Spanish version of Multidimensional Mentalizing Questionnaire (MMQ): Translation, adaptation and psychometric properties in a Chilean population

This paper presents the first translation and adaptation of the Multidimensional Mentalizing Questionnaire (MMQ) into Spanish for a native Spanish-speaking sample in Chile. The study examines the psychometric properties and internal consistency of the translated MMQ. The instrument undergoes modifications based on a confirmatory factor analysis of the original structure, resulting in the elimination of items with cross-loadings and improvement in model fit. The modified scale is then analyzed, demonstrating strong psychometric properties. Convergent evidence is assessed by correlating MMQ subscales with the Interpersonal Reactivity Index (IRI) and Empathy Quotient (EQ), while divergent evidence is assessed by correlating aggressive traits using the Buss-Perry Aggression Questionnaire (BPAQ). The study also explores gender differences and age. Results reveal positive correlations between good mentalizing and empathy, particularly cognitive empathy, supporting the significance of positive mentalization in empathy. Negative mentalization is associated with difficulties in perspective-taking and social skills, as well as aggressive traits. Gender differences in mentalizing capacities are observed, and negative aspects of mentalization decrease with age. The availability of the Spanish translation of the MMQ, the first self-reporting scale measuring mentalization adapted to Chilean population, contributes to research aiming to understand its relationship with other psychological phenomena in different cultural context and facilitating clinical interventions with different population groups. We therefore encourage further investigation into cultural, gender and age differences in mentalization.

Word or pseudoword? The lexicality effect in naming and lexical decision tasks during advanced aging

Although there is evidence that recognizing pseudowords is more difficult than recognizing words during childhood, adulthood, and early old age (60-75 years), it is not yet clear what happens during advanced aging or the fourth age, a stage when the decline of fluid intelligence strongly affects processing speed, but a good performance of crystallized intelligence is described through an increase in vocabulary and knowledge. The objective of this study was to determine the lexicality effect in advanced aging, specifically exploring how the ability to recognize words and pseudowords (ortho-phonologically plausible for Spanish) is affected during the third and fourth-ages. The lexicality effect was measured using naming and lexical decision tasks. Response time and accuracy were compared between a fourth-age group (80+ years) and two third-age groups (60-69 and 70-79 years) through linear regression models. The results showed that, in general, the fourth-age group had longer response times and reduced accuracy when recognizing words and pseudowords. Moreover, they showed a significant lexicality effect (which increases from the third- age onwards), reflected in higher costs during pseudoword recognition, especially when the task required more cognitive effort (lexical decision task). These results were consistent with the impact of the deterioration of fluid intelligence on the speed of lexical recognition and with the better performance that crystallized intelligence can generate on accuracy, especially in the early stages of old age. Additionally, this study supports the fact that pseudoword recognition resists cognitive decline, as accentuated deterioration is visualized only after 80 years.

Article comprehension in monolingual Spanish-speaking children with developmental language disorder: A longitudinal eye tracking study

PURPOSE

Article-noun disagreement in spoken language is a marker of children with developmental language disorder (DLD). However, the evidence is less clear regarding article comprehension. This study investigates article comprehension in monolingual Spanish-speaking children with and without DLD.

METHOD

Eye tracking methodology used in a longitudinal experimental design enabled the examination of real time article comprehension. The children at the time 1 were 40 monolingual Spanish-speaking preschoolers (20 with DLD and 20 with typical language development [TLD]). A year later (time 2), 27 of these children (15 with DLD and 12 with TLD) were evaluated. Children listened to simple phrases while inspecting a four object visual context. The article in the phrase agreed in number and gender with only one of the objects.

RESULT

At the time 1, children with DLD did not use articles to identify the correct image, while children with TLD anticipated the correct picture. At the time 2, both groups used the articles' morphological markers, but children with DLD showed a slower and weaker preference for the correct referent compared to their age-matched peers.

CONCLUSION

These findings suggest a later emergence, but a similar developmental trajectory, of article comprehension in children with DLD compared to their peers with TLD.

Building a Multidisciplinary Care Pathway Supported by a Surgical Approach to Local Bone Formation

Osteoporosis is the most common disease of bone mineral metabolism. In Spain, it affects approximately 3 million people, of whom 80% are females and 20% are males. Despite the advances that have been made in this field, we continue to witness alarming levels of fragility hip fractures. In 2010, the cost of osteoporosis in the European Union was estimated to be 37,000 million euros, which included the costs for the treatment of incident fractures (66%), pharmacological prevention (5%), and long-term fracture care (29%). A multidisciplinary care pathway supported by a surgical approach to local bone formation is needed. Recently, the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) included in their treatment guidelines a local osteo-enhancement procedure (LOEP) as a treatment option. In the Ossure™ LOEP technique (AgNovos Healthcare USA, LLC, Rockville, MD), a calcium-based triphasic osteoconductive implant material (AGN1), which has been shown to increase bone mineral density (BMD) and proximal femoral strength, is introduced percutaneously in the femoral neck and intertrochanteric region. Basically, the procedure consists of three percutaneous steps: prepare, clean, and fill the cavity with AGN1. It can be carried out with sedation and local anaesthesia or spinal anaesthesia. This report presents a clinical case and discusses how to select patients who could potentially benefit from this technique.

Tautological formal explanations: does prior knowledge affect their satisfiability?

It is known that formal explanations with categorical labels are more satisfying than explicit tautologies. However, would they still be more satisfying if they are implicitly tautological themselves? In two experiments, we compared the degree of satisfaction between tautological formal explanations, explicit tautologies, and proper explanations. Additionally, we examined whether participants knew the correct definitions for the labels used in the formal explanations. Finally, we asked whether cultural and linguistic differences can play a role in the treatment of formal explanations with categorical labels. To this end, the first experiment involved Chilean students (N = 50), and the second experiment involved Russian students (N = 51). It was found that formal explanations, despite their intentional tautology, were still rated as more convincing compared to explicit tautologies (but less convincing than proper explanations). Furthermore, this effect did not depend on participants' previous knowledge (the label's definitions) or linguistic and cultural background. Taking all this into account, we consider this effect as a relatively universal psychological phenomenon and relate our findings to existing theories of formal explanations.

