Multimodal fusion of structural and functional brain imaging in depression using linked independent component analysis

Previous structural and functional neuroimaging studies have implicated distributed brain regions and networks in depression. However, there are no robust imaging biomarkers that are specific to depression, which may be due to clinical heterogeneity and neurobiological complexity. A dimensional approach and fusion of imaging modalities may yield a more coherent view of the neuronal correlates of depression. We used linked independent component analysis to fuse cortical macrostructure (thickness, area, gray matter density), white matter diffusion properties and resting‐state functional magnetic resonance imaging default mode network amplitude in patients with a history of depression (n = 170) and controls (n = 71). We used univariate and machine learning approaches to assess the relationship between age, sex, case–control status, and symptom loads for depression and anxiety with the resulting brain components. Univariate analyses revealed strong associations between age and sex with mainly global but also regional specific brain components, with varying degrees of multimodal involvement. In contrast, there were no significant associations with case–control status, nor symptom loads for depression and anxiety with the brain components, nor any interaction effects with age and sex. Machine learning revealed low model performance for classifying patients from controls and predicting symptom loads for depression and anxiety, but high age prediction accuracy. Multimodal fusion of brain imaging data alone may not be sufficient for dissecting the clinical and neurobiological heterogeneity of depression. Precise clinical stratification and methods for brain phenotyping at the individual level based on large training samples may be needed to parse the neuroanatomy of depression.     

基于超效率DEA的天津市基本公共卫生配置资源效率研究

评价天津市各辖区基本公共卫生服务的资源配置效率,寻求有效的资源配置措施和方法,为进一步优化卫生资源配置提供参考依据。方法利用数据包络分析,对天津市16辖区的基本公共卫生服务进行效率评价。结果天津市基本公共卫生服务的资源配置效率整体不高,仅有5辖区达到了规模最优,多数区非DEA有效,且投入过剩与产出不足并存。结论为了达到最优的基本公共卫生服务效率,政府及各级基本公共卫生服务机构必须有效地完善、落实相关政策,优化资源投入结构,统筹地区差异,加强资源供给管理,提高资源利用效率。     

中医五行音乐疗法结合耳穴压豆改善肝火扰心失眠患者的效果体会

目的:探讨中医五行音乐疗法结合耳穴压豆改善肝火扰心失眠患者的效果。方法:选择我院在2016年10月1日-2018年9月30日收治的60例肝火扰心失眠患者。随机分为观察组与对照组各30例,对照组采用耳穴压豆法治疗,观察组采用中医五行音乐疗法结合耳穴压豆法治疗。治疗后比较两组的中医证候积分、睡眠时间与睡眠质量。结果:经过4个疗程治疗后,观察组中医证候积分低于对照组,睡眠时间长于对照组,睡眠质量优于对照组,组间各项数据均有明显差异,P<0.05。结论:在治疗肝火扰心失眠时,中医五行音乐疗法结合耳穴压豆法的临床疗效比常规药物治疗的疗效更加明显,患者失眠情况改善明显,值得在临床上进一步推广应用。     

Drunken driving and riding with a drunken driver: adolescent types at higher risk

Abstract

The leading cause of death of adolescents in developed countries is injury. Alcohol is a major contributor to adolescent injury. Most of the injury deaths in youth are caused by traffic crashes. Driving under the influence (DUI) and riding with a driver who is under the influence (RUI) of alcohol increase the risk of road crash. The focus of this study is how adolescents’ risk of DUI and RUI differ in relation to their experience of parental control and peer pressure to substance use, other risky behaviours and leisure time activities. The analyses are based on data from the European School Survey Project on Alcohol and Other Drugs collected from 15- to 16-year-old Finnish adolescents in 2015 (n?=?4049, response rate 88.7%). The study shows that problems tend to entangle in some adolescent groups in which DUI and RUI are also more common. Adolescents with higher probability of using various substances, of starting alcohol use at young age, of experiencing weak parental control, and high peer pressure are at higher risk of DUI and RUI. The results indicate that professionals and authorities handling underage DUI and RUI ought to consider adolescents’ situation as a whole.     

