Are we really measuring empathy? Proposal for a new measurement framework

Empathy – currently defined as the sharing of another’s affective state – has been the focus of much psychological and neuroscientific research in the last decade, much of which has been focused on ascertaining the empathic ability of individuals with various clinical conditions. However, most of this work tends to overlook the fact that empathy is the result of a complex process requiring a number of intermediate processing steps. It is therefore the case that describing an individual or group as ‘lacking empathy’ lacks specificity. We argue for an alternative measurement framework, in which we explain variance in empathic response in terms of individual differences in the ability to identify another’s emotional state (‘emotion identification’), and the degree to which identification of another’s state causes a corresponding state in the self (‘affect sharing’). We describe how existing empathy paradigms need to be modified in order to fit within this measurement framework, and illustrate the utility of this approach with reference to examples from both cognitive neuroscience and clinical psychology.     

1.5 T MR加速器临床剂量调试

目的:介绍1.5 T MR加速器的临床剂量调试方法和结果。方法:中国医学科学院肿瘤医院于2019年5月安装1台医科达Unity型1.5 T MR加速器,使用磁场兼容测量设备对其进行剂量调试。调试项目包括绝对剂量校准、数据采集和计划系统模型验证。结果:磁场下绝对剂量校准需要使用磁场修正因子修正,参考条件下的绝对剂量为87...     

二补助育汤对胚胎着床障碍小鼠子宫内膜的形态学影响

目的从形态学角度探讨二补助育汤对胚胎着床障碍模型小鼠子宫内膜的影响。方法将56只C57小鼠随机分为空白组、模型组、补佳乐组、阿司匹林组、二补助育汤低、中、高剂量组,每组8只。用吲哚美辛建立胚胎着床障碍动物模型,小鼠妊娠第5日下午脱颈椎处死,计算各组小鼠妊娠率及胚胎着床位点数;光学显微镜下观察各组小鼠子宫内膜形态结构;透射电子显微镜下观察超微结构、胞饮突表达情况,并计算胞饮突评分。结果 (1)模型组平均着床位点数(1.8±2.1)明显低于空白组(8.1±4.2)(P0.05);中药中、高剂量组平均着床位点数(分别为62.5%,75.0%)明显高于模型组(P0.05);与补佳乐组和阿司匹林组间无统计学差异。(2)光学显微镜下形态学观察:正常组内膜间质疏松、腺体和血管丰富、腺体扩张;模型组内膜变薄或消失、腺体和血管减少;二补助育汤各剂量组、补佳乐组、阿司匹林组内膜均有改善,以二补助育汤中剂量组与正常组最接近。(3)电子显微镜下超微结构观察:空白组子宫内膜上皮细胞及细胞器结构清晰;模型组细胞破坏严重甚至局灶性坏死,线粒体膜不完整、嵴结构消失,胞质中较多空泡样变,核糖体和内质网明显减少;二补助育汤各剂量组、补佳乐组、阿司匹林组细胞及细胞器有不同程度破坏,与模型组相比有明显改善。(4)胞饮突:空白组胞饮突丰富,绒毛较少;模型组绒毛丰富,但胞饮突很少;二补助育汤各剂量组胞饮突较模型组丰富,见少量绒毛;补佳乐组和阿司匹林组可见少量胞饮突,较模型组增加,绒毛表达稀疏。(5)胞饮突评分:模型组胞饮突评分(1.1±0.3)较空白组低(2.5±0.7)(P0.05);中药中剂量组(2.3±0.9)、阿司匹林组(2.0±0.7)评分高于模型组(P0.05),亦高于补佳乐组(1.3±0.5)(P0.05)。结论二补助育汤能够促进子宫内膜发育及胞饮突,从而提高子宫内膜容受性,有利于胚胎着床。     

肝衰竭预后模型研究新进展

肝衰竭患者并发症多,病死率高,及时准确评估肝衰竭患者预后,对于治疗方案的选择和治疗过程的把握十分重要,并最终改善肝衰竭患者的预后。本文对近几年出现的新的肝衰竭预后模型进行了综述,包括MELD评分、SOFA评分、改良的SOFA评分、ALFED模型,并提出了一个新的急性肝衰竭预后评分模型的优缺点和运用条件。另外,对新出现的肝衰竭生物标志物进行了归纳和总结。     

Living donor liver transplantation for high model for end-stage liver disease score: What have we learned?

