The use of augmented toys to facilitate play in school-aged children with visual impairments

BackgroundChildren with visual impairments (VIs) face challenges in social play activities, which limits their opportunities to practice social skills.AimsWe investigated whether augmented toys were effective to facilitate play in 52 children with VIs who attended special schools for students with visual impairments and blindness.Methods and procedures52 children with VIs (mean age: 9.22 years, SD = 2.07) played three times with both an augmented and a non-augmented toy. A Playmobil® knight’s castle was augmented with Radio Frequency Identification (RFID) technology, such that each play figure produced audio feedback during play. The RFID-technology could be activated and deactivated. Social and cognitive aspects of play were coded from video and data were analyzed using multilevel logistics.Outcomes and resultsChildren showed less disengagement and more parallel play, but less cooperative play when they used the augmented versus the non-augmented castle. This pattern persisted after repeated play sessions with both toys.ConclusionsThe addition of sounds to physical toys increased shared attention between children with VIs during the exploration of play materials, yet it interfered with social interaction during peer play.     

Spouse's subjective social status predicts older adults’ prospective cognitive functioning

Objectives: The current study aims to investigate the association between subjective social status (SSS) and prospective cognitive functioning of older adults and their spouses, and to explore the potential mediating roles of health habits and physical activities in this association.

Method: Using the longitudinal data of 512 pairs of community-dwelling older couples aged 65–91 years (M = 72.2 ± 4.6), we tested the effects of SSS in cognitive functioning using an Actor-Partner Interdependence Model. SSS was measured by a self-anchoring social ladder, and cognitive functioning was measured by the Mini-Mental State Examination at baseline and 4-year follow-up. Socioeconomic status (i.e. education) was tested as a moderator, and physical activity (measured by the Physical Activity Scale for the Elderly) as well as health habits (i.e. tobacco and alcohol consumption) were included as potential mediators.

Results: A partner effect of SSS was found only in the low-education group, in which the wife's higher level of SSS in the community was associated with the husband's better cognitive functioning in the follow-up. A small proportion of this effect was found to be partially mediated by participation in housework, such that the wife's higher SSS was associated with the husband's increased housework activity, which was related to higher prospective cognitive functioning.

Conclusion: By examining the dyadic effects of SSS with a longitudinal design, our findings extended the understanding on how subjective social status influenced older couples’ cognitive health, and provided evidence-based insights for future studies on cognitive health in later life.     

La pleine conscience incarnée : un concept unificateur entre les traditions orientales et occidentales de la pleine conscience

ObjectiveThe interest in mindfulness as a concept continues to grow as shown in the increase in the number of publications pertaining to mindfulness in the last four decades. This increase is also a reflection of the fact that the term “mindfulness” is currently used as an umbrella for a variety of approaches that assign different meanings to the same word. Although differences among varying conceptualizations and definitions of “mindfulness” have been previously highlighted, few efforts have attempted to compare these varying conceptual approaches as a means to address commonalties between them. Therefore, the objective of this paper is to review different conceptualizations of mindfulness in order to understand their common and distinctive components.MethodIn order to investigate commonalities and distinctions among different mindfulness conceptualizations, we conducted a thorough qualitative review of theoretical and empirical papers belonging to three approaches in mindfulness: Eastern Buddhist traditions, Western modern mindfulness meditation programs, and Langerian mindfulness. Each of these approaches is presented first at a conceptual level (i.e., how it defines mindfulness) and then at a practical level (i.e., how to operationalize mindfulness). Empirical research pertaining to the effectiveness of each approach is presented and discussed. As Buddhism incorporates different schools of thoughts, this paper focuses primarily on the conceptualization of mindfulness outlined within Theravada Buddhism. It operationalizes mindfulness through an engagement in intensive and daily meditative practice, which includes both concentrative and open-monitoring meditation. In addition, Buddhism includes a set of ethical principles. Western modern mindfulness meditation programs are conceptualized according to Kabat-Zinn and other western scholars. Definitions varied to some extent according to different scholars, each including a different set of components (e.g., attention, awareness, acceptance, nonjudgement, observation). Western modern mindfulness meditation programs are operationalized though the development and implementation of structured psychosomatic interventions, such as Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. Langerian mindfulness is conceptualized as a general style or mode of functioning through which individuals actively reconstruct their environment by creating new categories or distinctions, and seeking multiple perspectives. Langer operationalized mindfulness through a set of sociocognitive tasks. The role of the body in these three approaches and more specifically the mind-body connection is highlighted through the analysis of clinical, behavioral, and neuroscientific research findings.Results and DiscussionDefinitions from both eastern and western approaches share self-regulation of attention and awareness as central common elements. Both attention and awareness processes increase interoceptive and exteroceptive body awareness and mind-body connection, therefore suggesting a role of embodiment in conceptualizing and operationalizing mindfulness across different approaches. We therefore introduce the new concept of Embodied Mindfulness as an integration of top-down and bottom-up processes and argue for its utility in the empirical study of mindfulness across the three conceptual approaches.ConclusionsThe new notion of embodied mindfulness integrates different conceptualizations of mindfulness by allowing a common understanding of the mechanisms of change across these conceptualizations. This new notion has also both research and clinical implications. This new notion suggests further emphasizing the body and mind-body connection in both studying/measuring mindfulness and in developing/validating clinical interventions.     

