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PubMed2006

Do you see what I mean? Shared reference in non-native, early signing deaf children.

A group of non-native, early signing deaf children between the ages of 7 and 11 years were tested on a referential communication task. A group of hearing children matched for sex and mental and chronological age were also included in the study. The aim was to study the deaf children's ability to take another persons perspective in a task that resembled a real-life communicative situation to a higher extent than the standard theory of mind (ToM) tasks. A further aim was to investigate the possible importance of a number of background variables such as mental and chronological age, working memory, and false-belief attribution. Results show that the hearing children outperformed the deaf children on the referential communication task and that results were highly correlated with both chronological and mental age, as well as with working memory. There was a positive, but not significant, correlation between false belief and success on the referential communication task. This is an indication that the two tasks tap different abilities and that false belief might be necessary, but not sufficient in order to be skilled in the art of referential communication. The possible role of working memory in the referential communication task is also discussed. The results support the hypothesis of the importance of early talk about mental states for the later development of ToM abilities.

Analysis of Variance↗
PubMed2005

Alcoholic neurobiology: changes in dependence and recovery.

This article presents the proceedings of a symposium held at the meeting of the International Society for Biomedical Research on Alcoholism (ISBRA) in Mannheim, Germany, in October, 2004. Chronic alcoholism follows a fluctuating course, which provides a naturalistic experiment in vulnerability, resilience, and recovery of human neural systems in response to presence, absence, and history of the neurotoxic effects of alcoholism. Alcohol dependence is a progressive chronic disease that is associated with changes in neuroanatomy, neurophysiology, neural gene expression, psychology, and behavior. Specifically, alcohol dependence is characterized by a neuropsychological profile of mild to moderate impairment in executive functions, visuospatial abilities, and postural stability, together with relative sparing of declarative memory, language skills, and primary motor and perceptual abilities. Recovery from alcoholism is associated with a partial reversal of CNS deficits that occur in alcoholism. The reversal of deficits during recovery from alcoholism indicates that brain structure is capable of repair and restructuring in response to insult in adulthood. Indirect support of this repair model derives from studies of selective neuropsychological processes, structural and functional neuroimaging studies, and preclinical studies on degeneration and regeneration during the development of alcohol dependence and recovery form dependence. Genetics and brain regional specificity contribute to unique changes in neuropsychology and neuroanatomy in alcoholism and recovery. This symposium includes state-of-the-art presentations on changes that occur during active alcoholism as well as those that may occur during recovery-abstinence from alcohol dependence. Included are human neuroimaging and neuropsychological assessments, changes in human brain gene expression, allelic combinations of genes associated with alcohol dependence and preclinical studies investigating mechanisms of alcohol induced neurotoxicity, and neuroprogenetor cell expansion during recovery from alcohol dependence.

Adult↗
PubMed2005

Beyond emotion archetypes: databases for emotion modelling using neural networks.

There has been rapid development in conceptions of the kind of database that is needed for emotion research. Familiar archetypes are still influential, but the state of the art has moved beyond them. There is concern to capture emotion as it occurs in action and interaction ('pervasive emotion') as well as in short episodes dominated by emotion, and therefore in a range of contexts, which shape the way it is expressed. Context links to modality-different contexts favour different modalities. The strategy of using acted data is not suited to those aims, and has been supplemented by work on both fully natural emotion and emotion induced by various technique that allow more controlled records. Applications for that kind of work go far beyond the 'trouble shooting' that has been the focus for application: 'really natural language processing' is a key goal. The descriptions included in such a database ideally cover quality, emotional content, emotion-related signals and signs, and context. Several schemes are emerging as candidates for describing pervasive emotion. The major contemporary databases are listed, emphasising those which are naturalistic or induced, multimodal, and influential.

Computer Simulation↗
PubMed2003

Diagnosis of coronary artery disease by stress echocardiography and perfusion scintigraphy.