Lexical Access Restrictions after the Age of 80

BACKGROUND

During the fourth age (80+ years), cognitive difficulties increase. Although language seems to resist the advancement of age, an older person without pathological developments in cognition may exhibit deficits in lexical access. This study examines the restrictions on lexical access in people aged 80 and older in word recognition and retrieval modalities through four lexical tasks.

METHOD

The effect of aging on response time and accuracy was measured using recognition (lexical decision/naming/priming) and retrieval (picture naming) tasks. A fourth age group (>80) and two third age groups (60-69/70-79) were compared according to lexical access modality and type of task employed through linear regression models.

RESULTS

People aged 80 and older exhibit a strong lexical access constraint, as they are slower and less accurate in recognizing and retrieving words than both third age groups. These restrictions are more profound for the word retrieval modality, especially in the picture naming task.

CONCLUSION

Impaired fluid intelligence and internode transmission deficits during advanced aging could further reduce the ability to recognize and/or retrieve words, having an impact on access speed and accuracy. Furthermore, the idea that crystallized intelligence could strengthen the accuracy of lexical access during aging is supported, specifically in word recognition modality.

Quantitative and qualitative features of acute phase-adverse events following SARS-CoV-2 vaccination in a large sample of people with multiple sclerosis

INTRODUCTION

Few data are available on adverse events (AE) associated to vaccines in persons with multiple sclerosis (pwMS).

AIMS

to study the incidence of acute phase AE (AP-AE) related to SARS-CoV-2 mRNA vaccines in pwMS compared to a control group, and to analyze the association between AP-AE and disease modifying treatments (DMT).

METHODS

This was a cross-sectional study on 438 PwMS and 481 age- and sex-matched subjects not affected by dysimmune diseases that underwent two doses of SARS-CoV-2 mRNA BNT162b2 vaccine (Pfizer/BioNtech).

RESULTS

Two hundred and twenty five (51.4%) pwMS complained of ≥1 AP-AE after the first dose, 269 (61.4%) after the second dose. A logistic regression analysis revealed that only pwMS on Fingolimod and Ocrelizumab did not show a higher risk of developing AP-AE. The likelihood to present with ≥1 AP-AE, after correcting for age and sex, was significantly higher in pwMS than controls.

CONCLUSIONS

This study reports qualitative and quantitative features of AP-AE associated with the first and second doses of SARS-CoV-2 vaccine in a large sample of pwMS. The only risk factor identified for developing AP-AE is female gender. AntiCD-20 monoclonal antibodies and S1P inhibitors are associated with a lower risk of AP-AE occurrence.

Online Comprehension of Verbal Number Morphology in Children With Developmental Language Disorder: An Eye-Tracking Study

PURPOSE

Previous studies have raised the possibility of preserved language comprehension in children with developmental language disorder (DLD) in online tasks and within simple sentence structures. Consequently, we evaluated the capacity of children with DLD to comprehend verbal number agreement in simple sentence structures (i.e., verb-object-subject and verb-subject).

METHOD

Using an eye-tracking methodology, we conducted two psycholinguistic experiments with 96 Spanish- and Catalan-speaking participants. The sample was distributed into four groups: 24 children with DLD (age range: 4;6-12;6 [years;months]; average age = 7;8 [years;months]), 24 children with the same chronological age (4;6-12;2, 7;8), 24 children with the same linguistic level (4;6-9;4, 6;8), and 24 university students as language experts (18-30, 22;5).

RESULTS

The experimental data indicate that children with DLD can comprehend verbal number agreement at least under the present experimental conditions.

CONCLUSION

The empirical outcomes suggest that number morphology comprehension by children with DLD might be more typical than what it is generally considered to be.

Visual word recognition among oldest old people: The effect of age and cognitive load

During the fourth age, a marked physiological deterioration and critical points of dysfunction are observed, during which cognitive performance exhibits a marked decline in certain skills (fluid intelligence) but good performance of others (crystallized intelligence). Experimental evidence describes important constraints on word production during old age, accompanied by a relative stabilization of speech comprehension. However, cognitive changes associated with advanced aging could also affect comprehension, particularly word recognition. The present study examines how the visual recognition of words is affected during the fourth age when tasks involving different cognitive loads are applied. Through linear regression models, performance was compared between two third-age groups and a fourth-age group on reaction time (RT) and accuracy in naming, priming and lexical decision experiments. The fourth-age group showed a significant RT increase in all experiments. In contrast, accuracy was good when the task involved a low cognitive demand (Experiments 1 and 2); however, when a decisional cognitive factor was included (Experiment 3), the fourth-age group performed significantly worse than the younger third-age group. We argue that the behavior observed among fourth-age individuals is consistent with an unbalanced cognitive configuration, in which the fluid intelligence deficit significantly reduces the speed necessary to recognize words, independent of the cognitive load associated with the test. In contrast, the maintenance in crystallized intelligence improves the accuracy of the process, strengthening linguistic functionality in the advanced stages of old age.

Congenital pseudarthrosis of the tibia: Rate of and time to bone union following contralateral vascularized periosteal tibial graft transplantation

INTRODUCTION

Congenital pseudarthrosis of the tibia (CPT) is one of the most challenging orthopedic disorders. The use of a vascularized tibial periosteal grafts has been recently reported as a powerful tool to obtain bone union. We report its use in CPT.

