Hitting moving objects: is target speed used in guiding the hand?

We investigated what information subjects use when trying to hit moving targets. In particular, whether only visual information about the target's position is used to guide the hand to the place of interception or also information about its speed. Subjects hit targets that moved at different constant speeds and disappeared from view after varying amounts of time. This prevented the subjects from updating position information during the time that the target was invisible. Subjects hit further ahead of the disappearing point when the target moved faster, but not as much as they should have on the basis of the target's speed. This could be because more time is needed to perceive and use the correct speed than was available before the target disappeared. It could also be due to a speed-related misperception of the target's final position. The results of a second experiment were more consistent with the latter hypothesis. In a third experiment we moved the background to manipulate the perceived speed. This did not affect the hitting positions. We conclude that subjects respond only to the changing target position. Target speed influences the direction in which the hand moves indirectly, possibly via a speed-related misperception of position.     

急性呼吸窘迫综合征患者俯卧位通气护理质量评价指标的构建

目的 构建急性呼吸窘迫综合征（acute respiratory distress syndrome,ARDS）患者俯卧位通气护理质量评价指标,为评价ARDS患者俯卧位通气护理质量提供依据。 方法 基于三维质量结构模型,通过文献分析、半结构式访谈初步拟订ARDS患者俯卧位通气护理质量评价指标,于2020年9月—11月采用德尔菲法对35名专家进行2轮咨询确立ARDS患者俯卧位通气护理质量评价指标。 结果 2轮咨询问卷回收率均为100%,专家权威系数为0.85、0.89,肯德尔和谐系数为0.155、0.122。最终形成的ARDS患者俯卧位通气护理质量评价指标包含3项一级指标、8项二级指标、41项三级指标。 结论 构建的ARDS患者俯卧位通气护理质量评价指标具有较高可靠性和科学性,可作为评价ARDS患者俯卧位通气护理质量的依据。     

Rabies vaccines: WHO position paper,April 2018 – Recommendations

This article presented the World Health Organization’s (WHO) recommendations on the use of Rabies vaccines excerpted from the Rabies vaccines: WHO position paper – April 2018 published in the Weekly Epidemiological Record [1] This position paper replaces the 2010 WHO position paper on rabies vaccines [2]. It presents new evidence in the field of rabies and the use of rabies vaccines, focussing on programmatic feasibility, simplification of vaccination schedules and improved cost-effectiveness. The recommendations concern the 2 main immunization strategies, namely vaccination for post-exposure prophylaxis and vaccination for pre-exposure prophylaxis. In the context of post-exposure prophylaxis, recommendations are also provided on the use of rabies immunoglobulins.Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation tables. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO’s current position on the use of vaccines in the global context. Recommendations on the use of cholera vaccines were discussed by the Strategic Advisory Group of Experts (SAGE) in October 2017; evidence presented at these meetings can be accessed at:http://www.who.int/immunization/sage/meetings/2017/october/presentations_background_docs/en/.     

数字化曲面体层标记位点放大率的实验研究

目的:探讨数字化曲面体层(PTG)的标记位点放大率。方法:以曲面体层机颏托上的U型标记杆及以干燥下颌骨的正常摆放位置为参照,将种植用钢珠按牙弓形态进行唇舌向网点式排布,进行位点设置,按1-8区牙位排列放置钢珠,类似同心圆状辐射排列,位点间距10mm,逐点拍摄,进行投照后在PACS上高清晰显示屏进行测量所得图像的水平向及垂直向数值,对图像进行分析,得出放大率,再进行部位分析,构建体层域。结果:水平向放大率较垂直向为显著,U型标记杆覆盖范围为前牙及双尖牙区,其唇侧水平向放大率均小于1,舌侧水平向放大率均大于1,后磨牙区图像垂直向与水平向均为放大。结论:不同位置的钢珠图像放大率不同,坐标相交点即为同等放大率位置,即位于体层域中心,体层域为显示图像较为真实的扫描区域,体层域唇侧图像水平向缩窄舌侧图像水平向放大,而垂直向均显示放大,变化倍率以水平向为显著(P<0.01),以此来指导临床上对曲面体层片的判读。     

Esophageal positions relative to the left atrium; data from 293 patients before catheter ablation of atrial fibrillation

AimsThree-dimensional rotational angiography (3DRA) of the left atrium (LA) and the esophagus is a simple and safe method for analyzing the relationship between the esophagus and the LA during catheter ablation of atrial fibrillation. The purpose of this study is to describe the location of the esophagus relative to the LA and mobility of the esophagus during ablation procedure.MethodsFrom 3/2011 to 9/2015, 3DRA of the LA and esophagus was performed in 326 patients before catheter ablation of atrial fibrillation. 3DRAwas performed with visualization of the esophagus via peroral administration of a contrast agent. The positions of the esophagus were determined at the beginning of the procedure, for part of patients also at the end of procedure with contrast esophagography.ResultsThe most frequent position is behind the center of the LA (91 pts., 31.9%) The least frequent position is behind the right pulmonary veins (27 pts., 9.4%). The average shift of the esophagus position was 3.36 ± 2.15 mm, 3.59 ± 2.37 mm and 3.67 ± 3.23 mm for superior, middle and inferior segment resp.ConclusionsThe position of the esophagus to the LA is highly variable. The most common position of the esophagus relative to the LA is behind the middle and left part of the posterior wall of the LA. The least frequently observed position is behind the right pulmonary veins. No significant position change of esophagus motion from before to after the ablation procedure in the majority (≥95%) of the patients was observed.     

