基于R语言平台的糖尿病证候分布演化规律研究

糖尿病证候分布演变规律的研究对中医治疗糖尿病的临床决策具有重要的意义。本文提出基于R语言平台,以大量临床证候数据作为研究对象,采用聚类分析数据挖掘算法,构建糖尿病证候分布模型;以年龄作为时间变量,构建糖尿病时间序列证候分布演化模型;采用时间序列相似性分析方法,将数据可视化展示,结合中医临床知识分析数据挖掘结果。本研究为糖尿病证候分布演变研究提供一种新的思路与方法,对探究糖尿病证候分布演变的本质产生积极作用,并指导临床实践。     

家庭环境对儿童早期语言发育的影响

语言发育迟缓是儿童早期常见的发育问题,是影响儿童健康成长的重要因素之一。作为儿童早期所处的主要生活环境,家庭环境对儿童早期语言发育有重要影响,是决定儿童早期语言发育水平的关键因素之一。近年来,家庭环境对儿童早期语言发育影响的研究很多,已成为儿童语言发育领域的研究热点。本文对近期国内外探究家庭环境对儿童早期语言发育影响所取得的成果做一概述。     

Plain Language for Patient Education

Low health literacy continues to be a barrier in patient education. One solution to low health literacy is creating or providing patient education materials written in plain language. Plain language follows guidelines created for federal agencies to ensure that documents are written in clear and accessible language for all audiences. Health care professionals and librarians can locate or recommend plain language health information from many reputable consumer health websites.     

Real-time clinical note monitoring to detect conditions for rapid follow-up: A case study of clinical trial enrollment in drug-induced torsades de pointes and Stevens-Johnson syndrome

Identifying acute events as they occur is challenging in large hospital systems. Here, we describe an automated method to detect 2 rare adverse drug events (ADEs), drug-induced torsades de pointes and Stevens-Johnson syndrome and toxic epidermal necrolysis, in near real time for participant recruitment into prospective clinical studies. A text processing system searched clinical notes from the electronic health record (EHR) for relevant keywords and alerted study personnel via email of potential patients for chart review or in-person evaluation. Between 2016 and 2018, the automated recruitment system resulted in capture of 138 true cases of drug-induced rare events, improving recall from 43% to 93%. Our focused electronic alert system maintained 2-year enrollment, including across an EHR migration from a bespoke system to Epic. Real-time monitoring of EHR notes may accelerate research for certain conditions less amenable to conventional study recruitment paradigms.     

APOε2 and education in cognitively normal older subjects with high levels of AD pathology at autopsy: findings from the Nun Study

Asymptomatic Alzheimer''s disease (ASYMAD) subjects are individuals characterized by preserved cognition before death despite substantial AD pathology at autopsy. ASYMAD subjects show comparable levels of AD pathology, i.e. β-amyloid neuritic plaques (Aβ-NP) and tau-neurofibrillary tangles (NFT), to those observed in mild cognitive impairment (MCI) and some definite AD cases. Previous clinicopathologic studies on ASYMAD subjects have shown specific phenomena of hypertrophy in the cell bodies, nuclei, and nucleoli of hippocampal pyramidal neurons and other cerebral areas. Since it is well established that the allele APOε4 is a major genetic risk factor for AD, we examined whether specific alleles of APOE could be associated with the different clinical outcomes between ASYMAD and MCI subjects despite equivalent AD pathology. A total of 523 brains from the Nun Study were screened for this investigation. The results showed higher APOε2 frequency (p < 0.001) in ASYMAD (19.2%) vs. MCI (0%) and vs. AD (4.7%). Furthermore, higher education in ASYMAD vs. MCI and AD (p < 0.05) was found. These novel autopsy-verified findings support the hypothesis of the beneficial effect of APOε2 and education, both which seem to act as contributing factors in delaying or forestalling the clinical manifestations of AD despite consistent levels of AD pathology.     

Parents' Perceptions of Preschool Television

Preschool television in the United States has received acclaim from parents and communication researchers for its high quality. Some of the most popular programs in this genre are those that feature Latino themes, such as Dora the Explorer, prompting inquiry into whether there are differences between Spanish- and English-speaking families in the frequency of viewing these shows. An analysis was conducted to determine the programs available to children prior to the distribution of a survey to parents of preschool-age children to assess viewing habits focusing on shows that have Latino themes. The data reveal that Spanish-speaking families have more favorable perceptions toward television in general and desire more Latino-themed programming, whereas English-speakers are more complacent about additional shows. Further, it was found that primary language is a stronger predictor than ethnicity in determining differences in overall perceptions of the influence of television and the desire for more Latino programming.     

The encoding of word forms into memory may be challenging for college students with developmental language impairment

Purpose: To describe the word-learning problems characteristic of developmental language impairment (LI).

Method: College students with LI (n?=?39) or normal language development (ND, n?=?40) attempted to learn novel word forms. Training for half of the words was meaning-focused; training for the other half was form-focused. Form recognition and stem completion tasks administered immediately after training tapped encoding of the lexical configuration and a repetition of the stem completion task one week later tapped consolidation. A visual world paradigm tapped lexical engagement.

Result: At the immediate post-test, the LI group was poorer at recognition and completion of word forms than their ND peers, suggesting a deficit in encoding the lexical configuration. However, the gap between the LI and ND groups in stem completion did not grow over the week, suggesting intact consolidation. Form-focused training yielded better performance than meaning-focused training at immediate- and one week tests. For both groups, newly trained words slowed the recognition of familiar English words, revealing lexical engagement.

Conclusion: The encoding of word-form configurations is challenging for some, but not all, college students with LI. Training that encourages a focus on the form may be a useful part of vocabulary intervention for those affected.     

Dosage effects of X and Y chromosomes on language and social functioning in children with supernumerary sex chromosome aneuploidies: implications for idiopathic language impairment and autism spectrum disorders

Background: Supernumerary sex chromosome aneuploidies (X/Y‐aneuploidies), the presence of extra X and/or Y chromosomes, are associated with heightened rates of language impairments and social difficulties. However, no single study has examined different language domains and social functioning in the same sample of children with tri‐, tetra‐, and pentasomy X/Y‐aneuploidy. The current research sought to fill this gap in the literature and to examine dosage effects of X and Y chromosomes on language and social functioning. Methods: Participants included 110 youth with X/Y‐aneuploidies (32 female) and 52 with typical development (25 female) matched on age (mean ～12 years; range 4–22) and maternal education. Participants completed the Wechsler intelligence scales, and parents completed the Children’s Communication Checklist‐2 and the Social Responsiveness Scale to assess language skills and autistic traits, respectively. Results: Both supernumerary X and Y chromosomes were related to depressed structural and pragmatic language skills and increased autistic traits. The addition of a Y chromosome had a disproportionately greater impact on pragmatic language; the addition of one or more X chromosomes had a disproportionately greater impact on structural language. Conclusions: Given that we link extra X chromosomes with structural language impairments and an extra Y chromosome with pragmatic language impairments, X/Y‐aneuploidies may provide clues to genetic mechanisms contributing to idiopathic language impairment and autism spectrum disorders.