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Original article
Preliminary investigation of semantic memory assessments in Colombian adults with and without post-stroke aphasia
Investigación preliminar de evaluaciones de memoria semántica en adultos Colombianos con y sin afasia postictus
Yina M. Quiquea,
Corresponding author
yinaquique@northwestern.edu

Corresponding author at: 633 N. Saint Clair St., 20th Floor, Chicago, IL 60611, United States.
, Michael W. Dickeyb,c, Haley C. Dresangd,e
a Center for Education in Health Sciences, Northwestern University & Shirley Ryan Ability Lab, Chicago, IL, United States
b Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, United States
c VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
d Communication Sciences and Disorders, University of Wisconsin–Madison, Madison, WI, United States
e Waisman Center, University of Wisconsin–Madison, Madison, WI, United States
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0065">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">Semantic memory is a type of explicit&#44; declarative long-term memory that stores knowledge extending beyond specific and autobiographical experiences to include general facts &#40;e&#46;g&#46;&#44; Australia is south of the equator&#41;&#44; word meanings&#44; and object and action information &#40;e&#46;g&#46;&#44; swimming is typically done in water&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a> Semantic memory not only contains knowledge about objects and actions but also about <span class="elsevierStyleItalic">events</span>&#46; Events involve world knowledge of associated objects&#44; actions&#44; and contexts that commonly co-occur&#46;<a class="elsevierStyleCrossRefs" href="#bb0010"><span class="elsevierStyleSup">2&#8211;4</span></a> For example&#44; semantic memory for events might include knowledge that an action of measuring by a baker would likely involve flour and take place in a kitchen&#44; whereas measuring by a carpenter likely involves wood and takes place in a workshop&#46;<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> Event representations are thus complex and multidimensional&#58; they connect multiple types of semantic-memory representations&#44; including actions and objects&#46;<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a></p><p id="p0010" class="elsevierStylePara elsevierViewall">Semantic memory is the starting point for language production and is critically accessed during language comprehension at the word&#44; sentence&#44; and discourse levels&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> It may also serve as the basis for efficacious language treatment for aphasia&#46;<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a> This makes the assessment of semantic memory function critical in patients with post-stroke aphasia&#46; There are clinically established assessments of semantic memory for both objects &#40;Pyramids and Palm Trees &#91;PPT&#93;<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a>&#41; and actions &#40;Kissing and Dancing Test &#91;KDT&#93;<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a>&#41;&#46; These assessments use line-drawing pictures and ask participants to make judgments about the relationships among depicted objects or actions&#46; Notably&#44; no words are used in the assessments&#44; only images&#44; removing the need for translations to other languages&#46; Furthermore&#44; these assessments are sensitive to the presence and severity of semantic-memory impairments across a number of neurologically impaired populations&#44; including post-stroke aphasia&#46;<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0055"><span class="elsevierStyleSup">11</span></a> However&#44; a measure of semantic memory for events is not clinically available&#44; despite recent efforts<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> to develop such measures &#40;see discussion below&#41;&#46;</p><p id="p0015" class="elsevierStylePara elsevierViewall">Event&#44; action&#44; and object knowledge stored in semantic memory are contingent on a person&#39;s perceptual&#44; linguistic&#44; and interactive experience with the world&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a> Therefore&#44; the content of semantic memory may vary based on cultural and linguistic differences&#46; There is preliminary evidence that cultural and linguistic differences affect performance on clinical-standard measures of object- and action-related semantic memory &#40;PPT and KDT&#41;&#44; requiring culture-specific norming efforts&#46;<a class="elsevierStyleCrossRefs" href="#bb0065"><span class="elsevierStyleSup">13&#8211;16</span></a> There is also preliminary evidence for cross-linguistic and cross-cultural variability in event representations&#46; Specifically&#44; the co-occurrence between objects&#44; actions&#44; and contexts that make up event representations may differ across cultures&#44; and event representations may also differ across languages&#44; with different lexical&#8211;structural encoding of elements like space&#44; number&#44; motion&#44; and event structure&#46;<a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a> Sociolinguistic differences in object&#44; action&#44; and event representations have not been systematically examined to date&#44; nor has their association with the presence of language disorders such as aphasia&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">Given potential differences in semantic memory across sociolinguistic backgrounds&#44; it