Access to evidence-based care for eating disorders during the COVID-19 crisis

The COVID-19 pandemic has forced an abrupt change in the delivery of clinical services, including for individuals with an eating disorder. We present this Virtual Issue as a resource for the eating disorder community to showcase research published in the International Journal of Eating Disorders that provides information on effective strategies to help address the challenges arising from COVID-19-related disruptions. Articles included describe original research or systematic reviews on obstacles to health services use and strategies to improve access to care; technological tools to provide or enhance interventions; patients' and clinicians' attitudes or perspectives on using digital tools for clinical care; factors influencing therapeutic alliance; and ideas for improving reach and uptake of digital interventions. We hope that readers will find ways to observe and record their own experiences during this global crisis; the experiences of people at risk for developing or exhibiting an eating disorder; and the experiences of those who care for people with an eating disorder. These lived experiences will be invaluable in formulating hypotheses for future studies in service of advancing the understanding of eating disorders and improving interventions and policies for reducing the burden of suffering attributable to eating disorders.     

The role of 3D digital applications in manual therapy education – A scoping review

BackgroundCurrently, teaching methods for developing physical assessment and palpation skills in manual therapy is challenging for both learners and educators. 3D digital technologies such as virtual reality (VR) may facilitate and/or address these challenges. However, their current usage in improving learning outcomes in manual therapy education is unknown.MethodsThe following electronic databases were searched from Jan 2005 to April 2021: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), Science Direct and Google Scholar. Two independent reviewers reviewed the articles to assess for eligibility. Studies of any methodology that investigated the use or application of the 3D digital applications were included in the review. Primary outcomes included any outcome related to learning based on the updated Blooms taxonomy. Narrative synthesis was used to synthesize data from the included studies.ResultsA total of 4 articles were included in the final review. The main findings were classified into the following key concepts: (1) perception of tissue stiffness, (2) improved student self-efficacy in performing MT techniques, and (3) barriers and facilitators for utilizing 3D technologies. All included outcomes met understanding, applying, analysing and evaluating levels of Blooms taxonomy; however, no outcomes met the ‘creating’ level of Bloom's taxonomy.DiscussionOur review found that there are no AR, VR or mixed applications that specifically serve the needs of MT education in relation to joint motion assessment, but applications are available that can be readily used or potentially adapted to train skills of tissue palpation.     

Variable Appearances of Ductal Carcinoma In Situ Calcifications on Digital Mammography,Synthesized Mammography,and Tomosynthesis: A Pictorial Essay

This pictorial essay demonstrates the variable appearances of ductal carcinoma in situ on full-field digital mammography, synthesized mammography, and digital breast tomosynthesis. The spectrum of intercase and intracase variability suggests further refinement of reconstruction algorithms for synthesized mammography may be necessary to maximize early detection of ductal carcinoma in situ.     

Embolization of the Superior Rectal Arteries for Hemorrhoidal Disease: Prospective Results in 25 Patients

Purpose

To evaluate efficacy and safety of superior rectal artery embolization of hemorrhoidal disease as a first-line invasive treatment.

Clinical significance of disease‐specific MYD88 mutations in circulating DNA in primary central nervous system lymphoma

Recent sequencing studies demonstrated the MYD88 L265P mutation in more than 70% of primary central nervous system lymphomas (PCNSL), and the clinical significance of this mutation has been proposed as diagnostic and prognostic markers in PCNSL. In contrast, mutational analyses using cell‐free DNAs have been reported in a variety of systemic lymphomas. To investigate how sensitively the MYD88 L265P mutation can be identified in cell‐free DNA from PCNSL patients, we carried out droplet digital PCR (ddPCR) and targeted deep sequencing (TDS) in 14 consecutive PCNSL patients from whom paired tumor‐derived DNA and cell‐free DNA was available at diagnosis. The MYD88 L265P mutation was found in tumor‐derived DNA from all 14 patients (14/14, 100%). In contrast, among 14 cell‐free DNAs evaluated by ddPCR (14/14) and TDS (13/14), the MYD88 L265P mutation was detected in eight out of 14 (ddPCR) and in 0 out of 13 (TDS) samples, implying dependence on the detection method. After chemotherapy, the MYD88 L265P mutation in cell‐free DNAs was traced in five patients; unexpectedly, the mutations disappeared after chemotherapy was given, and they remained undetectable in all patients. These observations suggest that ddPCR can sensitively detect the MYD88 L265P mutation in cell‐free DNA and could be used as non‐invasive diagnostics, but may not be applicable for monitoring minimal residual diseases in PCNSL.     

