Letter Category Research Articles

Clinicians perspective of the new pregnancy and lactation labeling final rule(PLLR): results from a FDA/ AAAAI survey

In 2015, the FDA removed the letter category system (A,B,C,D or X) from the product label of all prescription drugs. The letter category system first established in 1979 was regarded as overly simplistic and misinterpreted as a grading system. A new PLLR format was created to better aid in presenting the available safety data. In an attempt to assess awareness, understanding and value of the new PLLR, a survey formed in collaboration between the AAAAI and the FDA was distributed among the membership of the AAAAI. An online survey was sent to a random sample of the US membership of the AAAAI. The survey content consisted of questions addressing the following: demographics, awareness and use of the PLLR, understanding of the new PLLR format in example form, and the value of the new PLLR format. Of 1500 members who received an email survey, 184 (12%) completed the survey. Less than half of responders were aware that the pregnancy letter categories were replaced with a narrative summary. Most of the responders did not feel the new PLLR format was clear or concise, and almost all responders continued to use the pregnancy letter category system (A,B,C,D,or X) to make prescribing decisions. Inadequate management of chronic medical conditions during pregnancy can have profound effects on maternal and fetal health. This survey shows that most clinicians find the new label does not meets their needs in obtaining critical information for patient care.

Dual-Tasking in the Near-Hand Space: Effects of Stimulus-Hand Proximity on Between-Task Shifts in the Psychological Refractory Period Paradigm.

Two decades of research indicate that visual processing is typically enhanced for items that are in the space near the hands (near-hand space). Enhanced attention and cognitive control have been thought to be responsible for the observed effects, amongst others. As accumulating experimental evidence and recent theories of dual-tasking suggest an involvement of cognitive control and attentional processes during dual tasking, dual-task performance may be modulated in the near-hand space. Therefore, we performed a series of three experiments that aimed to test if the near-hand space affects the shift between task-component processing in two visual-manual tasks. We applied a Psychological Refractory Period Paradigm (PRP) with varying stimulus-onset asynchrony (SOA) and manipulated stimulus-hand proximity by placing hands either on the side of a computer screen (near-hand condition) or on the lap (far-hand condition). In Experiment 1, Task 1 was a number categorization task (odd vs. even) and Task 2 was a letter categorization task (vowel vs. consonant). Stimulus presentation was spatially segregated with Stimulus 1 presented on the right side of the screen, appearing first and then Stimulus 2, presented on the left side of the screen, appearing second. In Experiment 2, we replaced Task 2 with a color categorization task (orange vs. blue). In Experiment 3, Stimulus 1 and Stimulus 2 were centrally presented as a single bivalent stimulus. The classic PRP effect was shown in all three experiments, with Task 2 performance declining at short SOA while Task 1 performance being relatively unaffected by task-overlap. In none of the three experiments did stimulus-hand proximity affect the size of the PRP effect. Our results indicate that the switching operation between two tasks in the PRP paradigm is neither optimized nor disturbed by being processed in near-hand space.

Auditory attention switching and judgment switching: Exploring multicomponent task representations.

An auditory attention-switching paradigm was combined with a judgment-switching paradigm to examine the interaction of a varying auditory attention component and a varying judgment component. Participants heard two dichotically presented stimuli-one spoken by a female speaker and one spoken by a male speaker. In each trial, the stimuli were a spoken letter and a spoken number. A visual explicit cue at the beginning of each trial indicated the auditory attention criterion (speaker sex/ear) to identify the target stimulus (Experiment 1) or the judgment that had to be executed (Experiment 2). Hence, the attentional selection criterion switched independently between speaker sexes (or between ears), while the judgment alternated between letter categorization andnumber categorization. The data indicate that auditory attention criterion and judgment were not processed independently, regardless of whether the attention criterion or the judgment was cued. The partial repetition benefits of the explicitly cued component suggested a hierarchical organization of the auditory attention component and the judgment component within the task set. We suggest that the hierarchy arises due to the explicit cuing of one component rather than due to a "natural" hierarchy of auditory attention component and judgment component.

