EXPRESS: Experimental evidence for a semantic typology of emoji: Inferences of co-, pro-, and post-text emoji.

Emoji symbols are widely used in online communication, particularly in instant messaging and on social media platforms. Existing research draws comparisons between the functions of emoji and those of gestures, with recent work extending a proposed typology of gestures to emoji, arguing that different emoji types can be distinguished by their placement within the modified text and by their semantic contribution (the linguistic inferences that they give rise to). In this paper, we present four experiments designed to test the predictions of this extended typology, the results of which suggest that emoji symbols indeed trigger the hypothesized linguistic inferences. The findings provide support for a semantic typology of emoji and contribute further evidence of the parallels between gesture and emoji.

Co-linguistic content inferences: From gestures to sound effects and emoji.

Among other uses, co-speech gestures can contribute additional semantic content to the spoken utterances with which they coincide. A growing body of research is dedicated to understanding how inferences from gestures interact with logical operators in speech, including negation ("not"/"n't"), modals (e.g., "might"), and quantifiers (e.g., "each," "none," "exactly one"). A related but less addressed question is what kinds of meaningful content other than gestures can evince this same behaviour; this is in turn connected to the much broader question of what properties of gestures are responsible for how they interact with logical operators. We present two experiments investigating sentences with co-speech sound effects and co-text emoji in lieu of gestures, revealing a remarkably similar inference pattern to that of co-speech gestures. The results suggest that gestural inferences do not behave the way they do because of any traits specific to gestures, and that the inference pattern extends to a much broader range of content.

Racial disparities in the use of blood transfusion in major surgery.

BACKGROUND: Racial disparities in healthcare in the United States are widespread and have been well documented. However, it is unknown whether racial disparities exist in the use of blood transfusion for patients undergoing major surgery. METHODS: We used the University HealthSystem Consortium database (2009-2011) to examine racial disparities in perioperative red blood cells (RBCs) transfusion in patients undergoing coronary artery bypass surgery (CABG), total hip replacement (THR), and colectomy. We estimated multivariable logistic regressions to examine whether black patients are more likely than white patients to receive perioperative RBC transfusion, and to investigate potential sources of racial disparities. RESULTS: After adjusting for patient-level factors, black patients were more likely to receive RBC transfusions for CABG (AOR = 1.41, 95% CI: [1.13, 1.76], p = 0.002) and THR (AOR = 1.39, 95% CI: [1.20, 1.62], p < 0.001), but not for colectomy (AOR = 1.08, 95% CI: [0.90, 1.30], p = 0.40). Black-white disparities in blood transfusion persisted after controlling for patient insurance and hospital effects (CABG: AOR = 1.42, 95% CI: [1.30, 1.56], p < 0.001; THR: AOR = 1.43, 95% CI: [1.29, 1.58], p < 0.001). CONCLUSIONS: We detected racial disparities in the use of blood transfusion for CABG and THR (black patients tended to receive more transfusions compared with whites), but not for colectomy. Reporting racial disparities in contemporary transfusion practices may help reduce potentially unnecessary blood transfusions in minority patients.

Variation of blood transfusion in patients undergoing major noncardiac surgery.

OBJECTIVE: To examine the hospital variability in use of red blood cells (RBCs), fresh-frozen plasma (FFP), and platelet transfusions in patients undergoing major noncardiac surgery. BACKGROUND: Blood transfusion is commonly used in surgical procedures in the United States. Little is known about the hospital variability in perioperative transfusion rates for noncardiac surgery. METHODS: We used the University HealthSystem Consortium database (2006-2010) to examine hospital variability in use of allogeneic RBC, FFP, and platelet transfusions in patients undergoing major noncardiac surgery. We used regression-based techniques to quantify the variability in hospital transfusion practices and to study the association between hospital characteristics and the likelihood of transfusion. RESULTS: After adjusting for patient risk factors, hospital transfusion rates varied widely for patients undergoing total hip replacement (THR), colectomy, and pancreaticoduodenectomy. Compared with patients undergoing THR in average-transfusion hospitals, patients treated in high-transfusion hospitals have a greater than twofold higher odds of being transfused with RBCs [adjusted odds ratio (AOR) = 2.41; 95% confidence interval (CI), 1.89-3.09], FFP (AOR = 2.81; 95% CI, 2.02-3.91), and platelets (AOR = 2.52; 95% CI, 1.95-3.25), whereas patients in low-transfusion hospitals have an approximately 50% lower odds of receiving RBCs (AOR = 0.45; 95% CI, 0.35-0.57), FFP (AOR = 0.37; 95% CI, 0.27-0.51), and platelets (AOR = 0.42; 95% CI, 0.29-0.62). Similar results were obtained for colectomy and pancreaticoduodenectomy. CONCLUSIONS: There was dramatic hospital variability in perioperative transfusion rates among patients undergoing major noncardiac surgery at academic medical centers. In light of the potential complications of transfusion therapy, reducing this variability in hospital transfusion practices may result in improved surgical outcomes.

Blood transfusion in the perioperative period.

Anemia is associated with perioperative mortality and morbidity. Since the presence of anemia and blood transfusion often go hand in hand, it can be difficult to separate the effects of anemia from the effects of perioperative transfusion. The role for blood transfusion in mitigating the mortality and morbidity associated with anemia is unclear. A restrictive transfusion strategy has been advocated for hemodynamically stable patients, as blood transfusion exposes the patient to both infectious and non-infectious complications. Further research is warranted in patients with the acute coronary syndrome, as there is insufficient evidence to make recommendations for this patient population. Additional multi-center randomized controlled trials need to be conducted in perioperative and critically ill patients with large enough sample sizes to examine differences in mortality and major complications between liberal and restrictive transfusion strategies. Further trials need to incorporate current practices in improved blood storage and leukoreduction techniques.