Toward integrated management of cerebral aneurysms

In the last few years, some of the visionary concepts behind the virtual physiological human began to be demonstrated on various clinical domains, showing great promise for improving healthcare management. In the current work, we provide an overview of image- and biomechanics-based techniques that, when put together, provide a patient-specific pipeline for the management of intracranial aneurysms. The derivation and subsequent integration of morphological, morphodynamic, haemodynamic and structural analyses allow us to extract patient-specific models and information from which diagnostic and prognostic descriptors can be obtained. Linking such new indices with relevant clinical events should bring new insights into the processes behind aneurysm genesis, growth and rupture. The development of techniques for modelling endovascular devices such as stents and coils allows the evaluation of alternative treatment scenarios before the intervention takes place and could also contribute to the understanding and improved design of more effective devices. A key element to facilitate the clinical take-up of all these developments is their comprehensive validation. Although a number of previously published results have shown the accuracy and robustness of individual components, further efforts should be directed to demonstrate the diagnostic and prognostic efficacy of these advanced tools through large-scale clinical trials.

Summarization of specialized discourse: the case of medical articles in Spanish

In this article, we present the current state of our work on a linguistically-motivated model for automatic summarization of medical articles in Spanish. The model takes into account the results of an empirical study which reveals that, on the one hand, domain-specific summarization criteria can often be derived from the summaries of domain specialists, and, on the other hand, adequate summarization strategies must be multidimensional, i.e., cover various types of linguistic clues. We take into account the textual, lexical, discursive, syntactic and communicative dimensions. This is novel in the field of summarization. The experiments carried out so far indicate that our model is suitable to provide high quality summarizations.

Development and validation of a postmortem radiological alteration index: the RA-Index.

This study aimed to derive an index quantifying the state of alteration of cadavers by quantifying the presence of gas in the body using postmortem multidetector computed tomography (MDCT) imaging, and to validate the index by defining its sensitivity and specificity. The RA (radiological alteration)-index was derived from postmortem MDCT data from 118 nontraumatically deceased people. To validate the index, 100 additional scanned bodies (50 % traumatically deceased) were retrospectively examined by two independent observers. Presence of gas at 82 sites was assessed by a radiologist, whereas a forensic pathologist only investigated the seven sites used for the RA-index. The RA-index was highly correlated to the overall presence of gas in all 82 sites (R(2) = 0.98 in the derivation set and 0.85 in the validation set). Semiquantitative evaluation of gas presence in each site showed moderate reliability (Cohen's kappa range, 0.41-0.78); nevertheless, the overall RA-index was very reliable (ICC(2,1) = 0.95; 95 % CI 0.92-0.96). Examiner using the RA-index detected heart cavities full of gas with a sensitivity of 100 % (95 % CI 51.7-100) and a specificity of 98.8 % (92.6-99.9). We conclude that determining the presence of gas at seven sites is a valid means to measure the distribution of gas due to cadaveric alteration in the entire body. The RA-index is rapid, easy-to-use, and reliable for nonexperienced users, and it is a valid method to suspect the normal presence of gas from cadaveric alteration. MDCT can be used to screen for gas embolism and to give indications for gas composition analysis (gas chromatography).

Spotting Translationese in two Corpora of Original and Translated Catalan Texts: an Empirical Approach

This research investigates the phenomenon of translationese in two monolingual comparable corpora of original and translated Catalan texts. Translationese has been defined as the dialect, sub-language or code of translated language. This study aims at giving empirical evidence of translation universals regardless the source language.Traditionally, research conducted on translation strategies has been mainly intuition-based. Computational Linguistics and Natural Language Processing techniques provide reliable information of lexical frequencies, morphological and syntactical distribution in corpora. Therefore, they have been applied to observe which translation strategies occur in these corpora.Results seem to prove the simplification, interference and explicitation hypotheses, whereas no sign of normalization has been detected with the methodology used.The data collected and the resources created for identifying lexical, morphological and syntactic patterns of translations can be useful for Translation Studies teachers, scholars and students: teachers will have more tools to help students avoid the reproduction of translationese patterns. Resources developed will help in detecting non-genuine or inadequate structures in the target language. This fact may imply an improvement in stylistic quality in translations. Translation professionals can also take advantage of these resources to improve their translation quality.

