Effects of exercise on craving and cigarette smoking in the human laboratory

Exercise is increasingly being pursued as a treatment to reduce cigarette smoking. The efficacy of clinical, exercise-based cessation interventions may be enhanced by conducting laboratory studies to determine maximally effective conditions for reducing smoking, and the mechanisms through which the effects on smoking are achieved. The main purpose of this study was to assess whether the effects of exercise on two components of craving (anticipated reward from smoking, anticipated relief from withdrawal) mediated the relationship between exercise and delay (in min) to ad libitum smoking. Experiment 1 (N = 21) assessed the effects of exercise intensity (inactivity, low, moderate) on craving components up to 60 min post-exercise. Because moderate-intensity exercise most effectively reduced craving on the reward component, all participants exercised at a moderate intensity in Experiment 2. Using an ABAB within-subjects design, Experiment 2 (N = 20) evaluated whether the effects of moderate-intensity exercise on reward and relief components of craving mediated the relationship between exercise and participants' delays (in min) to ad libitum smoking. Delays were significantly longer after exercise (M = 21 min) versus inactivity (M = 4 min), and the effects of exercise on delay were mediated through the reward component of craving. Future research should continue to explore the mechanisms through which exercise influences behavioral indices of smoking in the human laboratory. Additionally, given the benefits uniquely afforded by exercise-based cessation interventions (e.g., improving mood and other health outcomes), implementing these interventions in clinical settings may contribute substantially to improving public health.     

辛硫磷农药中毒患者血清胆碱酯酶恢复延迟的临床研究及探讨

目的研究辛硫磷农药中毒患者病情变化与血清胆碱酯酶（ChE）恢复的关系。方法95例重度有机磷中毒（AOPP）患者,包括A组辛硫磷中毒患者45例,B组其他有机磷中毒患者50例,入院后均给予洗胃、清除毒物、解磷定、阿托品及积极的对症支持治疗。分别于入院时、治疗后1、2、3、4、5、6～8、8～11、11～13天……及出院时抽血测定血清ChE,计算阿托品用量。结果血清ChE在两组患者治疗前无统计学意义（P〉0．05）,治疗后1—3天部分有下降趋势,第1天降至最低,3天后B组血清ClE逐渐上升,而A组ChE持续低水平。6—9天后缓慢回升,部分患者出院时仍低于甚至明显低于正常,但两组预后无显著差异．A组胆碱酯酶恢复时间13—44天,较B组7—25天明显延迟。阿托品用量大,治疗时间长。结论辛硫磷中毒患者ChE恢复明显延迟．对AOPP患者合理治疗具有重要指导意义。     

What's the hold up? Factors contributing to delays in discharge of trauma patients after medical clearance

Background

One area of potential savings in healthcare spending is the identification of nonmedical delays in discharge. The purpose of this study was to identify factors associated with discharge delays.

Methods

All patients admitted to our trauma center over a 1-year period with a social work consult were retrospectively evaluated to identify delays in discharge after medical clearance.

Results

Over half of our patients experienced a delay in discharge. Age was not associated with delay in discharge. Higher injury severity score, intensive care unit admission, and hospital length of stay greater than 1 week were all associated with increased delays in discharge. Other factors such as disposition to a rehabilitation/nursing facility and mechanism of injury were also associated with a nonmedical delay.

Conclusions

We have identified nonmedical factors associated with delays in discharge. Strategies using these data could be used to improve discharge planning and may help decrease healthcare costs.     

‘The clock keeps ticking’ – the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Objective

To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment.

Study design

Quasi-experimental study.

Methods

Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed.

Results

The median time taken to make the decision to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in the intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that the community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of a primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC, and poverty, distance, transportation difficulties and decision made by male guardian were associated with slower access to EmOC.

Conclusions

The intervention appeared to reduce the time taken to make the decision to access health care and the time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community.     

Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies

Decreased cognitive control over the urge to be involved in gambling activities is a core feature of Gambling Disorder (GD). Cognitive control can be differentiated into several cognitive sub-processes pivotal in GD clinical phenomenology, such as response inhibition, conflict monitoring, decision-making, and cognitive flexibility. This article aims to systematically review fMRI studies, which investigated the neural mechanisms underlying diminished cognitive control in GD. We conducted a comprehensive literature search and collected neuropsychological and neuroimaging data investigating cognitive control in GD. We included a total of 14 studies comprising 499 individuals. Our results indicate that impaired activity in prefrontal cortex may account for decreased cognitive control in GD, contributing to the progressive loss of control over gambling urges. Among prefrontal regions, orbital and ventromedial areas seem to be a possible nexus for sensory integration, value-based decision-making and emotional processing, thus contributing to both motivational and affective aspects of cognitive control. Finally, we discussed possible therapeutic approaches aimed at the restoration of cognitive control in GD, including pharmacological and brain stimulation treatments.     

