scholarly journals Language and Cognitive Functions in a Neurological Tumour Population: A Long-Term Follow-Up Study

2021 ◽  
Author(s):  
◽  
Katherine Fowler
Keyword(s):  
Cognitive Control ◽  
Language Processing ◽  
Language Deficits ◽  
Patient Sample ◽  
Core Skills ◽  
Sentence Level ◽  
Long Term Follow Up ◽  
The Relationship

<p>Complex cognitive capacities such as language and “executive function” are difficult to evaluate in neuropsychological populations due to their multifactorial nature. The current study takes a cognitively-motivated core-skills approach to their assessment. Across four investigations, these various capacities are decomposed into simpler core skills based on current cognitive theory. An undifferentiated sample of 28 neurological tumour patients is then assessed on these skills.  In the first study, we assessed the “core skills” underpinning language function at three time points: pre-operative (one day prior to surgery), post-operative (within three days of surgery), and at long-term follow-up (at least three months post-surgery). This approach was sensitive at detecting impairment; indeed, almost half of the patients showed persistent long-term language deficits even at long-term follow-up. The decompositional approach also proved effective at predicting long-term outcomes. Overall, these results suggest that the subtle language deficits may be more common and more persistent than previously estimated in tumour populations.  The second study examined the relationship between “core” language skills and sentence-level language processing at long-term follow up. Whilst there were few significant correlations, the results nonetheless suggest that “core skills” measures may be useful predictors of some aspects of sentence-level processing.  The third study isolated and identified “core” skills that are essential for complex cognitive control more generally, and assessed these in our patient sample at long-term follow-up. Results were broadly supportive of this decompositional approach, and again, our assessments proved highly sensitive at detecting deficits in this patient sample.  The fourth study examined the relationship between language processing and complex cognitive control. Specifically, we examined whether there are systems specially dedicated to the control of language, or whether control functions operate across all domains. Overall, our results were broadly consistent with the domain-specific view - that there may be functionally distinct control systems operating on verbal and nonverbal material.  The results, taken together suggest that a core skills approach to neuropsychological assessment has considerable promise, and is worth exploring further in a large patient sample. This approach may also help extend our understanding of the functional organisation of language, and the broader cognitive skills necessary for linguistic operations.</p>

scholarly journals Language and Cognitive Functions in a Neurological Tumour Population: A Long-Term Follow-Up Study

2021 ◽  
Author(s):  
◽  
Katherine Fowler
Keyword(s):  
Cognitive Control ◽  
Language Processing ◽  
Language Deficits ◽  
Patient Sample ◽  
Core Skills ◽  
Sentence Level ◽  
Long Term Follow Up ◽  
The Relationship

<p>Complex cognitive capacities such as language and “executive function” are difficult to evaluate in neuropsychological populations due to their multifactorial nature. The current study takes a cognitively-motivated core-skills approach to their assessment. Across four investigations, these various capacities are decomposed into simpler core skills based on current cognitive theory. An undifferentiated sample of 28 neurological tumour patients is then assessed on these skills.  In the first study, we assessed the “core skills” underpinning language function at three time points: pre-operative (one day prior to surgery), post-operative (within three days of surgery), and at long-term follow-up (at least three months post-surgery). This approach was sensitive at detecting impairment; indeed, almost half of the patients showed persistent long-term language deficits even at long-term follow-up. The decompositional approach also proved effective at predicting long-term outcomes. Overall, these results suggest that the subtle language deficits may be more common and more persistent than previously estimated in tumour populations.  The second study examined the relationship between “core” language skills and sentence-level language processing at long-term follow up. Whilst there were few significant correlations, the results nonetheless suggest that “core skills” measures may be useful predictors of some aspects of sentence-level processing.  The third study isolated and identified “core” skills that are essential for complex cognitive control more generally, and assessed these in our patient sample at long-term follow-up. Results were broadly supportive of this decompositional approach, and again, our assessments proved highly sensitive at detecting deficits in this patient sample.  The fourth study examined the relationship between language processing and complex cognitive control. Specifically, we examined whether there are systems specially dedicated to the control of language, or whether control functions operate across all domains. Overall, our results were broadly consistent with the domain-specific view - that there may be functionally distinct control systems operating on verbal and nonverbal material.  The results, taken together suggest that a core skills approach to neuropsychological assessment has considerable promise, and is worth exploring further in a large patient sample. This approach may also help extend our understanding of the functional organisation of language, and the broader cognitive skills necessary for linguistic operations.</p>

Abstract 5772: The Impact of Aortic Plaque Morphology on Survival Rate and the Incidence of Subsequent Embolic Event: Very Long-Term Follow-Up Data

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Chisato Izumi ◽  
Shuichi Takahashi ◽  
Sumiyo Hashiwada ◽  
Koji Hanazawa ◽  
Jiro Sakamoto ◽  
...  
Keyword(s):  
Survival Rate ◽  
Event Rate ◽  
Plaque Morphology ◽  
Embolic Event ◽  
Aortic Plaque ◽  
Long Term Follow Up ◽  
The Impact ◽  
The Relationship