8-month non-use of a language. A case tudy. A longitudinal study of the effects on non use of one of the languages (Spanish) of a German L1 multilingual

Under the Dynamic Model of Multilingualism multilinguals are especially vulnerable to language attrition. It was the aim of the present study to verify if this was the case and to observe whether the different linguistic skills (receptive vs. descriptive) and the different linguistic levels (syntactic, lexical, morphological, etc.) would be affected equally.Data were gathered longitudinally by means of a language test for the subject’s reading, writing, listening and speaking skills as well as her knowledge of grammar and vocabulary. Although the overall accuracy remained intact and no proof for attrition in the receptive skills was found, the productive skills - mainly fluency - were shown to have suffered from language attrition. This was demonstrated by an increase in the number of pauses, hesitations, repetitions and self-corrections among others and decrease in the percentage of error-free clauses and decrease in the clause length, in oral and written fluency respectively.

Wörter stehen da einige. On nominal split topicalization in non-standard viennese german

This work investigates the syntactic, semantic, and pragmatic properties of nominal Split Topicalization (ST) constructions in Standard and non-Standard German. The topic phrase denotes a property, and the MF phrase either modifies this property or picks out a specific entity. Semantically, the topic phrase will be analysed as a property-denoting expression which restricts the denotation of the verbal predicate, while the MF phrase is composed either via specify or restrict (cf. Chung and Ladusaw, 2003). Syntactically, the base position of the topic phrase is the (incorporating) verb, and the MF phrase is generated independently as the complement of the verb containing an empty pronoun. Since predicates introduce abstract discourse referents, the topic phrase can be resumed via "pro" in the MF phrase.

Nd-, O-, and H-isotopic evidence for complex, closed-system fluid evolution of the peralkaline Ilimaussaq intrusion, South Greenland

Relatively homogeneous oxygen isotope compositions of amphibole, clinopyroxene, and olivine separates (+5.2 to +5.7parts per thousand relative to VSMOW) and neodymium isotope compositions (epsilon(Nd(T)) = -0.9 to -1.8 for primary magmatic minerals and epsilon(Nd(T)) = -0.1 and -0.5 for mineral separates from late-stage pegmatites and hydrothermal veins) from the alkaline to agpaitic llimaussaq intrusion, South Greenland, indicate a closed system evolution of this igneous complex and support a mantle derivation of the magma. In contrast to the homogeneous oxygen and neodymium isotopic data, deltaD values for hand-picked amphibole separates vary between -92 and -232parts per thousand and are among the most deuterium-depleted values known from igneous amphiboles. The calculated fluid phase coexisting with these amphiboles has a homogeneous oxygen isotopic composition within the normal range of magmatic waters, but extremely heterogeneous and low D/H ratios, implying a decoupling of the oxygen- and hydrogen isotope systems. Of the several possibilities that can account for such unusually low deltaD values in amphiboles (e.g., late-stage hydrothermal exchange with meteoric water, extensive magmatic degassing, contamination with organic matter, and/or effects of Fe-content and pressure on amphibole-water fractionation) the most likely explanation for the range in deltaD values is that the amphiboles have been influenced by secondary interaction and reequilibration with D-depleted fluids obtained through late-magmatic oxidation of internally generated CH(4) and/or H(2). This interpretation is consistent with the known occurrence of abundant magmatic CH(4) in the Ilimaussaq rocks and with previous studies on the isotopic compositions of the rocks and fluids. Copyright (C) 2004 Elsevier Ltd.

