Individual differences in the production of disfluency: a latent variable analysis of memory ability and verbal intelligence

Recent work has begun to focus on the role that individual differences in executive function and intelligence have on the production of fluent speech. However, isolating the underlying causes of different types of disfluency has been difficult given the speed and complexity of language production. In this study, we focused on the role of memory abilities and verbal intelligence, and we chose a task that relied heavily on memory for successful performance. Given the task demands, we hypothesised that a substantial proportion of disfluencies would be due to memory retrieval problems. We contrasted memory abilities with individual differences in verbal intelligence as previous work highlighted verbal intelligence as an important factor in disfluency production. A total of 78 participants memorised and repeated 40 syntactically complex sentences, which were recorded and coded for disfluencies. Model comparisons were carried out using hierarchical structural equation modelling. Results showed that repetitions were significantly related to verbal intelligence. Unfilled pauses and repairs, in contrast, were marginally (p <.09) related to memory abilities. The relationship in all cases was negative. Conclusions explore the link between different types of disfluency and particular problems arising in the course of production, and how individual differences inform theoretical debates in language production

Successful resection of the recurrence of a cavernous malformation of the optic chiasm

The case of a 33-year-old female who suffered from a recurrence of an intrachiasmatic cavernous malformation is presented. She had already undergone surgery in 1991 and 2001 and was admitted to our hospital with reduced vision in the right eye. After MRI, and diagnosis of recurrence of the cavernoma, a neurosurgical operation was performed using the pterional approach. The intraoperative situation was documented with micro photographs. The postoperative course was uneventful. The female described a minimal improvement of her vision. No postoperative complications were observed. To our knowledge, microsurgically complete extirpation of a recurrence of an intrachiasmatic cavernoma has not yet been reported in the literature

The impact of microsurgery, stereotactic radiosurgery and radiotherapy in the treatment of meningiomas depending on different localizations

Scientific background: Meningiomas are the most common benign intracranial neoplasms with a slow growth presented as the intracranial lesion. These tumors are without any symptoms for a long time. At the time of diagnosis it is frequently an asymptomatic tumor. In that case the therapist may well suggest a wait-and-see strategy. The therapy of meningiomas focuses firstly on the microsurgical treatment. Volume reduction can be achieved immediately after treatment. Stereotactic radiosurgery is an important non-invasive treatment option for recurrent tumors or meningiomas with partial resection. The technical equipment for the stereotactic radiosurgery is a cost intensive investment. In this context the high precision of the intervention, presented as a low invasiveness of the treatment, is an important factor. The aim of this assessment is to identify the chances and limitations of the diverse treatment options and to estimate their outcome for different localisations of meningiomas. Methods: In December 2007 a systematic literature search was conducted using the most relevant medical databases. The whole strategy and the used search terms were documented. The literature search was supplemented with an internet and literature based hand search on law, ethics and economics. Primary studies and systematic reviews which report relevant outcomes are included in this analysis. The current assessment is based on the available evidence that was found at the time of the literature search. Results: A total of 31 publications for the medical focus of assessment and three reports from the economical hand search were included. In general, it is not possible to identify neither randomised clinical trials or prospective, contrasting cohort studies nor studies summarising results from such studies. The results presented in the literature published by surgeons strongly vary regarding localisation of meningiomas. Publications not differentiating between the localisation of meningiomas indicate a progression free survival rate of five years in 77 to 97% of the cases after complete surgical resection of the tumor, in 18 to 70% of the cases after subtotal resection and for patients who had undergone surgical resection and a combined radiotherapeutical treatment of their meningiomas a five year progression free survival rate between 82 and 97%. Other treatment options like hormone therapy or treatments to stop tumor growth had been used unsuccessfully so far. Based on the results presented regarding economic evaluation, costs resulting from radiosurgical treatment are lower in contrast to costs resulting from surgical resection. However, it has to be taken into account that costs resulting from radiosurgical treatment strongly depend on the number of patients treated in total with the radiosurgical equipment. Conclusion: Due to the strong dependencies between the results from surgical therapy and the localisation of the tumor, it is only possible to derive recommendations on whether or not to perform the surgical therapy with respect to the localisation of the tumor. Only for patients with tumors with a spinal localisation or WHO Grade I meningiomas with a cortical localisation, primary treatment with by means of microsurgery can be suggested. For all other localisations of the tumor, alternative treatment by radiosurgery should be discussed. From the literature identified, a clear recommendation of one or the other therapy however can not be deduced. Thus, there is a strong need for randomised clinical trials or prospective or contrasting cohort studies, which compare rigorously microsurgery with radiosurgery concerning different localisations of tumors

The impact of microsurgery, stereotactic radiosurgery and radiotherapy in the treatment of meningiomas depending on different localizations

