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Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction.
Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician–patient interaction.
Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback.
All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician–patient interaction.
The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician–patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.
Rapid, non-destructive methods for measuring seed germination and vigour are valuable. Standard germination and seed vigour were determined using 81 soybean seed lots. From these data, seed lots were separated into high and low germinating seed lots as well as high, medium and low vigour seed lots. Near-infrared spectra (950–1650 nm) were collected for training and validation samples for each seed category and used to create partial least squares (PLS) prediction models. For both germination and vigour, qualitative models provided better discrimination of high and low performing seed lots compared with quantitative models. The qualitative germination prediction models correctly identified low and high germination seed lots with an accuracy between 85.7 and 89.7%. For seed vigour, qualitative predictions for the 3-category (low, medium and high vigour) models could not adequately separate high and medium vigour seeds. However, the 2-category (low, medium plus high vigour) prediction models could correctly identify low vigour seed lots between 80 and 100% and the medium plus high vigour seed lots between 96.3 and 96.6%. To our knowledge, the current study is the first to provide near-infrared spectroscopy (NIRS)-based predictive models using agronomically meaningful cut-offs for standard germination and vigour on a commercial scale using over 80 seed lots.
Despite widespread recognition that the physiological systems underlying stress reactivity are well coordinated at a neurobiological level, surprisingly little empirical attention has been given to delineating precisely how the systems actually interact with one another when confronted with stress. We examined cross-system response proclivities in anticipation of and following standardized laboratory challenges in 664 4- to 14-year-olds from four independent studies. In each study, measures of stress reactivity within both the locus coeruleus-norepinephrine system (i.e., the sympathetic and parasympathetic branches of the autonomic nervous system) and the corticotrophin releasing hormone system (i.e., the hypothalamic–pituitary–adrenal axis) were collected. Latent profile analyses revealed six distinctive patterns that recurred across the samples: moderate reactivity (average cross-system activation; 52%–80% of children across samples), parasympathetic-specific reactivity (2%–36%), anticipatory arousal (4%–9%), multisystem reactivity (7%–14%), hypothalamic–pituitary–adrenal axis specific reactivity (6%–7%), and underarousal (0%–2%). Groups meaningfully differed in socioeconomic status, family adversity, and age. Results highlight the sample-level reliability of children's neuroendocrine responses to stress and suggest important cross-system regularities that are linked to development and prior experiences and may have implications for subsequent physical and mental morbidity.
The direct current (dc) conductivities and organic field-effect transistor (OFET) characteristics of a class of octa-substituted liquid crystalline (discotic mesophase) phthalocyanines (Pcs) are discussed. These molecules self-organize into columnar aggregates with large coherence lengths (up to approximately 300 nm). Langmuir–Blodgett films of these molecules were horizontally transferred to either interdigitated microelectrodes (IME) or OFET substrates, so that current flow could be measured either parallel or perpendicular to the column axis. Twenty-eight bilayer films of these Pcs on the IME substrates showed anisotropies in dc conductivity up to 50:1, whereas similar Pc films showed anisotropies in field effect mobilities of approximately 10:1, for a variety of W/L ratios (source/drain dimensions and spacing). Field-effect mobilities of 1 to 5 × 10-6 cm2·V-1·s-1 were determined from OFET measurements, along the Pc column axis, whereas charge mobilities measured from the space charge limited current regime on the IME substrates were in the range of 10-4 cm2·V-1·s-1. Conductive tip atomic force microscopy measurements on the apprximately 500-nm length scale showed that the conductivity anisotropy can be as high as 1000:1 when the Pc columns are intimately contacted to an adjacent Au bond pad.
Corballis presents a plausible evolutionary mechanism to explain the tight linkage between cerebral lateralization for language and for handedness in humans. This argument may be bolstered by invoking Stokoe's notion of semantic phonology to explain the role of Broca's area in grammatical functions.
This paper points to the need in ape language research to shift from experimentation to ethnography. We cannot determine what goes on inside the head of an ape when it communicates with a human being, but we can learn about the nature and content of the communication that occurs in such face-to-face interaction. This information is fundamental for establishing a baseline for the abilities of an ape-human common ancestor.