WH-Constructions in Cape Verdean Creole

This dissertation concerns two types of wh-constructions – interrogative and relative clauses – of Cape Verdean Creole (CVC), a Portuguese-based Creole language spoken on the archipelago of Cape Verde, specifically the variety spoken on Santiago Island, in the coast of West Africa. Chapter 2 focus on some aspects of the syntax of CVC, claiming that the possibilities of S-V inversion are very limited and that verbs stay in Vº, except for the Present tense form of the copula verb e ‘to be’, which is the spell out of the formal feature [Present] of T. It is proposed that CVC exhibits a clause functional structure that is similar to English: [CP [TP [NegP [AspP [VP … ]]]]]. In this chapter, it is also suggested that a non Split-CP, based on the formal features [±D, ±V, ±Q, ±Wh, ±T], correctly accounts for the distribution of the complementizers in CVC. Chapter 3 presents the wh-question formation strategies exhibited by CVC, showing that some of them involve Move, while others do not. Considering CVC data, it is said that the language has two clausal typing processes: an ambiguous complementizer ki ([±Q, ±Wh]), whose checking domain is strictly local; and an unambiguous complementizer Ø ([+Q, +Wh]), whose checking domain is not strictly local. The first one derives fronted wh-questions and the second one accounts for wh-in- -situ. Chapter 4 describes the relativization strategies displayed by CVC, focusing on the fact that PP pied-piping is ruled out and that resumption is possible both inside and outside syntactic islands. It is suggested a revision of Bianchi’s (2002a) head raising analysis for the structure of relative clauses. Chapter 5 discusses the properties of the defective copy strategy ([wh[+PL] … el]) and presents evidence in favor of a distinction between this type of wh-strategy and resumption ([wh[+PL] … es]). It is argued that the language requires an overt pronominal form (3SG) to occur in the complement position of the preposition because CVC types the clause with a complementizer ki [uCat +D] and does not allow for preposition incorporation. The set of formal features of the lower copy is ‘shrinked’, i.e. the features are deleted but not erased, being accessible to PF. This analysis of the defective copy xiv strategy predicts that it only applies to PPs and that it is an autonomous process involving wh-movement, which is distinct from resumption.

Why ethnic fractionalization? Polarization, ethnic conflict and growth

This paper ia an attempt to clarify the relationship between fractionalization,polarization and conflict. The literature on the measurement of ethnic diversityhas taken as given that the proper measure for heterogeneity can be calculatedby using the fractionalization index. This index is widely used in industrialeconomics and, for empirical purposes, the ethnolinguistic fragmentation isready available for regression exercises. Nevertheless the adequacy of asynthetic index of hetergeneity depends on the intrinsic characteristicsof the heterogeneous dimension to be measured. In the case of ethnicdiversity there is a very strong conflictive dimension. For this reasonwe argue that the measure of heterogeneity should be one of the class ofpolarization measures. In fact the intuition of the relationship betweenconflict and fractionalization do not hold for more than two groups. Incontrast with the usual problem of polarization indices, which are ofdifficult empirical implementation without making some arbitrary choiceof parameters, we show that the RQ index, proposed by Reynal-Querol (2002),is the only discrete polarization measure that satisfies the basic propertiesof polarization. Additionally we present a derivation of the RQ index froma simple rent seeking model. In the empirical section we show that whileethnic polarization has a positive effect on civil wars and, indirectly ongrowth, this effect is not present when we use ethnic fractionalization.

The size and burden of mental disorders and other disorders of the brain in Europe 2010.

Aims: To provide 12-month prevalence and disability burden estimates of a broad range of mental and neurological disorders in the European Union (EU) and to compare these findings to previous estimates. Referring to our previous 2005 review, improved up-to-date data for the enlarged EU on a broader range of disorders than previously covered are needed for basic, clinical and public health research and policy decisions and to inform about the estimated number of persons affected in the EU. Method: Stepwise multi-method approach, consisting of systematic literature reviews, reanalyses of existing data sets, national surveys and expert consultations. Studies and data from all member states of the European Union (EU-27) plus Switzerland, Iceland and Norway were included. Supplementary information about neurological disorders is provided, although methodological constraints prohibited the derivation of overall prevalence estimates for mental and neurological disorders. Disease burden was measured by disability adjusted life years (DALY). Results: Prevalence: It is estimated that each year 38.2% of the EU population suffers from a mental disorder. Adjusted for age and comorbidity, this corresponds to 164.8 million persons affected. Compared to 2005 (27.4%) this higher estimate is entirely due to the inclusion of 14 new disorders also covering childhood/adolescence as well as the elderly. The estimated higher number of persons affected (2011: 165 m vs. 2005: 82 m) is due to coverage of childhood and old age populations, new disorders and of new EU membership states. The most frequent disorders are anxiety disorders (14.0%), insomnia (7.0%), major depression (6.9%), somatoform (6.3%), alcohol and drug dependence (>4%), ADHD (5%) in the young, and dementia (1-30%, depending on age). Except for substance use disorders and mental retardation, there were no substantial cultural or country variations. Although many sources, including national health insurance programs, reveal increases in sick leave, early retirement and treatment rates due to mental disorders, rates in the community have not increased with a few exceptions (i.e. dementia). There were also no consistent indications of improvements with regard to low treatment rates, delayed treatment provision and grossly inadequate treatment. Disability: Disorders of the brain and mental disorders in particular, contribute 26.6% of the total all cause burden, thus a greater proportion as compared to other regions of the world. The rank order of the most disabling diseases differs markedly by gender and age group; overall, the four most disabling single conditions were: depression, dementias, alcohol use disorders and stroke. Conclusion: In every year over a third of the total EU population suffers from mental disorders. The true size of "disorders of the brain" including neurological disorders is even considerably larger. Disorders of the brain are the largest contributor to the all cause morbidity burden as measured by DALY in the EU. No indications for increasing overall rates of mental disorders were found nor of improved care and treatment since 2005; less than one third of all cases receive any treatment, suggesting a considerable level of unmet needs. We conclude that the true size and burden of disorders of the brain in the EU was significantly underestimated in the past.Concerted priority action is needed at all levels, including substantially increased funding for basic, clinical and public health research in order to identify better strategies for improved prevention and treatment for isorders of the brain as the core health challenge of the 21st century. (C) 2011 Published by Elsevier B.V.

