Non-adjacent dependency learning in Cantonese-speaking children with and without a history of specific language impairment

Purpose: This study investigated non-adjacent dependency learning in Cantonese-speaking children with and without a history of Specific Language Impairment (SLI) in an artificial linguistic context. Method: Sixteen Cantonese-speaking children with SLI history and 16 Cantonese-speaking children with typical language development (TLD) were tested with a non-adjacent dependency learning task using artificial languages that mimic Cantonese. Results: Children with TLD performed above chance and were able to discriminate between trained and untrained non-adjacent dependencies. However, children with SLI history performed at chance and were not able to differentiate trained versus untrained non-adjacent dependencies. Conclusions: These findings, together with previous findings with English-speaking adults and adolescents with language impairments, suggested that individuals with atypical language development, regardless of age, diagnostic status, language and culture, showed difficulties in learning non-adjacent dependencies. This study provides evidence for early impairments to statistical learning in individuals with atypical language development

PROBLEMS OF THE EXPRESSION OF CONDITIONAL RELATIONSHIPS IN THE UZBEK LANGUAGE

The article is aimed at investigating the problems of the expression of conditionals in the Uzbek language. Particularly, in the article a special emphasis is placed on the analysis of peculiarities of formal expressions of conditionals in the Uzbek language. The objectives of the research are formed by defining the notion of condition in Uzbek, studying the forms of expression of the conditionals, analyzing the syntactic structure of the conditional constructions, identifying the levels of language in which conditionals are expressed, analyzing the functions of conjunctions connecting the clauses of conditional sentences and identifying the stylistic features of conditional conjunctions. Linguistic description, generalization of prior ideas and theories in the field and componential analysis methods are used. The results of the study have shown that the conditionals are expressed by the synthetic and analytic forms, the synthetic forms (conditionals formed by affixes) refer to the conditional forms constructed by adding the conditional affix “-sа” to the stem of the verb, the analytic forms (the combination with two or more components) include the form of“-sа”+ to’liqsiz fe’l (an auxiliary verb (edi, ekan, emish), the combination of a part of speech which is not a verb+bo’l (to be)+sa, lexical units as desa, bo’lsa, yo’qsa and proverbs. The conditionals are mainly expressed at the grammatical and lexical levels of the language. In the grammatical layer, the conditionals are especially expressed through a syntactic unit which is a complex sentence and it is important to note the role of the conditional affix “-sa” in expressing a conditionat the morphological level. In the lexical layer, some lexical units and proverbs can be regarded as means of expressing conditionality. Also,conditional clauses are connected by various conjunctions (agar, basharti, mabodo, bordiyu, madomiki all referring to “if” in English) and these connectives possess different stylistic colorings and the main function of such conjunctions is not to express conditionality, but to emphasize and exaggerate a conditional meaning. So, the structural peculiarities of conditionals in Uzbek are determined by their syntactic structure, their expression in different language levels and the conditional conjunctions

Has primary care antimicrobial use really been increasing? Comparison of changes in different prescribing measures for a complete geographic population 1995-2014

Objectives To elucidate how population trends in total antimicrobials dispensed in the community translate into individual exposure. Methods Retrospective, population-based observational study of all antimicrobial prescribing in a Scottish region in financial years 1995, 2000 and 2005–14. Analysis of temporal changes in all antimicrobials and specific antimicrobials measured in: WHO DDD per 1000 population; prescriptions per 1000 population; proportion of population with ≥1 prescription; mean number of prescriptions per person receiving any; mean DDD per prescription. Results Antimicrobial DDD increased between 1995 and 2014, from 5651 to 6987 per 1000 population [difference 1336 (95% CI 1309–1363)]. Prescriptions per 1000 fell (from 821 to 667, difference –154, –151 to –157), as did the proportion prescribed any antimicrobial [from 39.3% to 30.8% (–8.5, –8.4 to –8.6)]. Rising mean DDD per prescription, from 6.88 in 1995 to 10.47 in 2014 (3.59, 3.55–3.63), drove rising total DDD. In the under-5s, every measure fell over time (68.2% fall in DDD per 1000; 60.7% fall in prescriptions per 1000). Among 5–64 year olds, prescriptions per 1000 were lowest in 2014 but among older people, despite a reduction since 2010, the 2014 rate was still higher than in 2000. Trends in individual antimicrobials provide some explanation for overall trends. Conclusions Rising antimicrobial volumes up to 2011 were mainly due to rising DDD per prescription. Trends in dispensed drug volumes do not readily translate into information on individual exposure, which is more relevant for adverse consequences including emergence of resistance.PostprintPeer reviewe

Dose-Specific Adverse Drug Reaction Identification in Electronic Patient Records: Temporal Data Mining in an Inpatient Psychiatric Population