is possible that clinical assessments and cognitive findings from English-speaking samples may not be similar in speakers of other languages&#46; This research serves as a preliminary investigation to assess semantic memory in monolingual Spanish-speaking Colombian adults with and without post-stroke aphasia&#46; In particular&#44; we seek to replicate findings from Dresang et al&#46; &#40;2019&#41;&#44; which to our knowledge&#44; has been the only study to directly compare performance across object-&#44; action-&#44; and event-related semantic memory and relate this to the presence of post-stroke aphasia&#46; We investigate whether 2 major findings from this work extend to a sample of adults with a distinct sociolinguistic background&#8212;monolingual Spanish-speakers from Colombia&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">First&#44; Dresang et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> found that performance on both object and action semantic-memory clinical assessments reliably predicted event semantic memory performance&#46; Consistent with theoretical models of event representations&#44;<a class="elsevierStyleCrossRefs" href="#bb0020"><span class="elsevierStyleSup">4&#8211;6</span></a> these results indicate that semantic memory for events reflects a confluence of object and action knowledge&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleItalic">Therefore&#44; the first objective of the current research was to assess the reproducibility of these findings by examining whether event semantic memory is associated with object and action semantic-memory performance in Colombian adults with aphasia</span>&#46; Because this finding reflects the structure underlying semantic memory domains&#44; we predicted that the findings reported in Dresang et al&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> should hold true for adults with a Colombian sociolinguistic profile&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">Second&#44; Dresang et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> found that clinical-standard semantic memory assessments for objects&#44; actions&#44; and events distinguished neurologically impaired adults from matched neurotypical controls&#46; This finding replicated evidence supporting that clinical-standard measures for object-related &#40;PPT<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a>&#41; and action-related semantic memory &#40;KDT<a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a>&#41; can distinguish between individuals with and without neurological impairments&#44; such as aphasia&#46;<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0055"><span class="elsevierStyleSup">11</span></a> Moreover&#44; Dresang and colleagues extended this evidence by finding that event semantic memory reliably differentiated individuals with aphasia from matched neurotypicals as well&#46; Although this finding is consistent with the hypothesis that access to semantic memory is associated with language performance&#44;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a> it remains unclear to what extent cultural and linguistic differences may affect the relationship between semantic memory and aphasia&#46; Therefore&#44; <span class="elsevierStyleItalic">the second objective of our research was to investigate whether clinical-standard semantic memory assessments for objects&#44; actions&#44; and events distinguished neurologically impaired adults from matched controls in Colombia&#46;</span> Given that semantic memory and event representations&#44; in particular&#44; may be subject to significant sociolinguistic variability&#44;<a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a> there may be differences in the ability of different semantic-memory measures &#40;for objects&#44; actions&#44; and events&#41; to detect the presence of neurological impairment&#46;</p><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Aims</span><p id="p0035" class="elsevierStylePara elsevierViewall">The current study addresses 2 research questions&#58; &#40;1&#41; whether event semantic memory is related to object and action semantic-memory impairments in Colombian adults with aphasia&#44; as previously found for English-speaking people with aphasia<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a>&#59; and &#40;2&#41; whether each of the semantic-memory measures &#40;action&#44; object&#44; and event&#41; can distinguish between people with and without aphasia in a Colombian sample&#46;</p></span></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Methods</span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0080">Participants</span><p id="p0040" class="elsevierStylePara elsevierViewall">Participants were recruited in Bogot&#225;&#44; Colombia from local collaborating institutions&#46; Local clinicians referred individuals with an existing diagnosis of post-stroke aphasia&#46; Sixteen persons with chronic aphasia and 16 age-&#44; gender- and education-matched controls participated in this study&#46; See <a class="elsevierStyleCrossRef" href="#t0005">Table 1</a> for demographic information&#46; All participants passed screenings to rule out frank visual&#44; memory&#44; and hearing deficits &#40;line bisection and recognition memory subtests from the Comprehensive Aphasia Test<a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a>&#59; and an audiometric screening at 40&#8239;dB at 0&#46;5&#44; 1&#44; 2&#44; and 4&#8239;kHz&#41;&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0045" class="elsevierStylePara