[Psychotropic effects of a cerebral blood circulation stimulating agent in geriatric patients].
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Adenosine↗
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Results for “Intelligent agents”
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Autistic children: diagnosis and clinical features.
Autism is one of the behaviorally defined developmental disorders of brain function. It has a variety of genetic and nongenetic etiologies, with etiology being unknown in the majority of children. Boys are more frequently affected than girls. Manifest in the preschool years, autism always affects sociability, communication, and the child's repertoire of activities and interests. Autism encompasses children with a broad range of severities and a variety of other signs of brain dysfunction. These include motor signs, notably stereotypies; abnormal responses to a variety of sensory stimuli; and disorders of affect and attention. A significant proportion of autistic children experience epileptic seizures and have abnormal EEGs. Neuroimaging, preferably magnetic resonance imaging, discloses abnormalities of brain development in a minority of autistic persons. The level of intelligence may range from profound mental deficiency to giftedness. The pattern of cognitive skills is likely to be uneven, typically with better nonverbal than verbal skills. In the preschool years, all autistic children have a developmental language disorder. Verbal expression may range from total lack of language to verbosity with echolalia; comprehension and language use are invariably impaired. While there is no specific pharmacologic agent to mitigate the fundamental disorder, children may benefit from drugs to treat specific symptoms such as attention disorder and seizures. Although autistic behaviors are the consequence of a static disorder of brain function, their character changes with maturation and appropriate intervention. Communication skills and sociability remain deficient but improve in all but the most severely affected children. Outcome is a function of both innate cognitive competence and the effectiveness of early intervention focused on the development of appropriate social skills and meaningful communication. Intelligent autistic adults may be educable, employable, and able to live independently, while more severely handicapped ones require a lifelong protected environment.
Autistic Disorder↗
Amiodarone: electrophysiologic actions, pharmacokinetics and clinical effects.
Interest in amiodarone has increased because of its remarkable efficacy as an antiarrhythmic agent. The purpose of this report is to review what is known about the electrophysiologic actions, hemodynamic effects, pharmacokinetics, alterations of thyroid function, response to treatment of supraventricular and ventricular tachyarrhythmias and adverse effects of amiodarone. Understanding the actions of amiodarone and its metabolism will provide more intelligent use of the drug and minimize the development of side effects. The mechanism by which amiodarone suppresses cardiac arrhythmias is not known and may relate to prolongation of refractoriness in all cardiac tissues, suppression of automaticity in some fibers, minimal slowing of conduction in fast channel-dependent tissue, or to interactions with the autonomic nervous system, alterations in thyroid metabolism or other factors. Amiodarone exerts definite but fairly minor negative inotropic effects that may be offset by its vasodilator actions. Amiodarone has a reduced clearance rate, large volume of distribution, low bioavailability and a long half-life that may last 2 months in patients receiving short-term therapy. Therapeutic serum concentrations range between 1.0 and 3.5 micrograms/ml. The drug suppresses recurrences of cardiac tachyarrhythmias in a high percent of patients, in the range of 80% or more for most supraventricular tachycardias and in about 66% of patients with ventricular tachyarrhythmias, sometimes requiring addition of a second antiarrhythmic agent. Side effects, particularly when high doses are used, may limit amiodarone's usefulness and include skin, corneal, thyroid, pulmonary, neurologic, gastrointestinal and hepatic dysfunction. Aggravation of cardiac arrhythmias occurs but serious arrhythmias are caused in less than 5% of patients. Amiodarone affects the metabolism of many other drugs and care must be used to reduce doses of agents combined with amiodarone.
Administration, Oral↗
Developing BSN leaders for the future: the Fuld Leadership Initiative for Nursing Education (LINE).
The Helene Fuld Leadership Initiative in Nursing Education (LINE) program was designed to enhance beginning leadership competencies of baccalaureate nursing students. Given the increasing need for strong and effective leadership throughout the health care system, and the demands new graduates encounter as they move into practice, the LINE program is built on the premise that leadership skills must be instilled at the undergraduate level. The program achieves its goal through an intensive 5-day institute focused on assessing and developing the leadership competencies of nurse educators and their clinical partners to enable them to be effective agents of curriculum change in their home institutions. The institute also assists participants to redesign their baccalaureate nursing (BSN) curricula to ensure that students learn to: (1) work effectively within and across complex, integrated organizational and institutional boundaries; (2) think and act from the perspective of a system; and (3) communicate, negotiate, lead, and facilitate change within health care organizations. D. Goleman's (1998) framework of emotional intelligence, which addresses both personal competence (managing oneself) and social competence (handling one's relationships with others) provides the framework for operationalizing leadership in the BSN curriculum. To date, 26 BSN programs and their clinical partners have participated in the LINE program, which has the potential to influence the beginning leadership development of more than 2,400 BSN students. Program outcomes reveal that education-practice collaboration, professional networking, individual leadership development of nurse educators and their clinical partners as change agents, and the integration of leadership experiences at all levels of the BSN curriculum are important in developing beginning leadership competencies in BSN students.
