Controlling for occasion-specific effects when assessing the test–retest reliability of self-report health questionnaires

OBJECTIVE: This study proposes a method for self-report health questionnaires to adjust test-retest reliability for changes during the test-retest interval based on an external measure, and to distinguish such changes from random response errors. METHODS: In our application, eighty participants completed the Symptoms of Illness Checklist (SIC) on two occasions, two weeks apart, immediately before interviews given on each occasion by one of two physicians in a crossover design. The physician interview scores served as external measures, and structural equation modeling was used to estimate the parameters of a model that corrected for the occasion-specific effect of participants' responses using information from the interviews. RESULTS: Correcting for changes in symptoms during the test-retest interval increased SIC test-retest reliability from .744 to .804 and significantly improved model fit (chi2(diff)(1) = 30.78, p < .001). CONCLUSIONS: The results suggest methods that can improve the evaluation of self-report health questionnaire test-retest reliability by identifying changes using an external measure, and distinguishing these from random response errors; these increased the estimated SIC test-retest reliability and indicated that the SIC was indeed able to measure changes over the studied time interval. This method can be applied across a broad range of questionnaires.     

Origin of impulse initiation in the slowly adapting stretch receptor of the crayfish

Summary Characteristic for the crayfish stretch receptor is a gradual decrease in axon diameter up to a stretch of axon about 350 m away from the soma-axon border. In response to depolarizing currents applied at different positions along the axon this stretch of axon can be localized as the most excitable membrane region. When depolarizing current steps of 10–25 nA intensity are injected into the soma the first impulse is always triggered in the soma (due to sudden rise in the membrane potential) while the second impulse originates at the axon region of highest escitability. As the intensity of the stimulus is increased the site of impulse initiation along the axon shifts nearer to the receptor soma. At a stimulus intensity of 50 nA the second impulse is suppressed and only the membrane potential at the axon hillock increases slightly. An analysis of the conductances for sodium and potassium ions as well as of the leakage current suggests that the molecular basis for the observed variations in excitability resides in a gradual decrease of the sodium conductance between the cell soma and the small-diameter region of the axon. However, the resting potential in this most excitable axon region is only some 3 mV more positive as compared to the receptor soma. A mathematical formulation is presented for the encoder mechanism in a soma-axon region with varying diameter. Using a slightly modified form of the Hodgkin-Huxley equations the experimentally observed changes in membrane potential and in the time course of the ionic currents can be adequately described by applying a nonlinear cable equation to the inhomogeneous axon.     

Heterosynaptic postactivation potentiation in hippocampal CA 3 neurons: Long-term changes of the postsynaptic potentials

Summary CA 3 neurons were excited synaptically by stimulation in the dentate hilus and the stratum radiatum of CA 1 in guinea pig hippocampal slices. Following repetitive stimulation (10–20 c/s, 10 s) of either stimulation site, the amplitudes of orthodromic population spikes or the probability of unitary discharges increased. Changes of the intracellularly recorded potentials were either (a) increased EPSP amplitudes associated with decreased IPSP amplitudes, or (b) increased IPSP amplitudes. A cell showing enhanced IPSPs after repetitive activation could respond with increased EPSP amplitudes and decreased IPSP amplitudes upon further repetitive activation. The potentiation, which was always preceded by a 5–10 min depression, lasted up to 3 h. This potentiation was heterosynaptic, since the responses to the non-stimulated input also changed and since the inputs were found to excite the pyramidal cells through separate synapses in double shock experiments. The heterosynaptic mode of the potentiation as well as the changes of the IPSPs indicate that not only the excitatory pathway but also the inhibitory pathway must be considered in explaining postactivation potentiation in this hippocampal field.     

The surgical care practitioner: a dual perspective

The ongoing balance of service delivery and training offset with the European Working Time Directive has resulted in a requirement to review the surgical workforce and new ways of working. The extended surgical team can be utilized to support the delivery of surgical services. Surgical care practitioners are trained to care for surgical patients across the whole patient pathway: in clinics, theatre and on the ward. They are continual members of the surgical team and can support both the service and training due to the flexible nature of the role. This article gives an overview of the role of the surgical care practitioner (SCP) and how the role impacts surgical training.     

强的松对大白鼠心肺肝脾肾影响的病理改变

为了解强的松对心肺肝脾肾影响的病理改变,应用正常Wistar大白鼠28只,分实验组及对照组各14只。实验组给予相当于人2mg/kg.d等效剂量的强的松片剂溶入当日饮水中,对照组饮自来水,共10周,之后解剖光镜见对照组心肺肝脾肾及实验组心肺均无异常。实验组肝肾轻度充血,脾充血明显,且见较多舍铁血黄素沉着,以红髓边缘明显。证实常规剂量的强的松对肝脾肾也有一定不良影响,应用激素时要注意及时调整剂量和给药方式与时间,尽量减少副作用。     

