ResearchPad - language https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[The Language of Innovation]]> https://www.researchpad.co/article/elastic_article_10245 Predicting innovation is a peculiar problem in data science. Following its definition, an innovation is always a never-seen-before event, leaving no room for traditional supervised learning approaches. Here we propose a strategy to address the problem in the context of innovative patents, by defining innovations as never-seen-before associations of technologies and exploiting self-supervised learning techniques. We think of technological codes present in patents as a vocabulary and the whole technological corpus as written in a specific, evolving language. We leverage such structure with techniques borrowed from Natural Language Processing by embedding technologies in a high dimensional euclidean space where relative positions are representative of learned semantics. Proximity in this space is an effective predictor of specific innovation events, that outperforms a wide range of standard link-prediction metrics. The success of patented innovations follows a complex dynamics characterized by different patterns which we analyze in details with specific examples. The methods proposed in this paper provide a completely new way of understanding and forecasting innovation, by tackling it from a revealing perspective and opening interesting scenarios for a number of applications and further analytic approaches.

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<![CDATA[Using case-level context to classify cancer pathology reports]]> https://www.researchpad.co/article/elastic_article_7869 Individual electronic health records (EHRs) and clinical reports are often part of a larger sequence—for example, a single patient may generate multiple reports over the trajectory of a disease. In applications such as cancer pathology reports, it is necessary not only to extract information from individual reports, but also to capture aggregate information regarding the entire cancer case based off case-level context from all reports in the sequence. In this paper, we introduce a simple modular add-on for capturing case-level context that is designed to be compatible with most existing deep learning architectures for text classification on individual reports. We test our approach on a corpus of 431,433 cancer pathology reports, and we show that incorporating case-level context significantly boosts classification accuracy across six classification tasks—site, subsite, laterality, histology, behavior, and grade. We expect that with minimal modifications, our add-on can be applied towards a wide range of other clinical text-based tasks.

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<![CDATA[Participant and informant memory-specific cognitive complaints predict future decline and incident dementia: Findings from the Sydney Memory and Ageing Study]]> https://www.researchpad.co/article/elastic_article_7842 Subjective Cognitive Complaints (SCCs) may represent one of the earliest stages of preclinical dementia. The objective of the present study was to extend previous work by our group to examine the relationship between participant-reported and informant-reported memory and non-memory SCCs, cognitive decline and incident dementia, over a six-year period. Participants were 873 community dwelling older adults (Mage = 78.65, SD = 4.79) without dementia and 843 informants (close friends or family) from the Sydney Memory and Ageing Study. Comprehensive neuropsychological testing and diagnostic assessments were carried out at baseline and biennially for six years. Linear mixed models and Cox proportional hazard models were performed to determine the association of SCCs, rate of cognitive decline and risk of incident dementia, controlling demographics and covariates of mood and personality. Participant and informant memory-specific SCCs were associated with rate of global cognitive decline; for individual cognitive domains, participant memory SCCs predicted decline for language, while informant memory SCCs predicted decline for executive function and memory. Odds of incident dementia were associated with baseline participant memory SCCs and informant memory and non-memory SCCs in partially adjusted models. In fully adjusted models, only informant SCCs were associated with increased risk of incident dementia. Self-reported memory-specific cognitive complaints are associated with decline in global cognition over 6-years and may be predictive of incident dementia, particularly if the individual is depressed or anxious and has increased neuroticism or decreased openness. Further, if and where possible, informants should be sought and asked to report on their perceptions of the individual’s memory ability and any memory-specific changes that they have noticed as these increase the index of diagnostic suspicion.

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<![CDATA[Children’s descriptions of playing and learning as related processes]]> https://www.researchpad.co/article/Nb68d6bfc-75c6-4e1a-9b4b-3dced51d37df

Many studies have examined children’s understanding of playing and learning as separate concepts, but the ways that children relate playing and learning to one another remain relatively unexplored. The current study asked 5- to 8-year-olds (N = 92) to define playing and learning, and examined whether children defined them as abstract processes or merely as labels for particular types of activities. We also asked children to state whether playing and learning can occur simultaneously, and examined whether they could give examples of playing and learning with attributes either congruent or incongruent with those activities. Older children were more likely to define both playing and learning in terms of abstract processes, rather than by describing particular topics or activities. Children who defined both playing and learning in this way were able to generate more examples of situations where they were simultaneously playing and learning, and were better able to generate examples of learning with characteristics of play, and examples of playing with characteristics of learning. These data suggest that children develop an understanding that learning and playing can coincide. These results are critical to researchers and educators who seek to integrate play and learning, as children’s beliefs about these concepts can influence how they reflect on playful learning opportunities.

