翻转课堂教学法在天然药物化学实验中的应用

目的利用翻转课堂教学法改进传统的天然药物化学实验课教学模式,提高该课程的教学效果。方法从实验教学的课程设计与开发,课前自主学习、课中内化及课后评估和讨论等环节进行了一系列的探讨与改革。结果翻转课堂教学模式为解决学生长期以来在天然药物化学实验课中缺乏主动参与性、探索性等问题提供一剂良方。结论在天然药物化学实验课教学中引入翻转课堂教学模式的初步探索为天然药物化学实验课的改革提供了依据和思路。     

A novel H7N3 reassortant originating from the zoonotic H7N9 highly pathogenic avian influenza viruses that has adapted to ducks

The first human case of zoonotic H7N9 avian influenza virus (AIV) infection was reported in March 2013 in China. This virus continues to circulate in poultry in China while mutating to highly pathogenic AIVs (HPAIVs). Through monitoring at airports in Japan, a novel H7N3 reassortant of the zoonotic H7N9 HPAIVs, A/duck/Japan/AQ‐HE30‐1/2018 (HE30‐1), was detected in a poultry meat product illegally brought by a passenger from China into Japan. We analysed the genetic, pathogenic and antigenic characteristics of HE30‐1 by comparing it with previous zoonotic H7N9 AIVs and their reassortants. Phylogenetic analysis of the entire HE30‐1 genomic sequence revealed that it comprised at least three different sources; the HA (H7), PB1, PA, NP, M and NS segments of HE30‐1 were directly derived from H7N9 AIVs, whereas the NA (N3) and PB2 segments of HE30‐1 were unrelated to zoonotic H7N9. Experimental infection revealed that HE30‐1 was lethal in chickens but not in domestic or mallard ducks. HE30‐1 was shed from and replicated in domestic and mallard ducks and chickens, whereas previous zoonotic H7N9 AIVs have not adapted well to ducks. This finding suggests the possibility that HE30‐1 may disseminate to remote area by wild bird migration once it establishes in wild bird population. A haemagglutination‐inhibition assay indicated that antigenic drift has occurred among the reassortants of zoonotic H7N9 AIVs; HE30‐1 showed similar antigenicity to some of those H7N9 AIVs, suggesting it might be prevented by the H5/H7 inactivated vaccine that was introduced in China in 2017. Our study reports the emergence of a new reassortant of zoonotic H7N9 AIVs with novel viral characteristics and warns of the challenge we still face to control the zoonotic H7N9 AIVs and their reassortants.     

力量支持协同护理模式在经口喂养不耐受<34孕周新生儿中的应用

目的:探讨力量支持协同护理模式在经口喂养不耐受<34孕周新生儿中的应用效果。方法:选取2019年1月—2020年8月收治的102例<34孕周经口喂养不耐受新生儿作为研究对象,将2019年1月—2019年10月接受常规护理的51例患儿作为对照组,将2019年11月—2020年8月接受力量支持协同护理模式的51例患儿作为观察组。比较两组经口喂养进程(留置胃管时间、过渡时间、住院时间)、喂养效率及患儿行为状态变化。结果:观察组患儿留置胃管时间、过渡时间、住院时间均短于对照组(P<0.05);观察组患儿干预第3天、实现全口喂养时吸吮效率和喂养效率均高于对照组(P<0.05);观察组患儿干预3 d、干预5 d后行为状态优于对照组(P<0.05)。结论:力量支持协同护理模式能有效改善早产儿经口喂养表现,减轻经口喂养不耐受症状,进一步推进经口喂养进程,缩短经口喂养过渡时间。     

Early Postpartum Maternal and Newborn Responses to Auditory,Tactile, Visual,Vestibular, and Olfactory Stimuli

ObjectiveTo compare maternal psychological well-being, newborn behavior, and maternal and newborn salivary oxytocin (OT) and cortisol before and after two maternally administered multisensory behavioral interventions or an attention control group.DesignRandomized prospective clinical trial.SettingU.S. Midwest community hospital.ParticipantsNewborns and their mothers (n = 102 dyads) participated. Mothers gave birth vaginally at term gestation and had no physical or mental health diagnoses. Newborns with low Apgar scores, receipt of oxygen, suspected infection, or congenital anomalies were excluded.MethodsDyads were randomly assigned to the auditory, tactile, visual, and vestibular (ATVV) intervention, the ATVV with odor from a baby lotion (ATVVO), or the attention control (AC) Group. Maternal psychological well-being, newborn behavior, and endocrine responses (salivary cortisol and OT) were measured before and after the intervention.ResultsNewborns in the ATVV and ATVVO groups exhibited increases in potent engagement behaviors (p < .0001 and p = .001, respectively). Newborns in the AC group exhibited a decrease in potent engagement (p = .013) and an increase in potent disengagement (p = .029). Mothers in the ATVVO group exhibited an increase in OT (p = .01) and the largest change in OT (p = .02) compared to mothers in the ATVV and AC groups. We noted no change in maternal psychological well-being or newborn endocrine responses.ConclusionInclusion of an odor via lotion with a behavioral intervention (ATVV) influenced maternal OT more than the behavioral intervention alone. Newborns were behaviorally responsive to the interventions; however, endocrine measures were not associated with intervention changes.     

