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Naming speed, phonological awareness and the initial stage of learning to read.

Phonological awareness in kindergarten and rapid naming of objects in Grade 1 were used as predictors of reading achievement in Grade 1. Two reading measures were used: oral decoding of both words and pseudowords. They were found to be highly correlated. Both rapid naming and phonological awareness accounted for independent variance in reading achievement except for pseudoword reading, where rapid naming did not contribute significantly after the effect of phonemic awareness had been accounted for. Phonological awareness was the stronger predictor and a large part of the variance was shared between it and rapid naming. The rapid naming testing procedure functioned well and its potential as a research and diagnostic tool is discussed.

Analysis of Variance↗

Public awareness is key to successful waste management.

A critical component in any waste management program is public awareness and participation, in addition to appropriate legislation, strong technical support, and adequate funding. Waste is the result of human activities and everyone needs to have a proper understanding of waste management issues, without which the success of even the best conceived waste management plan becomes questionable. The paper presents an overview of the fundamentals of waste management and, using examples from the United States, illustrates how public awareness and participation results in succcssful waste management. Examples of the methods and techniques that have been very effective in creating and enhancing public awareness of waste management problems, including the author's proven method of public education, are presented in the paper. The details of a course aimed at educating school teachers on waste management issues and a specialized curriculum on waste and litter control, designed for kindergarten through 8th grade students and developed by the author, are discussed in the paper. A case study dealing with remediation of one of the worst contaminated hazardous waste sites in the United States, that included substantial public participation, is reviewed. The paper concludes by emphasizing that the public must be made aware of waste management issues to understand the consequences of improper management of waste and how it may ultimately pose a serious threat to their lives and well-being.

Adolescent↗

A leakage-aware genomic prediction pipeline for meropenem resistance in Klebsiella pneumoniae using transformer-based resistome representation learning.

MOTIVATION: Antimicrobial resistance (AMR) in Klebsiella pneumoniae, particularly to carbapenems such as meropenem, is a major global health problem. Machine learning is increasingly used to predict resistance from genomic markers; however, many models fail to capture high-level gene-gene interactions and may exhibit inflated performance due to lineage-biased prediction. Existing genomic prediction models largely rely on flat feature representations that fail to capture epistatic gene interactions, and commonly suffer from inflated performance estimates due to phylogenetic data leakage. To address these limitations simultaneously, a leakage-aware hybrid TabTransformer-CatBoost pipeline was developed, combining self-attention-based resistome representation learning with gradient boosting classification under clade-aware data partitioning. A self-attention encoder converts sparse gene presence-absence profiles into contextualized latent embeddings, which are subsequently classified using gradient boosting to capture lineage-aware AMR patterns. RESULTS: The proposed architecture outperformed classical baselines including Logistic Regression, Random Forest, XGBoost, and optimized CatBoost models. Internal accuracy reached 92.59% for the Chained Hybrid configuration (area under the receiver operating characteristic curve, AUROC = 0.8670, F1 = 0.8537). Performance gains primarily originated from the embedding stage, as confirmed by ablation analysis. External validation across independent multinational cohorts (n = 305) demonstrated generalizability (AUROC = 0.8105; F1 = 0.7552). Permutation testing produced near-zero Matthews Correlation Coefficient (MCC) = 0.0091, indicating predictions reflect genuine biological signal rather than noise. These results establish attention-based genomic embedding with gradient boosting as a scalable, interpretable, and leakage-aware framework for clinical AMR prediction. AVAILABILITY AND IMPLEMENTATION: The source code for the TabTransformer-CatBoost framework, including preprocessing pipelines and pre-trained embeddings, is available at https://github.com/SibelKervanci/kp-meropenem-tabtransformer.

Journal Article↗

Orthodontically treated young adults: awareness of their own dental arrangement.

Orthodontic treatment goals are generally based upon professional ideals of function, aesthetics, and stability. In order to evaluate whether the professional treatment goals are meaningful to the patients, awareness of their own occlusion was studied in 80 orthodontically treated individuals (mean age 18.3 years). By comparing the treated patients to a control group of 50 untreated individuals (mean age 17.8 years) the effect of the treatment experience on the level of awareness was also examined. Awareness was assessed by comparing the subjects' answers to six questions about their own dental arrangement, to recordings on study casts according to two sets of criteria. These criteria defined malocclusion and minor deviations in tooth position. The validity of the method was tested by asking the subjects to identify their own teeth among 18 dental photographs. Almost two-thirds of the treated subjects described their teeth without making mistakes according to the malocclusion criteria. When the minor deviation criteria were applied, one third answered all the six questions correctly and two-thirds made not more than one mistake. Compared to the control group no significant differences existed as most untreated individuals also gave accurate descriptions. Eighty-two per cent of the tested subjects identified their own photo on the first attempt. Professional treatment goals seem to be justified by the high level of dental awareness in young adults, and the findings indicate that the treatment per se does not affect perceptual accuracy.