When we no longer look at an organic being as a savage looks at a ship, as at something wholly beyond his comprehension; when we regard every production of nature as one which has had a history; when we contemplate every complex structure and instinct as the summing up of many contrivances, each useful to the possessor, nearly in the same way as when we look at any great mechanical invention as the summing up of the labour, the experience, the reason, and even the blunders of numerous workmen; when we thus view each organic being, how far more interesting, I speak from experience, will the study of natural history become!
Charles Darwin, Origin of species
If “language” were substituted for “organic being” and “natural history” in the excerpt above, Darwin might be expressing the perspective on the origin and evolution of language which we have articulated in this book. We argue that language grows out of a complex of primary human adaptations, including bipedal locomotion, social living, reproduction without an estrous cycle, postnatal epigenesis, postreproductive longevity, and division of labor within the family. In addition, we argue that language grows out of more primitive primate and mammalian neuro-behavioral complexes, including those that govern face-to-face interaction, categorization, and symbolization. Finally, we argue that the key to the transition from primate vocal and visible gesture systems to language (that is, names organized into sentences) is the introduction of iconic, visible gestures at some point in hominid evolution.
A curious thing about the ontological problem is its simplicity. It can be put in three Anglo-Saxon monosyllables: “What is there?” It can be answered, moreover, in a word – “Everything” – and everyone will accept this answer as true. However, this is merely to say that there is what there is. There remains room for disagreement over cases; and so the issue has stayed alive down the centuries.
Willard Van Orman Quine, From a logical point of view
Language, like the physical universe, in all likelihood cannot be known fully by an observer in one place at one time. Language theorists and linguists, like physicists, must acknowledge uncertainty. In a masterful summing up of his philosophy of language and much else, Kenneth L. Pike (1993) explains how, as long ago as 1959, he wrote of “Language as Particle, Wave, and Field,” borrowing this three-part label for the principle of complementarity from the work of physicist Niels Bohr.
Complementarity and uncertainty go together: it is only by understanding the limitations on a single point of view or system of mathematics that one can begin to see further. Since Heisenberg, physicists have known that if one can locate a particle precisely, its action (as part of a wave of similar particles) will escape detection, and that if one studies the wave action, individual particles disappear. Field theory states the necessity of looking at both wave and particle.
Language is a part of social behavior. What is the mechanism whereby the social process goes on? It is the mechanism of gesture …
George Herbert Mead, Mind, self, and society
LANGUAGE FROM A SPECIAL PART OF THE UNIVERSE
If nothing else, language acquisition studies show that language does not develop through an individual's interaction with the natural environment. It emerges only out of social interaction, but social interaction within constrained limits. We would not know what a word means if we had not heard or seen it used by someone else in a context that made the relation between word and meaning reasonably unambiguous. Once language is acquired at a sufficient level, of course, its possessor is able to use language and the aids to thought that language provides to determine the meaning of an unfamiliar word by inference from its context. But the statement still holds. Without the introduction to words and the seminal idea that words symbolize – without the initial acquisition process, which is social – we would have no equipment with which to make linguistic inferences.
It may seem that the condition emphasized above is crucial; the association of a word with meaning makes both conversing and verbal thinking possible; but verbal thinking needs language, and language needs the interaction of at least two human beings.
The evidence … indicates that language could not have developed gradually out of protolanguage, and it suggests that no intermediate form exists. If this is so, then syntax must have emerged in one piece, at one time – the most likely cause being some kind of mutation that affected the organization of the brain. Since mutations are due to change, and beneficial ones are rare, it is implausible to hypothesize more than one such mutation.
Derek Bickerton, Language and species
THE SYSTEM OF LANGUAGE
It should be clear by now that we will argue against this hypothesis by Bickerton, an hypothesis which flows from transformational linguistic theory; although, in Chapter 8, we will discuss a candidate gene that has recently been proposed as a possible basis for this brain reorganization, as well as changes in the vocal tract (Greenhood, 1992). We propose, instead, that there are intermediate stages between non-syntactic communication and fully syntactic language. The essential vehicle of communication that must be understood according to our argument is the iconic, visible gesture. The key problem, according to Bickerton, is getting from nonhierarchical strings of symbols to hierarchical structures, with embedding of phrases. We have already presented alternatives to the rules and representations system that this implies (Chapter 5). Here we will argue that the key to building syntax incrementally is the discovery of relationships within symbols, and that embryo sentences are already inherent in simple visible gestures.