This meta-analysis was performed to compare the diagnostic efficacy of stress echocardiography (SE) and Stress perfusion studies (SPS) in detecting coronary artery disease (CAD). A meta-analysis of peer reviewed articles, published in English language, reporting head-to-head comparison of vasodilator stress echocardiography (VSE) and SPS for the diagnosis of CAD, was performed. Data of 13 studies comprising of 860 patients from 13 different institutions were analyzed. Algorithms were developed to generate raw data from published papers to calculate statistical parameters with confidence intervals and then compare them at specified significance levels. The overall diagnostic accuracy of the two tests was almost similar, 0.77 for VSE vs 0.8 for SPS (p=ns). SPS gave higher sensitivity, 0.88 vs 0.70 in cumulative data (p<0.0001) while VSE gave higher specificity, 0.90 vs 0.67 (p<0.0001). Accuracy of VSE with state-of-the-art protocols became even better than SPS (p<0.05). In hypertensive patients specificity of SPS was markedly deteriorated. Contrary to this, VSE gave higher specificity (0.90 vs 0.40) in this subgroup of patients as well. VSE might become an effective alternative of SPS where scintigraphy techniques are not available or affordable.

Coronary Artery Disease↗
PubMed2004

[Breaking bad news by the respiratory physician: a therapeutic process].

INTRODUCTION: The profession of respiratory medicine is often involved in communicating bad news, dealing with handicapping chronic disease or a poor prognosis. STATE OF THE ART: Particularly when dealing with a cancer diagnosis, the "bad news" process is poorly described in the literature. The communication techniques that are used are specific to this highly charged encountered and they are neither innate nor widely taught. Yet the performance of the doctor at this crucial stage has a bearing on the patient throughout their clinical course and later complications. Ethical values, in particular respect of the patient's right to autonomy, as well as psychological and practical issues, govern the decision of giving the diagnosis to the patient or their next of kin. PERSPECTIVES: From the patient's point of view, the breaking of bad news will be language, delivered with therapeutic intentions, which describes a significant loss. This language has the potential to unleash a mourning process, a calling into question and readjustment of direction and future plans. This process and its stages, if recognised by the doctor, can be harnessed so thatthe patient can by assisted into making correct therapeutic decisions whilst reinforcing their sense of autonomy. A study, which looks closely at the mechanisms of this process, and the benefits delivered, as well as the necessary training required by doctors, remains to be done. CONCLUSION: Breaking bad news to a patient is therefore as much a therapeutic process as the sharing of information.

Bereavement↗
PubMed2003

"Wild Child": how three principles of healing organized 12 years of psychotherapy.

Methods of conducting psychotherapy in the most severe forms of childhood posttraumatic stress disorder (PTSD), especially in those traumas discovered very early in life, are rarely reported. This paper presents such a report and in the process emphasizes three elements of treatment: abreaction (full emotional expression of the traumatic experience), context (understanding and gaining perspective on the experience), and correction (finding ways personally or through society to prevent or repair such experiences). With traumatized children, all three elements may be inserted into their therapeutic play, art, and/or talk. An overarching mood of light humor helps the transference stay positive and the child interested. The case of "Cammie," an infant who was bitten, shaken, and sexually abused, and whose 25-day-old sister was discovered at home, murdered, is the subject of this report. This little girl, upon removal at 13 months of age from her home of origin, growled, bit, sniffed sexual organs, rarely spoke, and behaved like the "feral children" described in the classic psychiatric literature. Two respected professionals diagnosed her as mentally retarded. A year in an outstanding foster home did little to improve her. At 29 months of age she was brought to the author, who saw enough imagination and pithy language to believe the child to be intelligent but severely traumatized. The author had begun to conceptualize three principles of PTSD treatment after a study of normal schoolchildren's reactions to the 1986 Challenger disaster. These three principles were used with varying emphases at different phases throughout the "wild child's" 12-year course of once-monthly therapy. Improvement beyond anyone's expectations ensued.

Adolescent↗
PubMed2024

PredIL13: Stacking a variety of machine and deep learning methods with ESM-2 language model for identifying IL13-inducing peptides.

Interleukin (IL)-13 has emerged as one of the recently identified cytokine. Since IL-13 causes the severity of COVID-19 and alters crucial biological processes, it is urgent to explore novel molecules or peptides capable of including IL-13. Computational prediction has received attention as a complementary method to in-vivo and in-vitro experimental identification of IL-13 inducing peptides, because experimental identification is time-consuming, laborious, and expensive. A few computational tools have been presented, including the IL13Pred and iIL13Pred. To increase prediction capability, we have developed PredIL13, a cutting-edge ensemble learning method with the latest ESM-2 protein language model. This method stacked the probability scores outputted by 168 single-feature machine/deep learning models, and then trained a logistic regression-based meta-classifier with the stacked probability score vectors. The key technology was to implement ESM-2 and to select the optimal single-feature models according to their absolute weight coefficient for logistic regression (AWCLR), an indicator of the importance of each single-feature model. Especially, the sequential deletion of single-feature models based on the iterative AWCLR ranking (SDIWC) method constructed the meta-classifier consisting of the top 16 single-feature models, named PredIL13, while considering the model's accuracy. The PredIL13 greatly outperformed the-state-of-the-art predictors, thus is an invaluable tool for accelerating the detection of IL13-inducing peptide within the human genome.

