Chronic liver disease-associated severe thrombocytopenia in Spain: Results from a retrospective study using machine learning and natural language processing.

BACKGROUND: Patients with chronic liver disease (CLD) often develop thrombocytopenia (TCP) as a complication. Severe TCP (platelet count<50×109/L) can increase morbidity and complicate CLD management, increasing bleeding risk during invasive procedures. OBJECTIVES: To describe the real-world scenario of CLD-associated severe TCP patients' clinical characteristics. To evaluate the association between invasive procedures, prophylactic treatments, and bleeding events in this group of patients. To describe their need of medical resource use in Spain. METHODS: This is a retrospective, multicenter study including patients who had confirmed diagnosis of CLD and severe TCP in four hospitals within the Spanish National Healthcare Network from January 2014 to December 2018. We analyzed the free-text information from Electronic Health Records (EHRs) of patients using Natural Language Processing (NLP), machine learning techniques, and SNOMED-CT terminology. Demographics, comorbidities, analytical parameters and characteristics of CLD were extracted at baseline and need for invasive procedures, prophylactic treatments, bleeding events and medical resources used in the follow up period. Frequency tables were generated for categorical variables, whereas continuous variables were described in summary tables as mean (SD) and median (Q1-Q3). RESULTS: Out of 1,765,675 patients, 1787 had CLD and severe TCP; 65.2% were male with a mean age of 54.7 years old. Cirrhosis was detected in 46% (n=820) of patients and 9.1% (n=163) had hepatocellular carcinoma. Invasive procedures were needed in 85.6% of patients during the follow up period. Patients undergoing procedures compared to those patients without invasive procedures presented higher rates of bleeding events (33% vs 8%, p<0.0001) and higher number of bleedings. While prophylactic platelet transfusions were given to 25.6% of patients undergoing procedures, TPO receptor agonist use was only detected in 3.1% of them. Most patients (60.9%) required at least one hospital admission during the follow up and 14.4% of admissions were due to bleeding events with a hospital length of stay of 6 (3, 9) days. CONCLUSIONS: NLP and machine learning are useful tools to describe real-world data in patients with CLD and severe TCP in Spain. Bleeding events are frequent in those patients who need invasive procedures, even receiving platelet transfusions as a prophylactic treatment, increasing the further use of medical resources. Because that, new prophylactic treatments that are not yet generalized, are needed.

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period.

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.

El trabajo de Nancy Suchman subrayó el papel fundamental de la mentalización maternal en la adicción materna, la salud mental y los retos de la prestación de cuidado. En este estudio, nos propusimos examinar el papel del lenguaje del estado mental como una medida de mentalización en las narrativas pre- y postnatales y su sentimiento en un grupo muestra de 91 madres primariamente blancas del oeste de los Estados Unidos, a quienes se les dio seguimiento a partir del segundo trimestre de embarazo, a través del tercer trimestre, hasta 4 meses después del parto. Específicamente, investigamos el uso de lenguaje del estado mental afectivo y cognitivo en las narrativas prenatales cuando las madres visualizaban el cuidado de su bebé, y las narrativas postnatales cuando las madres comparaban su visualización prenatal con la presente realidad de prestación de cuidado. Los resultados indicaron una consistencia moderada en el lenguaje del estado mental entre el segundo y tercer trimestres, pero el lenguaje del estado mental prenatal y postnatal no fue significativamente correlacionado. A los largo de todos los punto temporales, el más alto uso del lenguaje del estado mental se relacionó con un más positivo sentimiento, indicando así una asociación entre la mentalización y las representaciones positivas de la prestación de cuidado a lo largo del período perinatal. Las mujeres usaron más lenguaje del estado mental afectivo que cognitivo en la imaginación prenatal de la prestación de cuidado, pero este patrón se invirtió en sus reflexiones después del parto. Se discuten las implicaciones sobre el tener acceso a la mentalización del progenitor prenatalmente y considerar el relativo dominio del mentalizarse en lo afectivo y cognitivo, al tiempo que se consideran las limitaciones del estudio.

