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1.
CBE Life Sci Educ ; 23(2): ar22, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38709798

RESUMO

In recent years, an increasing number of deaf and hard of hearing (D/HH) undergraduates have chosen to study in STEM fields and pursue careers in research. Yet, very little research has been undertaken on the barriers and inclusive experiences often faced by D/HH undergraduates who prefer to use spoken English in research settings, instead of American Sign Language (ASL). To identify barriers and inclusive strategies, we studied six English speaking D/HH undergraduate students working in research laboratories with their eight hearing mentors, and their three hearing peers sharing their experiences. Three researchers observed the interactions between all three groups and conducted interviews and focus groups, along with utilizing the Communication Assessment Self-Rating Scale (CASS). The main themes identified in the findings were communication and environmental barriers in research laboratories, creating accessible and inclusive laboratory environments, communication strategies, and self-advocating for effective communication. Recommendations for mentors include understanding the key elements of creating an inclusive laboratory environment for English speaking D/HH students and effectively demonstrating cultural competence to engage in inclusive practices.


Assuntos
Estudantes , Humanos , Surdez , Masculino , Feminino , Pessoas com Deficiência Auditiva , Pesquisa , Língua de Sinais , Mentores , Idioma , Comunicação , Barreiras de Comunicação
2.
J Pak Med Assoc ; 74(4 (Supple-4)): S161-S164, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38712426

RESUMO

ChatGPT is reported to be an acceptable tool to answer a majority of frequently asked patient questions. ChatGPT also converses in other languages including Urdu, which offers immense potential for the education of Pakistani patients. Therefore, this study evaluated ChatGPT's Urdu answers to the ten most frequently asked questions on Total Hip Arthroplasty, which were then rated by an expert. Out of 10 answers in English, 9 (90%) were satisfactory requiring minimal clarification and 1 (10%) was satisfactory requiring moderate clarification. In both Roman and Nastaliq script Urdu, 1 (10%) answer was satisfactory requiring moderate clarification, while 9 (90%) were unsatisfactory requiring substantial clarification. In conclusion, as opposed to ChatGPT English responses, Urdu responses were much less rigorous, generic, and lacked scientific rigor. We have a long way to go before Pakistani patients with limited English language skills could benefit from AI chatbots like ChatGPT.


Assuntos
Artroplastia de Quadril , Inteligência Artificial , Humanos , Artroplastia de Quadril/métodos , Paquistão , Idioma , Educação de Pacientes como Assunto/métodos , Inquéritos e Questionários
3.
Neurosurg Rev ; 47(1): 210, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38724863

RESUMO

OBJECTIVE: The purpose of this study is to analyze an automated voice to text translation device by reporting the translation accuracy for recorded pediatric neurosurgery clinic conversations, classifying errors in translation according to their impact on overall understanding, and comparing the incidence of these errors in English to Spanish vs. Spanish to English conversations. METHODS: English and Spanish speaking patients at a single academic health system's outpatient pediatric neurosurgery clinic had their conversations recorded. These recordings were played back to a Google Pixel handheld smartphone with Live Translate voice to text translation software. A certified medical interpreter evaluated recordings for incidence of minor errors, errors impacting understanding, and catastrophic errors affecting patient-provider relationship or care. Two proportion t-testing was used to compare these outcomes. RESULTS: 50 patient visits were recorded: 40 English recordings translated to Spanish and 10 Spanish recordings translated to English. The mean transcript length was 4244 ± 992 words. The overall accuracy was 98.2% ± 0.5%. On average, 46 words were missed in translation (1.09% error rate), 31 understanding-altering translation errors (0.73% error rate), and 0 catastrophic errors were made. There was no significant difference in English to Spanish or vice versa. CONCLUSION: Voice to text translation devices using automatic speech recognition accurately translate recorded clinic conversations between Spanish and English with high accuracy and low incidence of errors impacting medical care or understanding. Further study should investigate additional languages, assess patient preferences and potential concerns with respect to device use, and compare these devices directly to medical interpreters in live clinic settings.


