Mutations in the transcription factor FOXO1 mimic positive selection signals to promote germinal center B cell expansion and lymphomagenesis

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健康信念模式在老年糖尿病患者足部自我管理中的应用

目的 探讨健康信念模式在老年糖尿病患者足部自我管理中的应用效果。方法 随机抽取2012年6月~2013年12月老年糖尿病患者80例,通过健康信念模式开展观察实施前后患者对足部自我管理能力的变化。结果 实施健康信念模式护理教育后,80例老年糖尿病患者对疾病的认识均有所提高,在认知态度、主动足部护理、掌握足部护理方法和足部症状改善方面与干预前比较,差异有统计学意义（P〈0.05）。结论 健康信念模式可提高老年糖尿病患者自我足部管理的能力,减轻足部神经病变症状,提高了患者的生活质量。     

Modeling heart failure in animal models for novel drug discovery and development

Introduction: When investigating drugs that treat heart diseases, it is critical when choosing an animal model for the said model to produce data that is translatable to the human patient population, while keeping in mind the principles of reduction, refinement, and replacement of the animal model in the research.

Areas covered: In this review, the authors focus on mammalian models developed to study the impact of drug treatments on human heart failure. Furthermore, the authors address human patient variability and animal model invariability as well as the considerations that need to be made regarding choice of species. Finally, the authors discuss some of the most common models for the two most prominent human heart failure etiologies; increased load on the heart and myocardial ischemia.

Expert opinion: In the authors’ opinion, the data generated by drug studies is often heavily impacted by the choice of species and the physiologically relevant conditions under which the data are collected. Approaches that use multiple models and are not restricted to small rodents but involve some verification on larger mammals or on human myocardium, are needed to advance drug discovery for the very large patient population that suffers from heart failure.     

Applying Health Belief Model to Unveil Employees’ Workplace COVID-19 Protective Behaviors: Insights for the Hospitality Industry

The overwhelming majority of the countries around the globe have witnessed severe cases of the COVID-19 outbreak. Unfortunately, many countries are still beset with such an infectious disease. Despite the fact that there is currently no specific approved cure for this deadly infection, restrictions (e.g., lockdown and border closing) are gradually eased. Meanwhile, businesses are reopening and outdoor leisure activities are about to start again based on strict health, social distancing, and hygiene rules. However, as we still have a long way to reach an ultimate treatment for such deadly virus, changing human behavior sounds the best defense in tackling this challenge till a vaccine is developed for protection against COVID-19. With this realization, using Health Belief Model as the theoretical underpinning, our study endeavors to unveil employees’ adherence to protective health behaviors (PHBs) in the hospitality industry, which is known as a people-focused, labor-intensive, and service-oriented business. This is so crucial since there is a high degree of (frequent) interaction between employees and customers in hotels. Moreover, such establishments are known as areas where customers engage in a variety of activities that make health concerns even more crucial. To achieve the objectives of this research, we used secondary data obtained from one of the largest hotel-related online communities in the world: the ‘Tales from the front desk’. Using template analysis approach, 1680 employees’ comments were examined. The results revealed that hotel employees found themselves at high risk of being infected and several obstacles that impeded their PHBs in the workplace were identified. Our study will provide momentous implications about PHBs against COVID-19 for the hospitality industry.     

Did We Get Sensorimotor Adaptation Wrong? Implicit Adaptation as Direct Policy Updating Rather than Forward-Model-Based Learning