Interoception Primes Emotional Processing: Multimodal Evidence from Neurodegeneration

Recent frameworks in cognitive neuroscience and behavioral neurology underscore interoceptive priors as core modulators of negative emotions. However, the field lacks experimental designs manipulating the priming of emotions via interoception and exploring their multimodal signatures in neurodegenerative models. Here, we designed a novel task that involves interoceptive and control-exteroceptive priming conditions followed by post-interoception and post-exteroception facial emotion recognition (FER). We recruited 114 participants, including healthy controls (HCs) as well as patients with behavioral variant frontotemporal dementia (bvFTD), Parkinson''s disease (PD), and Alzheimer''s disease (AD). We measured online EEG modulations of the heart-evoked potential (HEP), and associations with both brain structural and resting-state functional connectivity patterns. Behaviorally, post-interoception negative FER was enhanced in HCs but selectively disrupted in bvFTD and PD, with AD presenting generalized disruptions across emotion types. Only bvFTD presented impaired interoceptive accuracy. Increased HEP modulations during post-interoception negative FER was observed in HCs and AD, but not in bvFTD or PD patients. Across all groups, post-interoception negative FER correlated with the volume of the insula and the ACC. Also, negative FER was associated with functional connectivity along the (a) salience network in the post-interoception condition, and along the (b) executive network in the post-exteroception condition. These patterns were selectively disrupted in bvFTD (a) and PD (b), respectively. Our approach underscores the multidimensional impact of interoception on emotion, while revealing a specific pathophysiological marker of bvFTD. These findings inform a promising theoretical and clinical agenda in the fields of nteroception, emotion, allostasis, and neurodegeneration.SIGNIFICANCE STATEMENT We examined whether and how emotions are primed by interoceptive states combining multimodal measures in healthy controls and neurodegenerative models. In controls, negative emotion recognition and ongoing HEP modulations were increased after interoception. These patterns were selectively disrupted in patients with atrophy across key interoceptive-emotional regions (e.g., the insula and the cingulate in frontotemporal dementia, frontostriatal networks in Parkinson''s disease), whereas persons with Alzheimer''s disease presented generalized emotional processing abnormalities with preserved interoceptive mechanisms. The integration of both domains was associated with the volume and connectivity (salience network) of canonical interoceptive-emotional hubs, critically involving the insula and the anterior cingulate. Our study reveals multimodal markers of interoceptive-emotional priming, laying the groundwork for new agendas in cognitive neuroscience and behavioral neurology.     

La prise en charge du sujet âgé dépressif en thérapies cognitivo-comportementales : aspects pratiques et spécificités

Cognitive behavioral therapy (CBT) has been shown to be an effective approach for a wide range of psychological problems affecting older adults. A variety of empirical and clinical papers have examined modifications to the content and delivery of CBT to enhance its efficacy with older adults. But when mental health problems do occur in the elderly, these problems are often overlooked. Thus, only a fraction of elderly persons with psychological distress receive effective treatment despite evidence that interventions can be effective for the elderly. It is important to be aware of mental health symptoms, particularly depression, and to be knowledgeable about the various treatment options available and effective for adults in later stages of life. Depression is significant problem among the elderly. Due to complexities in the medical management of elderly patients, researchers and clinicians have sought psychosocial alternatives to pharmacotherapy in order to treat depression in the elderly. Cognitive-behavioral therapy in particular has been investigated as a promising treatment. Research conducted to date has established that cognitive-behavioral therapy produces significant improvement in depression symptoms among the elderly. Issues around optimizing the structure of CBT with older adults are presented, along with suggestions for realizing these changes within a clinical context.     

Internet-delivered exposure therapy versus internet-delivered cognitive behavioral therapy for panic disorder: A pilot randomized controlled trial

AimTo compare the efficacy and acceptability of internet-delivered exposure therapy for panic disorder, to multi-component internet-delivered cognitive behavioral therapy (iCBT) that included controlled breathing, cognitive restructuring and exposure.MethodsParticipants with panic disorder, with or without agoraphobia, were randomized to internet-delivered exposure therapy (n = 35) or iCBT (n = 34). Both programs were clinician guided, with six lessons delivered over eight weeks. Outcomes included panic disorder and agoraphobia symptom severity, as well as depression symptom severity, functional impairment and days out of role.ResultsParticipants in both conditions displayed a large reduction in panic disorder symptom severity (ds >1.30) from pre- to post-treatment. Participants in both conditions displayed medium to large reduction in agoraphobia and depression symptom severity, functional impairment and days out of role. Effects were maintained at three- and six-month follow-up. There was no significant difference between the interventions in clinical outcomes, adherence or treatment satisfaction.ConclusionsInternet-delivered exposure therapy appeared to be as acceptable and efficacious as more established iCBT, despite including less strategies. However, a fully powered replication is now needed to compare the two approaches.