Atypical attention to voice in toddlers and pre-schoolers with autism spectrum disorder is related to unimpaired cognitive abilities. An ERP study

BackgroundSound perception in autism spectrum disorder (ASD) is usually at typical levels, even when auditory stimuli carry a social value, as it is the case for speech. Nevertheless, orienting to sounds in a speech context might be atypical in some individuals with ASD, which in ERP studies is reflected by a diminished P3a component. As P3 values and cognitive abilities seem to be inversely related under some circumstances, the current study investigates whether diminished attentional orienting to sounds in speech is equally observable in children with ASD with and without developmental delay (DD).MethodChildren with typical development (TD, n = 17) or ASD, with or without comorbid DD (ASD/DD, n = 22, and ASD/noDD, n = 12), aged 1.5 through 4 years took part in a passive auditory oddball task while EEG data were recorded. The paradigm consisted in the presentation of two deviant stimuli (one vowel sound and one complex tone) either in a speech or in a non-speech context.ResultsWe found overall more negative MMN voltages in both ASD groups compared to TD. For P3a mean voltages, we found an attenuated response in children ASD/noDD when deviant tones were presented in speech, but not in other conditions. Children with ASD/DD did not differ from TD in P3a mean voltages.ConclusionAtypical speech sound processing might be more accentuated in children with ASD/noDD than in their peers with comorbid DD. This finding is interpreted within the theoretical framework of neural adaptation.     

Phenomenology of OCD: Lessons from a large multicenter study and implications for ICD-11

This study aimed to investigate the phenomenology of obsessive–compulsive disorder (OCD), addressing specific questions about the nature of obsessions and compulsions, and to contribute to the World Health Organization's (WHO) revision of OCD diagnostic guidelines. Data from 1001 patients from the Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders were used. Patients were evaluated by trained clinicians using validated instruments, including the Dimensional Yale–Brown Obsessive–Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, and the Brown Assessment of Beliefs Scale. The aims were to compare the types of sensory phenomena (SP, subjective experiences that precede or accompany compulsions) in OCD patients with and without tic disorders and to determine the frequency of mental compulsions, the co-occurrence of obsessions and compulsions, and the range of insight. SP were common in the whole sample, but patients with tic disorders were more likely to have physical sensations and urges only. Mental compulsions occurred in the majority of OCD patients. It was extremely rare for OCD patients to have obsessions without compulsions. A wide range of insight into OCD beliefs was observed, with a small subset presenting no insight. The data generated from this large sample will help practicing clinicians appreciate the full range of OCD symptoms and confirm prior studies in smaller samples the degree to which insight varies. These findings also support specific revisions to the WHO's diagnostic guidelines for OCD, such as describing sensory phenomena, mental compulsions and level of insight, so that the world-wide recognition of this disabling disorder is increased.     

Vitamin B6 catabolism and lung cancer risk: results from the Lung Cancer Cohort Consortium (LC3)

BackgroundIncreased vitamin B6 catabolism related to inflammation, as measured by the PAr index (the ratio of 4-pyridoxic acid over the sum of pyridoxal and pyridoxal-5'-phosphate), has been positively associated with lung cancer risk in two prospective European studies. However, the extent to which this association translates to more diverse populations is not known.Materials and methodsFor this study, we included 5323 incident lung cancer cases and 5323 controls individually matched by age, sex, and smoking status within each of 20 prospective cohorts from the Lung Cancer Cohort Consortium. Cohort-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between PAr and lung cancer risk were calculated using conditional logistic regression and pooled using random-effects models.ResultsPAr was positively associated with lung cancer risk in a dose-response fashion. Comparing the fourth versus first quartiles of PAr resulted in an OR of 1.38 (95% CI: 1.19–1.59) for overall lung cancer risk. The association between PAr and lung cancer risk was most prominent in former smokers (OR: 1.69, 95% CI: 1.36–2.10), men (OR: 1.60, 95% CI: 1.28–2.00), and for cancers diagnosed within 3 years of blood draw (OR: 1.73, 95% CI: 1.34–2.23).ConclusionBased on pre-diagnostic data from 20 cohorts across 4 continents, this study confirms that increased vitamin B6 catabolism related to inflammation and immune activation is associated with a higher risk of developing lung cancer. Moreover, PAr may be a pre-diagnostic marker of lung cancer rather than a causal factor.     

