Categorical versus gradient properties of handling handshapes in British Sign Language (BSL). Evidence from handling handshape perception and production by deaf BSL signers and hearing speakers

Sign languages include partially lexicalised signs (known as depicting constructions, DCs) that have been argued to blend linguistic and non-linguistic components, although it is unclear what these components are. To describe object handling, signers produce handshapes that represent how the hands shape for handling, but it has not yet been fully established whether the continuous object size is described by discrete handshapes in British Sign Language (BSL). The thesis examines whether experience with sign language influences perception and comprehension of BSL handling handshapes. In the first study, categorical perception (CP), using the identification and ABX discrimination tasks, is examined for handling handshapes (HHs) in BSL. The experiments reveal that adult deaf BSL signers and hearing non-signers perceive continuous HHs categorically while remaining perceptive to gradient aperture changes. Deaf BSL signers were more accurate than hearing non-signers when discriminating between handshape stimuli; this is likely due to visual language experience. However, reaction times showed no processing advantage suggesting that categorisation of BSL HHs has a general, visual-perceptual rather than linguistic basis. The second study examines whether deaf BSL signers compared with hearing non-signers express and interpret gradient sizes of manipulated objects categorically in discourse. Handling of objects gradiently increasing in size was recorded in BSL narratives, in English narratives via co-speech gesture and pantomime; recordings were shown to another group of judges who matched handling productions with the objects. All participants reliably associated smaller objects with smaller apertures and larger objects with larger apertures; however, in BSL and co-speech gesture, handshapes were not completely interpreted as gradient variations in comparison with pantomime. When gestures become more strategic or unusual, e.g. pantomime, speakers introduce finer-grained encoding of object sizes. The discontinuous patterns suggest that HHs have underlying representations outside of the linguistic realm; their categorisation arises from visual-perceptual experience that is embodied through interaction with real life entities. In discourse, handling constructions are partly conventionalised and may become decomposable in BSL overtime but it is suggested here that general cognitive and perceptual factors contribute to the conventionalisation, rather than purely linguistic. Further, the findings from both experiments lend support to the argument that HH category structure is graded. This thesis contributes to debates about the relationship between visual perception and language processing and the complex interface between language and gesture and highlights the nature of language as a multimodal phenomenon

Rethinking constructed action

We aim to demonstrate the importance of defining linguistic phenomena by using constructed action or CA (i.e. a stretch of discourse that represents one role or combination of roles depicting actions, utterances, thought, attitudes and/or feelings of one or more referents) as an example. The problem is that different assumptions about CA have led to some apparent contradictions about the nature of this phenomenon. Based on observations and analyses of the British Sign Language narrative data, we outline criteria and recommendations for defining and analysing CA. We show that, in carefully defining the phenomenon in question and providing criteria for its identification, applying these criteria to usage data leads to emergence of particular types of Constructed Action. We also show how identifying these types can help resolve some of the apparent contradictions in the literature

Lexicalisation and de-lexicalisation processes in sign languages: Comparing depicting constructions and viewpoint gestures

In this paper, we compare so-called “classifier” constructions in signed languages (which we refer to as “depicting constructions”) with comparable iconic gestures produced by non-signers. We show clear correspondences between entity constructions and observer viewpoint gestures on the one hand, and handling constructions and character viewpoint gestures on the other. Such correspondences help account for both lexicalisation and de-lexicalisation processes in signed languages and how these processes are influenced by viewpoint. Understanding these processes is crucial when coding and annotating natural sign language data

Predicate structures, gesture, and simultaneity in the representation of action in British Sign Language: evidence from deaf children and adults.

British Sign Language (BSL) signers use a variety of structures, such as constructed action (CA), depicting constructions (DCs), or lexical verbs, to represent action and other verbal meanings. This study examines the use of these verbal predicate structures and their gestural counterparts, both separately and simultaneously, in narratives by deaf children with various levels of exposure to BSL (ages 5;1 to 7;5) and deaf adult native BSL signers. Results reveal that all groups used the same types of predicative structures, including children with minimal BSL exposure. However, adults used CA, DCs, and/or lexical signs simultaneously more frequently than children. These results suggest that simultaneous use of CA with lexical and depicting predicates is more complex than the use of these predicate structures alone and thus may take deaf children more time to master

Beyond the marrow:insights from comprehensive next-generation sequencing of extramedullary multiple myeloma tumors

Extramedullary multiple myeloma (EMM) is an aggressive form of multiple myeloma (MM). This study represents the most comprehensive next-generation sequencing analysis of EMM tumors (N = 14) to date, uncovering key molecular features and describing the tumor microenvironment. We observed the co-occurrence of 1q21 gain/amplification and MAPK pathway mutations in 79% of EMM samples, suggesting that these are crucial mutational events in EMM development. We also demonstrated that patients with mutated KRAS and 1q21 gain/amplification at the time of diagnosis have a significantly higher risk of EMM development (HR = 2.4, p = 0.011) using data from a large CoMMpass dataset. We identified downregulation of CXCR4 and enhanced cell proliferation, along with reduced expression of therapeutic targets (CD38, SLAMF7, GPRC5D, FCRH5), potentially explaining diminished efficacy of immunotherapy. Conversely, we identified significantly upregulated EZH2 and CD70 as potential future therapeutic options. For the first time, we report on the tumor microenvironment of EMM, revealing CD8+ T cells and NK cells as predominant immune effector cells using single-cell sequencing. Finally, this is the first longitudinal study in EMM revealing the molecular changes from the time of diagnosis to EMM relapse.</p

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income&nbsp;countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m–2 in the vast majority of&nbsp;countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified