The Language of Creativity: Evidence from Humans and Large Language Models.

Recent developments in computerized scoring via semantic distance have provided automated assessments of verbal creativity. Here, we extend past work, applying computational linguistic approaches to characterize salient features of creative text. We hypothesize that, in addition to semantic diversity, the degree to which a story includes perceptual details, thus transporting the reader to another time and place, would be predictive of creativity. Additionally, we explore the use of generative language models to supplement human data collection and examine the extent to which machine-generated stories can mimic human creativity. We collect 600 short stories from human participants and GPT-3, subsequently randomized and assessed on their creative quality. Results indicate that the presence of perceptual details, in conjunction with semantic diversity, is highly predictive of creativity. These results were replicated in an independent sample of stories (n = 120) generated by GPT-4. We do not observe a significant difference between human and AI-generated stories in terms of creativity ratings, and we also observe positive correlations between human and AI assessments of creativity. Implications and future directions are discussed.

Dual-process moral judgment beyond fast and slow.

De Neys makes a compelling case that the sacrificial moral dilemmas do not elicit competing "fast and slow" processes. But are there even two processes? Or just two intuitions? There remains strong evidence, most notably from lesion studies, that sacrificial dilemmas engage distinct cognitive processes generating conflicting emotional and rational responses. The dual-process theory gets much right, but needs revision.

Evidence for Spinozan "Unbelieving" in the Right Inferior Prefrontal Cortex.

Humans can think about possible states of the world without believing in them, an important capacity for high-level cognition. Here, we use fMRI and a novel "shell game" task to test two competing theories about the nature of belief and its neural basis. According to the Cartesian theory, information is first understood, then assessed for veracity, and ultimately encoded as either believed or not believed. According to the Spinozan theory, comprehension entails belief by default, such that understanding without believing requires an additional process of "unbelieving." Participants (n = 70) were experimentally induced to have beliefs, desires, or mere thoughts about hidden states of the shell game (e.g., believing that the dog is hidden in the upper right corner). That is, participants were induced to have specific "propositional attitudes" toward specific "propositions" in a controlled way. Consistent with the Spinozan theory, we found that thinking about a proposition without believing it is associated with increased activation of the right inferior frontal gyrus. This was true whether the hidden state was desired by the participant (because of reward) or merely thought about. These findings are consistent with a version of the Spinozan theory whereby unbelieving is an inhibitory control process. We consider potential implications of these results for the phenomena of delusional belief and wishful thinking.

Boosting the impact of charitable giving with donation bundling and micromatching.

The most effective charities are hundreds of times more impactful than typical charities. However, most donors favor charities with personal/emotional appeal over effectiveness. We gave donors the option to split their donations between their personal favorite charity and an expert-recommended highly effective charity. This bundling technique increased donors' impact without undermining their altruistic motivation, boosting effective donations by 76%. An additional boost of 55% was achieved by offering matching donations with increasing rates for allocating more to the highly effective charity. We show further that matching funds can be provided by donors focused on effectiveness through a self-sustaining process of micromatching. We applied these techniques in a new online donation platform (GivingMultiplier.org), which fundraised more than $1.5 million in its first 14 months. While prior applied research on altruism has focused on the quantity of giving, the present results demonstrate the value of focusing on the effectiveness of altruistic behavior.

Cryotherapy for treatment of chronic rhinitis: 3-month outcomes of a randomized, sham-controlled trial.

BACKGROUND: The purpose of this study was to test whether cryotherapy is superior to a sham procedure for reducing symptoms of chronic rhinitis. METHODS: This study was a prospective, multicenter, 1:1 randomized, sham-controlled, patient-blinded trial. The predetermined sample size was 61 participants per arm. Adults with moderate/severe symptoms of chronic rhinitis who were candidates for cryotherapy under local anesthesia were enrolled. Participants were required to have minimum reflective Total Nasal Symptom Scores (rTNSSs) of 4 for total, 2 for rhinorrhea, and 1 for nasal congestion. Follow-up visits occurred at 30 and 90 days postprocedure. Patient-reported outcome measures included the rTNSS, standardized Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S)], and Nasal Obstruction Symptom Evaluation (NOSE) questionnaires. Adverse events were also recorded. The primary endpoint was the comparison between the treatment and sham arms for the percentage of responders at 90 days. Responders were defined as participants with a 30% or greater reduction in rTNSS relative to baseline. RESULTS: Twelve US investigational centers enrolled 133 participants. The primary endpoint analysis included 127 participants (64 active, 63 sham) with 90-day results. The treatment arm was superior at the 90-day follow-up with 73.4% (47 of 64) responders compared with 36.5% (23 of 63) in the sham arm (p < 0.001). There were greater improvements in the rTNSS, RQLQ(S), and NOSE scores for the active arm over the sham arm at the 90-day follow-up (p < 0.001). One serious procedure-related adverse event of anxiety/panic attack was reported. CONCLUSION: Cryotherapy is superior to a sham procedure for improving chronic rhinitis symptoms and patient quality of life.

Balloon dilation of the Eustachian tube with a seeker-based device: A registry of 169 patients.

OBJECTIVE: To collect real-world data on the safety and effectiveness of balloon dilation of the Eustachian tube using a seeker-based device in patients with persistent/chronic symptoms of Eustachian tube dysfunction. METHODS: A multicenter, prospective, single-arm registry was conducted from June 2018 through August 2020 at 10 US centers, including tertiary care and private practices. Primary endpoints included mean change from baseline in the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and the serious related adverse event rate. Secondary endpoints include changes in middle ear assessments, surgical intervention rate, and changes in Sino-Nasal Outcome Test and Work and Activity Impairment (WPAI) questionnaires. RESULTS: A total of 169 participants were treated with balloon dilation of the Eustachian tube, with 166 and 154 participants completing the 6-week and 6-month follow-ups, respectively. Repeated measures analysis of the change in ETDQ-7 scores indicated statistically significant improvement (-2.1; 95% CI -2.40, -1.84; P < .0001) at 6-month follow-up. The minimum clinically important difference of improvement was achieved by 85% of participants at 6 months. Four nonserious adverse events were reported. Middle ear functional assessments were improved in the majority of participants with abnormal baseline findings. There were no statistically significant differences in the change from baseline ETDQ-7 scores between participants who had concurrent procedures and those who did not. WPAI scores demonstrated significant improvement. CONCLUSION: Real-world evidence supports the clinical studies demonstrating that balloon dilation of the Eustachian tube with a seeker-based device is a safe and effective procedure to treat ETD symptoms. LEVEL OF EVIDENCE: 3.

A long time ago in a galaxy far, far away: How temporal are episodic contents?

A prominent feature of mental event (i.e. 'episodic') simulations is their temporal orientation: human adults can generate episodic representations directed towards the past or the future. Here, we investigated how the temporal orientation of imagined events relates to the contents of these events. Is there something intrinsically temporal about episodic contents? Or does their temporality rely on a distinct set of representations? In three experiments (N = 360), we asked participants to generate and later recall a series of imagined events differing in (1) location, (2) time of day, (3) temporal orientation, and (4) weekday. We then tested to what extent successful recall of episodic content (i.e. (1) and (2)) would predict recall of temporality and/or weekday information. Results showed that recall of temporal orientation was only weakly predicted by recall of episodic contents. Nonetheless, temporal orientation was more strongly predicted by content recall than weekday recall. This finding suggests that episodic simulations are unlikely to be intrinsically temporal in nature. Instead, similar to other forms of temporal information, temporal orientation might be determined from such contents by reconstructive post-retrieval processes. These results have implications for how the human ability to 'mentally travel' in time is cognitively implemented.

The Psychology of (In)Effective Altruism.

The most effective charities are hundreds of times more effective than typical charities, yet few donors prioritize effectiveness. Why is that? How might we increase the effectiveness of charitable giving? We review the motivational and epistemic causes of (in)effective giving. Many donors view charitable giving as a matter of personal preference, which favors decisions based on emotional appeal rather than effectiveness. In addition, while many donors are motivated to give effectively, they often have misconceptions and cognitive biases that reduce effective giving. Nearly all research on charitable giving interventions focuses on increasing donation amounts. However, to increase societal benefit, donation effectiveness is likely to be more important. This underscores the need for research on strategies to encourage effective giving.

Integration of choline geranate into electrospun protein scaffolds affords antimicrobial activity to biomaterials used for cutaneous wound healing.

Wound healing attempts to maintain homeostasis in the wound while minimizing the risk of infection to the tissue by foreign agents, such as opportunistic bacterial pathogens. Biofilms established by these pathogens are a common cause of chronic infections that slow the healing process. Preparation of skin wound healing devices comprised of electrospun proteins associated with skin have been shown to accelerate the healing process relative to conventional wound dressings. In this work, we have developed electrospinning methods to incorporate the antimicrobial ionic liquid/deep eutectic solvent choline geranate (CAGE) into these devices. Integration of CAGE into the dressing material was verified via 1 H nuclear magnetic resonance spectrometry, and the effect on the material property of the resultant devices were assessed using scanning electron microscopy. CAGE-containing devices demonstrate a concentration-dependent inactivation of exogenously applied solutions of both gram-positive and gram-negative pathogens (Enterococcus sp and Pseudomonas aeruginosa, respectively), but maintain their ability to serve as a compatible platform for proliferation of human dermal neonatal fibroblasts.

Changes in Nasal Staphylococcus Colonization and Infection Rates After Nasal Surgery.

Background: The relationship between nasal flora and infection rates in patients undergoing nasal surgery is of interest. This relationship has been studied though changes that may take place due to surgery have never been elucidated. Objective: To assess colonization rates and changes in colonization patterns of methicillin-resistant or methicillin-sensitive Staphylococcus aureus (MRSA/MSSA) in nasal flora in patients undergoing nasal surgery and to determine whether colonization is a risk factor for postoperative infection. Methods: Patients undergoing nasal surgery including septoplasty, rhinoplasty, or nasal valve repair were recruited prospectively. Patients completed a survey preoperatively concerning risk factors of postoperative infection. Nasal swabs and cultures were done preoperatively and at 1 week postoperatively. Patients were assessed for surgical site infections postoperatively. Results: Fifty-five patients completed both preoperative and postoperative nasal swabs. Preoperative to postoperative colonization rates increased for MRSA (2-5%) and MSSA (22-36%). Of the 55 patients, 11 had a change in nasal flora postoperatively, 9 of whom were colonized with a Staphylococcus aureus strain. However, MSSA/MRSA colonization either preoperatively or postoperatively was not associated with surgical site infections. Gender was the only variable found to be associated with postoperative infection (p = 0.007) with all four infections occurring in females. Conclusions: MSSA and MRSA do not appear to be major risk factors for surgical site infection in nasal surgery, whereas prior nasal surgery is a risk factor. This is the first report of a change in nasal colonization after nasal surgery. This could have implications for antibiotic prophylaxis in select nasal surgery cases.

Two Ways to Build a Thought: Distinct Forms of Compositional Semantic Representation across Brain Regions.

To understand a simple sentence such as "the woman chased the dog", the human mind must dynamically organize the relevant concepts to represent who did what to whom. This structured recombination of concepts (woman, dog, chased) enables the representation of novel events, and is thus a central feature of intelligence. Here, we use functional magnetic resonance (fMRI) and encoding models to delineate the contributions of three brain regions to the representation of relational combinations. We identify a region of anterior-medial prefrontal cortex (amPFC) that shares representations of noun-verb conjunctions across sentences: for example, a combination of "woman" and "chased" to encode woman-as-chaser, distinct from woman-as-chasee. This PFC region differs from the left-mid superior temporal cortex (lmSTC) and hippocampus, two regions previously implicated in representing relations. lmSTC represents broad role combinations that are shared across verbs (e.g., woman-as-agent), rather than narrow roles, limited to specific actions (woman-as-chaser). By contrast, a hippocampal sub-region represents events sharing narrow conjunctions as dissimilar. The success of the hippocampal conjunctive encoding model is anti-correlated with generalization performance in amPFC on a trial-by-trial basis, consistent with a pattern separation mechanism. Thus, these three regions appear to play distinct, but complementary, roles in encoding compositional event structure.

Concepts and Compositionality: In Search of the Brain's Language of Thought.

Imagine Genghis Khan, Aretha Franklin, and the Cleveland Cavaliers performing an opera on Maui. This silly sentence makes a serious point: As humans, we can flexibly generate and comprehend an unbounded number of complex ideas. Little is known, however, about how our brains accomplish this. Here we assemble clues from disparate areas of cognitive neuroscience, integrating recent research on language, memory, episodic simulation, and computational models of high-level cognition. Our review is framed by Fodor's classic language of thought hypothesis, according to which our minds employ an amodal, language-like system for combining and recombining simple concepts to form more complex thoughts. Here, we highlight emerging work on combinatorial processes in the brain and consider this work's relation to the language of thought. We review evidence for distinct, but complementary, contributions of map-like representations in subregions of the default mode network and sentence-like representations of conceptual relations in regions of the temporal and prefrontal cortex.

Veil-of-ignorance reasoning favors the greater good.

The "veil of ignorance" is a moral reasoning device designed to promote impartial decision making by denying decision makers access to potentially biasing information about who will benefit most or least from the available options. Veil-of-ignorance reasoning was originally applied by philosophers and economists to foundational questions concerning the overall organization of society. Here, we apply veil-of-ignorance reasoning in a more focused way to specific moral dilemmas, all of which involve a tension between the greater good and competing moral concerns. Across 7 experiments (n = 6,261), 4 preregistered, we find that veil-of-ignorance reasoning favors the greater good. Participants first engaged in veil-of-ignorance reasoning about a specific dilemma, asking themselves what they would want if they did not know who among those affected they would be. Participants then responded to a more conventional version of the same dilemma with a moral judgment, a policy preference, or an economic choice. Participants who first engaged in veil-of-ignorance reasoning subsequently made more utilitarian choices in response to a classic philosophical dilemma, a medical dilemma, a real donation decision between a more vs. less effective charity, and a policy decision concerning the social dilemma of autonomous vehicles. These effects depend on the impartial thinking induced by veil-of-ignorance reasoning and cannot be explained by anchoring, probabilistic reasoning, or generic perspective taking. These studies indicate that veil-of-ignorance reasoning may be a useful tool for decision makers who wish to make more impartial and/or socially beneficial choices.

Scope and efficacy of the broad-spectrum topical antiseptic choline geranate.

Choline geranate (also described as Choline And GEranic acid, or CAGE) has been developed as a novel biocompatible antiseptic material capable of penetrating skin and aiding the transdermal delivery of co-administered antibiotics. The antibacterial properties of CAGE were analyzed against 24 and 72 hour old biofilms of 11 clinically isolated ESKAPE pathogens (defined as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and Enterobacter sp, respectively), including multidrug resistant (MDR) isolates. CAGE was observed to eradicate in vitro biofilms at concentrations as low as 3.56 mM (0.156% v:v) in as little as 2 hours, which represents both an improved potency and rate of biofilm eradication relative to that reported for most common standard-of-care topical antiseptics in current use. In vitro time-kill studies on 24 hour old Staphylococcus aureus biofilms indicate that CAGE exerts its antibacterial effect upon contact and a 0.1% v:v solution reduced biofilm viability by over three orders of magnitude (a 3log10 reduction) in 15 minutes. Furthermore, disruption of the protective layer of exopolymeric substances in mature biofilms of Staphylococcus aureus by CAGE (0.1% v:v) was observed in 120 minutes. Insight into the mechanism of action of CAGE was provided with molecular modeling studies alongside in vitro antibiofilm assays. The geranate ion and geranic acid components of CAGE are predicted to act in concert to integrate into bacterial membranes, affect membrane thinning and perturb membrane homeostasis. Taken together, our results show that CAGE demonstrates all properties required of an effective topical antiseptic and the data also provides insight into how its observed antibiofilm properties may manifest.

Changes to social feeding behaviors are not sufficient for fitness gains of the Caenorhabditis elegans N2 reference strain.

The standard reference Caenorhabditis elegans strain, N2, has evolved marked behavioral changes in social feeding behavior since its isolation from the wild. We show that the causal, laboratory-derived mutations in two genes, npr-1 and glb-5, confer large fitness advantages in standard laboratory conditions. Using environmental manipulations that suppress social/solitary behavior differences, we show the fitness advantages of the derived alleles remained unchanged, suggesting selection on these alleles acted through pleiotropic traits. Transcriptomics, developmental timing, and food consumption assays showed that N2 animals mature faster, produce more sperm, and consume more food than a strain containing ancestral alleles of these genes regardless of behavioral strategies. Our data suggest that the pleiotropic effects of glb-5 and npr-1 are a consequence of changes to O2 -sensing neurons that regulate both aerotaxis and energy homeostasis. Our results demonstrate how pleiotropy can lead to profound behavioral changes in a popular laboratory model.

Sacrificial utilitarian judgments do reflect concern for the greater good: Clarification via process dissociation and the judgments of philosophers.

Researchers have used "sacrificial" trolley-type dilemmas (where harmful actions promote the greater good) to model competing influences on moral judgment: affective reactions to causing harm that motivate characteristically deontological judgments ("the ends don't justify the means") and deliberate cost-benefit reasoning that motivates characteristically utilitarian judgments ("better to save more lives"). Recently, Kahane, Everett, Earp, Farias, and Savulescu (2015) argued that sacrificial judgments reflect antisociality rather than "genuine utilitarianism," but this work employs a different definition of "utilitarian judgment." We introduce a five-level taxonomy of "utilitarian judgment" and clarify our longstanding usage, according to which judgments are "utilitarian" simply because they favor the greater good, regardless of judges' motivations or philosophical commitments. Moreover, we present seven studies revisiting Kahane and colleagues' empirical claims. Studies 1a-1b demonstrate that dilemma judgments indeed relate to utilitarian philosophy, as philosophers identifying as utilitarian/consequentialist were especially likely to endorse utilitarian sacrifices. Studies 2-6 replicate, clarify, and extend Kahane and colleagues' findings using process dissociation to independently assess deontological and utilitarian response tendencies in lay people. Using conventional analyses that treat deontological and utilitarian responses as diametric opposites, we replicate many of Kahane and colleagues' key findings. However, process dissociation reveals that antisociality predicts reduced deontological inclinations, not increased utilitarian inclinations. Critically, we provide evidence that lay people's sacrificial utilitarian judgments also reflect moral concerns about minimizing harm. This work clarifies the conceptual and empirical links between moral philosophy and moral psychology and indicates that sacrificial utilitarian judgments reflect genuine moral concern, in both philosophers and ordinary people.

Reduced engagement of the anterior cingulate cortex in the dishonest decision-making of incarcerated psychopaths.

A large body of research indicates that psychopathic individuals lie chronically and show little remorse or anxiety. Yet, little is known about the neurobiological substrates of dishonesty in psychopathy. In a sample of incarcerated individuals (n = 67), we tested the hypothesis that psychopathic individuals show reduced activity in the anterior cingulate cortex (ACC) when confronted with an opportunity for dishonest gain, reflecting dishonest behavior that is relatively unhindered by response conflict. During functional magnetic resonance imaging, incarcerated offenders with different levels of psychopathy performed an incentivized prediction task wherein they were given real and repeated opportunities for dishonest gain. We found that while incarcerated offenders showed a high rate of cheating, levels of psychopathic traits did not influence the frequency of dishonesty. Higher psychopathy scores predicted decreased activity in the ACC during dishonest decision-making. Further analysis revealed that the ACC was functionally connected to the dorsolateral prefrontal cortex, and that ACC activity mediated the relationship between psychopathic traits and reduced reaction times for dishonest behavior. These findings suggest that psychopathic individuals behave dishonestly with relatively low levels of response conflict and that the ACC may play a critical role in this pattern of behavior.

Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction.

Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.