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The Canon Group's effort: working toward a merged model.

OBJECTIVE: To develop a representational schema for clinical data for use in exchanging data and applications, using a collaborative approach. DESIGN: Representational models for clinical radiology were independently developed manually by several Canon Group members who had diverse application interests, using sample reports. These models were merged into one common model through an iterative process by means of workshops, meetings, and electronic mail. RESULTS: A core merged model for radiologic findings present in a set of reports that subsumed the models that were developed independently. CONCLUSIONS: The Canon Group's modeling effort focused on a collaborative approach to developing a representational schema for clinical concepts, using chest radiography reports as the initial experiment. This effort resulted in a core model that represents a consensus. Further efforts in modeling will extend the representational coverage and will also address issues such as scalability, automation, evaluation, and support of the collaborative effort.

Artificial Intelligence↗

Multiprocessor and memory architecture of the neurocomputer SYNAPSE-1.

A general purpose neurocomputer, SYNAPSE-1, which exhibits a multiprocessor and memory architecture is presented. It offers wide flexibility with respect to neural algorithms and a speed-up factor of several orders of magnitude--including learning. The computational power is provided by a 2-dimensional systolic array of neural signal processors. Since the weights are stored outside these NSPs, memory size and processing power can be adapted individually to the application needs. A neural algorithms programming language, embedded in C(+2) has been defined for the user to cope with the neurocomputer. In a benchmark test, the prototype of SYNAPSE-1 was 8000 times as fast as a standard workstation.

Algorithms↗

Learning to recognize three-dimensional objects.

A learning account for the problem of object recognition is developed within the probably approximately correct (PAC) model of learnability. The key assumption underlying this work is that objects can be recognized (or discriminated) using simple representations in terms of syntactically simple relations over the raw image. Although the potential number of these simple relations could be huge, only a few of them are actually present in each observed image, and a fairly small number of those observed are relevant to discriminating an object. We show that these properties can be exploited to yield an efficient learning approach in terms of sample and computational complexity within the PAC model. No assumptions are needed on the distribution of the observed objects, and the learning performance is quantified relative to its experience. Most important, the success of learning an object representation is naturally tied to the ability to represent it as a function of some intermediate representations extracted from the image. We evaluate this approach in a large-scale experimental study in which the SNoW learning architecture is used to learn representations for the 100 objects in the Columbia Object Image Library. Experimental results exhibit good generalization and robustness properties of the SNoW-based method relative to other approaches. SNoW's recognition rate degrades more gracefully when the training data contains fewer views, and it shows similar behavior in some preliminary experiments with partially occluded objects.

Artificial Intelligence↗

Febrile seizures: current concepts.

Approximately 2 to 5 per cent of all children experience seizures in association with their febrile illness. In a vast majority of instances, these seizures are of benign nature without any long-term adverse implications. A small percentage of these children develop recurrent febrile seizures and a still smaller percentage develop epilepsy. Several studies have attempted to identify those children who are at risk to develop either recurrences or subsequent epilepsy, while others have examined different modalities of management of children with febrile seizures. This review presents an overview of the problem based on the findings of these studies.

Age Factors↗

Dyslexia and neurodevelopmental pathology: relationships to cognition, intelligence, and reading skill acquisition.

This article addresses the neuroimaging (CT/MRI), electrophysiological (ERP/EEG), and postmortem evidence as to the neurological basis of dyslexia and discusses why these sources of evidence yield what appear to be inconsistent findings. It is concluded that what appear to be inconsistencies may relate in part to limitations of these investigative technologies. Then, important correlates of reading ability and disability are discussed in a developmental-neuropsychological context, and recommendations are made for research serving to further integrate cognitive and neurological paradigms. Of particular importance, inconsistencies between the results revealed through neuroimaging, electrophysiological, and postmortem studies, on the one hand, and neurolinguistic theory, on the other, must be addressed. Articulating the neurometabolic role-and particularly the nature of the behavioral correlates of the thalamus, supplementary motor area, and frontal cortex-in regard to bihemispheric mechanisms related to reading in developmental dyslexia should be a priority in future research.

Cognition Disorders↗

Reliability of old and new ventricular fibrillation detection algorithms for automated external defibrillators.

