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PubMed2005

Principal-components analysis of fluorescence cross-section spectra from pathogenic and simulant bacteria.

Principal-components analysis of a new set of highly resolved (< 1 nm) fluorescence cross-section spectra excited at 354.7 nm over the 370-646 nm band has been used to demonstrate the potential ability of UV standoff lidars to discriminate among particular biological warfare agents and simulants over short ranges. The remapped spectra produced by this technique from Bacillus globigii (Bg) and Bacillus anthracis (Ba) spores were sufficiently different to allow them to be cleanly separated, and the Ba spectra obtained from Sterne and Ames strain spores were distinguishable. These patterns persisted as the spectral resolution was subsequently degraded in processing from approximately 1 to 34 nm. This is to the author's knowledge the first time that resolved fluorescence spectra from biological warfare agents have been speciated or shown to be distinguishably different from those normally used surrogates by optical spectroscopy.

Algorithms↗
PubMed1991

Sunscreen. The ultimate cosmetic.

There are sunscreens for every type of skin, activity, and personality. The physician should select a product for his patients intelligently, considering factors such as convenience, protection, sensitization, and comedogenicity.

4-Aminobenzoic Acid↗
PubMed1997

Polymerized colloidal crystal hydrogel films as intelligent chemical sensing materials.

Chemical sensors respond to the presence of a specific analyte in a variety of ways. One of the most convenient is a change in optical properties, and in particular a visually perceptible colour change. Here we report the preparation of a material that changes colour in response to a chemical signal by means of a change in diffraction (rather than absorption) properties. Our material is a crystalline colloidal array of polymer spheres (roughly 100 nm diameter) polymerized within a hydrogel that swells and shrinks reversibly in the presence of certain analytes (here metal ions and glucose). The crystalline colloidal array diffracts light at (visible) wavelengths determined by the lattice spacing, which gives rise to an intense colour. The hydrogel contains either a molecular-recognition group that binds the analyte selectively (crown ethers for metal ions), or a molecular-recognition agent that reacts with the analyte selectively. These recognition events cause the gel to swell owing to an increased osmotic pressure, which increases the mean separation between the colloidal spheres and so shifts the Bragg peak of the diffracted light to longer wavelengths. We anticipate that this strategy can be used to prepare 'intelligent' materials responsive to a wide range of analytes, including viruses.

Barium↗
PubMed1990

Risk within reason.

Advances in low-level risk detection threaten to engulf us with information. Regulators typically respond to each newly highlighted risk, whether painstakingly uncovered through scientific investigation or divulged with fanfare by the media, on an ad hoc basis. This response makes it hard to relate disparate risks to the overall risk level and impedes intelligent risk reduction, which must consider the costs and benefits involved. Efficient risk management requires decisions not only about what to regulate and how stringently, but also about the appropriate division of labor among the agents influencing risks. These agents include individuals, whose potential contributions too often are overlooked, corporations, and government.

Decision Making↗
PubMed1986

Emotional and intellectual correlates of unsuccessful suicide attempts in people with epilepsy.

This study evaluated the emotional and intellectual correlates of unsuccessful suicide attempts in persons with seizure disorders. Psychosocial evaluations were completed on 198 adults with epilepsy, of whom 32 had made one or more suicide attempts. The MMPI demonstrated increased anxiety and decreased ego strength among those with histories of suicide attempts in comparison to those without such a history. Intellectual abilities as evaluated by the WAIS were slightly lower among the suicide attempters, especially on language-related tasks. Unsuccessful suicidal behavior in epilepsy is probably the product of multiple conditions and circumstances, including seizures themselves, decreased adaptive abilities, increased emotional problems, and the continual availability of agents (antiepileptic medications) with which a suicide attempt may be undertaken.

Adolescent↗
PubMed1989

The premenstrual syndrome--diagnosis and management.

Premenstrual syndrome is an extremely common disorder. Prospective documentation of symptoms and their temporal relationship to menstruation establishes the diagnosis of PMS. Because the pathophysiologic mechanisms causing PMS are still undetermined, therapy for PMS is largely empiric. A number of pharmacologic agents may be used to reduce PMS symptomatology, and therapeutic decisions should be tailored to the individual's symptom complex. Many women will be able to lead more productive lives if PMS is properly diagnosed and intelligently treated.