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<![CDATA[Effects of thyroplasty implant stiffness on glottal shape and voice acoustics]]> https://www.researchpad.co/article/Nab68174b-07f0-47f1-87dc-333bea4de1be

Abstract

Objectives

Vocal fold (VF) stiffness and geometry are determinant variables in voice production. Type 1 medialization thyroplasty (MT), the primary surgical treatment for glottic insufficiency, changes both of these variables. Understanding the cause and effect relationship between these variables and acoustic output might improve voice outcomes after MT. In this study, the effects of thyroplasty implants with variable stiffness on glottal shape and acoustics were investigated.

Methods

In an ex vivo human larynx phonation model, bilateral MT with implants of four stiffness levels (1386, 21.6, 9.3, and 5.5 kPa) were performed. Resulting acoustics and aerodynamics were measured across multiple airflow levels. A vertical partial hemilaryngectomy was performed and stereoscopic images of the VF medial surface taken to reconstruct its three‐dimensional (3D) surface contour. The results were compared across implants.

Results

The effects of implant stiffness on acoustics varied by airflow. Softer implants resulted in improved acoustics, as measured by cepstral peak prominence (CPP), at lower airflow levels compared to stiffer implants but this relationship reversed at high airflow levels. Stiffer implants generally required less airflow to generate a given subglottal pressure. Stiffer implants resulted in greater medialized surface area and maximal medialization, but all implants had similar effects on overall VF medial surface contour.

Conclusion

Softer implants result in less medialization but better acoustics at low airflow rates. Stiffer implants provide better acoustics and more stable pressure‐flow relationships at higher airflow rates. This highlights a potential role for patient‐specific customized thyroplasty implants of various stiffness levels.

Level of Evidence

NA.

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<![CDATA[Histologic effect of the potassium‐titanyl phosphorous laser on laryngeal papilloma]]> https://www.researchpad.co/article/N7e6bb6ea-73c0-4075-8a56-fc6253a1ff36

Objectives

Tissue effects occurring with potassium‐titanyl phosphorous (KTP) laser treatment are difficult to quantify due to the multiple variables that affect not only the fluence (energy delivered) but also the laser–tissue interaction. This histopathologic analysis of recurrent respiratory papilloma (RRP) removed after treatment with KTP laser therapy permits correlation of histologic effect with method of laser treatment.

Methods

The histopathology of RRP resected specimens in a single patient was compared following treatment with KTP laser in contact and non‐contact modes as documented with intraoperative photography and video imaging.

Results

Epithelial‐sparing injury selective to the microvasculature was identified on histopathologic assessment of a specimen treated with noncontact angiolysis. Highly cauterized papillomatous epithelium without identifiable vascular structures was identified on tissue removed after treatment with the KTP laser in contact mode.

Conclusion

The histopathologic assessment of acute KTP laser effect on papilloma permits correlation between technique of application and tissue effect. Similar assessments may be helpful to modify dosimetry for individual patients requiring repeated treatment and may also assist in refining the development of existing KTP laser treatment classification systems.

Level of Evidence

4

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<![CDATA[Variable weights theory and its application to multi-attribute group decision making with intuitionistic fuzzy numbers on determining decision maker’s weights]]> https://www.researchpad.co/article/5c89771bd5eed0c4847d2486

The determination of the weights of decision makers (DMs) is an important problem in multi-attribute group decision making. Many approaches have been presented to determine DMs’ weights. However, the computed weight vectors of DMs are usually assumed to be constant in existing studies, and this may cause irrationalities in the decision results. Therefore, this article proposes a novel method to determine DMs’ weights based on variable weights theory in which the evaluation information is described as intuitionistic fuzzy sets (IFSs). First, DMs provide their assessment with IFSs, and the intuitionistic fuzzy weighted averaging (IFWA) operator is applied to obtain weighted decision matrix based on the prior given DMs’ and attributes’ weights. Second, the DMs’ weights are obtained based on variable weights theory, and an alternative decision can be computed. Finally, the converted value of the achieved IFS of each alternative is calculated, and the best appropriate alternative is acquired. Two illustrative examples and the comparisons with exsiting approaches are also used to reflect the effectiveness of the proposed approach.

