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Routes are trees: the parsing perspective on protein folding.

An important puzzle in structural biology is the question of how proteins are able to fold so quickly into their unique native structures. There is much evidence that protein folding is hierarchic. In that case, folding routes are not linear, but have a tree structure. Trees are commonly used to represent the grammatical structure of natural language sentences, and chart parsing algorithms efficiently search the space of all possible trees for a given input string. Here we show that one such method, the CKY algorithm, can be useful both for providing novel insight into the physical protein folding process, and for computational protein structure prediction. As proof of concept, we apply this algorithm to the HP lattice model of proteins. Our algorithm identifies all direct folding route trees to the native state and allows us to construct a simple model of the folding process. Despite its simplicity, our model provides an account for the fact that folding rates depend only on the topology of the native state but not on sequence composition.

Algorithms↗

A conceptual model for information retrieval with UMLS.

Information retrieval in large information databases is a non-deterministic process which needs a sequence of search steps generally. One of the main problems to which the end-users are faced is to parse efficiently their questions into the query language that the computer systems allow. Conceptual graphs were initially designed for natural language analysis and understanding. Due to their closeness to semantic networks, their expressiveness is powerful enough to be applied to knowledge representation and use by computer systems. This work demonstrates that conceptual graphs are a suitable means to model the end-users querieson the basis of the thesaurus and the semantic network of the UMLS project.

Information Storage and Retrieval↗

Oral health-related quality of life: a model for dental hygiene.

During the past decade, dental hygiene has been challenged to develop conceptual models to define the discipline. Such models can provide a common language and infrastructure for the discipline to define the process of care. Health-Related Quality of Life conceptual models have been adopted by many health professions to assist in planning health-related interventions and assessing outcomes to care. Based on the Natural History of Disease Schema, the Wilson & Cleary model, and Neuman's Systems Model, a new conceptual model for dental hygiene is proposed. The Oral Health-Related Quality of Life Model, composed of six primary domains: Health/Preclinical Disease, Biological/Clinical Disease, Symptom Status, Functional Status, Health Perceptions, and General Quality of Life. This model proposes a dynamic relationship among these domains and characteristics unique to individual clients or populations, and may have utility for interdisciplinary communication. As an integrated model, it may serve as a foundation for assessing, planning, implementing, and evaluating outcomes to dental hygiene care. This paper reviews possible application of the model for clinical practice, research, and education.

Dental Hygienists↗

The frequency and nature of medical error in primary care: understanding the diversity across studies.

BACKGROUND: The identification and reduction of medical error has become a major priority for all health care providers, including primary care. Understanding the frequency and nature of medical error in primary care is a first step in developing a policy to reduce harm and improve patient safety. There has been scant research into this area. OBJECTIVES: This review had two objectives; first, to identify the frequency and nature of error in primary care, and, secondly, to consider the possible causes for the diversity in the stated rates and nature of error in primary care. METHODS: Literature searches of English language studies identified in the National Patient Safety Foundation bibliography database, in Medline and in Embase were carried out. Studies that were relevant to the purpose of the study were included. Additional information was obtained from a specialist medico-legal database. RESULTS: Studies identified that medical error occurs between five and 80 times per 100000 consultations, mainly related to the processes involved in diagnosis and treatment. Prescribing and prescription errors have been identified to occur in up to 11% of all prescriptions, mainly related to errors in dose. There are a wide variety of definitions and methods used to identify the frequency and nature of medical error. Incident reporting, systematic identification and medico-legal databases reveal differing aspects, and there are additional perspectives obtained from GPs, primary health care workers and patients. CONCLUSION: An understanding of the true frequency and nature of medical error is complicated by the different definitions and methods used in the studies. Further research is warranted to understand the complex nature and causes of such errors that occur in primary care so that appropriate policy decisions to improve patient safety can be made.

Communication↗

The striatum in a putative cerebral network activated by verbal awareness in normals and in ADHD children.