Le travail de Nancy Suchman a mis en lumière le rôle fondamental de la mentalisation maternelle dans l'addiction maternelle, la santé mentale et les défis de la prestation de soins. Dans cette étude nous nous sommes donné pour but d'examiner le rôle du langage d'état mental en tant que mesure de la mentalisation dans les narrations prénatales et postnatales et leur sentiment chez un échantillon de 91 mères dans l'ensemble blanches vivant dans l'ouest des Etats-Unis d'Amériques, et suivies du second trimestre de la grossesse, durant le troisième trimestre jusqu'à 4 mois après la naissance. Plus particulièrement nous nous sommes penchés sur l'utilisation du langage d'état mental affectif et cognitif dans des narrations prénatales lorsque les mères visualisaient les soins à leur bébé, et les narrations postnatales lorsque les mères comparaient leur visualisation prénatale à la réalité actuelle des soins au bébé. Les résultats ont indiqué une cohérence modérée dans le langage d'état mental entre les second et troisième trimestres mais le langage d'état mental prénatal et postnatal n'était pas significativement corrélé. Au travers de tous les points temporels l'utilisation plus grande de langage d'état mental était liée à un sentiment plus positif, indiquant un lien entre la mentalisation et les représentations positives des soins au travers de la période périnatale. Les femmes ont utilisé un langage d'état mentale plus affectif que cognitif dans l'imagination prénatale des soins, mais ce schéma était renversé dans leur réflexion postpartum. Les implications pour l'évaluation de la mentalisation parentale avant la naissance et pour la considération de la domination relative de la mentalisation affective et cognitive sont discutées, tout en considérant les limites de l'étude.

Growth of non-English-language literature on biodiversity conservation.

English is widely recognized as the language of science, and English-language publications (ELPs) are rapidly increasing. It is often assumed that the number of non-ELPs is decreasing. This assumption contributes to the underuse of non-ELPs in conservation science, practice, and policy, especially at the international level. However, the number of conservation articles published in different languages is poorly documented. Using local and international search systems, we searched for scientific articles on biodiversity conservation published from 1980 to 2018 in English and 15 non-English languages. We compared the growth rate in publications across languages. In 12 of the 15 non-English languages, published conservation articles significantly increased every year over the past 39 years, at a rate similar to English-language articles. The other three languages showed contrasting results, depending on the search system. Since the 1990s, conservation science articles in most languages increased exponentially. The variation in the number of non-English-language articles identified among the search systems differed markedly (e.g., for simplified Chinese, 11,148 articles returned with local search system and 803 with Scopus). Google Scholar and local literature search systems returned the most articles for 11 and 4 non-English languages, respectively. However, the proportion of peer-reviewed conservation articles published in non-English languages was highest in Scopus, followed by Web of Science and local search systems, and lowest in Google Scholar. About 20% of the sampled non-English-language articles provided no title or abstract in English; thus, in theory, they were undiscoverable with English keywords. Possible reasons for this include language barriers and the need to disseminate research in countries where English is not widely spoken. Given the known biases in statistical methods and study characteristics between English- and non-English-language studies, non-English-language articles will continue to play an important role in improving the understanding of biodiversity and its conservation.

