The role of anti-ribosomal P autoantibodies in the prediction of neuropsychiatric damage in systemic lupus erythematosus based on CSTAR cohort (XIV)

Clinical Rheumatology - To identify the predictive value of anti-ribosomal P protein (anti-RibP) antibodies on the accrual of neuropsychiatric damage in systemic lupus erythematosus (SLE) patients...     

An Efficient Approach for Automated Mass Segmentation and Classification in Mammograms

Breast cancer is becoming a leading death of women all over the world; clinical experiments demonstrate that early detection and accurate diagnosis can increase the potential of treatment. In order to improve the breast cancer diagnosis precision, this paper presents a novel automated segmentation and classification method for mammograms. We conduct the experiment on both DDSM database and MIAS database, firstly extract the region of interests (ROIs) with chain codes and using the rough set (RS) method to enhance the ROIs, secondly segment the mass region from the location ROIs with an improved vector field convolution (VFC) snake and following extract features from the mass region and its surroundings, and then establish features database with 32 dimensions; finally, these features are used as input to several classification techniques. In our work, the random forest is used and compared with support vector machine (SVM), genetic algorithm support vector machine (GA-SVM), particle swarm optimization support vector machine (PSO-SVM), and decision tree. The effectiveness of our method is evaluated by a comprehensive and objective evaluation system; also, Matthew’s correlation coefficient (MCC) indicator is used. Among the state-of-the-art classifiers, our method achieves the best performance with best accuracy of 97.73 %, and the MCC value reaches 0.8668 and 0.8652 in unique DDSM database and both two databases, respectively. Experimental results prove that the proposed method outperforms the other methods; it could consider applying in CAD systems to assist the physicians for breast cancer diagnosis.     

浅谈景观治疗对军队疗养员的作用及要求

景观治疗是环境与艺术、体力与心情、物资与精神良好结合的一次有益身体健康的积极活动。根据疗养首长的健康状况、心理需求、疾病程度和疗养院实际情况,我院开展了具有针对性的景观活动。景观治疗能顺利完成,必须揣摩研究疗养首长的心理特点,制定周密的行动方案,熟练掌握语言表达技巧,使疗养员在疗养期间身心得到放松。通过景观治疗,使疗养员老有所养、老有所乐、老有所学,达到修养身心,精神升华之目的。     

Ethical Issues Recognized by Critical Care Nurses in the Intensive Care Units of a Tertiary Hospital during Two Separate Periods

This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behaviorrelated issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-oflife (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behaviorrelated issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.

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Unidentified Bright Objects on Brain Magnetic Resonance Imaging Affect Vestibular Neuritis

Objectives

The aim of this study was to investigate the differences in clinical manifestations of in two groups of vestibular neuritis (VN) patients with or without unidentified bright objects (UBOs).

Methods

A prospective, observational study with 46 patients diagnosed with VN between May 2013 and November 2013 was executed. A caloric test, a cervical vestibular-evoked myogenic potentials (cVEMPs) test, brain magnetic resonance imaging (MRI), spontaneous nystagmus test, head impulse test, and head-shaking nystagmus test were performed.

Results

Of the patients, 56.5% (n=26) were classified as UBO-positive by MRI. These showed lower caloric weakness and more prominent cVEMP asymmetry compared with the UBO-negative group (P<0.05). Total VN (TVN) was the most common in the UBO-positive group (45.0%), followed by superior VN (SVN, 30.0%), and inferior VN (IVN, 25.0%). However, in the UBO-negative group, SVN (75.0%) was the most common, followed by TVN and IVN (P<0.05). The recovery rate was not influenced by UBOs (P>0.05).

Conclusion

UBOs on T2-weighted or fluid attenuated inversion recovery MRI may affect the patterns of the vestibular nerve in patients with VN.     

Mutations at the APC exon 15 in the colorectal neoplastic tissues of serial array

Although the APC protein is known to participate in cellular proliferation and apoptosis, APC mutations have been thought to play a major role in the early stage of colorectal tumorigenesis. The somatic APC mutation of exon 15 was assessed to determine its impact on various stages of colorectal tumorigenesis. The colorectal neoplastic tissues of serial array studied included sporadic adenomas (group 1, n = 36), adenomas (group 2, n = 33), and carcinomas (group 3, n = 32) in the synchronous adenoma and carcinoma as well as sporadic carcinomas (group 4, n = 36). Aberrant DNA was detected by protein truncation test and confirmed by direct sequencing. The mutation prevalence was 36.1% in group 1, 45.5% in group 2, 59.4% in group 3, and 41.7% in group 4 with no differences among the groups. Among the 18 patients with synchronous adenoma and carcinoma, 9 had mutation in their adenomas and 12 in their carcinomas. The mutation loci and patterns did not differ in adenomas and carcinomas. Mutations in the mutation cluster region (MCR) were much more frequent than in the preceding region of MCR, i.e., 85.7% vs. 14.3%. The mutation prevalence of villous adenomas appeared greater than that of tubular adenoma (3/21 vs. 3/4). Predominant pathogenic mutations at MCR suggest that the APC mutation is implicated in all stages of colorectal tumorigenesis.