elsevierViewall">Participants with aphasia had diagnoses of fluent aphasia&#44; established by the Colombian-certified Speech and Language Pathologists who referred them&#46; To confirm the presence of aphasia in stroke participants and the absence of aphasia in neurotypical controls&#44; all participants completed a Spanish version of the Language Screening Test &#40;LAST<a class="elsevierStyleCrossRef" href="#bb0100"><span class="elsevierStyleSup">20</span></a>&#41;&#46; The LAST includes a short assessment of naming&#44; repetition&#44; automatic speech&#44; and auditory comprehension of words and sentences&#46; LAST was chosen given resource and time limitations to complete the battery of language and semantic memory assessments in Colombia&#46; To further assess language impairments in participants with aphasia&#44; a language battery of noun and verb naming and comprehension was administered&#46;<a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0110"><span class="elsevierStyleSup">22</span></a> See <a class="elsevierStyleCrossRef" href="#t0010">Table 2</a> for language assessment performance&#46;</p><elsevierMultimedia ident="t0010"></elsevierMultimedia></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0085">Semantic memory assessments</span><p id="p0050" class="elsevierStylePara elsevierViewall">Semantic memory was assessed using current clinical-standard tests&#46; To assess <span class="elsevierStyleItalic">object-</span> and <span class="elsevierStyleItalic">action-related semantic memory</span>&#44; participants were given the Pyramids and Palm Trees &#40;PPT<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a>&#41; and the Kissing and Dancing Task &#40;KDT<a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a>&#41;&#44; respectively&#46; The PPT has norms for neurotypical Spanish speakers from Spain and Argentina&#46;<a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0115"><span class="elsevierStyleSup">23</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0120"><span class="elsevierStyleSup">24</span></a> KDT does not have established norms in Spanish&#44; but it has been adapted to meet the needs of non-English populations&#46;<a class="elsevierStyleCrossRef" href="#bb0075"><span class="elsevierStyleSup">15</span></a> For both PPT and KDT&#44; participants viewed images on a computer screen and indicated which of 2 images went best with a reference picture&#46; Participants pressed buttons on a computer keyboard that corresponded to images displayed on the left- or right-hand side of the screen&#46; There were 3 practice trials and 52 experimental trials for each of these assessments&#46;</p><p id="p0055" class="elsevierStylePara elsevierViewall">To assess <span class="elsevierStyleItalic">event-related semantic memory</span>&#44; participants were given the Event Task&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Participants viewed a naturalistic colored photograph on the computer screen and indicated whether each scene was something that &#8220;might normally happen&#8221;&#46; Participants pressed buttons on a laptop keyboard labeled &#8220;yes&#8221; and &#8220;no&#8221;&#46; Participants were instructed to respond as quickly and accurately as possible and were provided 5&#8239;s to respond before the program continued to the next trial&#46; There were 4 practice trials and 256 experimental trials&#44; which were separated by a halfway break&#46; Additional Event Task details&#44; including development and norming&#44; are reported in Dresang et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> and the complete stimulus set is located at <a href="https://osf.io/pzqcj/">https&#58;&#47;&#47;osf&#46;io&#47;pzqcj&#47;</a>&#46; All semantic memory assessments were administered on a computer&#44; using E-Prime 2&#46;0&#46;<a class="elsevierStyleCrossRef" href="#bb0125"><span class="elsevierStyleSup">25</span></a> Semantic memory assessments and procedures were exact replications of those reported in Dresang and colleagues&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a></p><p id="p0060" class="elsevierStylePara elsevierViewall">The Institutional Review Board of the University of Pittsburgh approved this international research&#46; Ethical approval from the partner institutions in Colombia was also obtained &#40;Colombian Institute of Neurosciences and the aphasia support group &#91;EFUNA&#93; sponsored by the National University of Colombia&#41;&#46;</p></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0090">Analyses</span><p id="p0065" class="elsevierStylePara elsevierViewall">We implemented Bayesian generalized linear mixed-effects models using Stan with the BRMS package in the R statistical software version 4&#46;2&#46;2&#46;<a class="elsevierStyleCrossRefs" href="#bb0130"><span class="elsevierStyleSup">26&#8211;29</span></a> We used a Bernoulli probability distribution with a logit link function and weakly informative priors for beta coefficients for all models&#46; Default BRMS priors were used for all other model parameters&#46; We ran 4 Hamiltonian Markov Chain Monte Carlo &#40;MCMC&#41; chains&#44; for each model&#44; with 6000 iterations&#46; The initial 1500 chains were used as a warm-up&#59; thus&#44; they were not included in the parameters&#39; estimation&#46; Model convergence was examined using the Gelman-Rubin Potential Scale Reduction statistic &#40;&#770;R&#41;&#44; the number of effective samples&#44; and trace plots&#46; Model fit was examined using posterior predictive checks&#46; We have provided details about model