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<![CDATA[Issue framing in online voting advice applications: The effect of left-wing and right-wing headers on reported attitudes]]> https://www.researchpad.co/article/5c785013d5eed0c484007c38

Voting Advice Applications (VAAs) provide voting recommendations to millions of people. As these voting recommendations are based on users’ answers to attitude questions, the framing of these questions can have far-reaching consequences. The current study reports on a field experiment in which the framing of the header above VAA statements (N = 17) was manipulated (condition 1: no header; condition 2: a right-wing header, e.g., finance; condition 3: a left-wing header, e.g., nature and environment). Visitors of a VAA developed for Utrecht, the fourth largest municipality in the Netherlands, were randomly guided to one of the versions of the tool in which the header type was varied. Results (based on Nrespondents = 27,404) show that providing a header (left-wing or right-wing) leads to more left-wing answers as compared a condition where there is no header above the attitude statement. This effect, however, is only observed for respondents with lower levels of political sophistication.

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<![CDATA[San Antonio refugees: Their demographics, healthcare profiles, and how to better serve them]]> https://www.researchpad.co/article/5c75abe5d5eed0c484d07e5c

Objective

The recent refugee crisis has resulted in the largest burden of displacement in history, with the US being the top resettlement country since 1975. Texas welcomed the second most US-bound refugees in 2016, with a large percentage arriving in San Antonio. Yet, the composition of the San Antonio refugees has not been described and their healthcare needs remain ill-defined. Through this study, we aim at elucidating their demographics and healthcare profiles, with the goal of devising recommendations to help guide refugee program development and guide other refugee resettlement programs.

Methods

Data from 731 charts belonging to 448 patients at the San Antonio Refugee Health Clinic (SARHC) were extracted and analyzed. Data included age, gender, country of origin, first language, interpretation need, health insurance status, medical history, vital signs, diagnoses, and prescribed medications.

Results

Women constituted the majority of patients (n = 267; 56.4%), and the median age of all patients was 39 (Q1:26, Q3:52). Nepali-speaking Bhutanese patients were the most represented group (n = 107, 43.1%), followed by Iraqi (n = 35, 14.1%), Burmese (n = 30, 12.1%), and Iranian (n = 19, 7.7%) refugees. Of those who responded, 200 (86.6%) did not have any form of health insurance. Additionally, 262 (50.9%) had a body-mass index (BMI) in the overweight or obese range. Further, 61.4% (n = 337) had blood pressures in the hypertensive range, while 9.3% (n = 51) had an elevated blood pressure. On average, each patient had 1.9 complaints, with abdominal pain, headaches, and cough being the predominant complaints. Allergic rhinitis, viral upper respiratory infections, and elevated blood pressure were the most common diagnoses. However, the list of common diagnoses differed per country of origin.

Conclusion

The SARHC demographics were different from those of other Texas refugees. The rate of the uninsured and the burden of non-communicable diseases were high. Furthermore, each refugee subgroup had a different set of common problems. These findings reveal important considerations for refugee healthcare providers and the unique approach that may be required for different communities.

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<![CDATA[The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement]]> https://www.researchpad.co/article/5c6dc9c0d5eed0c48452a138

Background

Physician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement.

Materials and methods

A qualitative mixed methods analysis was completed in 6 weeks, consisting of a preliminary analysis of the hospital system’s history that was used to purposefully recruit 20 physicians across specialties and 20 healthcare administrators across management levels for semi-structured interviews and observation. Participation rates of 77% (20/26) and 83% (20/24) were achieved for physicians and administrators, respectively. Cohorts consisted of equal numbers of men and women with experience ranging from 1 to 35 years within the organization. Field notes and transcripts were systematically analyzed using an iterative inductive-deductive approach. Emergent themes were presented and discussed with approximately 400 physicians and administrators within the organization to assess validity and which results were most meaningful.

Results & discussion

This investigation indicated a professional cultural disconnect was undermining efforts to improve physician engagement. This disconnect was further complicated by a minority (10%) not believing an issue existed and conflicting connotations not readily perceived by participants who often offered similar solutions. Physicians and administrators felt these results accurately reflected their realities and used this information as a common language to plan targeted interventions to improve physician engagement. Limitations of the study included its cross-sectional nature with a modest sample size at a single institution.

Conclusions

A qualitative mixed methods analysis efficiently identified professional cultural barriers within an academic hospital to serve as an institution-specific guide to improving physician engagement.