Effects of Systemic Administration of Dexmedetomidine on Intraocular Pressure and Ocular Perfusion Pressure during Laparoscopic Surgery in a Steep Trendelenburg Position: Prospective,Randomized, Double-Blinded Study

Increased intraocular pressure (IOP) during surgery is a risk factor for postoperative ophthalmological complications. We assessed the efficacy of systemically infused dexmedetomidine in preventing the increase in IOP caused by a steep Trendelenburg position, and evaluated the influence of underlying hypertension on IOP during surgery. Sixty patients undergoing laparoscopic surgery in a steep Trendelenburg position were included. Patients in the dexmedetomidine group received a 1.0 µg/kg IV loading dose of dexmedetomidine before anesthesia, followed by an infusion of 0.5 µg/kg/hr throughout the operation. Patients in the saline group were infused with the same volume of normal saline. IOP and ocular perfusion pressure (OPP) were measured 16 times pre- and intraoperatively. In the saline group, IOP increased in the steep Trendelenburg position, and was 11.3 mmHg higher at the end of the time at the position compared with the baseline value (before anesthetic induction). This increase in IOP was attenuated in the dexmedetomidine group, for which IOP was only 4.2 mmHg higher (P < 0.001 vs. the saline group). The steep Trendelenburg position was associated with a decrease in OPP; the degree of decrease was comparable for both groups. In intragroup comparisons between patients with underlying hypertension and normotensive patients, the values of IOP at every time point were comparable. Dexmedetomidine infusion attenuated the increase in IOP during laparoscopic surgery in a steep Trendelenburg position, without further decreasing the OPP. Systemic hypertension did not seem to be associated with any additional increase in IOP during surgery. (Registration at the Clinical Research Information Service of Korea National Institute of Health ID: KCT0001482)     

降低玻璃体切割联合硅油填充术后体位缺陷率的持续改进

目的 研究品管圈降低玻璃体切割联合硅油填充术后体位缺陷的效果分析及应用。方法 以2016年11月11日至12月2日收治的48例玻璃体切割联合硅油填充术患者设为对照组（实施品管圈管理前）,以2017年1月11日至2017年4月20日收治的168例玻璃体切割联合硅油填充术患者为研究组（实施品管圈管理）,比较品管圈活动前后玻璃体切割联合硅油填充术患者体位缺陷率的改变。结果对照组48例患者术后平均住院天数14天,其中30例体位不合格,缺陷率占62.50%;研究组168例患者平均住院天数8天,仅有4例体位不合格,缺陷率降为2.38%,两组比较差异具有统计学意义（P<0.05）。结论 品管圈活动对降低玻璃体切割联合硅油填充术后体位缺陷率效果明显。同时,护理人员学会并能够运用各种品管方法,增强了解决问题的意识和能力,提高了患者舒适性和促进患者更快康复。     

正畸美学区的CBCT测量分析

目的探究正畸美学区,包括面下1/3前牙区牙槽骨、切牙位置以及唇部软组织在不同矢状面型、年龄及性别之间的差异性。方法 2012年6月至2013年5月间在山东大学口腔医院进行治疗的60例12~50岁汉族人,根据不同矢状骨面型、性别和年龄分组。根据头影测量ANB的角度分为3组:骨性Ⅰ类(1°5°,18例,30%),骨性Ⅲ类(ANB≤1°,19例,31.7%);根据性别分组:女性41例(68.3%),男性19例(31.7%);根据年龄分组:青少年组12~19岁22例(36.7%),青年组20~29岁20例(33.3%),中年组30~50岁18例(30%)。分别进行锥形束CT(CBCT)测量分析。骨性分组以及年龄分组采用方差检验和多个独立样本检验(Kruskal-Wallis检验),性别组间用独立样本t检验。结果 1不同矢状骨面型之间,骨性Ⅱ类患者前牙区牙槽骨及切牙过度萌出,骨性Ⅲ类患者下唇缘点的唇厚度最小;2不同性别之间,骨和软组织的各项测量值男性均大于女性;3随年龄增长,切牙区牙槽骨的高度、切牙的位置以及唇部软组织变化明显,而牙槽骨的宽度和骨皮质厚度基本稳定。结论正畸美学区在不同的矢状面型、性别和年龄间呈现一定的变化规律,有利于指导临床决策。