The aim of the present study was to evaluate the striatum's involvement in verbal awareness (semantic processing and supra-modal attention) in normals and children with attention deficit hyperactivity disorder (ADHD). Our previous finding of striatal hypoperfusion in ADHD at rest, supports our prediction that the striatum will also show reduced activation in response to tasks requiring verbal awareness. Regional cerebral blood flow (rCBF) was studied with the Xenon133 SPECT method in 12 boys with ADHD and six normal controls. The experimental controls included: (1) White Noise, (2) Passive Listening to a series of animal names, and (3) Detection of Targets ("dangerous animals") from the same series of animal names. The conditions were selected to isolate the semantic processing (Passive Listening - White Noise) and supra-modal attention components (Detection of Targets - Passive Listening of verbal awareness). ADHD children had decreased rCBF in the right striatum when compared to normals (mean difference from grand mean of each subject 8.06 ml/100 g/min vs 14.16 ml/100 g/min, p < 0.05). Factor analysis of the rCBF data revealed high factor I loadings for the frontal and striatal regions, which, in conjunction with the nature of the experimental conditions supported the inference that factor I mediated verbal awareness. Factor scores, which summarized the activity of all of the regions of interest (ROI's) on factor I, were differentially affected by the language component of the experimental tasks. Function scores were derived from factor I for the anterior cingulum and infero-frontal regions to evaluate their respective involvement in supra-modal attention and semantic processing. Function scores were also developed for the striatum, because of its central location and potential role in ADHD. The anterior cingulum was activated by supra-modal attention. The infero-frontal and the striatal regions were both activated by the language demands of the tasks. However, the striatum demonstrated reduced function scores (p < 0.05) in ADHD for all tasks. Our finding that the anterior gyrus cinguli were activated by supramodal attention and that the infero-frontal and striatal regions were activated by semantic processing supports the involvement of these ROI's in verbal awareness. Furthermore, the depressed functional contribution of the striatum to verbal awareness in ADHD children is consistent with and helps to explain their reduced cognitive control over behaviour and mental function.

Journal Article↗

Underconstrained perception: a theoretical approach to the nature and function of verbal hallucinations.

We do not see the world as it is. Perception forms a subjective image of the world in a language that has proven to be adaptive to our interaction with the external world. Perception is mainly determined by current needs of the organism and goals of behavior. Sensory processing itself does not culminate in perception and is not essential for perception, since perception derives from representations of internal symbols and their features. The current stimulation of sensory organs does, however, constrain our perception. Perception might be less constrained by the external world in cases of (1) increased attention, (2) decreased sensory stimulation, or (3) facilitated formation of cortical associations between representations of expectations and internal symbols. Hallucinations are perceptions that are underconstrained by external sensory stimulation. Verbal hallucinations that allow the patient to infer about his self-image might constitute the core psychopathology in a subset of schizophrenia. Commenting and discussing voices might be perceived under the pressure of increased attention to environmental factors that relate to the patient's social fears and wishes. Secondarily, delusions about the possession of thoughts and disorders of self-experience may develop.

Association↗

Language acquisition in the absence of explicit negative evidence: how important is starting small?

It is commonly assumed that innate linguistic constraints are necessary to learn a natural language, based on the apparent lack of explicit negative evidence provided to children and on Gold's proof that, under assumptions of virtually arbitrary positive presentation, most interesting classes of languages are not learnable. However, Gold's results do not apply under the rather common assumption that language presentation may be modeled as a stochastic process. Indeed, Elman (Elman, J.L., 1993. Learning and development in neural networks: the importance of starting small. Cognition 48, 71-99) demonstrated that a simple recurrent connectionist network could learn an artificial grammar with some of the complexities of English, including embedded clauses, based on performing a word prediction task within a stochastic environment. However, the network was successful only when either embedded sentences were initially withheld and only later introduced gradually, or when the network itself was given initially limited memory which only gradually improved. This finding has been taken as support for Newport's 'less is more' proposal, that child language acquisition may be aided rather than hindered by limited cognitive resources. The current article reports on connectionist simulations which indicate, to the contrary, that starting with simplified inputs or limited memory is not necessary in training recurrent networks to learn pseudonatural languages; in fact, such restrictions hinder acquisition as the languages are made more English-like by the introduction of semantic as well as syntactic constraints. We suggest that, under a statistical model of the language environment, Gold's theorem and the possible lack of explicit negative evidence do not implicate innate, linguistic-specific mechanisms. Furthermore, our simulations indicate that special teaching methods or maturational constraints may be unnecessary in learning the structure of natural language.

Artificial Intelligence↗

Effects of acoustic manipulation on the real-time inflectional processing of children with specific language impairment.