RESUMEN: El inglés es reconocido como el idioma de la ciencia y las publicaciones en inglés (PI) cada vez son más. Con frecuencia se asume que el número de publicaciones en idiomas diferentes al inglés está disminuyendo. Esta suposición contribuye al uso reducido de las publicaciones que no están en inglés en las ciencias, prácticas y políticas de la conservación, especialmente a nivel internacional. Sin embargo, el número de artículos de conservación publicados en diferentes idiomas está muy mal documentado. Usamos sistemas de búsqueda locales e internacionales para buscar artículos científicos sobre la conservación de la biodiversidad publicados entre 1980 y 2018 en inglés y en quince idiomas diferentes al inglés. También comparamos la tasa de incremento de publicaciones en los diferentes idiomas. En doce de los quince idiomas diferentes al inglés, los artículos de conservación publicados incrementaron significativamente cada año durante los últimos 39 años, una tasa similar a los artículos en inglés. Los otros tres idiomas mostraron resultados contrastantes según el sistema de búsqueda. Desde la década de 1990, los artículos sobre ciencias de la conservación incrementaron exponencialmente en la mayoría de los idiomas. La variación en el número de artículos identificados en idiomas diferentes al inglés difirió notablemente de acuerdo con los sistemas de búsqueda (p. ej.: en el caso del chino simplificado, obtuvimos 11,148 artículos con el sistema de búsqueda local y 803 con Scopus). Google Scholar y los sistemas locales de búsqueda arrojaron la mayor cantidad de artículos en 11 y 4 idiomas diferentes al inglés, respectivamente. Sin embargo, la proporción de artículos sobre conservación revisados por pares y publicados en idiomas diferentes al inglés fue mayor en Scopus, seguida por Web of Science y los sistemas locales de búsqueda, con la menor proporción en Google Scholar. Aproximadamente el 20% de la muestra de artículos en idiomas diferentes al inglés no contaban con título o con resumen en inglés; por lo tanto, en teoría, eran imposibles de encontrar mediante palabras clave en inglés. Las posibles explicaciones de esto incluyen las barreras del idioma y la necesidad de difundir la investigación en países en los que el inglés no se habla extensamente. Con los sesgos conocidos de los métodos estadísticos y de las características de estudio entre los trabajos en inglés y en otros idiomas, los artículos en idiomas diferentes al inglés seguirán desempeñando un papel importante en el entendimiento de la biodiversidad y su conservación. Incremento de la Literatura sobre la Conservación de la Biodiversidad en Idiomas Diferentes al Inglés.

Sentiment analysis as a measure of conservation culture in scientific literature.

Culturomics is emerging as an important field within science, as a way to measure attitudes and beliefs and their dynamics across time and space via quantitative analysis of digitized data from literature, news, film, social media, and more. Sentiment analysis is a culturomics tool that, within the last decade, has provided a means to quantify the polarity of attitudes expressed within various media. Conservation science is a crisis discipline; therefore, accurate and effective communication are paramount. We investigated how conservation scientists communicate their findings through scientific journal articles. We analyzed 15,001 abstracts from articles published from 1998 to 2017 in 6 conservation-focused journals selected based on indexing in scientific databases. Articles were categorized by year, focal taxa, and the conservation status of the focal species. We calculated mean sentiment score for each abstract (mean adjusted z score) based on 4 lexicons (Jockers-Rinker, National Research Council, Bing, and AFINN). We found a significant positive annual trend in the sentiment scores of articles. We also observed a significant trend toward increasing negativity along the spectrum of conservation status categories (i.e., from least concern to extinct). There were some clear differences in the sentiments with which research on different taxa was reported, however. For example, abstracts mentioning lobe finned fishes tended to have high sentiment scores, which could be related to the rediscovery of the coelacanth driving a positive narrative. Contrastingly, abstracts mentioning elasmobranchs had low scores, possibly reflecting the negative sentiment score associated with the word shark. Sentiment analysis has applications in science, especially as it pertains to conservation psychology, and we suggest a new science-based lexicon be developed specifically for the field of conservation.

El Análisis de Opinión como Medida de la Cultura de Conservación en la Literatura Científica Lennox et al. Resumen La culturomía está emergiendo como un campo importante dentro de la ciencia pues es una manera de medir las actitudes, creencias y sus dinámicas a través del tiempo y el espacio por medio de un análisis cuantitativo de datos digitalizados a partir de la literatura, las noticias, las películas, las redes sociales y otros medios. El análisis de opinión es una herramienta de la culturomía que, en la última década, ha proporcionado los medios para cuantificar la polaridad de las actitudes expresadas en varios medios. La ciencia de la conservación es una disciplina de crisis; por lo tanto, la comunicación certera y efectiva es de suma importancia. Investigamos cómo los científicos de la conservación comunican sus hallazgos por medio de los artículos en las revistas científicas. Analizamos 15,001 resúmenes de artículos publicados entre 1998 y 2017 en seis revistas enfocadas en la conservación que fueron seleccionados con base en los índices de las bases de datos científicos. Categorizamos los artículos por año, taxón de enfoque y el estado de conservación de la especie focal. Calculamos la opinión promedio para cada resumen (puntaje z ajustado a la media) con base en cuatro lexicones (Jockers-Rinker, National Research Council, Bing y AFINN). Encontramos una significativa tendencia positiva anual en los puntajes de opinión de los artículos. También observamos una tendencia significativa hacia el incremento en la negatividad a lo largo del espectro de categorías de estado de conservación (es decir, de aquellas de menos preocupación a aquellas en peligro crítico o extintas). Sin embargo, hubo algunas diferencias claras en las opiniones con las cuales se reportaron las investigaciones sobre los diferentes taxones. Por ejemplo, los resúmenes que mencionaron a los peces de aletas lobuladas tendieron hacia los puntajes altos de opinión, lo que podría relacionarse con el redescubrimiento del celacanto como causa de una narrativa positiva. En contraste, los resúmenes que mencionaron a los elasmobranquios tuvieron puntajes bajos, lo que refleja el puntaje de opinión negativa asociado con la palabra tiburón. El análisis de opinión tiene aplicaciones en la ciencia, especialmente como parte de la psicología de la conservación, y sugerimos que se desarrolle un nuevo lexicón basado en la ciencia específicamente para el campo de la conservación.