PATIENTS AND METHODS

Retrospective short-term study of 29 children (18 male/11 female, 15 right-sided/14 left-sided) of mean age 45 months (range 11-144 months), operated upon after October 2014. Nonunion site was debrided, and the periosteum of the involved limb was excised. A vascularized tibial periosteal graft (mean length 10.7 cm (range 9-15 cm) with a monitoring skin island (mean length 4.1 cm (range 3-5 cm) and based on the anterior tibial vessels, was obtained from the contralateral tibia. Anterior tibial vessels were always the recipient vessels. Most cases were stabilized with an LCP plate. The rate of and time to bone union were analyzed. Charts only were evaluated through the first 3 months after bone union was achieved.

RESULTS

The flap survived and bone union was obtained in all cases, through a periosteal callus, in a mean time of 5.1 weeks (range 3-6 weeks). Mean follow-up was 8.3 months (range 7-19 months). No union failures occurred 3 months after resuming unprotected weight bearing.

CONCLUSIONS

Our novel technique produced a consistent, rapid capacity for CPT union, superior to previously-reported techniques. However, it cannot be recommended as a standard method of treatment until consistent, long-term, refracture-free follow-up is documented.

Do Children With Developmental Language Disorder Activate Scene Knowledge to Guide Visual Attention? Effect of Object-Scene Inconsistencies on Gaze Allocation

Our visual environment is highly predictable in terms of where and in which locations objects can be found. Based on visual experience, children extract rules about visual scene configurations, allowing them to generate scene knowledge. Similarly, children extract the linguistic rules from relatively predictable linguistic contexts. It has been proposed that the capacity of extracting rules from both domains might share some underlying cognitive mechanisms. In the present study, we investigated the link between language and scene knowledge development. To do so, we assessed whether preschool children (age range = 5;4–6;6) with Developmental Language Disorder (DLD), who present several difficulties in the linguistic domain, are equally attracted to object-scene inconsistencies in a visual free-viewing task in comparison with age-matched children with Typical Language Development (TLD). All children explored visual scenes containing semantic (e.g., soap on a breakfast table), syntactic (e.g., bread on the chair back), or both inconsistencies (e.g., soap on the chair back). Since scene knowledge interacts with image properties (i.e., saliency) to guide gaze allocation during visual exploration from the early stages of development, we also included the objects’ saliency rank in the analysis. The results showed that children with DLD were less attracted to semantic and syntactic inconsistencies than children with TLD. In addition, saliency modulated syntactic effect only in the group of children with TLD. Our findings indicate that children with DLD do not activate scene knowledge to guide visual attention as efficiently as children with TLD, especially at the syntactic level, suggesting a link between scene knowledge and language development.

Olaparib in combination with pegylated liposomal doxorubicin for platinum-resistant ovarian cancer regardless of BRCA status: a GEICO phase II trial (ROLANDO study)

BACKGROUND

There is limited evidence for the benefit of olaparib in platinum-resistant ovarian cancer (PROC) patients with BRCA wild-type tumors. This study investigated whether this combination of a DNA-damaging chemotherapy plus olaparib is effective in PROC regardless BRCA status.

PATIENTS AND METHODS

Patients with high-grade serous or endometrioid ovarian carcinoma and one previous PROC recurrence were enrolled regardless of BRCA status. Patients with ≤4 previous lines (up to 5 in BRCA-mut) with at least one previous platinum-sensitive relapse were included; primary PROC was allowed only in case of BRCA-mut. Patients initially received six cycles of olaparib 300 mg b.i.d. (biduum) + intravenous pegylated liposomal doxorubicin (PLD) 40 mg/m2 (PLD40) every 28 days, followed by maintenance with olaparib 300 mg b.i.d. until progression or toxicity. The PLD dose was reduced to 30 mg/m2 (PLD30) due to toxicity. The primary endpoint was progression-free survival (PFS) at 6 months (6m-PFS) by RECIST version 1.1. A proportion of 40% 6m-PFS or more was considered of clinical interest.

RESULTS

From 2017 to 2020, 31 PROC patients were included. BRCA mutations were present in 16%. The median of previous lines was 2 (range 1-5). The overall disease control rate was 77% (partial response rate of 29% and stable disease rate of 48%). After a median follow-up of 10 months, the 6m-PFS and median PFS were 47% and 5.8 months, respectively. Grade ≥3 treatment-related adverse events occurred in 74% of patients, with neutropenia/anemia being the most frequent. With PLD30 serious AEs were less frequent than with PLD40 (21% versus 47%, respectively); moreover, PLD30 was associated with less PLD delays (32% versus 38%) and reductions (16% versus 22%).

CONCLUSIONS

The PLD-olaparib combination has shown significant activity in PROC regardless of BRCA status. PLD at 30 mg/m2 is better tolerated in the combination.

Syntactic and Semantic Influences on the Time Course of Relative Clause Processing: The Role of Language Dominance

We conducted a visual world eye-tracking experiment with highly proficient Spanish-English bilingual adults to investigate the effects of relative language dominance, operationalized as a continuous, multidimensional variable, on the time course of relative clause processing in the first-learned language, Spanish. We found that participants exhibited two distinct processing preferences: a semantically driven preference to assign agency to referents of lexically animate noun phrases and a syntactically driven preference to interpret relative clauses as subject-extracted. Spanish dominance was found to exert a distinct influence on each of these preferences, gradiently attenuating the semantic preference while gradiently exaggerating the syntactic preference. While these results might be attributable to particular properties of Spanish and English, they also suggest a possible generalization that greater dominance in a language increases reliance on language-specific syntactic processing strategies while correspondingly decreasing reliance on more domain-general semantic processing strategies.

