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PubMed2001

West Nile virus serosurvey and assessment of personal prevention efforts in an area with intense epizootic activity: Connecticut, 2000.

West Nile virus (WNV) can cause large outbreaks of febrile illness and severe neurologic disease. This study estimates the seroprevalence of WNV infection and assesses risk perception and practices regarding potential exposures to mosquitoes of persons in an area with intense epizootics in 1999 and 2000. A serosurvey of persons aged > or = 12 years was conducted in southwestern Connecticut during October 10-15, 2000, using household-based stratified cluster sampling. Participants completed a questionnaire regarding concern for and personal measures taken with respect to WNV and provided a blood sample for WNV testing. Seven hundred thirty persons from 645 households participated. No person tested positive for WNV (95% CI: 0-0.5%). Overall, 44% of persons used mosquito repellent, 56% practiced > or = two personal precautions to avoid mosquitoes, and 61% of households did > or = two mosquito-source reduction activities. In multivariate analyses, using mosquito repellent was associated with age < 50 years, using English as the primary language in the home, being worried about WNV, being a little worried about pesticides, and finding mosquitoes frequently in the home (P<0.05). Females (OR = 2.0; CI = 1.2-2.9) and persons very worried about WNV (OR = 3.8; CI = 2.2-6.5) were more likely to practice > or = two personal precautions. Taking > or = two mosquito source reductions was associated with persons with English as the primary language (OR = 2.0; CI = 1.1-3.5) and finding a dead bird on the property (OR = 1.8; CI = 1.1-2.8). An intense epizootic can occur in an area without having a high risk for infection to humans. A better understanding of why certain people do not take personal protective measures, especially among those aged > or = 50 years and those whose primary language is not English, might be needed if educational campaigns are to prevent future WNV outbreaks.

Adolescent↗

PubMedDate not supplied

Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI).

UNLABELLED: Levels of evidence differ according to the audience addressed. Implementation of universal newborn hearing screening requires responses to a complex myriad of diverse groups: the general public, families with children who are deaf or hard of hearing, the deaf and hard of hearing communities, hospital administrators, physicians (pediatricians, general practitioners, ear nose and throat physicians, geneticists), managed care, Medicaid, insurance agencies, and politicians. The level of evidence required by medical/health agencies and task forces may differ from the levels of evidence available in education and intervention. Issues related to the low incidence of the disability, the lack of a normal distribution within the disability study, the obstacles to random assignment to treatment, and designs that include a control group with "no treatment" have implications legally and ethically for the professional providing services to families and children who are deaf or hard of hearing. This session will discuss issues related to "convenience samples," number of subjects included in research studies, and the population required to obtain a large enough sample of children with low-incidence disabilities. The level of evidence required to demonstrate sensitive periods of development, which are a critical element for justification of implementing a universal newborn hearing screening includes both behavioral and neurological information. Sensitive periods may have different duration for different aspects of development, such as social-emotional development, auditory and speech development, or language development. Further complicating the question of sensitive periods of development are the distinct possibility that different sensitive periods exist for development of age-level vocabulary, for establishing English phonology, or for mastering English syntax. Research outcomes provide evidence that age of identification of hearing loss is reduced, that age of intervention initiation is lowered, and that the outcomes of intervention are better because of the establishment of a screening program. Most professionals in communication disorders believe that screening is not the actual cause of better developmental outcomes but that the age when children begin to have access to language and communication and the characteristics of the intervention are the primary cause of better outcomes. Screening is the avenue through which access to quality intervention is made available. The research still remains at an infant level of development such that there is very little evidence for the efficacy of specific characteristics of the intervention provided. LEARNING OUTCOMES: (1) The learner will be able to identify the obstacles in conducting research on the effectiveness of intervention of children identified through universal newborn hearing screening programs. (2) The learner will be able to identify the type of research on developmental outcomes of children with early-identified hearing loss.

Cost-Benefit Analysis↗

PubMed1997

Parents can dose liquid medication accurately.

