How current risk assessment and risk management methods for drinking water in The Netherlands cover the WHO water safety plan approach

In the Netherlands, safe and sufficient drinking water is provided to the general population by ten drinking water companies. To guarantee safe drinking water the World Health Organization (WHO) developed a Water Safety Plan (WSP), a Risk Assessment and a Risk Management (RA/RM) framework. The objective of the study was to identify legally required RA approaches, to document application of RA/RM activities at Dutch drinking water companies and to determine to what extent these RA/RM activities as a whole cover all the elements of the WHO WSP approach. This study could be of interest to both managers of large water utilities and decision makers.The assessment was performed by means of a policy review and interviews with two to four staff members involved in RA/RM from all ten Dutch drinking water companies combined with a joint workshop. The drinking water companies are well aware of the potential hazards and risks that can influence the drinking water quality. To guarantee the supply of safe and sufficient drinking water, the Dutch drinking water sector uses six different legally required RA/RM approaches. This study shows that by using the six legally required RA/RM approaches, all WSP steps are covered. WSP entails a generic risk assessment for identifying all hazards and hazardous events from source to tap, whereas the six legally required RA/RM each focus on specific risks at an advanced level. Each risk assessment provides information on specific hazards and hazardous events covering a part of the water supply chain. These legal requirements are complemented with additional RA/RM activities at sector and water company level such as codes of practices and standard operating procedures. The outcomes of all RA/RM approaches combined provide information from source to tap. When using multiple RA/RM approaches, it is crucial to share and combine information derived from the different activities.     

Técnicas de imagen híbridas en cardiopatía isquémica

Hybrid imaging for ischemic heart disease refers to the fusion of information from a single or usually from multiple cardiovascular imaging modalities enabling synergistic assessment of the presence, the extent, and the severity of coronary atherosclerotic disease along with the hemodynamic significance of lesions and/or with evaluation of the myocardial function. A combination of coronary computed tomography angiography with myocardial perfusion imaging, such as single-photon emission computed tomography and positron emission tomography, has been adopted in several centers and implemented in international coronary artery disease management guidelines. Interest has increased in novel hybrid methods including coronary computed tomography angiography-derived fractional flow reserve and computed tomography perfusion and these techniques hold promise for the imminent diagnostic and management approaches of patients with coronary artery disease. In this review, we discuss the currently available hybrid noninvasive imaging modalities used in clinical practice, research approaches, and exciting potential future technological developments.     

轻中度癌痛患者的回顾性记忆与前瞻性记忆功能损害的临床研究

目的 探讨轻中度癌痛患者的回顾性记忆（RM）与前瞻性记忆（PM）功能，了解癌痛对记忆功能的影响。方法 收集轻中度癌痛患者和健康对照者各37例，进行总体认知评估及RM和PM问卷调查。结果癌痛组简易精神状态量表得分为24.19±3.20，低于健康对照组的27.54±1.83（P＜0.01）；PM得分为14.76±4.53，高于健康对照组的9.59±1.38（P＜0.01）；癌痛组RM得分略低于健康对照组（12.78±4.27 vs. 12.91±5.12），差异无统计学意义（P＞0.05）。结论 轻中度癌痛患者存在总体认知功能的损害，以记忆功能损害较为明显，其中以PM损害为主。     

Effects of Classic Progressive Resistance Training Versus Eccentric-Enhanced Resistance Training in People With Multiple Sclerosis

Objective

To compare the effects of classic progressive resistance training (PRT) versus eccentric strength-enhanced training (EST) on the performance of functional tests and different strength manifestations in the lower limb of people with multiple sclerosis (PwMS).

The specific contributions of force and velocity to muscle power in older adults

The purpose of this study is to examine the relative importance of the force-based and velocity-based measures of muscle performance to explain inter-individual differences in power production capability and functional task performance. Participants included seventy-nine men and women: middle-aged healthy adults (MH: 40-55years), older healthy adults (OH: 70-85years), and older adults with mobility limitations (OML: 70-85years). Muscle power at 180°/s, isometric maximal torque, and maximal contraction velocity at 40% 1RM were measured during unilateral leg extension. The Short Physical Performance Battery (SPPB) was used to differentiate between healthy and mobility limited older adults. Functional task performance was assessed using multiple chair rise and stair climb tests. Leg extensor force (torque), but not maximal contraction velocity, was significantly associated with muscle power in MH. Both torque and velocity were significantly associated with muscle power in OH. Maximal velocity, but not torque, was associated with power in OML. Maximal velocity demonstrated an association with multiple chair rise time and stair climb time in OML, but not MH or OH. It is concluded that movement velocity is an increasingly important determinant of maximal power output with advancing age. Furthermore, movement velocity is also a critical component of functional task performance with aging and may contribute to functional deficits. These findings help to explain why the rate-dependent variable power has emerged as a critical component of both assessment and rehabilitation of muscular performance and physical function in older adults.     

59例难治性肺癌化疗并异博定和（或）三苯氧胺疗效

５９例难治性肺癌：３５例接受常规联合化疗无效的为组１（Ｇ１）；２４例达缓解后复发和（或）转移者为组２（Ｇ２）。异搏定（ＶＰＬ）和（或）三苯氧胺（ＴＡＭ）始于化疗前３日，持续至化疗后４日止。ＶＰＬ及ＴＡＭ剂量各为６０－１２０ｍｇ／ｄ及６０－１２０ｍｇ／ｄ，均分３次服。     

家兔大脑皮层诱发电位的实验改进

目的:对家兔大脑皮层诱发电位的实验进行改进。方法:使用RM6240B生物信号采集处理系统,将刺激输出电极插入家兔前爪腕部,在家兔颅骨钻孔,将通道输入电极连于钻头,电刺激并观察电位变化。结果:在家兔大脑皮层记录到诱发电位,出现主反应、次反应和后发放。结论:改进后的钻孔术,不易损伤大脑皮层,也不需暴露外周神经,操作简单,成功率高。     

Controlled sleep restriction for rhythmic movement disorder

Rhythmic movement disorder is a parasomnia that is difficult to treat. In our study, 3 weeks of controlled sleep restriction with hypnotic administration in the first week resulted in almost complete resolution of the movements in 6 children. This therapeutic success suggests that rhythmic movement disorder results from a voluntary self-soothing behavior.