Communication↗
Coupled computational simulation and empirical research into the foraging system of Pharaoh's ant (Monomorium pharaonis).
The Pharaoh's ant (Monomorium pharaonis), a significant pest in many human environments, is phenomenally successful at locating and exploiting available food resources. Several pheromones are utilized in the self-organized foraging of this ant but most aspects of the overall system are poorly characterised. Agent-based modelling of ants as individual complex X-machines facilitates study of the mechanisms underlying the emergence of trails and aids understanding of the process. Conducting simultaneous modelling, and simulation, alongside empirical biological studies is shown to drive the research by formulating hypotheses that must be tested before the model can be verified and extended. Integration of newly characterised behavioural processes into the overall model will enable testing of general theories giving insight into division of labour within insect societies. This study aims to establish a new paradigm in computational modelling applicable to all types of multi-agent biological systems, from tissues to animal societies, as a powerful tool to accelerate basic research.
Animals↗
Bioinformatics integration and agent technology.
Vast amounts of life sciences data are scattered around the world in the form of a variety of heterogeneous data sources. The need to be able to co-relate relevant information is fundamental to increase the overall knowledge and understanding of a specific subject. Bioinformaticians aspire to find ways to integrate biological data sources for this purpose and system integration is a very important research topic. The purpose of this paper is to provide an overview of important integration issues that should be considered when designing a bioinformatics integration system. The currently prevailing approach for integration is presented with examples of bioinformatics information systems together with their main characteristics. Here, we introduce agent technology and we argue why it provides an appropriate solution for designing bioinformatics integration systems.
Algorithms↗
A hybrid fuzzy logic/constraint satisfaction problem approach to automatic decision making in simulation game models.
Possible techniques for representing automatic decision-making behavior approximating human experts in complex simulation model experiments are of interest. Here, fuzzy logic (FL) and constraint satisfaction problem (CSP) methods are applied in a hybrid design of automatic decision making in simulation game models. The decision processes of a military headquarters are used as a model for the FL/CSP decision agents choice of variables and rulebases. The hybrid decision agent design is applied in two different types of simulation games to test the general applicability of the design. The first application is a two-sided zero-sum sequential resource allocation game with imperfect information interpreted as an air campaign game. The second example is a network flow stochastic board game designed to capture important aspects of land manoeuvre operations. The proposed design is shown to perform well also in this complex game with a very large (billionsize) action set. Training of the automatic FL/CSP decision agents against selected performance measures is also shown and results are presented together with directions for future research.
Algorithms↗
Effect of neuroleptic treatment on involuntary movements and motor performances in Huntington's disease.
Eighteen patients with Huntington's chorea were examined before and after neuroleptic treatment (haloperidol, pimozide, tiapride) to study the effect of such treatment on hyperkinesia and motor performance. Pimozide and haloperidol improved hyperkinesia; none of the drugs significantly affected motor performance. No correlation was found between the severity of hyperkinesia and motor performance scores, or between hyperkinesia and intelligence score, before and after therapy.
Adult↗
Description and advantages of an index-driven medical knowledge base.