BACKGROUND: Data collected for medical, filing and administrative purposes in electronic patient records (EPRs) represent a rich source of individualised clinical data, which has great potential for improved detection of patients experiencing adverse drug reactions (ADRs), across all approved drugs and across all indication areas. OBJECTIVES: The aim of this study was to take advantage of techniques for temporal data mining of EPRs in order to detect ADRs in a patient- and dose-specific manner. METHODS: We used a psychiatric hospital’s EPR system to investigate undesired drug effects. Within one workflow the method identified patient-specific adverse events (AEs) and links these to specific drugs and dosages in a temporal manner, based on integration of text mining results and structured data. The structured data contained precise information on drug identity, dosage and strength. RESULTS: When applying the method to the 3,394 patients in the cohort, we identified AEs linked with a drug in 2,402 patients (70.8 %). Of the 43,528 patient-specific drug substances prescribed, 14,736 (33.9 %) were linked with AEs. From these links we identified multiple ADRs (p < 0.05) and found them to occur at similar frequencies, as stated by the manufacturer and in the literature. We showed that drugs displaying similar ADR profiles share targets, and we compared submitted spontaneous AE reports with our findings. For nine of the ten most prescribed antipsychotics in the patient population, larger doses were prescribed to sedated patients than non-sedated patients; five patients exhibited a significant difference (p < 0.05). Finally, we present two cases (p < 0.05) identified by the workflow. The method identified the potentially fatal AE QT prolongation caused by methadone, and a non-described likely ADR between levomepromazine and nightmares found among the hundreds of identified novel links between drugs and AEs (p < 0.05). CONCLUSIONS: The developed method can be used to extract dose-dependent ADR information from already collected EPR data. Large-scale AE extraction from EPRs may complement or even replace current drug safety monitoring methods in the future, reducing or eliminating manual reporting and enabling much faster ADR detection. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40264-014-0145-z) contains supplementary material, which is available to authorised users

Self-interest bias in the COVID-19 pandemic: A cross-cultural comparison between the United States and China

In the global crisis of the COVID-19 pandemic, many countries attempt to enforce new social norms to prevent the further spread of the coronavirus. A key to the success of these measures is the individual adherence to norms that are collectively beneficial to contain the spread of the pandemic. However, individuals’ self-interest bias (i.e., the prevalent tendency to license own but not others’ self-serving acts or norm violations) can pose a challenge to the success of such measures. The current research examines COVID-19-related self-interest bias from a cross-cultural perspective. Two studies (N = 1,558) sampled from the United States and China consistently revealed that participants from the United States evaluated their own self-serving acts (exploiting test kits in Study 1; social gathering and sneezing without covering the mouth in public in Study 2) as more acceptable than identical deeds of others, while such self-interest bias did not emerge among Chinese participants. Cultural underpinnings of independent versus interdependent self-construal may influence the extent to which individuals apply self-interest bias to justifications of their own self-serving behaviors during the pandemic

Competing risk events in antimalarial drug trials in uncomplicated Plasmodium falciparum malaria: a WorldWide Antimalarial Resistance Network individual participant data meta-analysis.

BACKGROUND: Therapeutic efficacy studies in uncomplicated Plasmodium falciparum malaria are confounded by new infections, which constitute competing risk events since they can potentially preclude/pre-empt the detection of subsequent recrudescence of persistent, sub-microscopic primary infections. METHODS: Antimalarial studies typically report the risk of recrudescence derived using the Kaplan-Meier (K-M) method, which considers new infections acquired during the follow-up period as censored. Cumulative Incidence Function (CIF) provides an alternative approach for handling new infections, which accounts for them as a competing risk event. The complement of the estimate derived using the K-M method (1 minus K-M), and the CIF were used to derive the risk of recrudescence at the end of the follow-up period using data from studies collated in the WorldWide Antimalarial Resistance Network data repository. Absolute differences in the failure estimates derived using these two methods were quantified. In comparative studies, the equality of two K-M curves was assessed using the log-rank test, and the equality of CIFs using Gray's k-sample test (both at 5% level of significance). Two different regression modelling strategies for recrudescence were considered: cause-specific Cox model and Fine and Gray's sub-distributional hazard model. RESULTS: Data were available from 92 studies (233 treatment arms, 31,379 patients) conducted between 1996 and 2014. At the end of follow-up, the median absolute overestimation in the estimated risk of cumulative recrudescence by using 1 minus K-M approach was 0.04% (interquartile range (IQR): 0.00-0.27%, Range: 0.00-3.60%). The overestimation was correlated positively with the proportion of patients with recrudescence [Pearson's correlation coefficient (ρ): 0.38, 95% Confidence Interval (CI) 0.30-0.46] or new infection [ρ: 0.43; 95% CI 0.35-0.54]. In three study arms, the point estimates of failure were greater than 10% (the WHO threshold for withdrawing antimalarials) when the K-M method was used, but remained below 10% when using the CIF approach, but the 95% confidence interval included this threshold. CONCLUSIONS: The 1 minus K-M method resulted in a marginal overestimation of recrudescence that became increasingly pronounced as antimalarial efficacy declined, particularly when the observed proportion of new infection was high. The CIF approach provides an alternative approach for derivation of failure estimates in antimalarial trials, particularly in high transmission settings

Temporal distribution of Plasmodium falciparum recrudescence following artemisinin-based combination therapy: an individual participant data meta-analysis.

