Quality assurance in a children's psychiatric hospital

The use of short-term isolation (STI) in a children's psychiatric hospital was examined using the Joint Commission on Accreditation of Hospitals (JCAH) quality assurance mode. A Clinical Care Evaluation addressed two questions: Are we providing quality use of STI? And are we adequately documenting its use? A medical record audit of 78 discharged patients and a review of unit records provided hospital staff with utilization and demographic statistics; structured interviews with staff and inpatients were conducted that provided information about their opinions of STI. The data gathered served as the basis for recommendations that led to planned, informed program changes.     

舌根癌的手术治疗

目的：探讨舌根癌的手术治疗方法。方法：舌根癌患者21例，经舌骨咽切开进路11例，下颌骨部分切除进路7例，下唇、下颌骨、舌正中切开进路3例。结果：3例下唇、下颌骨、舌正中切开者出现语言功能障碍，吞咽困难；余18例口腔功能均正常。随访2～5年，失访2例，2年生存18例，3年生存13例，5年生存5例。结论：经舌骨咽切开进路对吞咽功能及语言功能的影响较小，是一种值得推广的术式。     

Motor performance benefits of matched limb imitation in prosthesis users

Our previous work demonstrated that the action encoding parietofrontal network, which is crucial in planning and executing motor tasks, is less active in prosthesis users who imitate movements of intact actors (mismatched limb) versus prosthesis users (matched limb). Such activation could have behavioral consequences in prosthesis users rehabilitating with intact therapists. The goal was to identify behavioral effects of matched versus mismatched limb action imitation in naïve users of prostheses. Intact subjects donned a specially adapted prosthetic device to simulate the wrist and forearm movement that transradial amputees experience. While electrogoniometry was recorded, non-amputated prosthesis users (NAPUs) observed and imitated demonstrations of a skillful motor task performed by either an intact actor or NAPU. We hypothesized that NAPUs would elicit less motion variability when performing matched versus mismatched imitation. Matched imitation resulted in a significant decrease in shoulder motion variability compared with mismatched imitation. The matched group also developed elbow motion patterns similar to the NAPU demonstrator, while the mismatched group attempted patterns similar to the intact demonstrator. This suggests a behavioral advantage to matched imitation when adapting to a prosthetic device, as it yielded more consistent movements and facilitated development of new motor patterns. Further, these results suggest that when prosthesis users are faced with the impossible task of imitating movements of an intact hand, they perform this action with greater variability and poorer technique. This work has implications on how prosthetic device operation is conveyed to persons with amputation as their clinical interactions often involve mismatched limb imitation.     

Rh(iii)-catalyzed spiroannulation of 3-arylquinoxalin-2(1H)-ones with alkynes: practical access to spiroquinoxalinones

The Rh(iii)-catalyzed synthesis of spiroquinoxalinone derivatives from 3-arylquinoxalin-2(1H)-ones and alkynes via a C–H functionalization/[3 + 2] annulation sequence has been developed. This method, featuring low catalyst loading, was amenable to Gram scale synthesis and tolerated a variety of functional groups and substitution patterns on the aryl rings, providing the target products in good to excellent yields.

The use of imines as a H acceptor for Rh(iii)-catalyzed spirocyclization of 3-arylquinoxalinones and alkynes via a C–H functionalization/[3 + 2] annulation sequence has been achieved.     