Assuntos
Idioma , Tradução , Humanos , Criança , Neurocirurgia , Pediatria , Masculino , Feminino
4.
Cereb Cortex ; 34(5)2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38725293

RESUMO

Numerous studies reported inconsistent results concerning gender influences on the functional organization of the brain for language in children and adults. However, data for the gender differences in the functional language networks at birth are sparse. Therefore, we investigated gender differences in resting-state functional connectivity in the language-related brain regions in newborns using functional near-infrared spectroscopy. The results revealed that female newborns demonstrated significantly stronger functional connectivities between the superior temporal gyri and middle temporal gyri, the superior temporal gyri and the Broca's area in the right hemisphere, as well as between the right superior temporal gyri and left Broca's area. Nevertheless, statistical analysis failed to reveal functional lateralization of the language-related brain areas in resting state in both groups. Together, these results suggest that the onset of language system might start earlier in females, because stronger functional connectivities in the right brain in female neonates were probably shaped by the processing of prosodic information, which mainly constitutes newborns' first experiences of speech in the womb. More exposure to segmental information after birth may lead to strengthened functional connectivities in the language system in both groups, resulting in a stronger leftward lateralization in males and a more balanced or leftward dominance in females.


Assuntos
Idioma , Caracteres Sexuais , Espectroscopia de Luz Próxima ao Infravermelho , Humanos , Feminino , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Masculino , Recém-Nascido , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Descanso/fisiologia , Lateralidade Funcional/fisiologia , Vias Neurais/fisiologia , Mapeamento Encefálico/métodos
5.
J Acoust Soc Am ; 155(5): 2990-3004, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38717206

RESUMO

Speakers can place their prosodic prominence on any locations within a sentence, generating focus prosody for listeners to perceive new information. This study aimed to investigate age-related changes in the bottom-up processing of focus perception in Jianghuai Mandarin by clarifying the perceptual cues and the auditory processing abilities involved in the identification of focus locations. Young, middle-aged, and older speakers of Jianghuai Mandarin completed a focus identification task and an auditory perception task. The results showed that increasing age led to a decrease in listeners' accuracy rate in identifying focus locations, with all participants performing the worst when dynamic pitch cues were inaccessible. Auditory processing abilities did not predict focus perception performance in young and middle-aged listeners but accounted significantly for the variance in older adults' performance. These findings suggest that age-related deteriorations in focus perception can be largely attributed to declined auditory processing of perceptual cues. Poor ability to extract frequency modulation cues may be the most important underlying psychoacoustic factor for older adults' difficulties in perceiving focus prosody in Jianghuai Mandarin. The results contribute to our understanding of the bottom-up mechanisms involved in linguistic prosody processing in aging adults, particularly in tonal languages.


Assuntos
Envelhecimento , Sinais (Psicologia) , Percepção da Fala , Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Envelhecimento/psicologia , Envelhecimento/fisiologia , Adulto Jovem , Adulto , Percepção da Fala/fisiologia , Fatores Etários , Acústica da Fala , Estimulação Acústica , Percepção da Altura Sonora , Idioma , Qualidade da Voz , Psicoacústica , Audiometria da Fala
6.
J Acoust Soc Am ; 155(5): 3071-3089, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38717213

RESUMO

This study investigated how 40 Chinese learners of English as a foreign language (EFL learners) differed from 40 native English speakers in the production of four English tense-lax contrasts, /i-ɪ/, /u-ʊ/, /ɑ-ʌ/, and /æ-ε/, by examining the acoustic measurements of duration, the first three formant frequencies, and the slope of the first formant movement (F1 slope). The dynamic formant trajectory was modeled using discrete cosine transform coefficients to demonstrate the time-varying properties of formant trajectories. A discriminant analysis was employed to illustrate the extent to which Chinese EFL learners relied on different acoustic parameters. This study found that: (1) Chinese EFL learners overemphasized durational differences and weakened spectral differences for the /i-ɪ/, /u-ʊ/, and /ɑ-ʌ/ pairs, although they maintained sufficient spectral differences for /æ-ε/. In contrast, native English speakers predominantly used spectral differences across all four pairs; (2) in non-low tense-lax contrasts, unlike native English speakers, Chinese EFL learners failed to exhibit different F1 slope values, indicating a non-nativelike tongue-root placement during the articulatory process. The findings underscore the contribution of dynamic spectral patterns to the differentiation between English tense and lax vowels, and reveal the influence of precise articulatory gestures on the realization of the tense-lax contrast.


