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PubMed1982

A developmental study of proverb comprehension.

Growth in proverb comprehension was hypothesized to result from the gradual emergence of cognitive abilities reflected in a sequence of increasingly complex abilities: story matching, transfer of relations, desymbolization, proverb matching, and paraphrase. Items for these abilities for each of 10 proverbs of two structural types were administered in three test sessions to 438 students in grades three to seven. An analogy subtest was used to measure general intelligence. ANOVA yielded significant main effects for grade, tasks, and proverbs (all p's less than .01). A significant task x proverb interaction (p less than .01) revealed the difficulty of precise control over the language of the items. Proverb structure had no measurable impact on difficulty. Analogy score was a significant factor in performance (p less than .01) but not as potent as age (p less than .01). The sequential order of abilities received only weak confirmation, though tasks did correlate among themselves with medium strength (r's = .50-.70). Individual interviews added a qualitative dimension to the findings. The suitability of cognitive hierarchical models for proverb comprehension was questioned.

Aphorisms and Proverbs as Topic↗

PubMed1989

Verb processing during sentence comprehension: contextual impenetrability.

This paper examines verb processing during sentence comprehension. We describe two experiments that assess the interaction between verb complexity and the structural information contained in a sentence. Verb complexity is defined in terms of a verb's possible argument structure arrangements--linguistic information arrayed against a verb's entry in the mental lexicon. Normal subjects had to perform a secondary task presented in the immediate vicinity of the verb while listening to a sentence for meaning. Reaction times to this secondary task show that all of a verb's possible argument structures are momentarily and exhaustively activated in the vicinity of the verb, even in sentences that are structurally biased toward one particular argument structure. We thus argue that verb processing in sentences involves a contextually impenetrable subcomponent of the language comprehension system.

Adult↗

PubMed1989

Evoked potentials and the study of sentence comprehension.

Evoked brain potentials were used to monitor moment-by-moment decisions during language comprehension. Subjects read sentences containing temporary syntactic ambiguities for which one of the possible interpretations was semantically implausible. The N400 component of the evoked potential, which is sensitive to implausibility, was used to discover when during a sentence subjects made a decision about the ambiguity. The results demonstrate that readers try to interpret a syntactic ambiguity early in a sentence rather than waiting for disambiguating information. This introduces a new way to use brain activity to study sentence comprehension processes.

Decision Making↗

PubMed1983

Children's comprehension of semantic constraints on temporal prepositions.

Children's comprehension of the semantic rules for temporal prepositions was investigated. The temporal prepositions were in, on, and at. Leech's (1969) semantic analysis was used as the framework for the study. The contextual property [(x)] leads to TIM[PERI] with its related constraints indicates the ill-formedness of phrases like in noon, on January and at Saturday. Correct usage of these prepositions is based on the implicit distinction between time with or without duration (period versus moment). Comprehension differences among the prepositions, based on semantic differences were hypothesized, as well as developmental differences across age levels. Thirty-five children at each of three levels (kindergarten, grades 2, and 4) in Experiment 1, and 24 grade 4 children in Experiment 2, judged the appropriateness of sentences containing temporal prepositions and attempted to revise the ill-formed sentences. Significant developmental differences were observed. Kindergarten children could not discriminate between well- and ill-formed sentences; second grade children could discriminate but could not identify the reason for their discrimination, nor could they revise the ill-formed sentences. Fourth grade children could discriminate and identify or revise the ill-formedness. Ability to revise the prepositions was found to be related to cognitive developmental level. None of the children in either experiment were able to articulate the periodicity-moment temporal distinction which provides the basis for the semantic constraints. The awareness of semantic rules for temporal prepositions may be relatively late in developing, perhaps between the ages of 8 and 10 years. An advanced awareness of these rules may develop considerably later.

Child↗

PubMed1990

Temporal clause comprehension in fluent and nonfluent aphasics.

