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Development of intelligence and memory in children with hemiplegic cerebral palsy. The deleterious consequences of early seizures.

Although substantial data exist regarding the consequences of early lateralized cerebral lesions on intelligence and language ability, little is known about the development of other cognitive functions after such lesions. We examined the development of both verbal and nonverbal memory in 82 hemiplegic children, grouped according to hemispheric side of injury and presence or absence of seizure disorder. The control group consisted of 41 age-matched normal children, most of them siblings of the patients. Measures were obtained of intelligence and of immediate and delayed recall for prose passages, word paired associates and geometric designs. Electrophysiological and neuroradiological measures were available for a majority of the patients. The scores of the hemiplegic children on the IQ and memory tests did not exhibit the pattern seen in brain-damaged adults, in that the children's deficits showed no relation to hemispheric side of damage. Indeed, early cerebral damage to either hemisphere, even if extensive, resulted in relatively few and mild deficits if the damage was unaccompanied by seizure activity. By contrast, early lateralized lesions that were accompanied by a seizure disorder resulted in both a high incidence and degree of deficit that was unrelated to lesion side.

Cerebral Palsy↗

Defining a left-lateralized response specific to intelligible speech using fMRI.

Functional imaging studies of language have shown bilateral superior temporal activations in response to 'passive' perception of speech when the baseline condition did not control for the acoustic complexity of speech. Controlling for this complexity demonstrates speech-specific processing lateralized to the left temporal lobe, and our recent positron emission tomography study has emphasized a role for left anterolateral temporal cortex in speech comprehension. This contrasts with the more usual view that relates speech comprehension to left temporal-parietal cortex, the ill-defined area of Wernicke. This study attempted to reconcile these differences, using a more sensitive 3 T functional magnetic resonance imaging system, and a sparse sampling paradigm. We found left lateralized activations for intelligible speech with two distinct foci, one in the anterior superior temporal sulcus and the other on the posterior temporal lobe. Therefore, the results demonstrate that there are neural responses to intelligible speech along the length of the left lateral temporal neocortex, although the precise processing roles of the anterior and posterior regions cannot be determined from this study.

Acoustic Stimulation↗

Structural alerts to genotoxicity: the interaction of human and artificial intelligence.

The assignments of 'structural alerts' by Ashby and associates as predictors of genotoxic carcinogenicity were used as the entries for CASE, an artificial intelligence-based structure-activity relational method. CASE, using this human intelligence-based information, was able to derive structural determinants that duplicate the informational content of the structural alerts (sensitivity, 0.974; specificity, 0.948). The CASE-predicted alerts performed as well as the results of the Salmonella mutagenicity assay or the direct application of structural alerts in predicting carcinogens.

Artificial Intelligence↗

Impact of genetic vulnerability and hypoxia on overall intelligence by age 7 in offspring at high risk for schizophrenia compared with affective psychoses.

Risk factors for schizophrenia, such as genetic vulnerability and obstetric complications, have been associated with cognitive deficits in schizophrenia. We tested the association of these risk factors with general intellectual ability in offspring at high risk for psychoses and normal control subjects. Offspring of 182 parents with DSM-IV schizophrenia or affective psychoses were recruited and diagnosed from the Boston and Providence cohorts of the National Collaborative Perinatal Project (NCPP). Control subjects from the NCPP were selected to be comparable with affected parents based on the parent's age, ethnicity, study site, number of offspring enrolled in the NCPP, and payment status, and on the offspring's age, sex, and history of obstetric complications. Based on data prospectively acquired from pregnancy and events of gestation, labor, delivery, and the neonatal period, we derived a measure of probable hypoxic-ischemic insult. We also report on standardized measures of general intelligence (intelligence quotient [IQ]) collected at age 7. General linear mixed models were used to test for the simultaneous effects of genetic vulnerability, defined as parental diagnosis, and probable hypoxic insult on age 7 IQ. Specificity of the effects for schizophrenia compared with affective psychoses and sex effects were also tested. Low IQ at age 7 was significantly associated with genetic vulnerability to psychoses, in particular with schizophrenia.

Adult↗

Longitudinal, prospective evaluations of intelligence in children at risk.