Assuntos
Multilinguismo , Fonética , Acústica da Fala , Humanos , Masculino , Feminino , Adulto Jovem , Medida da Produção da Fala , Adulto , Idioma , Acústica , Aprendizagem , Qualidade da Voz , Espectrografia do Som , População do Leste Asiático
7.
Healthc Policy ; 19(3): 62-77, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38721735

RESUMO

Ethnolinguistically diverse 2S/LGBTQI+ (two-spirit, lesbian, gay, bisexual, transgender, queer and intersex) populations have unique healthcare needs and experience health inequities compared to their cisgender or heterosexual peers. This community-based participatory study sought to describe the profile and healthcare needs and experiences of official language minority French-speaking 2S/LGBTQI+ adults in Manitoba. Participants (N = 80) reported that gender and sexual identity were often concealed from service providers; many respondents faced discrimination based on their ethnolinguistic and sexual identities. Service gaps are identified pertaining to mental and sexual health; locating 2S/LGBTQI+-friendly, patient-centred care in French is difficult. Policy and practice should address systemic inequity and discrimination experienced by this equity-seeking population.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Minorias Sexuais e de Gênero , Humanos , Feminino , Masculino , Manitoba , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Idoso , Pesquisa Participativa Baseada na Comunidade , Adolescente , Idioma , Disparidades em Assistência à Saúde
8.
MedEdPORTAL ; 20: 11396, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38722734

RESUMO

Introduction: People with disabilities and those with non-English language preferences have worse health outcomes than their counterparts due to barriers to communication and poor continuity of care. As members of both groups, people who are Deaf users of American Sign Language have compounded health disparities. Provider discomfort with these specific demographics is a contributing factor, often stemming from insufficient training in medical programs. To help address these health disparities, we created a session on disability, language, and communication for undergraduate medical students. Methods: This 2-hour session was developed as a part of a 2020 curriculum shift for a total of 404 second-year medical student participants. We utilized a retrospective postsession survey to analyze learning objective achievement through a comparison of medians using the Wilcoxon signed rank test (α = .05) for the first 2 years of course implementation. Results: When assessing 158 students' self-perceived abilities to perform each of the learning objectives, students reported significantly higher confidence after the session compared to their retrospective presession confidence for all four learning objectives (ps < .001, respectively). Responses signifying learning objective achievement (scores of 4, probably yes, or 5, definitely yes), when averaged across the first 2 years of implementation, increased from 73% before the session to 98% after the session. Discussion: Our evaluation suggests medical students could benefit from increased educational initiatives on disability culture and health disparities caused by barriers to communication, to strengthen cultural humility, the delivery of health care, and, ultimately, health equity.


Assuntos
Currículo , Tomada de Decisão Compartilhada , Pessoas com Deficiência , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Estudos Retrospectivos , Educação de Graduação em Medicina/métodos , Barreiras de Comunicação , Inquéritos e Questionários , Masculino , Feminino , Língua de Sinais , Idioma
10.
Anaesthesiologie ; 73(5): 324-335, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38691128