In the FRAMEMED system design, the inherent attributes of its concepts are expressed in the hierarchical lists of its 26 Elements (e.g., Agents, Clinical Manifestations, Diseases, Tests, etc.). These concepts, contained in regular structures, are then alphabetized by phrase (and synonym), forming a combined index in which the user may quickly find a concept either alphabetically or hierarchically. Stored in the structures of the index are pointers to four types of knowledge records: 1) Descriptive (definition); 2) Relational (incidental attributes); 3) Conditional (rules); and 4) Procedural (how to). In contrast to the index which is stored in regular structures for rapid access (like relational databases), the knowledge records are stored in free text (variable length) and may include pointers to imaging and audio records. A particular feature of the FRAMEMED system is careful attention to modifiers, an aspect usually not emphasized in other systems. In trying to structure the free text describing a patient encounter, for example, the major concepts such as cough, fever, stiff neck, etc., are relatively easy to code (although a common system has not yet been agreed upon). The devil lies in the modifiers such as 'history of', 'severe,' 'constant,' 'absent,' 'left,' 'abnormal,' etc., particularly when there is concatenation of modifiers modifying modifiers. Our Relational records (in our knowledge base) and our Chronological Medical Records (CMR) in our patient record have the same format, namely, a title, several related items, and a date/author. For example, our disease profile (Relational record) for 'Influenza' might include 'cough,' 'fever,' and 'stiff neck.' The CMR of a particular patient encounter might include the same items. The only differences would be the title (disease name for the disease profile, date for the CMR, and the omission of the redundant date in the date/author line of the CMR). Each related item in either of these records is expressed in a four-part string, namely: 1) Relation; 2) Code; 3) Phrase; and 4) Comment. Modifiers (common ASCII symbols) are structured into each of these parts. For example, if the patient did not have 'cough,' the default '+' in the Relation would be edited to a '-', while 'history of' cough would be '>'. Each Relation can be graded (on a 5-level scale) for both importance and frequency. The Code for a test can carry the result suffix, '+ positive/high,' '-negative/low,' '# abnormal (qualitatively)', or '1 unremarkable/normal.' Topological information, such as '/left,' can be appended to a Code. If the cough is getting worse, its code can have the suffix, '<'. The standardized Phrases associated with the Codes come from the hierarchical lists of the index section described earlier. Phrases are not stored, being rematched to the codes as needed for user display. This practice not only saves memory space but allows a CMR encounter recorded in one language to be displayed in another second language subsequently, requiring only the existence of the hierarchical code/phrase in the second language. A free-text Comment is allowed for any related item in a Relational record or CMR, to allow the doctor to add important nuances such as 'worse on arising' or for a numeric result such as a test result or a thermometer reading. Some structuring can be accommodated in the Comment by introducing symbols such as '> relieved by,' followed by a list containing entries such as 'antacids.' Time can be sturctured through symbol lists such as '@-2 mo' representing '2 months previously.' Because Relational records in the knowledge ase and patient encoutner records in the CMR both display findings in hierarchical order; all similar items (e.g., Agents, Clinical Manifestations, Tests, Procedures, etc.) occur together and in an unique order. (abstract truncated)
Abstracting and Indexing↗
Using reinforcement learning to understand the emergence of "intelligent" eye-movement behavior during reading.
The eye movements of skilled readers are typically very regular (K. Rayner, 1998). This regularity may arise as a result of the perceptual, cognitive, and motor limitations of the reader (e.g., limited visual acuity) and the inherent constraints of the task (e.g., identifying the words in their correct order). To examine this hypothesis, reinforcement learning was used to allow an artificial "agent" to learn to move its eyes to read as efficiently as possible. The resulting patterns of simulated eye movements resembled those of skilled readers and suggest that important aspects of eye-movement behavior might emerge as a consequence of satisfying the constraints that are imposed on readers. These results also suggest novel interpretations of some contentious empirical results, such as the fixation duration costs associated with word skipping (R. Kliegl & R. Engbert, 2005), and theoretical assumptions, for example the familiarity check in the E-Z Reader model of eye-movement control (E. D. Reichle, A. Pollatsek, D. L. Fisher, & K. Rayner, 1998).
Algorithms↗
Evaluation of a remediation program using senior citizens as psychoeducational agents.
A remediation program for learning and psychosocially disabled pupils utilizing senior citizens as paraprofessional aides was evaluated. The senior citizens were effective in developing tutorial relationships conducive for the students' academic and psychosocial development, as indicated by pre- and posttesting. The disabled pupils improved their academic skills, as measured by standardized achievement and intelligence tests and by school grades. Statistical comparison with a control group further demonstrated the significance of the gains. The pupils' psychosocial adjustment also showed significant improvement on various personality assessment measures and behavior ratings by teachers and parents. Finally, self-reports by the senior citizen aides suggest that they also profited by their involvement in STEP.
Achievement↗
The influence of risperidone on attentional functions in children and adolescents with attention-deficit/hyperactivity disorder and co-morbid disruptive behavior disorder.
This study aims to examine the influence of risperidone on various attentional functions, including intensity and selectivity aspects of attention plus inhibitory control in children with attention deficit/hyperactivity disorder (ADHD) with co-morbid Disruptive Behavior Disorders (DBD) and normal IQ. Children with ADHD and DBD, aged 8-15 years, were treated with risperidone (mean daily dose: 1.5 mg; n = 23) and examined with three attentional paradigms before and after a 4-week treatment period. Age- and IQ-matched normal controls (n = 23) were also tested without medication on the same two occasions. No influence of the medication could be detected for any neuropsychological variable, neither as a positive enhancement nor as adverse side effects. However, clinical symptoms of ADHD and DBD assessed on the IOWA Conners Scale significantly improved after the 4-week treatment period. Divergent behavioral and cognitive effects of risperidone on ADHD symptoms were observed, with a significant reduction in behavioral symptoms, whereas no positive treatment effects were found on laboratory tasks of impulsivity. Thus, the cognitive effects of risperidone seem to differ from the cognitive effects of stimulant treatments in children with ADHD + DBD. However, no negative impact of risperidone was observed on attentional functions either, i.e., there was no slowing of cognitive speed.