Data are presented from the intellectual assessment of 153 children at two test periods in the St. Louis Risk Research Project. At phase I (1967-72) the Wechsler tests of intelligence were administered to offspring in families with one schizophrenic parent, one parent with affective disorder, one parent with schizoaffective disorder, one physically ill parent, or to offspring with two normal parents (mean age, 8 years). At phase II (1975-78) the intelligence of offspring was tested again at a mean age of 16 years. Differences between children as a function of parental diagnoses were assessed using a repeated measures analysis of covariance. The analyses yielded significant time effects. A time-by-parental-diagnosis effect was found for Verbal IQ, with children of parents with schizophrenia, affective disorder, or physical illness all showing a greater decrease in their scores at the second testing than offspring in the other groups. Offspring of psychotic mothers had lower IQ scores than those of psychotic fathers. Children of schizophrenics and children of schizoaffectives had the lowest stability in IQ scores from the first to the second testing.

Adolescent↗

Development of speech intelligibility in children with recurrent otitis media.

This study defined developmental functions for Pediatric Speech Intelligibility word and sentence materials presented in quiet and in competition for 25 normal children and 25 children with recurrent otitis media. Ages ranged from 24 to 56 mos. In normal children, developmental functions for Pediatric Speech Intelligibility speech materials showed earlier development of performance (1) in quiet than in competition and (2) for words than for sentences (competing condition). In children with otitis media, developmental functions were normal for both words and sentences in quiet and for sentences in competition. However, developmental functions were grossly abnormal for words in competition.

Child, Preschool↗

Norms for disproportionate loss in speech intelligibility.

The audiometric records of 324 subjects with sensorineural hearing loss, presumed to be cochlear, were analyzed in order to develop norms for "disproportionate loss" in speech intelligibility. From the scatterplot relating PBmax to PTA2 (average of HTLs at 1,000, 2,000, and 4,000 Hz), and the scatterplot relating SSImax to PTA1 (average of HTLs at 500, 1,000, and 2,000 Hz), linear boundaries were constructed encompassing approximately 98% of observed values. A speech intelligibility score (PB or SSI) may be considered "disproportionately poor" if it falls below this empirically derived boundary.

Adolescent↗

Comparison of three hearing aid fittings using the Speech Intelligibility Rating (SIR) Test.

This study compared the effects of three different hearing aids on subjective ratings of speech intelligibility. Insertion gain measurements on KEMAR indicated that the hearing aid fittings differed primarily in midfrequency gain. The test passages of the Speech Intelligibility Rating Test (SIR) were recorded onto tape through each hearing aid. The processed passages were presented monaurally to 13 subjects with hearing loss limited to frequencies above 2000 Hz. They rated five passages through each frequency responses (FR) in a randomized order. Each subject was retested within 2 or 3 days to assess test-retest reliability. Results indicated that the FR with the most midfrequency amplification did not differ significantly from the aid with the least amount of midfrequency gain. However, the FR with intermediate midfrequency gain received significantly lower ratings than did FR with most gain. Examination of the data from individual subjects indicated that the SIR results did not show differences among the FRs for the majority of subjects.

Acoustics↗

Predicting IQ of biologically "at risk" children from age 3 to school entry: sensitivity and specificity of the Stanford-Binet Intelligence Scale IV.

Predictive validity of the Stanford-Binet Intelligence Scale Fourth Edition (S-B IV) from age 3 years to ages 4-5 years was evaluated with biologically "at risk" children without major sensory or motor impairments (n = 236). Using the standard scoring, children with full scale IQ < or = 84 on the Wechsler Preschool and Primary Scale of Intelligence at age 4-5 years were poorly identified (sensitivity 54%) from the composite S-B IV score at age 3. However, sensitivity improved greatly to 78% by including as a predictor the number of subtests the child was actually able to perform at age 3 years. Measures from the Home Screening Questionnaire and ratings of mother-child interaction further improved sensitivity to 83%. The standard method for calculating the composite score on the S-B IV excludes subtests with a raw score of 0, which overestimates cognitive functioning in young biologically high risk children. Accuracy of early identification was improved significantly by considering the number of subtests the child did not perform at age 3 years.

Brain Damage, Chronic↗

Application of artifical intelligence principles to the analysis of "crazy" speech.

Artificial intelligence computer simulation methods can be used to investigate psychotic or "crazy" speech. Here, symbolic reasoning algorithms establish semantic networks that schematize speech. These semantic networks consist of two main structures: case frames and object taxonomies. Node-based reasoning rules apply to object taxonomies and pathway-based reasoning rules apply to case frames. Normal listeners may recognize speech as "crazy talk" based on violations of node- and pathway-based reasoning rules. In this article, three separate segments of schizophrenic speech illustrate violations of these rules. This artificial intelligence approach is compared and contrasted with other neurolinguistic approaches and is discussed as a conceptual link between neurobiological and psychodynamic understandings of psychopathology.

Artificial Intelligence↗

Mitigating the impact of hospital restructuring on nurses: the responsibility of emotionally intelligent leadership.