Scientific background Meningiomas are the most common benign intracranial neoplasms with a slow growth presented as the intracranial lesion. These tumors are without any symptoms for a long time. At the time of diagnosis it is frequently an asymptomatic tumor. In that case the therapist may well suggest a wait-and-see strategy. The therapy of meningiomas focuses firstly on the microsurgical treatment. Volume reduction can be achieved immediately after treatment. Stereotactic radiosurgery is an important non-invasive treatment option for recurrent tumors or meningiomas with partial resection. The technical equipment for the stereotactic r adio surgery is a cost intensive investment. In this context the high precision of the intervention, presented as a low invasiveness of the treatment, is an important factor.The aim of this assessment is to identify the chances and limitations of the diverse treatment options and to estimate their outcome for different localisations of meningiomas. Methods In December 2007 a systematic literature search was conducted using the most relevant medical databases. The whole strategy and the used search terms were documented. The literature search was supplemented with an internet and literature based hand search on law, ethics and economics. Primary studies and systematic reviews which report relevant outcomes are included in this analysis. The current assessment is based on the available evidence that was found at the time of the literature search. Results A total of 31 publications for the medical focus of assessment and three reports from the economical hand search were included. In general, it is not possible to identify neither randomised clinical trials or prospective, contrasting cohort studies nor studies summarising results from such studies. The results presented in the literature published by surgeons strongly vary regarding localisation of meningiomas. Publications not differentiating between the localisation of meningiomas indicate a progression free survival rate of five years in 77 to 97% of the cases after complete surgical resection of the tumor, in 18 to 70% of the cases after subtotal resection and for patients who had undergone surgical resection and a combined radiotherapeutical treatment of their meningiomas a five year progression free survival rate between 82 and 97%. Other treatment options like hormone therapy or treatments to stop tumor growth had been used unsuccessfully so far. Based on the results presented regarding economic evaluation, costs resulting from radiosurgical treatment are lower in contrast to costs resulting from surgical resection. However, it has to be taken into account that costs resulting from radiosurgical treatment strongly depend on the number of patients treated in total with the radiosurgical equipment. Conclusion Due to the strong dependencies between the results from surgical therapy and the localisation of the tumor, it is only possible to derive recommendations on whether or not to perform the surgical therapy with respect to the localisation of the tumor. Only for patients with tumors with a spinal localisation or WHO Grade I meningiomas with a cortical localisation, primary treatment with by means of microsurgery can be suggested. For all other localisations of the tumor, alternative treatment by radiosurgery should be discussed. From the literature identified, a clear recommendation of one or the other therapy however can not be deduced. Thus, there is a strong need for randomised clinical trials or prospective or contrasting cohort studies, which compare rigorously microsurgery with radiosurgery concerning different localisations of tumors.Hintergrund Meningeome sind meistens gutartige, langsam wachsende Tumore, die sich als intrakranielle oder intraspinale Raumforderung äußern. Da Meningeome über lange Zeit symptomlos bleiben, haben sie sich zum Zeitpunkt der Diagnosestellung häufig noch nicht manifestiert. In diesem Fall kann zunächst eine abwartende Haltung des Therapeuten eingenommen werden. Der Fokus der Therapiemaßnahmen stützt sich vor allem auf die chirurgische Entfernung des Tumors, da auf diese Weise eine sofortige Volumenreduktion erzielt werden kann. Eine nichtinvasive Maßnahme, die vor allem zur Nachbehandlung teilresizierter Tumore eingesetzt wird, stellt die stereotaktische Radiochirurgie dar. Für die stereotaktische Radiochirurgie ist eine aufwendige und kostenintensive Gerätetechnik notwendig. Der hohe Grad an Präzision, der durch einen steilen Abfall der Dosiskurven am Tumorrand gekennzeichnet ist, und die geringe Invasivität der Behandlung sind jedoch von zentraler Bedeutung. Das vorliegende Assessment soll die Möglichkeiten und Grenzen der unterschiedlichen Optionen in der Meningeomtherapie aufzeigen und das Outcome der Verfahren in Bezug zu den unterschiedlichen Lokalisationen der Meningeome bewerten. Methodik Die systematische Literatursuche erfolgt im Dezember 2007 in den wichtigsten medizinischen Datenbanken, wobei die in der Suchstrategie verwendeten Stichworte und ihre Verknüpfungen nachvollziehbar dokumentiert werden. Aufgrund der geringen Datenlage wird darüber hinaus für den Bereich der gesundheitsökonomischen Bewertungen eine Handsuche durchgeführt. Das gegenwärtige Assessment beruht somit auf der aktuellsten Evidenz themenbezogener Studien und Übersichtsarbeiten, die zum Zeitpunkt der Literatursuche zur Verfügung steht. Ergebnisse Insgesamt werden 31 Publikationen für die medizinische und drei Arbeiten für die gesundheitsökonomische Bewertung herangezogen. Die Ergebnisse der einzelnen Arbeiten sind stark abhängig von der Lokalisation des Meningeoms. Für die allgemeine Betrachtung der Meningeome werden vor allem Publikationen herangezogen, die ein progressionsfreies Intervall von fünf Jahren bei 77 bis 97% der Fälle nach kompletter chirurgischer Tumorentfernung beschreiben, bei 18 bis 70% nach subtotaler Tumorentfernung und bei 82 bis 97% nach kombinierter chirurgischer sowie strahlentherapeutischer Behandlung. Andere Therapieformen wie Hormontherapie oder Therapieformen, die dem Tumorwachstum entgegenwirken, zeigen bislang keinen durchgreifenden Erfolg. Der Kostenvergleich zwischen der Radiochirurgie mit dem Gamma knife und der mikrochirurgischen Operation fällt, bezogen auf die Daten aus der Literatur, zugunsten der Radiochirurgie aus. Allerdings stehen die Kosten der Radiochirurgie in unmittelbarer Abhängigkeit zur der Anzahl der mit der Intervention therapierten Patienten insgesamt. Schlussfolgerung Aus den vorliegenden Arbeiten kann lediglich zu einzelnen Lokalisationen von Tumoren ein Behandlungsvorschlag abgeleitet werden, da die Evidenzkategorie III nicht überschritten wird. In den meisten Fällen wird es somit eine Einzelfallentscheidung bleiben, die ausgehend von den Beschwerden des Patienten die operative Expertise des Neurochirurgen, die strahlentherapeutischen Möglichkeiten und letztlich den Patientenwunsch einbezieht.Dabei lässt sich eine primär chirurgische Therapie lediglich bei spinalen Tumoren und bei kortikal gelegenen Tumoren der Histologie Grad I vorschlagen. Alle übrigen Lokalisationen sind grundsätzlich auf mehrere Arten therapierbar und die vorliegende Literatur lässt bei dem existierenden Evidenzniveau keine eindeutigen Aussagen für oder gegen eine Therapie zu. Somit besteht die Notwendigkeit randomisiert kontrollierter Studien oder prospektiver Kohortenstudien, die in Abhängigkeit der unterschiedlichen Lokalisationen einen direkten Vergleich zwischen der Mikro- und der Radiochirurgie herstellen

