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Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters

Siah KTH, Gong X, Yang XJ, Whitehead WE, Chen M, Hou X, et al.

Gut, 2018 Jun;67(6):1071-1077.
PMID: 28592440 DOI: 10.1136/gutjnl-2016-312852

OBJECTIVE: Functional gastrointestinal disorders (FGIDs) are diagnosed by the presence of a characteristic set of symptoms. However, the current criteria-based diagnostic approach is to some extent subjective and largely derived from observations in English-speaking Western patients. We aimed to identify latent symptom clusters in Asian patients with FGID.
DESIGN: 1805 consecutive unselected patients with FGID who presented for primary or secondary care to 11 centres across Asia completed a cultural and linguistic adaptation of the Rome III Diagnostic Questionnaire that was translated to the local languages. Principal components factor analysis with varimax rotation was used to identify symptom clusters.
RESULTS: Nine symptom clusters were identified, consisting of two oesophageal factors (F6: globus, odynophagia and dysphagia; F9: chest pain and heartburn), two gastroduodenal factors (F5: bloating, fullness, belching and flatulence; F8 regurgitation, nausea and vomiting), three bowel factors (F2: abdominal pain and diarrhoea; F3: meal-related bowel symptoms; F7: upper abdominal pain and constipation) and two anorectal factors (F1: anorectal pain and constipation; F4: diarrhoea, urgency and incontinence).
CONCLUSION: We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings.

Matched MeSH terms: Linguistics
Fulltext Mental Health Conceptualization and Resilience Factors in the Kalasha Youth: An Indigenous Ethnic and Religious Minority Community in Pakistan

Choudhry FR, Khan TM, Park MS, Golden KJ

Front Public Health, 2018;6:187.
PMID: 30065918 DOI: 10.3389/fpubh.2018.00187

The Kalasha are a religious, ethnic, and linguistic minority community in Pakistan. They are indigenous people living in remote valleys of the Hindu Kush Mountains in northern Pakistan, neighboring Afghanistan. The Kalasha are pastoral, as well as agricultural people to some extent, although they are increasingly facing pressures from globalization and social change, which may be influencing youth and community development. Their traditional world view dichotomizes and emphasizes on the division of the pure (Onjeshta) and the impure (Pragata). There remains a scarcity of literature on mental health and resilience of indigenous communities in South Asia and Pakistan generally, and the polytheistic Kalasha community specifically. Thus, the current study was conducted with the aim to explore the cultural protective factors (resilience) of the Kalasha youth (adolescents and emerging adults) and to explore their perceived etiological understandings and preferred interventions for mental health support systems. The theoretical framework of Bronfenbrenner's (1, 2) ecological systems model was used. Interpretative Phenomenological Analysis (IPA) was conducted, considering the advantage of its idiographic approach and the "double hermeneutic" analytic process. This methodology was consistent with the aim to understand and make sense of mental health and resilience from the Kalasha indigenous perspective. A total of 12 in-depth interviews were conducted with adolescents and emerging adults (5 males, 7 females), along with ethnographic observations. The analysis revealed 3 superordinate themes of mental health perceptions and interventions, each with more specific emergent themes: (1) Psychological Resilience/Cultural Protective Factors Buffering Against Mental Health Problems (Intra-Communal Bonding & Sharing; Kalasha Festivals & Traditions; Purity Concept; Behavioral Practice of Happiness and Cognitive Patterns); (2) Perceived Causes of Mental Health Issues (Biological & Psychosocial; Supernatural & Spiritual; Environmental); and (3) Preferred Interventions [Shamanic Treatment; Ta'awiz (Amulets); Communal Sharing & Problem Solving; Medical Treatment; Herbal Methods]. The overall findings point to the need for developing culturally-sensitive and indigenous measures and therapeutic interventions. The findings highlighted the Kalasha cultural practices which may promote resilience. The findings also call for indigenous sources of knowledge to be considered when collaboratively designing public health programs.

