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Biomedical subjects

L B Smith

Publications and source records attributed to L B Smith.

At least 55 records · Page 3Linked to original sources

Evidence for the abstractive encoding of superficial position information in visual patterns.

When presented a series of patterns inside a frame, subjects unintentionally retained information concerning the frame-relative location of the elements composing the patterns; they could use this superficial information to estimate the frequency with which the elements occurred at various locations within the frame. There were two aspects of the results that supported the hypothesis that this superficial element-location information was abstractively encoded and, therefore, retrievable independent of the patterns comprising the elements: (1) Correlations between actual and estimated frequency remained significant after the effects of pattern recall were partialled out, and (2) correlations were enhanced by assuming that the frequency estimate for each location was affected by the imprecise coding of position for elements falling in surrounding locations. Additional experiments indicated that an orienting task emphasizing pattern recall resulted in very inaccurate estimation of element-location frequency, and intentional instructions improved the precision of position coding for individual elements.

Adult↗

Kawasaki syndrome and the eye.

Kawasaki syndrome is a systemic vasculitis in which bilateral nonexudative conjunctivitis and bilateral anterior uveitis are common findings early in the course of the illness. Slit lamp examination is a useful clinical tool in differentiating patients with KS from patients with other diseases characterized by fever, rash and bilateral conjunctivitis. Referral to a pediatric ophthalmologist early in the course of the illness can help in the diagnosis of this disease.

Conjunctival Diseases↗

Perceptual development.

Our selective review of perceptual development has attempted to highlight three different structural levels: sensory primitives, perceptual representations, and higher-order operations. Each of these levels appears to undergo considerable development. Moreover, both within- and between-level developments appear to influence the emergence and form of perceptual abilities. The distinction between levels is often elusive, defined more by task than by logic. As a result, some distinctions seem clearer than others. First, the emergence of sensory primitives, particularly in the visual modality, may severely constrain the quality of perceptual representations. Despite these constraints, however, there is strong support for the hypothesis that distal stimulation is primary at the level of perceptual representation. Second, perceptual representations, particularly in the domain of speech sounds, appear to undergo considerable reorganization that cannot be attributed to the emergence of sensory primitives. Although some of this development in perceptual representations can be attributed to representational changes per se, much of this reorganization at the level of perceptual representations appears to be mediated by emerging cognitive operations and linguistic processes. Unfortunately, an evaluation of reorganizational factors (e.g. familiarity) that are potentially independent of higher-order cognitive and language influences is confounded by the co-occurrence of postnatal experience with the emergence of more mature cognitive and language abilities. Obviously, to disentangle the effects of experience from the effects of higher-order processes on perceptual development, it would be necessary either to eliminate these higher-order processes or to accelerate their potential influence. Controlled experiments of this sort are difficult or impossible to conduct with humans, although suitable animal models of some aspects of perceptual development may be possible. Current and future research on perceptual development appears to be directed toward three general goals. First, the ecological and psychophysical perspectives appear headed for a marriage that will enhance both the richness and the utility of these two approaches. Second, computational techniques appear to offer a new level of sophistication that should force developmentalists to sharpen their hypotheses and to make point predictions rather than simple directional predictions. Third, the search will continue for methods to assess the role of higher-order processes.

Child↗

What do two-year-olds know about the sizes of things?

Knowledge about the sizes of things is an integral part of object concepts. In 5 experiments, we examined 2-, 3-, 4-year-olds' and adults' internalized representations of the sizes of buttons, plates, and shoes. We found that 3- and 4-year-olds had accurate knowledge of the typical sizes of buttons and plates. 2-year-olds' knowledge of plate and button sizes was more fragile; however, they demonstrated accurate internal representations of the sizes of shoes. The studies provide new empirical evidence about the young child's knowledge of the sizes of 3 everyday objects. The findings also suggest that the size of an object may be more accurately represented if its size is highly relevant for the object's intended function.

Attention↗

Gastric partitioning for morbid obesity: postoperative weight loss, technical complications, and protein status.