BACKGROUND: A decade of North American hospital restructuring in the 1990s resulted in the layoff of thousands of nurses, leading to documented negative consequences for both nurses and patients. Nurses who remained employed experienced significant negative physical and emotional health, decreased job satisfaction, and decreased opportunity to provide quality care. OBJECTIVE: To develop a theoretical model of the impact of hospital restructuring on nurses and determine the extent to which emotionally intelligent nursing leadership mitigated any of these impacts. METHODS: The sample was drawn from all registered nurses in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (N = 6,526 nurses; 53% response rate). Thirteen leadership competencies (founded on emotional intelligence) were used to create 7 data sets reflecting different leadership styles: 4 resonant, 2 dissonant, and 1 mixed. The theoretical model was then estimated 7 times using structural equation modeling and the seven data sets. RESULTS: Nurses working for resonant leaders reported significantly less emotional exhaustion and psychosomatic symptoms, better emotional health, greater workgroup collaboration and teamwork with physicians, more satisfaction with supervision and their jobs, and fewer unmet patient care needs than did nurses working for dissonant leaders. DISCUSSION: Resonant leadership styles mitigated the impact of hospital restructuring on nurses, while dissonant leadership intensified this impact. These findings have implications for future hospital restructuring, accountabilities of hospital leaders, the achievement of positive patient outcomes, the development of practice environments, the emotional health and well-being of nurses, and ultimately patient care outcomes.

Alberta↗

Intelligent database generated occupational questionnaire system.

Obtaining an adequate occupational history requires special expertise to "ask the right questions" that are relevant to a particular patient's specific health conditions and potential exposures. This article describes a way to systematically accomplish this by means of a computer system that can overcome limited availability of necessary clinical occupational health expertise. The Intelligent Questionnaire system is a computer-based system for generating case-specific questionnaires about the influence of work on respiratory disease. Intelligent Questionnaire includes three databases: Questions, Responses, and Calls (clues to identify questions). The Questionnaire also arranges questions in a logical manner and provides a customized data entry screen for each subject. This approach provides primary practitioners with expertise on a case-by-case basis. It also facilitates occupational health surveillance because it allows acquiring detailed case-specific information in a systematic fashion. A computer-based system can facilitate obtaining occupational histories with high specificity and consistency without depending on general availability of a human occupational health clinical expertise.

Artificial Intelligence↗

Open-label, prospective trial of olanzapine in adolescents with subaverage intelligence and disruptive behavioral disorders.

OBJECTIVE: Olanzapine, an atypical antipsychotic, has been shown to be efficacious for treatment of psychotic and mood disorders in adults. This prospective, open-label study was conducted to examine the safety and usefulness of olanzapine in treating disruptive behavior disorders in adolescents with subaverage intelligence. METHOD: Sixteen adolescents (ages 13-17 years) with borderline to moderate mental retardation and disruptive behavior were enrolled in an 8-week olanzapine trial (5-20 mg/day). Dependent measures included the Aberrant Behavior Checklist, Conners Parent Rating Scale, Clinical Global Impressions, and two side effects scales. RESULTS: Statistically significant improvement (p <.002) was found on the Irritability and Hyperactivity subscales of the Aberrant Behavior Checklist and the Conners Parent Rating Scale Hyperactivity Index. No subjects developed extrapyramidal side effects. However, four were terminated prematurely from the trial because of either worsening of symptoms (requiring psychiatric inpatient hospitalization in two subjects) or side effects. The most common side effect for the sample was weight gain (averaging 12.7 lb), with 67% of subjects gaining > or =10 lb. Although there was also a statistically significant increase in prolactin levels, no subjects reported prolactin-related side effects (e.g., gynecomastia, galactorhea, amenorrhea). CONCLUSION: Olanzapine may be useful in treating disruptive behavior in adolescents with subaverage intelligence. However, side effects, especially weight gain, are a significant issue. Future double-blind, placebo-controlled studies need to confirm these findings and assess long-term safety and outcome of olanzapine treatment.

Adolescent↗

Risperidone reduces aggression in boys with a disruptive behaviour disorder and below average intelligence quotient: analysis of two placebo-controlled randomized trials.