Listening to limericks: a pupillometry investigation of perceivers’ expectancy

What features of a poem make it captivating, and which cognitive mechanisms are sensitive to these features? We addressed these questions experimentally by measuring pupillary responses of 40 participants who listened to a series of Limericks. The Limericks ended with either a semantic, syntactic, rhyme or metric violation. Compared to a control condition without violations, only the rhyme violation condition induced a reliable pupillary response. An anomaly-rating study on the same stimuli showed that all violations were reliably detectable relative to the control condition, but the anomaly induced by rhyme violations was perceived as most severe. Together, our data suggest that rhyme violations in Limericks may induce an emotional response beyond mere anomaly detection

Use of Learning Media by Undergraduate Medical Students in Pharmacology: A Prospective Cohort Study

The ubiquity of the internet and computer-based technologies has an increasing impact on higher education and the way students access information for learning. Moreover, there is a paucity of information about the quantitative and qualitative use of learning media by the current student generation. In this study we systematically analyzed the use of digital and non-digital learning resources by undergraduate medical students. Daily online surveys and semi-structured interviews were conducted with a cohort of 338 third year medical students enrolled in a general pharmacology course. Our data demonstrate a predominant use of digital over non-digital learning resources (69 +/- 7% vs. 31 +/- 7%;p 300 pages) (10.6 +/- 3.3%),internet search (7.9 +/- 1.6%) and e-learning cases (7.6 +/- 3.0%). When comparing learning media use of teaching vs. pre-exam self-study periods, textbooks were used significantly less during self-study (-55%;p < 0.01), while exam questions (+334%;p < 0.01) and e-learning cases (+176%;p < 0.01) were utilized more. Taken together, our study revealed a high prevalence and acceptance of digital learning resources by undergraduate medical students, in particular mobile applications

Self-Regulating Demand and Supply Equilibrium in Joint Simulation of Travel Demand and a Ride-Pooling Service

This paper presents the coupling of a state-of-the-art ride-pooling fleet simulation package with the mobiTopp travel demand modeling framework. The coupling of both models enables a detailed agent- and activity-based demand model, in which travelers have the option to use ride-pooling based on real-time offers of an optimized ride-pooling operation. On the one hand, this approach allows the application of detailed mode-choice models based on agent-level attributes coming from mobiTopp functionalities. On the other hand, existing state-of-the-art ride-pooling optimization can be applied to utilize the full potential of ride-pooling. The introduced interface allows mode choice based on real-time fleet information and thereby does not require multiple iterations per simulated day to achieve a balance of ride-pooling demand and supply. The introduced methodology is applied to a case study of an example model where in total approximately 70,000 trips are performed. Simulations with a simplified mode-choice model with varying fleet size (0–150 vehicles), fares, and further fleet operators’ settings show that (i) ride-pooling can be a very attractive alternative to existing modes and (ii) the fare model can affect the mode shifts to ride-pooling. Depending on the scenario, the mode share of ride-pooling is between 7.6% and 16.8% and the average distance-weighed occupancy of the ride-pooling fleet varies between 0.75 and 1.17