RESUMO

BACKGROUND: The utilization of AI language models in education and academia is currently a subject of research, and applications in clinical settings are also being tested. Studies conducted by various research groups have demonstrated that language models can answer questions related to medical board examinations, and there are potential applications of these models in medical education as well. RESEARCH QUESTION: This study aims to investigate the extent to which current version language models prove effective for addressing medical inquiries, their potential utility in medical education, and the challenges that still exist in the functioning of AI language models. METHOD: The program ChatGPT, based on GPT 3.5, had to answer 1025 questions from the second part (M2) of the medical board examination. The study examined whether any errors and what types of errors occurred. Additionally, the language model was asked to generate essays on the learning objectives outlined in the standard curriculum for specialist training in anesthesiology and the supplementary qualification in emergency medicine. These essays were analyzed afterwards and checked for errors and anomalies. RESULTS: The findings indicated that ChatGPT was able to correctly answer the questions with an accuracy rate exceeding 69%, even when the questions included references to visual aids. This represented an improvement in the accuracy of answering board examination questions compared to a study conducted in March; however, when it came to generating essays a high error rate was observed. DISCUSSION: Considering the current pace of ongoing improvements in AI language models, widespread clinical implementation, especially in emergency departments as well as emergency and intensive care medicine with the assistance of medical trainees, is a plausible scenario. These models can provide insights to support medical professionals in their work, without relying solely on the language model. Although the use of these models in education holds promise, it currently requires a significant amount of supervision. Due to hallucinations caused by inadequate training environments for the language model, the generated texts might deviate from the current state of scientific knowledge. Direct deployment in patient care settings without permanent physician supervision does not yet appear to be achievable at present.


Assuntos
Anestesiologia , Inteligência Artificial , Medicina de Emergência , Anestesiologia/educação , Medicina de Emergência/educação , Humanos , Idioma , Currículo , Educação Médica/métodos
11.
Sci Rep ; 14(1): 10486, 2024 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714717

RESUMO

Every human has a body. Yet, languages differ in how they divide the body into parts to name them. While universal naming strategies exist, there is also variation in the vocabularies of body parts across languages. In this study, we investigate the similarities and differences in naming two separate body parts with one word, i.e., colexifications. We use a computational approach to create networks of body part vocabularies across languages. The analyses focus on body part networks in large language families, on perceptual features that lead to colexifications of body parts, and on a comparison of network structures in different semantic domains. Our results show that adjacent body parts are colexified frequently. However, preferences for perceptual features such as shape and function lead to variations in body part vocabularies. In addition, body part colexification networks are less varied across language families than networks in the semantic domains of emotion and colour. The study presents the first large-scale comparison of body part vocabularies in 1,028 language varieties and provides important insights into the variability of a universal human domain.


Assuntos
Idioma , Semântica , Vocabulário , Humanos , Corpo Humano , Cultura
12.
Commun Biol ; 7(1): 540, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714798

RESUMO

The genetic influence on human vocal pitch in tonal and non-tonal languages remains largely unknown. In tonal languages, such as Mandarin Chinese, pitch changes differentiate word meanings, whereas in non-tonal languages, such as Icelandic, pitch is used to convey intonation. We addressed this question by searching for genetic associations with interindividual variation in median pitch in a Chinese major depression case-control cohort and compared our results with a genome-wide association study from Iceland. The same genetic variant, rs11046212-T in an intron of the ABCC9 gene, was one of the most strongly associated loci with median pitch in both samples. Our meta-analysis revealed four genome-wide significant hits, including two novel associations. The discovery of genetic variants influencing vocal pitch across both tonal and non-tonal languages suggests the possibility of a common genetic contribution to the human vocal system shared in two distinct populations with languages that differ in tonality (Icelandic and Mandarin).


Assuntos
Estudo de Associação Genômica Ampla , Idioma , Humanos , Masculino , Feminino , Polimorfismo de Nucleotídeo Único , Adulto , Islândia , Estudos de Casos e Controles , Pessoa de Meia-Idade , Voz/fisiologia , Percepção da Altura Sonora , Povo Asiático/genética
13.
Sci Rep ; 14(1): 10155, 2024 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-38698157

RESUMO

The Russian government has long since engaged in an information campaign of propaganda and disinformation as a major part of foreign policy. This has been taken to new heights since the invasion of Ukraine in February 2022. In this study, we investigate pro-Russian misinformation within the opening weeks of the invasion in 6 languages: English, Japanese, Spanish, French, German, and Korean. Using Twitter data, we apply a combination of network and language embedding models to identify popular topics of misinformation amongst users in each language. Despite English users forming the most dominant language base on Twitter, we find that the popularity of misinformation in Japanese regularly outstrips English for certain topics. Misinformation shared by Spanish users is also over-represented in proportion to its much smaller user base. Our results provide insight into the current state of misinformation in each language. While we discuss some of the possible drivers behind the factors such as language over-representation, our study also highlights the need for further cross-lingual misinformation research in order to better understand this phenomena in a truly global context.