The Paris system of interpretation of urinary cytopathology.

The article presents the Paris system of interpretation of urinary cytopathology developed by joint efforts of cytologists, pathologists and urologists in April 2016. The seven accepted categories of cytological opinion letters are presented, including criteria of their evaluation, risk of malignancy development under various urinary pathology and recommended tactics of management of patients.

Engagement and Popularity Dynamics of YouTube Videos and Sensitivity to Meta-Data

YouTube, with millions of content creators, has become the preferred destination for viewing videos online. Through the Partner program, YouTube allows content creators to monetize their popular videos. Of significant importance for content creators is which meta-level features (title, tag, thumbnail, and description) are most sensitive for promoting video popularity. The popularity of videos also depends on the social dynamics, i.e., the interaction of the content creators (or channels) with YouTube users. Using real-world data consisting of about 6 million videos spread over 25 thousand channels, we empirically examine the sensitivity of YouTube meta-level features and social dynamics. The key meta-level features that impact the view counts of a video include: first day view count, number of subscribers, contrast of the video thumbnail, Google hits, number of keywords, video category, title length, and number of upper-case letters in the title, respectively, and illustrate that these meta-level features can be used to estimate the popularity of a video. In addition, optimizing the meta-level features after a video is posted increases the popularity of videos. In the context of social dynamics, we discover that there is a causal relationship between views to a channel and the associated number of subscribers. Additionally, insights into the effects of scheduling and video playthrough in a channel are also provided. Our findings provide a useful understanding of user engagement in YouTube.

Handwriting generates variable visual output to facilitate symbol learning.

Recent research has demonstrated that handwriting practice facilitates letter categorization in young children. The present experiments investigated why handwriting practice facilitates visual categorization by comparing 2 hypotheses: that handwriting exerts its facilitative effect because of the visual-motor production of forms, resulting in a direct link between motor and perceptual systems, or because handwriting produces variable visual instances of a named category in the environment that then changes neural systems. We addressed these issues by measuring performance of 5-year-old children on a categorization task involving novel, Greek symbols across 6 different types of learning conditions: 3 involving visual-motor practice (copying typed symbols independently, tracing typed symbols, tracing handwritten symbols) and 3 involving visual-auditory practice (seeing and saying typed symbols of a single typed font, of variable typed fonts, and of handwritten examples). We could therefore compare visual-motor production with visual perception both of variable and similar forms. Comparisons across the 6 conditions (N = 72) demonstrated that all conditions that involved studying highly variable instances of a symbol facilitated symbol categorization relative to conditions where similar instances of a symbol were learned, regardless of visual-motor production. Therefore, learning perceptually variable instances of a category enhanced performance, suggesting that handwriting facilitates symbol understanding by virtue of its environmental output: supporting the notion of developmental change though brain-body-environment interactions. (PsycINFO Database Record

A Late Antique Private Letter Mentioning Textiles and a Halter

This hitherto unpublished small-sized papyrus preserves a fragment of a late antique private letter falling into the large category of request letters. Its author asks the recipient to send him several objects. The text mentions the very rarely attested word φορβειά (halter) as well as an ὀθόνιον and a φακιάλι(ο)ν. Judging by the fact that the papyrus was incorporated in the collection of Vienna in 1886, we can consider the Hermopolite nome as the place of its provenance. The handwriting points to the late sixth or maybe the early seventh century.