BACKGROUND: A pivotal component in automated external defibrillators (AEDs) is the detection of ventricular fibrillation by means of appropriate detection algorithms. In scientific literature there exists a wide variety of methods and ideas for handling this task. These algorithms should have a high detection quality, be easily implementable, and work in real time in an AED. Testing of these algorithms should be done by using a large amount of annotated data under equal conditions. METHODS: For our investigation we simulated a continuous analysis by selecting the data in steps of one second without any preselection. We used the complete BIH-MIT arrhythmia database, the CU database, and the files 7001-8210 of the AHA database. All algorithms were tested under equal conditions. RESULTS: For 5 well-known standard and 5 new ventricular fibrillation detection algorithms we calculated the sensitivity, specificity, and the area under their receiver operating characteristic. In addition, two QRS detection algorithms were included. These results are based on approximately 330,000 decisions (per algorithm). CONCLUSION: Our values for sensitivity and specificity differ from earlier investigations since we used no preselection. The best algorithm is a new one, presented here for the first time.

Algorithms↗

Multiomics: the intersection of personalized nutrition in cardiometabolic diseases.

BACKGROUND: Cardiometabolic diseases are among the leading causes of increasing morbidity and mortality worldwide. However, current population-based dietary recommendations do not sufficiently account for biological differences between individuals and therefore do not have the same effect on everyone. The multiomic approach, which incorporates genomic, epigenomic, transcriptomic, proteomic, metabolomic, and microbiome data, facilitates more accurate classification of disease risk and selection of appropriate nutritional interventions by mapping food-disease relationships across different biological layers. METHODS: Through a narrative synthesis of the current literature, we focused on evidence from multiomic studies to assess their ability to guide personalized nutrition strategies based on individual genetic, metabolic, and microbiome characteristics in cardiometabolic diseases. RESULTS: Recent evidence indicates that metabolomic markers have been reported to provide predictive value in addition to classic risk indicators and to increase the predictive power of models when combined with genetic data. Microbiome research shows that glycemic and lipemic responses can be predicted using algorithms based on gut microbiota. Recent clinical studies show that personalized nutrition plans, which evaluate the microbiome and clinical characteristics together, improve continuous glucose monitoring-based glycemic control, glycated hemoglobin levels, and triglycerides more than the classic Mediterranean diet. CONCLUSION: This review summarizes the current multiomic evidence, discusses the methodological and practical challenges in this field, and highlights future priorities. The integration of digital biomarkers obtained from wearable technologies with multiomic systems and artificial intelligence-supported models, when developed in accordance with ethical and equitable access principles, has the potential to support the transition from the discovery phase to patient-centered clinical applications.

Humans↗

Stereotactic limbic leucotomy--a follow-up at 16 months.

Sixty-six patients were assessed clinically, psychologically and physiologically before operation, at six weeks and at a mean of 16 months following stereotactic limbic leucotomy. Seventy-three per cent were clinically improved at six weeks and 76 per cent at 16 months. In obsessional neurosis, 89 per cent of patients showed definite clinical improvement at 16 months; in chronic anxiety, 66 per cent were improved; in depression, 78 per cent; and in the small number of schizophrenics treated the improvement rate was over 80 per cent. Self-assessment and observer-assessment questionaires and scales measuring Depression, Anxiety, Neuroticism, Hysterical symptoms and Obsessional symptoms and traits all showed highly significant reductions of mean scores at 16 months. There was no fall-off in intelligence, and adverse effects were minimal. Limbic leucotomy, with its enhanced accuracy and safety, compares very favourably with similarly assessed, more extensive 'free-hand' procedures, and in obsessional neurosis and chronic anxiety the results are superior.

Adult↗

Hepatitis C virus infection and neurocognitive function.

Hepatitis C virus (HCV) infection may be associated with neurocognitive deficits. The Hemophilia Growth and Development Study enrolled HIV-infected and HIV-uninfected patients and a group of nonhemophiliac siblings. After controlling for multiple factors, HCV monoinfection was not associated with deficits in adaptive behavior, intelligence, or attention/concentration.

Adaptation, Psychological↗

Maternal seizure disorder, outcome of pregnancy, and neurologic abnormalities in the children.

Among 45,000 pregnant women, 21.4 per 1000 (2.1%) reported at least one seizure before or during pregnancy. During the study pregnancy, 4.4 per 1000 had a noneclamptic seizure, and another 4.5 per 1000 had one in the 5 years preceding the study. Stillbirth, microcephaly, mental retardation, and nonfebrile seizure disorders occurred with heightened frequency in the offspring of women with seizure disorders; low birthweight, neonatal seizures, and first-year deaths were not more common. Approximately 80% of the women with seizure disorders had infants with none of the unfavorable outcomes studied. The observational nature of this and other clinical studies on this topic makes it difficult to evaluate the role of medical therapy in the outcome.