As Línguas de Cabo Verde: uma Radiografia Sociolinguística

Esta dissertação constitui um estudo de caso, exploratório e de carácter descritivo. Tem como objectivo fazer uma radiografia sociolinguística de Cabo Verde, particularmente centrada no actual uso das duas línguas faladas no arquipélago, o português (PCV) e o crioulo cabo-verdiano (LCV). A linha de pesquisa adoptada inspira-se fortemente nos estudos de macrosociolinguística, tomando a situação de contacto de línguas, caracterizadora da sociedade cabo-verdiana, como ponto de partida para o enquadramento de um conjunto de questões seleccionadas para investigação mais aprofundada. São, assim, explorados os processos implicados nesta situação de contacto concreta e os resultados linguísticos decorrentes da mesma, como o bilinguismo ou a diglossia (cf. Cap. 3). Recorrendo a contributos teóricos de áreas associadas e complementares (cf. Cap. 1), foca-se a importância da análise dos domínios em que cada uma das línguas é usada, das redes sociais dos falantes ou das suas atitudes linguísticas. A investigação partiu de uma recolha de dados realizada para o efeito, nas nove ilhas habitadas. As unidades de análise retidas correspondem a uma amostragem de dois grupos sociais distintos: falantes jovens, alunos do ensino secundário (inquiridos por questionário), e falantes adultos cuja profissão implica uma intensa actividade linguística (professores e ‘líderes’, inquiridos por entrevistas semi-dirigidas). Foi usada uma metodologia de recolha o mais rigorosa possível e adoptado o tratamento estatístico de dados (cf. Cap. 2). O confronto dos comportamentos linguísticos e das atitudes das duas gerações inquiridas, com diferentes características (cf. Introdução), forneceu importantes informações sobre a dinâmica linguística da sociedade cabo-verdiana, conclusões essas que serão importantes para a definição de orientações no âmbito da política linguística (cf. Cap. 5). É apresentada, como complemento, uma análise exploratória de alguns aspectos sintácticos atestados nas produções dos indivíduos inquiridos com instrução superior (cf. Cap. 4), um contributo, embora modesto, para a definição da variedade padrão do PCV

Estimating uncertainty of alcohol-attributable fractions for infectious and chronic diseases.

Background: Alcohol is a major risk factor for burden of disease and injuries globally. This paper presents a systematic method to compute the 95% confidence intervals of alcohol-attributable fractions (AAFs) with exposure and risk relations stemming from different sources.Methods: The computation was based on previous work done on modelling drinking prevalence using the gamma distribution and the inherent properties of this distribution. The Monte Carlo approach was applied to derive the variance for each AAF by generating random sets of all the parameters. A large number of random samples were thus created for each AAF to estimate variances. The derivation of the distributions of the different parameters is presented as well as sensitivity analyses which give an estimation of the number of samples required to determine the variance with predetermined precision, and to determine which parameter had the most impact on the variance of the AAFs.Results: The analysis of the five Asian regions showed that 150 000 samples gave a sufficiently accurate estimation of the 95% confidence intervals for each disease. The relative risk functions accounted for most of the variance in the majority of cases.Conclusions: Within reasonable computation time, the method yielded very accurate values for variances of AAFs.

