Modeling severely discordant hematocrits and normal amniotic fluids after incomplete laser therapy in twin-to-twin transfusion syndrome

Our objective was to explain the clinical presentations of sustained arteriovenous anastomotic transfusion of blood after incomplete laser therapy in twin-to-twin transfusion syndrome (TTTS). We extended our mathematical model of TTTS by adding the dynamics of hematocrit, and simulated incomplete laser therapy, first, by leaving one patent opposite arteriovenous anastomosis from the recipient to the donor and, second, by leaving one patent arteriovenous anastomosis from the donor to the recipient. In both simulations we reproduced the clinical observation of severe hematocrit discordance preceding delayed amniotic fluid imbalance. In conclusion, incomplete laser therapy may cause a severe circulatory imbalance between the twins which presents predominantly as discordant hematocrits rather than discordant amniotic fluid volumes as in primary TTTS. These results imply that the anemia-polycythemia sequence is a sensitive mechanism to identify transfusion reversal after complicated laser therapy, confirming the suggested role of middle cerebral artery peak systolic velocity Doppler measurements as a useful method of follow-up.     

基于立体MDT模式引导下2型糖尿病患者临床护理路径的构建与应用

目的 构建基于立体MDT模式引导下2型糖尿病(T2DM)患者临床护理路径,旨在使临床护理工作流程化、路径化.方法 以住院患者需求调查表与患者舒适度调查表为横断面调查工具,对2018年1月～11月在我院内分泌科接受住院治疗的80例T2DM患者的护理需求、满意度及舒适状况进行横断面调查,为基于立体MDT模式引导下T2DM患...     

Cocktails of Mycotoxins,Phytoestrogens, and Other Secondary Metabolites in Diets of Dairy Cows in Austria: Inferences from Diet Composition and Geo-Climatic Factors

Dairy production is a pivotal economic sector of Austrian and European agriculture. Dietary toxins and endocrine disruptors of natural origin such as mycotoxins and phytoestrogens can affect animal health, reproduction, and productivity. This study characterized the profile of a wide spectrum of fungal, plant, and unspecific secondary metabolites, including regulated, emerging, and modified mycotoxins, phytoestrogens, and cyanogenic glucosides, in complete diets of lactating cows from 100 Austrian dairy farms. To achieve this, a validated multi-metabolite liquid chromatography/electrospray ionization–tandem mass spectrometric (LC/ESI–MS/MS) method was employed, detecting 155 of >800 tested metabolites. Additionally, the most influential dietary and geo-climatic factors related to the dietary mycotoxin contamination of Austrian dairy cattle were recognized. We evidenced that the diets of Austrian dairy cows presented ubiquitous contamination with mixtures of mycotoxins and phytoestrogens. Metabolites derived from Fusarium spp. presented the highest concentrations, were the most recurrent, and had the highest diversity among the detected fungal compounds. Zearalenone, deoxynivalenol, and fumonisin B1 were the most frequently occurring mycotoxins considered in the EU legislation, with detection frequencies >70%. Among the investigated dietary factors, inclusion of maize silage (MS) and straw in the diets was the most influential factor in contamination with Fusarium-derived and other fungal toxins and metabolites, and temperature was the most influential among the geo-climatic factors.     

养老机构老年人心理社会支持服务需求Kano属性及影响因素分析

目的 探讨养老机构老年人心理社会支持服务需求属性及其影响因素.方法 于2019年2-6月抽取四川省27家养老机构内773名老年人为调查对象,采用一般资料调查表、孤独感量表(U L S-8)、社会网络量表(LSNS)及自制养老机构老年人心理社会支持服务需求卡诺(Kano)属性问卷进行调查.结果 在改进Kano模型细分下,11项心理社会支持服务可以划分为2项比较必备型需求(M1),4项期望型需求(O),1项不太魅力型需求(A3),4项无差异型需求(I);因子分析结果显示,机构老年人的心理社会支持服务需求可以划分为心理抚慰需求、支持保障需求、互助参与需求3种属性特征;多元线性逐步回归结果显示,孤独感、功能性共患病指数、年龄是老年人心理抚慰需求的主要影响因素,每月机构照护费用、退休前职业、文化程度是老年人支持保障需求的主要影响因素,每月机构照护费用、户口所在地、文化程度、年龄是老年人互助参与需求的主要影响因素.结论 本研究中养老机构老年人有较高的心理社会支持服务需求,机构应注意在对老年人的心理社会服务需求进行属性划分的基础上进行服务需求的针对性满足.     