干扰素调节因子 5、粒细胞 -巨噬细胞集落刺激因子在细菌性肺炎病儿血清中的表达及预后价值

目的探讨干扰素调节因子 5(interferon regulatory factor 5,IRF5)、粒细胞 -巨噬细胞集落刺激因子( granulocyte-macrophage colony-stimulating factor,GM-CSF)在细菌性肺炎病儿血清中的表达变化及疾病预后价值。方法选取 2019年 4月至 2021年 5月中国人民解放军联勤保障部队第九二八医院收治的细菌感染性肺炎病儿 96例作为细菌组,同期非细菌感染性肺炎病儿 88例作为非细菌组,另外选取健康体检儿童 96例为对照组,收集检测三组病儿基本临床资料。检测血清中 IRF5、GM-CSF及其组间差异;采用 Pearson法分析细菌性肺炎病儿血清 IRF5、GM-CSF水平与病情指标的相关性;应用受试者操作特征曲线(ROC曲线)分析 IRF5、GM-CSF及二者联合预测细菌性肺炎预后的价值。结果细菌组血清 IRF5水平［(38.85±13.86)ng/L］显著高于非细菌组［( 11.15±4.37)ng/L］和对照组［( 10.76±1.55)ng/L］,且重症组高于轻症组( P<0.05);细菌组血清 GM-CSF水平［(54.73±16.56)ng/L］显著低于非细菌组［(246.73±28.94)ng/L］和对照组［(250.64±55.67)ng/L］,且重症组低于轻症组( P<0.05)。重症组气促、吐沫、三凹征、肺部明显湿啰音比例、 C反应蛋白( C-reactive protein,CRP)、白细胞水平显著高于轻症组、非细菌组(P<0.05)轻症组、非细菌组 CRP水平显著高于对照组( P<0.05),非细菌组 CRP水平显著高于对照组( P<0.05)。血清 IRF5水平与 CRP、,白细胞、临床肺部感染评分( clinical pulmonary infection score,CPIS)均呈正相关( r=0.34、0.36、0.41,P<0.05)血清 GM-CSF水平与 CRP、白细胞、 CPIS均呈负相关( r=-0.40、-0.32、-0.45,P<0.05)。预后不良组血清 IRF5水平高于预后良好,组,血清 GM-CSF水平低于预后良好组( P<0.05)。 ROC曲线显示, IRF5、GM-CSF对预后预测的 AUC分别为 0.90、0.87,二者联合对预后预测的 AUC为 0.96,明显高于二者单独诊断,(Z联合 vs.IRF5=2.86,P=0.004;Z联合 vs.GM-CSF =2.24,P=0.025),其灵敏度、特异度分别为 90.32%、90.77%。结论细菌性肺炎病儿血清 IRF5水平升高, GM-CSF水平降低,二者在评估病情进展及疾病预后预测方面具有较高的价值。     

国产头孢三嗪对金葡菌,大肠杆菌及绿脓杆菌超微结构影响的观察

本文采用负染和超薄切片技术在电镜下的观察,研究了国产头孢三嗪在高浓度下和亚最低抑菌浓度下对金葡菌、大肠杆菌和绿脓杆菌超微结构的作用。结果显示,10MIC的头孢三嗪作用3小时即可导致细菌发生不可逆性改变,出现细胞膜皱缩,胞质稀疏,细胞膜连续性丧失,甚至细胞破裂,解体死亡。经Sub-MIC的头孢三嗪作用后,金葡菌呈现菌体增大,横膈增宽;而大肠杆菌和绿脓杆菌则表现为菌体增长和菌丝体形成,胞内出现大小不一的空泡,电子密度下降.本研究证实了头孢三嗪为一杀菌类抗生素;提示本药对细菌的形态学改变,主要由于和PBP_3结合所致。     

杭菊品种及产地现状考察

目的:对杭菊不同产地及所产品种现状进行考察,了解全国杭菊资源历史和现状。方法:实地调查、标本和文献研究。结果:杭菊道地产区一直位于杭嘉湖平原,现形成以浙江桐乡为道地,江苏射阳和湖北麻城为引种产区的新格局,分别主产湖菊、小白菊、大白菊,而杭黄菊仅产于江苏射阳。其中桐乡和射阳出现杭菊新兴加工品胎菊,引种产区均出现早菊。结论:由于长期人工栽培和选育,杭菊产生了多样品种、其习性各异,适应不同产地环境。     

洞庭湖傍山移民建镇地区血吸虫病疫情变化研究

目的 查明傍山移民建镇地区环境改变对血吸虫病流行因素的影响及疫情变化趋势。方法 采用试点现场调查和实验室检查相结合的方法，观测人、畜血吸虫病感染、钉螺分布、环境因素等变化情况。结果 傍山移民建镇后，居民点距易感地带变远，居民血吸虫病感染率呈下降趋势；由于人畜粪便污染减少，易感地带感染性钉螺密度下降。结论 傍山移民建镇对控制血吸虫病疫情有积极意义。     

外环境湿度和换气次数对独立通风笼盒微环境湿度和氨浓度的影响

目的：评估在独立通风笼盒（IVC）所处环境不同湿度条件下,IVC 不同换气次数时,大、小鼠 IVC 微环境湿度和氨浓度的变化。方法屏障环境内,以7 d 为换笼周期,分别设定室内环境低湿（40％）、中湿（50％）、高湿（60％）,IVC 换气次数为40次/h、60次/h 时,对3个品牌大、小鼠 IVC 微环境进行测定,观察笼盒内湿度和氨浓度的变化。结果当室内环境为低湿条件,小鼠和大鼠 IVC 换气次数设置为40次/h 时;当室内环境为中湿条件,小鼠换气次数设置为40次/h、大鼠换气次数设置为60次/h 时;当室内环境为高湿条件,小鼠换气次数设置为60次/h 时,笼盒内微环境均基本能够满足 GB14925-2010对湿度和氨浓度的要求。而在高湿情况下,即使大鼠 IVC换气次数置为60次/h 也不能满足要求。结论室内环境湿度和 IVC 换气次数是影响 IVC 微环境的关键指标,只有依据室内环境条件合理设置 IVC 换气次数才能较好地维护 IVC 微环境和达到有效管理的目的。