Ten fluent and ten nonfluent aphasics participated in this study. Their ability to comprehend before and after clauses which mirrored the order of occurrence and those which did not mirror the order of events was investigated. Results indicate that type of aphasia was not a significant variable related to comprehension but that sentence type was a significant variable. Aphasics' comprehend before clauses better than after clauses. Nonfluent aphasics were able to comprehend those temporal clauses that mirror the order of occurrence better than those that do not. Order of mention was not a significant factor related to comprehension in the fluent group.

Adult↗

PubMed1996

Comprehension of idiomatic expressions in Japanese--auditory and visual presentations.

This study reports on the auditory and visual comprehension of Japanese idioms having both literal and figurative meanings. Experiment I conducted the rating of the semantic distance between the two meanings. Experiment II investigated the difference of comprehension between semantically far and close idioms. Here the materials are presented in isolation both auditorily and visually. Experiment III conducted the same investigation as Experiment II, except that idioms were presented embedded in literally and figuratively induced contexts. Experiment IV reinvestigated the findings obtained from the previous experiments. The results of these experiments show that in isolation visual presentation precedes auditory presentation, and that both in the auditory and visual presentations semantically for idioms are comprehended more accurately than semantically close idioms.

Cognition↗

PubMed1995

Participant roles and the processing of verbs during sentence comprehension.

This paper explores the nature of thematic information made available when a verb is accessed during sentence comprehension. Following Shapiro, Zurif, and Grimshaw (1987), a cross-modal lexical decision (interference) task was employed to examine whether either the number of argument structures or the number of participant (thematic) roles inherent in a verb cause an increase in processing load upon access of the verb. It was determined that there was no evidence for such an increased processing load covarying with the number of argument structures of the verb, at least for those verb types examined in this study. However, there was an increase in processing load as a direct function of the number of participant roles carried by the verb. It is concluded that the participant roles (thematic roles associated with the central meaning of the verb) are stored with the representation of a verb and are made immediately available upon access of the verb for further processing during comprehension.

Female↗

PubMed1990

Comprehension of concrete and abstract words in autistic children.

This study employed the Stroop paradigm to examine comprehension of single words in autistic children. The words of interest varied along a concrete-abstract dimension. In the Stroop paradigm, subjects are asked to name the color of ink in which color words are printed. Comprehension is indexed by the degree to which the automatic processing of words interferes with the color-naming task. For both concrete and abstract words, autistic children showed the same degree of interference as reading-matched controls. The findings corroborate and extend previous work suggesting that autistic children understand, and by implication, can mentally represent, at least some word meanings.

Adolescent↗

PubMed1989

Affect comprehension in children with pervasive developmental disorders.

Affect comprehension was studied in children with pervasive developmental disorders (PDD) and normal children matched for mental age. Three matching tasks were used: matching objects (a nonsocial control task), matching faces, and matching affects. The three tasks were developed to be of equal difficulty for normal children. Children were also tested for comprehension and expression of affect terms. The PDD children were impaired on affect matching relative to the normal controls. The PDD children were impaired on face and affect matching relative to their own performance on object matching, whereas the normal children were not. Within the PDD sample, object matching was correlated with mental age measures but not with measures of social behavior and play, but face and affect matching were significantly correlated with mental age as well as social behavior and play. Individual PDD children who showed relative deficits on face or affect matching tended to be more socially impaired than PDD children whose face and affect matching was consonant with their mental age. Results are discussed in terms of possible etiologies of the social deficit in PDD children, and the importance of subtypes within this population.

Adolescent↗

PubMed1988

Colorectal cancer. The bases for a comprehensive follow-up.

The purpose of this article was to review the effectiveness of follow-up in patients with colorectal cancer submitted to curative treatment. A comprehensive follow-up involves rational initial management of the primary tumor, knowledge of prognostic factors, selection of the patient to be followed, determination of the time for follow-up, use of the most appropriate tests for early diagnosis of recurrence, and eventual curative treatment. The updated answers to all these questions are given through an extensive review of the world literature and confronted with the authors' experience of eight years of follow-up in a series of 170 colorectal cancer patients treated for cure. Although the future might be more promising, past world experience suggests only a few patients could be saved. It is concluded that there is no place for incomplete and disperse screening tests, and only comprehensive, intensive, and very well-coordinated follow-up programs should be undertaken if better results are hoped to be achieved.