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<![CDATA[Gender and cultural bias in student evaluations: Why representation matters]]> https://www.researchpad.co/article/5c6dca10d5eed0c48452a728

Gendered and racial inequalities persist in even the most progressive of workplaces. There is increasing evidence to suggest that all aspects of employment, from hiring to performance evaluation to promotion, are affected by gender and cultural background. In higher education, bias in performance evaluation has been posited as one of the reasons why few women make it to the upper echelons of the academic hierarchy. With unprecedented access to institution-wide student survey data from a large public university in Australia, we investigated the role of conscious or unconscious bias in terms of gender and cultural background. We found potential bias against women and teachers with non-English speaking backgrounds. Our findings suggest that bias may decrease with better representation of minority groups in the university workforce. Our findings have implications for society beyond the academy, as over 40% of the Australian population now go to university, and graduates may carry these biases with them into the workforce.

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<![CDATA[The impact of bilingualism on executive functions and working memory in young adults]]> https://www.researchpad.co/article/5c6dc9a6d5eed0c484529f7c

A bilingual advantage in a form of a better performance of bilinguals in tasks tapping into executive function abilities has been reported repeatedly in the literature. However, recent research defends that this advantage does not stem from bilingualism, but from uncontrolled factors or imperfectly matched samples. In this study we explored the potential impact of bilingualism on executive functioning abilities by testing large groups of young adult bilinguals and monolinguals in the tasks that were most extensively used when the advantages were reported. Importantly, the recently identified factors that could be disrupting the between groups comparisons were controlled for, and both groups were matched. We found no differences between groups in their performance. Additional bootstrapping analyses indicated that, when the bilingual advantage appeared, it very often co-occurred with unmatched socio-demographic factors. The evidence presented here indicates that the bilingual advantage might indeed be caused by spurious uncontrolled factors rather than bilingualism per se. Secondly, bilingualism has been argued to potentially affect working memory also. Therefore, we tested the same participants in both a forward and a backward version of a visual and an auditory working memory task. We found no differences between groups in either of the forward versions of the tasks, but bilinguals systematically outperformed monolinguals in the backward conditions. The results are analysed and interpreted taking into consideration different perspectives in the domain-specificity of the executive functions and working memory.

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<![CDATA[elPrep 4: A multithreaded framework for sequence analysis]]> https://www.researchpad.co/article/5c6dc9a8d5eed0c484529f91

We present elPrep 4, a reimplementation from scratch of the elPrep framework for processing sequence alignment map files in the Go programming language. elPrep 4 includes multiple new features allowing us to process all of the preparation steps defined by the GATK Best Practice pipelines for variant calling. This includes new and improved functionality for sorting, (optical) duplicate marking, base quality score recalibration, BED and VCF parsing, and various filtering options. The implementations of these options in elPrep 4 faithfully reproduce the outcomes of their counterparts in GATK 4, SAMtools, and Picard, even though the underlying algorithms are redesigned to take advantage of elPrep’s parallel execution framework to vastly improve the runtime and resource use compared to these tools. Our benchmarks show that elPrep executes the preparation steps of the GATK Best Practices up to 13x faster on WES data, and up to 7.4x faster for WGS data compared to running the same pipeline with GATK 4, while utilizing fewer compute resources.

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<![CDATA[Liberals lecture, conservatives communicate: Analyzing complexity and ideology in 381,609 political speeches]]> https://www.researchpad.co/article/5c648d4ad5eed0c484c8247b

There is some evidence that liberal politicians use more complex language than conservative politicians. This evidence, however, is based on a specific set of speeches of US members of Congress and UK members of Parliament. This raises the question whether the relationship between ideology and linguistic complexity is a more general phenomenon or specific to this small group of politicians. To address this question, this paper analyzes 381,609 speeches given by politicians from five parliaments, by twelve European prime ministers, as well as speeches from party congresses over time and across countries. Our results replicate and generalize earlier findings: speakers from culturally liberal parties use more complex language than speakers from culturally conservative parties. Economic left-right differences, on the other hand, are not systematically linked to linguistic complexity.

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<![CDATA[Online comprehension across different semantic categories in preschool children with autism spectrum disorder]]> https://www.researchpad.co/article/5c6b2693d5eed0c484289cd9

Background

Word comprehension across semantic categories is a key area of language development. Using online automated eye-tracking technology to reduce response demands during a word comprehension test may be advantageous in children with autism spectrum disorder (ASD).

Objectives

To measure online accuracy of word recognition across eleven semantic categories in preschool children with ASD and in typically developing (TD) children matched for gender and developmental age.

