A research framework for pharmacovigilance in health social media: Identification and evaluation of patient adverse drug event reports

Social media offer insights of patients’ medical problems such as drug side effects and treatment failures. Patient reports of adverse drug events from social media have great potential to improve current practice of pharmacovigilance. However, extracting patient adverse drug event reports from social media continues to be an important challenge for health informatics research. In this study, we develop a research framework with advanced natural language processing techniques for integrated and high-performance patient reported adverse drug event extraction. The framework consists of medical entity extraction for recognizing patient discussions of drug and events, adverse drug event extraction with shortest dependency path kernel based statistical learning method and semantic filtering with information from medical knowledge bases, and report source classification to tease out noise. To evaluate the proposed framework, a series of experiments were conducted on a test bed encompassing about postings from major diabetes and heart disease forums in the United States. The results reveal that each component of the framework significantly contributes to its overall effectiveness. Our framework significantly outperforms prior work.     

Intensity-based image registration using scatter search

ObjectiveWe present a novel intensity-based algorithm for medical image registration (IR).Methods and materialsThe IR problem is formulated as a continuous optimization task, and our work focuses on the development of the optimization component. Our method is designed over an advanced scatter search template, and it uses a combination of restart and dynamic boundary mechanisms integrated within a multi-resolution strategy.ResultsThe experimental validation is performed over two datasets of human brain magnetic resonance imaging. The algorithm is evaluated in both a stand-alone registration application and an atlas-based segmentation process targeted to the deep brain structures, considering a total of 16 and 18 scenarios, respectively. Five established IR techniques, both feature- and intensity-based, are considered for comparison purposes, and ground-truth data is used to quantitatively assess the quality of the results. Our approach ranked first in both studies and it is able to outperform all competitors in 12 of 16 registration scenarios and in 14 of 18 registration-based segmentation tasks. A statistical analysis confirms with high confidence (p < 0.014) the accuracy and applicability of our method.ConclusionsWith a proper, problem-specific design, scatter search is able to provide a robust, global optimization. The accuracy and reliability of the registration process are superior to those of classic gradient-based techniques.     

Learning predator promotes coexistence of prey species in host-parasitoid systems

Ecological theory suggests that frequency-dependent predation, in which more common prey types are disproportionately favored, promotes the coexistence of competing prey species. However, many of the earlier empirical studies that investigated the effect of frequency-dependent predation were short-term and ignored predator-prey dynamics and system persistence. Therefore, we used long-term observation of population dynamics to test how frequency-dependent predation influences the dynamics and coexistence of competing prey species using insect laboratory populations. We established two-host-one-parasitoid populations with two bruchid beetles, Callosobruchus chinensis and C. maculatus, as the hosts and the pteromalid wasp Anisopteromalus calandrae as their common parasitoid. When the parasitoid was absent, C. chinensis was competitively excluded in ～20 wk. Introducing the parasitoid greatly enhanced the coexistence time to a maximum of 118 wk. In the replicates of long-lasting coexistence, the two host species C. maculatus and C. chinensis exhibited periodic antiphase oscillations. Behavioral experiments showed frequency-dependent predation of A. calandrae that was caused by learning. Females of A. calandrae learned host-related olfactory cues during oviposition and increased their preference for the common host species. Numerical simulations showed that parasitoid learning was the essential mechanism that promoted persistence in this host-parasitoid system. Our study is an empirical demonstration that frequency-dependent predation has an important role in greatly enhancing the coexistence of prey populations, suggesting that predator learning affects predator-prey population dynamics and shapes biological communities in nature.     

