Online Processing of "Real" and "Fake": The Cost of Being Too Strong

Strengthening literal meanings of linguistic expressions appears central to communicative success. Weakening on the other hand would appear not to be viable given that literal meaning already grossly underdetermines reality, let alone possibility. We discuss productive weakening in fake-type adjectival modification and present evidence from event-related brain potentials that such weakening has neurophysiological consequences and is qualitatively different from other mechanisms of modification. Specifically, the processing of fake-type constructions (e.g., ä fake diamond\") evokes a Late Positivity as characteristic of certain types of referential shift or reconceptualization. We argue that fake-type composition involves an intermediate representation that is semantically contradictory and that the Late Positivity reflects an interface repair mechanism that redresses the contradiction. In contrast, composition involving reputedly over-informative real-type adjectives evokes no comparable processing costs

Optimal Strategy for the First Episode of Primary Spontaneous Pneumothorax in Young Men: A Decision Analysis

OBJECTIVE: Primary spontaneous pneumothorax (PSP) is not uncommon in young men and is associated with frequent recurrence. The frequent recurrence after conservative treatment and resultant anxiety for recurrence are sources of disability. We explored which procedure is more appropriate as the initial therapy in terms of quality-adjusted life expectancy (QALE). DESIGN: Decision analysis using a Markov model. DATA SOURCES: Structured literature review for clinical probability. Utility derived from patients and medical staff using time trade-off method. SETTING: Hypothetical cohort. PATIENTS: Twenty-year-old men with a first episode of PSP for which simple aspiration was ineffective. INTERVENTIONS: One of the following treatment options: 1) thoracoscopic surgery, 2) pleural drainage followed by thoracoscopic surgery for recurrence, 3) pleural drainage followed by thoracoscopic surgery for the second recurrence, 4) pleurodesis followed by thoracoscopic surgery for recurrence, 5) pleurodesis followed by thoracoscopic surgery for the second recurrence, 6) pleural drainage followed by pleurodesis for the first recurrence and thoracoscopic surgery for the second recurrence. MEASUREMENTS AND MAIN RESULTS: During the 1-year period after one of the initial treatments, the QALE was 9.49 months for thoracoscopic surgery, 9.47 for pleurodesis, and 7.80–7.99 for pleural drainage. The QALE for thoracoscopic surgery was the longest among the 6 strategies during the period from 5 to 24 months. None of the variables in sensitivity analyses altered the main results except for thoracoscopic surgical death rate. When it exceeds 0.3%, pleurodesis becomes the preferred strategy. CONCLUSION: On the basis of the current best available data and patients' preference, thoracoscopic surgery can be considered the treatment of choice for the first episode of PSP