OBJECTIVE: To determine whether parental errors in dosing liquid medication can be decreased through education. DESIGN: Randomized convenience sample stratified to three study groups. SETTING: General pediatric clinic, largely indigent and Latino. PATIENTS: A total of 45 English-speaking and 45 Spanish-speaking children diagnosed with otitis media and treated with an antibiotic suspension. INTERVENTION: Group 1 patients received the prescription and verbal instructions. Group 2 patients received the prescription and a syringe, then the correct dose was demonstrated. Group 3 patients received the prescription, a syringe with a line marked at the correct dose, and a demonstration. After returning from the pharmacy, parents administered the medication under observation. Parents in group 1 used a dispensing device similar to that planned for home use. The other groups used the syringe. After observation but before discharge, everyone received a syringe with a line marked at the correct dose. Patients were seen again at approximately 1 month, and parents demonstrated how much medication they had administered. MAIN OUTCOME MEASURE: Percent of parents who administered the correct dose. RESULTS: Patients in group 1 received between 32% and 147% of the correct dose, with only 11 of 30 (37%) receiving the correct dose (+/-0.2 mL). In group 2, 25 of 30 (83%) parents administered the correct dose, and in group 3, 30 of 30 (100%) gave the correct dose. Simultaneous logistic regression indicated that accuracy of dosage differed across instructional groups and language. At follow-up, 23 of 26 parents demonstrated the correct dose. CONCLUSION: Education can decrease medication dosing errors made by both Spanish-speaking and English-speaking parents. Effectiveness was also shown at follow-up.

Anti-Bacterial Agents↗

PubMed1975

[Further studies of the cytoarchitectonic division in the dorsal surface of the lst temporal gyrus of a linguistic genius and 2 anthropoids].

1. As an addition to already published studies in this journal (BEHEIM 1974) about the cytoarchitectonic divisions in six left human dorsal surfaces, the left and the right dorsal surface of a linguistic genius and of two anthropoids were examined; a second human right dorsal surface was used for a comparison. 2. In all these cases it was possible to confirm the presented in the first article dividing characteristics of the described partitions of the cortex in spite of considerable cytoarchitectonic differences between individuals, as well as, between left and right dorsal surfaces. 3. The linguistic genius (El 9) showed on the left side a striking development of the 2d transverse gyrus by the repetition of two fields and threefold increase of the most interior field of the medial segment with the smallest nerve cells of the tr 2. 4. On the right side El 9 revealed, besides a considerable narrowing of the caudal part of the lst transverse gyrus in the 2nd transverse gyrus, only division into two parts of the medial segment of the gyrus; the most interior field was missing. The caudal field of the tr 2 and regio t par tr were large in comparison with the left side. A similar picture was presented by the right dorsal surface in the case of the highly musical scientist (El 2) in whom the left tr 1 was especially extensive. In both right dorsal surfaces the nerve cells of the tr 1, especially in markedly narrowed caudal part, were very small; the nerve cells of the tr 2 - exclusive tr 2 c - were smaller than on the left side - as much as it was possible to judge without comparative microphotographs; the nerve cells of the tr 2 c appeared to correspond to that on the left side. In regio t par tr the nerve cells, practically of "normal" size, were so severely damaged that it could not be topographically differentiated. 5. In both anthropoids, the topography of the dorsal surfaces was similar to that of the man; in both left sides area tr 1 c could not be subdivided; on the right side the differentiation between the subareae of tr 1 i and tr 1 c was even not possible. In tr 2 on both sides it was possible to divide in two the middle part of the gyrus similarly as in examined human right side; in addition there was a conspicuous extension of the lateral and caudal area of the tr 2. 6. The literature concerning the left-right differences in the dorsal surfaces and about the sensory primary auditory cortex is quoted and discussed.

Adolescent↗

PubMed1997

[Children of the GAZEL Cohort: I--Prevalence of contacts with the medico-educational system for psychological reasons, and associated factors].