Candidate gene variant effects on language disorders in Robinson Crusoe Island.

Background: Robinson Crusoe Island is a geographically and socially isolated settlement located over 600 km west of the Port of Valparíso, Chile. An unusually high incidence (30%) of the Chilean equivalent of developmental language disorder (in Spanish, trastorno especifico de lenguaje (TEL)), has been reported in Islander children, with 90% of these affected children found to be direct descendants of a pair of original founder-brothers, therefore strongly suggesting a shared genetic basis. Aim: This study reports a comprehensive examination of 34 genes that have been previously directly implicated in language-related mechanisms. It utilises whole-genome sequencing to investigate potential underlying variants in seven TEL affected and 10 unaffected islanders. The aim was to identify the underlying genetic cause of the TEL phenotype under two inheritance model paradigms; Mendelian monogenic and complex susceptibility. Subjects and methods: A targeted candidate gene approach was used to look for rare, shared variants that may underlie the diagnosis of TEL in a Mendelian genetic model. This study tested whether an overall burden of rare variants is enriched in individuals affected by TEL or with Islanders related to the founder-brother lineage. It further examined if any variants segregate with affection status or with founder-brother-related status and, therefore, may increase risk of developing a language disorder as part of a complex model. Finally, gene-based tests were performed to evaluate relationships between combined variation across candidate genes and TEL affection status. Results: No single pathogenic rare variant segregated with either affection or founder-related status within the 34 candidate genes. Additionally, no evidence was found of an overall increased variant burden in TEL individuals compared to those with TLD. Gene-based analysis found no clear association between the combined effects of variants across the 34 genes and affection status or founder-brother-relatedness. Conclusion: The high prevalence of language disorders found on Robinson Crusoe Island is not caused by either a shared high-impact variant, or an increased burden of variants within candidate genes previously implicated in language disorders. We have comprehensively tested for 'low hanging fruit' in genes implicated in language disorders. Therefore, the underlying cause of TEL on Robinson Crusoe lies outside of these known language disorder genes, or within a complex susceptibility model.

FOOD NEGLECT AND INFANT DEVELOPMENT.

The impact of food insecurity on child development in the general U.S. population is well-established, yet little is known about the harm of food neglect relative to other types of maltreatment. Due to the harmful physiological impact of inadequate nutrients and the social impact of food-related stress, it was hypothesized that food neglect would be more likely to impair infant cognitive and language development than physical abuse, sexual abuse, and other forms of neglect. Families of infants (N = 1,951) investigated by Child Protective Services were studied using the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II; NSCAW Research Group, 2002). Results from multivariable logistic regression models that controlled for likely confounding variables showed that the odds of impairment in cognition and language were significantly greater when food neglect was the most serious form of maltreatment. Considering that both food insecurity and child neglect are associated with poverty and parental mental health problems, it will be important for child welfare and mental health professionals to work collaboratively to better the health of these vulnerable children.

SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS IN TODDLERS WITH LANGUAGE DELAY.