OP55 – 2335: Effect of adjunctive perampanel on language and coordination in adolescents with uncontrolled partial-onset seizures

Objective To evaluate the short-term effects of adjunctive perampanel on language and coordination in adolescents with refractory partial-onset seizures (POS), supplementing previously reported primary cognition outcomes (Meador et al., AAN 2014). Methods In this Phase II study, 133 adolescents (12–17 years) with uncontrolled POS were randomised 2:1 to receive perampanel (target dose 8–12 mg/day) or placebo (PBO). Patients received blinded treatment over a 6-week titration phase and 13-week maintenance phase. Effects on language were assessed at various study visits using the Controlled Oral Word Association Test (COWAT), which consists of two parts (letter fluency and category fluency). The Lafayette Grooved Pegboard Test (LGPT) was used to evaluate the effects on coordination skills. For each assessment, mean change from baseline to end of treatment was calculated from the cognition population and results were compared between treatment groups. Results Of the 133 randomised adolescent patients, 123 adolescents (PBO, n=44; perampanel, n=79) were included in the cognition population. No difference in the mean change in COWAT letter fluency scores from baseline to end of treatment was observed between PBO and perampanel (+0.5 and +0.7, respectively). Although a small difference in the mean change in COWAT category fluency scores from baseline to end of treatment was observed between PBO (+0.3) and perampanel (–0.5), this difference was not considered clinically relevant. Results of the LGPT indicated that patients' motor skills did not worsen with perampanel treatment compared with PBO. Conclusion Assessment of language and coordination using COWAT and LGPT, respectively, in adolescent patients with POS receiving adjunctive perampanel showed that there was no clinically relevant changes in these parameters with perampanel treatment. Acknowledgements: Study sponsor: Eisai Inc. Medical writing: Choice Healthcare Solutions, funded by Eisai Ltd.

Abstract T P391: Stroke Knowledge Among Children Is Associated With Measures Of Economic Need

Background and Purpose: To identify potential community- and school-level quality measures which may influence trends in baseline stroke knowledge of children participating in the Hip Hop Stroke program from 2005-2014. Methods: We gathered baseline stroke knowledge surveys from 2,839 available surveys of 4th, 5th, and 6th grade students enrolled in the Hip Hop Stroke program from November 2005-April 2014. We explored several objective standardized factors assessed city-wide, including performance grade (letter categories A-F, as measured via standardized testing) and economic need index (incorporates subsidized housing and meals; range 0-2 and higher scores indicate higher needs; example: a value of 2 indicates 100% students requiring food and housing subsidies or support). Students who left ≥3 questions blank were discarded; other blank answers were treated as missing. Data were analyzed using Chi-Square and regression analysis (SPSS v22.0). Results: Schools studied included those with performance grades B (n=196), C (n=1590), and D (n=1053) and mean economic need index of 0.85 (SD 0.23). For a composite assessment of knowledge including 4 stroke symptoms (blurred vision, facial droop, sudden headache, and slurred speech), 1 distractor (chest pain), and urgent action plan (call 911), asked consistently since 2006, overall students scored a mean 2.86 (95% CI: 2.80-2.92; possible range 0-6, expected value 2.75). For quartiles of economic need, means scores ranged from Q1: 2.89 (95% CI: 2.79-2.99), Q2: 3.08 (95% CI: 2.96-3.20), Q3: 2.77 (95% CI: 2.66-2.89), and Q4: 2.57 (95% CI: 2.43-2.71), p-trend <0.001. Students at B schools scored 2.96 (95% CI: 2.72-3.20), C: 2.93 (95% CI 2.85-3.01), D: 2.71 (95% CI: 2.63-2.81), p-trend=0.001. Conclusion: Lower student knowledge of stroke is strongly associated with measures of greater economic need and lower school performance. Consideration should be given to focus implementation of stroke education campaigns in schools and communities with higher needs.

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Med Check

Evaluative Stimulus (In)Congruency Impacts Performance in an Unrelated Task

In two experiments, we assessed evaluative priming effects in a task that was unrelated to the congruent or incongruent stimulus pairs. In each trial, participants saw two valent (positive or negative) pictures that formed evaluatively congruent or incongruent stimulus pairs and a letter that was superimposed on the second picture. Different from typical evaluative priming studies, participants were not required to respond to the second of the valent stimuli, but asked to categorize the letter that was superimposed on the second picture. We assessed the impact of the evaluative (in)congruency of the two pictures on the performance in responding to the letter. In addition, we manipulated attention to the evaluative dimension by asking participants in one experimental group to respond to the valence of the pictures on a subset of trials (evaluative task condition). In both experiments, we found evaluative priming effects in letter categorization responses: Participants categorized the letter faster (and sometimes more correctly) in trials with congruent picture-pairs. These effects were present only in the evaluative task condition. These findings can be explained with different resource-based accounts of evaluative priming and the additional assumption that attention to valence is necessary for evaluative congruency to affect processing resources. According to resource-based accounts valence-incongruent trials require more cognitive resources than valence-congruent trials (e.g., Hermans, Van den Broeck, & Eelen, 1998).