The human motor system can rapidly adapt its motor output in response to errors. The prevailing theory of this process posits that the motor system adapts an internal forward model that predicts the consequences of outgoing motor commands and uses this forward model to plan future movements. However, despite clear evidence that adaptive forward models exist and are used to help track the state of the body, there is no definitive evidence that such models are used in movement planning. An alternative to the forward-model-based theory of adaptation is that movements are generated based on a learned policy that is adjusted over time by movement errors directly (“direct policy learning”). This learning mechanism could act in parallel with, but independent of, any updates to a predictive forward model. Forward-model-based learning and direct policy learning generate very similar predictions about behavior in conventional adaptation paradigms. However, across three experiments with human participants (N = 47, 26 female), we show that these mechanisms can be dissociated based on the properties of implicit adaptation under mirror-reversed visual feedback. Although mirror reversal is an extreme perturbation, it still elicits implicit adaptation; however, this adaptation acts to amplify rather than to reduce errors. We show that the pattern of this adaptation over time and across targets is consistent with direct policy learning but not forward-model-based learning. Our findings suggest that the forward-model-based theory of adaptation needs to be re-examined and that direct policy learning provides a more plausible explanation of implicit adaptation.SIGNIFICANCE STATEMENT The ability of our brain to adapt movements in response to error is one of the most widely studied phenomena in motor learning. Yet, we still do not know the process by which errors eventually result in adaptation. It is known that the brain maintains and updates an internal forward model, which predicts the consequences of motor commands, and the prevailing theory of motor adaptation posits that this updated forward model is responsible for trial-by-trial adaptive changes. Here, we question this view and show instead that adaptation is better explained by a simpler process whereby motor output is directly adjusted by task errors. Our findings cast doubt on long-held beliefs about adaptation.     

基于Andersen行为模型的消化道肿瘤患者支持性照顾需求现状及影响因素分析

目的调查消化道肿瘤患者的支持性照顾需求现状并分析其影响因素。方法于2019年1—10月间,采用便利抽样的方法,抽取重庆市三峡中心医院内消化道肿瘤患者共370例,采用一般资料调查表、癌症病人支持性照顾需求简明问卷(SCNS-SF34)、医院焦虑和抑郁量表(HADS)、社会网络支持量表(LSNS)进行问卷调查。以Andersen行为模型为基础,将调查内容中关于消化道肿瘤患者支持性照顾需求的影响因素分别纳入倾向性因素、使能因素和需求性因素中,构建4个线性回归模型进行分析,并检验各模型的拟合优度,采用多元线性回归分析消化道肿瘤患者支持性照顾需求的影响因素。结果共发放问卷370份,回收有效问卷365份,有效回收率为98.6%。365例消化道肿瘤患者支持性照顾需求总均分为(3.42±0.54)分,其中生理与日常生活需求>健康信息需求>照顾与支持需求>心理需求>性需求。多元线性回归分析结果显示:倾向性因素中年龄、婚姻状况,使能因素中的家庭平均月收入、疾病负担能力、社会网络支持,需求性因素中的病程、疾病分期、疼痛情况、焦虑程度、抑郁程度是消化道肿瘤患者支持性照顾需求的主要影响因素(P<0.05)。结论消化道肿瘤患者有较高的支持性照顾需求,其需求受多种因素的影响,建议临床医护人员针对不同需求患者进行针对性满足,并对不同影响因素进行综合考量并加以分类分析。     

At the intersection of science and theory: How the Nurse Role Integration Model reconciles the conflict

As more nurses embrace precision science, there is a tendency to utilize theoretical frameworks from other disciplines thus, placing nursing at risk of losing its autonomy and independence. The discipline has fallen prey to internal binary opposition, eliminating opportunities to engage in civil discourse. To explore how the roles nurses select might fit together in a theoretical framework and help nurses understand how the roles they choose to support their identity as nurses, this paper introduced a model of nursing that includes the bench scientists, the policy activists, and bedside nurses, using the Neuman Systems Model (NSM). The Nurse Role Integration Model (NRIM) espouses the basic tenets of NSM: prevention counteracts stressors from penetrating the client’s lines of defense thus, reducing stress response. Primary prevention reflects the work of the nurse bench scientists, investigating the underlying mechanisms behind pathophysiology; secondary prevention is applied nurse scientists who build upon nurse researchers’ work, identifying and testing potential interventions; tertiary prevention is nurse policy activists, the fulcrum, who leverage primary and secondary findings to argue policy change at all levels. Once policy change is adopted, bedside nurses are educated and implement the change. This lens provides an opportunity to create greater solidarity, strengthening the unity and autonomy of the discipline.