Ladies First: Gender Stereotypes Drive Anticipatory Eye-Movements During Incremental Sentence Interpretation

Immediate contextual information and world knowledge allow comprehenders to anticipate incoming language in real time. The cognitive mechanisms that underlie such behavior are, however, still only partially understood. We examined the novel idea that gender attitudes may influence how people make predictions during sentence processing. To this end, we conducted an eye-tracking experiment where participants listened to passive-voice sentences expressing gender-stereotypical actions (e.g., "The wood is being painted by the florist") while observing displays containing both female and male characters representing gender-stereotypical professions (e.g., florists, soldiers). In addition, we assessed participants' explicit gender-related attitudes to explore whether they might predict potential effects of gender-stereotypical information on anticipatory eye movements. The observed gaze pattern reflected that participants used gendered information to predict who was agent of the action. These effects were larger for female- vs. male-stereotypical contextual information but were not related to participants' gender-related attitudes. Our results showed that predictive language processing can be moderated by gender stereotypes, and that anticipation is stronger for female (vs. male) depicted characters. Further research should test the direct relation between gender-stereotypical sentence processing and implicit gender attitudes. These findings contribute to both social psychology and psycholinguistics research, as they extend our understanding of stereotype processing in multimodal contexts and regarding the role of attitudes (on top of world knowledge) in language prediction.

The Role of Literal Features During Processing of Novel Verbal Metaphors

When a word is used metaphorically (for example “walrus” in the sentence “The president is a walrus”), some features of that word's meaning (“very fat,” “slow-moving”) are carried across to the metaphoric interpretation while other features (“has large tusks,” “lives near the north pole”) are not. What happens to these features that relate only to the literal meaning during processing of novel metaphors? In four experiments, the present study examined the role of the feature of physical containment during processing of verbs of physical containment. That feature is used metaphorically to signify difficulty, such as “fenced in” in the sentence “the journalist's opinion was fenced in after the change in regime.” Results of a lexical decision task showed that video clips displaying a ball being trapped by a box facilitated comprehension of verbs of physical containment when the words were presented in isolation. However, when the verbs were embedded in sentences that rendered their interpretation metaphorical in a novel way, no such facilitation was found, as evidenced by two eye-tracking reading studies. We interpret this as suggesting that features that are critical for understanding the encoded meaning of verbs but are not part of the novel metaphoric interpretation are ignored during the construction of metaphorical meaning. Results and limitations of the paradigm are discussed in relation to previous findings in the literature both on metaphor comprehension and on the interaction between language comprehension and the visual world.

Real-time comprehension of Spanish prepositions and prepositional locutions in bilingual children with developmental language disorder: A study based on eye-movement evidence

BACKGROUND

Function words, and more specifically prepositions and prepositional locutions, are considered to be one of the most important difficulties for children with DLD.

AIMS

To examine the capacity of bilingual children with developmental language disorder (DLD) to comprehend different Spanish prepositions and prepositional locutions in a simple sentence structure, for example, El gato está sobre la mesa/El gato está bajo la mesa (The cat is on the table/The cat is under the table).

METHODS & PROCEDURES

We used simple sentence structures to reduce lexical difficulties in order to focus our evaluation strictly on the grammatical morphemes under study. A total of 96 Spanish and Catalan-speaking participants, divided into four groups, were evaluated in an eye-tracking psycholinguistic experiment: 24 children with DLD (average age = 7.8 years, age range = 4.6-12.6), 24 children with the same chronological age (average age = 7.8 years, age range = 4.6-12.2), 24 children with the same linguistic level (average age = 6.8 years, age range = 4.6-9.4) and 24 adults (average age = 22.5 years, age range = 18-30).

OUTCOMES & RESULTS

The empirical data show that, despite some differences, bilingual children with and without DLD can comprehend Spanish prepositions and prepositional locutions under the current experimental conditions.

CONCLUSIONS & IMPLICATIONS

Our results suggest that the capacity of bilingual children with DLD to comprehend Spanish prepositions and prepositional locutions in real time and within simple sentence structures is preserved. What this paper adds What is already known on the subject The empirical literature indicates that children with DLD show important errors in the production of functional words in general, and prepositions in particular. However, unlike other grammatical morphemes (such as clitic pronouns and articles), prepositions have been less studied, and the few existing studies have focused on the dimension of language production, not comprehension. What this paper adds to existing knowledge The present study, composed of two experimental tasks, seeks to determine to what extent the observable difficulty in the linguistic production of prepositions is also present in the comprehension of children with DLD. The empirical results suggest a less atypical comprehension in comparison with our initial hypothesis, and the differences that appear between the two tasks, allow us to formulate a theoretical interpretation regarding the mechanisms of their understanding. Thus far, we are not aware of other studies that have evaluated in real time the comprehension of prepositions and prepositional locutions in parallel. Clinical implications of this study Results suggest the presence of a more preserved comprehension of prepositions and prepositional locutions, at least in real-time experimental conditions (eye-tracking) and in simple sentence structures. A less atypical comprehension raises the possibility of a better prognosis for children with DLD. Working with comprehension of simple sentences and the gradual addition of more difficult grammatical morphemes could help to enhance the comprehension of a growing complex grammar.

Processing Speaker-Specific Information in Two Stages During the Interpretation of Referential Precedents

To reduce ambiguity across a conversation, interlocutors reach temporary conventions or referential precedents on how to refer to an entity. Despite their central role in communication, the cognitive underpinnings of the interpretation of precedents remain unclear, specifically the role and mechanisms by which information related to the speaker is integrated. We contrast predictions of one-stage, original two-stage, and extended two-stage models for the processing of speaker information and provide evidence favoring the latter: we show that both stages are sensitive to speaker-specific information. Using an experimental paradigm based on visual-world eye tracking in the context of a referential communication task, we look at the moment-by-moment interpretation of precedents and focus on the temporal profile of the influence of the speaker and linguistic information when facing ambiguity. We find two clearly identifiable moments where speaker-specific information has its effects on reference resolution. We conclude that these two stages reflect two distinct cognitive mechanisms, with different timings, and rely on different representational formats for encoding and accessing information about the speaker: a cue-driven memory retrieval process that mediates language processing and an inferential mechanism based on perspective-taking abilities.