An epidemiological survey of French children aged 4 to 16 was conducted in order to estimate the 12-months rates of service utilization for psychological reasons and to assess the factors associated with service use in this community sample. A large sample of 2582 children and adolescents was recruited from the families whose one parent was employed by the national electricity and gaz company (EDF-GDF). Of these employees, 20,000 have volunteered for a long-term prospective cohort study of their health and, since 1989, they have participated to annual surveys and additional ad hoc research programmes. Families with a child aged 4 to 16 in 1991 were selected. Only one child was selected in each family, and the sample was stratified by socio-economic status and family size according to census data. A survey questionnaire comprising a valid measure of child psychopathology (Child Behavior Checklist: CBCL) and an additional questionnaire including questions related to service use was used as a means of data collection. The response rate was 62.2% and factors associated with participation in the survey were analysed. The 12-months prevalence rate of contact for psychological motives were: 42.3% for general practitioners and family doctors, 7.8% for speech and language therapists, 9.5% for educational specialists, and 6.0% for mental health professionals. With the exception of general practitioners, rates of service contact were significantly higher for boys. Logistic regression analysis was used to identify separately factors associated with recent contact for each category of professionals. Results showed that, for all professionals, high scores on the CBCL measure was significantly associated with service use, the strongest association being found for mental health professionals. Family structure was also predictive of the latter, with higher rates of contacts for those children living in families whose parents are divorced, separated or widowed. Some differences for contacts with doctors were found according to the region; otherwise, no effects of socio-economic status, educational level of the parent, or other socio-economic indicators were found to predict service utilization. The implications for services are discussed.

Adolescent↗

PubMed2005

Pathway analysis of coronary atherosclerosis.

Large-scale gene expression studies provide significant insight into genes differentially regulated in disease processes such as cancer. However, these investigations offer limited understanding of multisystem, multicellular diseases such as atherosclerosis. A systems biology approach that accounts for gene interactions, incorporates nontranscriptionally regulated genes, and integrates prior knowledge offers many advantages. We performed a comprehensive gene level assessment of coronary atherosclerosis using 51 coronary artery segments isolated from the explanted hearts of 22 cardiac transplant patients. After histological grading of vascular segments according to American Heart Association guidelines, isolated RNA was hybridized onto a customized 22-K oligonucleotide microarray, and significance analysis of microarrays and gene ontology analyses were performed to identify significant gene expression profiles. Our studies revealed that loss of differentiated smooth muscle cell gene expression is the primary expression signature of disease progression in atherosclerosis. Furthermore, we provide insight into the severe form of coronary artery disease associated with diabetes, reporting an overabundance of immune and inflammatory signals in diabetics. We present a novel approach to pathway development based on connectivity, determined by language parsing of the published literature, and ranking, determined by the significance of differentially regulated genes in the network. In doing this, we identify highly connected "nexus" genes that are attractive candidates for therapeutic targeting and followup studies. Our use of pathway techniques to study atherosclerosis as an integrated network of gene interactions expands on traditional microarray analysis methods and emphasizes the significant advantages of a systems-based approach to analyzing complex disease.

Adult↗

PubMed2006

The MGED Ontology: a resource for semantics-based description of microarray experiments.

MOTIVATION: The generation of large amounts of microarray data and the need to share these data bring challenges for both data management and annotation and highlights the need for standards. MIAME specifies the minimum information needed to describe a microarray experiment and the Microarray Gene Expression Object Model (MAGE-OM) and resulting MAGE-ML provide a mechanism to standardize data representation for data exchange, however a common terminology for data annotation is needed to support these standards. RESULTS: Here we describe the MGED Ontology (MO) developed by the Ontology Working Group of the Microarray Gene Expression Data (MGED) Society. The MO provides terms for annotating all aspects of a microarray experiment from the design of the experiment and array layout, through to the preparation of the biological sample and the protocols used to hybridize the RNA and analyze the data. The MO was developed to provide terms for annotating experiments in line with the MIAME guidelines, i.e. to provide the semantics to describe a microarray experiment according to the concepts specified in MIAME. The MO does not attempt to incorporate terms from existing ontologies, e.g. those that deal with anatomical parts or developmental stages terms, but provides a framework to reference terms in other ontologies and therefore facilitates the use of ontologies in microarray data annotation. AVAILABILITY: The MGED Ontology version.1.2.0 is available as a file in both DAML and OWL formats at http://mged.sourceforge.net/ontologies/index.php. Release notes and annotation examples are provided. The MO is also provided via the NCICB's Enterprise Vocabulary System (http://nciterms.nci.nih.gov/NCIBrowser/Dictionary.do). CONTACT: Stoeckrt@pcbi.upenn.edu SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Computational Biology↗

PubMed2006

Combining evidence, biomedical literature and statistical dependence: new insights for functional annotation of gene sets.