Clinical Trials as Topic↗
PubMed2003

Formalizing an electronic institution for the distribution of human tissues.

The use of multi-agent systems (MAS) in health-care domains is increasing. Such agent-mediated medical systems can manage complex tasks and have the potential to adapt gracefully to unexpected events. However, in these kinds of systems the issues of privacy, security and trust are particularly sensitive in relation to matters such as agents' access to patient records, what is acceptable behaviour for an agent in a particular role and the development of trust both between (heterogeneous) agents and between users and agents. To address these issues we propose a formal normative framework, deriving from and developing the notion of an electronic institution. Such institutions provide a framework to define and police norms that guide, control and regulate the behaviour of the heterogeneous agents that participate in the institution. These norms define the acceptable actions that each agent may perform depending on the role or roles it is playing, and clearly specifies the data it may access and/or modify in playing those roles. In this paper, we present the formalization of Carrel, a virtual organization for the procurement of organs and tissues for transplantation purposes, as an electronic institution using the ISLANDER institution specification language as formalizing languages. We demonstrate aspects of the formalization of such an institution, example fragments in the language used for the textual specification, and how such formalization can be used as a blueprint in the implementation of the final agent architecture, through techniques such as skeleton generation.

Artificial Intelligence↗
PubMed2006

[Spectrum of neuropsychiatric features associated with velocardiofacial syndrome (Deletion 22q11.2)].

Microdeletion 22q11.2 (22q11DS) is the most frequent chromosomal deletion known in man. Velocardiofacial syndrome is one of numerous clinical syndromes that can be attributed to this micro deletion. There is an increasing recognition of associations with neuropsychiatric disorders. Particularly, schizophrenic psychosis, attention-deficit/hyperactivity disorder (ADHD), intellectual impairment and learning disabilities, seizures and motoric abnormalities have been identified in patients with 22q11DS. Recent studies supported the association of schizophrenia and 22q11DS, but the pathogenetic implications for idiopathic schizophrenia are still controversial. We report on two clinical cases in which psychotic symptoms led to the molecularcytogenetic diagnosis of microdeletion 22q11.2. Additionally, this article gives a systematic review of literature regarding psychiatric disorders, neurologic symptoms and partly corresponding morphological brain abnormalities in 22q11 deletion syndromes.

Adult↗
PubMed1999

Brain tumors in children with neurofibromatosis: additional neuropsychological morbidity?

Neurofibromatosis type 1 is a common autosomal dominant genetic disorder associated with numerous physical anomalies and an increased incidence of neuropsychological impairment. Tumors of the CNS occur in approximately 15% of children with neurofibromatosis, presenting additional risk for cognitive impairment. This study examines the impact of an additional diagnosis of brain tumor on the cognitive profile of children with neurofibromatosis. A comprehensive battery of neuropsychological tests was administered to 149 children with neurofibromatosis. Thirty-six of these children had a codiagnosis of brain tumor. A subset of 36 children with neurofibromatosis alone was matched with the group of children diagnosed with neurofibromatosis and brain tumor. Although mean scores of the neurofibromatosis plus brain tumor group were, in general, lower than those of the neurofibromatosis alone group, these differences were not statistically significant. Children in the neurofibromatosis plus brain tumor group who received cranial irradiation (n = 9) demonstrated weaker academic abilities than did children with brain tumor who had not received that treatment. These results suggest that neurofibromatosis is associated with impairments in cognitive functioning, but the severity of the problems is not significantly exacerbated by the codiagnosis of a brain tumor unless treatment includes cranial irradiation.

Adolescent↗
PubMed1984

The fear of reducing medication, and where have all the patients gone?

In spite of the enormous effort made by the Boston group, the findings were few. The high rate of dropouts and refusals to be assessed raise serious questions. One significant point that should be raised is that there was no difference in the use of medication between the treatments, and there should have been to foster underlying change with expressive psychotherapy. Also, treatment was not attempted without medication. Did patients drop out to avoid medication? Would a more flexible technique such as multiple crisis intervention have reduced dropout? Did selecting subjects with normal Wechsler Adult Intelligence Scale scores eliminate severe thought disorders, making differential improvement impossible? Was eliminating the sickest third of patients a mistake?