The acquisition of pronouns by French children: A parallel study of production and comprehension

This study examines syntactic and morphological aspects of the production and comprehension of pronouns by 99 typically developing French-speaking children aged 3 years, 5 months to 6 years, 5 months. A fine structural analysis of subject, object, and reflexive clitics suggests that whereas the object clitic chain crosses the subject chain, the reflexive clitic chain is nested within it. We argue that this structural difference introduces differences in processing complexity, chain crossing being more complex than nesting. In support of this analysis, both production and comprehension experiments show that children have more difficulty with object than with reflexive clitics (with more omissions in production and more erroneous judgments in sentences involving Principle B in comprehension). Concerning the morphological aspect, French subject and object pronouns agree in gender with their referent. We report serious difficulties with pronoun gender both in production and comprehension in children around the age of 4 (with nearly 30% errors in production and chance level judgments in comprehension), which tend to disappear by age 6. The distribution of errors further suggests that the masculine gender is processed as the default value. These findings provide further insights into the relationship between comprehension and production in the acquisition process.

Development and validation of a clinical decision rule for the diagnosis of influenza.

INTRODUCTION: A clinical decision rule to improve the accuracy of a diagnosis of influenza could help clinicians avoid unnecessary use of diagnostic tests and treatments. Our objective was to develop and validate a simple clinical decision rule for diagnosis of influenza. METHODS: We combined data from 2 studies of influenza diagnosis in adult outpatients with suspected influenza: one set in California and one in Switzerland. Patients in both studies underwent a structured history and physical examination and had a reference standard test for influenza (polymerase chain reaction or culture). We randomly divided the dataset into derivation and validation groups and then evaluated simple heuristics and decision rules from previous studies and 3 rules based on our own multivariate analysis. Cutpoints for stratification of risk groups in each model were determined using the derivation group before evaluating them in the validation group. For each decision rule, the positive predictive value and likelihood ratio for influenza in low-, moderate-, and high-risk groups, and the percentage of patients allocated to each risk group, were reported. RESULTS: The simple heuristics (fever and cough; fever, cough, and acute onset) were helpful when positive but not when negative. The most useful and accurate clinical rule assigned 2 points for fever plus cough, 2 points for myalgias, and 1 point each for duration <48 hours and chills or sweats. The risk of influenza was 8% for 0 to 2 points, 30% for 3 points, and 59% for 4 to 6 points; the rule performed similarly in derivation and validation groups. Approximately two-thirds of patients fell into the low- or high-risk group and would not require further diagnostic testing. CONCLUSION: A simple, valid clinical rule can be used to guide point-of-care testing and empiric therapy for patients with suspected influenza.

Cape Verdean Creole of São Vicente: Its genesis and Structure

Although the Santiago variety of Cape Verdean Creole (CVC) has been the subject of numerous linguistic works, the second major variety of the language, i.e. the São Vicente variety of CVC (CVSV), has hardly been described. Nevertheless this lack of studies and given its striking differences, on all linguistic levels, from the variety of Santiago (CVST), the implicit explanation for such divergences, echoed for decades in the literature on CVC, has been the presumably decreolized character of CVSV. First, this study provides a comprehensive fieldwork-based synchronic description of CVSV major morpho-syntactic categories in the intent to document the variety. Second, it aims to place the study of CVSV within a broader scope of contact linguistics in the quest to explain its structure. Based on analyses of historical documents and studies, it reconstructs the sociohistorical scenario of the emergence and development of CVSV in the period of 1797- 1975. From the comparison of the current structures of CVSV and CVST, the examination of linguistic data in historical texts and the analysis of sociohistorical facts it becomes clear that the contemporary structure of CVSV stems from the contact-induced changes that occurred during the intensive language and dialect contact on the island of São Vicente in the early days of its settlement in the late 18th and ensuing early 19th century development, rather than from modern day pressure of Portuguese. Although this dissertation argues for multiple explanations rather than a single theory, by showing that processes such as languages shift among the first Portuguese settlers, L2 acquisition, migration of the Barlavento speakers and subsequent dialect leveling as well as language borrowing at a later stage were at stake, it demonstrates the usefulness of partial-restructuring model proposed by Holm (2004).