convergence&#44; model fit&#44; and comprehensive model results in the supplemental materials&#46;</p><p id="p0070" class="elsevierStylePara elsevierViewall">For research question 1&#44; we used 2 models testing the prediction that event semantic-memory representations reflect action and object knowledge<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a> in people with aphasia&#46; The first model &#40;action knowledge&#41; used trial-level accuracy in the Event Task as a dependent variable and a fixed effect of mean KDT performance per participant&#46; LAST performance served as a control variable to approximate overall aphasia severity&#44; given that aphasia severity accounts for significant variability in performance for any task&#46;<a class="elsevierStyleCrossRef" href="#bb0150"><span class="elsevierStyleSup">30</span></a> Random effects included intercepts for participants and items and random slopes within participants for aphasia severity and KDT performance&#46; The second model &#40;object knowledge&#41; used the same dependent variable as the model above but with a fixed effect of mean PPT performance per participant&#46; Random effects included intercepts for participants and items and random slopes within participants for aphasia severity and PPT performance&#46; All variables &#40;PPT&#44; KDT&#44; and LAST&#41; were scaled and centered around their respective means&#46;</p><p id="p0075" class="elsevierStylePara elsevierViewall">For research question 2&#44; we used 3 models to explore whether assessments of object-&#44; action-&#44; and event-related semantic memory could distinguish between people with aphasia and people without aphasia &#40;age&#44; gender&#44; and education-matched controls&#41;&#46; In the first model&#44; we used trial-level accuracy in PPT as the dependent variable and group &#40;PWA vs&#46; controls&#41; as a fixed effect&#59; with controls as a reference value&#46; Random effects included intercepts for participants and items and random slopes within participants for aphasia severity &#40;LAST&#41;&#46; In the second model&#44; we used trial-level accuracy in KDT as the dependent variable with the same fixed and random effects structure as the model above&#46; Similarly&#44; in the third model&#44; we used trial-level accuracy in the Event Task as the dependent variable with the same fixed and random effects structure described above&#46; We have provided details of all models in the supplemental materials&#46;</p></span></span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0095">Results</span><p id="p0080" class="elsevierStylePara elsevierViewall">For research question 1 regarding the relationship between object&#44; action&#44; and event semantic memory&#44; we found that KDT was a reliable predictor of Event Task performance &#40;&#946;&#8239;&#61;&#8239;0&#46;64&#44; 90&#37; CI&#58; 0&#46;15&#44; 1&#46;28&#41;&#46; Although PPT was not a reliable predictor of Event Task performance &#40;&#946;&#8239;&#61;&#8239;0&#46;45&#44; 90&#37; CI&#58; &#8722;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#44; 0&#46;93&#41;&#44; there was evidence of positive effects when examining its posterior distribution&#46; Specifically&#44; 94&#37; of the posterior distribution for this effect was greater than zero&#46; This provides weak but positive evidence that PPT is associated with Event Task performance&#46; Together&#44; these results provide preliminary evidence that better access to object and action semantic memory may be associated with better Event Task performance in Colombian people with aphasia&#46; Semantic memory performance for all participants is reported in <a class="elsevierStyleCrossRef" href="#t0015">Table 3</a>&#46;</p><elsevierMultimedia ident="t0015"></elsevierMultimedia><p id="p0085" class="elsevierStylePara elsevierViewall">For research question 2&#44; group reliably predicted trial-level accuracy on PPT &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61; &#8722;0&#46;57&#44; 90&#37; CI&#58; &#8722;<span class="elsevierStyleHsp" style=""></span>1&#46;03&#44; &#8722;<span class="elsevierStyleHsp" style=""></span>0&#46;11&#41;&#44; with participants with aphasia performing worse than controls&#46; Group did not reliably predicted trial-level accuracy on KDT &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61; &#8722;0&#46;63&#44; 90&#37; CI&#58; &#8722;<span class="elsevierStyleHsp" style=""></span>1&#46;25&#44; 0&#46;01&#41; or the Event Task &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61; &#8722;0&#46;47&#44; 90&#37; CI&#58; &#8722;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#44; 0&#46;08&#41;&#59; however&#44; there was evidence of positive effects when examining their posterior distributions&#46; Specifically&#44; 95&#37; and 92&#37; of the posterior distributions for group predicting KDT and the Event Task&#44; respectively&#44; were below zero&#46; These results provide weak but positive evidence that participants with aphasia performed worse than controls in both of these assessments&#46; Taking these results into consideration&#44; we provide preliminary evidence that PPT&#44; KDT&#44; and the Event Task could each distinguish between people with and without aphasia in the Colombian context&#46; However&#44; these findings require additional examination and replication&#46;</p></span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0100">Discussion</span><p id="p0090" class="elsevierStylePara elsevierViewall">This work examined semantic memory performance in a group of Colombian adults with post-stroke