Humans↗
PubMed1995

Adjunctive therapy in patients with Alzheimer's disease. A practical approach.

Alzheimer's disease (AD) primarily results in memory impairment and cognitive deficits in areas such as language, visuospatial function, calculation, praxis and judgement. However, over 30% of patients with dementia develop a group of secondary behavioural disturbances, including depression, hallucinations and delusions, agitation, insomnia and wandering. Because these secondary symptoms impair patients' function, increase their need for supervision, and often influence the decision to institutionalise them, the control of these symptoms is a priority in managing AD. Psychotropic drugs, particularly antipsychotics (neuroleptics), have been a mainstay in treating many of these symptoms, but carry a high risk of adverse effects. Patients with AD may be particularly vulnerable to adverse effects of medications because of changes in pharmacokinetics and neurotransmitter systems, related to both AD and aging. At present, treating secondary symptoms of AD is more of an art than a science. For virtually every group of symptoms, older and newer classes of medications are available, with proven efficacy in patients without dementia and less clear results in AD patients. We review current treatment options and suggest preferences for each symptom complex, based on a trade-off between efficacy and adverse effects. New agents, such as selective serotonin reuptake inhibitors and atypical antipsychotics, may herald the arrival of symptom- (and receptor-) specific drugs with minimal adverse effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2006

Implementing a new ADT based on the HL7 version 3 RIM.

The University Hospitals of Geneva (HUG) are the result of the merge of six hospitals into one single organization. While a true fusion of the management has been effectively done, it was not the case 5 years after for several databases, and in particular the ADT (admission, discharge, transfer). In order to truly realize the fusion, a new ADT service has been built using state of the art technology and standards in order to replace the existing seven services. This paper presents the results of the redesign and development of the new ADT service. The data model, based on HL7 RIM, is described and the technologies selected are presented. Finally, a status after 1 year of production is presented.

Hospital Information Systems↗
PubMed1998

An anatomy memorial tribute: fostering a humanistic practice of medicine.

Medical students' first "patients" are the individuals who donate their bodies for laboratory dissection, and these first lessons of medicine serve as a model for the doctor-patient relationship. An Anatomy Memorial Tribute was initiated by students at Mount Sinai School of Medicine to honor these donors. Students and faculty shared music, art, and readings of original poetry and prose. The event facilitated dialogue about attitudes and feelings with regards to death and dying. Controversial issues included anonymity versus identification of donors and the appropriateness of professionals showing emotion in public. The feedback from both students and faculty participants in the event was overwhelmingly positive. Students wrote that the tribute provided a sense of closure for their dissection experience and reinvolved them in shaping their education; faculty indicated that it was appropriate. Memorial tributes are a first step toward fostering the personal growth and emotional preparation required for competent and compassionate patient care. To encourage a humanistic approach to medical education, faculty have the opportunity to participate in such tributes, facilitate sensitive use of language in the anatomy laboratory, and expand the broader medical school curriculum in relation to death and dying. Medical students may expand the concept of memorial tributes and enhance their professional growth in this area by sharing information, ideas, and experiences through national organizations such as the Humanistic Medicine Group of the American Medical Students Association. The capacity of physicians to effectively serve patients facing the end of life is particularly relevant in the setting of palliative medicine.

Journal Article↗
PubMed1994

[Evaluation of the entrance examination for baccalaureate nursing program].