Anticonvulsants↗

Higher neonatal cerebral blood flow correlates with worse childhood neurologic outcome.

Cerebral blood flow (CBF) in newborn infants is often below levels necessary to sustain brain viability in adults. Controversy exists regarding the effects of such low CBF on subsequent neurologic function. We determined the current childhood neurologic status and IQ in 26 subjects who had measurements of CBF performed with PET in the neonatal period between 1983 and 1989 as part of a study of hypoxic-ischemic encephalopathy. Follow-up information at ages 4 to 12 years was obtained on all 26 subjects. Ten subjects had died. All 16 survivors underwent clinical neurologic evaluation, and 14 also underwent intelligence testing. Eight had abnormal clinical neurologic evaluations; eight were normal. The mean neonatal CBF in those with abnormal childhood neurologic outcome was significantly higher than in those with normal childhood neurologic outcome (35.64 +/- 11.80 versus 18.26 +/- 8.62 mL 100 g(-1) min(-1), t = 3.36, p = 0.005). A significant negative correlation between neonatal CBF and childhood IQ was demonstrated (Spearman rank correlation r = -0.675, p = 0.008). Higher CBF was associated with lower IQ. The higher CBF in subjects with worse neurologic and intellectual outcome may reflect greater loss of cerebrovascular autoregulation or other vascular regulatory mechanisms due to more severe brain damage.

Cerebrovascular Circulation↗

Exploring MEDLINE abstracts with XplorMed.

XplorMed is a publicly available web tool conceived to make life easier for MEDLINE(c) users looking for scientific information. Searching scientific literature is an information retrieval problem. Abstracts that are of possible interest to the user are usually selected by a keyword search followed by manual screening, which often results in the retrieval of a large number of abstracts. Interesting references can be buried among irrelevant ones because of nonspecific queries. XplorMed is intended to extract dependency relations between the words of the abstracts. These relations can be filtered and arranged to deduce different subjects in the query and offer a condensed view of the abstract, allowing users to select texts of interest without having to read them all. XplorMed is available http://www.bork. embl-heidelberg.de/xplormed.

Artificial Intelligence↗

["The demon that turned into worms": the translation of public health in the British Caribbean, 1914-1920].

The earliest programs of the Rockefeller Foundation's International Health Commission - IHC were pilot projects for the treatment of hookworm disease in the British colonies of British Guiana and Trinidad. These pioneering ventures into international health have often been portrayed as governed by rigid biomedical principles. In contrast to this view, the article emphasizes the degree to which the exigencies of a public health project that sought to make biomedicine intelligible within the medical systems of subject populations combined with the knowledge of local IHC staff members of Indo-Caribbean descent to generate some fascinating experiments in ethno-medical translation. One term in particular "The Demon that Turned into Worms" is focused on to show how these efforts at medical translation may have legitimized and promoted medical pluralism.

Animals↗

Assessment of the health effects of chemicals in humans: II. Construction of an adverse effects database for QSAR modeling.

The FDA's Spontaneous Reporting System (SRS) database contains over 1.5 million adverse drug reaction (ADR) reports for 8620 drugs/biologics that are listed for 1191 Coding Symbols for Thesaurus of Adverse Reaction (COSTAR) terms of adverse effects. We have linked the trade names of the drugs to 1861 generic names and retrieved molecular structures for each chemical to obtain a set of 1515 organic chemicals that are suitable for modeling with commercially available QSAR software packages. ADR report data for 631 of these compounds were extracted and pooled for the first five years that each drug was marketed. Patient exposure was estimated during this period using pharmaceutical shipping units obtained from IMS Health. Significant drug effects were identified using a Reporting Index (RI), where RI = (# ADR reports / # shipping units) x 1,000,000. MCASE/MC4PC software was used to identify the optimal conditions for defining a significant adverse effect finding. Results suggest that a significant effect in our database is characterized by > or = 4 ADR reports and > or = 20,000 shipping units during five years of marketing, and an RI > or = 4.0. Furthermore, for a test chemical to be evaluated as active it must contain a statistically significant molecular structural alert, called a decision alert, in two or more toxicologically related endpoints. We also report the use of a composite module, which pools observations from two or more toxicologically related COSTAR term endpoints to provide signal enhancement for detecting adverse effects.

Adverse Drug Reaction Reporting Systems↗