Toddlers with language delay are at risk for persistent developmental and behavioral difficulties; however, the association between socioemotional/behavior problems and language in young children is not well understood. This study explored socioemotional/behavior problems in a unique sample of toddlers with language delays using a measure developed explicitly for this age group. Toddlers identified by 18 months with receptive and expressive language delay (LD; n = 30) or typical development (TD; n = 61) were evaluated at 18 and 24 months of age using the Infant-Toddler Social and Emotional Assessment (ITSEA) and the Mullen Scales of Early Learning. Compared to toddlers who had TD, toddlers with LD had significantly more concerning scores at 18 and 24 months on all ITSEA domains. The rate of "clinical concern" on most domains was not high in either group, except that >60% of LD toddlers were in the clinical concern range on the Competence domain. Socioemotional/behavioral problems were dimensionally related to receptive and expressive language, with greater language delay associated with more concerning ITSEA scores. Socioemotional and behavioral problems are related to receptive and expressive language abilities in 18- and 24-month-olds, indicating the need for screening of both types of concerns in toddlers identified with potential language delays.

MEDIATING ROLE OF MATERNAL SENSITIVITY: ENHANCING LANGUAGE DEVELOPMENT IN AT-RISK FAMILIES.

Home-visiting programs have gained increasing importance in family-centered prevention and intervention. However, few studies have examined the mechanisms underlying early intervention treatment effects. The goal of this study is to analyze the mediating role of maternal sensitivity in enhancing language development with the home-visiting program Parents as Teachers (PAT). Data were collected and analyzed within the ongoing, long-term ZEPPELIN study, a randomized controlled trial with 251 participating at-risk families. Via longitudinal mediation analysis, we examined whether effects of the PAT on receptive and expressive language outcomes at 24 and 36 months were mediated by maternal sensitivity at 12 months. Within a moderated mediation framework, we investigated whether the level of family psychosocial stress affects this mediation. Results showed that intervention effects on language outcomes are mediated by maternal sensitivity-weakly and through specific pathways. Moderation and moderated mediation analyses indicated that effects of the PAT and also specific mediation effects increase with the level of psychosocial stress. Implications of the results for practice are discussed.

MENTAL STATE LANGUAGE DEVELOPMENT: THE LONGITUDINAL ROLES OF ATTACHMENT AND MATERNAL LANGUAGE.

Maternal mental state language is thought to influence children's mental state language and sociocognitive understanding (e.g., theory of mind), but the mechanism is unclear. The current study examined the longitudinal development of mental state language in mother-child interactions. The methodology included assessments of the child and/or mother-child dyad at six time points between 12 to 52 months of the child's age. Measures determined child's attachment style and language abilities, and mental state language used by mother and child during a block-building task. Results showed that (a) mental state talk, including belief and desire language, increased over time; (b) there were differences between the type of mental state words used by the mother in insecure versus secure dyads; (c) there were differences in patterns of mental state words used in both mothers and children in insecure versus secure dyads; and (d) attachment appeared to exert a consistent influence over time.

THE MAGIC OF PLAY: LOW-INCOME MOTHERS' AND FATHERS' PLAYFULNESS AND CHILDREN'S EMOTION REGULATION AND VOCABULARY SKILLS.

Using data from a diverse sample of low-income families who participated in the Early Head Start Research Evaluation Project (n = 73), we explored the association between mothers' and fathers' playfulness with toddlers, toddler's affect during play, and children's language and emotion regulation at prekindergarten. There were two main findings. First, fathers' playfulness in toddlerhood was associated with children's vocabulary skills in prekindergarten whereas mothers' playfulness was related to children's emotion regulation. Cross-parental effects were found only for mothers. The association between mothers' playfulness and children's vocabulary and emotion regulation was strengthened when fathers engaged in more pretend play and when children were affectively positive during the play. These findings show that playfulness is an important source of variation in the vocabulary and emotion regulation of children growing up in low-income families. They also point to domain-specific ways that mothers and fathers promote children's regulatory and vocabulary skills, and highlight the importance of children's positive engagement in play.

Executive functions and language in children with different subtypes of specific language impairment. / Funciones ejecutivas y lenguaje en subtipos de niños con trastorno específico del lenguaje.