The purpose of this study was to examine the relationship among the variables of the entrance examination for baccalaureate nursing program, records from senior high school, and records of the courses during nursing program. The variables of the entrance examination were the scores obtained by subjects on their entrance examination which included Japanese, English, Chemistry, short essay examination, and interview. Senior high school records included grade-point-average, Japanese, Social Studies, Mathematics, Science, Health Science, Arts, English and Home Economics. The variables of records during nursing program were achievement scores of the essential courses which taken by all subjects. The data were attained from records of 551 baccalaureate program graduates (graduates from 1982 to 1991, 61 students with recommendation entrance included) from one of the urban colleges of nursing in Japan. Peason product moment correlations and stepwise multiple regression analyses were used to identify the relationship between variables. As results, there were no relationship between entrance examination records and senior high school records except English (r = .47, p < .001). There was moderate relationship between entrance examination English and English during nursing program. Between senior high school record and nursing program records, there was a weak relationship between English & Foreign languages, Health Sciences & Physical Exercise, Science & Natural Science. Among those courses during nursing education, there was a tendency for English scores correlated significantly high with another courses than any other subjects. These findings indicate that educators could identify students early in their college education who would have difficulty in nursing courses and assist them in their learning.

Education, Nursing, Baccalaureate↗
PubMed1994

The "new" democratic woman of modernity: Georgia O'Keeffe and Melanie Klein.

O'Keeffe put into visual language the psychic splitting that had occurred between the sexes in the United States, attempting to integrate what had formerly been separated as feminine and masculine into the female psyche. In her most important contribution, she explored presence rather than absence and opened up possibilities for thinking about openings. The concept of the female opening in particular had heretofore been assigned a negative meaning, signifying more often than not a gaping wound rather than a space and place of possibilities. Klein's complex and evocative understanding of some of the earliest mental processes of life enabled researchers to delve into the meanings made of the presence of the mother and father and baby, in the context of the baby's body-mind. Klein's female or male baby desires to know from the beginning. She discovered splitting and projective identification, the development of anxiety and guilt under the aegis of these mental processes, the multiple meanings of aggression, and, significantly, she permitted the female baby's body to have its own language. The answers provided by O'Keeffe and Klein bequeathed new possibilities for women's self-invention and remain pivot points for female identity throughout the century, to be confronted again by the second wave of feminism beginning in the late 1960s, by "postfeminist" debates, and by a challenged psychoanalysis. A more careful probing of these issues may help us to better understand our past so as to have greater resources for a more comprehensive reading of our present.

Art↗
PubMed1995

The acquisition of the English past tense in children and multilayered connectionist networks.

The apparent very close similarity between the learning of the past tense by Adam and the Plunkett and Marchman model is exaggerated by several misleading comparisons--including arbitrary, unexplained changes in how graphs were plotted. The model's development differs from Adam's in three important ways: Children show a U-shaped sequence of development which does not depend on abrupt changes in input; U-shaped development in the simulation occurs only after an abrupt change in training regimen. Children overregularize vowel-change verbs more than no-change verbs; the simulation overregularizes vowel-change verbs less often than no-change verbs. Children, including Adam, overregularize more than they irregularize; the simulation overregularized less than it irregularized. Interestingly, the RM model--widely criticized as being inadequate--does somewhat better, correctly overregularizing vowel-change verbs more often than no-change verbs, and overregularizing more often than it irregularizes. Although Plunkett and Marchman's (1993) state of the art model incorporated hidden layers and back-propagation, used a more realistic phonological coding scheme, and explored a broader range of parameters than Rumelhart and McClelland's model, their results are farther from psychological reality. It is unknown whether any connectionist model can mimic a child's performance without resorting to unrealistic exogenous changes in the training or input, but it is clear that adding a hidden-layer and back-propagation does not ensure a solution.

Child Language↗
PubMed1997

Implications of the people = male theory for the interpretation of the Draw-A-Person Test.

Researchers in the language and social-cognitive fields have suggested that social mores and the use of masculine generic grammatical terms such as he and man have resulted in a people = male bias. This information processing bias causes most people to attribute male gender to a gender-unspecified person. Male gender appears to be prototypic of the person construct or category. These research findings have implications for the interpretation of the Draw-A-Person Test (Machover, 1949).

Art↗
PubMed1997

Medical narratives in electronic medical records.