The photobiology of the human circadian clock

In modern society, the widespread use of artificial light at night disrupts the suprachiasmatic nucleus (SCN), which serves as our central circadian clock. Existing models describe excitatory responses of the SCN to primarily blue light, but direct measures in humans are absent. The combination of state-of-the-art neuroimaging techniques and custom-made MRI compatible light-emitting diode devices allowed to directly measure the light response of the SCN. In contrast to the general expectation, we found that blood oxygen level–dependent (BOLD) functional MRI signals in the SCN were suppressed by light. The suppressions were observed not only in response to narrowband blue light (λ_max: 470 nm) but remarkably, also in response to green (λ_max: 515 nm) and orange (λ_max: 590 nm), but not to violet light (λ_max: 405 nm). The broadband sensitivity of the SCN implies that strategies on light exposure should be revised: enhancement of light levels during daytime is possible with wavelengths other than blue, while during nighttime, all colors are potentially disruptive.

Due to the Earth’s rotation around its axis, many organisms developed an internal clock to anticipate the predictable changes in the environment that occur every 24 h, including the daily light–dark cycle. In mammals, this clock is located in the suprachiasmatic nucleus (SCN), located in the hypothalamus directly above the optic chiasm (1, 2). The SCN receives information from the retina regarding ambient light levels via intrinsically photosensitive retinal ganglion cells (ipRGCs), thus synchronizing its internal clock to the external light–dark cycle. ipRGCs contain the photopigment melanopsin, which is maximally sensitive to blue light, with a peak response to 480-nm light (3, 4). In addition, ipRGCs also receive input from rod cells and cone cells (5–7). The three cone cell subtypes in the human retina respond maximally to 420-nm, 534-nm, and 563-nm light, while rod cells respond maximally to 498-nm light (8). In rodents, input from cone cells renders the SCN sensitive to a broad spectrum of wavelengths (9), while rod cells mediate the SCN’s sensitivity to low-intensity light (10, 11). Recently, these findings in rodents were proposed to translate to humans (12), suggesting that the human clock is not only sensitive to blue light, but may also be sensitive to other colors.In humans, circadian responses to light are generally measured indirectly (e.g., by measuring melatonin levels or 24-h behavioral rhythms). These indirect measures revealed that circadian responses to light in humans are most sensitive to blue light (13–16); however, green light has also been found to contribute to circadian phase shifting and changes in melatonin to a larger extent than would have been predicted based solely on the melanopsin response, suggesting that rods and/or cones may also provide functional input to the circadian system in humans (17). Despite this indirect evidence suggesting that several colors can affect the human circadian clock, this has never been measured directly due to technical limitations. Thus, current guidelines regarding the use of artificial light are based solely on the clock’s sensitivity to blue light. For example, blue light is usually filtered out in electronic screens during the night (18, 19), and blue-enriched light is used by night shift workers to optimize their body rhythm for achieving maximum performance (20–22).The ability to directly image the human SCN in vivo has been severely limited due to its small size and the relatively low spatial resolution provided by medical imaging devices. Previous functional MRI (fMRI) studies using 3-Tesla (3T) scanners were restricted to recording the “suprachiasmatic area,” which encompasses a large part of the hypothalamus and thus includes many other potentially light-sensitive nuclei (23–25). To overcome this limitation, we used a 7T MRI scanner, which can provide images with sufficiently high spatial resolution to image small brain nuclei (26) such as the SCN. Here, we applied colored light stimuli to healthy volunteers using a custom-designed MRI-compatible light-emitting diode (LED) device designed to stimulate specific photoreceptors while measuring SCN activity using fMRI. Using analytical approaches, we then identified the SCN’s response, the smallest brain nucleus that has so far been imaged. We found that the human SCN responds to a broad range of wavelengths (i.e., blue, green and orange light). Surprisingly, we also found that the blood oxygen level–dependent (BOLD) fMRI signal at the SCN is actually suppressed—not activated—by light.     

护理专案对消毒供应中心精密器械过程损坏率及工作质量满意度的影响分析

目的：研究分析消毒供应中心精密手术器械管理中应用护理专案的效果。方法：以2020年1月～6月从本院手术室回收的精密手术器械200件及同期手术室23名手术组人员为对照组采用常规管理模式,以2020年7月～12月从本院手术室回收的精密手术器械200件及同期手术室22名手术组人员为研究组采用护理专案管理模式,以精密手术器械过程损坏率、消毒供应中心工作质量满意度作为本次研究的观察指标。结果：与对照组相比,研究组精密手术器械过程损坏率更低（P<0.05）,且研究组手术人员对消毒供应中心工作质量满意度明显更高（P<0.05）。结论：应用护理专案能够有效降低精密手术器械过程损坏率,提高手术人员对消毒供应中心工作质量满意度。     