Dissociating activity in the lateral intraparietal area from value using a visual foraging task

We make decisions about where to look approximately three times per second in normal viewing. It has been suggested that eye movements may be guided by activity in the lateral intraparietal area (LIP), which is thought to represent the relative value of objects in space. However, it is not clear how values for saccade goal selection are prioritized while free-viewing in a cluttered visual environment. To address this question, we compared the neural responses of LIP neurons in two subjects with their saccadic behavior and three estimates of stimulus value. These measures were extracted from the subjects' performance in a visual foraging task, in which we parametrically controlled the number of objects on the screen. We found that the firing rates of LIP neurons did not correlate well with the animals' behavior or any of our estimated measures of value. However, if the LIP activity was further normalized, it became highly correlated with the animals' decisions. These data suggest that LIP activity does not represent value in complex environments, but that the value can easily be extracted with one further step of processing. We propose that activity in LIP represents attentional priority and that the downstream normalization of this activity is an essential process in guiding action.     

A Mirror in the Mind: A Case of Visual Allaesthesia in Homonymous Hemianopia

We report the case of a 61-year-old female patient with intracranial bleeding in left parietal and parieto-temporal regions and a history of epilepsy and migraine. MR images showed lesions of the optic radiation, but primary visual cortical areas were intact. Perimetric testing revealed an incomplete right hemianopia. The patient claimed that visual percepts from her intact field were projected as “mirror images” into the hemianopic field. The illusory images were weak and sometimes difficult to detect, but focusing spatial attention on the “mirror” image increased its saliency. Drawings the patient made of her pseudo-hallucinations revealed that the illusions were lateral transpositions instead of mirror images of real objects. The illusions were tilted in clockwise direction and were never colored, although color discrimination was unimpaired in the patient's left hemifield. We quantified the characteristics of the pseudohallucinations in several experiments: The patient was asked to adjust the position, rotation angle, and size of a white test card in her blind field so that it corresponded with the illusory projection of a card of standard size and position that was presented in the intact field. The test card was compressed in horizontal size by 20% and positioned 17° visual angle to the right of the standard, shifted 1.5° upward or downward, and rotated in clockwise direction by 22.6° on average. Large objects in the intact field were projected incompletely into the blind area. Our patient's symptoms are similar to those reported in earlier case studies of visual allaesthesia. We hypothesize that the “mirror image” is induced by sparse input from contralesional V1 via the corpus callosum upstream of the lesion site and a lack of inhibition or hyperexcitability of ipsilesional early visual areas after deafferentation. The rotation of the illusions may be induced by the parietal lesions causing faulty co-ordinate computations, e.g., an inability to integrate visual and otholitic input.     

Site-Dependent Effects of tDCS Uncover Dissociations in the Communication Network Underlying the Processing of Visual Search

BackgroundThe right posterior parietal cortex (rPPC) and the right frontal eye field (rFEF) form part of a network of brain areas involved in orienting spatial attention. Previous studies using transcranial magnetic stimulation (TMS) have demonstrated that both areas are critically involved in the processing of conjunction visual search tasks, since stimulation of these sites disrupts performance.ObjectiveThis study investigated the effects of long term neuronal modulation to rPPC and rFEF using transcranial direct current stimulation (tDCS) with the aim of uncovering sharing of these resources in the processing of conjunction visual search tasks.MethodsParticipants completed four blocks of conjunction search trials over the course of 45 min. Following the first block they received 15 min of either cathodal or anodal stimulation to rPPC or rFEF, or sham stimulation.ResultsA significant interaction between block and stimulation condition was found, indicating that tDCS caused different effects according to the site (rPPC or rFEF) and type of stimulation (cathodal, anodal, or sham). Practice resulted in a significant reduction in reaction time across the four blocks in all conditions except when cathodal tDCS was applied to rPPC.ConclusionsThe effects of cathodal tDCS over rPPC are subtler than those seen with TMS, and no effect of tDCS was evident at rFEF. This suggests that rFEF has a more transient role than rPPC in the processing of conjunction visual search and is robust to longer-term methods of neuro-disruption. Our results may be explained within the framework of functional connectivity between these, and other, areas.     