Colonic Neoplasms↗

PubMed1989

Comprehensive geriatric assessment: toward understanding its efficacy.

Comprehensive geriatric assessment (CGA) offers health care professionals a technique for multidimensional diagnosis of frail elderly people to plan medical, psychosocial, and rehabilitative care. In the present paper, we provide a brief history of geriatric assessment, a description of the varied organization of geriatric assessment programs (GAPs), and a review of published effectiveness studies of programs worldwide performing comprehensive geriatric assessment. Program diversity has complicated drawing conclusions about the efficacy of CGA from a literature reporting generally positive, but not uniformly significant, results. We suggest that sample size limitations explain much of the variability in findings. Using the techniques of meta-analysis, we evaluate the effect of GAPs on mortality when all controlled trials are considered cumulatively. Meta-analysis of six-month mortality demonstrates a statistically significant 36% reduction of mortality for inpatient CGA programs (odds ratio = 0.64; 95% confidence interval = 0.50 to 0.83), and a 32% mortality reduction for all CGA programs (odds ratio = 0.68; 95% confidence interval = 0.57 to 0.80). Further use of meta-analytic techniques can be employed to clarify the effect of GAPs on other important outcomes (e.g., reduced hospital and nursing home use, improved functional status), and to identify program characteristics best promoting these benefits.

Aged↗

PubMed2005

A short comprehensive assessment to predict outcome of elderly patients after hip fracture.

BACKGROUND AND AIMS: Hip fractures result in significant functional impairment and a high rate of institutionalization. The aim of our study was to evaluate in patients with a recent hip fracture the contribution of a short (15-min) comprehensive assessment to predict the length of stay and the risk of discharge to a nursing home. METHODS: Prospective clinical study conducted in a rehabilitation ward of the Geriatric Hospital. Functional assessment included basic activities of daily living (BADL), cognitive status (MMSE) and a 4-item geriatric depression scale (Mini-GDS). Information on demographic data, living situation, diagnosis and illness burden was also collected. RESULTS: The mean age of the 86 patients (67W/19M) was 84.2 +/- 6.8 years. In a multiple regression analysis, the length of stay in a geriatric hospital was significantly associated with both marital status (living alone) (p = 0.035) and the intervention of a caregiver on a regular basis (p = 0.036), but not with Charlson's comorbidity score. In a logistic regression model, adjusted for age, gender, marital status, intervention of a caregiver on a regular basis, BADL, Mini-GDS and Charlson's comorbidity score, the only independent predictor of nursing home admission was a MMSE < 24, which increased by 10.7-fold (2.2-50.9) the risk of being admitted to a nursing home (p = 0.003). CONCLUSIONS: A short comprehensive assessment completed a few days after a hip fracture is useful in predicting length of stay and risk of nursing home admission.

Aged↗

PubMed2004

[DRG reimbursement for multiple trauma patients -- a comparison with the comprehensive hospital costs using the German trauma registry].