Assuntos
Comunicação , Idioma , Mídias Sociais , Ucrânia , Humanos , Federação Russa , Multilinguismo
14.
J Clin Neurophysiol ; 41(4): 334-343, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38710040

RESUMO

PURPOSE: Language lateralization relies on expensive equipment and can be difficult to tolerate. We assessed if lateralized brain responses to a language task can be detected with spectral analysis of electroencephalography (EEG). METHODS: Twenty right-handed, neurotypical adults (28 ± 10 years; five males) performed a verb generation task and two control tasks (word listening and repetition). We measured changes in EEG activity elicited by tasks (the event-related spectral perturbation [ERSP]) in the theta, alpha, beta, and gamma frequency bands in two language (superior temporal and inferior frontal [ST and IF]) and one control (occipital [Occ]) region bilaterally. We tested whether language tasks elicited (1) changes in spectral power from baseline (significant ERSP) at any region or (2) asymmetric ERSPs between matched left and right regions. RESULTS: Left IF beta power (-0.37±0.53, t = -3.12, P = 0.006) and gamma power in all regions decreased during verb generation. Asymmetric ERSPs (right > left) occurred between the (1) IF regions in the beta band (right vs. left difference of 0.23±0.37, t(19) = -2.80, P = 0.0114) and (2) ST regions in the alpha band (right vs. left difference of 0.48±0.63, t(19) = -3.36, P = 0.003). No changes from baseline or hemispheric asymmetries were noted in language regions during control tasks. On the individual level, 16 (80%) participants showed decreased left IF beta power from baseline, and 16 showed ST alpha asymmetry. Eighteen participants (90%) showed one of these two findings. CONCLUSIONS: Spectral EEG analysis detects lateralized responses during language tasks in frontal and temporal regions. Spectral EEG analysis could be developed into a readily available language lateralization modality.


Assuntos
Eletroencefalografia , Lateralidade Funcional , Idioma , Humanos , Masculino , Feminino , Adulto , Lateralidade Funcional/fisiologia , Eletroencefalografia/métodos , Adulto Jovem , Encéfalo/fisiologia , Ondas Encefálicas/fisiologia , Mapeamento Encefálico/métodos
15.
Sci Rep ; 14(1): 10392, 2024 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-38710829

RESUMO

The effect of family socioeconomic status (SES) on academic achievement in literacy and numeracy has been extensively studied with educational inequalities already witnessed in preschoolers. This is presumably explained by the effect of family SES on cognitive and socioemotional abilities associated with academic achievement. Metacognition which refers to knowledge and regulation skills involving reflexivity about one's own cognitive processes is one of these abilities. However, most of the studies investigating the association between metacognition and academic achievement have focused on school-aged students and studies with younger students are only emerging. Meanwhile, the association between family SES and metacognition abilities has surprisingly received little attention regardless of participants' age. The aim of this study was to explore the associations between family SES, metacognition, language and mathematical abilities in preschoolers aged 5 to 6. We provide the first evidence that the effect of family SES on preschoolers' language and mathematical abilities is mediated by the effect of family SES on their metacognitive abilities. The implications for future research, education and policies aiming at reducing educational inequalities are discussed.


