Dermal and epidermal remodeling using botulinum toxin type A for facial, non reducible, hyperkinetic lines: two case studies

Background  Many studies confirm the safety and efficacy of botulinum toxin type A in a variety of clinical indications. Its use for treatment of hyperfunctional facial lines has become the most popular cosmetic procedure. These case studies comprise an evaluation of the long-term treatment of two subjects treated with botulinum toxin type A (BOTOX®, Allergan, Irvine, CA, USA) for hyperfunctional, nonreducible, facial lines.
Aims  This paper aims to assess the long-term effectiveness of BOTOX treatment for hyperfunctional facial lines in two subjects over 7 years.
Patients/methods  Two subjects (case 1: female aged 53 years; case 2: male age 50 years) presenting with glabelar, forehead, and periorbital facial lines were treated with BOTOX over a 7-year period. Case 1 received a total of 24 treatments at 4-monthly intervals, and case 2 received 21 treatments at 3- to 6-monthly intervals.
Results  Skin quality continued to improve over time, revealing a smoother, enhanced, yet "natural" look. In particular, nonreducible forehead lines were effaced suggesting dermal and epidermal remodeling over long-term treatment. There was no evidence of development of any new wrinkles secondary to BOTOX use, and both subjects continue to report high levels of treatment satisfaction. No safety issues were raised.
Conclusions  These case studies demonstrate that nonreducible horizontal forehead lines can show long-term reduction with BOTOX treatment and high levels of subject satisfaction.     

临床医学学科科技进步贡献率评估方法

本文借鉴国内外医疗机构的评估机制和研究方法,提出临床医学优势学科全要素生产率的测度与分解方法,在基于DEA的基础上结合Malaquist生产率指数,构建区域临床医学优势学科科技进步评估研究的基本思路。     

以先进的人才理念推动医院学科发展

加强学科建设,以先进的人才理念推动医院发展。提出在学科建设中：①强化人才意识,加强人才队伍建设;②加强学科建设,搭建人才发展的平台;③提升自主创新能力,加强创新人才建设;④创新用人机制,加强绩效考核;⑤不断加强交流合作,共同营造人才脱颖而出的良好氛围。激活用人新机制,永葆人才活力。     

Inherited understandings: the breast as object

This paper discusses findings from a research study that investigated the experience of being a breastfeeding woman in New Zealand. The study was motivated by a desire to better understand why the majority of New Zealand women wean their infants before 6 months of age, despite the benefits of prolonged breastfeeding being well accepted. Nineteen women, who were breastfeeding or had recently breastfed, were engaged in unstructured interviews about their experience, and the results were examined using a reflective lifeworld research methodology. The findings presented here demonstrate that women often employ an interpretive framework that is aligned with the philosophical tradition of Descartes' mind–body split, also know as Cartesian dualism. This leads to a widely held perception of the breast as an object, which emerged in the participants' narratives and is explored using Heidegger's philosophical interpretation of equipment. We conclude that the objectification of the breast in our society fails to provide women with language that describes the breastfeeding experience in a meaningful way, thus undermining women's ability to articulate and reconcile their embodied breastfeeding experiences.     

Short echo time 1H MRSI of the human brain at 3T with adiabatic slice‐selective refocusing pulses; reproducibility and variance in a dual center setting

Purpose:

To assess the reproducibility of ¹H‐MR spectroscopic imaging (MRSI) of the human brain at 3T with volume selection by a double spin echo sequence for localization with adiabatic refocusing pulses (semi‐LASER).

Materials and Methods:

Twenty volunteers in two different institutions were measured twice with the same pulse sequence at an echo time of 30 msec. Magnetic resonance (MR) spectra were analyzed with LCModel with a simulated basis set including an experimentally acquired macromolecular signal profile. For specific regions in the brain mean metabolite levels, within and between subject variance, and the coefficient of variation (CoV) were calculated (for taurine, glutamate, total N‐acetylaspartate, total creatine, total choline, myo‐inositol + glycine, and glutamate + glutamine).

