linguistic and semantic processing4-12, the derivation of linguistic meaning in neural tissue at the cellular level and over the timescale of action potentials remains largely unknown. Here we recorded from single cells in the left language-dominant prefrontal cortex as participants listened to semantically diverse sentences and naturalistic stories. By tracking their activities during natural speech processing, we discover a fine-scale cortical representation of semantic information by individual neurons. These neurons responded selectively to specific word meanings and reliably distinguished words from nonwords. Moreover, rather than responding to the words as fixed memory representations, their activities were highly dynamic, reflecting the words' meanings based on their specific sentence contexts and independent of their phonetic form. Collectively, we show how these cell ensembles accurately predicted the broad semantic categories of the words as they were heard in real time during speech and how they tracked the sentences in which they appeared. We also show how they encoded the hierarchical structure of these meaning representations and how these representations mapped onto the cell population. Together, these findings reveal a finely detailed cortical organization of semantic representations at the neuron scale in humans and begin to illuminate the cellular-level processing of meaning during language comprehension.

Readability and Information Quality in Cancer Information From a Free vs Paid Chatbot.

Importance: The mainstream use of chatbots requires a thorough investigation of their readability and quality of information. Objective: To identify readability and quality differences in information between a free and paywalled chatbot cancer-related responses, and to explore if more precise prompting can mitigate any observed differences. Design, Setting, and Participants: This cross-sectional study compared readability and information quality of a chatbot's free vs paywalled responses with Google Trends' top 5 search queries associated with breast, lung, prostate, colorectal, and skin cancers from January 1, 2021, to January 1, 2023. Data were extracted from the search tracker, and responses were produced by free and paywalled ChatGPT. Data were analyzed from December 20, 2023, to January 15, 2024. Exposures: Free vs paywalled chatbot outputs with and without prompt: "Explain the following at a sixth grade reading level: [nonprompted input]." Main Outcomes and Measures: The primary outcome measured the readability of a chatbot's responses using Flesch Reading Ease scores (0 [graduate reading level] to 100 [easy fifth grade reading level]). Secondary outcomes included assessing consumer health information quality with the validated DISCERN instrument (overall score from 1 [low quality] to 5 [high quality]) for each response. Scores were compared between the 2 chatbot models with and without prompting. Results: This study evaluated 100 chatbot responses. Nonprompted free chatbot responses had lower readability (median [IQR] Flesh Reading ease scores, 52.60 [44.54-61.46]) than nonprompted paywalled chatbot responses (62.48 [54.83-68.40]) (P < .05). However, prompting the free chatbot to reword responses at a sixth grade reading level was associated with increased reading ease scores than the paywalled chatbot nonprompted responses (median [IQR], 71.55 [68.20-78.99]) (P < .001). Prompting was associated with increases in reading ease in both free (median [IQR], 71.55 [68.20-78.99]; P < .001)and paywalled versions (median [IQR], 75.64 [70.53-81.12]; P < .001). There was no significant difference in overall DISCERN scores between the chatbot models, with and without prompting. Conclusions and Relevance: In this cross-sectional study, paying for the chatbot was found to provide easier-to-read responses, but prompting the free version of the chatbot was associated with increased response readability without changing information quality. Educating the public on how to prompt chatbots may help promote equitable access to health information.

Improving consumer understanding of pesticide toxicity labels: experimental evidence.

Consumers often inadvertently misperceive the health hazards associated with over-the-counter pesticides under the current textual labeling policy, potentially leading to improper use. We conducted an incentivized framed field experiment with eye tracking to evaluate the effectiveness of the current pesticide labels that convey risk using signal words (Caution, Warning, Danger) compared to two visually focused label alternatives: traffic light colors and skull intensity symbols. A total of 166 participants were randomly assigned to one of three label formats and asked to rank toxicity levels and make purchasing decisions within multiple price lists. Results show that signal words fail to adequately communicate toxicity levels. Specifically, participants' correct assessment of toxicity level dramatically improves from 54% under the existing signal word label to 95% under the traffic light and 83% under the skull intensity symbol labels. We also find that participants are more likely to choose the less toxic alternatives under the new labels, suggesting the current labeling system may affect choice and have unintended adverse effects on human health.

How teachers make connections among ideas in mathematics instruction.

Conceptual understanding involves understanding connections among ideas within a domain. In this chapter, we consider how teachers support students in learning about connections among ideas in mathematics. We review research focusing on teachers' connection making in mathematics classrooms, and we consider several dimensions of variability in that connection making. Across three corpora of lessons that varied in students' grade levels (first grade to college), cultural settings (United States and China), and mathematics content, we found that all teachers produced linking episodes, but the frequency with which they did so varied substantially, raising new questions about the sources and consequences of that variability. Teachers of first-grade students in China routinely engaged their students in co-constructing links; teachers of middle schoolers and college students in the United States typically explained links to students. Linking episodes targeted many different types of connections, including connections between representations, connections between principles and exemplars, connections between procedures and concepts, and connections between concepts and real-world instantiations. Across all three corpora, teachers expressed linked ideas multimodally in a majority of linking episodes. Based on the findings, we present several hypotheses about how teacher behaviors may support students' understanding of connections among ideas, and we suggest directions for future work.

Actions chains and intention understanding in 3- to 6-year-old children.

In intentional behavior, the final goal of an action is crucial in determining the entire sequence of motor acts. Neurons have been described in the inferior parietal lobule of monkeys, which besides encoding a specific motor act (e.g., grasping), have their discharge modulated by the final goal of the intended action (e.g., grasping-to-eat). Many of these "action-constrained" neurons have mirror properties responding to the observation of the motor act they encode, provided that this is embedded in a specific action. Thanks to this mechanism, the observers have an internal copy of the whole action before its execution and may, in this way, understand the agent's intention. The chained organization of motor acts has been demonstrated in schoolchildren. Here, we examined whether this organization is already present in very young children. To this purpose, we recorded EMG from the mylohyoid (MH) muscle in the children aged 3 to 6 y. The results showed that preschoolers, like older children, possess the chained organization of motor acts in execution. Interestingly, in comparison to older children, they have a delayed ability to use this mechanism to infer others' intentions by observation. Finally, we found a significant negative association between the children's age and the activation of the MH muscle during the grasp-to-eat phase in the observation condition. We, tentatively, interpreted it as a sign of an immature control of motor acts.