In this article, we describe the state of the art and directions of current development and research with respect to the inclusion of medical narratives in electronic medical-record systems. We used information about 20 electronic medical-record systems as presented in the literature. We divided these systems into 'classical' systems that matured before 1990 and are now used in a broad range of medical domains, and 'experimental' systems, more recently developed and, in general, more innovative. In the literature, three major challenges were addressed: facilitation of direct data entry, achieving unambiguous understandability of data, and improvement of data presentation. Promising approaches to tackle the first and second challenge are the use of dynamic data-entry forms that anticipate sensible input, and free-text data entry followed by natural-language interpretation. Both these approaches require a highly expressive medical terminology. How to facilitate the access to medical narratives has not been studied much. We found facilitating examples of presenting this information as fluent prose, of optimising the screen design with fixed position cues, and of imposing medical narratives with a structure of indexable paragraphs that can be used in flowsheets. We conclude that further study is needed to develop an optimal searching structure for medical narratives.

Database Management Systems↗
PubMed2001

Laparoscopy in the staging of pancreatic cancer.

BACKGROUND: Over the past decade, laparoscopy has emerged as a popular method of detecting extrapancreatic metastatic disease in patients presumed to have localized pancreatic cancer. METHODS AND RESULTS: The English language literature on laparoscopic staging of pancreatic cancer was reviewed. Interpretation of this literature on staging laparoscopy is difficult because (1) there has been inconsistent use of high-quality computed tomography (CT) in prospective studies, (2) many studies have included patients with locally advanced disease, and (3) the R0/R1/R2 resection rates among patients staged by laparoscopy have not been reported, making it impossible to correlate laparoscopic findings with the R0 resection rate. Laparoscopy may prevent unnecessary laparotomy in a proportion of CT-staged patients presumed to have resectable pancreatic cancer. However, routine laparoscopy is performed on patients judged to have resectable disease by high-quality CT, this fraction of patients is between 4 and 13 per cent. CONCLUSION: When state-of-the-art CT is available, the routine use of staging laparoscopy may not be easily justified from the data in the recent literature. Selective use of laparoscopy may be more appropriate and will probably be a more cost-effective staging approach. Criteria are presented for the selective use of laparoscopy in the staging of patients with localized pancreatic cancer.

Cost-Benefit Analysis↗
PubMed2005

Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review.

OBJECTIVE: Evidence suggests that cognitive functioning in bipolar disorder may be impaired even in euthymic states, but it is unclear if the pattern of deficits is similar to the deficits found in schizophrenia. The aim of this study was to review quantitatively the studies on cognitive performance in schizophrenia and bipolar disorder. METHODS: Articles for consideration were identified through a literature search in MEDLINE and PsycLIT in the period between 1985 and October 2004, using the keywords "schizophrenia" combined with "bipolar disorder", or "manic-depress*" or "manic" combined with "cogniti*" or "neuropsycholog*". Thirty-one studies were included that: i) evaluated cognitive performance using standardized and reliable neuropsychological testing procedures; ii) compared adult patients with schizophrenia and with bipolar disorder; iii) reported test scores of both patient groups, or exact p-values, t-values, or F-values; and iv) were published as an original article in a peer-reviewed English language journal. RESULTS: Meta-analyses of all studies indicated that patients with bipolar disorder generally perform better than patients with schizophrenia, but the distribution of effect sizes showed substantial heterogeneity. Results based on a more homogeneous subset of studies that matched patient groups on clinical and demographic characteristics pointed in the same direction, with effect sizes in the moderate range. CONCLUSIONS: Patients with bipolar disorder show better cognitive performance than patients with schizophrenia, even when matched for clinical and demographic characteristics.

Bipolar Disorder↗
PubMed1985

The electronic spreadsheet as a general-purpose programming tool.

Electronic spreadsheets computerise the traditional layout of any tabulation or complex calculation done with pencil, paper and calculator. They therefore have great potential in aiding routine calculations which might be done by these means or with a small BASIC computer program. Their simple structure and strong affinity with traditional methods make them particularly suitable for those who have not yet mastered the art of programming. However, a necessarily brief review of their application to science and technology demonstrates that this potential is not being realised in comparison with their wide-spread usage in the business world. The application of both Multiplan and Visicalc running respectively on the Macintosh and the Apple IIe microcomputers in four types of calculation is demonstrated: tabulation, curve-fitting and statistics, simulation, and numerical approximation. Advantages are found in the concurrent display of data and results, the ease of correction or modification of data and the escape from traditional linear programming methods. The spreadsheet format imposes its own constraints. It is not so flexible as BASIC, it demands more memory and may have a slower execution time than a program written in a high-level language, and it is more difficult to produce graphical output.

Algorithms↗