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What to expect when you're expecting
A look at love through the eyes of five interconnected couples experiencing the thrills and surprises of having a baby, and ultimately coming to understand the universal truth that no matter what you plan for, life doesn't always deliver what's expected.
DVD
Scrutinizing reference adaptation: Do people only adapt to infrequent discourse structures?
People use context to resolve ambiguous pronouns, for example, one contextual bias is to assign pronouns to the subject of the previous sentence, for example, Ana in \"Ana ate with Liz. She….\" Recent evidence suggests that these biases shift in the direction of the most frequent patterns in the local context. Yet referential adaptation is different from adaptation to words and structures, raising questions about the mechanism of adaptation. Here we test whether all recent exposures equally influence processing biases. Alternatively, learning may only occur when people encounter unexpected patterns, as predicted by error-based learning accounts that have been proposed for syntactic adaptation. We thus further test whether this “inverse frequency effect” also occurs during referential adaptation. In English the subject-reference pattern is more common than the nonsubject-reference pattern, so if people only adapt to rare patterns they should only adjust their processing biases when exposed to the less-common nonsubject-reference pattern. We tested this by comparing subject- and nonsubject-exposure with a neutral exposure condition. In two experiments we found that only the nonsubject-exposure condition differed from the neutral exposure condition, supporting the conclusion that referential adaptation exhibits an inverse frequency effect.
Journal Article
My pronouns are they/them: Talking about pronouns changes how pronouns are understood
The pronoun “they” can be either plural or singular, perhaps referring to an individual who identifies as nonbinary. How do listeners identify whether “they” has a singular or plural sense? We test the role of explicitly discussing pronouns (e.g., “Alex uses they/them pronouns”). In three experiments, participants read short stories, like “Alex went running with Liz. They fell down.” Answers to “Who fell down” indicated whether participants interpreted
they
as Alex or Alex-and-Liz. We found more singular responses in discourse contexts that make Alex more available: when Alex was either the only person in the context or mentioned first. Critically, the singular interpretation was stronger when participants heard explicit instructions that Alex uses
they/them
pronouns, even though participants in all conditions had ample opportunity to learn this fact through observation. Results show that the social trend to talk about pronouns has a direct impact on how language is understood.
Journal Article
Hearing Pronouns Primes Speakers to Use Pronouns
Speaking requires frequent decisions about how to refer, for example whether to use a pronoun (she) or a name (Ana). It is well known that this choice is guided by the discourse context, but little is known about the representations that are activated. We use priming to test whether this choice can be facilitated through recent exposure, and if so, what representations are activated. In a storytelling task, participants take turns with experimenters telling a story that is illustrated in 2-panel cartoons. The first sentence is given, and participants describe the second panel in their own words. We manipulate whether the experimenter used a pronoun or name in the prior story. Experiment 1 provides the first evidence in the literature that reference form choice can be primed, and that it is not dependent on the syntactic position of the antecedent. However, the effect is not finely tuned to the preceding prime. Instead, exposure at the start of the experiment persists throughout, even when the prime changes. Experiments 2 and 3 further show that exposure to pronoun primes result in greater pronoun use than at baseline, but that there is no sensitivity to the prime on the most recent trial. Results argue against a role for production facilitation in pronoun use, which suggests that reference production is not impacted by production efficiency.
Journal Article
Opportunistic predation of birds by breeding Herring Gulls (Larus argentatus)
Dietary specialization, exploiting a small fraction of available food resources, is commonly reported for gulls and skuas. Predation of birds by these species is usually considered a specialist strategy employed by the minority of the population but non-specialists also predate birds and may actually have a greater impact on the prey species. To date, most studies have focused on predatory bird-specialists, down-playing the possible importance of opportunistic predation by non-specialists. We addressed this by studying diet (regurgitated pellets and prey remains) and behavior of breeding Herring Gulls (Larus argentatus) over three summers at Gull Island, a mixed-species breeding colony in Lake Ontario. One-third of all pellets analyzed contained bird remains, primarily the most numerous breeding bird: Ring-billed Gull (L. delawarensis) chicks (51%) and adults (36%). Although all but one pair of Herring Gulls ate birds, all pairs maintained broad and mostly similar diets, with birds accounting for at most one-third of prey. Behavior also indicated that Herring Gulls at Gull Island were not predatory bird-specialists because predation was too infrequent to meet energetic requirements, was largely unsuccessful and was only ever observed when Ring-billed Gulls strayed into Herring Gull breeding territories. Instead, bird predation appeared mainly opportunistic, increasing with seasonal availability, access to shoreline, proximity to nesting Ring-billed Gulls and breeding territory size. Compared with predatory specialist Herring Gulls in the same region, individuals that predated birds at Gull Island did not display specialist behaviors and killed six times fewer birds (0.1-0.4 per day, on average) but were over 20 times more numerous (98% of the population versus 4%). Thus, our results indicate that opportunistic predation by non-specialists may have important consequences for prey species. Since opportunistic predation cannot be effectively managed using techniques widely advocated for specialist predators, it is essential to investigate cause of predation by large gulls prior to lethal management.
Journal Article
Impact of residual retinal fluid on treatment outcomes in neovascular age-related macular degeneration
Treatment decisions for neovascular age-related macular degeneration (nAMD) in the setting of individualised treatment regimens are adapted to disease activity. The main marker of disease activity and trigger for re-treatment with anti-vascular endothelial growth factor (anti-VEGF) agents is the presence of retinal fluid on optical coherence tomography (OCT). Recently, attention has focused on the impact of residual retinal fluid on nAMD management. Based on a literature review and the combined clinical experience of an international group of retinal specialists, this manuscript provides expert guidance on the treatment of nAMD according to fluid status and proposes an algorithm for determining when to administer anti-VEGF treatment according to residual fluid status. We explore the role of residual fluid in treatment decisions and outcomes in nAMD, taking into consideration fluid evaluation and, in particular, distinguishing between fluid in different anatomic compartments and at different stages during the treatment course. Current limitations to identifying and interpreting fluid on OCT, and the assumption that any residual retinal fluid reflects ongoing VEGF activity, are discussed.