Acute evaluation of conversational discourse skills in traumatic brain injury

This study looked at performance on the conversational discourse checklist of the Protocole Montréal d’évaluation de la communication (D-MEC) in 195 adults with TBI of all severity hospitalized in a Level 1 Trauma Centre. To explore validity, results were compared to findings on tests of memory, mental flexibility, confrontation naming, semantic and letter category naming, verbal reasoning, and to scores on the Montreal Cognitive Assessment. The relationship to outcome as measured with the Disability Rating Scale (DRS), the Extended Glasgow Outcome Scale (GOS-E), length of stay, and discharge destinations was also determined. Patients with severe TBI performed significantly worse than mild and moderate groups (χ2KW2df = 24.435, p = .0001). The total D-MEC score correlated significantly with all cognitive and language measures (p < .05). It also had a significant moderate correlation with the DRS total score (r = −.6090, p < .0001) and the GOS-E score (r = .539, p < .0001), indicating that better performance on conversational discourse was associated with a lower disability rating and better global outcome. Finally, the total D-MEC score was significantly different between the discharge destination groups (F(3,90) = 20.19, p < .0001). Thus, early identification of conversational discourse impairment in acute care post-TBI was possible with the D-MEC and could allow for early intervention in speech-language pathology.

Analysis of reliability of professor recommendation letters based on concordance with self-introduction letter.

The purpose of this study was to examine the concordance between a checklist's categories of professor recommendation letters and characteristics of the self-introduction letter. Checklists of professor recommendation letters were analyzed and classified into cognitive, social, and affective domains. Simple correlation was performed to determine whether the characteristics of the checklists were concordant with those of the self-introduction letter. The difference in ratings of the checklists by pass or fail grades was analyzed by independent sample t-test. Logistic regression analysis was performed to determine whether a pass or fail grade was influenced by ratings on the checklists. The Cronbach alpha value of the checklists was 0.854. Initiative, as an affective domain, in the professor's recommendation letter was highly ranked among the six checklist categories. Self-directed learning in the self-introduction letter was influenced by a pass or fail grade by logistic regression analysis (p<0.05). Successful applicants received higher ratings than those who failed in every checklist category, particularly in problem-solving ability, communication skills, initiative, and morality (p<0.05). There was a strong correlation between cognitive and affective characteristics in the professor recommendation letters and the sum of all characteristics in the self-introduction letter.

The effects of orthographic complexity and diglossia on letter naming in Arabic: A developmental study

The purpose of the study was to examine the influence of orthographic complexity and diglossia on letter naming and automaticity in Arabic. Two experiments were carried out by 31 first graders, 30 third graders, 34 fifth graders and 20 university students. In the first experiment we took advantage of the Arabic orthographic variation in letter shape, and compared the Stroop effect for correctly written and orthographically distorted words. All participants revealed a Stroop effect with both types of words, but only first graders showed the same degree of interference with distorted and correctly written words. We interpret these results to reflect the development of automaticity in reading. In the second experiment, six letter-naming tests were performed. The results showed that retrieval time of naming letters or the sounds that these letters represent decreased inversely with age. A different pattern was found between the school-age children and the university students. In children, the relationships between types of tests of retrieval speed remained constant: retrieval of letter names or sounds which do not have visual or phonological neighbours was the fastest, and of letter names representing sounds that do not exist in spoken Arabic was the slowest. There was no effect of changing letter shape. However, among the university students only changing letter shape affected the speed of responses. We interpret these results to reflect different representations of letter categories in adults and children. The findings have implications for models of reading development in Arabic.