心内科临床教学中WPBL教学模式的应用研究

目的研究对心内科实习护士实施WPBL教学模式的效果。方法选取医院心内科实习护士45例展开研究,时间跨度为2018年5月—2018年9月,按模式差异分为对照(常规教学)和观察组(WPBL模式),对比分析两组实习护士学习效果、对心内科理论知识和护理技能掌握程度。结果观察组带教后心内科疾病认知和兴趣(8.11±1.01)分,自主学习能力(7.36±1.11)分,学习效率(7.24±1.21)分,独立思考能力(7.75±1.36)分,护患沟通能力(8.11±1.11)分,临床基础能力(8.44±1.03)分,自身批判性行为(7.25±1.44)分学习效果各项评分明显较对照组高,P<0.05。观察组理论知识掌握度95.5%,护理技能掌握度95.5%,对照组分别为73.9%和69.6%,P<0.05。结论对心内科实习护士实施WPBL教学效果显著,值得推广。     

Quantitative chemical exchange saturation transfer (qCEST) MRI – omega plot analysis of RF‐spillover‐corrected inverse CEST ratio asymmetry for simultaneous determination of labile proton ratio and exchange rate

Chemical exchange saturation transfer (CEST) MRI is sensitive to labile proton concentration and exchange rate, thus allowing measurement of dilute CEST agent and microenvironmental properties. However, CEST measurement depends not only on the CEST agent properties but also on the experimental conditions. Quantitative CEST (qCEST) analysis has been proposed to address the limitation of the commonly used simplistic CEST‐weighted calculation. Recent research has shown that the concomitant direct RF saturation (spillover) effect can be corrected using an inverse CEST ratio calculation. We postulated that a simplified qCEST analysis is feasible with omega plot analysis of the inverse CEST asymmetry calculation. Specifically, simulations showed that the numerically derived labile proton ratio and exchange rate were in good agreement with input values. In addition, the qCEST analysis was confirmed experimentally in a phantom with concurrent variation in CEST agent concentration and pH. Also, we demonstrated that the derived labile proton ratio increased linearly with creatine concentration (P < 0.01) while the pH‐dependent exchange rate followed a dominantly base‐catalyzed exchange relationship (P < 0.01). In summary, our study verified that a simplified qCEST analysis can simultaneously determine labile proton ratio and exchange rate in a relatively complex in vitro CEST system. Copyright © 2015 John Wiley & Sons, Ltd.     

Evolutionary puzzle of Toxoplasma gondii with suicidal ideation and suicide attempts: An updated systematic review and meta‐analysis

The World Health Organization has reported an annual global suicide rate of 14.5 per 100,000 people. On the other hand, it is estimated that approximately one‐third of the global population are infected with Toxoplasma gondii (T. gondii) parasite. It is widely assumed that microbial pathogens, such as T. gondii, are probably associated with affective and behavioural modulation. The present article aimed to assess the proposed role of toxoplasmosis in raising the risk of suicidal ideation (SI) and suicide attempts (SA) using the available epidemiological data. Seven major electronic databases and the Internet search engine Google were searched for all the studies published between the 1st of January 1950 and 31st of October 2019. The heterogeneity and the risk of bias within and across studies were assessed. Following data extraction, pooled odds ratios (ORs) with 95% confidence interval (CI) across studies were calculated using the random‐effects models. A total number of 9,696 articles were screened and 27 studies were regarded as eligible in our systematic review (SI with five papers and 22 papers on SA). A significant association was detected between antibodies against T. gondii with TA (ORs = 1.57; 95% confidence interval [CI] 1.23–2.00, p = .000). Exploration of the association between T. gondii and SA yielded a positive effect of seropositivity for IgG antibodies but not IgM. Despite the limited number of studies, a statistical association was detected between suicidal behaviours and infection with latent T. gondii.     

新生儿重症监护病房中重症肺炎多种菌感染相关因素分析

目的分析新生儿重症监护病房(NICU)中重症肺炎新生儿多种菌感染危险因素。方法回顾分析2014年1月至2019年5月收入NICU的1 057例重症细菌肺炎新生儿的临床资料,分析其多种菌感染的危险因素。结果单因素分析显示,胎龄(37周)、出生体质量(2 500 g)、发病日龄(7 d)、羊水污染(Ⅱ、Ⅲ度)、感染类型(医院感染)、住院时间(≥14天)、机械通气、Apagar评分(7分)、胎膜早破、抗菌药物使用天数(≥10天)、更换抗菌药物(≥3种)、联合使用抗菌药物(≥3种)12个因素是NICU中重症肺炎新生儿多种菌感染的危险因素,差异有统计学意义(P均0.05)。多因素分析显示,更换抗菌药物(≥3种)、Apagar评分(7分)、感染类型(医院感染)、机械通气、羊水污染(Ⅱ、Ⅲ度)是NICU中重症肺炎新生儿多种菌感染的独立危险因素(P0.05)。结论临床应针对主要危险因素采取综合防控措施,减少NICU新生儿重症肺炎多种菌感染。