Methods

Using eye-tracker methodology we measured the relative number of fixations on a target image as compared to a foil of the same category shown simultaneously on screen. This online accuracy measure was considered a measure of word understanding. We tested the relationship between online accuracy and offline word recognition and the effects of clinical variables on online accuracy. Twenty-four children with ASD and 21 TD control children underwent the eye-tracking task.

Results

On average, children with ASD were significantly less accurate at fixating on the target image than the TD children. After multiple comparison correction, no significant differences were found across the eleven semantic categories of the experiment between preschool children with ASD and younger TD children matched for developmental age. The ASD group showed higher intragroup variability consistent with greater variation in vocabulary growth rates. Direct effects of non-verbal cognitive levels, vocabulary levels and gesture productions on online word recognition in both groups support a dimensional view of language abilities in ASD.

Conclusions

Online measures of word comprehension across different semantic categories show higher interindividual variability in children with ASD and may be useful for objectively monitor gains on targeted language interventions.

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<![CDATA[Visual habituation in deaf and hearing infants]]> https://www.researchpad.co/article/5c648d4bd5eed0c484c824a4

Early cognitive development relies on the sensory experiences that infants acquire as they explore their environment. Atypical experience in one sensory modality from birth may result in fundamental differences in general cognitive abilities. The primary aim of the current study was to compare visual habituation in infants with profound hearing loss, prior to receiving cochlear implants (CIs), and age-matched peers with typical hearing. Two complementary measures of cognitive function and attention maintenance were assessed: the length of time to habituate to a visual stimulus, and look-away rate during habituation. Findings revealed that deaf infants were slower to habituate to a visual stimulus and demonstrated a lower look-away rate than hearing infants. For deaf infants, habituation measures correlated with language outcomes on standardized assessments before cochlear implantation. These findings are consistent with prior evidence suggesting that habituation and look-away rates reflect efficiency of information processing and may suggest that deaf infants take longer to process visual stimuli relative to the hearing infants. Taken together, these findings are consistent with the hypothesis that hearing loss early in infancy influences aspects of general cognitive functioning.

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<![CDATA[Deliberate reasoning is not affected by language]]> https://www.researchpad.co/article/5c5ca2cbd5eed0c48441eb2e

Background

Millions of people use a second language every day. Does this have an effect on their decision-making? Are decisions in a second language more deliberate? Two mechanisms have been proposed: reduced emotionality or increased deliberation. Most studies so far used problems where both mechanisms could contribute to a foreign language effect. Here, we aimed to identify whether deliberate reasoning increases for problems that are devoid of any emotional connotation when using a second language or having to switch between native and second language.

Method

We measured deliberate reasoning with items from the cognitive reflection test, ratio bias, a probability matching task, and base rate neglect items. We recruited over 500 participants from Norway and the Netherlands that had English as their second language. Participants were randomly assigned to either the native, switching or second language condition. We measured: number of correctly answered items–deliberate reasoning score, perceived effort, perceived accuracy or confidence, and language proficiency.

Results

Deliberate reasoning was not increased when using a second language or when having to switch between native and second language. All three groups performed equally well. Significant predictors of deliberate reasoning were age, gender, education, perceived effort, and confidence but not the language context. Participants with low English proficiency spent more time reading compared to more fluent speakers.

Conclusion

There is no advantage of second language on deliberate reasoning in the absence of time pressure. Deliberation was not increased by providing items in a second language, but through the willingness to spend cognitive effort and time to read carefully.

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<![CDATA[A systematic review of ethnic minority women’s experiences of perinatal mental health conditions and services in Europe]]> https://www.researchpad.co/article/5c59fed4d5eed0c4841356fe

Background

Women from ethnic minority groups are at greater risk of developing mental health problems. Poor perinatal mental health impacts on maternal morbidity and mortality and can have a devastating impact on child and family wellbeing. It is important to ensure that services are designed to meet the unique needs of women from diverse backgrounds.

Aim

The aim of the review was to explore ethnic minority women's experiences of perinatal mental ill health, help-seeking and perinatal mental health services in Europe.

Data sources

Searches included CINAHL, Maternity and Infant Care, MEDLINE and PsycINFO with no language or date restrictions. Additional literature was identified by searching reference lists of relevant studies.

Design

This was a mixed method systematic review. Study selection, appraisal and data extraction were conducted by two researchers independently. A convergent approach was adopted for the analysis and the data were synthesised thematically.