BACKGROUND: Large-scale genomic studies based on transcriptome technologies provide clusters of genes that need to be functionally annotated. The Gene Ontology (GO) implements a controlled vocabulary organised into three hierarchies: cellular components, molecular functions and biological processes. This terminology allows a coherent and consistent description of the knowledge about gene functions. The GO terms related to genes come primarily from semi-automatic annotations made by trained biologists (annotation based on evidence) or text-mining of the published scientific literature (literature profiling). RESULTS: We report an original functional annotation method based on a combination of evidence and literature that overcomes the weaknesses and the limitations of each approach. It relies on the Gene Ontology Annotation database (GOA Human) and the PubGene biomedical literature index. We support these annotations with statistically associated GO terms and retrieve associative relations across the three GO hierarchies to emphasise the major pathways involved by a gene cluster. Both annotation methods and associative relations were quantitatively evaluated with a reference set of 7397 genes and a multi-cluster study of 14 clusters. We also validated the biological appropriateness of our hybrid method with the annotation of a single gene (cdc2) and that of a down-regulated cluster of 37 genes identified by a transcriptome study of an in vitro enterocyte differentiation model (CaCo-2 cells). CONCLUSION: The combination of both approaches is more informative than either separate approach: literature mining can enrich an annotation based only on evidence. Text-mining of the literature can also find valuable associated MEDLINE references that confirm the relevance of the annotation. Eventually, GO terms networks can be built with associative relations in order to highlight cooperative and competitive pathways and their connected molecular functions.

Algorithms↗

PubMed2005

A scale space approach for automatically segmenting words from historical handwritten documents.

Many libraries, museums, and other organizations contain large collections of handwritten historical documents, for example, the papers of early presidents like George Washington at the Library of Congress. The first step in providing recognition/ retrieval tools is to automatically segment handwritten pages into words. State of the art segmentation techniques like the gap metrics algorithm have been mostly developed and tested on highly constrained documents like bank checks and postal addresses. There has been little work on full handwritten pages and this work has usually involved testing on clean artificial documents created for the purpose of research. Historical manuscript images, on the other hand, contain a great deal of noise and are much more challenging. Here, a novel scale space algorithm for automatically segmenting handwritten (historical) documents into words is described. First, the page is cleaned to remove margins. This is followed by a gray-level projection profile algorithm for finding lines in images. Each line image is then filtered with an anisotropic Laplacian at several scales. This procedure produces blobs which correspond to portions of characters at small scales and to words at larger scales. Crucial to the algorithm is scale selection, that is, finding the optimum scale at which blobs correspond to words. This is done by finding the maximum over scale of the extent or area of the blobs. This scale maximum is estimated using three different approaches. The blobs recovered at the optimum scale are then bounded with a rectangular box to recover the words. A postprocessing filtering step is performed to eliminate boxes of unusual size which are unlikely to correspond to words. The approach is tested on a number of different data sets and it is shown that, on 100 sampled documents from the George Washington corpus of handwritten document images, a total error rate of 17 percent is observed. The technique outperforms a state-of-the-art gap metrics word-segmentation algorithm on this collection.

Abstracting and Indexing↗

PubMedDate not supplied

Evaluating the coverage of controlled health data terminologies: report on the results of the NLM/AHCPR large scale vocabulary test.

