IMPORTANCE Numerous prognostic models of suicide risk have been published, but few have been implemented outside of integrated managed care systems. OBJECTIVE To evaluate performance of a suicide attempt risk prediction model implemented in a vendor-supplied electronic health record to predict subsequent (1) suicidal ideation and (2) suicide attempt. DESIGN, SETTING, AND PARTICIPANTS This observational cohort study evaluated implementation of a suicide attempt prediction model in live clinical systems without alerting. The cohort comprised patients seen for any reason in adult inpatient, emergency department, and ambulatory surgery settings at an academic medical center in the mid-South from June 2019 to April 2020. MAIN OUTCOMES AND MEASURES Primary measures assessed external, prospective, and concurrent validity. Manual medical record validation of coded suicide attempts confirmed incident behaviors with intent to die. Subgroup analyses were performed based on demographic characteristics, relevant clinical context/setting, and presence or absence of universal screening. Performance was evaluated using discrimination (number needed to screen, C statistics, positive/ negative predictive values) and calibration (Spiegelhalter z statistic). Recalibration was performed with logistic calibration. RESULTS The system generated 115 905 predictions for 77 973 patients (42 490 [54%] men, 35 404 [45%] women, 60 586 [78%] White, 12 620 [16%] Black). Numbers needed to screen in highest risk quantiles were 23 and 271 for suicidal ideation and attempt, respectively. Performance was maintained across demographic subgroups. Numbers needed to screen for suicide attempt by sex were 256 for men and 323 for women; and by race: 373, 176, and 407 for White, Black, and non-White/non-Black patients, respectively. Model C statistics were, across the health system: 0.836

Recent experiments have shown that people iconically modulate their prosody corresponding with the meaning of their utterance (e.g., Shintel et al., 2006). This article reports findings from a story reading task that expands the investigation of iconic prosody to abstract meanings in addition to concrete ones. Participants read stories that contrasted along concrete and abstract semantic dimensions of speed (e.g., a fast drive, slow career progress) and size (e.g., a small grasshopper, an important contract). Participants read fast stories at a faster rate than slow stories, and big stories with a lower pitch than small stories. The effect of speed was distributed across the stories, including portions that were identical across stories, whereas the size effect was localized to sizerelated words. Overall, these findings enrich the documentation of iconicity in spoken language and bear on our understanding of the relationship between gesture and speech.

We describe the repertoire of learned vocal and breathing-related behaviors (VBBs) performed by the enculturated gorilla Koko. We examined a large video corpus of Koko and observed 439 VBBs spread across 161 bouts. Our analysis shows that Koko exercises voluntary control over the performance of nine distinctive VBBs, which involve variable coordination of her breathing, larynx, and supralaryngeal articulators like the tongue and lips. Each of these behaviors is performed in the context of particular manual action routines and gestures. Based on these and other findings, we suggest that vocal learning and the ability to exercise volitional control over vocalization, particularly in a multimodal context, might have figured relatively early into the evolution of language, with some rudimentary capacity in place at the time of our last common ancestor with great apes.

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This study investigated phonological components of reading skill at two ages, using a novel pseudoword repetition task for assessing phonological memory (PM). Pseudowords were designed to incorporate control over segmental, prosodic and lexical features. In experiment 1, the materials were administered to 3- and 4-year-old children together with a standardized test of phonological awareness (PA). PA and pseudoword repetition showed a moderate positive correlation, independent of age. Experiment 2, which targeted young adults, employed the same pseudoword materials, with a different administration protocol, together with standardized indices of PA, other memory measures, and decoding skill. The results showed moderate to strong positive correlations among our novel pseudoword repetition task, measures of PM and PA, and decoding. Together, the findings demonstrate the feasibility of assessing PM with the same carefully controlled materials at widely spaced points in age, adding to present resources for assessing phonological memory and better enabling future studies to map the development of relationships among phonological capabilities in both typically developing children and those with language-related impairments.