Context and hand posture modulate the neural dynamics of tool–object perception

Prior research has linked visual perception of tools with plausible motor strategies. Thus, observing a tool activates the putative action-stream, including the left posterior parietal cortex. Observing a hand functionally grasping a tool involves the inferior frontal cortex. However, tool-use movements are performed in a contextual and grasp specific manner, rather than relative isolation. Our prior behavioral data has demonstrated that the context of tool-use (by pairing the tool with different objects) and varying hand grasp postures of the tool can interact to modulate subjects' reaction times while evaluating tool-object content. Specifically, perceptual judgment was delayed in the evaluation of functional tool-object pairings (Correct context) when the tool was non-functionally (Manipulative) grasped. Here, we hypothesized that this behavioral interference seen with the Manipulative posture would be due to increased and extended left parietofrontal activity possibly underlying motor simulations when resolving action conflict due to this particular grasp at time scales relevant to the behavioral data. Further, we hypothesized that this neural effect will be restricted to the Correct tool-object context wherein action affordances are at a maximum.64-channel electroencephalography (EEG) was recorded from 16 right-handed subjects while viewing images depicting three classes of tool–object contexts: functionally Correct (e.g. coffee pot–coffee mug), functionally Incorrect (e.g. coffee pot–marker) and Spatial (coffee pot–milk). The Spatial context pairs a tool and object that would not functionally match, but may commonly appear in the same scene. These three contexts were modified by hand interaction: No Hand, Static Hand near the tool, Functional Hand posture and Manipulative Hand posture. The Manipulative posture is convenient for relocating a tool but does not afford a functional engagement of the tool on the target object. Subjects were instructed to visually assess whether the pictures displayed correct tool-object associations. EEG data was analyzed in time–voltage and time–frequency domains. Overall, Static Hand, Functional and Manipulative postures cause early activation (100–400 ms post image onset) of parietofrontal areas, to varying intensity in each context, when compared to the No Hand control condition. However, when context is Correct, only the Manipulative Posture significantly induces extended neural responses, predominantly over right parietal and right frontal areas [400–600 ms post image onset]. Significant power increase was observed in the theta band [4–8 Hz] over the right frontal area, [0–500 ms]. In addition, when context is Spatial, Manipulative posture alone significantly induces extended neural responses, over bilateral parietofrontal and left motor areas [400–600 ms]. Significant power decrease occurred primarily in beta bands [12–16, 20–25 Hz] over the aforementioned brain areas [400–600 ms].Here, we demonstrate that the neural processing of tool-object perception is sensitive to several factors. While both Functional and Manipulative postures in Correct context engage predominantly an early left parietofrontal circuit, the Manipulative posture alone extends the neural response and transitions to a late right parietofrontal network. This suggests engagement of a right neural system to evaluate action affordances when hand posture does not support action (Manipulative). Additionally, when tool-use context is ambiguous (Spatial context), there is increased bilateral parietofrontal activation and, extended neural response for the Manipulative posture. These results point to the existence of other networks evaluating tool-object associations when motoric affordances are not readily apparent and underlie corresponding delayed perceptual judgment in our prior behavioral data wherein Manipulative postures had exclusively interfered in judging tool-object content.     

应用CNASCL-36标准评估HBVDNA定量检测试剂的抗干扰能力

目的评估乙型肝炎病毒(hepatitis B virus,HBV)脱氧核糖核酸(deoxyribonucleic acid,DNA)定量检测试剂的抗干扰能力。方法选择临界值、低值、中值和高值HBV DNA阳性血清样本,采用实时荧光定量PCR(quantitative real-time polymerase chain reaction,q-RT-PCR)技术检测1.63~17.25 g/L的血红蛋白(hemoglobin,Hb)或26.55~497.50μmol/L的总胆红素(total bilirubin,TBIL)对HBV DNA阳性样本检测结果的干扰,依据中国合格评定国家认可委员会(China National Accreditation Service for Conformity Assessment,CNAS)CL-36中的评价标准:偏差大于等于±7.5%时,判断检测结果受到干扰。结果当Hb浓度为7.75~17.25 g/L时,各样本均受到干扰;当Hb≤3.50 g/L时,各样本均未受到干扰。当TBIL浓度为274.60~399.15μmol/L时,仅HBV DNA=2.24×108IU/m L的样本检测未受到干扰;当TBIL=153.55μmol/L时,仅HBV DNA=4.62×102IU/m L的样本检测受到干扰;当TBIL=26.55μmol/L时,各样本均未受到干扰。结论该HBV DNA定量检测试剂具有一定的抗干扰能力:Hb≤3.50 g/L、TBIL≤26.55μmol/L对检测结果没有影响。