Whole-language and item-specific control in bilingual language production.

The current study investigated the scope of bilingual language control differentiating between whole-language control involving control of an entire lexicon specific to 1 language and lexical-level control involving only a restricted set of recently activated lexical representations. To this end, we tested 60 Dutch-English (Experiment 1) and 64 Chinese-English bilinguals (Experiment 2) on a verbal fluency task in which speakers produced members of letter (or phoneme for Chinese) categories first in 1 language and then members of either (a) the same categories or (b) different categories in their other language. Chinese-English bilinguals also named pictures in both languages. Both bilingual groups showed reduced dominant language fluency after producing exemplars from the same categories in the nondominant language, whereas nondominant language production was not influenced by prior production of words from the same categories in the other language. Chinese-English, but not Dutch-English, bilinguals exhibited similar testing order effects for different letter/phoneme categories. In addition, Chinese-English bilinguals who exhibited significant testing order effects in the repeated categories condition of the fluency task exhibited no such effects when naming repeated pictures after a language switch. These results imply multiple levels of inhibitory control in bilingual language production. Testing order effects in the verbal fluency task pinpoint a lexical locus of bilingual control, and the finding of interference effects for some bilinguals even when different categories are tested across languages further implies a whole-language control process, although the ability to exert such global inhibition may only develop for some types of bilinguals.

The internal structure of chaos: Letter category determines visual word perceptual units

The processes and the cues determining the orthographic structure of polysyllabic words remain far from clear. In the present study, we investigated the role of letter category (consonant vs. vowels) in the perceptual organization of letter strings. In the syllabic counting task, participants were presented with written words matched for the number of spoken syllables and comprising either one vowel cluster less than the number of syllables (hiatus words, e.g., pharaon) or the same number of vowel clusters (e.g., parodie). Relative to control words, readers were slower and less accurate for hiatus words, for which they systematically underestimated the number of syllables (Experiment 1). The effect was stronger when the instructions emphasized response speed (Experiment 2) and when concurrent articulation was used (Experiment 3), and the effect did not stem from phonological structure (Experiment 4). Furthermore, hiatus words were more slowly and less accurately pronounced than control ones (Experiment 5). Finally, in lexical decision, opposite effects occurred as a function of word length, with shorter words producing a facilitatory effect and longer words showing interference (Experiment 6). Taken together, the results show that perceptual units extracted from visual letter strings are influenced by the orthographic status of letters. We discuss the implications of such findings in view of current theories of visual word recognition.

Risk Factors for Conversion to Neovascular Age-related Macular Degeneration Based on Longitudinal Morphologic and Visual Acuity Data

To use longitudinal quantitative morphologic and visual acuity (VA) data to investigate the risk of choroidal neovascularization (CNV) event occurrence in eyes with dry age-related macular degeneration (AMD). Prospective observational study. A total of 513 participants (844 eyes) followed longitudinally in one center enrolled in the Age-Related Eye Disease Study (AREDS) or the Prophylactic Treatment of AMD Study (PTAMD). We assessed images of previously obtained fundus photographs for the presence of macular pigmentation, drusen area, and drusen distribution (number and size), and fellow eye CNV status at baseline. Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity at each visit and the age of each subject were obtained. We used a longitudinal logistic mixed-effects model with random intercepts fitted to event occurrences to assess risk on a per eye basis. Odds ratios for CNV event. Thirty-one subjects (6.0%) had events. Only VA changes over time and follow-up interval showed statistically significant effects. Several statistical models that included VA at the previous visit were used. In 2 models, 3 categories of VA were used: ≤ 75 letters, >75 and ≤ 85 letters, and >85 letters. Two categories were used for follow-up: ≤ 3 years versus >3 years or ≤ 1 year versus >1 year. In the first model with categorization at 3 years, a decrease in acuity from the >85 letter category to ≤ 75 letters increased the odds of CNV by 16.9 times (P = 0.022). In the model with categorization at 1 year, a decrease in acuity from the >85-letter category to ≤ 75 letters increased the odds of CNV by 21.4 times (P = 0.0175). Differences between the follow-up intervals were significant (P = 0.043) and indicated a more than 7-fold increase in the odds. Changes in morphologic features of the macula did not show significant effects. A decrease in VA to ≤ 75 ETDRS letters in an eye with an initial ETDRS baseline acuity of >85 letters increases the likelihood of CNV by approximately 20-fold. This likelihood also increases with aging.