Adolescent↗
Intellectual, neuropsychological, and academic functioning in long-term survivors of leukemia.
OBJECTIVE: To assess the effects of treatment for acute lymphoblastic leukemia (ALL) on children's cognitive functioning. METHOD: Participants were long-term survivors of ALL treated with cranial irradiation and central nervous system (CNS) chemotherapy (n = 20), or CNS chemotherapy only (n = 21), healthy children (n = 21), and children with chronic asthma (n = 21). The groups were compared on measures of intellectual, neuropsychological, and academic functioning. RESULTS: CNS chemotherapy, with and without cranial irradiation, was associated with significantly lower levels of intellectual and academic functioning. Children with chronic asthma obtained lower scores than healthy controls, but these differences were not significant. Tests of neuropsychological functioning did not consistently separate the groups. CONCLUSIONS: CNS chemotherapy and, to a lesser extent, chronic illness both contribute to the poorer performance of long-term survivors of ALL on measures of intellectual and academic functioning.
Achievement↗
Platelets and glomerulonephritis.
There is evidence derived from both experimental studies and from observation of human nephritis that platelets are important in the glomerular injury of chronic soluble-complex disease. It is not yet clear if platelets are involved in the events initiating endothelial damage, in perpetuating and amplifying injury, or both. Antiplatelet agents appear to have a role in the treatment of chronic forms of glomerulonephritis; but more knowledge of platelet involvement in nephritis and more readily available tests for platelet involvement are necessary before this suggestion can be tested intelligently.
Blood Platelets↗
Medication adherence among HIV+ adults: effects of cognitive dysfunction and regimen complexity.
BACKGROUND: Although the use of highly active antiretroviral therapy in the treatment of HIV infection has led to considerable improvement in morbidity and mortality, unless patients are adherent to their drug regimen (i.e., at least 90 to 95% of doses taken), viral replication may ensue and drug-resistant strains of the virus may emerge. METHODS: The authors studied the extent to which neuropsychological compromise and medication regimen complexity are predictive of poor adherence in a convenience sample of 137 HIV-infected adults. Medication adherence was tracked through the use of electronic monitoring technology (MEMS caps). RESULTS: Two-way analysis of variance revealed that neurocognitive compromise as well as complex medication regimens were associated with significantly lower adherence rates. Cognitively compromised participants on more complex regimens had the greatest difficulty with adherence. Deficits in executive function, memory, and attention were associated with poor adherence. Logistic regression analysis demonstrated that neuropsychological compromise was associated with a 2.3 times greater risk of adherence failure. Older age (>50 years) was also found to be associated with significantly better adherence. CONCLUSIONS: HIV-infected adults with significant neurocognitive compromise are at risk for poor medication adherence, particularly if they have been prescribed a complex dosing regimen. As such, simpler dosing schedules for more cognitively impaired patients might improve adherence.
Adult↗
Alzheimer's disease: risk and protection.
Only four risk factors for Alzheimer's disease can be regarded as confirmed--old age, family history of dementia, apo-E genotype and Down syndrome. Other disputed risk factors with some supporting evidence include ethnic group, head trauma and aluminium in drinking water. Possible protection factors, such as anti-inflammatory drugs, oestrogen replacement therapy and a high education level, are of great interest because they suggest possible preventive action.
Adult↗
Pharmacotherapy in early infantile autism.
An up-to-date review of drug treatment in psychoses of early childhood is presented. At the present time, of all biological interventions in these developmental disorders, drug treatment alone remains a valuable addition or an essential treatment modality of the total treatment. Experience has shown that a therapeutically effective potent drug can make the autistic child more amenable to other therapies, including special education. However, knowledge is lacking about the effect of various psychoactive agents on cognition in this patient population as well as their influence on growth, weight, endocrine systems, and organs. Drugs currently in use treat symptoms, not diseases. A great need for classification in this area persists. The same symptoms may be caused by a variety of etiologic factors, and autism may or may not be the earliest expression of childhood schizophrenia. It is suggested that clinical distinctions be correlated or even improved by certain biochemical, neuroendocrine, and physiological criteria; this also may be of considerable value in predicting whether a child can benefit from a specific drug.
Adolescent↗
Drug delivery and targeting.
When a pharmaceutical agent is encapsulated within, or attached to, a polymer or lipid, drug safety and efficacy can be greatly improved and new therapies are possible. This has provided the impetus for active study of the design of degradable materials, intelligent delivery systems and approaches for delivery through different portals in the body.
Drug Administration Routes↗