INTRODUCTION: The marked heterogeneity among children diagnosed with specific language impairment (SLI) highlights the importance of studying and describing cases based on the distinction between the expressive and receptive-expressive SLI subtypes. The main objective of this study was to examine neuropsychological, linguistic, and narrative behaviours in children with different SLI subtypes. METHOD: A comprehensive battery of language and neuropsychological tests was administered to a total of 58 children (29 with SLI and 29 normal controls) between 5.60 and 11.20 years old. RESULTS: Both SLI subtypes performed more poorly than the control group in language skills, narrative, and executive function. Furthermore, the expressive SLI group demonstrated substantial ungrammaticality, as well as problems with verbal fluency and both verbal and spatial working memory, while the receptive-expressive SLI subtype displayed poorer neuropsychological performance in general. CONCLUSIONS: Our findings showed that children with either SLI subtype displayed executive dysfunctions that were not limited to verbal tasks but rather extended to nonverbal measures. This could reflect a global cognitive difficulty which, along with declining linguistic and narrative skills, illustrates the complex profile of this impairment.

The role of automated feedback in training and retaining biological recorders for citizen science.

The rapid rise of citizen science, with lay people forming often extensive biodiversity sensor networks, is seen as a solution to the mismatch between data demand and supply while simultaneously engaging citizens with environmental topics. However, citizen science recording schemes require careful consideration of how to motivate, train, and retain volunteers. We evaluated a novel computing science framework that allowed for the automated generation of feedback to citizen scientists using natural language generation (NLG) technology. We worked with a photo-based citizen science program in which users also volunteer species identification aided by an online key. Feedback is provided after photo (and identification) submission and is aimed to improve volunteer species identification skills and to enhance volunteer experience and retention. To assess the utility of NLG feedback, we conducted two experiments with novices to assess short-term (single session) and longer-term (5 sessions in 2 months) learning, respectively. Participants identified a specimen in a series of photos. One group received only the correct answer after each identification, and the other group received the correct answer and NLG feedback explaining reasons for misidentification and highlighting key features that facilitate correct identification. We then developed an identification training tool with NLG feedback as part of the citizen science program BeeWatch and analyzed learning by users. Finally, we implemented NLG feedback in the live program and evaluated this by randomly allocating all BeeWatch users to treatment groups that received different types of feedback upon identification submission. After 6 months separate surveys were sent out to assess whether views on the citizen science program and its feedback differed among the groups. Identification accuracy and retention of novices were higher for those who received automated feedback than for those who received only confirmation of the correct identification without explanation. The value of NLG feedback in the live program, captured through questionnaires and evaluation of the online photo-based training tool, likewise showed that the automated generation of informative feedback fostered learning and volunteer engagement and thus paves the way for productive and long-lived citizen science projects.

Proxemics in Couple Interactions: Rekindling an Old Optic.

Utilizing as a lens the interpersonal implications of physical interpersonal distances in social contexts (a set of variables present during the professional discourse during the 1960s and 1970s, to then fade away), this article explores interactive process displayed by the protagonic couple in Bela Bartok's opera "Bluebeard Castle," an exercise aimed at underlining the value of maintaining proxemics as an explicit level of observation for clinical practice and interpersonal research.

We-Language and Sustained Reductions in Drinking in Couple-Based Treatment for Alcohol Use Disorders.

Couple-based treatments for alcohol use disorders (AUDs) produce higher rates of abstinence than individual-based treatments and posit that active involvement of both identified patients (IPs) and significant others (SOs) is partly responsible for these improvements. Separate research on couples' communication has suggested that pronoun usage can indicate a communal approach to coping with health-related problems. The present study tested whether communal coping, indicated by use of more first-person plural pronouns ("we" language), fewer second-person pronouns ("you" language), and fewer first-person singular pronouns ("I" language), predicted improvements in abstinence in couple-based AUD treatment. Pronoun use was measured in first- and mid-treatment sessions for 188 heterosexual couples in four clinical trials of alcohol behavioral couple therapy (ABCT). Percentages of days abstinent were assessed during treatment and over a 6-month follow-up period. Greater IP and SO "we" language during both sessions was correlated with greater improvement in abstinent days during treatment. Greater SO "we" language during first- and mid-treatment sessions was correlated with greater improvement in abstinence at follow-up. Greater use of IP and SO "you" and "I" language had mixed correlations with abstinence, typically being unrelated to or predicting less improvement in abstinence. When all pronoun variables were entered into regression models, only greater IP "we" langue and lower IP "you" language predicted improvements in abstinence during treatment, and only SO "we" language predicted improvements during follow-up. Most pronoun categories had little or no association with baseline relationship distress. Results suggest that communal coping predicts better abstinence outcomes in couple-based AUD treatment.