Antipsychotic Agents↗
PubMed2005

A multiagent system enhancing home-care health services for chronic disease management.

In this paper, a multiagent system (MAS) is presented, aiming to enhance monitoring, surveillance, and educational services of a generic medical contact center (MCC) for chronic disease management. In such a home-care scenario, a persistent need arises for efficiently monitoring the patient contacts and the MCC's functionality, in order to effectively manage and interpret the large volume of medical data collected during the patient sessions with the system, and to assess the use of MCC resources. Software agents were adopted to provide the means to accomplish such real-time information-processing tasks, due to their autonomous, reactive and/or proactive nature, and their effectiveness in dynamic environments by incorporating coordination strategies. Specifically, the objective of the MAS is to monitor the MCC environment, detect important cases, and inform the healthcare and administrative personnel via alert messages, notifications, recommendations, and reports, prompting them for actions. The main aim of this paper is to present the overall design and implementation of a proposed MAS, emphasizing its functional model and architecture, as well as on the agent interactions and the knowledge-sharing mechanism incorporated, in the context of a generic MCC.

Artificial Intelligence↗
PubMed2003

Cochlear implantation for progressive hearing loss.

The concept of neural plasticity and the early natural abilities of hearing children to acquire speech and language without instruction have led many authorities to advocate cochlear implantation before the age of 5 years in congenital deafness. Older children therefore become lower priority for scarce public funds because they are perceived to have passed the "window of opportunity" to learn speech, even if hearing is restored, and continue to rely on sign language. This paper shows that a subgroup of congenitally deaf children exists, who, having made good progress with conventional hearing aids, suffer a sudden or progressive hearing deterioration which arrests the speech development. Sixty children have been implanted in the Cambridge Programme, half for meningitis or other acquired losses and half for congenital prelingual deafness. Six of this latter group were congenital but progressive; their progress, deterioration, and improvement after implantation are summarised.

Adolescent↗
PubMed2004

Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry.

OBJECTIVE: Some children in the United States continue to be exposed to levels of lead that increase their risk for lowered intellectual functioning and behavior problems. It is unclear whether chelation therapy can prevent or reverse the neurodevelopmental sequelae of lead toxicity. The objective of this study was to determine whether chelation therapy with succimer (dimercaptosuccinic acid) in children with referral blood lead levels between 20 and 44 microg/dL (0.96-2.12 micromol/L) at 12 to 33 months of age has neurodevelopmental benefits at age 7 years. METHODS: The Treatment of Lead-Exposed Children (TLC) study is a randomized, double-blind, placebo-controlled trial that was conducted between September 1994 and June 2003 in Philadelphia, PA; Newark, NJ; Cincinnati, OH; and Baltimore, MD. Of 1854 referred children who were between the ages of 12 to 33 months and screened for eligibility, 780 were randomized to the active drug and placebo groups stratified by clinical center, body surface area, blood lead level, and language spoken at home. At 7 years of age, 647 subjects remained in the study. Participants were randomly assigned to receive oral succimer or placebo. Up to 3 26-day courses of succimer or placebo therapy were administered depending on response to treatment in those who were given active drug. Eighty-nine percent had finished treatment by 6 months, with all children finishing by 13 months after randomization. All participants received residential lead hazard control measures before treatment. TLC subjects also received a daily multivitamin supplement before and after treatment(s) with succimer or placebo. Scores on standardized neuropsychological measures that tap cognition, behavior, learning and memory, attention, and neuromotor skills were measured. RESULTS: Chelation therapy with succimer lowered average blood lead levels for approximately 6 months but resulted in no benefit in cognitive, behavioral, and neuromotor endpoints. CONCLUSION: These new follow-up data confirm our previous finding that the TLC regimen of chelation therapy is not associated with neurodevelopmental benefits in children with blood lead levels between 20 and 44 microg/dL (0.96-2.17 micromol/L). These results emphasize the importance of taking environmental measures to prevent exposure to lead. Chelation therapy with succimer cannot be recommended for children with blood lead levels between 20 and 44 microg/dL (0.96-2.12 micromol/L).