The Associations between Visual Attention and Facial Expression Identification in Patients with Schizophrenia

Objective

Visual search is an important attention process that precedes the information processing. Visual search also mediates the relationship between cognition function (attention) and social cognition (such as facial expression identification). However, the association between visual attention and social cognition in patients with schizophrenia remains unknown. The purposes of this study were to examine the differences in visual search performance and facial expression identification between patients with schizophrenia and normal controls, and to explore the relationship between visual search performance and facial expression identification in patients with schizophrenia.

Methods

Fourteen patients with schizophrenia (mean age=46.36±6.74) and 15 normal controls (mean age=40.87±9.33) participated this study. The visual search task, including feature search and conjunction search, and Japanese and Caucasian Facial Expression of Emotion were administered.

Results

Patients with schizophrenia had worse visual search performance both in feature search and conjunction search than normal controls, as well as had worse facial expression identification, especially in surprised and sadness. In addition, there were negative associations between visual search performance and facial expression identification in patients with schizophrenia, especially in surprised and sadness. However, this phenomenon was not showed in normal controls.

Conclusion

Patients with schizophrenia who had visual search deficits had the impairment on facial expression identification. Increasing ability of visual search and facial expression identification may improve their social function and interpersonal relationship.     

Assessment of spatial neglect using computerised feature and conjunction visual search tasks

The purpose of this study was to assess the diagnostic sensitivity of tasks employing feature and conjunction visual searches in stroke patients with unilateral spatial neglect (USN).

Seventy-two stroke patients (right/left hemispheric damage with/without USN) and 39 healthy controls participated in the study. Hit rate and reaction time measures of feature and conjunction searches were tested using a newly developed computerised programme for the assessment of visual spatial attention (VISSTA). In addition, subjects received a set of diagnostic paper-and-pencil tests, and were also assessed for the impact of neglect on activities of daily living. Results indicated that the computerised test clearly differentiated between stroke patients and healthy controls, and between the different patient groups. USN patients showed significant contralesional disadvantage in both feature and conjunction visual search tasks. It is proposed that computerised assessment of visual search capacity is a useful and sensitive adjunct to standard paper-and-pencil tests of USN, with the advantage of testing responses based on attention shifts under a time constraint. The learning effects that limit the usefulness of paper-and-pencil tests in longitudinal studies are less likely to affect a computerised test, making it more suitable for monitoring treatment-induced or natural recovery by way of repeated testing.     

Representational demands modulate involvement of perirhinal cortex in face processing

The classic view holds that the medial temporal lobes (MTL) are dedicated to declarative memory functioning. Recent evidence, however, suggests that perirhinal cortex (PrC), a structure within the anterior MTL, may also play a role in perceptual discriminations when representations of complex conjunctions of features, or of gestalt‐characteristics of objects must be generated. Interestingly, neuroimaging and electrophysiological recordings in nonhuman primates have also revealed a face patch in the anterior collateral sulcus with preferential responses to face stimuli in various task contexts. In the present fMRI study, we investigated the representational demands that influence PrC involvement in different types of judgments on human faces. Holding stimulus complexity constant, we independently manipulated the nature of the task and the orientation of the stimuli presented (through face inversion). Aspects of right PrC showed increased responses in a forced‐choice recognition‐memory and a perceptual‐oddity task, as compared to a feature‐search task that was included to probe visual detection of an isolated face feature. Effects of stimulus orientation in right PrC were observed when the recognition‐memory condition for upright faces was compared with all other experimental conditions, including recognition‐memory for inverted faces‐a result that can be related to past work on the role of PrC in object unitization. Notably, both effects in right PrC paralleled activity patterns in broader networks of regions that also included the right fusiform gyrus and the amygdala, regions frequently implicated in face processing in prior research. As such, the current findings do not support the view that reference to a prior study episode clearly distinguishes the role of PrC from that of more posterior ventral visual pathway regions. They add to a growing body of evidence suggesting that the functional role of specific MTL structures may be best understood in terms of the representations that are required by the task and the stimuli at hand. © 2013 Wiley Periodicals, Inc.