[Incidence and causes of early end in awake surgery for language mapping not directly related to eloquence]. / Incidencia y causas de finalización anticipada de la cirugía con paciente despierto para mapeo del lenguaje, no relacionadas directamente con la elocuencia.

The incidence and causes that may lead to an early end (unfinished cortical/subcortical mapping) of awake surgery for language mapping are little known. A study was conducted on 41 patients with brain glioma located in the language area that had awake surgery under conscious sedation. Surgery was ended early in 6 patients. The causes were: tonic-clonic seizure (1), lack of cooperation due to fatigue/sleep (4), whether or not word articulation was involved, a decreased level of consciousness for ammonia encephalopathy that required endotracheal intubation (1). There are causes that could be expected and in some cases avoided. Tumour size, preoperative aphasia, valproate treatment, and type of anaesthesia used are variables to consider to avoid failure in awake surgery for language mapping. With these results, the following measures are proposed: l) If the tumour is large, perform surgery in two times to avoid fatigue, 2) if patient has a preoperative aphasia, do not use sedation during surgery to ensure that sleepiness does not cause worse word articulation, 3) if the patient is on valproate treatment, it is necessary to rule out the pre-operative symptoms that are not due to ammonia encephalopathy.

Update and validation of the early word perception test in the Spanish language.

INTRODUCTION: It is extremely important to assess speech perception skills in children with hearing loss, since these skills are essential to guide the rehabilitation process. OBJECTIVE: Update and validate the Early Speech Perception test in Spanish in normal-hearing children. METHOD: Different drawings were selected from children's books used daily in the work of teachers and speech therapists. 69 children aged between 3 and 8 years old participated in the study, divided into 6 groups by age (group 1, 3 years of age (n = 13); group 2, 4 years of age (n = 15); group 3, 5 years of age (n = 12); group 4, 6 years of age (n = 8); group 5, 7 years of age (n = 10); group 6, 8 years of age (n = 11)). For each category of the test, the children had to name and point to the corresponding drawing. RESULTS: The difference between age and gender groups was statistically evaluated. For the naming phase, a significant difference was observed between groups 1 and group 5; and between group 1 and group 6. For the pointing phase there was no difference between the groups, and in all groups, there was a score greater than 98%. In relation to gender, there was no difference between the groups. CONCLUSION: The present study demonstrates that the material developed to assess auditory reception in normal-hearing children from 3 to 8 years old is appropriate.

Bilingualism and language in children with autistic spectrum disorder: a systematic review.

INTRODUCTION: Communication and language skills are among the most severely affected domains in individuals with autistic spectrum disorder (ASD). When a child diagnosed with ASD lives in a bilingual environment, the parents often express concerns about whether their child should learn both languages simultaneously, turning to specialists for advice. Despite the lack of evidence of any negative effect, some professionals disagree on this subject. In this systematic review we study whether bilingualism affects language development in children with ASD. METHODS: We reviewed the literature published in 4 different databases. After applying a series of selection criteria, we selected 12 scientific articles, including a total of 328 children diagnosed with ASD (169 bilingual and 159 monolingual), with ages ranging from 3 to 12 years. These patients were evaluated with different receptive and expressive language assessment instruments covering several areas. The assessments were performed directly on the children, although indirect assessment of parents was also performed in some studies. CONCLUSIONS: There seems to be consensus regarding the assertion that bilingualism does not entail any additional difficulty for language development in children with ASD from the age of 3.

Oral anticoagulant treatment in atrial fibrillation: the AFIRMA real-world study using natural language processing and machine learning.