高分压氧体外抑制大鼠脾脏淋巴细胞功能及N-乙酰半胱氨酸的预防作用

目的 :观察高分压氧体外暴露对脾淋巴细胞功能的影响及 N-乙酰半胱氨酸 (NAC)的预防作用。 方法 :分离成年大鼠脾脏淋巴细胞 ,制成细胞悬液 ,置于压力舱内以 4 0 0 k Pa氧气 (含 1.5 % CO2 )培养 4 h。 NAC预防组在培养液中加入 30mm ol/ L NAC。用流式细胞术测定淋巴细胞亚型 ,3H- Td R掺入法测定淋巴细胞增殖反应及 EL ISA法测定细胞经刀豆球蛋白(Con A )刺激后分泌的 IL - 2水平。 结果 :经高分压氧处理后 ,脾淋巴细胞 CD3+ 、CD4 + CD3+ 及 CD8+ CD3+ 比例均显著下降(P<0 .0 1,P<0 .0 5 ) ,CD4 + CD3+ / CD8+ CD3+ 比值未有变化 ;淋巴细胞增殖率及经 Con A刺激后的 IL - 2分泌量显著减少(P<0 .0 1,P<0 .0 5 )。培养液中添加 30 mm ol/ L NAC后 ,各指标值的下降程度均明显减轻 (P<0 .0 1,P<0 .0 5 )。 结论 :高分压氧对离体大鼠脾淋巴细胞功能有直接抑制作用 ,NAC能部分预防该抑制作用。     

Disgust and Self-Disgust in Eating Disorders: A Systematic Review and Meta-Analysis

Disgust and self-disgust are aversive emotions which are often encountered in people with eating disorders. We conducted a systematic review and meta-analysis of disgust and self-disgust in people with eating disorders using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The systematic review of the literature revealed 52 original research papers. There was substantial heterogeneity regarding the research question and outcomes. However, we found 5 articles on disgust elicited by food images, 10 studies on generic disgust sensitivity, and 4 studies on self-disgust, and we proceeded to a meta-analytic approach on these studies. We found that women with eating disorders have significantly higher momentary disgust feelings in response to food images (1.32; 95% CI 1.05, 1.59), higher generic disgust sensitivity (0.49; 95% CI 0.24, 0.71), and higher self-disgust (1.90; 95% CI 1.51, 2.29) compared with healthy controls. These findings indicate the potential clinical relevance of disgust and self-disgust in the treatment of eating disorders.     

人体慢性肝病和肝癌的定量病理诊断研究（Ⅰ. 慢性肝病及肝癌的形态定量分析）

利用自动化图象分析技术对轻度慢性肝炎、重度慢性肝炎、小结节肝硬变、大结节肝硬变、癌周肝硬变和肝细胞癌等6种慢性肝病及正常对照共67例样本,分别作了13项参数的形态定量研究和肝细胞DNA含量测定分析．结果：结合两种形态定量方法,除重度慢性肝炎和大结节肝硬变间差异无显著性外,其余各组间均有显著性差异,提示肝细胞形态及DNA含量参数对上述慢性肝病具有较好的诊断和鉴别诊断价值．     

A multivariate neuromonitoring approach to neuroplasticity-based computerized cognitive training in recent onset psychosis

Two decades of studies suggest that computerized cognitive training (CCT) has an effect on cognitive improvement and the restoration of brain activity. Nevertheless, individual response to CCT remains heterogenous, and the predictive potential of neuroimaging in gauging response to CCT remains unknown. We employed multivariate pattern analysis (MVPA) on whole-brain resting-state functional connectivity (rsFC) to (neuro)monitor clinical outcome defined as psychosis-likeness change after 10-hours of CCT in recent onset psychosis (ROP) patients. Additionally, we investigated if sensory processing (SP) change during CCT is associated with individual psychosis-likeness change and cognitive gains after CCT. 26 ROP patients were divided into maintainers and improvers based on their SP change during CCT. A support vector machine (SVM) classifier separating 56 healthy controls (HC) from 35 ROP patients using rsFC (balanced accuracy of 65.5%, P < 0.01) was built in an independent sample to create a naturalistic model representing the HC-ROP hyperplane. This model was out-of-sample cross-validated in the ROP patients from the CCT trial to assess associations between rsFC pattern change, cognitive gains and SP during CCT. Patients with intact SP threshold at baseline showed improved attention despite psychosis status on the SVM hyperplane at follow-up (p < 0.05). Contrarily, the attentional gains occurred in the ROP patients who showed impaired SP at baseline only if rsfMRI diagnosis status shifted to the healthy-like side of the SVM continuum. Our results reveal the utility of MVPA for elucidating treatment response neuromarkers based on rsFC-SP change and pave the road to more personalized interventions.Subject terms: Predictive markers, Psychosis