孔边裂纹J积分失效评定曲线

计算了单边椭圆缺口试件（ＳＥＮＣＰ）高应变区裂纹的Ｊ积分失效评定曲线（ＦＡＣ），考察了影响ＦＡＣ的几种因素。结果表明：在外加载荷与塑性屈服载荷之比（Ｌｒ）１．０时，用Ｒ６通用失效评定曲线进行结构高应变区裂纹断裂评定与疲劳剩余寿命估算是安全的。     

lnter-rater reliability of an oral assessment guide for elderly patients residing in a rehabilitation ward

The aim of this study was to test the inter-rater reliability of a revised oral assessment guide (ROAG) for patients residing in a geriatric rehabilitation ward. A consecutive sample of 140 patients was recruited for the study. Oral assessments were performed for 133 newly admitted patients by one registered nurse (RN) during a period of six months. A dental hygienist (DH) carried out 103 oral assessments during the same half-year. For 66 patients, the RN and the DH performed independent assessments. There was an agreement between the RN and the DH in the majority of the independent assessments, except for tongue and teeth/dentures. The percentage agreement exceeded 80 percent. Inter-rater agreement measured by Cohen's Kappa coefficient ranged from moderate to very good and percentage agreement had a range of 58 to 91 percent. The agreement was highest in assessment of voice and swallowing (91%). Assessments of teeth and dentures seemed to be most difficult for the RN to evaluate. ROAG was found to be a clinically useful assessment tool. Additional education and training is needed to improve the reliability of the oral assessments and should include continuous support from a dental hygienist as well as a pictorial manual on how to use the ROAG.     

Breast Cancer Risk Assessment and Counseling: A Clinician's Guide

Abstract: Most individuals concerned about hereditary breast cancer risk will neither order nor benefit from genetic testing at the present time. Many will, however, seek information about their risk and testing. Risk assessment services, in addition to providing information about hereditary risk and genetic testing, need also to include assessment of non-hereditary risks, information about how to evaluate risks, early detection modalities, the etiology of cancer, and assistance in devising follow-up health care plans. Psychosocial factors, particularly those pertaining to the individual's past history with illness and beliefs about causes and prognosis, must be taken into account to provide relevant information that is understood. A case history with examples of some of the types of information that lead to informed consent in a cancer risk assessment setting is provided.     

1999～2001年全国治疗药物监测室间质评结果

目的:通过开展室间质量评价活动提高临床实验室的检验结果质量。方法:每年向参加治疗药物监测(TDM)室间质量评价活动的单位发放质控品10个批号,测定项目包括茶碱、地高辛、苯妥英、苯巴比妥、卡马西平和环孢菌素A,实验室用常规方法测定并回报测定结果,经计算机软件对全部结果进行统计分析。结果:2001年参加TDM室间质评的实验室数为48家,测定结果的平均及格率分别为茶碱94.2％、地高辛82.6％、苯妥英83.8％、苯巴比妥88.4％、卡马西平94.2和环孢菌素A92.4％。1999～2001年全国TDM室间质评的年平均及格率分别为78.7％、84.7％和89.3％。不同测定方法的精密度分别为茶碱4.4％～14.2％、地高辛11.5％～21.9％、苯妥英8.5％～29.5％、苯巴比妥8.2％～13.9％、卡马西平10.8％～12.6％和环孢菌素A15.5％～16.6％。结论:多数参加TDM室间质评实验室的测定结果有较好的一致性,及格率逐年上升,但参加TDM室间质评的实验室数占开展TDM的实验室总数的比例较低,在不同的测定方法间还存在较大的差异。     

The natural history of untreated phenylketonuria over 20 years

Fifty-one adults with untreated phenylketonuria (PKU), have been reviewed after a 20 year interval, at ages ranging from 28.8 to 71.8 years. Five died of causes unrelated to PKU. Three severely affected individuals had shown a progressive loss of motor function and three had developed epilepsy, bringing the total with this problem to 12. No loss of abilities was apparent in 41 patients. Other health problems, including cataracts, were not frequent. Serum phenylalanine levels had decreased over the 20 year period. Untreated PKU does not generally cause progressive loss of abilities during adult life.     

Automatic assessment of levodopa-induced dyskinesias in daily life by neural networks.

We developed an objective and automatic procedure to assess the severity of levodopa-induced dyskinesia (LID) in patients with Parkinson's disease during daily life activities. Thirteen patients were continuously monitored in a home-like situation for a period of approximately 2.5 hours. During this time period, the patients performed approximately 35 functional daily life activities. Behavior of the patients was measured using triaxial accelerometers, which were placed at six different positions on the body. A neural network was trained to assess the severity of LID using various variables of the accelerometer signals. Neural network scores were compared with the assessment by physicians, who evaluated the continuously videotaped behavior of the patients off-line. The neural network correctly classified dyskinesia or the absence of dyskinesia in 15-minute intervals in 93.7, 99.7, and 97.0% for the arm, trunk, and leg, respectively. In the few cases of misclassification, the rating by the neural network was in the class next to that indicated by the physicians using the AIMS score (scale 0-4). Analysis of the neural networks revealed several new variables, which are relevant for assessing the severity of LID. The results indicate that the neural network can accurately assess the severity of LID and could distinguish LID from voluntary movements in daily life situations.     

Positive Outcome Expectancies and Smoking Behavior: The Role of Expectancy Accessibility

This study examined the association between smoking outcome expectancy accessibility and smoking behavior. Daily smokers completed a smoking expectancy accessibility task in which they made timed judgments to a series of positive consequences of smoking either after 6 hr deprivation or within 10 min of smoking. Participants then completed a questionnaire battery that contained assessments of smoking behavior and smoking outcome expectancies. Results of hierarchical regression analyses showed that expectancy accessibility was associated with the number of cigarettes smoked per day even when controlling for corresponding questionnaire measures of smoking expectancies. Moreover, smoking expectancy accessibility predicted urge to smoke ratings following exposure to a smoking cue after controlling for the effects of deprivation. Findings suggest that smoking expectancy accessibility may play a central role in smoking behavior and that individual differences in this attribute may be assessed directly through reaction time assessment.