Results:

Repeated measurements showed no significant differences with a paired t‐test and a high reproducibility (CoV ranging from 3%–30% throughout the selected volume). Mean metabolite levels and CoV obtained in similar regions in the brain did not differ significantly between two contributing institutions. The major source of differences between different measurements was identified to be the between‐subject variations in the volunteers.

Conclusion:

We conclude that semi‐LASER ¹H‐MRSI at 3T is an adequate method to obtain quantitative and reproducible measures of metabolite levels over large parts of the brain, applicable across multiple centers. J. Magn. Reson. Imaging 2010;31:61–70. © 2009 Wiley‐Liss, Inc.     

Morphosyntactic production in Greek- and Italian-speaking individuals with probable Alzheimer’s disease: evidence from subject–verb agreement,tense/time reference,and mood

ABSTRACT

Background: In probable Alzheimer’s disease (AD), different memory systems, executive functioning, visuospatial recognition, and language are impaired. Regarding the latter, only a few studies have investigated morphosyntactic production thus far.

Aims: This study, which is a follow-up on Fyndanis, V., Manouilidou, C., Koufou, E., Karampekios, S., and Tsapakis, E. M. (2013). Agrammatic patterns in Alzheimer's disease: Evidence from tense, agreement, and aspect. Aphasiology, 27, 178–200. doi:10.1080/02687038.2012.705814, investigates whether verb-related morphosyntactic production is (selectively) impaired in AD focusing on two highly inflected languages, Greek and Italian. The morphosyntactic phenomena explored are subject–verb Agreement, Tense/Time Reference, and Mood. Focusing on these phenomena allows us to investigate if recent hypotheses, originally developed in aphasia research, can also capture results related to AD. We tested the hypotheses discussed in Fyndanis, V., Manouilidou, C., Koufou, E., Karampekios, S., and Tsapakis, E. M. (2013). Agrammatic patterns in Alzheimer's disease: Evidence from tense, agreement, and aspect. Aphasiology, 27, 178–200. doi:10.1080/02687038.2012.705814, that is, the Interpretable Features’ Impairment Hypothesis (IFIH) (e.g., Fyndanis, V., Varlokosta, S., & Tsapkini, K. 2012. Agrammatic production: Interpretable features and selective impairment in verb inflection. Lingua, 122, 1134–1147. doi:10.1016/j.lingua.2012.05.004) and the PAst DIscourse LInking Hypothesis (PADILIH; Bastiaanse, R., Bamyaci, E., Hsu, C., Lee, J., Yarbay Duman, T., & Thompson, C. K. 2011. Time reference in agrammatic aphasia: A cross-linguistic study. Journal of Neurolinguistics, 24, 652–673. doi:10.1016/j.jneuroling.2011.07.001).

Methods & Procedures: Two sentence completion tasks testing the production of subject–verb Agreement, Tense/Time Reference, and Mood were administered to 16 Greek-speaking and 10 Italian-speaking individuals with mild-to-moderate AD, as well as to 16 Greek-speaking and 11 Italian-speaking neurologically intact individuals who were matched with the participants with AD on age and education. Mixed-effects models were fitted to the data.

Outcomes & Results: At the group level, both the Greek and Italian participants with AD performed worse than the controls. Both AD groups revealed selective patterns of morphosyntactic production (Greek: Agreement/Mood > Time Reference; Italian: Agreement > Time Reference > Mood). Past Reference and Future Reference did not dissociate in either of the two AD groups. Nevertheless, in all four participants with AD who showed dissociations, Past Reference was more impaired than Future Reference.

Conclusions: The results indicate that the production of verb-related morphosyntactic categories can be impaired in mild-to-moderate AD. The different patterns observed in the two languages are partly attributable to the different way these languages encode Mood. The group results (of both the Greek- and Italian-speaking participants with AD) do not lend support to the PADILIH, whereas only the results of the Italian AD group are fully consistent with the IFIH. However, the individual data are consistent with the PADILIH, and the IFIH is informed by the present data and modified accordingly so that it can capture cross-linguistic patterns of morphosyntactic impairment.     