Atheromatous plaques of the aorta have been regarded as a potential source of emboli, but there are few reports about the frequency and prognosis of patients with thoracic aortic plaques and about the relationship between plaque morphology and prognosis, especially long-term follow-up data. The purpose of this study is to clarify the impact of aortic atheromatous plaque morphology on survival rate and the incidence of subsequent embolic event. We retrospectively investigated 1570 consecutive patients who underwent transesophageal echocardiography between 1991 and 2003. The presence of severe plaque (>5mm in thickness) in the thoracic aorta were examined. Survival rate and subsequent embolic event rate were compared between patients with severe plaque and 109 control patients. The control patients were selected from the patients who showed no or mild plaque and as they were matched for age, gender, and risk factors of atherosclerosis with the patients with severe aortic plaque. The relationship between aortic plaque morphology and prognosis was also estimated, according to the presence of ulceration, calcification, hypoechoic plaques, and mobile plaques. Mean follow-up period was 8.7 years. Among 1570 patients, severe aortic plaque was detected in 92 patients (5.9%). These 92 patients showed significantly low survival rate and high subsequent embolic event rate compared with control patients (8-year survival rate, 50% vs 87%, 8-year embolic event free rate, 57% vs 90%). The relative risk of death was significantly increased for ulceration (2.4, 95% CI;1.1–5.2) and the relative risk of embolic events was significantly increased for mobile plaques (2.2, 95% CI;1.1–5.1). In conclusion, aortic plaque > 5mm in thickness was a predictor of a low survival rate and a high embolic event rate. Among patients with aortic plaque >5mm in thickness, ulceration was a predictor of a low survival rate and mobile plaque was a predictor of a high embolic event rate.

Longitudinal Observations of the Relationship Between Free Erythrocyte Porphyrins and Whole Blood Lead

PEDIATRICS ◽  
1976 ◽  
Vol 57 (1) ◽  
pp. 54-59
Author(s):  
J. Routt Reigart ◽  
Norris H. Whitlock
Keyword(s):  
Whole Blood ◽  
Blood Lead ◽  
Elevated Blood ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
First Contact ◽  
The Relationship ◽  
Clinical Category

Short- and long-term comparison of the variations with time of whole blood lead and free erythrocyte porphyrins (FEP) suggests that changes in FEP are slow and predictable whereas blood lead changes are quite unpredictable. However, when FEP suggests a different clinical category from blood lead, the blood lead is likely to change in the direction predicted by the FEP. Comparison of FEP to blood lead at first contact in 349 children with mild elevation of blood lead reliably predicted which children would still have elevated blood lead six weeks later and which would fall or be normal. The observation of long-term follow-up in four groups of children with various combinations of FEP and blood lead indicated that the follow-up blood lead could be predicted to change in the direction indicated by the FEP measurement. The implications for screening for lead poisoning are discussed.

Syndactyly—A Review and Long Term Results

HAND ◽  
1977 ◽  
Vol os-9 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Peter M. Brown
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Anatomical Distribution ◽  
Long Term Follow Up ◽  
Relationship Of ◽  
The Relationship ◽  
Results Of Surgery

Syndactyly is classified and the principles of its surgical treatment discussed. The notes of eighty-five patients who had 222 webs between them were reviewed. A long term follow-up was carried out on thirty-two of these patients who had seventy-six clefts separated. The sexual and anatomical distribution of the syndactyly was investigated. The results of surgery were assessed including complications, and the relationship of complications to the type of graft used and the age at operation. It is suggested that complicated syndactyly is often separated at too early an age.

scholarly journals Long-term developmental follow-up in children with nonsyndromic craniosynostosis

2015 ◽  
Vol 16 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Maggie Bellew ◽  
Paul Chumas
Keyword(s):  
Normal Population ◽  
Time Of Surgery ◽  
Different Types ◽  
Long Term Follow Up ◽  
The Mean ◽  
The Relationship ◽  
Single Suture ◽  
The Average Range