Assuntos
Idioma , Metacognição , Classe Social , Humanos , Pré-Escolar , Masculino , Feminino , Metacognição/fisiologia , Criança , Matemática , Sucesso Acadêmico , Cognição/fisiologia
16.
Sci Rep ; 14(1): 10413, 2024 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-38710885

RESUMO

Generative artificial intelligence technologies, especially large language models (LLMs) like ChatGPT, are revolutionizing information acquisition and content production across a variety of domains. These technologies have a significant potential to impact participation and content production in online knowledge communities. We provide initial evidence of this, analyzing data from Stack Overflow and Reddit developer communities between October 2021 and March 2023, documenting ChatGPT's influence on user activity in the former. We observe significant declines in both website visits and question volumes at Stack Overflow, particularly around topics where ChatGPT excels. By contrast, activity in Reddit communities shows no evidence of decline, suggesting the importance of social fabric as a buffer against the community-degrading effects of LLMs. Finally, the decline in participation on Stack Overflow is found to be concentrated among newer users, indicating that more junior, less socially embedded users are particularly likely to exit.


Assuntos
Inteligência Artificial , Internet , Humanos , Conhecimento , Idioma
17.
Proc Natl Acad Sci U S A ; 121(23): e2320489121, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38805278

RESUMO

Neural oscillations reflect fluctuations in excitability, which biases the percept of ambiguous sensory input. Why this bias occurs is still not fully understood. We hypothesized that neural populations representing likely events are more sensitive, and thereby become active on earlier oscillatory phases, when the ensemble itself is less excitable. Perception of ambiguous input presented during less-excitable phases should therefore be biased toward frequent or predictable stimuli that have lower activation thresholds. Here, we show such a frequency bias in spoken word recognition using psychophysics, magnetoencephalography (MEG), and computational modelling. With MEG, we found a double dissociation, where the phase of oscillations in the superior temporal gyrus and medial temporal gyrus biased word-identification behavior based on phoneme and lexical frequencies, respectively. This finding was reproduced in a computational model. These results demonstrate that oscillations provide a temporal ordering of neural activity based on the sensitivity of separable neural populations.


Assuntos
Idioma , Magnetoencefalografia , Percepção da Fala , Humanos , Percepção da Fala/fisiologia , Masculino , Feminino , Adulto , Lobo Temporal/fisiologia , Adulto Jovem , Modelos Neurológicos
18.
PLoS One ; 19(5): e0304150, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38805447

RESUMO

When comprehending speech, listeners can use information encoded in visual cues from a face to enhance auditory speech comprehension. For example, prior work has shown that the mouth movements reflect articulatory features of speech segments and durational information, while pitch and speech amplitude are primarily cued by eyebrow and head movements. Little is known about how the visual perception of segmental and prosodic speech information is influenced by linguistic experience. Using eye-tracking, we studied how perceivers' visual scanning of different regions on a talking face predicts accuracy in a task targeting both segmental versus prosodic information, and also asked how this was influenced by language familiarity. Twenty-four native English perceivers heard two audio sentences in either English or Mandarin (an unfamiliar, non-native language), which sometimes differed in segmental or prosodic information (or both). Perceivers then saw a silent video of a talking face, and judged whether that video matched either the first or second audio sentence (or whether both sentences were the same). First, increased looking to the mouth predicted correct responses only for non-native language trials. Second, the start of a successful search for speech information in the mouth area was significantly delayed in non-native versus native trials, but just when there were only prosodic differences in the auditory sentences, and not when there were segmental differences. Third, (in correct trials) the saccade amplitude in native language trials was significantly greater than in non-native trials, indicating more intensely focused fixations in the latter. Taken together, these results suggest that mouth-looking was generally more evident when processing a non-native versus native language in all analyses, but fascinatingly, when measuring perceivers' latency to fixate the mouth, this language effect was largest in trials where only prosodic information was useful for the task.