aphasia and age-matched neurotypical controls to address 2 research questions&#46; First&#44; this study investigated the relationship of impaired performance across domains of semantic memory&#44; examining whether event knowledge impairments were related to action- and object-knowledge impairments&#44; as has previously been found in a sample of English-speaking US stroke survivors with aphasia&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Second&#44; this study evaluated whether assessments of object-&#44; action-&#44; and event-related semantic memory could distinguish between people with and without aphasia in monolingual Colombian Spanish-speaking adults&#46; This preliminary work provides a step toward developing sociolinguistically sensitive models of cognitive impairments and assessment measures for diverse patient populations&#46;</p><p id="p0095" class="elsevierStylePara elsevierViewall">The current results are largely consistent with previous findings that performance on object- and action-related semantic memory can independently predict event semantic memory performance in adults with aphasia&#46; We found that stronger action semantic performance was robustly associated with stronger event semantic memory&#46; We also found weak&#44; but positive evidence that object semantic memory was associated with event semantic memory&#46; This broadly replicates findings from the same assessment measures used in adults with aphasia in the USA&#58; Dresang and colleagues<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> found that both PPT and KDT performance predicted Event Task performance in 26 English-speaking adults with chronic stroke aphasia&#46; If replicated and further examined&#44; these results would support the hypothesis that event representations reflect a combination and possible binding of object and action semantic knowledge&#46;<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a> As such&#44; specific variations in world knowledge may not be expected to influence general interactions between object&#44; action&#44; and event domains of semantic memory&#46; However&#44; future work is still required to thoroughly evaluate the contributions of sociolinguistic variations in semantic memory&#46;</p><p id="p0100" class="elsevierStylePara elsevierViewall">In addition&#44; this study offers preliminary evidence suggesting that different semantic-memory measures may distinguish between people with and without aphasia in Spanish-speaking Colombian adults&#46; We found that participant group status reliably predicted performance on object-related semantic memory&#44; but action- and event-related semantic memory did not&#46; However&#44; the posterior distributions provide weak but positive evidence suggesting that all 3 semantic memory assessments could be sensitive to the presence of aphasia&#44; which is consistent with previous findings in monolingual English-speaking adults in the USA&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Given the semantically rich and experience-driven nature of event knowledge&#44; it is possible that compared to objects&#44; event semantic memory may be susceptible to greater variation across individuals of different cultural and linguistic backgrounds&#46;<a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0165"><span class="elsevierStyleSup">33</span></a> Thus&#44; action and event semantic memory measures that are more sociolinguistically appropriate to the target population might improve reliability in distinguishing between Colombian adults with and without aphasia&#46; Additional research is required to characterize sociolinguistic similarities and differences in semantic memory and to establish clinical assessments that are sensitive to semantic memory impairments in diverse patient populations&#46;</p><p id="p0105" class="elsevierStylePara elsevierViewall">There remains a lack of assessments with appropriate psychometric properties that measure semantic memory in Spanish speakers with aphasia&#44; particularly in Latin American countries&#46; More broadly&#44; very few aphasia tests have been standardized and normed in languages other than English&#44; which challenges the reliability and validity of these measures when applied to diverse populations&#46;<a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a> This study takes an important first step in examining semantic memory assessments in monolingual Spanish-speaking Colombian adults with and without aphasia&#46; As a preliminary investigation&#44; this work is limited by a non-standardized translation of the LAST and modest sample sizes&#46; Future work should use a Spanish-normed assessment of aphasia severity and pursue larger sample sizes in this and other Latin American groups&#46; As mentioned above&#44; culturally and linguistically appropriate assessment adaptations are also required&#46; Overall&#44; it is crucial to continue to pursue adaptations of aphasia assessments and treatments to multiple languages&#46;</p></span><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0105">Conclusion</span><p id="p0110" class="elsevierStylePara elsevierViewall">The current study replicated and extended previous findings that object and action deficits contribute to event memory impairments in aphasia&#46; Furthermore&#44; the current findings provided preliminary evidence that clinical-standard semantic memory assessments could distinguish between Colombian adults with and without aphasia&#44; but further examination is required&#46; This work underscores the