BACKGROUND: The duration of trial follow-up affects the ability to detect recrudescent infections following anti-malarial treatment. The aim of this study was to explore the proportions of recrudescent parasitaemia as ascribed by genotyping captured at various follow-up time-points in treatment efficacy trials for uncomplicated Plasmodium falciparum malaria. METHODS: Individual patient data from 83 anti-malarial efficacy studies collated in the WorldWide Antimalarial Resistance Network (WWARN) repository with at least 28 days follow-up were available. The temporal and cumulative distributions of recrudescence were characterized using a Cox regression model with shared frailty on study-sites. Fractional polynomials were used to capture non-linear instantaneous hazard. The area under the density curve (AUC) of the constructed distribution was used to estimate the optimal follow-up period for capturing a P. falciparum malaria recrudescence. Simulation studies were conducted based on the constructed distributions to quantify the absolute overestimation in efficacy due to sub-optimal follow-up. RESULTS: Overall, 3703 recurrent infections were detected in 60 studies conducted in Africa (15,512 children aged  48 mg/kg total piperaquine (PIP) dose and 9% [95% CI 0-22%] in those treated with ≤ 48 mg/kg PIP dose. In absolute terms, the simulation study found that trials limited to 28 days follow-up following AL underestimated the risk of recrudescence by a median of 2.8 percentage points compared to day 63 estimates and those limited to 42 days following DP underestimated the risk of recrudescence by a median of 2.0 percentage points compared to day 42 estimates. The analysis was limited by few clinical trials following patients for longer than 42 days (9 out of 83 trials) and the imprecision of PCR genotyping which overcalls recrudescence in areas of higher transmission biasing the later distribution. CONCLUSIONS: Restricting follow-up of clinical efficacy trials to day 28 for AL and day 42 for DP will miss a proportion of late recrudescent treatment failures but will have a modest impact in derived efficacy. The results highlight that as genotyping methods improve consideration should be given for trials with longer duration of follow-up to detect early indications of emerging drug resistance

The rehabilitation definition for scientific research purposes by Cochrane Rehabilitation – first results

Background. Since its launch in 2016, Cochrane Rehabilitation (CR) has increasingly found the need to better define what rehabilitation is and what is not. We found that currently available definitions of rehabilitation fall short with regard to defining exactly what is needed for research purposes, specifically inclusion and exclusion criteria on an operational level. Objectives. The aim was to specify a definition of rehabilitation suitable for research purposes that also defines inclusion and exclusion criteria. Methods. The methodology was developed based on discussions during the CR Executive and Methodology Committees Meetings and with the Advisory Board of CR, which includes all relevant rehabilitation stakeholders, during its meeting in Kobe in June 2019. The methodology was then refined to include: (1) a survey involving a) the Advisory and b) the Executive Committee members and c) the participants invited to the consensus meeting here reported to collect the current definitions promoted by CR stakeholders, (2) a consensus meeting (CM) held in Milan (Italy) in February 2020, and (3) a Delphi procedure to reach a final definition. The CM was organized in three parts. Part 1: presentation and discussion of current definitions and related problems. Part 2: work in smaller groups to prepare a proposal of the new operational definition of rehabilitation for research purposes. Part 3: discussion and voting procedures on the proposal to be submitted to the Delphi procedure. The first round of the Delphi procedure will be conducted among the Meeting participants and the second round among the CR Advisory Board members. The results of the two rounds will be reviewed and synthesized, and a third Delphi round will be held again among the participants to the Meeting. Results. During the Meeting it was decided that the proposed definition should contain all the essential key words that constitute the inclusion and exclusion criteria for research purposes, following the PICO (Population, Intervention, Control, Outcome) model as much as possible. The current definition to be proposed for the Delphi Rounds is: In a health care context rehabilitation is: “a multimodal person-centered process, including functioning interventions targeting (1) body functions, and/or (2) activities and participation, and/or (3) the interaction with the environment” (Intervention), with the goal of “optimizing functioning” (Outcome) for “(1) persons with health conditions (a) experiencing disability or (b) likely to experience disability and/or (2) persons with disability” (Population). This definition is currently provisional, and it should not be used until the final results of the Delphi are published. Conclusions. These results will inform all the future work of CR and could also serve the scientific rehabilitation community. Patient or healthcare consumer involvement. Representative of healthcare consumers are present in the Advisory Board of CR and contributed at all stages of the project when the Advisory Board was involved