Morphological,Functional, and Tissue Characterization of Silent Myocardial Involvement in Patients With Primary Biliary Cholangitis

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Relevance of 10-min delayed recall in dementia screening

Within the context of early diagnosis of Alzheimer's disease (AD), there is a growing interest in neuropsychological screening tests. Amongst these tests, we focused on the largely used Memory Impairment Screen (MIS). The objective of the present work was to show that adding a 10-min delayed recall to the MIS, improves the test psychometric characteristics in order to detect dementia in the earliest stages. A prospective study was carried out on a cohort of 270 consecutive elderly ambulatory subjects attending the Broca Hospital Memory Clinic: normal controls ( n  = 67), mild cognitive impairment subjects ( n  = 98) and mildly demented patients [ n  = 105, Mini Mental State Examination (MMSE) = 23 ± 4]. This study consisted in testing the advantage of the 10-min delayed recall entitled MIS-D compared with the MIS. At a cut-off score of 6, the MIS-D revealed satisfying psychometric characteristics with a sensitivity of 81% and a specificity of 91%, whilst the MIS alone indicated a sensitivity of 60% and a specificity of 88% in detecting dementia. In demented patients with MMSE score ≥26, MIS-D properties still remained satisfying (sensitivity: 75%, specificity: 92%). MIS-D is a more relevant screening test than MIS alone at very early stages of dementia.     

急性冠状动脉综合征患者介入术前后血小板活化及血管内皮功能的变化

目的观察急性冠状动脉综合征患者介入治疗后血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物及内皮功能的改变。方法60例急性冠状动脉综合征患者在冠状动脉介入术前和术后即刻以及次日采用流式细胞仪检测血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物;双抗体夹心固相酶联免疫吸附试验测定血浆假血友病因子的表达水平;放射免疫测定法测定血浆内皮素1表达水平;酶法测定血浆一氧化氮的含量;彩色多谱勒超声诊断仪测量内皮依赖性血管舒张功能。选择健康体检者和稳定型心绞痛患者各30例作对照,观察急性冠状动脉综合征患者冠状动脉介入前后指标的变化并与对照组比较。结果与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物明显增高(P<0.05或0.01);急性冠状动脉综合征患者介入术后即刻CD62p、CD63和糖蛋白Ⅱb/Ⅲa受体复合物与术前相比明显增高(P<0.01),但术后24h较术前无明显变化(P>0.05)。与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组假血友病因子、内皮素1的表达水平明显增高(P<0.01),内皮依赖性血管舒张功能和一氧化氮降低(P<0.05或<0.01);急性冠状动脉综合征患者介入术后即刻血浆假血友病因子和内皮素1水平升高(P<0.05或P<0.01),内皮依赖性血管舒张功能和一氧化氮水平降低(P<0.05),且介入术后24h假血友病因子水平也较术前升高(P<0.05),内皮依赖性血管舒张功能降低(P<0.05),但内皮素1和一氧化氮水平与术前差异无显著性(P>0.05)。结论血小板活化和内皮功能的损伤在急性冠状动脉综合征发生和发展过程中起重要的作用,冠状动脉介入术后血管内皮受到一定损伤,血小板有一定程度的激活。     

老年轻度认知功能损害患者血清维生素E、超氧化物歧化酶和丙二醛的测定及临床意义

目的　了解轻度认知功能损害 (MCI)患者血清维生素E(VitE)、超氧化物歧化酶 (SOD)和丙二醛(MDA)的水平 ,探讨其变化的临床意义。方法　采用 1∶1配对病例对照设计 ,受试者均于晨 7时空腹抽静脉血 ,应用紫外分光光度法测定了 4 5例老年MCI患者和 4 5例健康老年人血清VitE ,SOD和MDA的含量。结果　老年MCI患者血清VitE含量及SOD活性显著低于健康老年人 (P <0 .0 1) ,血清MDA含量显著高于健康老年人 (P <0 .0 1)。结论　以MDA为代表的自由基代谢产物参与了MCI的病理生理过程 ;临床上应给予外源性VitE以进行早期干预治疗。     

“The experiences and needs of persons with disabilities in using paratransit services”

BackgroundPersons with disabilities do not yet experience equality with the rest of the population when using transportation. Paratransit services take over transportation for persons with disabilities when public transportation cannot be used or can only be used to a limited extent. The usefulness of these services remains limited due to financial and structural reasons.ObjectiveThis study aims to identify the experiences of persons with disabilities with paratransit in Switzerland, explores their needs and verifies facilitators and barriers to the use of paratransit services. Furthermore, perceived experiences of how barriers and facilitators of transportation influence the participation in different areas of life of these persons are examined.MethodsIn this study, we adopted a qualitative approach with four online focus group discussions and one physically present discussion group, including 31 participants overall. We collected data between July and October 2021 and analyzed the data using content analysis according to Mayring (2015).ResultsOverall, persons with disabilities experience paratransit as important and appreciated this alternative to public transportation. Specifically, the services’ need is individual for each person and depends on different facilitating factors (e.g., habits, health condition, activities, safety, accessibility, service) and barriers (e.g., costs, weather conditions).ConclusionsThe need for paratransit services is highly individual and impacts participation in different life areas. On one hand, the federalist system in Switzerland supports a local and cultural embedment, but on the other hand leads to difficulties concerning transportation beyond the close local environment and for longer distances.     

针药结合治疗血管性认知障碍40例临床观察

目的观察针刺结合舒血宁注射液治疗血管性认知障碍的疗效。方法以针刺法痰瘀并治加舒血宁针静滴治疗血管性认知障碍患者40例,另设26例单纯针刺对照组均以15天为1疗程,2疗程后统计结果。结果针药结合组疗效明显优于单纯针刺组。结论针药结合治疗血管性认知障碍疗效确切。     

Differential verbal working memory effects on linguistic production in children with Specific Language Impairment

Deficits in verbal working memory (vWM) have often been reported in children with Specific Language Impairments (SLIs) and might significantly contribute to their linguistic difficulties. The linguistic and narrative skills of a group of children with diagnosis of SLI were compared to those of a group of children with typical development. The linguistic assessment included a comprehensive analysis of their lexical, grammatical and narrative abilities. Overall, the participants with SLI had difficulties at all three levels of linguistic processing. The effect of vWM was marginal on lexical processing, significant on grammatical structuring, and null on narrative construction.     

A scoping review of public building accessibility

BackgroundThe built environment needs to be designed so that all people can participate in the activities they want and need to do. Yet, accessibility is difficult to put into practice, and accessibility issues tend to be overlooked in the building and planning processes.ObjectivesThe aim of this scoping review was to summarize the research front in the area of accessibility to public buildings. Specific aims were to identify knowledge gaps, to identify access activities in relation to environmental features and to link to predominant activities in terms of the International Classification of Functioning, Disability and Health (ICF).MethodsA literature search was performed in PubMed, PsycINFO, Inspec, Embase and Cochrane databases. Articles in English based on original empirical studies investigating accessibility of public buildings for adults aged ≥18 years with functional limitations were considered.ResultsOf the 40 articles included, ten involved study participants, while 30 only examined buildings using instruments to assess accessibility. In addition, the psychometric properties were only tested for a few of them. All articles concerned mobility and several visual limitations, while few addressed cognitive or hearing limitations. Ten main access activities were identified, from using parking/drop-off area to exiting building.ConclusionsBy using the ICF and theoretically relating the accessibility problems to activities, the results revealed that there are large knowledge gaps about accessibility to public buildings for older people and people with functional limitations and that there is a need for more methodological considerations in this area of research.