甲基强的松龙冲击治疗甲醇中毒性视神经病变的临床观察

对40例甲醇中毒性视神经病变患者采取甲基强的松龙冲击治疗，以患者治疗前视力为依据，分为无光感组、光感＜0.6组、光感0.6?1.0组，对比三组患者的临床疗效。结果显示，总有效率为95.00%；各组用药不良反应发生率较低，且差异无统计学意义（P＜0.05）。提示甲基强的松龙冲击治疗甲醇中毒性视神经病变疗效较为显著。     

疱疹病毒抗体阳性肺炎支原体肺炎患儿免疫状况及临床特征

目的探讨疱疹病毒抗体阳性的肺炎支原体肺炎(MPP)患儿免疫状况及临床特征。方法回顾分析2015年1月—2017年5月收治的360例2个月～16岁因MPP住院的患儿临床资料,以EB病毒(EBV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)任一疱疹病毒IgM抗体阳性的162例患儿为抗体阳性组,另198例EBV、CMV、HSV抗体均阴性的患儿作为对照组,两组进行分析比较。结果 360例MPP患儿中男188例、女172例,合并疱疹病毒IgM抗体阳性162例,其中EBV IgM阳性97例,阳性率26.9%;CMV IgM阳性39例,阳性率10.8%;HSV IgM阳性97例,阳性率26.9%。所有患儿均未予抗病毒治疗,经治疗症状缓解好转出院。抗体阳性组重症MPP、大叶性实变、并发呼吸衰竭的比例均高于对照组,血清IgM、CD~(4+)T细胞、CD~(8+)T细胞、淋巴细胞、NK细胞、白细胞计数、乳酸脱氢酶、丙氨酸氨基转移酶均高于对照组,大环内酯类抗生素使用时间长于对照组,使用激素率高于对照组,差异均有统计学意义(P均0.05)。MPP合并2种病毒IgM抗体阳性者的血IgM和三酰甘油水平高于合并1种者,差异有统计学意义(P0.05)。合并3种病毒IgM抗体阳性者与合并1种者比较,住院时间、发热时间、大环内酯类抗生素使用时间均有延长,血IgM、丙氨酸氨基转移酶水平更高,重症MPP发生率增高,差异均有统计学意义(P0.05)。结论疱疹病毒IgM抗体阳性MPP患儿的炎症反应强烈,临床症状重,病程长,并发症多,需更长时间的治疗。     

Landscape assessment for gender neutral human papillomavirus vaccination recommendations including head and neck cancer burden data

IntroductionHead and neck cancers (HNC) accounted for over 450,000 deaths and 900,000 cases in 2018 worldwide. Of those, 38,000 cases were attributable to human papillomavirus (HPV). HNC is two to four times more prevalent in men than in women. The incidence of oropharyngeal cancers (OPC) and oral cavity cancers caused by HPV has increased in recent decades. Given the substantial burden of HPV-related HNC in males, this study aimed to assess whether and how national agencies included HPV-related HNC when evaluating HPV genderneutral vaccination (GNV) programs.MethodsA systematic literature review was conducted in MEDLINE® and EMBASE®, and on the websites of selected national agencies.ResultsSearches identified a potential 205 records; seventeen were eligible for the review. Seventy percent of assessments were published by European countries and most were recent (2014–2019). Eleven (65%) reports considered OPC when discussing HNC, and a few included other anatomic sites. All reports that considered incidence data were in consensus that incidence of OPC was higher in men and showed that the mortality rates for HPV-related HNC were also higher in men. When looking at the economic impact, the incremental cost-effectiveness ratios in the assessments varied widely, as the inputs into the analyses were heterogeneous. However, several reports concluded GNV programs were likely to be cost-effective versus not vaccinating males.ConclusionThe burden of HPV-related HNC in the general male population has been recognized by several Heatlth Technology Assessment (HTA) agencies and National Immunization Technical Advisory Groups (NITAGs) when evaluating HPV GNV programs. The assessments identified on GNV programs strongly indicate a cost-effective clinical benefit. Nevertheless, the epidemiological burden of HNC may have been underestimated in some countries due to limited data. Further research is crucial to obtain more robust data that will help address the information gap in epidemiological and economic burden of HPV-associated HNC in men.     

