Comparison of the Cozart DDS 801 on-site drug test device and gas chromatography/mass spectrometry (GC/MS) confirmation results of cannabis and cocaine in oral fluid specimens

Driving under the influence of drugs (DUID) is a problem around the world. The objective of this study is to assess the reliability of the oral fluid screening device the Cozart DDS 801 by comparing the on-site results with confirmatory gas chromatography/mass spectrometry (GC/MS) oral fluid analysis. The study was carried out in Catalonia (Spain) with a sample of 2180 oral fluid specimens taken from subjects suspected of driving under the influence of drugs of abuse, and collected by police officers during 2009–2010. Statistical parameters of the tests were determined for cannabis and cocaine. The sensitivity, specificity, predictive positive value, predictive negative value, likelihood positive ratio and likelihood negative ratio for cocaine were 92%, 90%, 95%, 85%, 9.44, and 0.09 respectively. Sensitivity, specificity, predictive positive value, predictive negative value, likelihood positive ratio and likelihood negative ratio for cannabis were 87%, 86%, 94%, 73%, 6.15 and 0.6 respectively. Accuracy was 91% for cocaine and 86% for cannabis. The Cozart DDS 801 drug test system is a simple to use screening tool for cocaine and cannabis in oral fluid, at initial screening cut-off established by the manufacturer, confirmed with a GC/MS analysis. The system has demonstrated its acceptable performance.     

动脉粥样硬化斑块稳定性的影响因素分析

目的 探讨动脉粥样硬化斑块稳定性及其影响因素.方法 回顾性分析30例经外科手术病理检查证实为周围血管动脉粥样硬化患者的病理资料,根据斑块类型分为稳定性斑块组及不稳定性斑块组,比较两组的相关临床因素;采用单因素分析方法,分析动脉粥样硬化斑块稳定性与临床因素的相关性.结果 血浆纤维蛋白原（FIB）、低密度脂蛋白（LDL）、脉压差及既往心脑血管疾病史在两组间有差异,不稳定性斑块组患者的FIB、LDL水平较稳定性斑块组患者高,既往有心脑血管疾病史的患者也较稳定性斑块组为多,且差异有统计学意义（P＜0.05）.结论 FIB、LDL、脉压差及既往心脑血管疾病史是动脉粥样硬化不稳定性斑块的影响因子.     

腰硬联合麻醉与全麻对老年腹部手术患者术后短期认知功能的影响

目的 探讨腰硬联合麻醉(CSEA)与全麻对老年腹部手术患者术后认知功能的影响。方法 选取本院2018年5月—2019年5月收治的82例老年腹部手术患者,按随机数表法分为观察组和对照组,各41例。观察组应用CSEA,对照组则采用全身麻醉。比较两组的麻醉相关指标,术后6 h、12 h、24 h的精神功能状态以及患者术后短期认知功能障碍的发生率。结果 观察组麻醉起效时间(min)、完全清醒时间(min)分别为(8.19±1.04)、(28.67±5.60)与对照组的(10.17±2.12)、(37.25±6.12)比较差异有统计学意义(P<0.05);观察组视觉模拟评分(VAS)(3.51±1.12)与对照组的(4.27±1.15)比较差异有统计学意义(P<0.05);观察组患者术后6 h、12 h、24 h时的MMSE评分分别为(22.27±1.46)、(26.23±1.26)、(28.19±1.24),均高于对照组的(21.46±1.35)、(24.68±1.23)、(26.37±1.19)(P<0.05);观察组短期内POCD的发生率为4.88%,低于对照组的24.39%,差异有统计学意义(P<0.05)。结论 对老年腹部手术患者采用CSEA,不仅能缩短麻醉起效时间和完全清醒的时间,减轻疼痛,而且对患者精神功能的影响小,可有效减少短期内认知功能障碍发生率。     

