语境与阅读语用能力的培养

语境是语用学研究最主要的课题之一 ,它的内涵主要包括上下文、社交及文化等语境知识。在阅读理解时 ,读者必须依赖语境 ,综合有效地运用各种语境知识 ,排除歧义 ,消除模糊 ,合理推断 ,达到全面且准确的理解。为此 ,阅读教学中应着力培养学生的语用能力 ,以文化导入为手段 ,不断提高学生运用文化等语境知识推断语用意义的能力     

Hospital Frailty Risk Score Outperforms Current Risk Stratification Models in Primary Total Hip and Knee Arthroplasty

BackgroundModels for risk stratification and prediction of outcome, such as the Charlson Comorbidity Index (CCI), the Elixhauser Comorbidity Method (ECM), the 5-factor modified Frailty Index (mFI-5), and the Hospital Frailty Risk Score (HFRS) have been validated in orthopedic surgery. The aim of this study is to compare the predictive power of these models in total hip and knee replacement.MethodsIn a retrospective analysis of 8250 patients who had undergone total joint replacement between 2011 and 2019, CCI, ECM, mFI-5, and HFRS were calculated for each patient. Receiver operating characteristic curve plots were generated and the area under the curve (AUC) was compared between each score with regard to adverse events such as transfusion, surgical, medical, and other complications. Multivariate logistic regression models were used to assess the relationship among risk stratification models, demographic factors, and postoperative adverse events.ResultsIn prediction of surgical complications, HFRS performed best (AUC: 0.719, P < .001), followed by ECM (AUC: 0.578, P < .001), mFI-5 (AUC: 0.564, P = .003), and CCI (AUC: 0.555, P = .012). With regard to medical complications, other complications, and transfusion, HFRS also was superior to ECM, mFI-5, and CCI. Multivariate logistic regression analyses revealed HFRS as an independent risk stratification model associated with all captured adverse events (P ≤ .001).ConclusionThe HFRS is superior to current risk stratification models in the context of total joint replacement. As the HRFS derives from routinely collected administrative data, healthcare providers can identify at-risk patients without additional effort or expense.     

基于儿科护士需求的人文关怀分层培训实践

目的探讨基于儿科护士需求分析的人文关怀分层培训的应用效果。方法采用访谈法了解不同层级儿科护士的人文关怀培训需求,根据培训需求对142名儿科护士实施人文关怀分层培训6个月,比较培训前及培训后各层级儿科护士关怀能力和培训满意度。结果培训后不同层级儿科护士关怀能力及对人文关怀培训满意度显著高于培训前(P<0.05,P<0.01)。结论采用基于需求的人文关怀分层培训有利于提高各层级儿科护士的人文关怀能力,提高培训满意度。     

Using psychometric ability to improve education in ultrasound-guided regional anaesthesia: a multicentre randomised controlled trial

The learning curve for novices developing regional anaesthesia skills, such as real-time ultrasound-guided needle manipulation, may be affected by innate visuospatial ability, as this influences spatial cognition and motor co-ordination. We conducted a multinational randomised controlled trial to test if novices with low visuospatial ability would perform better at an ultrasound-guided needling task with deliberate practice training than with discovery learning. Visuospatial ability was evaluated using the mental rotations test-A. We recruited 140 medical students and randomly allocated them into low-ability control (discovery learning), low-ability intervention (received deliberate practice), high-ability control, and high-ability intervention groups. Primary outcome was the time taken to complete the needling task, and there was no significant difference between groups: median (IQR [range]) low-ability control 125 s (69–237 [43–600 s]); low-ability intervention 163 s (116–276 [44–600 s]); high-ability control 130 s (80–210 [41–384 s]); and high-ability intervention 177 s (113–285 [43–547 s]), p = 0.06. No difference was found using the global rating scale: mean (95%CI) low-ability control 53% (95%CI 46–60%); low-ability intervention 61% (95%CI 53–68%); high-ability control 63% (95%CI 56–70%); and high-ability intervention 66% (95%CI 60–72%), p = 0.05. For overall procedure pass/fail, the low-ability control group pass rate of 42% (14/33) was significantly less than the other three groups: low-ability intervention 69% (25/36); high-ability control 68% (25/37); and high-ability intervention 85% (29/34) p = 0.003. Further research is required to determine the role of visuospatial ability screening in training for ultrasound-guided needle skills.     

miR-21对骨质疏松小鼠骨髓基质细胞增殖的影响

目的探讨miR-21对骨质疏松小鼠骨髓基质细胞(BMSCs)增殖的影响。方法采用双侧卵巢切除法构建骨质疏松小鼠模型(VOX),分离、培养、纯化小鼠BMSCs并采用si PORT Neo FX转染pre-miR-21、pre-miR-negative control(pre-miR-NC)、antmiR-21、ant-miR-negative control(ant-miR-NC)并进行RT-PCR验证,MTT法检测小鼠BMSCs增殖情况、茜素红与碱性磷酸酶染色法检测小鼠BMSCs成骨能力、Western-blotting检测细胞增殖、成骨分化相关蛋白水平。结果骨质疏松症小鼠BMSCs中miR-21相对表达水平低于Ctrl组(P0.05),OVX-pre-miR-21组BMSCs中miR-21相对表达水平、细胞增殖、PCNA水平、Ki-67水平、ALP染色程度、ALP活性、茜素红染色程度、Runx2水平、Osterix水平均高于OVX-pre-miR-NC组(P0.05),OVX-premiR-NC组BMSCs中miR-21相对表达水平、细胞增殖、PCNA水平、Ki-67水平、ALP染色程度、ALP活性、茜素红染色程度、Runx2水平、Osterix水平均显著低于Ctrl-pre-miR-NC(P0.05); OVX-ant-miR-21组BMSCs中miR-21相对表达水平、细胞增殖、PCNA水平、Ki-67水平、ALP染色程度、ALP活性、茜素红染色程度、Runx2水平、Osterix水平均显著低于OVX-ant-miR-NC组(P0.05),OVX-ant-miR-NC组BMSCs中miR-21相对表达水平、细胞增殖、PCNA水平、Ki-67水平、ALP染色程度、ALP活性、茜素红染色程度、Runx2水平、Osterix水平均显著低于Ctrl-ant-miR-NC(P0.05)。结论提高miR-21表达水平可促进骨质疏松小鼠BMSCs增殖能力与成骨分化能力。     