PURPOSE: This study reports the findings of an investigation designed to examine the effects of acoustic enhancement on the processing of low-phonetic-substance inflections (e.g., 3rd-person singular -s, possessive -s) versus a high-phonetic-substance inflection (e.g., present progressive -ing) by children with specific language impairment (SLI) in a word recognition, reaction time (RT) processing task. The effects of acoustic enhancement on the processing of the same morphemes as well as an additional morpheme (comparative -er) were examined in an offline grammaticality judgment task. The grammatical function of 1 of the higher-phonetic-substance inflections, -ing, was presumed to be hypothesized relatively early by children; the function of the other, -er, was presumed to be hypothesized relatively late. METHOD: Sixteen children with SLI (age(M) = 9 years;0 months) and 16 chronological age (CA; age(M) = 8;11) children participated. For both tasks, children listened to sentences containing the target morphemes as they were produced naturally (natural condition) or with acoustic enhancement (enhanced condition). RESULTS: On the RT task, the children with SLI demonstrated RT sensitivity only to the presence of the high-substance inflection, irrespective of whether it was produced naturally or with enhancement. Acoustic enhancement had no effect on these children's processing of low-substance inflections. The CA children, by contrast, showed sensitivity to low-substance inflections when they were produced naturally and with acoustic enhancement. These children also showed sensitivity to the high-substance inflection in the natural condition, but in the enhanced condition they demonstrated significantly slower RT. On the grammaticality judgment task, the children with SLI performed worse than the CA children overall and showed especially poor performance on low-substance inflections. Acoustic enhancement had a beneficial effect on the inflectional processing of the children with SLI, but it had no effect on CA children. CONCLUSION: The findings are interpreted to suggest that the reduced language processing capacity of children with SLI constrains their ability to process low-substance grammatical material in real time. This factor should be considered along with any difficulty that might be attributable to the grammatical function of the inflection.

Child↗

A new method of representing constituent structures.

The class of acceptable expressions (with no restrictions on length) of a natural language appears to form a regular set. The class of grammatical structures that corresponds to that class of expressions, however, does not, if those structures are represented in tree or bracketing form. We propose a parenthesis-free method of representing grammatical structures which permits the class that corresponds to the acceptable expressions of a natural language to constitute a regular set. The results of this method can be considered the basis of a viable model of human representation of grammatical structure for two reasons. First, the grammatical structures of acceptable expressions may be computed in tandem with the processing of those expressions from left to right; and, second, this computation can itself be carried out by a finite automaton. We apply this method to a fragment of English and show how it works for that fragment. A portion of this application has been implemented in PL/I.

Humans↗

Validation of the Brazilian Children's Test of Pseudoword Repetition in Portuguese speakers aged 4 to 10 years.

The phonological loop is a component of the working memory system specifically involved in the processing and manipulation of limited amounts of information of a sound-based phonological nature. Phonological memory can be assessed by the Children's Test of Nonword Repetition (CNRep) in English speakers but not in Portuguese speakers due to phonotactic differences between the two languages. The objectives of the present study were: 1). to develop the Brazilian Children's Test of Pseudoword Repetition (BCPR), a Portuguese version of the CNRep, and 2). to validate the BCPR by correlation with the Auditory Digit Span Test from the Stanford-Binet Intelligence Scale. The BCPR and Digit Span were assessed in 182 children aged 4-10 years, 84 from Minas Gerais State (42 from a rural region) and 98 from the city of S o Paulo. There are subject age and word length effects causing repetition accuracy to decline as a function of the number of syllables of the pseudowords. Correlations between BCPR and Digit Span forward (r = 0.50; P <or= 0.01) and backward (r = 0.43; P <or= 0.01) were found, and partial correlation indicated that higher BCPR scores were associated with higher Digit Span scores. BCPR appears to depend more on schooling, while Digit Span was more related to development. The results demonstrate that the BCPR is a reliable measure of phonological working memory, similar to the CNRep.

Analysis of Variance↗

Assessment of children with developmental apraxia of speech: a rationale.

A rationale to guide assessment and subsequent management of children with developmental speech disorders is described. Hypotheses about the nature of praxis, the role of oral-verbal praxis in linguistic processing and speech development, and the effects of disturbances in praxis on speech behavior are presented. Implications of a diagnosis of developmental apraxia of speech (DAS) for treatment planning and expected speech, language, and social communication outcomes are discussed. Misconceptions about children diagnosed with DAS and assumptions underlying the author's approach to assessing children with DAS are identified. The desired functional outcome of the assessment approach advocated is a management plan that addresses the needs of the child and family and maximizes the child's ability to communicate.