Matched MeSH terms: Linguistics
Fulltext Geographical and social isolation drive the evolution of Austronesian languages

Padilla-Iglesias C, Gjesfjeld E, Vinicius L

PLoS One, 2020;15(12):e0243171.
PMID: 33259529 DOI: 10.1371/journal.pone.0243171

The origins of linguistic diversity remain controversial. Studies disagree on whether group features such as population size or social structure accelerate or decelerate linguistic differentiation. While some analyses of between-group factors highlight the role of geographical isolation and reduced linguistic exchange in differentiation, others suggest that linguistic divergence is driven primarily by warfare among neighbouring groups and the use of language as marker of group identity. Here we provide the first integrated test of the effects of five historical sociodemographic and geographic variables on three measures of linguistic diversification among 50 Austronesian languages: rates of word gain, loss and overall lexical turnover. We control for their shared evolutionary histories through a time-calibrated phylogenetic sister-pairs approach. Results show that languages spoken in larger communities create new words at a faster pace. Within-group conflict promotes linguistic differentiation by increasing word loss, while warfare hinders linguistic differentiation by decreasing both rates of word gain and loss. Finally, we show that geographical isolation is a strong driver of lexical evolution mainly due to a considerable drift-driven acceleration in rates of word loss. We conclude that the motor of extreme linguistic diversity in Austronesia may have been the dispersal of populations across relatively isolated islands, favouring strong cultural ties amongst societies instead of warfare and cultural group marking.

Matched MeSH terms: Linguistics
Fulltext Predicting probable Alzheimer's disease using linguistic deficits and biomarkers

Orimaye SO, Wong JS, Golden KJ, Wong CP, Soyiri IN

BMC Bioinformatics, 2017 Jan 14;18(1):34.
PMID: 28088191 DOI: 10.1186/s12859-016-1456-0

BACKGROUND: The manual diagnosis of neurodegenerative disorders such as Alzheimer's disease (AD) and related Dementias has been a challenge. Currently, these disorders are diagnosed using specific clinical diagnostic criteria and neuropsychological examinations. The use of several Machine Learning algorithms to build automated diagnostic models using low-level linguistic features resulting from verbal utterances could aid diagnosis of patients with probable AD from a large population. For this purpose, we developed different Machine Learning models on the DementiaBank language transcript clinical dataset, consisting of 99 patients with probable AD and 99 healthy controls.
RESULTS: Our models learned several syntactic, lexical, and n-gram linguistic biomarkers to distinguish the probable AD group from the healthy group. In contrast to the healthy group, we found that the probable AD patients had significantly less usage of syntactic components and significantly higher usage of lexical components in their language. Also, we observed a significant difference in the use of n-grams as the healthy group were able to identify and make sense of more objects in their n-grams than the probable AD group. As such, our best diagnostic model significantly distinguished the probable AD group from the healthy elderly group with a better Area Under the Receiving Operating Characteristics Curve (AUC) using the Support Vector Machines (SVM).
CONCLUSIONS: Experimental and statistical evaluations suggest that using ML algorithms for learning linguistic biomarkers from the verbal utterances of elderly individuals could help the clinical diagnosis of probable AD. We emphasise that the best ML model for predicting the disease group combines significant syntactic, lexical and top n-gram features. However, there is a need to train the diagnostic models on larger datasets, which could lead to a better AUC and clinical diagnosis of probable AD.

Matched MeSH terms: Linguistics
The effects of linguistic modification on ESL students' comprehension of nursing course test items

Bosher S, Bowles M

Nurs Educ Perspect, 2008 May-Jun;29(3):165-72.
PMID: 18575241

Recent research has indicated that language may be a source of construct-irrelevant variance for non-native speakers of English, or English as a second language (ESL) students, when they take exams. As a result, exams may not accurately measure knowledge of nursing content. One accommodation often used to level the playing field for ESL students is linguistic modification, a process by which the reading load of test items is reduced while the content and integrity of the item are maintained. Research on the effects of linguistic modification has been conducted on examinees in the K-12 population, but is just beginning in other areas. This study describes the collaborative process by which items from a pathophysiology exam were linguistically modified and subsequently evaluated for comprehensibility by ESL students. Findings indicate that in a majority of cases, modification improved examinees' comprehension of test items. Implications for test item writing and future research are discussed.

Matched MeSH terms: Linguistics