OBJECT The aim of this study was to determine the distribution of Full Scale IQ (FSIQ) by type of craniosynostosis and to verify the finding that at long-term follow-up, verbal IQ (VIQ) is significantly higher than performance IQ (PIQ) in patients with single-suture sagittal synostosis (SS) despite falling within the “average” range for intelligence. Whether this also occurs in other types of craniosynostosis and whether surgery and sex are relevant were also determined. The relationship between age at time of surgery and later IQ was ascertained. METHODS The data for 91 children with craniosynostosis (47 sagittal, 15 unicoronal, 13 metopic, 9 multisuture, and 7 bicoronal) were collected at their routine, 10 years of age IQ assessment (mean age 123.8 months). The patients included 61 males and 30 females; 62 patients had undergone surgery and 29 had not. RESULTS The mean FSIQ for all types of craniosynostosis combined (96.2) fell within the average range for the general population. Some variation was evident across the different types of craniosynostosis: the SS group showed the highest FSIQs and a “normal” distribution of bandings; the other types had a higher proportion of FSIQs in the lower bandings. The data confirmed the finding that VIQ is greater than PIQ despite falling within the average range for intelligence, with a difference of 5.0 for all types of craniosynostosis combined (p = 0.001), 7.6 for the SS group (p = 0.001), and 6.9 for the unicoronal group (p = 0.029). This VIQ > PIQ effect was not found with multisuture craniosynostosis. The VIQ > PIQ discrepancy occurred regardless of whether the patient had undergone surgery and occurred more often in males than females. In the SS group and the bicoronal group, FSIQ (p = 0.036 and p = 0.046, respectively) and PIQ (p = 0.012 and p = 0.017, respectively), though not VIQ, were higher when surgery had been performed early. CONCLUSIONS The study confirms that at long-term follow-up, although children with nonsyndromic craniosynostosis fall within the normal range for intelligence, there is a VIQ > PIQ discrepancy above what would be expected in the normal population, which may be indicative of more subtle difficulties in achievement. This discrepancy is affected by type of craniosynostosis, sex, and age at time of surgery.

Abstract 172: Medical and Demographic Predictors of Long-term Cognitive Outcomes of Pediatric Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Alice A Holland ◽  
Kimberly D Goodspeed ◽  
Patricia Plumb ◽  
Peter L Stavinoha ◽  
Michael Dowling
Keyword(s):  
Neurological Impairment ◽  
Cognitive Outcomes ◽  
Stroke Severity ◽  
Pediatric Stroke ◽  
Post Stroke ◽  
Age Related ◽  
Long Term Follow Up ◽  
The Relationship

Introduction: Studies examining cognitive outcomes for pediatric stroke are sparse, and few account for stroke severity. The Pediatric Stroke Outcome Measure (PSOM) provides an objective, comprehensive rating of neurological impairment. This study investigated the relationship between initial PSOM score and long-term cognitive outcomes. It was hypothesized that greater severity of stroke (worse initial PSOM score) would predict lower IQ at long-term follow-up. Other factors considered were age at stroke and months post stroke. Age-related studies in broad cognitive outcomes for pediatric stroke are sparse and somewhat inconsistent in findings. It was hypothesized that severity of stroke would be more relevant than age of stroke for long-term cognitive outcomes. Methods: PSOM scores at initial visit and IQ scores at long-term follow-up (M=3.77 years) were obtained for 84 survivors of pediatric stroke ages 4:0-25:6 (M=11:5 years; 37 females). A one-sample t-test was conducted to compare mean IQ to the normative sample. To examine the hypotheses, all variables of interest (PSOM, age at stroke, and months s/p) were entered into a stepwise regression equation. Results: Mean IQ for the sample was 84.77 (SD=17.26), significantly below average relative to healthy norms ( t =-8.088, p =.000). PSOM scores ranged 0-5.5 (median/mode=1.0). The regression was significant ( F =8.798; p =.000), with both PSOM score ( b =-.350; t [80]=-3.483; p =.001) and months post stroke ( b =-.355; t [80]=-3.005; p =.004) significantly contributing to the model, but not age at stroke. Conclusions: PSOM was more relevant than age at stroke in predicting long-term cognitive outcomes, and greater stroke severity was associated with lower IQ at follow-up. Finding suggest that initial PSOM score and greater time since stroke may be more relevant to long-term cognitive outcomes than age at stroke. The present study lends validity to using the PSOM both as a marker of functional severity of stroke and a potential indicator of relative risk for poorer long-term cognitive outcomes. Better predictors of cognitive outcomes for pediatric stroke are greatly needed in order to facilitate earlier intervention/rehabilitation and improve the efficacy of such efforts.

scholarly journals Pharmacoepidemiology and Big Data Analytics: Challenges and Opportunities when Moving towards Precision Medicine

2019 ◽  
Vol 73 (12) ◽  
pp. 1012-1017
Author(s):  
Andrea M. Burden
Keyword(s):  
Machine Learning ◽  
Language Processing ◽  
Real World ◽  
Big Data Analytics ◽  
Large Size ◽  
Challenges And Opportunities ◽  
Long Term Follow Up ◽  
Machine Learning Applications

Pharmacoepidemiology is the study of the safety and effectiveness of medications following market approval. The increased availability and size of healthcare utilization databases allows for the study of rare adverse events, sub-group analyses, and long-term follow-up. These datasets are large, including thousands of patient records spanning multiple years of observation, and representative of real-world clinical practice. Thus, one of the main advantages is the possibility to study the real-world safety and effectiveness of medications in uncontrolled environments. Due to the large size (volume), structure (variety), and availability (velocity) of observational healthcare databases there is a large interest in the application of natural language processing and machine learning, including the development of novel models to detect drug–drug interactions, patient phenotypes, and outcome prediction. This report will provide an overview of the current challenges in pharmacoepidemiology and where machine learning applications may be useful for filling the gap.

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