Mother–infant interactions and infant intake during breastfeeding versus bottle‐feeding expressed breast milk

Bottle‐fed infants are at higher risk for rapid weight gain compared with breastfed infants. Few studies have attempted to disentangle effects of feeding mode, milk composition and relevant covariates on feeding interactions and outcomes. The objective of the present study was to compare effects of breastfeeding directly at the breast versus bottle‐feeding expressed breast milk on feeding interactions. Mothers with <6‐month‐old infants (n = 47) participated in two counterbalanced, feeding observations. Mothers breastfed their infants directly from the breast during one visit (breast condition) and bottle‐fed their infants expressed breast milk during the other (bottle condition). Masked raters later coded videos using the Nursing Child Assessment Parent–Child Interaction Feeding Scale. Infant intake was assessed. Mothers self‐reported sociodemographic characteristics, infant feeding patterns (i.e. percentage of daily feedings from bottles) and level of pressuring feeding style. Mother and infant behaviours were similar during breast and bottle conditions. Percent bottle‐feeding moderated effects of condition on intake (P = 0.032): greater percent bottle‐feeding predicted greater intake during the bottle compared with breast condition. Effects of feeding mode were not moderated by parity or pressuring feeding style, but, regardless of condition, multiparous mothers fed their infants more than primiparous mothers (P = 0.028), and pressuring feeding style was positively associated with infant intake (P = 0.045). Findings from the present study do not support the hypothesis that feeding mode directly impacts dyadic interaction for predominantly breastfeeding mothers and infants, but rather suggest between‐subject differences in feeding experiences and styles predict feeding outcomes for this population.     

Subject allocation and study curtailment for fixed event comparative Poisson trials

Comparative Poisson trials of prophylactic interventions, such as vaccines, can be lengthy and costly. We evaluate two easily implemented approaches to reduce numbers of disease cases and person years of follow up (N(u+t)) for comparative Poisson trials with fixed numbers of cases (T); (i) altering k the portion of N(u+t) allocated to treatment and (ii) curtailed stopping before T cases if numbers of cases in the treatment or control group indicate that H(0) has already been rejected or will not be rejected at T cases. Normal and arcsine approximations as well as discrete exact tests are evaluated. For studies not stopped early, allocating about 1/(1+\sqrt r_a) of person years to treatment roughly minimizes T needed for given size and power (where r(a) is the alternative hypothesized relative disease incidence in treated subjects used to power the study). This reduces T moderately vs equal allocation (k=0.5) by 2-3 cases in our examples with exact tests. However, the common practice of allocating k=0.5 of the person years to treatment may be the overall best strategy to minimize N(u+t) for studies that are not stopped early. For studies analysed by exact test and planned with a one-sided alpha ranging from 0.005 to 0.025, beta from 0.1 to 0.2 and r(a) from 0.2 to 0.5, curtailed stopping reduces both the number of disease cases and N(u+t) by 6-40 per cent depending on true treatment benefit. With curtailed stopping, allocating k=0.5 person years to treatment approximately minimizes the numbers of cases and person years under most conditions, although k as large as 0.6 often performs comparably well. If a specific localized k is selected to minimize disease cases for a study analysed by exact test, the study may be underpowered should the final allocation deviate even slightly from that k when it is conducted.     

上海地区91名正常人强直性肌营养不良基因CTG重复数测定

目的：研究上海地区正常人强直性肌营养不良（ＤＭ）基因中三核苷酸ＣＴＧ重复数的值。方法：用ＰＣＲ扩增及Ｓｏｕｔｈｅｒｎ杂交法检测９１名正常人ＤＭ基因的ＣＴＧ数。结果：测出７个等位基因，其ＣＴＧ重复数分别为５，１１，１３，１５，１９，２３及３０个，其中以１３的频率最高（８０．２１％）。结论：上海地区９１名正常人的结果与日本人群相似，与欧洲人群及中国成都人群不同。