股骨转子间骨折患者围手术期输血的影响因素分析

目的：探讨股骨转子间骨折患者围手术期输血的影响因素。方法：收集2013年1月至2018年1月因股骨转子间骨折于复旦大学附属金山医院手术281例患者的病例资料，包括性别，年龄，骨折Evans-Jensen分型，既往是否有高血压病史、冠心病史、糖尿病史及脑梗死病史，术前白蛋白、血红蛋白、血小板、活化部分凝血活酶时间，术前等候天数，手术方式，美国麻醉医师协会（ASA）麻醉分级以及是否输血。按是否输血分为输血组（127例）与非输血组（154例）。采用t检验、秩和检验、χ²检验、logistic回归进行统计学处理。结果：围手术期的输血率为45.2%（127/281）。输血组与未输血组相比，性别、骨折分型、糖尿病病史、脑梗死病史、手术方式、麻醉分级、年龄、术前白蛋白水平、术前血红蛋白水平、术前血小板水平及术前等候天数差异均有统计学意义（P<0.05）。多因素logistic回归分析显示，输血的影响因素有骨折分型为4型或5型、术前血红蛋白<90 g/L、有脑梗死病史、手术方式为人工股骨头置换或行切开复位股骨近端抗旋髓内钉固定术。结论：股骨转子间骨折分型为4型或5型、术前血红蛋白<90 g/L、有脑梗死病史、手术方式为人工股骨头置换或行切开复位股骨近端抗旋髓内钉固定术对股骨转子间骨折患者围手术期输血有影响。     

影响周围性面神经麻痹预后的相关指标

目的探讨影响周围性面神经麻痹预后的相关指标。方法对109例周围性面神经麻痹患者行面神经病变定位、House-Brackmann(H-B)分级及神经电生理检查。随访半年,以H-B分级法评估预后,分为预后好组(1~2级)及预后差组(3~6级),两组的临床及电生理指标行统计学处理。结果根据H-B分级法,将患者分为预后好组89例,预后差组20例。与预后好组比较,预后差组年龄及入院时H-B分级4级的比率显著升高,入院时H-B分级3级的比率显著降低(均P0.001)。预后好组及预后差组膝状神经节、面神经管镫骨神经以上、面神经管镫骨神经以下、茎乳孔以外病变比率依次增高和降低,且预后差组膝状神经节病变比率显著高于,茎乳孔以外病变显著低于预后好组(均P0.001)。预后差组患侧面神经复合动作电位(CMAP)潜伏期、波幅下降比及F波消失率显著高于,波幅显著低于预后好组(均P0.001)。年龄(OR=2.545,95%CI:1.155~5.608,P0.05)、面神经病变部位(OR=0.178,95%CI:0.075~0.426,P0.01)、患侧面神经CMAP潜伏期(OR=1.843,95%CI:1.574~9.271,P0.05)及波幅下降比(OR=2.447,95%CI:0.577~5.631,P0.05)是预后差的独立影响因素。结论年龄、面神经病变部位、患侧面神经CMAP潜伏期及波幅下降比是周围性面神经麻痹患者预后差的独立影响因素。     

A social network perspective on heroin and cocaine use among adults: evidence of bidirectional influences

Aims   While several studies have documented a relationship between initiation of drug use and social network drug use in youth, the direction of this association is not well understood, particularly among adults or for stages of drug involvement beyond initiation. The present study sought to examine two competing theories (social selection and social influence) in the longitudinal relationship between drug use (heroin and/or cocaine) and social network drug use among drug-experienced adults.
Design   Three waves of data came from a cohort of 1108 adults reporting a life-time history of heroin and/or cocaine use.
Setting   Low-income neighborhoods with high rates of drug use in Baltimore, Maryland.
Participants   Participants had weekly contact with drug users and were 18 years of age or older.
Measurements   Drug use data were self-report. Network drug use was assessed through a social network inventory. Close friends were individuals whom the participant reported seeing daily or rated as having the highest level of trust.
Findings   Structural equation modeling indicated significant bidirectional influences. The majority of change in network drug use over time was due to change in the composition of the network rather than change in friends' behavior. Drug use by close peers did not influence participant drug use beyond the total network.
Conclusions   There is evidence of both social selection and social influence processes in the association between drug use and network drug use among drug-experienced adults.     

Web‐Based Experiments for the Study of Collective Social Dynamics in Cultural Markets

Social scientists are often interested in understanding how the dynamics of social systems are driven by the behavior of individuals that make up those systems. However, this process is hindered by the difficulty of experimentally studying how individual behavioral tendencies lead to collective social dynamics in large groups of people interacting over time. In this study, we investigate the role of social influence, a process well studied at the individual level, on the puzzling nature of success for cultural products such as books, movies, and music. Using a “multiple‐worlds” experimental design, we are able to isolate the causal effect of an individual‐level mechanism on collective social outcomes. We employ this design in a Web‐based experiment in which 2,930 participants listened to, rated, and downloaded 48 songs by up‐and‐coming bands. Surprisingly, despite relatively large differences in the demographics, behavior, and preferences of participants, the experimental results at both the individual and collective levels were similar to those found in Salganik, Dodds, and Watts (2006) . Further, by comparing results from two distinct pools of participants, we are able to gain new insights into the role of individual behavior on collective outcomes. We conclude with a discussion of the strengths and weaknesses of Web‐based experiments to address questions of collective social dynamics.     