The use of droplet digital PCR in liquid biopsies: A highly sensitive technique for MYD88 p.(L265P) detection in cerebrospinal fluid

The gold standard for diagnosis of central nervous system lymphomas still regards a stereotactic brain biopsy, with the risk of major complications for the patient. As tumor cells can be detected in cerebrospinal fluid (CSF), CSF analysis can be used as an alternative. In this respect, mutation analysis in CSF can be of added value to other diagnostic parameters such a cytomorphology and clonality analysis. A well‐known example of targeted mutation analysis entails MYD88 p.(L265P) detection, which is present in the majority of Bing Neel syndrome and primary central nervous system lymphoma (PCNSL) patients. Unfortunately, tumor yield in CSF can be very low. Therefore, use of the highly sensitive droplet digital PCR (ddPCR) might be a suitable analysis strategy for targeted mutation detection. We analyzed 26 formalin fixed paraffin embedded (FFPE) samples (8 positive and 18 negative for MYD88 p.(L265P) mutation) by ddPCR, of which the results were compared with next generation sequencing (NGS). Subsequently, 32 CSF samples were analyzed by ddPCR. ddPCR and NGS results on FFPE material showed 100% concordance. Among the 32 CSF samples, 9 belonged to patients with lymphoplasmacytic lymphoma (LPL) and clinical suspicion of Bing Neel syndrome, and 3 belonged to patients with PCNSL. Nine of these samples tested positive for MYD88 p.(L265P) (8 LPL and 1 PCNSL). This study shows that sensitive MYD88 mutation analysis by ddPCR in CSF is highly reliable and can be applied even when DNA input is low. Therefore, ddPCR is of added value to current diagnostic parameters, especially when the available amount of DNA is limited.     

无症状成人颈胸交界区脊柱矢状面参数的相关性

背景:颈胸交界区脊柱矢状面平衡不仅与全脊柱矢状面平衡相关,还与颈椎矢状面平衡相关。目的:探讨无症状成人颈胸交界区脊柱矢状面参数的相关性。方法:选择2017年1月至2018年12月在河北医科大学第二医院体检中心行健康体检且无颈椎病相关临床症状者120名,年龄23-79岁,根据年龄分为21-40岁组、41-60岁组、61-80岁组,每组40名,均拍摄颈椎侧位DR影像,测量下面影像学参数:C2-C7矢状面轴向垂直距离、头部重心到C7椎体矢状面轴向垂直距离、胸廓入口角、颈倾角、T1倾斜角、颅倾角。结果与结论:①3组间C2-C7矢状面轴向垂直距离、头部重心到C7椎体矢状面轴向垂直距离、胸廓入口角、颈倾角、T1倾斜角、颅倾角比较差异均有显著性意义(P<0.05),并且组间两两比较差异亦有显著性意义(P<0.05);胸廓入口角、颈倾角、T1倾斜角随着年龄的增大而增大;②相关性分析显示胸廓入口角、颈倾角、T1倾斜角与年龄呈正相关(r=0.622,r=0.439,r=0.533,P均<0.001);胸廓入口角与T1倾斜角呈正相关(r=0.569,P<0.001);胸廓入口角、T1倾斜角均与C2-C7矢状面轴向垂直距离呈负相关(r=-0.725,r=-0.352,P均<0.001);③结果表明,无症状成人胸廓入口角、颈倾角、颅倾角、T1倾斜角呈随年龄增大而增大的趋势,且胸廓入口角、颈倾角、T1倾斜角与年龄呈正相关。     

The Chinese Visible Human (CVH) datasets incorporate technical and imaging advances on earlier digital humans

We report the availability of a digitized Chinese male and a digitzed Chinese female typical of the population and with no obvious abnormalities. The embalming and milling procedures incorporate three technical improvements over earlier digitized cadavers. Vascular perfusion with coloured gelatin was performed to facilitate blood vessel identification. Embalmed cadavers were embedded in gelatin and cryosectioned whole so as to avoid section loss resulting from cutting the body into smaller pieces. Milling performed at ?25 °C prevented small structures (e.g. teeth, concha nasalis and articular cartilage) from falling off from the milling surface. The male image set (.tiff images each of 36 Mb) has a section resolution of 3072 × 2048 pixels (～170 µm, the accompanying magnetic resonance imaging and computer tomography data have a resolution of 512 × 512, i.e. ～440 µm). The Chinese Visible Human male and female datasets are available at http://www.chinesevisiblehuman.com . (The male is 90.65 Gb and female 131.04 Gb). MPEG videos of direct records of real‐time volume rendering are at: http://www.cse.cuhk.edu.hk/~crc     

数字化医院与数字图书馆

数字化医院是现代医院的发展方向,数字图书馆是数字化医院的重要组成部分,应建立以图书馆为中心的数字图书馆。本文探讨了数字化医院建设的策略和途径以及数字图书馆的发展趋势。     

第三趾屈肌腱及趾背腱膜的断面解剖

目的：为解剖学及断趾再植提供第三趾断面解剖学资料。方法：经组织学处理切片，在显微镜下进行观测。结果：根据屈肌腱和趾背腱膜的形态，各分为8种和4种类型。屈肌腱的平均厚度在1．90mm左右，趾背腱膜I、Ⅱ断面分别为0．86m和0．54m。结论：屈肌腱和趾背腱膜的面积由近到远逐步变小。