Strategic Spatial Anchoring as Cognitive Compensation During Word Categorization in Parkinson's Disease: Evidence from Eye Movements

The association between a word and typical location (e.g., cloud-up) appears to modulate healthy individuals' response times and visual attention. This study examined whether similar effects can be observed in a clinical population characterized by difficulties in both spatial representation and lexical processing. In an eye-tracking experiment, participants categorized spoken words as either up-associated or down-associated. Parkinson's disease patients exhibited a tendency to maintain their visual attention in the upper half of the screen, however, this tendency was significantly lower when participants categorized concepts as down-associated. Instead, the control group showed no preference for either the upper or lower half of the screen. We argue that Parkinson's disease patients present an over-reliance on space during word categorization as a form of cognitive compensation. Such compensation reveals that this clinical population may use spatial anchoring when categorizing words with a spatial association, even in the absence of explicit spatial cues.

Real time comprehension of Spanish articles in children with developmental language disorder: Empirical evidence from eye movements

Function words and, more specifically, articles have been widely indicated as one of the main sources of difficulty for children with Developmental Language Disorder (DLD). The present study is the first to assess the online comprehension of Spanish articles in bilingual children with DLD. In an eye tracking experiment, we monitored participants' eye movements as they listened to Spanish articles embedded in structurally simple sentences. Ninety-six subjects from four different groups were evaluated: 24 children with DLD (average age 7;08), 24 children with the same chronological age (average age 7;08), 24 younger children matched for mean length utterance (average age 6;08), and 24 adults (average age 22;05). We calculated the proportion between the preference for the correct visual referent and a competitor object. Our results suggest that children with DLD are capable of timely comprehension of Spanish articles in real time and within simple sentence structures. However, we observed a strong effect of chronological age in the sample of interest; younger children with DLD are able to identify the correct referent, but this preference is weaker compared to the older children with DLD. We also observed local differences between the DLD group, and the other two children control groups, particularly when the chronological age group is introduced as a factor. These findings suggest a developmental trajectory that is different in the DLD group relative to children with typical language development. Notwithstanding, in spite of the article production difficulties previously reported, children with DLD in the present sample appear to be able to comprehend Spanish articles in the current experimental conditions.

European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates of β-isomerized C-terminal telopeptide of type I collagen (β-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin, intact fibroblast growth factor 23 and uncarboxylated-unphosphorylated matrix-Gla protein-a cooperation between the EFLM Working Group on Biological Variation and the International Osteoporosis Foundation-International Federation of Clinical Chemistry Committee on Bone Metabolism

We have calculated the biological variation (BV) of different bone metabolism biomarkers on a large, well-described cohort of subjects. BV is important to calculate reference change value (or least significant change) which allows evaluating if the difference observed between two consecutive measurements in a patient is biologically significant or not.

INTRODUCTION

Within-subject (CV_I) and between-subject (CV_G) biological variation (BV) estimates are essential in determining both analytical performance specifications (APS) and reference change values (RCV). Previously published estimates of BV for bone metabolism biomarkers are generally not compliant with the most up-to-date quality criteria for BV studies. We calculated the BV and RCV for different bone metabolism markers, namely β-isomerized C-terminal telopeptide of type I collagen (β-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin (OC), intact fibroblast growth factor 23 (iFGF-23), and uncarboxylated-unphosphorylated Matrix-Gla Protein (uCuP-MGP) using samples from the European Biological Variation Study (EuBIVAS).

METHODS

In the EuBIVAS, 91 subjects were recruited from six European laboratories. Fasting blood samples were obtained weekly for ten consecutive weeks. The samples were run in duplicate on IDS iSYS or DiaSorin Liaison instruments. The results were subjected to outlier and variance homogeneity analysis before CV-ANOVA was used to obtain the BV estimates.

RESULTS

We found no effect of gender upon the CV_I estimates. The following CV_I estimates with 95% confidence intervals (95% CI) were obtained: β-CTX 15.1% (14.4-16.0%), PINP 8.8% (8.4-9.3%), OC 8.9% (8.5-9.4%), iFGF23 13.9% (13.2-14.7%), and uCuP-MGP 6.9% (6.1-7.3%).

CONCLUSIONS

The EuBIVAS has provided updated BV estimates for bone markers, including iFGF23, which have not been previously published, facilitating the improved follow-up of patients being treated for metabolic bone disease.

Infants' conceptual representations of meaningful verbal and nonverbal sounds

In adults, words are more effective than sounds at activating conceptual representations. We aimed to replicate these findings and extend them to infants. In a series of experiments using an eye tracker object recognition task, suitable for both adults and infants, participants heard either a word (e.g. cow) or an associated sound (e.g. mooing) followed by an image illustrating a target (e.g. cow) and a distracter (e.g. telephone). The results showed that adults reacted faster when the visual object matched the auditory stimulus and even faster in the word relative to the associated sound condition. Infants, however, did not show a similar pattern of eye-movements: only eighteen-month-olds, but not 9- or 12-month-olds, were equally fast at recognizing the target object in both conditions. Looking times, however, were longer for associated sounds, suggesting that processing sounds elicits greater allocation of attention. Our findings suggest that the advantage of words over associated sounds in activating conceptual representations emerges at a later stage during language development.

Priming semántico directo y mediado orto-fonológicamente en pacientes con enfermedad de Parkinson: un estudio de tiempos de reacción

El presente estudio aborda el impacto de la enfermedad de Parkinson en el procesamiento de información semántica durante una tarea de reconocimiento visual de palabras. Para ello, se comparó el rendimiento de un grupo de pacientes con Parkinson con el rendimiento de sujetos sin daño neurológico en dos experimentos. Se evaluaron los efectos de tiempo de presentación de un prime semántico directo (Experimento 1) y un prime semántico mediado orto-fonológicamente (Experimento 2). Además, se evaluó la influencia de la frecuencia léxica tanto del prime como la palabra target, sobre el acceso léxico. Los participantes estaban divididos en tres grupos (grupo clínico, grupo de control etario, y grupo de adultos jóvenes). Los tres grupos completaron una tarea de decisión léxica de tiempo de reacción en la modalidad go-no-go. Los participantes debían responder presionando una tecla del computador si el estímulo presentado en la pantalla era una palabra. En el caso contrario cuando era una pseudo palabra, los participantes no debían presionar ninguna tecla. Los resultados en base al número de respuestas correctas y los tiempos de reacción muestran dificultades de procesamiento semántico en el grupo clínico. Sin embargo, este grupo mostró ser sensible a la frecuencia de las palabras y los tiempos de presentación de estas. En su conjunto, los resultados son coherentes con la literatura existente, y contribuyen a comprender de mejor manera el déficit lingüístico presente en la enfermedad de Parkinson.

