Effects of context in human sentence parsing: Evidence against a discourse-based proposal mechanism.

Carried out 2 S-paced reading experiments to examine the way in which discourse information exerts its influence in sentence comprehension. The results show that whereas prior discourse context appears to affect the way in which sentences are ultimately parsed, there is no evidence that it has any direct influence on the initial assignment of structure. These findings argue against parsing models (e.g., the referential support model) that assume that discourse factors influence the initial structural assignment. In contrast, they support models (e.g., the "garden path" model) that posit that initial structural proposals are made on a purely syntactic basis, whereas discourse effects are confined to a later set of disposal operations. These conclusions are discussed in the light of broader accounts of interactive processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental aneurysms: proposal for a new technic

The authors present a critical analysis of the various methods of experimental production of aneurysms and report their own method in which saccular aneurysms were produced at the bifurcation of the common carotid artery in dogs with vein patch grafts. The objective point of this study was the creation of an experimental model to evaluate the efficacy of a therapeutic procedure. These aneurysms have a low incidence of thrombosis and a tendency to enlarge and to become spherical. They closely simulate the saccular aneurysms developing spontaneously in the cerebral arteries of man, and as such are useful models for experimental purposes.     

Adrenal incidentaloma: proposal for a correct treatment

BACKGROUND: The incidence of unsuspected adrenal masses (incidentalomas) based on CT-scan results to be higher than in the past. The aim for our study was to establish some guidelines for an appropriate management. METHODS: From 1986 to 1995, 61 patients with no history or clinical findings suggestive of adrenal mass or adrenal hyperfunction were discovered by radiologic examination to have an incidentaloma larger than 1 cm. In each patient basal biochemical evaluations were obtained to exclude the presence of adrenal cortical or medullary dysfunction. There were 28 men and 33 (54.1%) women, with a mean age of 53 years (range 16-74). 19 patients underwent CT-guided fine-needle biopsy to exclude metastatic tumors. Furthermore in 29 patients 75-Se-selenomethyl-norcholesterol was performed and 17 were studied by MRI. RESULTS: At CT-scan mean lesion diameter was 5.48 +/- 3.76 cm (range 2-23); 32 adrenal masses were right sided and 3 (4.9%) were bilateral. 17 patients had concordant scintigraphic imaging pattern, 6 bilateral uptake and 6 had discordant imaging. CT-guided FNAB showed malignancy in 9. Adrenalectomy was performed in 45 patients according to a score calculated by 4 parameters: age of the patients, size of the mass, scintigraphic pattern, MR imaging. Twenty-four had a score greater than 9 and in the remaining 21 patients in spite of a score lower than 10 adrenalectomy was performed based on: 1) increased size at CT scan follow-up (15 pts); 2) either suspected primitive malignant neoplasm at CT-guided FNAB or history of malignancy (6 pts); 3) elevated 24-hour dopamine (4 pts). In 12 (26.7%) patients a malignant tumor was found. There were not any statistically significant differences (p > 0.05) between the age of the patients with malignant neoplasms and those with benign masses, and between the size of the masses, which were 7.58 +/- 5.93 cm (range 2-23) and 5.03 +/- 2.81 cm (range 3-17) respectively. The difference in scores between the patients with malignant masses (12.17 +/- 2.95) and those with benign ones (9.09 +/- 1.33) was statistically significant (p < 0.01). CONCLUSIONS: Since adrenal incidentaloma have a malignancy rate higher than the other adrenal tumors, it is crucial to outlinesome criteria to sort out the patients at risk for whom adrenalectomy is to be warranted. Based on our results we believe that patients with a score > 9 should undergo adrenalectomy.     

Minor advocacy in healthcare: a proposal for a more efficient solution

Autonomy is a crucial, yet litigious right in health care that is usually unquestioned in the case of adults. However, children's or their guardian's refusal to accept necessary medical care can expedite the question of autonomy from the medical to the legal arena. Therefore, to save time, money, and lives, the health care establishment, specifically ethics committees, must be given rights as a judicial body to hand down binding judgments in cases of minors refusing the medical community's standard of care.     

Opisthorchiasis control in northeast Thailand: proposal for a new approach

In a prospective study 102 patients with malignant tumors of the tongue, oropharynx, hypopharynx, and larynx were staged by means of MRI. Special attention was directed at those tumour extensions that could influence the treatment strategy. The MR findings were correlated with the results of palpation, endoscopy, ultrasound, computerised tomography and histopathological findings. MRI showed a good delineation of pT2 to pT4 tumours. However, visualisation of small tumours in the soft palate, the tonsils, the pyriform sinuses and vocal cords was difficult. In conclusion our results suggest that in addition to endoscopy MRI is a valuable tool for the examination of tumours of tongue, oropharynx, hypopharynx and larynx.     

The development of schemes for recognizing additive and alternative effects in a "natural experiment" context.

20 Ss at each of 4 age levels (4th, 6th, and 8th grade and college) were presented a "natural experiment" problem situation in which they were asked to interpret the more complex situations in which (a) either of 2 alternative variables is sufficient to produce an outcome, or (b) 2 variables are additive in their effect on an outcome. Not until adolescence could Ss isolate alternative or additive causes in a multivariable situation, though it is speculated they may comprehend the concept of alternative causes well before this age. Only 65% of college Ss exhibited correct reasoning in one or both situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Constructivism: a naturalistic methodology for nursing inquiry

This article will explore the philosophical underpinnings of the constructivist research paradigm. Despite its increasing popularity in evaluative health research studies there is limited recognition of constructivism in popular research texts. Lincoln and Guba's original approach to constructivist methodology is outlined and a detailed framework for nursing research is offered. Fundamental issues and concerns surrounding this methodology are debated and differences between method and methodology are highlighted.     

"Community health care: serving Colorado's uninsured"--a health policy legislative proposal

The article presents a hypothetical legislative proposal titled "Community Health Care: Serving the Uninsured." Briefly stated, the purpose of this legislation is to encourage public and private initiatives to provide health care for the uninsured, the indigent, and the underinsured citizens of Colorado. Lessons learned from this project can facilitate APNs' understanding of the issues surrounding the development of health policy.     

Exhaustion of vascular endowment in hemodialysis: proposal for a permanent inlet access

A simple left atrial procedure for atrial fibrillation (AF) was performed in 16 elderly patients (age over 70 years old) with chronic AF associated with mitral and/or aortic valvular diseases. Chronic AF was eliminated upon discharge in 13 out of the 16 patients (81%). Twelve of the 13 patients (92%) whose AF had disappeared recovered the atrial kick of their right atrium, and 9 patients (70%) recovered the atrial kick of their left atrium. A simple surgical procedure to the left atrium was effective in the treatment of chronic AF associated with mitral valve disease in elderly patients. This simple procedure is preferable to other methods for the elimination of chronic AF with mitral valve disease in elderly patients.     

Decision-making and paediatric pain: a review

The aim of this paper is to present an overview of the literature on the factors influencing decision-making in the nursing care of children in pain. To that effect published and unpublished references were reviewed. The most frequently cited factors influencing the assessment and management of pain in children are summarized and discussed. Finally recommendations are made where further research is warranted.     

History dependence of force production in skeletal muscle: a proposal for mechanisms

Leukotrienes, products of the 5-lipoxygenase pathway of arachidonic acid metabolism, possess properties consistent with their involvement in a range of inflammatory diseases. In this study the pharmacokinetics and pharmacodynamics of the selective 5-lipoxygenase inhibitor, fenleuton, have been examined in the horse. Orally administered fenleuton (four 5 mg kg(-1) doses, given once daily) was absorbed from the gastrointestinal tract, and penetrated readily into tissue cage exudate, the ratio of the plasma:exudate AUC0-48h being 0.90+/-0.02 (n=6). Ionophore-stimulated leukotriene (LT) B4 synthesis, measured ex vivo in whole blood as immunoreactive LTB4, was significantly (P<0.05) inhibited throughout the 48 hour sampling period. Low levels of immunoreactive LTB4 were detected in transudate and these did not increase following addition of carrageenan to the tissue cages. Fenleuton had no significant inhibitory effect on exudate LTB4 concentrations. A reduction in carrageenan-induced skin swelling occurred, although this did not achieve statistical significance. The results obtained in this study suggest that fenleuton could be used to examine the role of LTs in inflammatory diseases of the horse.     

Theoretical medicine: a proposal for reconceptualizing medicine as a science of actions

The main task of a critical theory of medicine should be to develop a perspectival, context-fair, and multidimensional science of actions which integrates both diversity and heterogeneity within medicine without eliminating either one. Such a theory should employ diversity in the following areas: (1) in systems, subsystems, and professions, because different medical professions embody different health-care subsystems, thereby influencing the way manpower is utilized, (2) in actors, (e.g., patients, health-care experts, and society), processes, and situations, because each actor potentially conceptualizes health, illness, and desired outcomes differently; and (3) in models of medicine (i.e., as an object science versus an action science). Situational influences modify concepts and explanatory models; even the particular terms, such as illness, disease, and sickness, are not necessarily concordant with each other.     

Medical dictionaries for patient encoding systems: a methodology

Medical language is highly compositional and makes extensive use of common roots, especially Latino-Greek roots. Besides words devoted to common sense, medical language presents some typical characteristics, especially on morphological and semantic aspects of word formation. Morphological decomposition and identification precedes semantic analysis. It is only when these two prerequisites are fulfilled that an attempt to grasp the meaning of a whole expression is made possible. The main aim of the proposed approach is that of coping with 'the lack of coverage of the medical lexical knowledge', in order to help physicians find the correct international classification for diseases (ICD) codes for a written diagnosis. The proposed methodology allows the development of a powerful dynamic dictionary dedicated to natural language processing in the field of diagnoses and narrative procedures. It describes the design of an analyser that can profit from a dictionary. The methods used have proved to be efficient for various classifications, s well as for multiple languages, as the system presently supports French, German, English and Dutch for ICD-9 and ICD-10 classifications.     

A national trainee advisory network: a proposal

Trainees should have a well-defined and consistent communication conduit to the authorities involved with their training. It is important that trainees are involved in the evolution of structured training programmes and for training authorities to receive feedback from individuals in each specialty. This paper proposes a structure for trainee representation on regional and national training authorities to facilitate an advisory network.