Bipolar I disorder with mood-incongruent psychotic symptoms

Objectives  The purpose of this paper is to demonstrate similarities and differences between bipolar I patients with and without mood-incongruent symptoms (MIS) over a long period of time, independently of longitudinal syndromatic constellations. Methods  The Halle bipolarity longitudinal study (HABILOS) prospectively investigates 182 patients meeting the DSM-IV criteria for bipolar I disorders over a long period of time (x;⁻ = 16.84 years). One thousand five hundred thirty-nine (1,539) episodes have been evaluated with standardized instruments. Patients and episodes were divided into two groups (with and without MIS) and were compared on various levels. Results  It was found: (1) The majority of the episodes of bipolar I patients during long-term course did not have MIS, but the majority of patients did. (2) Bipolar I patients with MIS differ from patients without MIS in the following features: (a) Bipolar I patients with MIS are more frequently males. (b) Bipolar I patients with MIS need treatment at a significantly younger age than those without MIS. (c) First manifestation of bipolar I disorder with MIS after the age of 50 is extremely seldom. (d) Bipolar I patients with MIS more frequently have relatives with schizophrenia. (e) Bipolar I patients with MIS more frequently become disabled and retire at a significantly younger age than patients without MIS and (f) Significantly fewer patients with MIS than those without MIS live in a stable partnership. Conclusions  It can be concluded that bipolar I disorders with MIS are more severe disorders than bipolar I disorders without MIS. This finding in combination with the above results, however, can give rise to the conclusion that bipolar I disorders with MIS are the epiphenomenon of the overlap, possibly genetic, of a “schizophrenic spectrum” and a “bipolar spectrum” and their antagonistic influence creating a “schizo-affective” area between them as a kind of psychotic continuum between prototypes. Supported by grants of the DFG German Research Association MA 915/11-1.     

Peer facilitation of emotion regulation in adolescence

Emotion regulation is particularly important for adolescents as they undergo normative developmental changes in affective systems and experience heightened risk for psychopathology. Despite a high need for emotion regulation during adolescence, commonly studied emotion regulation strategies like cognitive reappraisal are less beneficial for adolescents than adults because they rely on neural regions that are still developing during this period (i.e., lateral prefrontal cortex). However, adolescence is also marked by increased valuation of peer relationships and sensitivity to social information and cues. In the present review, we synthesize research examining emotion regulation and peer influence across development to suggest that sensitivity to peers during adolescence could be leveraged to improve emotion regulation for this population. We first discuss developmental trends related to emotion regulation at the level of behavior and brain in adolescents, using cognitive reappraisal as an exemplar emotion regulation strategy. Next, we discuss social influences on adolescent brain development, describing caregiver influence and increasing susceptibility to peer influence, to describe how adolescent sensitivity to social inputs represents both a window of vulnerability and opportunity. Finally, we conclude by describing the promise of social (i.e., peer-based) interventions for enhancing emotion regulation in adolescence.     

保定市普通人群睡眠质量及相关影响因素

目的：了解保定市普通人群睡眠质量特点及相关影响因素。方法：采用多阶段分层整群抽样方法随机抽取≥18岁的人群,共10073名;以匹兹堡睡眠质量指数（PSQI）评定睡眠质量及相关影响因素（按我国睡眠质量常模,总分〉7分为睡眠障碍）。结果：8773人完成了调查,保定市普通人群睡眠障碍的发生率为9.95%（873/8773）;女性较男性、城市较农村、高龄较低龄人群睡眠障碍的发生率显著为高（P均〈0.001）;婚姻和职业状况影响睡眠质量,丧偶、再婚、离退休人员睡眠障碍的发生率分别为23.08%、18.48%和25.26%（P均〈0.001）。PSQI总分与社会人口学资料的相关分析显示,除目前职业外,其他因素如女性、城市、婚姻及年龄均与PSQI总分呈显著正相关（P均〈0.001）;PSQI总分与社会心理及环境问题的相关分析显示,除其他社会心理问题外,,其他因素如经济、卫生保健、支持群体、职业、教育、住房、社会环境及法律/犯罪问题均与PSQI总分呈显著正相关（P均〈0.001）。结论：普通人群中存在睡眠障碍的比例较高,应重视并改善高危人群的睡眠问题,减少社会心理及环境问题,有助于提高普通人群的睡眠质量。