EEG functional connectivity contributes to outcome prediction of postanoxic coma

ObjectiveTo investigate the additional value of EEG functional connectivity features, in addition to non-coupling EEG features, for outcome prediction of comatose patients after cardiac arrest.MethodsProspective, multicenter cohort study. Coherence, phase locking value, and mutual information were calculated in 19-channel EEGs at 12 h, 24 h and 48 h after cardiac arrest. Three sets of machine learning classification models were trained and validated with functional connectivity, EEG non-coupling features, and a combination of these. Neurological outcome was assessed at six months and categorized as “good” (Cerebral Performance Category [CPC] 1–2) or “poor” (CPC 3–5).ResultsWe included 594 patients (46% good outcome). A sensitivity of 51% (95% CI: 34–56%) at 100% specificity in predicting poor outcome was achieved by the best functional connectivity-based classifier at 12 h after cardiac arrest, while the best non-coupling-based model reached a sensitivity of 32% (0–54%) at 100% specificity using data at 12 h and 48 h. Combination of both sets of features achieved a sensitivity of 73% (50–77%) at 100% specificity.ConclusionFunctional connectivity measures improve EEG based prediction models for poor outcome of postanoxic coma.SignificanceFunctional connectivity features derived from early EEG hold potential to improve outcome prediction of coma after cardiac arrest.     

Developmental trajectories of the socioeconomic status of occupational aspirations during adolescence

IntroductionProminent theories of career development suggest age-related changes in adolescents' occupational aspirations. However, little is known about how exactly and to what extent, adolescents' aspirations change, particularly regarding the socioeconomic status (SES) of aspired occupations. We aim at extending our knowledge of the developmental trajectories of the SES of occupational aspirations and potential gender differences in those trajectories.MethodsWe used longitudinal data from the German National Educational Panel Study (NEPS) consisting of a large and representative sample of secondary school students (N = 5,964, 50% females) from Grades 8 to 10 (age 14–16). Data were collected via a paper and pencil survey which was carried out in classrooms.ResultsOur analysis of a latent growth curve model revealed that adolescents experienced small increases in the SES of occupational aspirations from Grades 8 to 10. Multi-group models reveal that females initially aspired to higher-SES occupations and their aspirations exhibited larger growth over time compared to males.ConclusionsOur findings are in line with those from other countries but not with all, indicating some cross-cultural variabilities. Within cultures, the developmental trajectories of the SES of occupational aspirations seem to be similar across age-cohorts in the last 30 years. Despite women aspire to higher-SES occupations during adolescence, they often obtain lower-SES occupations than men in adulthood. Future research is needed to better understand the link between gender differences in the SES of occupational aspirations in adolescence and gender differences in the SES of occupational attainment in adulthood.     

Quantifying gender norm resistance

IntroductionQualitative and mixed-methods researchers have described the experience of gender norm resistance in adolescence and identified potential types of resistance including indirect resistance (motivated by a preference for gender-atypicality) and direct resistance (motivated by dislike of gender norms and a desire to change them). Building on this work, we developed the Gender Norm Resistance measure to operationalize indirect and direct gender norm resistance. We explored how gender norm resistance aligns with and differs from other gender self-concepts (e.g., felt pressure to conform to gender norms) and peer relations (e.g., contact with peers) and tested for gender differences.MethodsParticipants included 484 early adolescents (girls = 234; M_age = 11.44 years, SD = 0.56). Analyses included factor analyses (EFA, CFA) and bivariate correlations to gather validity evidence, and ANOVAs to determine mean level differences.ResultsEvidence that validated using the proposed measure as intended was found including confirmation of the two types of gender norm resistance (indirect and direct). Mean differences were found across participant gender as well as across types of gender norm resistance.ConclusionsThe findings highlight the strengths and weaknesses of the Gender Norm Resistance measure, the different ways adolescents experience indirect and direct gender norm resistance, and the limited role of felt pressure in gender norm resistance.