Adolescent↗

Highly active antiretroviral therapy (HAART). Awareness and beliefs about infectivity and the influence on sexual behaviour in the general population of Sweden.

The purpose of the present study was to assess the relationship between the awareness of HAART, beliefs regarding transmission of HIV of persons taking HAART, norms associated with sexual risk behaviour, fear of HIV/AIDS, optimism of finding a cure or vaccine, and sexual behaviour in the general population of Sweden. A mail survey was sent to 4,000 randomly selected individuals aged 16-44 years. The study shows that the general public of Sweden is aware of HAART. Only 15% of the population had never heard of HAART. Eight percent believed that those taking HAART were 'no longer' or 'less' infective. Those not aware of HAART reported greater fear of HIV infected persons, less volunteer testing for HIV, and more sexual partners. Those who believed that persons taking HAART were less infective reported greater fear, more optimism concerning the possibilities to find a cure or vaccine, and had more discussions regarding HIV. We conclude that a group that may be at increased risk of HIV infection may be persons who are not aware of HAART or believe that persons are no longer infective when taking HAART. These persons may be an additional target group for HIV prevention.

Adolescent↗

Venous air embolism from central venous catheterization: a need for increased physician awareness.

OBJECTIVES: To report a series of patients with clinically diagnosed venous air embolism (VAE) and major sequelae as a complication of the use of central venous catheters (CVCs), to survey health care professionals' practices regarding CVCs, and to implement an educational intervention for optimizing approaches to CVC insertion and removal. SETTING: Tertiary care, university-based 806-bed medical center. INTERVENTIONS: We surveyed 140 physicians and 53 critical care nurses to appraise their awareness of the proper management and complications of CVCs. We then designed, delivered, and measured the effects of a multidisciplinary educational intervention given to 106 incoming house officers. MEASUREMENTS AND MAIN RESULTS: Although most physicians (127, 91%) chose the Trendelenburg position for CVC insertion, only 42 physicians (30%) reported concern for VAE. On CVC removal, only 36 physicians (26%) cited concern for VAE. Some physicians (13, 9%) reported elevating the head of the bed during CVC removal, possibly increasing the risk of VAE. Awareness of VAE or its prevention did not correlate with the level of physician training, experience, or specialty. After the educational intervention, concern for and awareness of proper methods of prevention of VAE improved (p < .001). At 6-month follow-up, reported use of the Trendelenburg position continued, but concern cited for VAE had returned to baseline. CONCLUSIONS: There is inadequate awareness of VAE as a complication of CVC use. Focused instruction can improve appreciation of this potentially fatal complication and knowledge of its prevention, but the effect declines rapidly. To achieve a more sustained improvement, a more intensive, hands-on, periodic educational program will likely be necessary, as well as reinforcement through enhanced supervision of CVC insertion and removal practices.

Academic Medical Centers↗

Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study.

OBJECTIVES: To determine prevalence, awareness, treatment, and control of hypertension, and its risk factors in an urban Korean population. DESIGN AND SETTING: A cross-sectional survey in Ansan-city, Korea. SUBJECTS AND METHODS: Population-based samples of people aged 18-92 years in Ansan-city, Korea, were selected, yielding 2278 men and 1948 women, and their blood pressures were measured using a highly standardized protocol. Hypertension was defined as a systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or reported treatment with antihypertensive medications, and subclassified according to 1999 WHO-ISH guidelines. Isolated systolic hypertension (ISH) defined as a systolic BP > or = 140 mmHg and diastolic BP < 90 mmHg was also examined. Data were stratified by age and sex. RESULTS: The overall prevalence of hypertension in this study was 33.7%. Among these, 64.9% had Grade 1 hypertension, 22.5% Grade 2, and 12.5% Grade 3. Age-specific prevalence of hypertension increased progressively with age, from 14.19% in 18 to 24 year-olds to 71.39% in those 75 years or older. Hypertension prevalence was significantly higher in men (41.5%) than in women (24.5%) (P < 0.001). Isolated systolic hypertension had significantly lower prevalence (4.33%) within the population, although in the elderly aged 55 years or more it rose by 11.13%. Overall, 24.6% of hypertensive individuals were aware that they had high blood pressure, as much as 78.6% were being treated with antihypertensive medications, and 24.3% were under control. Hypertension awareness as well as treatment and control rates varied by sex, with women higher in all three rates. Multivariate analysis revealed that age, body mass index and abdomen circumference were significantly associated with prevalence of hypertension both in men and women. CONCLUSIONS: Hypertension is highly prevalent in Korea. Despite the high rate of treatment, the rates of awareness and control are relatively low, suggesting the nationwide demand for preventing and controlling high blood pressure in Korea in order to avert an epidemic of cardiovascular disease.