need for culturally and linguistically appropriate adaptations of neuropsychological tests so that clinical advancements can reach broader patient populations in Spanish-speaking Latin American communities&#46;</p></span><span id="s0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0110">Informed consent</span><p id="p0115" class="elsevierStylePara elsevierViewall">This work involved the use of human subjects&#46; All work described herein has been carried out in accordance with The Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41; for experiments involving humans&#46; All subjects had comprehension sufficient to understanding study demands and participation involvement&#46; Informed consent was obtained&#44; and privacy rights of human subjects were observed in accordance with the University of Pittsburgh Institutional Review Board approval&#46;</p></span><span id="s0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0115">Ethical considerations</span><p id="p0120" class="elsevierStylePara elsevierViewall">The Institutional Review Board &#40;IRB&#41; of the University of Pittsburgh approved this international research&#46; Ethical approval from the partner institutions in Colombia was also obtained &#40;Colombian Institute of Neurosciences and the aphasia support group &#91;EFUNA&#93; sponsored by the <span class="elsevierStyleGrantSponsor" id="gts0005">National University of Colombia</span>&#41;&#46; All work was carried out in accordance with The Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41;&#46;</p></span><span id="s0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0120">Funding and acknowledgments</span><p id="p0125" class="elsevierStylePara elsevierViewall">This research was supported by the Tinker Summer Field Research Grant from the Center for Latin American Studies &#40;<span class="elsevierStyleGrantSponsor" id="gts0010">University of Pittsburgh</span>&#41; awarded to Yina Quique&#46; It was also supported by the Stanley Prostrednik Health Sciences Grant from the <span class="elsevierStyleGrantSponsor" id="gts0015">University of Pittsburgh</span>&#8216;s Nationality Rooms and Intercultural Exchange Programs awarded to Haley Dresang&#46; The authors are grateful to the Instituto Colombiano de Neurociencias &#40;Dr&#46; Jorge Eslava&#41; and the EFUNA team at Universidad Nacional de Colombia&#46;</p></span></span>"
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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Purpose</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">This work evaluates clinical-standard semantic memory assessments in monolingual Spanish-speaking Colombian adults with and without aphasia&#44; addressing 2 aims&#58; &#40;1&#41; to examine whether event semantic memory is related to object and action semantic memory performance&#59; and &#40;2&#41; to explore whether clinical-standard semantic memory assessments can distinguish between Colombian adults with and without aphasia&#46;</p></span> <span id="as0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Methods</span><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">Object&#44; action&#44; and event semantic memory clinical assessments were used evaluate 16 adults with aphasia and 16 matched controls from Colombia&#46; Bayesian linear mixed-effects models were used to examine the 2 specific aims&#46;</p></span> <span id="as0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Results</span><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall">First&#44; results replicated and extended findings that object and action deficits may contribute to event semantic memory impairments in aphasia&#46; Second&#44; results suggested that clinical-standard semantic memory assessments may distinguish between people with and without post-stroke aphasia in a Colombian sample&#46;</p></span> <span id="as0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Conclusion</span><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall">This work identifies the need to continue developing sociolinguistically sensitive neuropsychological assessments&#44; which are critical for establishing valid cognitive models and improving clinical diagnostics and treatments in diverse populations of stroke survivors&#46;</p></span>"
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        "resumen" => "<span id="as0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Prop&#243;sito</span><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall">Este trabajo busca examinar evaluaciones cl&#237;nicas de memoria sem&#225;ntica en adultos monoling&#252;es hispanohablantes colombianos con y sin afasia&#46; Se describen dos objetivos&#58; &#40;1&#41; examinar si la memoria sem&#225;ntica de eventos se relaciona con la memoria sem&#225;ntica de objetos y acciones&#59; y &#40;2&#41; explorar si las evaluaciones cl&#237;nicas de memoria sem&#225;ntica pueden distinguir entre adultos colombianos con y sin afasia&#46;</p></span> <span id="as0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">M&#233;todos</span><p id="sp0070" class="elsevierStyleSimplePara elsevierViewall">Se utilizaron evaluaciones cl&#237;nicas de memoria sem&#225;ntica de objetos&#44; acciones y eventos en 16 adultos con afasia y 16 controles de Colombia&#46; Se utilizaron modelos bayesianos lineales de efectos mixtos para examinar los dos objetivos espec&#237;ficos&#46;</p></span> <span id="as0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Resultados</span><p id="sp0075" class="elsevierStyleSimplePara elsevierViewall">Primero&#44; nuestros