UNLABELLED: The introduction of diagnosis related groups (DRG) will radically change the payment system for German hospitals. In 2002 the values for most DRG's were published for the german system (G-DRG). The polytrauma working group of the German Trauma Society developed a calculating algorithm to estimate the comprehensive hospital costs for every patient in the German trauma registry. The aim of this study was to compare these costs with the reimbursement according the the G-DRG's for a standardized population of polytrauma patients. MATERIAL AND METHODS: For polytrauma patients treated at Hannover Medical School in 2000 and 2001 the reimbursement according to the G-DRG's was calculated using a base value of 2900 euro. In the same patients the total cost of inpatient treatment was calculated according to the algorithm developed by the polytrauma working group of the German Trauma Society. The difference between these values represents the economic result. This was calculated as an overall result, but also for specific subgroups of patients (injury severity, mortality, G-DRG grouping). RESULTS: Datasets of 103 polytrauma patients were included. The following G-DRG's were most frequently occuring: A06Z (n=41), A07Z (n=16), W01Z (n=13). All other G-DRG's were documented less than 3 times. The mean reimbursement according to the G-DRG was 21.380+/-12.300 euro for a polytrauma patient. However, the mean hospital cost accounted to 34.274+/-22.501 euro, which resulted in a mean deficit of 12.893+/-15.534 euro. Analysis of subgroups revealed, that an ISS of more than 35 points, patients with a prolonged hospital stay and patients of the G-DRG group A06Z show a particularly negative result. CONCLUSION: The comprehensive hospital costs for treating polytrauma patients are on average 12.893 euro higher than the reimbursement according the G-DRG's. For hospitals to be fully reimbursed G-DRG values have to be reconfigured according to the German health care system. Thus, inclusion criteria to specific G-DRG have to be changed and a specific G-DRG group for very severely injured patients needs to be established.

Adult↗

PubMed2002

[Prevention without radiation--a strategy for comprehensive early detection using magnetic resonance tomography].

Recent advances in hardware technology, noninvasiveness, lack of radiation and high diagnostic accuracy combine to allow the usage of magnetic resonance imaging (MRI) for disease screening in asymptomatic people. 175 volunteers were examined by means of a comprehensive 60-minute MR-screening-protocol covering four organ systems: the brain, the arterial vasculature, the heart and the colon. In 28% of the cases vascular pathology (cerebral, peripheral or cardiovascular) was detected. In up to 17% of the single examination parts relevant incidental findings were seen. The outlined comprehensive MR-protocol is an accurate and patient-friendly imaging tool for the detection of vascular pathology as well as colonic polyps. The socio-economic relevance of this screening exam has to be further investigated in larger patient cohorts.

Adult↗

PubMed2006

Comprehensive profiling of N-acylhomoserine lactones produced by Yersinia pseudotuberculosis using liquid chromatography coupled to hybrid quadrupole-linear ion trap mass spectrometry.

A method for the comprehensive profiling of the N-acylhomoserine lactone (AHL) family of bacterial quorum-sensing molecules is presented using liquid chromatography (LC) coupled to hybrid quadrupole-linear ion trap (QqQLIT) mass spectrometry. Information-dependent acquisition (IDA), using triggered combinations of triple-quadrupole and linear ion trap modes in the same LC-MS/MS run, was used to simultaneously screen, quantify and identify multiple AHLs in a single sample. This MS method uses common AHL fragment ions attributed to the homoserine moiety and the 3-oxo-, 3-hydroxy- or unsubstituted acyl side chains, to identify unknown AHLs in cell-free culture supernatants in an unbiased manner. This LC-MS technique was applied to determine the relative molar ratios of AHLs produced by Yersinia pseudotuberculosis and the consequences of inactivating by mutation either or both of the AHL synthase genes (ypsI and ytbI) on AHL profile and concentration. The Y. pseudotuberculosis wild type but not the ypsI ytbI double mutant produced at least 24 different AHLs with acyl chains ranging from C4 to C15 with or without 3-oxo or 3-hydroxy substituents. YtbI, in contrast to YpsI, could direct the synthesis of all of the AHLs identified. The most abundant and hence most biologically relevant Y. pseudotuberculosis AHLs were found to be the 3-oxo-substituted C6, C7 and C8 AHLs and the unsubstituted C6 and C8 compounds. The LC-QqQLIT methodology is broadly applicable to quorum-sensing signal molecule analysis and can provide comprehensive AHL profiles and concentrations from a single sample and simultaneously collect confirmatory spectra for each AHL identified.

4-Butyrolactone↗

PubMed2002

Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study.

Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery.

Adult↗

PubMed1997

Behavioral and functional analysis of mouse phenotype: SHIRPA, a proposed protocol for comprehensive phenotype assessment.