Adult↗

College women's awareness and consumption of folic acid for the prevention of neural tube defects.

PURPOSE: Awareness and consumption of folic acid in the context of neural tube defect prevention among college women were assessed. METHODS: Subjects documented folic acid awareness and multivitamin consumption. Beliefs about folic acid before and after an educational intervention were characterized using the Health Belief Model (HBM) and the Fetal Health Locus of Control Scale (FHLCS). RESULTS: Awareness of folic acid was not associated with multivitamin consumption. Belief variables were not associated with awareness or consumption of folic acid. CONCLUSION: This study does not support educational interventions based on the HBM or FHLCS to increase multivitamin consumption among college women.

Adolescent↗

Trends in blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2000/01.

OBJECTIVE: To assess trends in blood pressure (BP) levels, prevalence, awareness, and control of hypertension in the Czech population from 1985 to 2000/01. DESIGN: Five independent cross-sectional population surveys conducted in 1985, 1988, 1992, 1997/98, and 2000/01. SETTING: Six, mostly rural, districts of the Czech Republic (Praha-východ, Benesov, Pardubice, Chrudim, Cheb, and Jindrichův Hradec). PARTICIPANTS: Men and women aged 25-64 years randomly selected from six districts using the National Population Register/General Health Insurance Company Register (covering, by law, all citizens). The total number of participants was 11 726. MAIN OUTCOME MEASURES: We assessed the mean systolic BP, diastolic BP and pulse pressure, prevalence of hypertension (systolic BP > or = 140 mmHg and/or diastolic BP > or = 90 mmHg, or current treatment with antihypertensive drugs), awareness, treatment, and control of hypertension. RESULTS: Mean systolic BP, diastolic BP, and pulse pressure decreased significantly over a period of 15/16 years. This was associated with a significant decrease in the prevalence of hypertension (from 47.1 to 39.1%, P < 0.001) and with an increase in its awareness (from 49.5 to 67.2%, P < 0.001), use of antihypertensive medication (from 29.3 to 49.3%, P < 0.001), and hypertension control (from 3.9 to 17.0%, P < 0.001). Despite having lower BP values and prevalence of hypertension, females showed higher awareness of the disease, and were more frequently taking antihypertensive medication, and their hypertension was better controlled. CONCLUSION: The reduction in population BP and improved control of hypertension may have contributed to the decrease in cerebrovascular and coronary heart disease mortality in the Czech Republic. The positive longitudinal changes seen in the MONICA regions need not necessarily reflect the situation in the country as a whole. The situation is far from being optimal; a major problem is inadequate treatment of hypertension

Adult↗

Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003.

OBJECTIVE: To determine the distribution of blood pressure (BP) and prevalence, awareness, treatment and control of hypertension in Turkey (PatenT). DESIGN: A population-based cross-sectional epidemiology survey was carried out in 2003. SETTING: Twenty-six cities from seven geographical provinces of Turkey, with proportional representation of urban and rural populations. PARTICIPANTS: A two-stage stratified sampling method was used to select a sample of the adult population over 18 years of age. The total number of participants was 4910. INTERVENTIONS: Data collection and BP measurements were conducted by specifically trained physicians in the households of the participants. MAIN OUTCOME MEASURES: The mean systolic and diastolic BP levels, distribution of blood pressure, prevalence of hypertension (mean systolic BP>or=140 mmHg or mean diastolic BP>or=90 mmHg, or previously diagnosed and/or taking antihypertensive drugs), awareness, treatment and control of hypertension were assessed. RESULTS: The overall age-adjusted and sex-adjusted prevalence of hypertension in Turkey was 31.8%, and it was higher in women than in men (36.1 versus 27.5%, P<0.001). In the whole group, 32.2% had never had their BP measured. Overall, 40.7% of those with hypertension were aware of their diagnosis, only 31.1% were receiving pharmacologic treatment and only 8.1% had their BP under control. The subjects who were aware and treated had a control ratio of 20.7%. CONCLUSIONS: PatenT data indicate that hypertension is a highly prevalent but inadequately managed health problem in Turkey. There is an urgent need for population-based strategies to improve the prevention, early detection and control of hypertension.

