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PubMed2006

Neuropsychiatry and deletions of 18q; case report and diagnostic considerations.

The 18q deletion syndrome can be caused by several terminal and interstitial deletions of which terminal deletions of the distal part of 18q are the most frequent and known as the DeCroughy syndrome. The neuropsychiatric phenotype is not well documented and includes disorganised and disinhibited behaviours as well as language difficulties. Non development of language seems to be specific for cases with a more proximally located interstitial deletions. In the present paper a 18-year-old severely mentally retarded male with an interstitial deletion of 18q is described (46.XY,del(18)(q12.1q22.1) who was referred for behavioural problems and neuropsychiatric evaluation. No categorical psychiatric diagnosis could be established. Given this and other reports, it is advocated to describe the psychopathological phenotype of 18q deletions in a dimensional way that will result in a clinical picture characterised mainly by symptoms from the motor and motivation domains. Treatment should include primarily behavioural measures, combined if necessary with symptomatic psychopharmacotherapy.

Adolescent↗
PubMed1988

Hemispheric specialization and creativity.

The results of an experimental study on commissurotomy (split-brain) patients and normal control subjects illuminate the difference in creativity. The surgical disconnection of transcallosal interhemispheric exchange and of any access or communication between the two hemispheres creates in commissurotomy patients an outstanding lack of creativity which could be demonstrated on a lexical, sentential, global, affective, and EEG-analysis level. In contrast to split-brain or alexithymic people, expressive-creative persons verbalized their presentational symbolization and imagery of the right hemisphere which was transformed via corpus callosum to the left hemisphere, called symbollexia. Thus, creativity can be understood as the opposite of alexithymia. The hypothetical concept of creativity as hemispheric bisociation was supported by EEG findings, suggesting an inhibition and lack of inner speech between the two language centers in alexithymic people versus a higher interhemispheric coherence level in expressive-creative persons. Further on, the difference of expressed feelings of anxiety and hostility suggests a restrictive set of rules and of early superego components in commissurotomy patients in contrast to expressive-creative people who empathically experience and verbalize their anxiety about death and are open to the experience of their being in the world as an act of creation. Finally, the vignette of a creative patient whose left hemisphere was overflooded by affects and imagery, expressed in her pictures, illuminates the importance of a balanced transcallosal symbollexia and hemispheric bi-sociation in psychotherapy.

Affective Symptoms↗
PubMed2001

Communicating with children and adolescents about their cancer.

BACKGROUND: Communication with children and adolescents with cancer about their disease and treatment and the implications of these is an important aspect of good quality care. It is often poorly performed in practice. Various interventions have been developed that aim to enhance communication involving children or adolescents with cancer. OBJECTIVES: To examine the effects of interventions to enhance communication with children and/or adolescents about their cancer, its treatment and their implications. SEARCH STRATEGY: The following electronic databases were searched: Cochrane Library; Medline; PsycLit; Cinahl; Cancerlit; EMBASE; Sociofile; Health Management Information Consortium; ASSIA; LISA; ERIC; PAIS; Information Science Abstracts; Dissertation Abstracts; JICST; Pascal; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; AMED; MANTIS. Bibliographies of identified studies were also checked and contact made with experts in the field. SELECTION CRITERIA: Randomised and non-randomised controlled trials and before and after studies that evaluated the effects of interventions to enhance communication with children and/or adolescents about their cancer, treatment and related issues. DATA COLLECTION AND ANALYSIS: Data relating to the interventions, populations and outcomes studied and the design and methodological quality of included studies were extracted by one reviewer and checked by another reviewer. A narrative summary of the results is presented. MAIN RESULTS: Six studies met the criteria for inclusion. They were diverse in terms of the interventions evaluated, study designs used, types of people who participated and the outcomes measured. One study of a computer-assisted education programme reported improvements in knowledge and understanding about blood counts and cancer symptoms. Two out of two studies of school reintegration programs reported improvements in some aspects of psychosocial wellbeing (one in anxiety and one in depression), social wellbeing (two in social competence and one in social support) and behavioural problems; and one reported improvements in physical competence. REVIEWER'S CONCLUSIONS: Interventions to enhance communication involving children and adolescents with cancer have not been widely or rigorously assessed. The weak evidence that exists suggests that some children and adolescents with cancer may derive some benefit from specific information-giving programs and from interventions that aim to facilitate their reintegration into school and social activities. More research is needed to investigate the effects of these and other related interventions.

Adolescent↗
PubMed2003

Head-to-head comparison of dipyridamole echocardiography and stress perfusion scintigraphy for the detection of coronary artery disease: a meta-analysis. Comparison between stress echo and scintigraphy.

OBJECTIVES: This meta-analysis was performed to assess and compare the diagnostic accuracy of dipyridamole echocardiography test (DET) vs. stress perfusion scintigraphy (SPS) for the diagnosis of coronary artery disease (CAD). METHODS: We performed a meta-analysis of peer reviewed articles, published in English language reporting head-to-head comparison of DET vs. SPS for the diagnosis of CAD. Data of 10 studies comprising 651 patients from 10 different institutions were analyzed. DET dose was 0.56 mg/kg (low dose) in two studies, 0.75 mg/kg in 10 min or 0.84 mg/kg in 10 min (high dose) in six studies, and 0.84 mg/kg in 6 min (accelerated high dose) in one study and 0.84 mg/kg in 10 min + 1 mg atropine co-administration (augmented dose) in one study. SPS was performed with dipyridamole in six studies, with exercise in three studies and with dobutamine in one study. RESULTS: The overall diagnostic accuracy of the two tests was almost similar, 77% (95% CI = 74-81) for DET vs. 81% (95% CI = 78-84) for SPS (p = ns). SPS gave higher sensitivity, 88% (95% CI = 85-89) than DET, 70% (95% CI = 66-75) in cumulative data (p < 0.0001) while DET gave higher specificity, 90% (95% CI = 86-94) vs. 67% (95% CI = 60-73) (p < 0.0001). With state of the art protocols, i.e. accelerated dose and atropine augmented high dose, sensitivity of DET improved and overall accuracy was better than SPS (p < 0.05). CONCLUSION: DET and SPS have a similar diagnostic accuracy. DET has a markedly higher specificity regardless of the dose employed. SPS shows a superior sensitivity, however this sensitivity gap diminishes when more aggressive dipyridamole dosage is used for the stress echocardiography.

Coronary Disease↗
PubMed2005

[Laboratory methods for detection and identification of biological pathogens].

Laboratory detection and recognition methods of infectious diseases agents have developed markedly in recent years, following the proliferation of nucleic acid and immuno-based detection technologies. The present review summarizes the state of the art in current biorecognition methods: antigenic identification, genetic identification such as PCR, RFLP and FISH, protemics and mass spectrometry. For each method we have specified the technology and qualification required, time to result, specifity and sensitivity, while emphasizing the advantages and disadvantages of using each method for the detection of a given pathogen. Nucleic acid-based detection is more specific and sensitive than immunological-based detection, while the latter is simpler and expected to further development with the improvements in the affinity, specifity and mass production of new immunoglobulins. Protein-based detection methods have an advantage comparing to nucleic acid identification: the presence of the protein approves that the tested gene is functional. Mass spectrometry enables simultaneous detections of multiple proteins and thus holds a promise for new technical developments with a vast array of applications. Most physicians do not practice biodetection technologies in their every day routine, but encounter those terms in their clinical and academic work. The review aims to display basic information in this field in order to enable a common language with basic science specialists.

Bacteria↗
PubMed2006

On teaching psychoanalysis.