Journal Article
Dexamethasone intravitreal implant in treatment-naïve diabetic macular oedema: findings from the prospective, multicentre, AUSSIEDEX study
AimTo evaluate the effectiveness of dexamethasone intravitreal implant 0.7 mg (DEX; Ozurdex) monotherapy in the patient subgroup of the AUSSIEDEX study with treatment-naïve diabetic macular oedema (DME).MethodsThe open-label, prospective, phase 4, real-world study included pseudophakic eyes and phakic eyes scheduled for cataract surgery that were treatment-naïve or non-responsive to antivascular endothelial growth factors. No eyes were excluded based on baseline best-corrected visual acuity (BCVA) or central subfield retinal thickness (CRT). After the initial DEX injection at the baseline visit, reinjection was permitted at ≥16-week intervals. Week-16 and week-52 visits were mandatory. Primary endpoints were changes in mean BCVA and CRT from baseline to 52 weeks.ResultsOf 200 eyes enrolled in the AUSSIEDEX study, 57 were treatment-naïve. Baseline mean BCVA was 58.8 letters and baseline mean CRT was 418.6 µm; changes in mean BCVA and CRT from baseline to 52 weeks in this subgroup were 3.4 letters (p=0.042) and –89.6 µm (p<0.001), respectively, with a mean 2.5 injections. The change in mean CRT from baseline was –55.8 µm at week 16 (p<0.001). The most common adverse event was increased intraocular pressure (IOP), with 20.0% of eyes requiring IOP-lowering medication. One patient was discontinued due to increased IOP. No eyes required filtration surgery. No serious, treatment-related ocular adverse events were reported.ConclusionIn this largest prospective, real-world study of DEX monotherapy for DME to date, DEX significantly improved CRT and BCVA at 52 weeks in treatment-naïve eyes, without new safety concerns, supporting DEX use in treatment-naïve DME.Trial registration number NCT02731911.
Journal Article
Longer treatment intervals are associated with reduced treatment persistence in neovascular age related macular degeneration
Aims
To test the hypothesis that patients treated for neovascular age related macular degeneration (nAMD) with longer treatment intervals are more likely to persist with treatment.
Methods
Data were obtained from the prospectively-defined Fight Retinal Blindness! registry. Treatment interval at 2 years was stratified based on the mean treatment interval over the three visits prior to and including the 2-year visit. Rates of non-persistence to follow-up were assessed from 2 to 5 years.
Results
Data from 1538 eyes were included. The overall rate of non-persistence was 51% at 5 years. Patients on longer treatment intervals (12-weeks) at 2 years were found to be
less
persistent to long-term follow-up. These eyes were found to have fewer active disease visits in the first 2 years (40%) than eyes treated at 4-weekly intervals (66%,
p
< 0.001). In the multivariable analysis, better vision at 2 years was associated with a lower risk of non-persistence (hazards ratio [HR] [95% CI]: 0.95 [0.93, 0.97], P < 0.001), while longer treatment intervals (HR [95% CI]: 1.31 [0.95, 1.8] and 1.54 [1.15, 2.06] for 12-week and > 12-week intervals vs. 4-week intervals, respectively,
P
= 0.002) and older patients (HR [95% CI]: 1.03 [1.02, 1.04],
p
< 0.001) were at higher risk of non-persistence.
Conclusions
We found that patients on longer treatment intervals at 2 years were more likely to be non-persistent with treatment in later years. Reinforcing the need for ongoing treatment is important for patients on longer intervals who may feel complacent or that treatment is no longer effective, particularly if newer, longer lasting agents become widely available.
Journal Article
Prevalence and characteristics of macular atrophy in eyes with neovascular age-related macular degeneration. A study from a long-term observational dataset: the Fight Retinal Blindness! project
BackgroundTo assess the prevalence and characteristics associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.MethodsThis was a retrospective, cross-sectional study of nAMD eyes that commenced anti-VEGF between January 2006 and August 2016. MA (absent/extrafoveal/subfoveal) was graded by treating practitioners based on multimodal imaging from April 2016. The prevalence of MA over time and risk factors of MA were assessed.ResultsThe prevalence of MA in a cohort of 1689 eyes was 9.9% (22/222) in eyes within 1 year of starting treatment, 41.5% (71/171) after 5 years and 48.4% (30/62) after 9 years of treatment. Risk factors for subfoveal MA included the proportion of visits at which the lesion was graded as inactive ((adjusted OR (AOR) 3.72 for the highest vs lowest the quartile of frequency of inactive gradings (95% CI 2.33 to 6.07)), age (AOR 1.05 per year (95% CI 1.02 to 1.07)), baseline visual acuity (AOR 3.9 for ≤35 letters vs ≥70 letters (95% CI 2.4 to 6.4)) and the number of injections received (AOR 1.20 every 10 injections (95% CI 1.08 to 1.33)). Similar associations were observed with extrafoveal MA.ConclusionsThe risk of MA appeared to drop in eyes that had not developed it within 5 years. Low choroidal neovascularisation activity was by far the strongest predictor. We could not determine whether the increased prevalence of MA with time was due to anti-VEGF treatment or the natural history of the condition.
Journal Article