The study of 325 patients who underwent gastric partitioning (stapling) was undertaken to assess the complications and weight-loss records over a 5-year period. A subgroup of 15 patients was studied to determine protein status preoperatively and 2, 4, and 6 months after surgery. Laboratory tests, anthropometric measures, and food records were used to assess patient health and nutritional status. Four operative techniques have been used by a surgeon in Reno, NV, since 1979. The main postoperative complication in the first two procedures, a nonreinforced horizontal staple line (Groups 1 and 2), was staple line disruption and, therefore, poor weight-loss results. The staple line was reinforced in the next 193 patients (Group 3), and the patients followed a blenderized diet for 8 weeks postoperatively. Persistent vomiting was the most common problem in that group; 24% required dilatation of the stoma via gastroscopy. The vertical staple procedure was adopted for the next 48 patients (Group 4) to further minimize disruption and severe vomiting. Other operative complications were relatively few. At 48 and 18 months, respectively, Groups 3 and 4 showed an average weight loss of 27% of the preoperative weight. Eating patterns and food tolerances changed dramatically postoperatively, and protein intake dropped significantly. Mean protein intakes below standard recommended dietary allowance (RDA) were observed in a subgroup of Groups 3 and 4. However, the mean total lymphocyte count and albumin values demonstrated that patients were not compromising visceral proteins. The mean creatinine height indexes and arm muscle areas showed no significant difference in somatic protein status.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

What is "high"? The development of reference points for "high" and "low".

Young children have been characterized as interpreting relative adjectives as if they were nominal or categorical terms. The categorical interpretation of relative terms, however, may be quite complex. Indeed, the mature understanding of relative terms would seem to include a complex system of reference points for the terms' categorical usages. In 5 experiments we examined the complexity of 3-5-year-old children's and adults' categorical interpretations. We specifically examined how reference points for the categorical interpretation of high and low are defined. The definition of reference points relative to the object judged, the vertical position of the observer, and the extent of vertical variation were assessed. 3 major developmental trends were observed: a trend from the application of the terms to only extreme values to their application to broader categories; a trend from nominal-like categories to ones defined flexibly relative to context (e.g., nature of object judged, and extent of vertical variation); and a trend from reference points functioning as focal points to their operating as directional category boundaries. In brief, the results suggest that the categorical usage of relative terms involves a rich and intricate knowledge system and that it takes children considerable time to acquire and organize the relevant pieces of knowledge.

Child, Preschool↗

Effects of color stimulation and information on the copying performance of attention-problem adolescents.

The optimal stimulation theory proposes that hyperactive children are less tolerant of lower levels of arousal than nonhyperactive children and should thus derive greater gains from stimulation added to repetitive copying tasks than do comparisons. To test this hypothesis, 16 adolescents, rating high on attention and behavior problems, were matched on the basis of age and poor handwriting performance to 16 controls. Matched pairs were randomly assigned to treatment order (high-stimulation colored letters followed in 2 weeks by low-stimulation black letters or the reverse order) and to level of information (color added to difficult letter parts or added to randomly selected letters), counterbalanced for treatment order and level of information within each order. Errors and activity were subjected to a mixed-design analysis of covariance, with IQ the covariate. The major findings indicated that attention-problem adolescents performed better with high-stimulation task stimuli than with low, relative to the opposite performance pattern of controls. Different responding was significant for experimental but not for control children.

Achievement↗

Young children's attention to global magnitude: evidence from classification tasks.

Young children often compare objects holistically and not in terms of separate dimensions such as size and color. One holistic relation that often governs young children's object comparisons is overall similarity. Two experiments were conducted to examine the possibility that a holistic magnitude relation might also govern children's object comparisons. Objects varying on two dimensions of magnitude-size and saturation--were classified by 3-, 4-, and 5-year-olds. The results indicated that the younger children were sensitive to global magnitude as well as overall similarity. They grouped together large and saturated objects or small and desaturated objects more often than they did large and desaturated (or small and saturated) objects and thus appear to have been classifying by combined magnitude across both dimensions. This new finding that young children classify by a global relation of magnitude refines the understanding of perceptual development and provides information about the structure of perception. Young children's use of global magnitudes in classification also fits well with recent findings about children's acquisitions of dimension words.

Attention↗

Young children's understanding of attributes and dimensions: a comparison of conceptual and linguistic measures.

Preschoolers' (2-, 3-, and 4-year-olds) understanding of attributes and dimensions was examined in 3 experiments. Attribute knowledge is the knowledge that a particular attribute--for example, red--can be instantiated in a variety of distinct objects. Dimension knowledge is the knowledge that there are qualitatively distinct kinds of attributes; for example, red and blue are attributes of the same kind, a kind that is different from that of big. Preschoolers' understanding of attributes and dimensions was assessed by both a conceptual measure and a linguistic measure. A language-free follow-the-leader task served as the conceptual measure. In this task, all the children showed strong attribute knowledge. However, 2-year-olds did not appear to differentiate attributes into their dimensional kinds. The observed trend in the linguistic task was not isomorphic to that observed in the conceptual task. The acquisition of some attribute and dimension labels appears to follow closely the trend in conceptual development, whereas the acquisition of others (specifically, size-attribute labels) lags severely behind the attainment of the basic concepts. The results provide new information about the development of object comparison and the acquisition of dimensional terms.

