Decreased movement-related beta desynchronization and impaired post-movement beta rebound in amyotrophic lateral sclerosis

ObjectiveThis study explored event-related desynchronization (ERD) and synchronization (ERS) in amyotrophic lateral sclerosis (ALS) to quantify cortical sensorimotor processes during volitional movements. We furthermore compared ERD/ERS measures with clinical scores and movement-related cortical potential (MRCP) amplitudes.MethodsElectroencephalograms were recorded while 21 ALS patients and 19 controls performed two self-paced motor tasks: sniffing and right index finger flexion. Based on Wavelet analysis the alpha and beta frequency bands were selected for subsequent evaluation.ResultsPatients generated significantly smaller resting alpha spectral power density (SPD) and smaller beta ERD compared to controls. Additionally patients exhibited merely unilateral post-movement ERS (beta rebound) whereas this phenomenon was bilateral in controls. ERD/ERS amplitudes did not correlate with corresponding MRCPs for either patients or controls.ConclusionsThe smaller resting alpha SPD and beta ERD and asymmetrical appearance of beta ERS in patients compared to controls could be the result of pyramidal cell degeneration and/or corpus callosum involvement in ALS.SignificanceThese results support the notion of reduced movement preparation in ALS involving also areas outside the motor cortex. Furthermore post-movement cortical inhibition seems to be impaired in ALS. ERD/ERS and MRCP are found to be independent measures of cortical motor functions in ALS.     

Consumption of takeaway meals and risk markers for coronary heart disease,type 2 diabetes,and obesity in children aged 9–10 years: a cross-sectional study

BackgroundFrequent consumption of takeaway meals is associated with increased risks of coronary heart disease, type 2 diabetes, and obesity in adults, but little is known about such risks in childhood. This study aimed to assess whether consumption of takeaway meals is linked to chronic disease in childhood.MethodsA cross-sectional study of UK schoolchildren aged 9–10 years (Year 5) was carried out in a sample of 85 primary schools in London, Birmingham, and Leicester, with a high prevalence of ethnic minority pupils (black African-Caribbean or South Asian). All children in Year 5 classes were invited to participate. Children self-reported their frequency of consumption of takeaway meals, completed a 24 h dietary recall, had anthropometric measurements taken, and provided a fasting blood sample. Analyses were done with multilevel linear modelling allowing for clustering at school level. Ethics approval was obtained and written informed consent secured for all participants.FindingsAmong 3679 invited children, 2529 participated (69% response rate), of whom 1948 (77%) had complete data (1023 girls, 52%). They included similar numbers of children of white European (n=475), black African-Caribbean (496), South Asian (495), and other ethnic origins (482); 499 (26%) never or hardly ever consumed a takeaway meal, 894 (46%) did so less than once per week, and 555 (28%) once or more per week. In analyses adjusted for age, sex, month, school, ethnic group, and socioeconomic status, children who reported eating a takeaway meal once or more per week had higher mean total cholesterol and LDL cholesterol, by 0·09 mmoL/L (95% CI 0·01–0·18) and by 0·10 mmoL/L (0·02–0·18), respectively, than did children who never or hardly ever ate a takeaway meal; their mean fat mass index was also higher (by 5·06%, 95% CI 0·53–9·79). Mean total cholesterol, LDL cholesterol, and fat mass index in the never or hardly ever group were 4·44 mmoL/L, 2·58 mmoL/L, and 2·01 kg/m⁵, respectively. Children who reported more frequent consumption of takeaway meals had substantially higher intakes of energy, fat (percent of energy), and saturated fat (percent of energy), and lower starch, protein, and micronutrient intakes.InterpretationFrequent consumption of takeaway meals in childhood is common and is associated with higher intakes of saturated fat and higher concentrations of LDL cholesterol. This research adds to growing evidence of the adverse health effects of takeaway meals.FundingThis research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (South London) and by grants from Diabetes UK and the Wellcome Trust.     

长期住院精神分裂症患者的孤独感与共情缺陷

目的探讨长期住院精神分裂症患者的孤独感和共情缺陷特征。方法采用病例对照研究,67例住院时间超过2年的精神分裂症患者为研究组,66例病史大于2年的门诊精神分裂症患者为对照组。所有受试完成一般情况调查表、感情-社会孤独量表(ESLS)和人际反应指针量表(IRI-C)。结果①两组性别、年龄、文化程度差异均无统计学意义(P均0.05);②研究组感情-社会孤独量表总评分高于对照组[(29.78±5.58)分vs.(27.16±3.79)分],差异有统计学意义(t=-3.17,P=0.002),情感孤独与社会孤独因子分也均高于对照组,差异有统计学意义(P均0.05);③研究组IRI-C总评分低于对照组[(31.39±11.02)分vs.(39.69±9.61)分],差异有统计学意义(t=4.61,P0.001),反映共情缺陷的"同情关心"因子评分研究组低于对照组[(9.21±3.46)分vs.(11.18±2.93)分],差异有统计学意义(t=3.55,P=0.001)。结论长期住院精神分裂症患者共情缺陷和孤独感明显,需鼓励患者回归社区以缓解孤独感,降低共情缺陷。     

Seeking autonomy: Grounded theory of clinical reasoning processes during simulation based experiences