OBJECTIVE: To determine the extent to which a combination of existing machine-readable health terminologies cover the concepts and terms needed for a comprehensive controlled vocabulary for health information systems by carrying out a distributed national experiment using the Internet and the UMLS Knowledge Sources, lexical programs, and server. METHODS: Using a specially designed Web-based interface to the UMLS Knowledge Source Server, participants searched the more than 30 vocabularies in the 1996 UMLS Metathesaurus and three planned additions to determine if concepts for which they desired controlled terminology were present or absent. For each term submitted, the interface presented a candidate exact match or a set of potential approximate matches from which the participant selected the most closely related concept. The interface captured a profile of the terms submitted by the participant and for each term searched, information about the concept (if any) selected by the participant. The term information was loaded into a database at NLM for review and analysis and was also available to be downloaded by the participant. A team of subject experts reviewed records to identify matches missed by participants and to correct any obvious errors in relationships. The editors of SNOMED International and the Read Codes were given a random sample of reviewed terms for which exact meaning matches were not found to identify exact matches that were missed or any valid combinations of concepts that were synonymous to input terms. The 1997 UMLS Metathesaurus was used in the semantic type and vocabulary source analysis because it included most of the three planned additions. RESULTS: Sixty-three participants submitted a total of 41,127 terms, which represented 32,679 normalized strings. More than 80% of the terms submitted were wanted for parts of the patient record related to the patient's condition. Following review, 58% of all submitted terms had exact meaning matches in the controlled vocabularies in the test, 41% had related concepts, and 1% were not found. Of the 28% of the terms which were narrower in meaning than a concept in the controlled vocabularies, 86% shared lexical items with the broader concept, but had additional modification. The percentage of exact meanings matches varied by specialty from 45% to 71%. Twenty-nine different vocabularies contained meanings for some of the 23,837 terms (a maximum of 12,707 discrete concepts) with exact meaning matches. Based on preliminary data and analysis, individual vocabularies contained < 1% to 63% of the terms and < 1% to 54% of the concepts. Only SNOMED International and the Read Codes had more than 60% of the terms and more than 50% of the concepts. CONCLUSIONS: The combination of existing controlled vocabularies included in the test represents the meanings of the majority of the terminology needed to record patient conditions, providing substantially more exact matches than any individual vocabulary in the set. From a technical and organizational perspective, the test was successful and should serve as a useful model, both for distributed input to the enhancement of controlled vocabularies and for other kinds of collaborative informatics research.

Evaluation Studies as Topic↗

PubMed1999

The foundation of Piaget's theories: mental and physical action.

Piaget's late theory of action and action implication was the realization of a long history of development. A review of that history shows the central place of action in all of his theoretical assertions, despite the waxing and waning of other important features of his theories. Action was said to be the primary source of knowledge with perception and language in secondary roles. Action is for the most part not only organized but there is logic in action. Action, which is at first physical, becomes internalized and transformed into mental action and mental representation, largely in the development of the symbolic or semiotic function in the sensorimotor period. A number of alternative theories of cognitive development place primary emphasis on mental representation. Piaget provided it with an important place as well, but subordinated it to mental action in the form of operations. In this, as Russell claims, he paralleled Schopenhauer's distinction between representation and will. Piaget's theory of action was intimately related to the gradual development of intentionality in childhood. Intentions were tied to actions by way of the conscious awareness of goals and the means to achieve them. Mental action, following the sensorimotor period, was limited in its logical form to semilogical or one-way functions. These forms were said by Piaget to lack logical reversibility, which was achieved only in the sixth or seventh year, in concrete operations. Mental action was not to be fully realized until the development of formal operations, with hypothetical reasoning, in adolescence, according to the classical Piagetian formulation. This view of the child's logical development, which relied heavily on truth-table (extensional) logic, underwent a number of changes. First from the addition of other logics: category theory and the theory of functions among them. In his last theory, however, an even more radical change occurred. With the collaboration of R. Garcia, he proposed a logic of meanings that would require a recasting of his earlier truth-table-based operatory logic that he claimed explained the development of logical thought and problem solving. The new logic of meanings, influenced by Anderson and Belnap's (1975) logic of entailment, placed new emphasis on inferential processes in the sensorimotor period, introduced protological forms in the actions of the very young child, and proposed that knowledge has an inferential dimension. The consequence was that the late theory shifted emphasis to intentional (qualitative) logic and meaning from the earlier extensional (quantitative) logic and truth testing. The profound changes in Piaget's late theory requires a serious reevaluation of Piaget's entire corpus of research and theory; a task which is yet to be done. Seen in a new light, the late theory is much closer to intellectual currents associated with hermeneutic and semiotic traditions in their concern with meaning and interpretation and less, if at all, with truth. This, despite Piaget's couching of the new theory in a logical mode. The late theory added significant new elements to the theory of action and action-implication, and suggest that Piaget's, and his collaborator's, new research data, which were interpreted within the new theoretical framework, require corroboration and review. The question as to whether Piaget's assertions are at root metaphorical and lack psychological reality, which has followed his theories from its earliest days, arises as well with the assertions of the late theory. Possibly, even more so, since even a limited historical review of his theories points to a considerable concurrence between changes in the fundamental assumptions of his theories and intellectual currents of the times. In hindsight, Piaget's theories appear as "works in progress," down to his last theory. Yet, even in the end, he charted the direction of possible further progress.

Child↗