Chelating Agents↗
PubMed2005

Follow-up at 15 years of preterm infants from a controlled trial of moderately early dexamethasone for the prevention of chronic lung disease.

OBJECTIVE: Postnatal dexamethasone treatment of ventilator-dependent preterm infants results in rapid improvement in lung function and reduction in chronic lung disease. However, limited data are available on long-term outcomes after such therapy. We studied growth, neurodevelopmental, and pulmonary outcomes at adolescence in children who had participated in a double-blind, placebo-controlled trial of dexamethasone beginning at 2 weeks of age for the prevention of chronic lung disease. METHODS: Thirty-six infants (birth weight < or =1250 g and gestational age < or =30 weeks) who were dependent on mechanical ventilation at 2 weeks of age received a 42-day course of dexamethasone, an 18-day course of dexamethasone, or saline placebo. Twenty-two children survived to 15 years (69% of the 42-day dexamethasone group, 67% of the 18-day dexamethasone group and 45% of the control group), and all were evaluated. Intact survival was defined as survival with normal neurologic examination, IQ >70, and receiving education in the regular classroom. RESULTS: There were no differences among groups for growth or incidence of neurologic abnormalities. The mean IQ for the 42-day dexamethasone group was 85 +/- 10 compared with 60 +/- 20 for the 18-day dexamethasone group and 73 +/- 23 for the control group. All children in the 42-day dexamethasone group were receiving education in the regular classroom compared with only 50% of the 18-day dexamethasone group and 40% of the control group. As a result, intact survival was significantly greater for the 42-day dexamethasone group (69%) than for either the 18-day dexamethasone group (25%) or the control group (18%). Pulmonary function was significantly better for the 42-day dexamethasone group compared with the 18-day dexamethasone group (eg, forced expiratory volume in 1 second: 90 +/- 16 vs 71 +/- 15% predicted, respectively). CONCLUSION: A 42-day course of dexamethasone therapy beginning at 2 weeks of age in preterm infants who are at high risk for severe chronic lung disease was associated with improved long-term neurodevelopmental outcome. Although additional research is needed to establish the optimal steroid preparation, dosage, and duration of therapy, these data support the view that moderately early (beginning at 1-2 weeks) corticosteroid treatment is advantageous for a select group of ventilator-dependent preterm infants.

Adolescent↗
PubMed2004

Simulating physiology and methods for therapeutic evaluation with emphasis on hypertension.

Improvements in therapy are aimed at better diagnosis and more effective treatment. The use of computer simulation has the potential to improve therapy in both ways. Computational methods have been used extensively in diagnosis, for interpreting MRI results, CAT scans and the development of treatments in the study of biochemical structure. The present review examines how simulation may be used to play a more fundamental role in therapeutic treatment often referred to as In Silico Biology. Simulation of cells, organs and systems, such as pulmonary and cardiovascular, can be used in clinical practice to improve diagnosis. Initially these developments will probably have to be refined before being used in general practice. However, when these simulations are linked with artificial intelligence techniques containing experimental databases then very powerful tools will result. The use of simulation in the design and development of new drugs can both be cost and time effective. Again, artificial intelligence techniques are likely to play an important role in evaluating patient risk factors and unwanted side effects.

Antihypertensive Agents↗
PubMed2002

Long-term neuropsychological follow-up and nosological considerations in five patients with continuous spikes and waves during slow sleep.

Continuous spikes and waves during slow sleep (CSWSS) is a well-known EEG pattern that can be associated with cognitive and behavioural deterioration. We present the long-term neuropsychological follow-up and nosological considerations of five patients who developed CSWSS during childhood. All five of our patients presented CSWSS, although the duration and severity of this pattern varied. The outcome was of three basic types: acquired frontal dementia, language deficits and normal. Four of our patients were initially diagnosed with Landau-Kleffner syndrome but have had markedly diverse outcomes in terms of the severity and type of compromise. Our data suggest that the initial diagnosis, according to current nosological categories, has almost no prognostic significance, while the length and the age of onset of CSWSS, the site of epileptiform activity and the individual neuropsychological profile are more useful for identifying the long-term outcome of patients with CSWSS.

Adrenocorticotropic Hormone↗