Joint maximum likelihood estimation of activation and Hemodynamic Response Function for fMRI

Blood Oxygen Level Dependent (BOLD) functional magnetic resonance imaging (fMRI) maps the brain activity by measuring blood oxygenation level, which is related to brain activity via a temporal impulse response function known as the Hemodynamic Response Function (HRF). The HRF varies from subject to subject and within areas of the brain, therefore a knowledge of HRF is necessary for accurately computing voxel activations. Conversely a knowledge of active voxels is highly beneficial for estimating the HRF. This work presents a joint maximum likelihood estimation of HRF and activation based on low-rank matrix approximations operating on regions of interest (ROI). Since each ROI has limited data, a smoothing constraint on the HRF is employed via Tikhonov regularization. The method is analyzed under both white noise and colored noise. Experiments with synthetic data show that accurate estimation of the HRF is possible with this method without prior assumptions on the exact shape of the HRF. Further experiments involving real fMRI experiments with auditory stimuli are used to validate the proposed method.     

Low Faecal Elastase 1 Concentrations in Type 2 Diabetes Mellitus

Background: Previous studies have suggested an association between impaired pancreatic exocrine function and diabetes, but the evidence is weak because the invasive nature of the tests used to define exocrine function has led to small studies on selected patients. The availability of faecal elastase 1 as a non-invasive test has aided the detection of impaired exocrine function in population studies. We describe the association between levels of faecal elastase 1 and Type 2 diabetes. Methods:     

Patients' Conceptions of Terms Related to Sexual Interest,Desire, and Arousal

BackgroundMeasurement of sexual function typically uses self-report, which, to work as intended, must use language that is understood consistently by diverse respondents. Commonly used measures employ multiple terms, primarily (sexual) interest, desire, and arousal, that might not be understood in the same way by laypeople and professionals.AimTo inform self-reported measurement efforts for research and clinical settings by examining how US men and women recruited from a health care setting understand and interpret different terms.MethodsWe conducted 10 focus groups in Durham, NC (N = 57). Discussions were audio-recorded and transcribed, and the content of the discussions was systematically analyzed in 2 phases of coding by the research team, facilitated by Nvivo qualitative analysis software (QSR International, Doncaster, VIC, Australia).OutcomesPatient focus group discussions about the meanings and connotations of multiple terms related to sexual function, especially interest, desire, and arousal.Results5 groups included male participants and 5 included female participants. Participants characterized (sexual) interest as a cognitive phenomenon and a situational response to a specific person. Similarly, they characterized (sexual) desire as a situational person-specific experience with some support for it as a cognitive phenomenon but more support for it as a physical phenomenon. In contrast, participants characterized sexual arousal as a physical phenomenon occurring in response to physical or visual stimulation and not related to a specific person.Clinical ImplicationsThese results can help us understand how laypeople are using and responding to these terms when they are used in clinical and research settings.Strengths and LimitationsPatient participants in these groups were diverse in age, gender, sexual orientation, and health, with the potential to voice diverse perspectives on sexual functioning; however, the sample was limited to a single city in the southeastern United States.ConclusionThe meanings of interest, desire, and arousal were defined, compared, and contrasted in the context of patient focus groups. Qualitative coding showed that interest was considered the most “cognitive,” arousal the most “physical,” and desire somewhere in between.DeLamater JD, Weinfurt KP, Flynn KE. Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal. J Sex Med 2017;14:1327–1335.     

Long-Term Function After Restorative Proctocolectomy

PURPOSE Early functional outcome after restorative proctocolectomy and formation of an ileoanal pouch is known to be good, but there are minimal data on the long-term function of the pouch. The aim of this study was to look at the long-term functional outcome in patients who had undergone restorative proctocolectomy and formation of an ileoanal pouch.METHODS A total of 151 consecutive patients (96 males, 55 females) who underwent ileoanal pouch surgery between April 1983 and May 1993 were identified. Functional outcomes from the previous 12 months were appraised by a standardized questionnaire.RESULTS The median age at surgery was 31 years (range, 6–63 years), with a median follow-up of 142 months (range, 100–221 months). Eighteen patients have had their pouches excised, with another patient being defunctioned. Therefore 19 patients (13 percent) had suffered pouch failure. Altogether, 115 patients were available for follow-up, and 98 patients (85 percent) returned questionnaires. The median pouch-emptying frequency was five times (range, 1–17) during the day and one time (range, 0–6) at night. A total of 74 percent of patients had perfect continence during the day. Most of the patients had no life-style restrictions related to the pouch, and 98 percent of patients would recommend a pouch to others.CONCLUSIONS Long-term functional outcome after ileoanal pouch surgery is good in most patients. For patients requiring proctocolectomy, ileoanal pouch surgery can now be recommended as an excellent long-term option.Presented at the Association of Coloproctology of Great Britain and Ireland, Manchester, United Kingdom, July 2 to 5, 2002 Reprints are not available.     

Consequences of multiple withdrawals from alcohol

This article represents the proceedings of a symposium at the 2003 annual meeting of the Research Society on Alcoholism in Fort Lauderdale, FL, organized by Theodora Duka and chaired by Dai Stephens. The purpose of the symposium was to examine the effects of multiple experiences of withdrawal from alcohol in animals made dependent on alcohol and in humans who are alcohol dependent. Parallels were drawn to the effects of repeated short-lived high-content alcohol exposures in animals and in humans who are social drinkers but indulge in binge drinking. The presentations were (1) Multiple detoxifications and risk of relapse in abstinent alcoholics, by John Gentry and Robert Malcolm; (2) Emotional and cognitive impairments after long-term use of alcohol: relationship to multiple detoxifications and binge drinking, by Theodora Duka; (3) The effect of repeated withdrawal from ethanol on conditioning to appetitive stimuli, by Tamzin Ripley, Gilyanna Borlikova, and Dai Stephens; (4) Alcohol withdrawal kindling: electrographic measures in a murine model of behavioral seizure sensitization, by Lynn Veatch and Howard Becker; and (5) Binge drinking induced changes in CNS, by Fulton Crews.     

中西医结合序贯治疗支气管哮喘64例疗效观察

目的：观察中西医结合序贯治疗对支气管哮喘患者的临床疗效。方法将128例支气管哮喘患者随机分为观察组与对照组,均分发作期、缓解期、稳定期三期序贯治疗。对照组64例予西医常规治疗,观察组64例在对照组基础上配合中药,应用中西医结合疗法,每一期疗程结束评价疗效。结果观察组在发作期病情平均缓解时间,以及肺功能指标、症状体征积分、临床总有效率、1年内复发率等方面与对照组比较,差异有统计学意义（P ﹤0.05,P ﹤0.01）。结论中西医结合序贯疗法能有效改善哮喘患者肺功能,临床近期、远期疗效高,复发率低,提高患者生活质量,值得推广应用。     

洛汀新与缬沙坦对老年急性心肌梗死患者心室重塑及心功能的影响

目的：对洛汀新（盐酸贝那普利片）与缬沙坦治疗老年急性心肌梗死患者对心室重塑及心功能的影响进行探讨。方法回顾性分析从2013年1月—2014年12月期间的90例在该院接受治疗的心肌梗死老年患者的临床资料,并根据随机数字表法将患者分成观察组与对照组两组,各为45例。观察组使用洛汀新治疗,对照组使用缬沙坦治疗。对比两组临床治疗效果以及对患者心功能的影响。结果两组患者治疗后心室重塑指标改善明显,对比两组改善情况发现使用洛汀新治疗的观察组患者情况优于对照组,P＜0.05;观察组患者治疗后心功能指标水平改善情况显著优于对照组,且差异有统计学意义,P＜0.01;治疗后观察组临床症状评分与对照组比较明显降低,P＜0.05;对照组NYHA分级显著低于观察组,P＜0.05。结论对于老年急性心肌梗死患者采用洛汀新与缬沙坦治疗,可有效改善患者心功能,并帮助心室重建,临床具有推广意义。     

护理干预对股骨干骨折内固定术后膝关节功能与疼痛的影响

目的：探讨股骨干骨折内固定术后患者采用护理干预对膝关节功能和疼痛的影响。方法选取该院于2012年4月—2014年2月间收治的采用内固定术治疗的股骨干骨折患者86例为研究对象,按照其护理方式的不同,分为常规护理组和针对护理干预组,每组各43例,其中,常规护理组患者采用普通护理方式,针对护理组患者采用针对性的护理措施进行干预,比较两组护理干预对股骨干骨折患者内固定术后膝关节功能与疼痛的影响。结果两组患者护理效果相比,常规护理组优35例（81.40%）,良2例（4.65%）,一般4例（9.30%）,差2例（4.65%）,优良率为37例（86.05%）;针对护理组优39例（90.70%）,良2例（4.65%）,一般2例（4.65%）,差0例,优良率为41例（95.34%）,针对护理组的护理效果明显优于常规护理组,且差异明显,具有统计学意义。同时,记录两组患者的VAS评分值（视觉模拟疼痛评分法）及HSS评分值（膝关节损伤标准评分法）。结论对股骨干骨折患者在内固定术后采用针对性的护理措施干预可有效减轻患者痛苦,加快患者膝关节功能的恢复,降低患者术后疼痛,提高患者生活质量,临床护理效果显著。