AIM: To assess the impact of model for end-stage liver disease(MELD) score on patient survival and morbidity post living donor liver transplantation(LDLT). METHODS: A retrospective study was performed on 80 adult patients who had LDLT from 2011-2013. Nine patients were excluded and 71 patients were divided into two groups; Group 1 included 38 patients with a MELD score 20, and Group 2 included 33 patients with a MELD score 20. Comparison between both groups was done regarding operative time, intra-operative blood requirement, intensive care unit(ICU) and hospital stay, infection, and patient survival.RESULTS: Eleven patients died(15.5%); 3/38(7.9%)patients in Group 1 and 8/33(24.2%) in Group 2 with significant difference(P = 0.02). Mean operative time, duration of hospital stay, and ICU stay were similar in both groups. Mean volume of blood transfusion and cell saver re-transfusion were 8 ± 4 units and 1668 ± 202 m L, respectively, in Group 1 in comparison to 10 ± 6 units and 1910 ± 679 m L, respectively, in Group 2 with no significant difference(P = 0.09 and 0.167, respectively). The rates of infection and systemic complications(renal, respiratory, cardiovascular and neurological complications) were similar in both groups. CONCLUSION: A MELD score 20 may predict mortality after LDLT.     

Reversibility of minimal hepatic encephalopathy following liver transplantation in Egyptian cirrhotic patients

AIM To evaluate the reversibility of minimal hepatic encephalopathy(MHE) following liver transplantation(LT) in Egyptian cirrhotic patients. METHODS This prospective study included twenty patients with biopsy-proven liver cirrhosis listed for LT and twenty ageand sex-matched healthy control subjects. All underwent neuro-psychiatric examination, laboratory investigations, radiological studies and psychometric tests including trail making test A(TMT A), TMT B, digit symbol test and serial dotting test. The psychometric hepatic encephalopathy score(PHES) was calculated for patients to diagnose MHE. Psychometric tests were repeated six months following LT in the cirrhotic patient group. RESULTS Before LT, psychometric tests showed highly significant deficits in cirrhotic patients in comparison to controls(P 0.001). There was a statistically significant improvement in test values in the patient group after LT; however, their values were still significantly worse than those of the controls(P 0.001). The PHES detected MHE in 16 patients(80%) before LT with a median value of -7 ± 3.5. The median PHES value was significantly improved following LT, reaching-4.5 ± 5(P 0.001), and the number of patients with MHE decreased to 11(55%). The pre-transplant model for end-stage liver disease(MELD) score ≥ 15 was significantly related to the presence of post-transplant MHE(P = 0.005). More patients in whom reversal of MHE was observed had a pre-transplant MELD score 15.CONCLUSION Reversal of MHE in cirrhotic patients could be achieved by LT, especially in those with a MELD score 15.     

Advances in liver transplantation allocation systems

With the growing number of patients in need of liver transplantation, there is a need for adopting new and modifying existing allocation policies that prioritize patients for liver transplantation. Policy should ensure fair allocation that is reproducible and strongly predictive of best pre and post transplant outcomes while taking into account the natural history of the potential recipients liver disease and its complications. There is wide acceptance for allocation policies based on urgency in which the sickest patients on the waiting list with the highest risk of mortality receive priority. Model for end-stage liver disease and Child-Turcotte-Pugh scoring system, the two most universally applicable systems are used in urgencybased prioritization. However, other factors must be considered to achieve optimal allocation. Factors affecting pre-transplant patient survival and the quality of the donor organ also affect outcome. The optimal system should have allocation prioritization that accounts for both urgency and transplant outcome. We reviewed past and current liver allocation systems with the aim of generating further discussion about improvement of current policies.     

ScienceOpen的“互联网+学术出版”模式介绍、分析及启示

【目的】 研究传统学术出版行业与互联网技术相融合的学术出版模式,以更好地促进科学研究的发展与传播,为我国探索新兴的学术期刊出版模式提供借鉴。【方法】 以ScienceOpen为例,对其基于互联网思维的学术出版模式进行详细介绍和分析。【结果】 ScienceOpen将预出版和OA出版相结合,采用非匿名的公开评审模式,使传统学术期刊出版流程得到优化,并通过合集、群组的方式,更好地促进了互联网时代学术交流与合作。【结论】 基于互联网的学术出版平台必须具有平等、开放、协作、分享的基本特征,使科研人员可以参与学术论文出版、传播的全过程,并可基于社交网络进行分享和评价,提高科研成果发布和传播的效率。     

医务工作者职业倦怠影响因素研究

目的分析影响医务工作者职业倦怠因素。方法采用分层抽样法抽取在职职工270人为调查对象。基于SEM构建职业倦怠因素假设模型,编制调查表进行问卷调查,运用SPSS18.0软件检验模型及数据的信度、效度,使用Amos7.0软件Maximum Likelihood法建立结构方程模型。结果医院管理、心理资本、工作压力、人际交往、自身条件、负面舆论等对医务工作者职业倦怠有着显著影响,其中心理资本、人际交往通过工作压力对医务工作者职业倦怠有着间接影响。结论医院管理者应当重视职业倦怠问题。