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

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

Corrigendum: Semantic Interference and Facilitation: Understanding the Integration of Spatial Distance and Conceptual Similarity During Sentence Reading

[This corrects the article DOI: 10.3389/fpsyg.2018.00718.].

Semantic Interference and Facilitation: Understanding the Integration of Spatial Distance and Conceptual Similarity During Sentence Reading

Existing evidence has shown a processing advantage (or facilitation) when representations derived from a non-linguistic context (spatial proximity depicted by gambling cards moving together) match the semantic content of an ensuing sentence. A match, inspired by conceptual metaphors such as 'similarity is closeness' would, for instance, involve cards moving closer together and the sentence relates similarity between abstract concepts such as war and battle. However, other studies have reported a disadvantage (or interference) for congruence between the semantic content of a sentence and representations of spatial distance derived from this sort of non-linguistic context. In the present article, we investigate the cognitive mechanisms underlying the interaction between the representations of spatial distance and sentence processing. In two eye-tracking experiments, we tested the predictions of a mechanism that considers the competition, activation, and decay of visually and linguistically derived representations as key aspects in determining the qualitative pattern and time course of that interaction. Critical trials presented two playing cards, each showing a written abstract noun; the cards turned around, obscuring the nouns, and moved either farther apart or closer together. Participants then read a sentence expressing either semantic similarity or difference between these two nouns. When instructed to attend to the nouns on the cards (Experiment 1), participants' total reading times revealed interference between spatial distance (e.g., closeness) and semantic relations (similarity) as soon as the sentence explicitly conveyed similarity. But when instructed to attend to the cards (Experiment 2), cards approaching (vs. moving apart) elicited first interference (when similarity was implicit) and then facilitation (when similarity was made explicit) during sentence reading. We discuss these findings in the context of a competition mechanism of interference and facilitation effects.

Abstract P1-03-08: Withdrawn

This abstract was withdrawn by the authors.

Prognostic Value of Mutations in TP53 and RAS Genes in Breast Cancer

The identification of molecular indicators of higher risk for specific subgroups of cancer patients may allow to develop more aggressive therapeutic strategies aimed at cases with the highest likelihood of response. This would avoid unnecessary toxicity to patients and alleviate the burden of cancer care for healthcare systems. Activated oncogenes and mutated tumor suppressor genes are causal determinants of the appearance and progression of tumors in man. They therefore represent potential indicators of prognosis and/or response to therapy. However, even in cases of well-studied oncogenes and tumor suppressor genes such as TP53 and RAS, their attributed prognostic and predictive value is often based on studies of insufficient statistical power that often lead to conflicting conclusions. Findings in favor or against the use of TP53 and RAS as prognostic and predictive indicators in breast cancer are reviewed and discussed here.

Radial head prosthesis: surgical tips and tricks

Radial head prostheses (RHP) have been developed to decrease the complications rate following a radial head resection surgery. The aim of the RHP is to replicate the physiological radiocapitellar tracking, reproducing the mechanical function of the native radial head: to stabilize the elbow and to shear the forces passing through the elbow along with the other stabilizers. The currently used RHP models try to achieve this target with three different prosthesis' strategies: (a) loose fit stem, (b) bipolar radial head or (c) anatomical radial head. Even if the radial head fixation is the preferred technique in every possible case and the resection can be still considered a possible option, in the last years there has been a growing worldwide consensus in using the radial head replacement in patients with unfixable radial head fractures, especially if associated with complex elbow instability. However, complications after a RHP are not uncommon, and their rate is raising as long as the implants number are increasing. The main difficulties are due to the implantation technique that needs to be performed with the same attention and precision used for the replacement of all the other joints, and to the concurrent treatment of the associated lesions. A personalized postoperative rehabilitation program is essential for obtaining good results and decreasing the complications rate. Concern exists for the young age of the patients that often require a RHP: personal experience and literature analysis suggest that if the clinical and radiographic results are positive after a 6-12-month follow-up, good outcomes can be also expected at a medium- or long-term follow-up.

Young athletes with ventricular premature beats: Continuing or not intense training and competition?

Isolated ventricular premature beats (VPBs) are commonly found during pre-participation screening in athletes. Currently, the debate about the role of detraining in reducing the number of VPBs is still open. This study evaluated the arrhythmic risk in a population of young competitive athletes who showed VPBs during eligibility evaluation and that did not undergo detraining but continued practicing competitive sports. 3746 consecutive subjects underwent pre-participation screening. Athletes who showed VPBs were selected and underwent second level evaluation (Echocardiogram, 24 hour Holter ECG and Exercise test). Athletes were re-evaluated after a follow-up period (6-48 months) while they continued practicing competitive sports. 5.3% of the whole population showed ventricular arrhythmias. 73% of the subjects showed isolated VPBs. 88% of the subjects showed monomorphic VPBs, and 12% of athletes showed polymorphic VPBs. At echocardiogram, there was not any pathology which contraindicated competitive sport activity. At 24 hour Holter ECG recording, mean number of daily VPBs was 1592±3217 (range 0-16678). At holter ECG follow-up (16±12 months), the median number of VPBs decreased from 93 (IQR 20-3065) to a new value of 72 (IQR 2-1299). Continuing competitive sport in subjects with ventricular arrhythmias even though frequent but with a low grade of complexity and without structural cardiomyopathy does not increase sudden death risk.