Teaching psychoanalysis is no less an art than is the practice of psychoanalysis. As is true of the analytic experience, teaching psychoanalysis involves an effort to create clearances in which fresh forms of thinking and dreaming may emerge, with regard to both psychoanalytic theory and clinical practice. Drawing on his experience of leading two ongoing psychoanalytic seminars, each in its 25th year, the author offers observations concerning (1) teaching analytic texts by reading them aloud, line by line, in the seminar setting, with a focus on how the writer is thinking/writing and on how the reader is altered by the experience of reading; (2) treating clinical case presentations as experiences in collective dreaming in which the seminar members make use of their own waking dreaming to assist the presenter in dreaming aspects of his experience with the patient that the analytic pair has not previously been able to dream; (3) reading poetry and fiction as a way of enhancing the capacity of the seminar members to be aware of and alive to the effects created by the patient's and the analyst's use of language; and (4) learning to overcome what one thought one knew about conducting analytic work, i.e. learning to forget what one has learned.

Dreams↗
PubMed2004

Understanding of and attitudes to xenotransplantation: a survey among Italian university students.

UNLABELLED: Xenotransplantation is currently at the experimental stages on animal models and many problems still have to be overcome in the biomedical, immunological and ethical fields. Moreover, people's attitudes to xenotransplantation vary: surveys among intensive-care staff have revealed negative opinions, while the general public and students seem to be more positive. Little is known about the influence of schooling and the choice of university faculty on attitudes to xenotransplantation. The aims of this study were: (i) to evaluate university students' attitudes to xenotransplantation; (ii) to investigate any socio-demographic, religious and educational determinants behind students' opinions on xenotransplantation. University undergraduates on five different courses were surveyed at Padua University. A 24-item questionnaire was distributed to students at the end of lectures and completed anonymously immediately after its distribution. No information was given to students beforehand. STATISTICAL ANALYSIS: chi-squared, Pearson's test; P-values <0.05 were considered significant. A total of 585 of 602 (97.2%) students completed the questionnaire (132 males, 453 females, mean age 20.4, range 19 to 43 yr). They were on courses in Medicine (33.85%), Agriculture (5.98%), Veterinary Medicine (11.45%), Psychology (18.46%) and Educational Sciences (30.26%). As for their previous schooling, they came from classical or scientific high school (58.3%), technical college (14.7%), language college (6.3%), teacher training college (11.9%) or others (8.8%). Concerning their religious beliefs, 83% were Catholics, and 56.2% defined themselves as practising Catholics. Eighty-eight percentage of the students knew of the possibility of animal organs being transplanted into humans and 77.9% of them approved of this idea. When grouped according to gender and education, a higher proportion of students approving of xenotransplantation were male (P = 0.017) and had attended classical or scientific high school (P = 0.011). Disapproval for moral, ethical or religious reasons was higher among practising than among non-practising Catholics; the latter rejected xenotransplantation more for immunological and infectious reasons (P = 0.014). As for the type of university course, a higher proportion of students approving of xenotransplantation attended science courses (Veterinary Medicine, Agriculture and Medicine vs. Educational Sciences and Psychology) (P = 0.013). University students generally approved of xenotransplantation. Male gender and a high-school education were associated with a greater acceptance of xenotransplantation. Practising vs. non-practising Catholics reported significantly different reasons for any disapproval of xenotransplantation. The choice of a science rather than an arts faculty at university was more strongly associated with a positive opinion on xenotransplantation.

Adult↗
PubMed1987

Review of text-to-speech conversion for English.

The automatic conversion of English text to synthetic speech is presently being performed, remarkably well, by a number of laboratory systems and commercial devices. Progress in this area has been made possible by advances in linguistic theory, acoustic-phonetic characterization of English sound patterns, perceptual psychology, mathematical modeling of speech production, structured programming, and computer hardware design. This review traces the early work on the development of speech synthesizers, discovery of minimal acoustic cues for phonetic contrasts, evolution of phonemic rule programs, incorporation of prosodic rules, and formulation of techniques for text analysis. Examples of rules are used liberally to illustrate the state of the art. Many of the examples are taken from Klattalk, a text-to-speech system developed by the author. A number of scientific problems are identified that prevent current systems from achieving the goal of completely human-sounding speech. While the emphasis is on rule programs that drive a format synthesizer, alternatives such as articulatory synthesis and waveform concatenation are also reviewed. An extensive bibliography has been assembled to show both the breadth of synthesis activity and the wealth of phenomena covered by rules in the best of these programs. A recording of selected examples of the historical development of synthetic speech, enclosed as a 33 1/3-rpm record, is described in the Appendix.

