Caregiver- and Child-Reported Anxiety Using an Autism-Specific Measure: Measurement Properties and Correlates of the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD) in Verbal Young People with ASD

Identifying and measuring anxiety in young people on the autism spectrum can be challenging. The present study investigated the use of the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD), a self- and caregiver-rated screening tool in a Singaporean sample of ninety-one verbal autistic youths and their caregivers. Internal consistency ranged from satisfactory to desirable (α?=?.74–.92). Convergent validity with medium-large effect size was established using a structured diagnostic interview, the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). ASC-ASD scores were positively associated with autistic symptoms and response patterns indicated strong endorsement of autism-specific items. The findings are discussed in relation to existing literature on assessment of anxiety in ASD and in light of the study’s strengths and limitations.

     

大学生言语能力及职业成就的刻板解释偏差

目的考察大学生对言语能力及其职业成就是否存在内隐性别刻板印象。方法运用两个SEB实验设计对85名大学生进行团体施测。结果①1-SEB1与0存在极显著差异(t=3.531,P<0.001),2-SEB1与0存在显著差异(t=-1.979,P<0.05),2-SEB2与0存在显著差异(t=-3.211,P<0.01);②在职业成就上,主语性别和成败表现对被试归因倾向的交互作用显著(F=34.828,P<0.01)。结论大学生具有"女性言语能力很强,但男性言语能力不一定很弱"及"男性在言语能力要求高的职业上成就大于女性"的内隐性别刻板印象。即使在承认女性言语能力很强的基础上,仍存在女性职业成就不如男性的内隐性别刻板观念。     

Emulsion Self‐Assembly Synthesis of Chitosan/Poly(lactic‐co‐glycolic acid) Stimuli‐Responsive Amphiphiles

An amphiphilic graft copolymer using chitosan (CS) as a hydrophilic main chain and poly(lactic‐co‐glycolic acid) (PLGA) as a hydrophobic side chain is prepared through an emulsion self‐assembly synthesis. CS aqueous solution is used as a water phase and PLGA in chloroform is served as an oil phase. A water‐in‐oil (W/O) emulsion is fabricated in the presence of the surfactant span‐80. The self‐assembly reaction is performed between PLGA and CS under the condensation of EDC. Fourier transform IR (FTIR) spectroscopy reveals that PLGA is grafted onto the backbone of CS through the interactions between end carboxyl and amino groups of the two components. ¹H NMR spectroscopy directly indicates the grafting content of PLGA in the CS‐graft‐PLGA (CS‐g‐PLGA) copolymer is close to 25%. X‐ray diffraction (XRD) confirms that the copolymer exhibits an amorphous structure. The CS‐g‐PLGA amphiphile can self‐assemble to form micelles with size in the range of ≈100–300 nm, which makes it easy to apply in various targeted‐drug‐release and biomaterial fields.     

Masthead,Volume 73, Issue 1

This review provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ASL in Dementia consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this review, we describe the major considerations and trade‐offs in implementing an ASL protocol and provide specific recommendations for a standard approach. Our conclusion is that as an optimal default implementation, we recommend pseudo‐continuous labeling, background suppression, a segmented three‐dimensional readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model. Magn Reson Med 73:102–116, 2015. © 2014 Wiley Periodicals, Inc.     

CT angiography as a confirmatory test in diagnosis of brain death: comparison between three scoring systems

PURPOSE

Computed tomography (CT) angiography emerges as a viable alternative technique for confirmation of brain death. However, evaluation criteria are not well established for demonstration of cerebral circulatory arrest. This retrospective study aimed to evaluate CT angiography scoring systems in diagnosis of brain death, review the literature, and compare interobserver agreement between different scales for the diagnosis of brain death.

METHODS

CT angiography examinations of 25 patients with a clinical diagnosis of brain death were reevaluated according to 10-, 7-, and 4-point scales. Exams were performed with a 64-slice CT scanner including unenhanced, arterial (20 s) and venous phase (60 s) scans. Subtraction images of both phases were obtained. Interobserver agreement was evaluated for the assessment of vessel opacification and diagnosis of brain death.

RESULTS

According to 10-, 7-, and 4-point scales; 13, 16, and 22 of 25 patients had full score, respectively. Using the clinical exam as the reference standard, sensitivities obtained for 10-, 7-, and 4-point scales were 52%, 64%, and 88%, respectively. Percent agreement between readers was 100% for 10- and 7-point scales and 88% for 4-point scale. Percent agreement for opacification of scale vessels was equally high for all three scales (93.6%, 93.7%, 91% for 10-, 7-, and 4-point scales, respectively).