Results

The 15 eligible studies included women from a range of minority ethnic backgrounds and were all undertaken in the United Kingdom (UK). Seven overarching themes were identified; awareness and beliefs about mental health, isolation and seeking support, influence of culture, symptoms and coping strategies, accessing mental health services, experiences of mental health services and what women want.

Conclusion

Lack of awareness about mental ill health, cultural expectations, ongoing stigma, culturally insensitive and fragmented health services and interactions with culturally incompetent and dismissive health providers all impact on ethnic minority women's ability to receive adequate perinatal mental health support in the UK. Future research should focus on in-depth exploration of the experiences of these women across multiple European settings and interventions to reduce health inequalities among vulnerable mothers and families affected by perinatal mental ill health.

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<![CDATA[Switching between reading tasks leads to phase-transitions in reading times in L1 and L2 readers]]> https://www.researchpad.co/article/5c63394bd5eed0c484ae6445

Reading research uses different tasks to investigate different levels of the reading process, such as word recognition, syntactic parsing, or semantic integration. It seems to be tacitly assumed that the underlying cognitive process that constitute reading are stable across those tasks. However, nothing is known about what happens when readers switch from one reading task to another. The stability assumptions of the reading process suggest that the cognitive system resolves this switching between two tasks quickly. Here, we present an alternative language-game hypothesis (LGH) of reading that begins by treating reading as a softly-assembled process and that assumes, instead of stability, context-sensitive flexibility of the reading process. LGH predicts that switching between two reading tasks leads to longer lasting phase-transition like patterns in the reading process. Using the nonlinear-dynamical tool of recurrence quantification analysis, we test these predictions by examining series of individual word reading times in self-paced reading tasks where native (L1) and second language readers (L2) transition between random word and ordered text reading tasks. We find consistent evidence for phase-transitions in the reading times when readers switch from ordered text to random-word reading, but we find mixed evidence when readers transition from random-word to ordered-text reading. In the latter case, L2 readers show moderately stronger signs for phase-transitions compared to L1 readers, suggesting that familiarity with a language influences whether and how such transitions occur. The results provide evidence for LGH and suggest that the cognitive processes underlying reading are not fully stable across tasks but exhibit soft-assembly in the interaction between task and reader characteristics.

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<![CDATA[Predictive validity of preschool screening tools for language and behavioural difficulties: A PRISMA systematic review]]> https://www.researchpad.co/article/5c61e912d5eed0c48496f791

Background

Preschool screening for developmental difficulties is increasingly becoming part of routine health service provision and yet the scope and validity of tools used within these screening assessments is variable. The aim of this review is to report on the predictive validity of preschool screening tools for language and behaviour difficulties used in a community setting.

Methods

Studies reporting the predictive validity of language or behaviour screening tools in the preschool years were identified through literature searches of Ovid Medline, Embase, EBSCO CINAHL, PsycInfo and ERIC. We selected peer-reviewed journal articles reporting the use of a screening tool for language or behaviour in a population-based sample of children aged 2–6 years of age, including a validated comparison diagnostic assessment and follow-up assessment for calculation of predictive validity.

Results

A total of eleven eligible studies was identified. Six studies reported language screening tools, two reported behaviour screening tools and three reported combined language & behaviour screening tools. The Language Development Survey (LDS) administered at age 2 years achieved the best predictive validity performance of the language screening tools (sens 67%, spec 94%, NPV 88% and PPV 80%). The Strengths and Difficulties Questionnaire (SDQ) administered at age 4 years achieved the best predictive validity compared to other behaviour screening tools (Sens 31%, spec 93%, NPV 84% and PPV 52%). The SDQ and Sure Start Language Measure (SSLM) administered at 2.5 years achieved the best predictive validity of the combined language & behaviour assessments (sens 87%, spec 64%, NPV 97% and PPV 31). Predictive validity data and diagnostic odds ratios identified language screening tools as more effective and achieving higher sensitivity and positive predictive value than either behaviour or combined screening tools. Screening tools with combined behaviour and language assessments were more specific and achieved higher negative predictive value than individual language or behaviour screening tools. Parent-report screening tools for language achieved higher sensitivity, specificity and negative predictive value than direct child assessment.

Conclusions

Universal screening tools for language and behaviour concerns in preschool aged children used in a community setting can demonstrate excellent predictive validity, particularly when they utilise a parent-report assessment. Incorporating these tools into routine child health surveillance could improve the rate of early identification of language and behavioural difficulties, enabling more informed referrals to specialist services and facilitating access to early intervention.

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