Assuntos
Idioma , Fonética , Percepção da Fala , Humanos , Feminino , Masculino , Adulto , Percepção da Fala/fisiologia , Adulto Jovem , Face/fisiologia , Percepção Visual/fisiologia , Movimentos Oculares/fisiologia , Fala/fisiologia , Tecnologia de Rastreamento Ocular
19.
Cochrane Database Syst Rev ; 5: CD015067, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38808659

RESUMO

BACKGROUND: Primary progressive aphasia (PPA) accounts for approximately 43% of frontotemporal dementias and is mainly characterised by a progressive impairment of speech and communication abilities. Three clinical variants have been identified: (a) non-fluent/agrammatic, (b) semantic, and (c) logopenic/phonological PPA variants. There is currently no curative treatment for PPA, and the disease progresses inexorably over time, with devastating effects on speech and communication ability, functional status, and quality of life. Several non-pharmacological interventions that may improve symptoms (e.g. different forms of language training and non-invasive brain stimulation) have been investigated in people with PPA. OBJECTIVES: To assess the effects of non-pharmacological interventions for people with PPA on word retrieval (our primary outcome), global language functions, cognition, quality of life, and adverse events. SEARCH METHODS: We searched the Cochrane Dementia and Cognitive Improvement Group's trial register, MEDLINE (Ovid SP), Embase (Ovid SP), four other databases and two other trial registers. The latest searches were run on 26 January 2024. SELECTION CRITERIA: We included randomised controlled trials (RCTs) evaluating the effects of non-pharmacological interventions in people with PPA. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: There were insufficient data available to conduct the network meta-analyses that we had originally planned (due to trial data being insufficiently reported or not reported at all, as well as the heterogeneous content of the included interventions). Therefore, we provide a descriptive summary of the included studies and results. We included 10 studies, with a total of 132 participants, evaluating non-pharmacological interventions. These were: transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) as stand-alone treatments (used by two and one studies, respectively); tDCS combined with semantic and phonological word-retrieval training (five studies); tDCS combined with semantic word-retrieval training (one study); and tDCS combined with phonological word-retrieval training (one study). Results for our primary outcome of word retrieval were mixed. For the two studies that investigated the effects of tDCS as stand-alone treatment compared to placebo ("sham") tDCS, we rated the results as having very low-certainty evidence. One study found a significant beneficial effect on word retrieval after active tDCS; one study did not report any significant effects in favour of the active tDCS group. Five studies investigated tDCS administered to the dorsolateral prefrontal cortex, inferior frontal cortex, left frontotemporal region, or the temporoparietal cortex, combined with semantic and phonological word-retrieval training. The most consistent finding was enhancement of word-retrieval ability for trained items immediately after the intervention, when behavioural training was combined with active tDCS compared to behavioural training plus sham tDCS. We found mixed effects for untrained items and maintenance of treatment effects during follow-up assessments. We rated the certainty of the evidence as very low in all studies. One study investigated tDCS combined with semantic word-retrieval training. Training was provided across 15 sessions with a frequency of three to five sessions per week, depending on the personal preferences of the participants. tDCS targeted the left frontotemporal region. The study included three participants: two received 1 mA stimulation and one received 2 mA stimulation. The study showed mixed results. We rated it as very low-certainty evidence. One study investigated tDCS combined with phonological word-retrieval training. Training was again provided across 15 sessions over a period of three weeks. tDCS targeted the left inferior frontal gyrus. This study showed a significantly more pronounced improvement for trained and untrained words in favour of the group that had received active tDCS, but we rated the certainty of the evidence as very low. One study compared active rTMS applied to an individually determined target site to active rTMS applied to a control site (vertex) for effects on participants' word retrieval. This study demonstrated better word retrieval for active rTMS administered to individually determined target brain regions than in the control intervention, but we rated the results as having a very low certainty of evidence. Four studies assessed overall language ability, three studies assessed cognition, five studies assessed potential adverse effects of brain stimulation, and one study investigated quality of life. AUTHORS' CONCLUSIONS: There is currently no high-certainty evidence to inform clinical decision-making regarding non-pharmacological treatment selection for people with PPA. Preliminary evidence suggests that the combination of active tDCS with specific language therapy may improve impaired word retrieval for specifically trained items beyond the effects of behavioural treatment alone. However, more research is needed, including high-quality RCTs with detailed descriptions of participants and methods, and consideration of outcomes such as quality of life, depressive symptoms, and overall cognitive functioning. Moreover, studies assessing optimal treatments (i.e. behavioural interventions, brain stimulation interventions, and their combinations) for individual patients and PPA subtypes are needed. We were not able to conduct the planned (network) meta-analyses due to missing data that could not be obtained from most of the authors, a general lack of RCTs in the field, and heterogeneous interventions in eligible trials. Journals should implement a mandatory data-sharing requirement to assure transparency and accessibility of data from clinical trials.