INTRODUCTION: Oral anticoagulation (OAC) is key in atrial fibrillation (AF) thromboprophylaxis, but Spain lacks substantial real-world evidence. We aimed to analyze the prevalence, clinical characteristics, and treatment patterns among patients with AF undertaking OAC, using natural language processing (NLP) and machine learning (ML). MATERIALS AND METHODS: This retrospective study included AF patients on OAC from 15 Spanish hospitals (2014-2020). Using EHRead® (including NLP and ML), and SNOMED_CT, we extracted and analyzed patient demographics, comorbidities, and OAC treatment from electronic health records. AF prevalence was estimated, and a descriptive analysis was conducted. RESULTS: Among 4,664,224 patients in our cohort, AF prevalence ranged from 1.9% to 2.9%. A total of 57,190 patients on OAC therapy were included, 80.7% receiving Vitamin K antagonists (VKA) and 19.3% Direct-acting OAC (DOAC). The median age was 78 and 76 years respectively, with males constituting 53% of the cohort. Comorbidities like hypertension (76.3%), diabetes (48.0%), heart failure (42.2%), and renal disease (18.7%) were common, and more frequent in VKA users. Over 50% had a high CHA2DS2-VASc score. The most frequent treatment switch was from DOAC to acenocoumarol (58.6% to 70.2%). In switches from VKA to DOAC, apixaban was the most chosen (35.2%). CONCLUSIONS: Utilizing NLP and ML to extract RWD, we established the most comprehensive Spanish cohort of AF patients with OAC to date. Analysis revealed a high AF prevalence, patient complexity, and a marked VKA preference over DOAC. Importantly, in VKA to DOAC transitions, apixaban was the favored option.

Cortical and subcortical mapping of language areas: correlation of functional MRI and tractography in a 3T scanner with intraoperative cortical and subcortical stimulation in patients with brain tumors located in eloquent areas.

OBJECTIVE: To describe the detection of cortical areas and subcortical pathways involved in language observed in MRI activation studies and tractography in a 3T MRI scanner and to correlate the findings of these functional studies with direct intraoperative cortical and subcortical stimulation. MATERIAL AND METHODS: We present a series of 14 patients with focal brain tumors adjacent to eloquent brain areas. All patients underwent neuropsychological evaluation before and after surgery. All patients underwent MRI examination including structural sequences, perfusion imaging, spectroscopy, functional imaging to determine activation of motor and language areas, and 3D tractography. All patients underwent cortical mapping through cortical and subcortical stimulation during the operation to resect the tumor. Postoperative follow-up studies were done 24 hours after surgery. RESULTS: The correlation of motor function and of the corticospinal tract determined by functional MRI and tractography with intraoperative mapping of cortical and subcortical motor areas was complete. The eloquent brain areas of language expression and reception were strongly correlated with intraoperative cortical mapping in all but two cases (a high grade infiltrating glioma and a low grade glioma located in the frontal lobe). 3D tractography identified the arcuate fasciculus, the lateral part of the superior longitudinal fasciculus, the subcallosal fasciculus, the inferior fronto-occipital fasciculus, and the optic radiations, which made it possible to mark the limits of the resection. The correlation with the subcortical mapping of the anatomic arrangement of the fasciculi with respect to the lesions was complete. CONCLUSION: The best treatment for brain tumors is maximum resection without associated deficits, so high quality functional studies are necessary for preoperative planning.

Artificial Intelligence and new language models in Ophthalmology: Complications of the use of silicone oil in vitreoretinal surgery.

Artificial intelligence (AI) is an emerging technology that facilitates everyday tasks and automates tasks in various fields such as medicine. However, the emergence of a language model in academia has generated a lot of interest. This paper evaluates the potential of ChatGPT, a language model developed by OpenAI, and DALL-E 2, an image generator, in the writing of scientific articles in ophthalmology. The selected topic is the complications of the use of silicone oil in vitreoretinal surgery. ChatGPT was used to generate an abstract and a structured article, suggestions for a title and bibliographical references. In conclusion, despite the knowledge demonstrated by this tool, the scientific accuracy and reliability on specific topics is insufficient for the automatic generation of scientifically rigorous articles. In addition, scientists should be aware of the possible ethical and legal implications of these tools.