人为提高儿童肱骨髁上骨折外侧克氏针出针点的可行性及置针经验分析

目的初步探讨人为提高儿童肱骨髁上骨折外侧克氏针出针点的可行性及其相应的置入方法。方法本研究分为两个阶段。第一阶段:收集2016年3月至2016年12月中国医科大学附属盛京医院161例儿童伸直型肱骨髁上骨折外侧针构型病例术中透视图像中最外侧针的出针点和入针点位置,测量最外侧针冠状面和矢状面钢针角度。第二阶段(2017年1月至2017年12月)基于第一阶段的研究结果,由中国医科大学附属盛京医院两名小儿骨科医生尝试人为提高最外侧针的出针位置(预期组),另外两名外科医生继续按照常规流程置针(对照组),对两组各项治疗参数进行比较。结果第一阶段参与回顾性研究的161例患者中,47例(29.2%)最外侧针出针点位于骨干-干骺端交界区(metaphyseal-diaphyseal junction,MDJ)上边界线以上,其中40例最外侧针(85.1%)由肱骨小头骨化中心(ossific nucleus of the capitellum,ONC)外侧或骨化中心外1/3置入(正位像),于骨化中心后1/3或骨化中心后方置入(侧位像)。冠状面和矢状面钢针平均角度分别为58.4°和90.5°。第二阶段,预期组中有47例(65.3%,47/72)患者的最外侧针出针点位于MDJ上边界线以上,而对照组中仅32例(36%,32/89)出针点位于MDJ上边界线以上。两组比较差异有统计学意义(χ2=16.134,P<0.05)结论在单纯外侧针构型中,人为提高最外侧针出针点可行。钢针路径位于正位像肱骨小头骨化中心外侧、外1/3及侧位像在肱骨小头后方或后1/3位置时更容易获得高位的出针点。     

肌萎缩侧索硬化伴认知功能障碍的研究进展

认知功能障碍在肌萎缩侧索硬化（ALS）患者中是普遍存在的，ALS伴认知功能障碍常提示预后不良。近年来对ALS患者认知功能障碍的研究取得了一定的进展，本文对ALS伴认知功能障碍的临床特点、生物标志物、遗传学特征和最新治疗进展进行综述，以期为ALS伴认知功能障碍的临床诊疗提供新思路。     

COVID-19 and hemolysis,elevated liver enzymes and thrombocytopenia syndrome in pregnant women - association or causation?

Pregnant women are among the high-risk population for severe coronavirus disease 2019 (COVID-19) with unfavorable peripartum outcomes and increased incidence of preterm births. Hemolysis, the elevation of liver enzymes, and low platelet count (HELLP) syndrome and severe preeclampsia are among the leading causes of maternal mortality. Evidence supports a higher odd of pre-eclampsia in women with COVID-19, given overlapping pathophysiology. Involvement of angiotensin-converting enzyme 2 receptors by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for the entry to the host cells and its downregulation cause dysregulation of the renin-angiotensin-aldosterone system. The overexpression of Angiotensin II mediated via p38 Mitogen-Activated Protein Kinase pathways can cause vasoconstriction and uninhibited platelet aggregation, which may be another common link between COVID-19 and HELLP syndrome. On PubMed search from January 1, 2020, to July 30, 2022, we found 18 studies on of SARS-COV-2 infection with HELLP Syndrome. Most of these studies are case reports or series, did not perform histopathology analysis of the placenta, or measured biomarkers linked to pre-eclampsia/HELLP syndrome. Hence, the relationship between SARS-CoV-2 infection and HELLP syndrome is inconclusive in these studies. We intend to perform a mini-review of the published literature on HELLP syndrome and COVID-19 to test the hypothesis on association vs causation, and gaps in the current evidence and propose an area of future research.     

Head and neck Ewing sarcoma: French surgical practice analysis pleads for surgery centralization

This study aimed to analyze surgical procedures for head and neck Ewing sarcoma (HNES) with regard to oncological, functional, and esthetic outcomes.A blinded multidisciplinary retrospective chart review of operated French HNES patients (Euro-EWING 99 trial, 1999–2014) was performed to assess patient/tumor characteristics, treatment details, and outcomes.Primary surgery without reconstruction was undertaken in 13 patients (emergency context/misdiagnosis). However, because of contaminated surgical margins, all patients had to undergo systematic postoperative radiotherapy. Twenty-six patients underwent multidisciplinary evaluation and were scheduled to undergo postchemotherapy surgery, with 19 patients scheduled for immediate reconstruction. All cases showed R0 margins after postchemotherapy surgery of the initial tumor bed by multidisciplinary surgical teams, while n = 3/4 of local relapses (very poor prognosis) had R1a margins after surgery of the residual tumor volume following chemotherapy. Only three surgical expertise centers operated on ≥ 4 patients over the 15-year period. Thirty patients developed long-term sequelae, with increased complications following radiotherapy.Referring patients to surgical expertise centers following a suspected diagnosis, with planned postchemotherapy surgery of the initial tumor bed at these centers, might limit the need for intralesional resections, allowing radical R0 resections and thus reducing long-term sequelae as well as the risk of secondary radio-induced malignancy by limiting the need for postoperative radiotherapy.     

糖尿病肾病患者认知功能障碍与血清β淀粉样蛋白的关系

目的 探讨糖尿病肾病(diabetic kidney disease,DKD)患者认知功能障碍与人β淀粉样蛋白1-42(human β Amyloid 1-42,Aβ1-42)的关系。方法 选取2020年5月至2021年5月在徐州医科大学附属医院内分泌科治疗的2型糖尿病(type 2 diabetes mellitus,T2DM)患者161例,根据尿白蛋白/肌酐比值(urine albumin creatine ratio,UACR)水平分为正常白蛋白尿(DM)组(n=60)、微量白蛋白尿(DKD1)组(n=58)和大量白蛋白尿(DKD2)组(n=43)。采用蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)量表评估患者认知功能。检测患者Aβ1-42、UACR、胱抑素C(Cystatin C,CysC)、估算肾小球滤过率(estimated glomerular filtration rate,eGFR),并分析上述指标与MoCA评分的关系。结果 与DM组比较,DKD1和DKD2组CysC、Aβ1-42均升高(P<0.05),eGFR降低(P<0.05)。与DKD1组比较,DKD2组CysC升高(P<0.05),eGFR降低(P<0.05)。与DM组相比,DKD1组、DKD2组MoCA评分均降低(P<0.05)。与DKD1组比较,DKD2组MoCA评分降低(P<0.05)。3组MoCA评分与Aβ1-42、UACR、CysC呈负相关(均P<0.01),与eGFR呈正相关(P<0.01)。3组Aβ1-42与UACR、CysC呈正相关(均P<0.01),与eGFR呈负相关(P<0.01)。多因素线性回归分析结果显示,Aβ1-42、UACR是影响DKD患者MoCA评分的影响因素,Aβ1-42、UACR水平越高,MoCA评分越低,患者认知功能越差。结论 DKD患者存在认知功能障碍,与Aβ1-42水平及肾损害严重程度密切相关。