resultados replican y ampl&#237;an hallazgos previos que indican que los d&#233;ficits de memoria semantica de objetos y acciones contribuyen a las alteraciones de la memoria sem&#225;ntica de eventos en personas con afasia&#46; Segundo&#44; nuestros resultados sugirieren que las evaluaciones de memoria sem&#225;ntica cl&#237;nica pueden distinguir entre personas con y sin afasia en una muestra colombiana&#46;</p></span> <span id="as0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Conclusi&#243;n</span><p id="sp0080" class="elsevierStyleSimplePara elsevierViewall">Este trabajo resalta la necesidad de desarrollar evaluaciones neuropsicol&#243;gicas que sean socioling&#252;&#237;sticamente apropiadas&#46; Estas evaluaciones son cr&#237;ticas para establecer modelos cognitivos v&#225;lidos para cada poblaci&#243;n&#44; y para mejorar el diagn&#243;stico y tratamiento de poblaciones diversas con afasia&#44; sobrevivientes de accidentes cerebrovasculares&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "as0025"
            "titulo" => "Prop&#243;sito"
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          1 => array:2 [
            "identificador" => "as0030"
            "titulo" => "M&#233;todos"
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          2 => array:2 [
            "identificador" => "as0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "as0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="p0140" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="ec0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "s0070"
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:8 [
        "identificador" => "t0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "al0005"
            "detalle" => "Table "
            "rol" => "short"
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        "tabla" => array:3 [
          "leyenda" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">SD&#8239;&#61;&#8239;standard deviation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ID<a class="elsevierStyleCrossRef" href="#tf0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gender&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">MPO<a class="elsevierStyleCrossRef" href="#tf0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ID&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gender&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Edu&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">301&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">TBI<a class="elsevierStyleCrossRef" href="#tf0030"><span class="elsevierStyleSup">f</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">639&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">66&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">302&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA<a class="elsevierStyleCrossRef" href="#tf0035"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">303&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">716&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">304&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">705&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">305&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">702&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">312&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">552&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">710&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">313&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">703&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">314&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">712&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3652973.png"
              ]
            ]
          ]
          "notaPie" => array:7 [
            0 => array:3 [
              "identificador" => "tf0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="np0005">ID&#8239;&#61;&#8239;participant identification number &#40;300 for PWA&#44; 700 for controls&#59; each row shows a match between PWA and controls&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tf0010"
              "etiqueta" => "b"
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          "leyenda" => "<p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">&#42;All values&#44; except for participant ID are given in percentage correct&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">ID&#8239;&#61;&#8239;participant identification number &#40;300 for PWA&#44; 700 for controls&#41;&#59; SM&#8239;&#61;&#8239;semantic memory subtest from the CAT&#59; RM&#8239;&#61;&#8239;recognition memory subtest from the CAT&#59; LAST<span class="elsevierStyleInf">P</span>&#8239;&#61;&#8239;language production score from the LAST&#59; LAST<span class="elsevierStyleInf">C</span>&#8239;&#61;&#8239;language comprehension score from the LAST&#59; LAST<span class="elsevierStyleInf">T</span>&#8239;&#61;&#8239;LAST total score&#59; VCT&#8239;&#61;&#8239;Verb Comprehension Test &#40;VCT&#41; from the Northwestern Assessment of Verbs and Sentences&#59; PALPA&#8239;&#61;&#8239;Spanish adaptation of the Psycholinguistic Assessments of Language Processing in Aphasia number 47&#59; Objects&#8239;&#61;&#8239;percentage correct of objects from the Object and Action Naming Battery &#40;OANB&#41;&#59; Actions&#8239;&#61;&#8239;percentage correct of actions from the Object and Action Naming Battery &#40;OANB&#41;&#46;</p>"
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                  """
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos