A hybrid knowledge and ensemble classification approach for prediction of venous thromboembolism

Clinical narratives such as progress summaries, lab reports, surgical reports, and other narrative texts contain key biomarkers about a patient's health. Evidence-based preventive medicine needs accurate semantic and sentiment analysis to extract and classify medical features as the input to appropriate machine learning classifiers. However, the traditional approach of using single classifiers is limited by the need for dimensionality reduction techniques, statistical feature correlation, a faster learning rate, and the lack of consideration of the semantic relations among features. Hence, extracting semantic and sentiment-based features from clinical text and combining multiple classifiers to create an ensemble intelligent system overcomes many limitations and provides a more robust prediction outcome. The selection of an appropriate approach and its interparameter dependency becomes key for the success of the ensemble method. This paper proposes a hybrid knowledge and ensemble learning framework for prediction of venous thromboembolism (VTE) diagnosis consisting of the following components: a VTE ontology, semantic extraction and sentiment assessment of risk factor framework, and an ensemble classifier. Therefore, a component-based analysis approach was adopted for evaluation using a data set of 250 clinical narratives where knowledge and ensemble achieved the following results with and without semantic extraction and sentiment assessment of risk factor, respectively: a precision of 81.8% and 62.9%, a recall of 81.8% and 57.6%, an F measure of 81.8% and 53.8%, and a receiving operating characteristic of 80.1% and 58.5% in identifying cases of VTE.     

Sensitive Mother-to-Adolescent Disclosures After Divorce: Is the Experience of Sons Different From That of Daughters?

This study addressed two main questions: (a) Are adolescent sons and daughters exposed to sensitive maternal disclosures after divorce with similar frequency and in similar detail? and (b) Does gender act as a moderator in the association between maternal disclosures and adolescent adjustment difficulties? Forced-choice and open-ended data were collected from 194 adolescents within 2 years after their parents' divorce. Quantitative analyses revealed that although the majority of adolescents experience some level of maternal disclosure, neither frequency nor detail of maternal disclosure differed as a function of adolescent gender. Frequent and detailed maternal disclosures were associated with adolescent adjustment difficulties, primarily psychological distress. Gender did not moderate that significant association. Qualitative analysis shed light on the link between maternal disclosures and adolescent distress, suggested the importance of how disclosures are made, and revealed several gender differences in reactions to maternal disclosures. Implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Support and Social Strain Among Husbands and Wives: A Multilevel Analysis.

In response to recent calls in the literature for within-person examinations of social support processes over time, this study explores the relationships of spousal support, spousal strain, and well-being among husbands and wives, both within the same day and across days. Eighty-three couples were interviewed and completed a structured diary twice daily for 1 week. The results of multilevel hierarchical modeling suggest that both spousal support and spousal strain made significant, independent contributions to concurrent negative affect, although only spousal support was a significant predictor of next-day negative affect. Spousal strain interacted with spousal support to predict next-day negative affect. Direct and moderating effects of perceived marital adjustment on negative affect were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A phase I-II study of paclitaxel, ifosfamide, and vinorelbine with filgrastim (rhG-CSF) support in advanced non-small-cell lung cancer

PURPOSE: We designed a phase I-II trial of three active agents, paclitaxel, ifosfamide, and vinorelbine, in advanced non-small-cell lung cancer (NSCLC) to: 1) define the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of paclitaxel with filgrastim (G-CSF) support; and 2) determine the overall response rate and median survival of patients treated on this regimen. PATIENTS AND METHODS: We treated cohorts of patients with stage IIIB or IV NSCLC with ifosfamide 1.2-1.6 g/m2/day x 3 and vinorelbine 20-25 mg/m2/day x 3 and escalating doses of paclitaxel at 100-175 mg/m2 on day 2 with G-CSF support on a 21-day cycle. One prior experimental single-agent chemotherapy regimen was allowed. RESULTS: Fifty-six patients, were enrolled on this trial: 27 on the phase I portion of the study and an additional 29 at the recommended phase II dose (RPTD). Thirteen patients had received prior chemotherapy. Paclitaxel doses of 175 mg/m2 and 150 mg/m2 produced dose-limiting myelosuppression, and the RPTD was determined to be paclitaxel 135 mg/m2 with ifosfamide 1.2 g/m2/day on days 1-3 and vinorelbine 20 mg/m2/ day on days 1-3 with G-CSF support. The overall response rate was 18%, with a median survival of 6.1 months. Six of 35 patients (17%) treated at the RPTD achieved a partial response to therapy. Grade IV neutropenia was observed in 19 of 35 patients at this dose, with eight patients suffering febrile neutropenia. CONCLUSIONS: This non-cisplatin-containing three-drug regimen has substantial toxicity and low activity in advanced NSCLC, and does not seem to improve on prior regimens. It is unclear whether the lack of efficacy relates to an antagonistic reaction between the specific drugs, administration schedule, or to subtherapeutic doses of the individual agents.     

Facial myokymia and spastic paretic facial contracture as the result of anaplastic pontocerebellar glioma

The case of a 36-year-old man who sought treatment of right facial myokymia and spastic paretic facial contracture is reported. Computed tomography and magnetic resonance imaging revealed a tumor located in the right cerebellar peduncle and the right dorsal pons bulging into the fourth ventricle. After microsurgical partial resection of the mass, which was verified histologically as an anaplastic glioma, facial myokymia initially ceased. The vermicular rippling movements were less intense upon recurrence and could be controlled by low-dose dexamethasone in the further course, when magnetic resonance imaging showed an interstitial pontine edema after percutaneous radiation therapy. It is assumed that facial myokymia and spastic paretic facial contracture were generated by ectopic activity due to alterations in the microenvironment at the intrapontine portion of the axons of the seventh nerve caused by the compressive effect of the tumor and later by edema.     

Providing information to clients about psychological tests: A survey of attorneys' and law students' attitudes.

Surveyed 70 practicing attorneys and 150 law students to determine the extent to which they felt it was their responsibility to inform clients they referred for psychological testing about the testing process and about the validity scales on tests. Results showed that almost 50% of the attorneys and over 33% of the students believe that clients referred for testing always or usually should be informed of validity scales on tests. These results suggest that many test takers, particularly in forensic settings, may have information about validity scales that facilitates their giving biased responses without detection. Psychologists doing forensic evaluations should be alert to this possibility and should consider using more than one approach to detect response distortions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Institutional research productivity in industrial/organizational psychology.

Updated the report of W. M. Cox and V. Catt (see record 1978-21651-001) by determining the 40 top contributing institutions to the Journal of Applied Psychology, 1976–1982, and assessed the generalizability of productivity rankings based solely on contributions to this journal. A number of industrial and organizational psychologists were asked to indicate all the journals in which psychologists in the field were likely to publish. Five journals suggested by these nominators were used for comparison in the review. A list of the 40 most productive graduate programs based on these 5 journals is included. Results show the inadequacy of Cox and Catt's decision to base productivity ratings solely on contributions to 1 journal. Using 5 journals, 4 programs were catapulted into the top 10 rankings, while 7 programs dropped from top rankings in the Cox study (1970–1975) to below the 65th rank in the present study. Using only the Journal of Applied Psychology contributions, 2 of these programs ranked in the top 10, 1976–1982. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison between the binding of chlorpheniramine maleate to poly(sodium 4-styrenesulfonate) and the binding to other polyelectrolytes

The interactions of the antihistaminic drug chlorpheniramine maleate (CPM) with the negatively charged polyelectrolytes poly(sodium 4-styrenesulfonate) (PSS) and poly(acrylic acid) (PAA) are studied by the washing method of the diafiltration technique at conditions simulating those of the small intestine such as pH 7.5 and 0.13 M NaCl. The results are compared with those already reported involving other pharmacologically important polyelectrolytes such as alginic acid (ALG), carboxymethylcellulose (CMC), and κ- and ι-carrageenan (κ- and ι-CAR). As in the case of ALG, CMC, and CAR, interactions of CPM with PAA appear to be electrostatic and are cleaved in the presence of 0.13 M NaCl. On the contrary, apart from electrostatic interactions, additional interactions are found with PSS and residual interactions are kept in the presence of 0.13 M NaCl, a fact that may be attributed to π-π interactions and hydrophobic forces. The effect of the addition of 4 M urea, branched poly(ethyleneimine) (BPEI), and poly(vinylpyrrolidone) (PVP) is also studied. The addition of urea 4 M or 0.001 M BPEI produces a decrease on the amounts of counterions bound to PSS at infinite elution, while the addition of PVP does not produce any change on the diafiltration profiles.