The present study aimed to analyse the effect of risperidone on a priori defined core aggression items. Data were pooled from 163 boys (aged 5-12 years, with or without comorbid attention-deficit/hyperactivity disorder) with a DSM-IV diagnosis of either conduct disorder or oppositional defiant disorder who had participated in either of two identical, 6-week, randomized, double-blind, placebo-controlled trials. All received treatment with either placebo or oral risperidone solution (0.01-0.06 mg/kg/day). Subjects had below average intelligence [intelligence quotient (IQ) 36-84] and a score of > or =24 on the Conduct Problem subscale of the Nisonger Child Behaviour Rating Form (N-CBRF). An expert advisory panel selected six core aggression items from the N-CBRF, from which a total Aggression Score (AS, range 0-18) was constructed. Compared to those treated with placebo, risperidone-treated subjects experienced significantly greater mean decreases from baseline in the AS at each of weeks 1-6 (P<0.001). By study endpoint, aggression among risperidone-treated subjects had declined by 56.4% (mean baseline AS 10.1; mean endpoint AS 4.4), which was more than twice that of placebo-treated subjects (mean baseline AS 10.6; mean endpoint AS 8.3; 21.7% reduction). Risperidone was efficacious in reducing symptoms of aggression in boys of below average IQ with disruptive behaviour disorders.

Aggression↗

Intelligence with representation.

Behaviour-based robotics has always been inspired by earlier cybernetics work such as that of W. Grey Walter. It emphasizes that intelligence can be achieved without the kinds of representations common in symbolic AI systems. The paper argues that such representations might indeed not be needed for many aspects of sensory-motor intelligence but become a crucial issue when bootstrapping to higher levels of cognition. It proposes a scenario in the form of evolutionary language games by which embodied agents develop situated grounded representations adapted to their needs and the conventions emerging in the population.

Adaptation, Physiological↗

Intelligent machines in the twenty-first century: foundations of inference and inquiry.

The last century saw the application of Boolean algebra to the construction of computing machines, which work by applying logical transformations to information contained in their memory. The development of information theory and the generalization of Boolean algebra to Bayesian inference have enabled these computing machines, in the last quarter of the twentieth century, to be endowed with the ability to learn by making inferences from data. This revolution is just beginning as new computational techniques continue to make difficult problems more accessible. Recent advances in our understanding of the foundations of probability theory have revealed implications for areas other than logic. Of relevance to intelligent machines, we recently identified the algebra of questions as the free distributive algebra, which will now allow us to work with questions in a way analogous to that which Boolean algebra enables us to work with logical statements. In this paper, we examine the foundations of inference and inquiry. We begin with a history of inferential reasoning, highlighting key concepts that have led to the automation of inference in modern machine-learning systems. We then discuss the foundations of inference in more detail using a modern viewpoint that relies on the mathematics of partially ordered sets and the scaffolding of lattice theory. This new viewpoint allows us to develop the logic of inquiry and introduce a measure describing the relevance of a proposed question to an unresolved issue. Last, we will demonstrate the automation of inference, and discuss how this new logic of inquiry will enable intelligent machines to ask questions. Automation of both inference and inquiry promises to allow robots to perform science in the far reaches of our solar system and in other star systems by enabling them not only to make inferences from data, but also to decide which question to ask, which experiment to perform, or which measurement to take given what they have learned and what they are designed to understand.

Artificial Intelligence↗

Abstraction and reformulation in artificial intelligence.

This paper contributes in two ways to the aims of this special issue on abstraction. The first is to show that there are compelling reasons motivating the use of abstraction in the purely computational realm of artificial intelligence. The second is to contribute to the overall discussion of the nature of abstraction by providing examples of the abstraction processes currently used in artificial intelligence. Although each type of abstraction is specific to a somewhat narrow context, it is hoped that collectively they illustrate the richness and variety of abstraction in its fullest sense.

Artificial Intelligence↗

Intelligent stretching of ankle joints with contracture/spasticity.

An intelligent stretching device was developed to treat the spastic/contractured ankle of neurologically impaired patients. The device stretched the ankle safely throughout the range of motion (ROM) to extreme dorsiflexion and plantarflexion until a specified peak resistance torque was reached with the stretching velocity controlled based on the resistance torque. The ankle was held at the extreme position for a period of time to let stress relaxation occur before it was rotated back to the other extreme position. Stretching was slow at the joint extreme positions, making it possible to reach a larger ROM safely and it was fast in the middle ROM so the majority of the treatment was spent in stretching the problematic extreme ROM. Furthermore, the device evaluated treatment outcome quantitatively in multiple aspects, including active and passive ROM, joint stiffness and viscous damping and reflex excitability. The stretching resulted in considerable changes in joint passive ROM, stiffness, viscous damping and reflex gain. The intelligent control and yet simple design of the device suggest that with appropriate simplification, the device can be made portable and low cost, making it available to patients and therapists for frequent use in clinics/home and allowing more effective treatment and long-term improvement.

Adult↗