AimTo conceptualize how undergraduate nursing students’ reason and think during Simulation-Based experiences (SBE) and explore the indicators of sound clinical judgment.BackgroundNursing students’ clinical reasoning processes during Simulation Based Experiences (SBE) are not well understood and underexplored. The purpose of this study is to conceptualize how undergraduate nursing students’ reason and think during SBE.DesignA constructivist grounded theory methodology was used to explore nursing students’ clinical reasoning during SBEMethodA grounded theory methodology was used to explore nursing students’ clinical reasoning during SBE. A purposive sample was used to recruit participants including 32 third-year nursing students. Data collection using semi-structured interviews conducted over 9 months in 2020–2021. The interviews were recorded and transcribed verbatim and the data were analyzed using the logic of constant comparison supported by memoing, theoretical sampling and conceptual mapping.ResultsSeeking autonomy is the core category that emerged from the participants’ responses that conceptualizes the students' reasoning process during SBEs.ConclusionEvidence from this grounded theory study adds validation to the practice of using SBEs to support students’ clinical reasoning process and prepare them to be competent in clinical practice.     

Poverty and outcomes of people with severe mental disorders in rural China: a 21-year survey

Background

Little is known about the relationship between poverty and outcomes of severe mental illness (SMI) during a period of sustained rapid socioeconomic development. This study explored the relationship between poverty and outcomes of people with SMI in a 21-year longitudinal study in a rural area of China.

阻塞性睡眠呼吸暂停低通气综合征患者的人格心理特征及社会功能的相关分析

目的调查分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的人格心理特征。方法参考多导睡眠监测(PSG)结果,将确诊的60例OSAHS患者和30例单纯鼾症患者(对照组)纳入本研究,采用Epworth嗜睡程度量表(ESS)和多次小睡潜伏期测验(MSLT)评价患者的日间嗜睡情况,采用明尼苏达多相人格量表(MMPI)评估患者的人格心理状况;采用简明健康状况调查表(SF-36)、疲劳量表(FS-14)、注意缺陷量表分别评价患者生活质量、疲劳程度、注意缺陷程度。结果①与对照组相比,OSAHS组MMPI疑病分量表(Hs)平均得分更高[(56.0±9.1)vs.(52.0±6.6),P0.05],高T分临床分量表(T分数60分)的平均个数更多[(2.4±2.1)vs.(0.6±1.0),P0.01],OSAHS组Hs、Hy、Pd、D、Pt、Sc分量表T分数得分60分的患者例数高于对照组(P0.05或0.01)。②MMPI测图中高T分分量表数≥4的患者(残疾组)SF-36总分和各维度平均分均低于高T分分量表数=0的患者(正常组),FS-14、注意缺陷平均分高于正常组;2≤高T分分量表数≤3的患者(中度异常组)SF-36总分和大部分维度平均分低于正常组,注意缺陷平均分高于正常组。③在所有受试者中,MMPI总平均分与总睡眠时间(TST)、总微觉醒指数(TAI)、SF-36总分及各维度平均分呈负相关(P0.05或0.01),与FS-14、注意缺陷平均分呈正相关(P0.01)。结论与单纯鼾症患者相比,OSAHS患者表现了更多的疑病、抑郁、癔症、精神病态行为、精神衰弱和精神分裂症等人格心理问题。OSAHS患者和单纯鼾症患者的夜间睡眠时间、睡眠的连续性和白天功能可能受到其心理症状严重程度的影响。     

Does motilin stimulate the gastrointestinal motility of the pig? In vitro study using smooth muscle strips and dispersed muscle cells

To clarify the physiological role of motilin in the pig gastrointestinal (GI) tract, effect of Leu¹³-porcine motilin (LMT) on the contractility of GI smooth muscle was investigated in studies using isolated muscle strips and dispersed muscle cells. LMT produced no contraction in either longitudinal muscle (LM) or circular muscle (CM) of the stomach (fundus, corpus, antrum), duodenum, ileum and colon even at 1 μM. Pretreatment with LMT (1 nM-1 μM) did not potentiate the contractile response to acetylcholine (ACh) in each muscle strip. Dispersed cells from the duodenum responded to ACh in a concentration-dependent manner (EC₅₀= 10 pM), but not to LMT even at a high concentration (10 μM). Electrical field stimulation (EFS) caused a frequency-dependent (0.2–10 Hz) contraction of the duodenal LM that was almost completely inhibited by atropine or tetrodotoxin. EFS caused the relaxation of duodenal CM in a frequency-dependent manner (0.1–10 Hz). This relaxation was not inhibited by atropine, propranolol, phentolamine or guanethidine, indicating the involvement of noncholinergic, nonadrenergic (NCNA) nerves. N^G-nitro l-arginine methylester (l-NAME, 100 μM) attenuated the EFS-induced relaxation and the inhibition at low frequency was larger than that at high frequency. l-Arginine prevented the inhibition by l-NAME but d-arginine did not. LMT (1 nM-1 μM) had no influence on EFS-induced cholinergic contraction of LM and EFS-induced NCNA relaxation of CM layer. The present in vitro studies indicate that motilin is ineffective in producing contraction and in modulating the autonomic neuroeffector transmission of the pig GI smooth muscle, and suggest that pig GI smooth muscle lacks functional motilin receptors.