探讨闭合性胸部创伤的早期诊断与延误原因分析

开放性胸部创伤,临床上易早期诊断,及时处理.而闭合性胸部创伤,因早期症状、体征不典型、隐匿多变等特点,往往延误诊治.本文就我院2004年1月～2007年12月收治的闭合性胸部创伤60例进行分析,并就其中延误的40例病例资料进行归纳总结,试探讨延误诊治的原因及应采取的对策.     

漏声表面波生物传感器不同检测方法的实验研究

目的构建双通道漏声表面波生物传感器液相检测技术平台。方法以人乳头状瘤病毒为检测对象,传感器检测系统运用相位、频率及延迟线3种检测方法对其进行实时检测;利用扫描隧道显微镜观察传感器裸金表面、固定巯基化探针以及核酸杂交后的金膜表面结构的微观变化。结果相位和频率两种检测方法较好;扫描隧道显微镜下可以看到裸金膜表面金原子排列有序;探针分子分布密度增加;杂交后寡核酸分子密度更为密集。结论成功构建了漏声表面波生物传感器液相检测技术平台并运用多种检测方法;扫描隧道显微镜可以形象直观地对传感器金膜表面、核酸杂交进行直接观察,结果进一步证实了实验结论的正确性。     

Discounting of delayed rewards in substance abusers: relationship to antisocial personality disorder

RATIONALE: Delay discounting is associated with impulsivity and drug abuse, and this study evaluated the relationship between discounting of delayed rewards and antisocial personality disorder (ASP). OBJECTIVES: To determine whether discounting is increased in substance abusers with ASP relative to those without; both groups were compared with non-substance-abusing controls. METHODS: Subjects ( n=166) chose between hypothetical monetary amounts available after various delays or immediately. Under one condition, a US $1000 reward was delayed at intervals ranging from 6 h to 25 years. At each delay interval, the immediately available rewards varied from US $1 to US $999 until choices reflected indifference between the smaller immediate and larger delayed rewards. Under a second condition, the delayed reward was US $100, and immediate rewards varied from US $0.10 to US $99.90. RESULTS: In all three groups, hyperbolic discounting functions provided a good fit of the data, and the smaller reward was discounted at a higher rate than the larger reward. Substance abusers discounted delayed rewards at significantly greater rates than controls, and substance abusers with ASP discounted delayed rewards at higher rates than their non-ASP substance-abusing counterparts. Discounting rates were correlated with impulsivity scores on a personality questionnaire. CONCLUSIONS: These results provide further evidence of more rapid discounting of delayed rewards in substance abusers, especially among substance abusers with a co-morbid diagnosis of ASP.     

Reassessment of parameters for applying motor-unit triggered stimuli in peri-stimulus time histograms

We reassessed the response properties of peri-stimulus time histograms (PSTHs) in cases when a test stimulus was triggered by a motor-unit discharge with a constant delay time. In this experiment, single motor unit action potentials were recorded from the right tibialis anterior (TA) muscle of five healthy persons. A test stimulus of the common peroneal nerve with low intensity to activate only Ia afferents of the TA was applied through a bipolar stimulating electrode placed distal to the neck of the fibula. We obtained several PSTHs with various delay times and stimulus intensities in the same recording session for maintaining the background property as the same among the test situations. As a result, we confirmed three characteristics of PSTHs from observed data: (1) given the same delay time (the same background firing properties), a weaker stimulus intensity evokes a lessened effect on PSTHs, naturally; (2) delay time alters the induction balance of direct and indirect effects on PSTHs even if the stimulus intensity is the same because the background firing properties are different; and (3) response probabilities do not correspond directly to stimulus intensities when background firing properties are different; it is possible for a relatively strong intensity stimulus to produce a weaker effect than a weak stimulus. We concluded that comparisons of effects taken at different phases in the control distribution (and also effects taken from different control distributions or different motor units) can be misleading. Therefore, such comparisons should only be made within data obtained from the same phase in the same control distribution of the same motor unit.     

闭合型肠破裂延迟诊断的原因分析

目的 探讨闭合性肠破裂的延迟诊断的原因。方法 回顾分析了我院10年来68例闭合性肠破裂的延迟诊断临床资料。结果 本组病例入院后肠破裂的确诊时间为12小时～5天；平均50小时。有3例颅脑损伤及5例老年病例为伤后3～5天才确诊；有15例以化脓性腹膜炎在伤后第2～3天行剖腹探查术中确诊。结论 虽然外伤性肠破裂在临床得到正确的诊断并不是很困难，但在一些特殊情况下，也常有误诊、漏诊或延迟诊断，我们必需引起重视。