Assuntos
Afasia Primária Progressiva , Terapia da Linguagem , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Afasia Primária Progressiva/terapia , Terapia da Linguagem/métodos , Idoso , Comunicação , Viés , Estimulação Transcraniana por Corrente Contínua/métodos , Pessoa de Meia-Idade , Idioma , Cognição , Estimulação Magnética Transcraniana/métodos
20.
Codas ; 36(3): e20230170, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38808858

RESUMO

PURPOSE: This study aimed to translate and cross-culturally adapt the "Voice-related Experiences of Nonbinary Individuals" (VENI) to Brazilian Portuguese (BP). METHODS: Cross-cultural adaptation was performed based on the combined guidelines of the World Health Organization's (WHO) Translation Recommendations and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The process included five stages: a) Translation of the instrument into BP by a translator specialized in the construct and a non-specialist, both native BP speakers and fluent in English; b) Synthesis of the two translations by consensus; c) Back-translation by a translator specialized in the construct and a non-specialist, both native English speakers and fluent in BP; d) Analysis by a committee of five speech-language pathologists voice specialist and the creation of the final version; e) Pre-testing with 21 individuals from the target population, conducted virtually. RESULTS: During the translation stage, there were disagreements regarding the title, instructions, response key, and 15 items. In the back-translation stage, there were discrepancies in the format of 12 items and the content of four items. The expert committee's analysis led to changes in the title, instructions, one option in the response key, and eight items to meet the equivalence criteria. In the pre-test, a significantly higher proportion of usual responses to the instrument was observed when compared to the non-applicable option; this is frequently observed in instrument adaptations. CONCLUSION: The cross-cultural adaptation of VENI into Brazilian Portuguese was successful, resulting in the "Experiências relacionadas à Voz de Pessoas Não Binárias - VENI-Br" version.


OBJETIVO: Traduzir e adaptar transculturalmente o Voice-related Experiences of Nonbinary Individuals ­ VENI para o português brasileiro. MÉTODO: Os procedimentos de adaptação transcultural foram baseados na combinação das recomendações e diretrizes da World Health Organization (WHO) Guidelines on Translation com o COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Foram realizadas cinco etapas: a) tradução do instrumento para o Português Brasileiro (PB) por um tradutor especialista no construto e um não-especialista, nativos do PB e fluentes em inglês; b) elaboração da síntese das duas traduções por consenso; c) retrotradução por um tradutor especialista no construto e um não-especialista, nativos do inglês e fluentes em PB; d) análise de um comitê formado por cinco fonoaudiólogos especialistas em voz e elaboração da versão final; e) pré-teste com 21 pessoas da população-alvo, aplicado virtualmente. RESULTADOS: Na tradução houve discordância no título, instruções, chave de resposta e em 15 itens. Na retrotradução, houve discordância quanto à forma em 12 itens e ao conteúdo em 4 itens. A análise do comitê de especialistas indicou mudanças no título, instruções de resposta, uma opção da chave de resposta, e em oito itens, para atender aos critérios de equivalência. No pré-teste houve proporção significativamente maior de respostas habituais do instrumento quando comparadas com a opção não-aplicável, usada regularmente nas adaptações de instrumentos. CONCLUSÃO: A adaptação transcultural para o português brasileiro do VENI foi bem sucedida e resultou na versão denominada "Experiências relacionadas a Voz de Pessoas Não Binárias - VENI-Br".


Assuntos
Comparação Transcultural , Traduções , Humanos , Brasil , Inquéritos e Questionários , Distúrbios da Voz/diagnóstico , Feminino , Masculino , Adulto , Idioma , Tradução , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
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