Communication Devices for People with Disabilities↗
PubMed1990

Unrelieved cancer pain: selections from the literature.

The words writers have used to characterize unrelieved cancer pain, render the notion of emergency--that which is urgent, requiring prompt action--compelling. This information, together with the knowledge that families whose loved ones died in pain have more difficulty with their bereavement and our ethical responsibility to do no harm cannot be ignored. It is interesting that one can read an account of cancer pain that describes agony, isolation, and preoccupation in a classic work of literature such as The Death of Ivan Ilyich, written in 1886. It is disturbing that contemporary literature, even in works published as recently as 1986, contains accounts of cancer pain that describe similar experiences--experiences with pain that exclude thought of anything else that those who are painfree would associate with life, experiences that suggest one is dying while living rather than living until death. How is it that in 100 years art, which is said to imitate life, does not reflect the significant advances made in the scientific understanding and treatment of cancer pain? Can it be that we are less willing to apply this scientific information clinically than other advances? These lay accounts confirm what clinical experience and professional literature suggest--there is an abyss between the scientific advances that have been made in understanding pain and its pathophysiology, the availability of effective therapies, and the clinical application of this knowledge. Why does this gap exist? In part it exists because many professionals and laypersons believe that that's the way it is, that nothing can be done, that cancer is necessarily a painful disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergencies↗
PubMed2004

Comparison of character-level and part of speech features for name recognition in biomedical texts.

The immense volume of data which is now available from experiments in molecular biology has led to an explosion in reported results most of which are available only in unstructured text format. For this reason there has been great interest in the task of text mining to aid in fact extraction, document screening, citation analysis, and linkage with large gene and gene-product databases. In particular there has been an intensive investigation into the named entity (NE) task as a core technology in all of these tasks which has been driven by the availability of high volume training sets such as the GENIA v3.02 corpus. Despite such large training sets accuracy for biology NE has proven to be consistently far below the high levels of performance in the news domain where F scores above 90 are commonly reported which can be considered near to human performance. We argue that it is crucial that more rigorous analysis of the factors that contribute to the model's performance be applied to discover where the underlying limitations are and what our future research direction should be. Our investigation in this paper reports on variations of two widely used feature types, part of speech (POS) tags and character-level orthographic features, and makes a comparison of how these variations influence performance. We base our experiments on a proven state-of-the-art model, support vector machines using a high quality subset of 100 annotated MEDLINE abstracts. Experiments reveal that the best performing features are orthographic features with F score of 72.6. Although the Brill tagger trained in-domain on the GENIA v3.02p POS corpus gives the best overall performance of any POS tagger, at an F score of 68.6, this is still significantly below the orthographic features. In combination these two features types appear to interfere with each other and degrade performance slightly to an F score of 72.3.

Abbreviations as Topic↗
PubMed1995

State of the art in continuous speech recognition.

In the past decade, tremendous advances in the state of the art of automatic speech recognition by machine have taken place. A reduction in the word error rate by more than a factor of 5 and an increase in recognition speeds by several orders of magnitude (brought about by a combination of faster recognition search algorithms and more powerful computers), have combined to make high-accuracy, speaker-independent, continuous speech recognition for large vocabularies possible in real time, on off-the-shelf workstations, without the aid of special hardware. These advances promise to make speech recognition technology readily available to the general public. This paper focuses on the speech recognition advances made through better speech modeling techniques, chiefly through more accurate mathematical modeling of speech sounds.

Algorithms↗
PubMedDate not supplied

Database-supported teleconferencing: an additional clinical mentoring tool to assist a multinational company HIV/AIDS treatment program in Africa.

BACKGROUND: The lack of human resources for health is presently recognized as a major factor limiting scale-up of antiretroviral treatment (ART) programs in resourcelimited settings. The mobilization of public and private partners, the decentralization of care, and the training of non-HIV specialist nurses and general practitioners could help increase the number of HIV-infected patients receiving ART. In addition to other forms of training, scheduled teleconferences (TCs) have been organized to support a comprehensive HIV treatment program delivered by a private company's health team. OBJECTIVE: To describe the role of the TC as an additional tool in mentoring a company's health care workers (HCWs). METHOD: For this study, all TC reports were retrospectively reviewed and the questions classified by topic. Participating Heineken physicians evaluated the technical quality and scientific relevance of the TCs through an anonymous survey. RESULTS: From October 2001 to December 2003, 10 HCWs working in 14 operating companies in 5 African countries raised 268 problems during 45 TCs. A total of 79 questions (29%) were asked about antiretroviral (ARV) therapy, 53 (20%) about the diagnosis and treatment of opportunistic infection, 43 (16%) about ARV toxicity, 40 (15%) about care organization and policy, 32 (12%) about laboratory or drug supply, and 21 (8%) about biological parameters. The mean TC attendance rate was 70%. The level of satisfaction among local company physicians was 65% for logistics, 89% for scientific relevance, 84% for applicability of advice, and 85% overall. The most common complaints concerned the poor quality of the telephone connection and language problems for francophone participants. CONCLUSION: Database-supported teleconferencing could be an additional tool to mentor company HCWs in their routine care of HIV-infected workers and family members. The role and costeffectiveness of telemedicine in improving health outcomes should be further studied.

Africa↗
PubMed1991

Authorial intentions and metaphor comprehension.

Three experiments investigated the role of authorial intentions in metaphor comprehension. In these studies, subjects read metaphoric (e.g., "A family album is like a museum"), literal (e.g., "An art gallery is like a museum"), and anomalous (e.g., "A tortoise shell is like an art gallery") comparisons and rated their degree of meaningfulness (Experiment 1), made speeded decisions as to whether each phrase was meaningful or not (Experiment 2), or wrote out interpretations of each comparison statement (Experiment 3). The subjects were told that the comparisons were written either by famous 20th century poets or by a computer program that randomly generated the statements from a list of words. Our general hypothesis was that knowing that intentional agents (the poets) authored the different comparisons should facilitate subjects' comprehension of the metaphors. Experiment 1 showed that subjects rated both metaphoric and literal comparisons as being more meaningful in the poet condition than when these statements were supposedly written by computer. Experiment 2 demonstrated that subjects were faster in making their meaningfulness judgments for metaphors in the poet condition than in the computer context, but that subjects were also slower in rejecting anomalous comparisons when these were supposedly written by the poets. Experiment 3 indicated that subjects produced more meanings or interpretations for comparisons presumably written by poets than by computer. These results highlight the importance of implied, authorial intentions in understanding metaphorical statements. We discuss the implications of this work for psycholinguistic theories of figurative language comprehension, as well as for theories of literary interpretation.

Adult↗
PubMed2004

This art of psychoanalysis. Dreaming undreamt dreams and interrupted cries.

It is the art of psychoanalysis in the making, a process inventing itself as it goes, that is the subject of this paper. The author articulates succinctly how he conceives of psychoanalysis, and offers a detailed clinical illustration. He suggests that each analysand unconsciously (and ambivalently) is seeking help in dreaming his 'night terrors' (his undreamt and undreamable dreams) and his 'nightmares' (his dreams that are interrupted when the pain of the emotional experience being dreamt exceeds his capacity for dreaming). Undreamable dreams are understood as manifestations of psychotic and psychically foreclosed aspects of the personality; interrupted dreams are viewed as reflections of neurotic and other non-psychotic parts of the personality. The analyst's task is to generate conditions that may allow the analysand--with the analyst's participation--to dream the patient's previously undreamable and interrupted dreams. A significant part of the analyst's participation in the patient's dreaming takes the form of the analyst's reverie experience. In the course of this conjoint work of dreaming in the analytic setting, the analyst may get to know the analysand sufficiently well for the analyst to be able to say something that is true to what is occurring at an unconscious level in the analytic relationship. The analyst's use of language contributes significantly to the possibility that the patient will be able to make use of what the analyst has said for purposes of dreaming his own experience, thereby dreaming himself more fully into existence.

