We investigated the semantic blocking effect in picture naming and word-picture matching for two nonfluent aphasic patients who show evidence of a deficit in inhibiting verbal representations (M.L. and B.Q), one fluent aphasic patient (K.V.), and neurologically intact control participants. In two picture-naming tasks (Experiments 1A and 1B), M.L. and B.Q, relative to controls, showed a greatly exaggerated semantic blocking effect in naming latencies that increased dramatically across repeated presentations. On two corresponding word-picture matching tasks (Experiments 2A and 2B), both also showed an increasing semantic blocking effect, though the effects were not as large nor as consistent as those in naming. The fluent patient, K.V., showed a pattern like controls on both tasks. On an associated word-picture matching task, both M.L. and B.Q showed results paralleling those of controls. The contrast between the production and comprehension patterns for M.L. and B.Q. supports the conclusion that their exaggerated blocking effect in production arises during lexical rather than semantic selection. We postulate that M.L.'s (and potentially B.Q's) production effect is due to difficulties in postselection inhibition, which results in overactivation of lexical representations. This overactivation is likely to be one source of their nonfluency in spontaneous speech.

Controversy remains as to the scope of advanced planning in language production. Smith and Wheeldon (1999) found significantly longer onset latencies when subjects described moving picture displays by producing sentences beginning with a complex noun phrase than for matched sentences beginning with a simple noun phrase. While these findings are consistent with a phrasal scope of planning, they might also be explained on the basis of: 1) greater retrieval fluency for the second content word in the simple initial noun phrase sentences and 2) visual grouping factors. In Experiments 1 and 2, retrieval fluency for the second content word was equated for the complex and simple initial noun phrase conditions. Experiments 3 and 4 addressed the visual grouping hypothesis by using stationary displays and by comparing onset latencies for the same display for sentence and list productions. Longer onset latencies for the sentences beginning with a complex noun phrase were obtained in all experiments, supporting the phrasal scope of planning hypothesis. The results indicate that in speech, as in other motor production domains, planning occurs beyond the minimal production unit. Evidence for a Phrasal Scope of Planning in Speech ProductionIn cognitive tasks involving motor output, be it language production, problem solving, or skilled motor performance (such as playing a musical instrument), people must execute a sequence of actions toward some goal. Crucial issues in all these cognitive domains concern the levels of representation at which advance planning takes place and the extent or scope of such planning (e.g., Catrambone, 1998;Rosenbaum, 2010;Smith & Wheeldon, 1999). There are major benefits to planning ahead -such as avoiding mistakes. One can insure that in problem solving, for instance, one will not end up in a game position from which there is no legal move without backtracking. In piano playing one can avoid choosing fingering for the first notes of a run that would impede rapid execution of the entire arpeggio. In language production, one can avoid becoming tongue-tied because of the difficulty in finding an appropriate word or phrase to complete a thought given what has already been produced. Advance planning has its downsides as well. Advance planning at multiple levels is

Studies of semantic interference in language production have provided evidence for a role of cognitive control mechanisms in regulating the activation of semantic competitors during naming. The present study investigated the relationship between individual differences in cognitive control abilities, for both younger and older adults, and the degree of semantic interference in a blocked cyclic naming task. We predicted that individuals with lower working memory capacity (as measured by word span), lesser ability to inhibit distracting responses (as measured by Stroop interference), and a lesser ability to resolve proactive interference (as measured by a recent negatives task) would show a greater increase in semantic interference in naming, with effects being larger for older adults. Instead, measures of cognitive control were found to relate to specific indices of semantic interference in the naming task, rather than overall degree of semantic interference, and few interactions with age were found, with younger and older adults performing similarly. The increase in naming latencies across naming trials within a cycle was negatively correlated with word span for both related and unrelated conditions, suggesting a strategy of narrowing response alternatives based upon memory for the set of item names. Evidence for a role of inhibition in response selection was obtained, as Stroop interference correlated positively with the change in naming latencies across cycles for the related, but not unrelated, condition. In contrast, recent negatives interference correlated negatively with the change in naming latencies across unrelated cycles, suggesting that individual differences in this tap the degree of strengthening of links in a lexical network based upon prior exposure. Results are discussed in terms of current models of lexical selection and consequences for word retrieval in more naturalistic production.

Compared to other demographic factors, insurance status was associated with the greatest disparities in immunotherapy utilization and mortality for patients who underwent surgery for advanced melanoma.

Traumatic brain injury severity affected prospective judgments of memory performance and learning strategies, but did not appear to affect either word retention or the forgetting of words over a delay. Implications for rehabilitation are discussed.

Background: Assessment of an individual medical school’s performance in the match is an important outcome of the educational program. Unfortunately, student rank lists are not public. A method to objectively gauge the quality of an institution’s match regardless of student preference has not been described in the literature.Objective: This manuscript serves to determine the relative weights of included variables and derive a statistically valid Match Quality Score (MQS).Design: Between 2016 and 2018, student affairs experts derived from a national cohort validated the MQS by scoring factitious mini-match lists that covered three variables: student’s Match Status, specialty Competitiveness, and residency program Reputation.Results: Of the variables assessed, only Match Status and Competitiveness were found to be significant. We derived the resulting coefficients for the Match Quality Score (MQS) as: [3.74A (# students successfully matched) + 2.34B (# students matching into their initial specialty in the SOAP process) + 1.77C (# students who secured a SOAP position in another specialty) + 0.26D (# students matching into a specialty where there are more applicants than spots)]/Total # students.Conclusions: The MQS is a potentially useful educational outcome measurement for US medical schools and may be considered as an outcome measure for continuous quality improvement to tailor future institutional changes to training, mentoring, and student-advising programs.

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Intraoperative neuromonitoring during thyroid surgery has been used to successfully prevent permanent neurological injury by early identification of anatomical variants. Proper interpretation of neuromonitoring data requires knowledge of what factors might affect the data. In this study, we examined the effect of surgical positioning on the latency and amplitude of neural recordings made from the vocalis muscle during thyroid surgery. A retrospective review was performed of 145 patients who underwent thyroid surgery. Eighty-three had open cervical procedures, and 62 had robotic-assisted transaxillary procedures. Intraoperative neuromonitoring recordings were made by stimulation of the vagus and recurrent laryngeal nerves for both groups. Ultrasound measurements were made of a subset of the transaxillary patients immediately before and after arm positioning. Groups differed only on right-sided recordings. Patients with transaxillary surgeries had significantly shorter latencies evoked from the vagus nerve. We found that vagus nerve-evoked latencies were also correlated to ultrasound measurements of the nerves. Surgical positioning during thyroid surgery is a factor that may affect intraoperative neuromonitoring data and should be taken into account by the surgeon during interpretation.