A-Book: A Feedback-Based Adaptive System to Enhance Meta-Cognitive Skills during Reading

In the digital era, tech devices (hardware and software) are increasingly within hand’s reach. Yet, implementing information and communication technologies for educational contexts that have robust and long-lasting effects on student learning outcomes is still a challenge. We propose that any such system must a) be theoretically motivated and designed to tackle specific cognitive skills (e.g., inference making) supporting a given cognitive task (e.g., reading comprehension) and b) must be able to identify and adapt to the user’s profile. In the present study, we implemented a feedback-based adaptive system called A-book (assisted-reading book) and tested it in a sample of 4th, 5th, and 6th graders. To assess our hypotheses, we contrasted three experimental assisted-reading conditions; one that supported meta-cognitive skills and adapted to the user profile (adaptive condition), one that supported meta-cognitive skills but did not adapt to the user profile (training condition) and a control condition. The results provide initial support for our proposal; participants in the adaptive condition improved their accuracy scores on inference making questions over time, outperforming both the training and control groups. There was no evidence, however, of significant improvements on other tested meta-cognitive skills (i.e., text structure knowledge, comprehension monitoring). We discussed the practical implications of using the A-book for the enhancement of meta-cognitive skills in school contexts, as well as its current limitations and future developments that could improve the system.

A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest

Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG). Viscoelastic tests (VET)s, including the TEG and rotational thromboelastometry (ROTEM), may provide more individualized blood component therapy (BCT) in the treatment of severe PPH associated with AFE as has been previously noted with trauma resuscitation in the literature. However, VET's efficacy is often limited by a lack of standardization, quality assurance norms, and consistent operator proficiency. We suggest that there may be a role for perfusionsts adept at utilizing TEG in the optimization of BCT and adjunctive hemostatic agents in severely hemorrhagic patients. This patient's successful resuscitation demonstrates the importance of resuscitation guided by the perfusionist or other medical professionals with expertise in TEG guided resuscitation and how the administration of specific blood products and hemostatic agents guided by the TEG can help optimize patient outcomes in comparison to traditional 1:1:1 packed red blood cells (PRBC) /fresh frozen plasma (FFP) /platelets ratios given to severely hemorrhaging patients.

SEOM Clinical Guideline in ovarian cancer (2016)

Despite remarkable advances in the knowledge of molecular biology and treatment, ovarian cancer (OC) is the first cause of death due to gynecological cancer and the fifth cause of death for cancer in women in Spain. The aim of this guideline is to summarize the current evidence and to give evidence-based recommendations for clinical practice.

Elbow instability: Are we able to classify it? Review of the literature and proposal of an all-inclusive classification system

BACKGROUND

In the recent years, considerable improvements have come in biomechanical knowledge about the role of elbow stabilizers. In particular, the complex interactions among the different stabilizers when injured at the same time have been better understood. Anyway, uncertainties about both nomenclature and classification still exist in the definition of the different patterns of instability.

MATERIAL AND METHODS

The authors examine the literature of the last 130 years about elbow instability classification, analyzing the intuitions and the value of each of them. However, because of the lack of a satisfactory classification, in 2015 a working group has been created inside SICSeG (Italian Society of Shoulder and Elbow Surgery) with the aim of defining an exhaustive classification as simple, complete and reproducible as possible.

RESULTS

A new all-inclusive elbow instability classification is proposed. This classification considers two main parameters: timing (acute and chronic forms) and involved stabilizers (simple and complex forms), and four secondary parameters: etiology (traumatic, rheumatic, congenital…), the involved joint (radius and ulna as a single unit articulating with the humerus or the proximal radio-ulnar joint), the degree of displacement (dislocation or subluxation) and the mechanism of instability or dislocation (PLRI, PMRI, direct axial loading, pure varus or valgus stress).

CONCLUSIONS

This classification is at the same time complete enough to include all the instability patterns and practical enough to be effectively used in the clinical practice. This classification can help in defining a shared language, can improve our understanding of the disorder, reduce misunderstanding of diagnosis and improve comparison among different case series.

Effects of concurrent aerobic and strength training on breast cancer survivors: a pilot study

OBJECTIVES

The aim of the study was to evaluate the effects of a combined aerobic and strength program on physiological and psychological parameters in female breast cancer survivors.

STUDY DESIGN

Randomised controlled trial.

METHODS

20 patients (age: 45.6 ± 2.7 yrs) surgically treated for breast cancer that had completed all cancer therapies at least 6 months before and with no contraindications to physical activity, were recruited and randomly assigned to an intervention group (n = 10) and a control group (n = 10). Intervention group patients attend to a 24-week combined aerobic and strength training program. Physiological (i.e. VO2max, bioelectrical impedance test, maximal strength of principal muscular groups) and psychological (i.e. functional assessment of chronic illness therapy-fatigue: FACIT-F) parameters were assessed at baseline and after 24 weeks.

RESULTS

After 24 weeks the intervention group showed significant improvement in VO2max (38.8%), strength of upper and lower limbs (ranging from 13 to 60%) and decrease in fat mass percentage (-6.3%). The FACIT-F showed significant increase in all of the three scores that can be derived (FACIT-F Trial outcome: 13%; FACT-G total score: 18%; FACIT-F total score: 15%) showing patient's quality of life (QOL) improvement. No significant change in all the parameters was found for the control group.

CONCLUSION

These results show the positive effects of a combined aerobic and strength training program on breast cancer survivors and underline the importance of the early inclusion of structured physical activity in the rehabilitation protocol.

Proximal humeral fracture fixation: multicenter study with carbon fiber peek plate

BACKGROUND

Locking plate fixation is a reliable treatment for many displaced proximal humeral fractures. Carbon fiber-reinforced-poly-ether-ether-ketone (CFR-PEEK) plates have recently been introduced as an alternative to traditional metallic plates.