CONCLUSION

The 4-point scale appears to be more sensitive than the 10-and 7-point scales in CT angiography evaluation for brain death. Interobserver agreement is high for all three scales when subtraction images are used.Clinical diagnosis of brain death is established by national guidelines and laws in many countries. Deep unresponsive coma, absence of brain stem functions and spontaneous ventilation are principal requisites for diagnosis (1). Guidelines are revised by New York Task Forces in 2011 for determining brain death and represent a broad consensus on clinical evaluation (2). Although clinical criteria are well established, considerable practice variations are found between countries or leading hospitals of the countries such as the number of staff responsible from diagnosis, number of required examinations, observation period between examinations, application of apnea test, and confirmatory tests (3).Confirmatory tests are required in the presence of confounding factors that could influence the exam (e.g., sedative medications, electrolyte disturbances, acid-base disorders) or make the examination severely difficult to test (e.g., severe facial or orbital trauma) (4). In neonates and children, diagnosis of brain death is more complicated and ancillary tests are usually advocated (5–7). On the other hand, a confirmatory test demonstrating lack of cerebral function or circulation is obligatory after clinical evaluation in some countries. Among the ancillary tests demonstrating absence of cerebral blood flow, multidetector computed tomography (CT) angiography emerges as a viable alternative to other tests due to its noninvasiveness, ease of access, lower operator dependence, and greater rapidity (8). However, an international consensus about application and parameters of this technique is currently not established.The CT angiography protocols for diagnosis of brain death differ between studies in the literature. Scanning time of arterial or venous phase is the major difference in applied protocols. Beside this, disparities in scoring systems, evaluation of blood flow phases, specific vessels, and number of vessels may constitute confusing points for radiologists. Also, CT angiography findings in patients with open skull or anoxia following cardiac arrest may cause false negative interpretation (9). In the context of those diversities, diagnosis of brain death by CT angiography may become quite complicated.In the present study, we aimed to retrospectively evaluate CT angiograms of patients with a clinical diagnosis of brain death according to 10-, 7- and 4-point score systems, review the literature, and emphasize the difficulties and confusing points of the diagnosis by previous methods. Interobserver agreement was evaluated for the diagnosis of brain death and opacification of scale vessels by CT angiography.     

胃癌腹腔镜手术近远期疗效的循证医学评价

治疗胃癌的腹腔镜胃切除手术(laparoscopic gastrectomy,LG)在过去的20年中运用范围日益广泛。相关的循证医学结果显示,在近期疗效方面,LG 已达到不低于开腹胃切除手术(open gastrectomy,OG)的肿瘤临床治疗效果,且具有微创等优势。在远期疗效方面,LG 与 OG 治疗早期胃癌相近的疗效已获得了充足的循证医学证据,LG 已成为早期胃癌可选的标准治疗方法之一。虽然不少研究显示 LG 治疗进展期胃癌亦能取得 OG 同样的远期疗效,但仍缺乏多中心的前瞻性随机对照研究结果来评价腹腔镜手术的优劣。外科医师只有严格选择合适病例,手术中严格遵循恶性肿瘤手术的根治原则,才能使腹腔镜胃癌根治术在取得微创优势的基础上具有与开腹手术相当的疗效。     

腹腔镜下经腹腔腹膜前疝修补术中子宫圆韧带的处理

目的探讨针对女性腹股沟疝患者行腹腔镜下经腹腔腹膜前疝修补术(TAPP)中处理子宫圆韧带的方法。方法回顾分析该院普外科自2011年1月-2014年1月,共34例女性腹股沟疝患者行TAPP的临床资料及手术录像,其中,保留子宫圆韧带25例(A组),离断子宫圆韧带9例(B组)。结果 34例手术均顺利完成,A和B两组手术时间分别为(44±8)min和(36±7)min。术后患者均恢复理想,平均随访17个月,无疝复发及慢性疼痛发生。结论与离断子宫圆韧带手术相比,沿子宫圆韧带两侧纵向切开腹膜,保留子宫圆韧带的手术操作相对复杂,用时较长,但可保证子宫圆韧带及腹膜的完整性,临床应用前景及推广价值较高。     

Effect of tumor-associated macrophages on gastric cancer stem cell in omental milky spots and lymph node micrometastasis

We observed whether the effect of tumor-associated macrophages on gastric cancer stem cell in omental milky spots and lymph nodes micrometastasis and research its possible mechanism. Macrophage THP-1 cells and Human gastric adenocarcinoma SGC-7901 cells were collectively cultivated in vivo. We found macrophage could suppress the proliferation and accelerated cell death of MFC cell. Meanwhile, these effects may be concerned with many signaling pathways, and we detected MCP-1 and COX-2 miRNA expressions, PGE-2 release levels, IL-4 and IL-10 activities, and TGF-β, IFN-γ, VEGF, MMP-2 and MMP-9 protein expressions in collectively cultivated cell. We found that MCP-1 and COX-2 miRNA expressions, and PGE-2 release levels were suppressed, IL-4 activity was inhibited and IL-10 activity was activated in collectively cultivated cell. Meanwhile, TGF-β, MMP-2 and MMP-9 protein expressions were inhibited and IFN-γ and VEGF protein expressions were activated in collectively cultivated cell. Taken together, these results suggest that the effect of tumor-associated macrophages on gastric cancer stem cell in omental milky spots and lymph nodes micrometastasis via COX-2/PGE-2/TGF-β/VEGF signal pathways.