For an understanding of the aberrant biology seen in mouse mutations and identification of more subtle phenotype variation, there is a need for a full clinical and pathological characterization of the animals. Although there has been some use of sophisticated techniques, the majority of behavioral and functional analyses in mice have been qualitative rather than quantitative in nature. There is, however, no comprehensive routine screening and testing protocol designed to identify and characterize phenotype variation or disorders associated with the mouse genome. We have developed the SHIRPA procedure to characterize the phenotype of mice in three stages. The primary screen utilizes standard methods to provide a behavioral and functional profile by observational assessment. The secondary screen involves a comprehensive behavioral assessment battery and pathological analysis. These protocols provide the framework for a general phenotype assessment that is suitable for a wide range of applications, including the characterization of spontaneous and induced mutants, the analysis of transgenic and gene-targeted phenotypes, and the definition of variation between strains. The tertiary screening stage described is tailored to the assessment of existing or potential models of neurological disease, as well as the assessment of phenotypic variability that may be the result of unknown genetic influences. SHIRPA utilizes standardized protocols for behavioral and functional assessment that provide a sensitive measure for quantifying phenotype expression in the mouse. These paradigms can be refined to test the function of specific neural pathways, which will, in turn, contribute to a greater understanding of neurological disorders.

Animals↗

PubMed2006

Clearing the cervical spine in critically injured patients: a comprehensive C-spine protocol to avoid unnecessary delays in diagnosis.

Clearing the cervical spine in polytrauma patients still presents a challenge to the trauma team. The risk of an overlooked cervical spine injury is substantial since these patients show painful and life-threatening injuries to one or more organ systems so that clinical examination is usually not reliable. A generally approved guideline to assess the cervical spine in polytrauma patients might significantly reduce delays in diagnosis, but a consistent protocol for evaluating the cervical spine has not been uniformly accepted or followed by clinicians. One purpose of this study was to analyse the common methods for cervical spine evaluation in critically injured patients and its safety and efficacy at this trauma centre. The second purpose was to present a comprehensive diagnostic C-spine protocol, based on the authors' experiences with documented cases. From a prospectively gathered polytrauma database, we retrospectively analysed the clinical records of all polytrauma patients, with skeletal and/or non-skeletal cervical spine injuries, who were admitted to this level I trauma centre between 1980 and 2004. All patients were assessed following the trauma algorithm of our unit (modified by Nast-Kolb). Standard radiological evaluation of the cervical spine consisted of either a single lateral view or a three-view cervical spine series (anteroposterior, lateral, odontoid). Further radiological examinations (functional flexion/extension views, oblique views, CT scan, MRI) were carried out for clinical suspicion of an injury or when indicated by the standard radiographs. Sixteen patients (14%) had a single cross-table lateral view for radiological assessment of the cervical spine during initial trauma evaluation, Twenty-nine patients had a three-view cervical spine series (anteroposterior, lateral, odontoid) and 81 patients underwent extended radiological examinations by cervical CT scan (n=52), functional flexion/extension views (n=26) or MRI (n=3). Correct diagnosis was made in 107 patients (91%) during primary trauma evaluation, whereas in 11 patients (9%) our approach to clear the cervical spine failed to detect significant cervical spine injuries. In six patients skeletal injuries were missed by a single lateral view and in two patients by a three-view standard series because inadequate radiographs with poor technical quality or incomplete visualization of the cervical spine did not show the extent of the injury. In three cases ligamentous injuries were missed despite complete sets of standard radiographs and cervical CT scan, but without functional radiography. Common methods for cervical spine evaluation in critically injured patients were plain radiographs, cervical CT scan and functional flexion/extension views. Cervical CT scan was the most efficient imaging tool in detecting skeletal injuries, showing a sensitivity of 100%. A single cross-table lateral view appeared to be insufficient, as we found a sensitivity of only 63%. Functional radiography or MRI was also necessary, as plain radiographs and CT scan failed to detect significant ligamentous injuries in 6% of the patients. For more comprehensive assessment of the C-spine, we presented a new C-spine protocol based on the authors' experiences, with the aim to avoid unnecessary delays in diagnosis.

Adolescent↗