Adolescent↗

Activities to increase provider awareness of early syphilis in men who have sex with men in 8 cities, 2000-2004.

OBJECTIVE: Describe provider awareness campaigns undertaken in response to syphilis epidemics among men who have sex with men (MSM). METHODS: Descriptive data from 8 cities facing MSM syphilis epidemics was compiled. RESULTS: Provider awareness efforts included medical alerts, provider visits, lectures to providers on symptom recognition and treatment, and ongoing provision of syphilis and other sexually transmitted diseases (STD) morbidity information through mailings, visits, and e-mail communications. Increases in private provider reporting of syphilis cases followed provider visits in Atlanta and overall provider education efforts in New York City. Decreases in reporting delays and increases in physician calls to the STD program were reported in San Francisco following provider syphilis lectures. Increases in provider participation in community action meetings followed provider awareness efforts in Houston, Chicago, and Miami. CONCLUSIONS: Various methods were used to increase provider awareness of syphilis in these 8 cities. The cost and impact of these activities merits more formal evaluation to determine their contribution to syphilis control in MSM.

Disease Outbreaks↗

Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs.

OBJECTIVES: To compare the prevalence of high-risk sexual behaviors in HIV persons aware of their serostatus with that in HIV persons unaware of their status in the United States and to discuss implications for HIV prevention programs. METHODS: A meta-analysis was conducted on 11 independent findings. Six findings compared HIV(+) aware persons with independent groups of HIV(+) unaware persons (between-group comparisons), and 5 findings compared seroconverting individuals before and after being notified of their HIV status (within-subject comparisons). Outcomes were self-reported unprotected anal or vaginal intercourse (UAV) during specified recall periods. RESULTS: The analysis integrating all 11 findings indicated that the prevalence of UAV with any partner was an average of 53% (95% confidence interval [CI]: 45%-60%) lower in HIV persons aware of their status relative to HIV(+) persons unaware of their status. There was a 68% reduction (95% CI: 59%-76%) after adjusting the data of the primary studies to focus on UAV with partners who were not already HIV(+). The reductions were larger in between-group comparisons than in within-subject comparisons. Findings for men and women were highly similar. CONCLUSIONS: The prevalence of high-risk sexual behavior is reduced substantially after people become aware they are HIV(+). Increased emphasis on HIV testing and counseling is needed to reduce exposure to HIV(+) from persons unaware they are infected. Ongoing prevention services are needed for persons who know they are HIV(+) and continue to engage in high-risk behavior.

Adolescent↗

Does the use of standardized history and physical forms improve billable income and resident physician awareness of billing codes?

OBJECTIVES: Resident physician knowledge of financial reimbursement guidelines for patient encounters is limited. We determined whether the use of standardized history and physical examination forms by residents for hospital admissions plus a brief lecture would increase the level of billing codes, increase billable income, and increase resident awareness of billing guidelines. METHODS: Residents used history and physical examination forms after a brief documentation lecture. Pretrial and posttrial surveys measured awareness of billing guidelines. The admission billing codes for a 6-month period were obtained, and the percentages were compared with a control 6-month period. RESULTS: There was an absolute increase of 14.5% in the highest code between the two study periods (P < 0.0001). Billable income increased by $10,385. Resident documentation awareness also increased (P < 0.001). CONCLUSIONS: The use of history and physical examination forms, combined with a brief lecture, significantly increased the percentage of highest billing codes, which increased billable income. Resident awareness of documentation requirements significantly improved.

Centers for Medicare and Medicaid Services, U.S.↗

Abnormalities in the awareness and control of action.

Much of the functioning of the motor system occurs without awareness. Nevertheless, we are aware of some aspects of the current state of the system and we can prepare and make movements in the imagination. These mental representations of the actual and possible states of the system are based on two sources: sensory signals from skin and muscles, and the stream of motor commands that have been issued to the system. Damage to the neural substrates of the motor system can lead to abnormalities in the awareness of action as well as defects in the control of action. We provide a framework for understanding how these various abnormalities of awareness can arise. Patients with phantom limbs or with anosognosia experience the illusion that they can move their limbs. We suggest that these representations of movement are based on streams of motor commands rather than sensory signals. Patients with utilization behaviour or with delusions of control can no longer properly link their intentions to their actions. In these cases the impairment lies in the representation of intended movements. The location of the neural damage associated with these disorders suggests that representations of the current and predicted state of the motor system are in parietal cortex, while representations of intended actions are found in prefrontal and premotor cortex.