Child Development↗

Phase I trial of aclacinomycin-A. A clinical and pharmacokinetic study.

Aclacinomycin-A is a new anthracycline antibiotic with a broad spectrum of antitumor activity in animals. Compared to doxorubicin, it was found to produce less cardiotoxicity and alopecia. A Phase I trial of aclacinomycin-A given as a weekly 15 min IV infusion was conducted in 20 previously treated patients with advanced solid tumors. Four dose levels ranging from 40 to 100 mg/m2 were studied; myelotoxicity was dose-limiting at 85 and 100 mg/m2. Other toxicities were moderate to severe nausea and vomiting in 9 patients, mild phlebitis in 2 patients, and mild abnormality of liver function tests in 3 patients. No cardiac or renal toxicities were seen, but two partial responses were observed. The pharmacokinetic profile of aclacinomycin-A in plasma and urine was studied in 3 patients given 65 mg/m2 using a high performance liquid chromatography assay. The data obtained were consistent with a two compartment model of drug disposition with initial and terminal half-life values of 6.6 min and 13.3 h, respectively. The major fluorescent metabolite was eliminated with a terminal half-life of 25 h. Two metabolites as well as the parent drug were excreted in the urine as less than 10% of the doses given. This pharmacokinetic profile is similar to that of other anthracyclines, although aclacinomycin-A appears to have lower blood levels than doxorubicin given at equivalent doses. On this weekly schedule, the recommended dose is 65 mg/m2 for Phase II trials.

Aclarubicin↗

Results and complications of gastric partitioning. Four year follow-up of 300 morbidly obese patients.

Two-hundred seventy-seven morbidly obese patients were followed 6 to 48 months through three modifications of gastric partitioning. Technical failures caused poor results in 75 percent of patients in Groups I and II. Group III patients were operated on using a single TA-90 application with three midlateral staples removed. The proximal staple line was reinforced by a row of interrupted 2-0 silk sutures and a circumferential 1-0 silk suture supported with Teflon pledgets around the stoma. This technique effected good or excellent weight loss in 70 percent of the patients. Complications were minimal except for stomal dilatation through the gastroscope required in 22 percent of the patients and staple line disruption despite reinforcing maneuvers in 7 percent. Because of the dilatations and the 7 percent technical failure, I recently adopted the vertical gastroplasty as described by Eckhout and Prinzing [5]. Long-term follow-up by an experienced team consisting of a surgeon, gastroenterologist, dietition, and supportive staff is essential for the continued success of the surgical management of the morbidly obese patient.

Follow-Up Studies↗

Modification of the gastric partitioning operation for morbid obesity.

Two hundred patients operated on for morbid obesity were followed through the evolution and modification of gastric partitioning. Twenty-six patients (group I) were treated by complete TA-90 partitioning with a 1.2 cm gastrogastrostomy; only 23 percent had an excellent result. Fifty-nine (group II) were treated with a single TA-90 partitioning from which three staples were removed to form the stoma between the proximal and distal stomach; 44 percent had excellent results. One hundred fifteen patients (group III) were treated with TA-90 partitioning (three staples removed) using additional staple line reinforcement with 2-0 interrupted silk sutures and support of the stoma with a circumferential 1-0 silk suture reinforced with Teflon pledgets; all have had a good or excellent response. There have been minimal complications and no deaths. We encourage the adoption of this procedure as a safe and reliable surgical method in attacking the problem of morbid obesity. These patients must be treated by a team of surgeons, dietitians, nurses and office personnel who will provide the long-term support system necessary for the behavior modification induced by the surgery.

Adolescent↗

Importance of the overall similarity of objects of adults' and children's classifications.

Previous work has shown that adults and older children tend to classify multi-dimensional objects by identity on one dimension, whereas children under 8 years of age tend to classify these same objects by a relation of overall similarity. The present study investigated the hypothesis that this developmental trend is restricted to the classification of simple objects that differ only by limited amounts on a few dimensions. The specific hypothesis was that overall-similarity relations structure both adults' and children's classifications of heterogenous objects (objects that differ in a variety of ways). This hypothesis was suggested by the correspondence between the structure of young children's classifications and the structure of natural categories. The result of two experiments supported the hypothesis. When the to-be-classified objects varied simultaneously on relatively many dimensions, adults as well as children constructed classifications that maximized within-category similarity on all varying dimensions. The implications of these results for accounts of the perception of multidimensional relations and classificatory behavior are discussed.

Adult↗