四川省色达县居民棘球蚴病防治知信行调查及影响因素分析

目的了解四川省色达县居民棘球蚴病防治知识、态度和行为现状及其影响因素,为当地进一步实施健康教育干预措施提供科学依据。方法 2018年9月,采用多阶段分层随机抽样方法,共抽取10个乡(镇),每个乡(镇)随机抽取2~3个行政村,每个村随机抽取20~40户,每户调查1~2名村民。采用入户问卷调查了解调查居民棘球蚴病防治知识、态度和行为情况,采用χ~2检验及logistic回归分析对影响居民防治知识合格率的因素进行分析。结果本次调查共发放问卷760份,回收有效问卷748份,问卷回收率为98.42%。色达县居民棘球蚴病防治知识合格率为56.42%(422/748),其中"人是怎样感染棘球蚴的?"知晓率仅为48.40%;调查对象棘球蚴病防治积极态度持有率在64.71%~94.79%,防治行为正确率在10.40%~82.45%。单因素分析表明,居民棘球蚴病防治知识合格率影响因素包括性别、职业、受教育程度、是否曾经接受棘球蚴病筛查服务及健康教育(P均<0.05);二分类logistic回归分析结果显示,女性、主要职业为牧民、小学及以下受教育程度、未接受过棘球蚴病筛查服务及健康教育是导致防治知识知晓率不合格的影响因素(P均<0.05)。结论四川省色达县居民棘球蚴病防治知识知晓率偏低、行为正确率不高,需因地制宜地采取多种形式加强疾病防治知识宣传,并进行适当行为干预。     

基于西南地区居民EQ-5D-5L量表信效度评价

  目的  探究EQ-5D-5L量表应用于我国西南地区人群中生命质量评价的信度和效度。  方法  采用克朗巴哈α系数（Cronbach’s α）测量量表的内部一致性信度,探索性因子分析结合验证性因子分析测量结构效度、聚敛效度和区分效度。  结果  Cronbach’s α系数为0.857,探索性因子分析提取2个方差累计贡献率为77.311%的公因子,第一公因子代表行动能力、自己照顾自己能力和日常活动能力,第二公因子代表疼痛或不舒服、焦虑或抑郁。验证性因子分析两个公因子的相关性为0.659,第一公因子平均方差变异为0.862且组合信度为0.949,第二公因子的平均方差提取值为0.587且组合信度为0.739,四处走动、自我照顾和日常活动在第一公因子上的载荷分别为0.871、0.945和0.967,疼痛或不舒服、焦虑或沮丧在第二公因子上的载荷分别为0.708和0.820。  结论  EQ-5D-5L在应用于西南地区居民测量生命质量有较好的信度和效度。     

The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial

ObjectiveThis study was intended to examine the efficacy of lavender essential oil for the alleviation of fatigue in haemodialysis patients.Methods and materialsThis randomized clinical trial was conducted on 59 haemodialysis patients in two groups. The routine care group received the routine care, but the experimental group inhaled lavender essence 5% for 10 min, three times a week for 4 consecutive weeks. The Fatigue Severity Scale was used to assess fatigue before the intervention and after the last intervention in the second and fourth weeks.ResultsNo statistically significant differences were observed between the two groups in terms of the fatigue scores before, and after the last intervention in the second and fourth weeks.ConclusionOur result does not support other studies suggesting that lavender essential oil is effective on fatigue in haemodialysis patients. This conflicting result can mostly be ascribed to a variety of factors such as duration of aromatherapy and differences in concentrations of lavender essential oil.     

Effects of thermotherapy and transcutaneous electrical nerve stimulation on patients with primary dysmenorrhea: A randomized,placebo-controlled,double-blind clinical trial

ObjectivesTo evaluate the effects of thermotherapy and transcutaneous electrical nerve stimulation (TENS) on pain intensity, pressure pain threshold (PPT) and conditioned pain modulation (CPM) in patients with primary dysmenorrhea (PD).DesignA randomized, placebo-controlled, double-blind clinical trial.SettingPhysiotherapy Department of the Universidade Cidade de São Paulo, São Paulo (Brazil).InterventionsEighty-eight dysmenorrheic women were randomly allocated into four groups: Thermotherapy + TENS(n = 22), Thermotherapy(n = 22), TENS(n = 22) and Placebo(n = 22). Thermotherapy was applied by microwave diathermy (20 min), and TENS (200 μs, 100 Hz, 30 min), into the lower abdomen both.Main outcome measuresPain intensity was measured using the numeric rating scale (NRS) and the McGill Pain Questionnaire (Br-MPQ). PPT and CPM were recorded from women’s abdominal and lumbar. The evaluation was done in 5 times: baseline, after 20, 50, 110 min and 24 h from intervention.ResultsThere was a significant decrease in the NRS for Thermotherapy + TENS vs. TENS, for Thermotherapy vs. TENS and for Placebo, after 20 min; for Thermotherapy vs. TENS and for Placebo, after 110 min and 24 h. Abdome PPT increased in the Thermotherapy + TENS vs. TENS and Placebo, after 50 min; for Thermotherapy + TENS vs. Placebo and for Thermotherapy vs. Placebo, after 110 min. No changes in lumbar PPT and CPM were observed.ConclusionsThe use of thermotherapy reduced NRS compared to the TENS and Placebo after 20, 110 min and 24 h. Thermotherapy demonstrated an increase in the PPT in the abdomen after 50 and 110 min and decreased the Br-MPQ scores after 110 min in patients with PD.     