Agnosia↗

A real-time architecture for time-aware agents.

This paper describes the specification and implementation of a new three-layer time-aware agent architecture. This architecture is designed for applications and environments where societies of humans and agents play equally active roles, but interact and operate in completely different time frames. The architecture consists of three layers: the April real-time run-time (ART) layer, the time aware layer (TAL), and the application agents layer (AAL). The ART layer forms the underlying real-time agent platform. An original online, real-time, dynamic priority-based scheduling algorithm is described for scheduling the computation time of agent processes, and it is shown that the algorithm's O(n) complexity and scalable performance are sufficient for application in real-time domains. The TAL layer forms an abstraction layer through which human and agent interactions are temporally unified, that is, handled in a common way irrespective of their temporal representation and scale. A novel O(n2) interaction scheduling algorithm is described for predicting and guaranteeing interactions' initiation and completion times. The time-aware predicting component of a workflow management system is also presented as an instance of the AAL layer. The described time-aware architecture addresses two key challenges in enabling agents to be effectively configured and applied in environments where humans and agents play equally active roles. It provides flexibility and adaptability in its real-time mechanisms while placing them under direct agent control, and it temporally unifies human and agent interactions.

Algorithms↗

Phonological awareness of syllables, rhymes, and phonemes in deaf children.

Phonological awareness is important for reading development in hearing children, in whom it develops at the three consecutive levels of the syllable, rhyme, and phoneme. Deaf children typically have literacy difficulties, and previous research has been equivocal about whether deaf children can develop phonological awareness. Three experiments are presented that investigate the phonological skills of deaf children (mean age 11 years) at the three linguistic levels of syllable, rhyme, and phoneme. The first experiment showed that deaf children's syllable awareness can be equivalent to that of chronological age-matched hearing controls. In the second experiment, deaf children's ability to make rhyme judgements was above chance, but poorer than that of younger reading-matched hearing controls. The third experiment showed that deaf children could phonologically recode nonsense words at a level above chance, suggesting that they could draw on phonemic skills in certain conditions. We conclude that deaf children can develop phonological awareness, but that their phonological skills lag those of hearing children and may develop in different ways. Differences between our tasks and those used in other studies are discussed.

Adolescent↗

Visual awareness of low-contrast stimuli is reflected in event-related brain potentials.

Visual awareness was studied in 11 subjects by using coherent and scrambled objects as stimuli. The stimuli were presented near the subjective perceptual threshold. Explicitly recognized stimuli elicited a specific negative ERP deflection peaking at 460 ms. Our reaction time experiment suggests that this visual awareness negativity (VAN) is similar to that found previously at a shorter latency. We propose that VAN might reflect the exact moment of becoming aware of the task-relevant stimulus properties and provide an online marker of the temporal dynamics of visual awareness.

Adult↗

Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness.

BACKGROUND: Organ transplant recipients (OTRs) have 100-fold increased risk of developing squamous cell carcinomas. Cumulative exposure to ultraviolet radiation is the main risk factor and there is evidence that lack of dermatological surveillance may be responsible for poor levels of knowledge and photoprotection among OTRs. OBJECTIVES: This study evaluated whether routine consultation in a specialist OTR dermatology clinic improves understanding of skin cancer risk and compliance with photoprotection measures. METHODS: A cross-sectional questionnaire-based study was performed in a specialist OTR dermatology clinic at Bart's and the London NHS Trust, London, U.K. The subjects were 399 white-skinned patients under surveillance in a renal transplant clinic, who were sent a postal questionnaire from the renal transplant clinic. The main outcome measures were responses to the questionnaire regarding photoprotective practices and skin cancer risk awareness. RESULTS: Two hundred and ninety-two of 399 (73%) responded, of whom 89% had previously attended the specialist dermatology clinic. Ninety-six per cent recalled receiving photoprotection advice at least once (85% from dermatologists); 92% reported use of sunscreen; 88% specifically dressed to photoprotect themselves; 96% directly avoided sun exposure during summer; 68% were aware that an increased risk of skin cancer was the reason that extra photoprotective measures were important after a transplant. Photoprotective measures and level of skin cancer awareness were significantly lower in those responders who had never attended the specialist clinic. No obvious bias was identified among nonresponders. CONCLUSIONS: Skin cancer awareness and compliance with photoprotective measures in our patient population is generally greater than previously reported, suggesting that delivery of educational messages regarding skin cancer may be improved if provided in a specialist dermatological setting.

Cross-Sectional Studies↗