Apraxias↗

Constructing simultaneous communication: the contributions of natural sign language.

This article examines simultaneous communication (SC) by analyzing the changes in productions of teachers who underwent a program specifically designed to address improvements in the signed modality by working with both English-based signing and American Sign Language (ASL). Based on theoretical concepts found in bilingualism, language contact situations, and conversational analysis, we focus on the process of constructing utterances by examining the teachers' spontaneous repair sequences as evidence of an active productive system. Two teachers received special instruction in SC that included both ASL and English-based signing systems as separate but equal systems. Videotapes of their use of SC, collected over four years, were analyzed for sign/speech ratio and repair sequences. Repairs were classified as repetitions, replacements, or synchronization. We found that the sign/speech ratio of both teachers increased over time. Examination of repair sequences showed that repetitions tended to occur in speech with the sign channel more completely encoded in the repair. Changes in speech tended to be accompanied by changes in sign. Errors in synchrony were relatively rare. We conclude that the simultaneous communication of both teachers was speech-driven, but error detection was largely sign-driven. The greater the automaticity of both languages, the more attention could be devoted to monitoring the coordination of the two modalities. The amount and quality of monitoring that actually occurred, however, were subject to individual differences.

Journal Article↗

Reporting quality of nursing home care to consumers: the Maryland experience.

OBJECTIVE: To design and implement a reporting system for quality of long-term care to empower consumers and to create incentives for quality improvement. To identify a model to approach this technically and politically difficult task. APPROACH: Establishment of a credible and transparent decision process using a public forum. Development of the system based on: (1) review of the literature and existing systems, and discussions with stakeholders about strengths and weaknesses; (2) focus on consumer preferences in the design; and (3) responsiveness to industry concerns in the implementation. LESSONS LEARNED: None of the existing systems appeared to be a suitable model. We decided to develop an entirely new system based on three key design principles that allowed us to tailor the system to consumer needs: (1) designing a decision tool rather than a database; (2) summarizing rather than simplifying information; and (3) accounting for the target audience in the creative execution. Industry concerns focused on the burden of the system, the potential for errors, and the possible communication of a negative impression of the industry. As methodological and data limitations prevented us from resolving those concerns, we addressed them by using cautionary language in the presentation and by making a commitment to incorporate improvements in the future. All stakeholders regarded the final design as an acceptable compromise. CONCLUSIONS: Despite its potentially controversial nature and many methodological challenges, the system has been well received by both the public and the industry. We attribute this success to two key factors: a collaborative decision process, in which all critical design and execution choices were laid out explicitly and debated with stakeholders in a public forum, and realism and honesty regarding the limitations of the system.

Aged↗

Separable processing of consonants and vowels.

There are two views about the nature of consonants and vowels. One view holds that they are categorically distinct objects that play a fundamental role in the construction of syllables in speech production. The other view is that they are convenient labels for distinguishing between peak (vowel) and non-peak (consonant) parts of a continuous stream of sound that varies in sonority (roughly the degree of openness of the vocal apparatus during speech), or that they are summary labels for bundles of feature segments. Taking the latter view, consonants and vowels do not have an independent status in language processing. Here we provide evidence for the possible categorical distinction between consonants and vowels in the brain. We report the performance of two Italian-speaking aphasics who show contrasting, selective difficulties in producing vowels and consonants. Their performance in producing individual consonants is independent of the sonority value and feature properties of the consonants. This pattern of results suggests that consonants and vowels are processed by distinct neural mechanisms, thereby providing evidence for their independent status in language production.

Adult↗

A comparison of semantic memory in vascular dementia and dementia of Alzheimer's type.