Dreams↗
PubMed2006

SVM Classifier - a comprehensive java interface for support vector machine classification of microarray data.

MOTIVATION: Graphical user interface (GUI) software promotes novelty by allowing users to extend the functionality. SVM Classifier is a cross-platform graphical application that handles very large datasets well. The purpose of this study is to create a GUI application that allows SVM users to perform SVM training, classification and prediction. RESULTS: The GUI provides user-friendly access to state-of-the-art SVM methods embodied in the LIBSVM implementation of Support Vector Machine. We implemented the java interface using standard swing libraries. We used a sample data from a breast cancer study for testing classification accuracy. We achieved 100% accuracy in classification among the BRCA1-BRCA2 samples with RBF kernel of SVM. CONCLUSION: We have developed a java GUI application that allows SVM users to perform SVM training, classification and prediction. We have demonstrated that support vector machines can accurately classify genes into functional categories based upon expression data from DNA microarray hybridization experiments. Among the different kernel functions that we examined, the SVM that uses a radial basis kernel function provides the best performance. The SVM Classifier is available at http://mfgn.usm.edu/ebl/svm/.

Cluster Analysis↗
PubMed2004

Online recognition of Chinese characters: the state-of-the-art.

Online handwriting recognition is gaining renewed interest owing to the increase of pen computing applications and new pen input devices. The recognition of Chinese characters is different from western handwriting recognition and poses a special challenge. To provide an overview of the technical status and inspire future research, this paper reviews the advances in online Chinese character recognition (OLCCR), with emphasis on the research works from the 1990s. Compared to the research in the 1980s, the research efforts in the 1990s aimed to further relax the constraints of handwriting, namely, the adherence to standard stroke orders and stroke numbers and the restriction of recognition to isolated characters only. The target of recognition has shifted from regular script to fluent script in order to better meet the requirements of practical applications. The research works are reviewed in terms of pattern representation, character classification, learning/adaptation, and contextual processing. We compare important results and discuss possible directions of future research.

Algorithms↗
PubMed2004

Analytic preparation: the creation of an analytic climate with patients not yet in analysis.

The art and science of beginning an analysis has a life of its own and can be considered in many ways quite apart from its later stages. An incremental path forward is smoothed for patients who are not yet prepared to analyze, and builds eventually into something readily recognizable as an analysis. The term analytic preparation refers to this set of processes. Early on, the analyst is concerned less with facilitating an early replica of an idealized analysis than with facilitating the mutual adaptation of patient and analyst as they begin to negotiate a "thought community." Since analytic preparation is not an entity, it does not neatly overlap in real time with the opening phase as usually described, does not have a discrete beginning or end, and does not abruptly shift mid-stream into analysis proper. Some relations between analytic preparation, analytic interaction, and the interpretation of transference are examined.

Humans↗
PubMed1996

Health education about sun and skin cancer: language, ideas and perceptions of young children.

Excessive sunlight in early childhood is thought to be a risk factor for skin cancer. We report the use of the 'draw and write' technique for determining changing perceptions, attitudes and knowledge of young children (aged 4-12 years) to the sun and skin cancer. Children were asked to draw pictures and label them in response to a series of carefully worded invitations and questions. The captions were then analysed to assess changing views and perceptions about particular issues in relation to behaviour in the sun. Four hundred and sixty children completed the exercise. An increasing spiral of knowledge with age about effects of the sun and appropriate behaviour was demonstrated. The study revealed a relatively high level of knowledge. Misconceptions and stereotypes were demonstrated. This technique is a simple and effective way of eliciting information from children about health issues. It provides baseline data for producing material for health education for children in relation to sun and skin. It is also a method of assessing the effectiveness in young children of health promotion initiatives.

Art↗