Platelet/Lymphocyte Ratio Is Superior to Neutrophil/Lymphocyte Ratio as a Predictor of Chemotherapy Response and Disease-free Survival in Luminal B-like (HER2−) Breast Cancer

BackgroundThe neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been associated with the prognosis in breast cancer (BC). The relationship of the NLR and PLR with chemotherapy sensitivity and prognosis in luminal B-like (human epidermal growth factor receptor 2-negative [HER2⁻]) BC are not well studied.Patients and MethodsThe clinical data from 980 patients with luminal B-like (HER2⁻) BC from June 2012 to June 2016 were collected. The differences among the variables were calculated using the χ² test. The associations among the clinicopathologic factors, pretreatment NLR, pretreatment PLR, and disease-free survival (DFS) were analyzed using Kaplan-Meier curves and Cox analyses.ResultsThe median follow-up was 37 months (range, 5-77 months). For the 480 patients who had received neoadjuvant chemotherapy, low pretreatment PLR values were associated with higher pathologic complete response (pCR) rates compared with the high PLR group (15.8% for low vs. 9.2% for high PLR group; P = .027). Multivariate analyses showed that larger tumors, a greater number of lymph nodes involved, a high Ki-67 score, and a high PLR were independent prognostic factors of worse outcomes for the patients with luminal B-like (HER2⁻) BC. The risk of metastasis and/or recurrence was greater for the high PLR group than for the low PLR group (hazard ratio, 1.576; 95% confidence interval, 1.039-2.390; P = .032). The pretreatment NLR showed no such associations among this cohort of patients.ConclusionsThe results of the present study have shown that the pretreatment PLR is superior to the NLR as a predictor of pCR and DFS outcomes in patients with luminal B-like (HER2⁻) BC. A low pretreatment PLR was associated with higher pCR rates after neoadjuvant chemotherapy and was an independent predictive factor for better DFS outcomes among patients with luminal B-like (HER2⁻) BC.     

西部贫困农村地区健康信息传播对婴幼儿母亲科学喂养认知的促进

目的 明晰西部贫困农村地区健康信息传播模式对婴幼儿母亲母乳喂养认知的影响,为提高该类地区妇女的婴幼儿喂养认知,从而改善婴幼儿的健康状况,提供科学建议。 方法 分别于2014年、2019年在我国西部贫困农村地区,选取24月龄及以下婴幼儿及其母亲为研究对象,通过问卷调查收集其人口学特征、健康信息传播模式、科学喂养认知等资料。运用回归分析健康信息传播模式对婴幼儿母亲的科学喂养认知的影响。 结果 共纳入1 284对（2014年）、1 049对（2019年）母婴。2019年婴幼儿母亲早开奶知晓率（72.64%）、纯母乳喂养知晓率（31.36%）均分别显著高于2014年（65.73%,25.30%）（均 P < 0.05）。在信息传播模式中,70.54%的婴幼儿母亲主要通过基层医务工作者获取喂养信息。回归分析显示,基层医务工作者结合信息传播材料传递母乳喂养信息( OR = 2.23, 95% CI 1.03～4.85)促进了婴幼儿母亲的早开奶认知;基层医务工作者传播母乳喂养信息( OR = 1.57, 95% CI 1.04～2.38)、基层医务工作者与亲友协同传播母乳喂养信息的交互作用( OR = 2.39, 95% CI 1.48～3.87)促进了婴幼儿母亲纯母乳喂养认知。 结论 以基层医务工作者为核心的母乳喂养信息传播模式促进了西部贫困农村地区婴幼儿母亲早开奶、纯母乳喂养的认知。