A novel Chinese letter fluency test applied to healthy youth

Objective Letter fluency test is one of the important neuropsychological tests which can examine the cognitive function of the prefrontal cortex (PFC) of human brain.However,there is no successful Chinese version.This research is trying to develop a Chinese letter fluency test similar to the English version,and to provide an effective approach to investigate the function of the PFC of the native Chinese speakers.Methods Thirty 19 ～33 years old healthy native Chinese speakers were chosen (13 men and 17 women).The near-infrared spectroscopy was used to observe the activation of the PFC while the participants carried out the Chinese letter fluency tests.Some of the participants carried out three kinds of letter fluency tests and category fluency test.Results The average score of the Chinese letter fluency test using syllable cue in 60 s was 12.8 ±4.7.The relative value of [oxy-Hb] in 12 channels of 13 ones located in the PFC during carrying out the test was higher than before and after the test significantly (P＜ 0.05 ).Conclusion The novel Chinese letter fluency test using syllable cue is similar to the English version formally.The objective evidence shows that it can activate neural activity located in the PFC of human brain, and can be applied to the native Chinese speakers as a neuropsychological test investigating the function of the PFC. Key words: Letter fluency test; Chinese; Prefrontal cortex; Near-infrared spectroscopy

Comprehensive Citation Factor: A novel method in ranking medical journals

The Institute for Scientific Information (ISI) defines substantive articles as source items, which include only research and review (R&R) articles. This policy encourages some Journals to publish a significant number of original reports in the category of letters to the editor and reviews in the category of Editorials. Consequently, the Impact Factor (IF) fails to provide a fair comparison between medical journals. We introduce a new value, the Comprehensive Citation Factor (CCF), which would include in the denominator all original reports and review articles. We reassessed the 2007 ISI IF rankings of 39 dermatology journals using the CCF formula. Along with research and review articles, research letters, editorials and case reports were also included in the denominator value. The CCF was calculated for each journal and then compared with the IF provided by the ISI for 2007. The rank orders of 27/39 journals (69%) were altered by two or more places bi-directionally. Journals with a significant number of editorial and/or letters had a lower CCF. Only 4 of the 39 journals (10%) kept the same rank when evaluated with the new CCF formula. The CCF is a more accurate quantitative representation to use for individual journal comparison. This formula would encourage editors to publish more manuscripts as original or review articles, rather letters or editorials, and eliminate the need for the controversial subjective classification.

The shielding function of task sets and its relaxation during task switching.

The goal of the presented experiments was to investigate the dynamic interplay of task shielding and its relaxation during task switching. Task shielding refers to the finding that single task sets in terms of 2-choice categorization rules help shielding against distraction from irrelevant stimulus attributes. During task switching, this shielding should temporarily be relaxed to prevent the perseveration of the previous task, on the downside making the system more vulnerable toward the intrusion of irrelevant information. Participants had to switch between a digit and a letter categorization task. An irrelevant stimulus feature (Experiment 1: color, Experiment 2: font) varied randomly, orthogonal to the task. The presence or absence of an interaction of the irrelevant feature (switch vs. repetition) and the response (switch vs. repetition) was taken as evidence for the absence or presence of task shielding, respectively. Replicating previous results, irrelevant feature and response did not interact on task repetitions, indicating successful shielding. On task switches, however, the irrelevant feature interacted with the response, supporting the assumption that task shielding is temporarily relaxed during task switching.