OBJECTIVE: To determine whether semantic memory is impaired in vascular dementia and to assess the utility of semantic memory measures in differentiating vascular dementia from dementia of Alzheimer's type (DAT). DESIGN: Case-control study. PATIENTS: Ten patients with Cambridge Mental Disorders in the Elderly (CAMDEX) diagnosis of 'definite' mild or moderate vascular dementia (mean age 77) were individually matched with 10 patients with a CAMDEX diagnosis of 'definite' DAT on the basis of age, education, sex, premorbid IQ (as measured by the National Adult Reading Test) and performance on the Cambridge Cognitive Examination (CAMCOG). In addition, 10 age, sex and education matched volunteer or relative controls were assessed. OUTCOME MEASURES: A detailed semantic memory test battery consisting of five subtests: category fluency, picture naming, picture sorting, word-picture matching and generation of verbal definitions. RESULTS: Compared to normal controls, both patient groups were impaired on all subtests of the semantic battery with the exception of the word-picture matching test. No differences were found between the vascular dementia and DAT groups on any of the measures. CONCLUSIONS: Impairment of semantic memory is a feature of both vascular dementia and DAT. Tests of semantic memory appear, therefore, of little value in differentiating between these two major causes of dementia. Further work is required to determine whether the nature of the processing deficit is the same in these conditions.

Aged↗

Specialization of left auditory cortex for speech perception in man depends on temporal coding.

Speech perception requires cortical mechanisms capable of analysing and encoding successive spectral (frequency) changes in the acoustic signal. To study temporal speech processing in the human auditory cortex, we recorded intracerebral evoked potentials to syllables in right and left human auditory cortices including Heschl's gyrus (HG), planum temporale (PT) and the posterior part of superior temporal gyrus (area 22). Natural voiced /ba/, /da/, /ga/) and voiceless (/pa/, /ta/, /ka/) syllables, spoken by a native French speaker, were used to study the processing of a specific temporally based acoustico-phonetic feature, the voice onset time (VOT). This acoustic feature is present in nearly all languages, and it is the VOT that provides the basis for the perceptual distinction between voiced and voiceless consonants. The present results show a lateralized processing of acoustic elements of syllables. First, processing of voiced and voiceless syllables is distinct in the left, but not in the right HG and PT. Second, only the evoked potentials in the left HG, and to a lesser extent in PT, reflect a sequential processing of the different components of the syllables. Third, we show that this acoustic temporal processing is not limited to speech sounds but applies also to non-verbal sounds mimicking the temporal structure of the syllable. Fourth, there was no difference between responses to voiced and voiceless syllables in either left or right areas 22. Our data suggest that a single mechanism in the auditory cortex, involved in general (not only speech-specific) temporal processing, may underlie the further processing of verbal (and non-verbal) stimuli. This coding, bilaterally localized in auditory cortex in animals, takes place specifically in the left HG in man. A defect of this mechanism could account for hearing discrimination impairments associated with language disorders.

Acoustic Stimulation↗

Interactions of language and memory in deaf children and adults.

This article reviews theoretical and empirical issues concerning the relations of language and memory in deaf children and adults. An integration of previous studies, together with the presentation of new findings, suggests that there is an intimate relation between spoken language and memory. Either spoken language or sign language can serve as a natural mode of communication for young children (deaf or hearing), leading to normal language, social, and cognitive development. Nevertheless, variation in spoken language abilities can be shown to have a direct impact on memory span. Although the ways in which memory span can effect other cognitive processes and academic achievement are not considered in depth here, several variables that can have direct impact on the language-memory interaction are considered. These findings have clear implications for the education of deaf children.

Adult↗

Automatic sign language analysis: a survey and the future beyond lexical meaning.

Research in automatic analysis of sign language has largely focused on recognizing the lexical (or citation) form of sign gestures as they appear in continuous signing, and developing algorithms that scale well to large vocabularies. However, successful recognition of lexical signs is not sufficient for a full understanding of sign language communication. Nonmanual signals and grammatical processes which result in systematic variations in sign appearance are integral aspects of this communication but have received comparatively little attention in the literature. In this survey, we examine data acquisition, feature extraction and classification methods employed for the analysis of sign language gestures. These are discussed with respect to issues such as modeling transitions between signs in continuous signing, modeling inflectional processes, signer independence, and adaptation. We further examine works that attempt to analyze nonmanual signals and discuss issues related to integrating these with (hand) sign gestures. We also discuss the overall progress toward a true test of sign recognition systems--dealing with natural signing by native signers. We suggest some future directions for this research and also point to contributions it can make to other fields of research. Web-based supplemental materials (appendicies) which contain several illustrative examples and videos of signing can be found at www.computer.org/publications/dlib.

Algorithms↗