METHODS

In a multicenter study involving the Orthopedic Services of 6 Italian hospitals, 182 patients with a proximal humeral fracture were treated with a Diphos H (Lima Corporate, San Daniele del Friuli, Italy) CFR-PEEK plate, 160 of whom were followed clinically and radiographically for 2 years or more. Fractures were classified by Neer's system. The functional results were assessed by Constant and DASH scores.

RESULTS

The average time to radiographic healing was 5.6 months in 158 of 160 cases. Mean Constant score was 76, and mean DASH score was 28 at 2 years. There were two nonunions (one septic and one aseptic) and 13 cases of partial (9) or massive (4) humeral head necrosis. In three of the 78 patients treated with the first-generation plates, hardware breakage happened during the operation and the plate was replaced. There was no failure among the cases treated with the thicker second-generation plate. In eight cases, there was a perforation of the humeral head by the cephalic screws.

CONCLUSIONS

CFR-PEEK plates proved as reliable as metallic plates in the treatment of proximal humeral fractures. The advantages of these new devices include a better visualization of fracture reduction during intraoperative fluoroscopic assessment and easy hardware removal due to the absence of screw-plate cold fusion.

Physical fitness assessment in multiple sclerosis patients: a controlled study

There is growing evidence to show the effectiveness of physical exercise for multiple sclerosis (MS) patients. Aim of this study was to evaluate aerobic capacity, strength, balance, and the rate of perceived exertion (RPE) after exercise, in ambulatory patients with mild MS and matched control healthy participants. Seventeen MS patients aged 48.09 ± 10.0 years, with mild MS disability (Expanded Disability Status Scale: EDSS 1.5 to 4.5) and 10 healthy sedentary age matched (41.9 ± 11.2 years) subjects volunteered for the study. MS patients underwent medical examination with resting electrocardiogram, arterial blood pressure, EDSS, and Modified Fatigue Impact Scale-MFIS. Both groups also underwent physical assessment with the Berg Balance Scale(,) test (Berg), Six Minutes Walking Test (6MWT), maximal isometric voluntary contraction (MIVC) of forearm, lower limb, shoulder strength test, and the Borg 10-point scale test. The one-way ANOVA showed significant differences for MFIS (F1.19=9.420; p<0.01), Berg (F1.19=13.125; p<0.01), handgrip MIVC (F1.19=4.567; p<0.05), lower limbs MIVC (F1.19=7.429; p<0.01), and 6MWT (F1.19=28.061; p<0.01) between groups. EDSS, Berg test and Borg scores explained 80% of 6MWT variation. Mild grade EDSS patients exhibited impaired balance, muscle strength, and low self pace-6MWT scores, whereas RPE response after the exercise was similar to that of sedentary individuals. Both groups showed similar global physiological adjustments to exercise.

Spatial distance effects on incremental semantic interpretation of abstract sentences: evidence from eye tracking

A large body of evidence has shown that visual context information can rapidly modulate language comprehension for concrete sentences and when it is mediated by a referential or a lexical-semantic link. What has not yet been examined is whether visual context can also modulate comprehension of abstract sentences incrementally when it is neither referenced by, nor lexically associated with, the sentence. Three eye-tracking reading experiments examined the effects of spatial distance between words (Experiment 1) and objects (Experiment 2 and 3) on participants' reading times for sentences that convey similarity or difference between two abstract nouns (e.g., 'Peace and war are certainly different...'). Before reading the sentence, participants inspected a visual context with two playing cards that moved either far apart or close together. In Experiment 1, the cards turned and showed the first two nouns of the sentence (e.g., 'peace', 'war'). In Experiments 2 and 3, they turned but remained blank. Participants' reading times at the adjective (Experiment 1: first-pass reading time; Experiment 2: total times) and at the second noun phrase (Experiment 3: first-pass times) were faster for sentences that expressed similarity when the preceding words/objects were close together (vs. far apart) and for sentences that expressed dissimilarity when the preceding words/objects were far apart (vs. close together). Thus, spatial distance between words or entirely unrelated objects can rapidly and incrementally modulate the semantic interpretation of abstract sentences.

Checklist for anesthesiological process: analysis of risks

BACKGROUND

Several methods are reported in the literature to analyze medically undesirable events during hospital care. Each method has several limitations, so no one has been defined as the standard tool to be able to detect failure during a medical process. The aim of this study was to compare an anesthesiological perioperative checklist with traditional Regional Incident Reporting (RIR) form in detecting and describing failures.

METHODS

We analyzed RIR number of reports, seriousness and contributing factors. We also analyzed anesthesiological checklist data for: number of reports, seriousness of incident, contributing factors and distribution in macro-phases.

RESULTS

We screened 2681 patients who underwent gynecological and obstetrical surgeries. RIR showed only the most harmful events in 0.4% of surgeries. Conversely, we recorded 135 failures with anesthesiological checklists (3.3%), of which 123 (91.1%) were solved. Categories of incident in checklists were: failures for medical device/equipment (N.=30, 22.2%), for treatment/procedures (N.=25, 18.5%), for clinical assessment (N.=22, 16.2%), for consent/communication (N.=19, 14%), for medication (N.=16, 11.8%) and for documentation (N.=8, 5.9%). Ninety-four failures (69.6%) resulted in no harm for the patient, 41 (30.3%) in reversible damage and there were no cases of permanent damage/death. Contributing factors in checklists were mainly related to team (43.7%), task factors (28.1%) and work environment (22.2%). Failures detected in macro-phases were related to: clinical assessment (31.8%), presurgical re-assessment (23.7%), preparation for anesthesia (30.3%), anesthesia conduction (8.8%) and awakening (5.1%).

CONCLUSION

An anesthesiological checklist compared with traditional RIR provided a more sensible and complete framework for incident analysis during the perioperative period in patients undergoing gynecological and obstetrical surgeries.