Qualité des supports de communication de crise lors de la pandémie de la COVID-19 au Grand Maghreb

ObjectiveTo objectively assess the quality of “crisis communication” media, during the COVID-19 pandemic, in the three Greater Maghreb countries (Tunisia, Algeria, Morocco).MethodsA compliance audit for press releases and epidemiological bulletins was analyzed against a quality benchmark, which had been specifically designed by the authors. This framework, made up of five dimensions and 50 items, graded (0/1), was applied by two researchers in preventive medicine. Multiplying the scores by a coefficient of two resulted in a partial score of 20 points for each dimension and a total score of 100 points for the checklist taken as a whole. The quality of the communication media was considered to be good when exceeding the thresholds of 15/20 for the different dimensions and 75/100 for the entire grid.ResultsA total of 141 information media were included in this audit (Tunisia: 60; Algeria: 60; Morocco: 21). The overall median quality score for these media was only 56/100 (IIQ: [46–58]), without major variability between countries. The most appreciated dimension was “maintaining the confidence of the population”, with an overall median score of 14/20 (12/20 for epidemiological bulletins and 16/20 for press releases). The most poorly rated dimension was “strengthening community participation”, with a median score of only 4/20 (6/20 for epidemiological bulletins and 4/20 for press releases).ConclusionThe quality of the Maghreb crisis communication media during COVID-19 was insufficient in most of its dimensions and items, particularly from a psychosocial standpoint. Reinforcement of the capacities of communication officers to develop information material and supports during health crises is indispensable and should be considered as an urgent matter.     

医疗器械全生命周期管理服务评价体系的建立

目的建立医疗器械全生命周期管理服务评价体系。方法从2019年1月1日—12月31日,于医院建立医疗器械全生命周期管理服务评价体系考核表,对医院器械科的维修服务、资产管理服务、工程师服务态度、质控管理能力等方面进行评价考核。结果在医院医疗器械全生命周期管理服务评价体系中,器械科管理人员及工程师维修服务方面、资产管理能力方面、质控管理能力方面、服务态度方面的平均满意率分别为76.1%、78.8%、82.3%、68.9%。结论建立医疗器械全生命周期管理服务评价体系,有助于加强器械科工程师服务临床工作的能力,从而提高医务人员的诊疗质量。     

The Hawaii family study of cognition: A reply

Differences in age and number of children tested per family between two ethnic groups (Americans of Japanese ancestry and Americans of European ancestry) have a trivial effect on differences in regressions of midchild on midparent for tests of specific cognitive abilities. Although the regression of offspring on midparent value is not a mathematical function of the spouse correlation, an empirical association between these two measures of familial resemblance is expected for characters with nonzero heritability. Such an association is reported for anthropometric characters. Since age effects contribute to the covariance of family members, age correction of family cognitive data is essential.The results reported here are made possible by collaboration of a group of investigators (G. C. Ashton, R. C. Johnson, M. P. Mi, and M. N. Rashad at the University of Hawaii, and J. C. DeFries, G. E. McClearn, S. G. Vandenberg, and J. R. Wilson at the University of Colorado) supported by NSF Grant GB-34720 and Grant HD-06669 from the National Institute of Child Health and Human Development.     

Further evidence for a gene influencing spatial ability

Data for six spatial tests from 927 families of European ancestry, 369 families of Japanese ancestry, and 93 families of Chinese ancestry from the Hawaiian Family Study of Cognition were subjected to unified mixed-model segregation analysis. Father, mother, son, and daughter data sets from each ethnic group were separately age-adjusted and standardized and then separately subjected to transformation procedures to reduce skewness and kurtosis. Families were reassociated prior to segregation analysis. Evidence for a major gene contributing to spatial visualizing ability was obtained for Mental Rotations and Progressive Matrices even with a normalizing transformation which reduced skewness and kurtosis to zero. It was concluded that provision for testing deviation from Mendelian transmission in the unified model protected against false inference of a segregating major gene. Minimizing distributional differences in the components of a data set is an important pretreatment.The results reported here are made possible by the collaboration of a group of investigators (G. C. Ashton, R. C. Johnson, M.-P. Mi, and M. N. Rashad at the University of Hawaii and J. C. DeFries, G. E. McClearn, S. G. Vandenberg, and J. R. Wilson at the University of Colorado) supported by NSF Grant GB 34720 and National Institute of Child Health and Human Development Grant HD 06669. Support for I.B.B. was provided by NIMH Grant MH 14677.     

早期康复护理对脑卒中患者日常生活能力的影响

目的：为了检验早期康复护理对脑卒中患日常生活能力（ＡＤＬ）的影响,本对比观察了早期介入康复护理和一般临床护理（以下简称对照组）两组病例。结果：发现早期介入康复护理患的肩痛、肩手综合症的发生率较一般护理组明显降低（Ｐ〈０．０１）,Ｂ指数康复护理组较一般护理组明显提高（Ｐ〈０．０１）,而肩关节脱位发生率两组之间无明显差异（Ｐ〉０．０５）。结论：说明早期介入康复护理能明显提高脑卒患的日常生活能力