Procedia, social and behavioral sciences最新文献

Background: Family factors are linked to the development of anorexia nervosa (AN) and bulimia nervosa (BN). However, due to a lack of direct comparison, it is still unknown whether the two entities of eating disorders differ with respect to the age gaps between parents and their affected children.

Methods: In a cohort of 568 patients from the FamFINED study (FAMily Factors INvolved in Eating Disorders) diagnosed with eating disorders, we assessed the relationships between the parent-child age differences and family dysfunction, as determined by means of the General Family Questionnaire ("Allgemeiner Familienbogen" [FBA]).

Results: Data showed that the age difference between the mother and the affected child was significantly higher in AN compared to BN patients (29.3 ± 5.3 vs. 28.3 ± 5.1 years, p = 0.017). Logistic regression confirmed that, also in adjusted models, the mother-child age difference significantly differed between the diagnoses of the two eating disorders (exp (B) = 0.918, 95% confidence interval 0.87-0.97, p = 0.004). However, the paternal age difference did not reach a statistical significance in the comparison between the two groups (p = 0.071).

Conclusions: The two entities of eating disorders differed significantly with respect to the age difference between the mother and the affected subject. The maternal age difference was higher in anorectic than in bulimic patients from the same study population. Further research is required to identify the psychophysiological mechanisms underlying these age-dependent effects.

An aberrant vessel presenting as a pulsatile neck mass poses a significant challenge intraoperatively if overlooked during the pre-operative period. We present a case of a high-riding innominate artery (HRIA) just above the suprasternal notch, with the right common carotid artery crossing the midline just inferior to the thyroid gland in a 72-year-old lady referred for tracheostomy. The surgeon operating on the anterior part of the neck must be aware of the HRIA and equipped with sufficient knowledge of interventions that may be adapted to prevent injury. We aim to highlight the importance of careful investigations of subtle signs which may lead to the diagnosis and treatment with a review of various interventions for this unusual condition.

Background: During the coronavirus disease 2019 (Covid-19) pandemic, mental health services adopted telehealth to facilitate ongoing assessment and treatment of patients with severe mental illness. We aimed to assess the telehealth experience of mental health patients and clinicians during the COVID-19 pandemic to inform ongoing clinical telehealth service usage.

Methods: Two participant cohorts were recruited: Patients with severe mental illness at a community public mental health service; and clinicians working within this service. Participants from both cohorts were surveyed regarding their experience of using telehealth.

Results: The survey was completed by 44 patients and 51 clinicians. Most participants reported having access to appropriate telehealth technology. Among patients, 80% reported having participated in any telephone consultations, while 39% reported having taken part in video-telehealth consultations with their psychiatrist. Similarly, 77% of clinicians reported having used video telehealth. Patients reported feeling more confident with video telehealth if they were younger, lived with friends, family or partner, or had access to the internet or a smartphone. Patients reported that telehealth consultations were more convenient and may reduce nonattendance. They reported having good rapport when using video telehealth. The majority of clinicians reported feeling positively about assessing risk and delivering therapy using video telehealth but not with telephone consultations.

Conclusions: Our study suggests that video telehealth is a feasible way of delivering mental health care and appears to be acceptable to both patients and clinicians. However, clinicians raised concerns about their ability to assess risk and provide therapy using telephone consultations. Patients also reported that the convenience of telehealth may improve engagement.

Introduction: Optimal treatment of hepatocellular carcinoma (HCC) beyond the Milan criteria is in debate. We aimed to identify candidates for surgical resection (SR) in Barcelona Clinic Liver Cancer (BCLC)-A/B HCC beyond the Milan criteria with survival benefit.

Methods: Patients with BCLC-A/B HCC beyond the Milan criteria at the National Taiwan University Hospital during 2005 and 2019 were screened, and those who received transarterial chemoembolization (TACE) or SR were consecutively included. The tumor burden was classified by the seven-eleven criteria into low (≤7), intermediate (7-11), or high (>11). Multivariable Cox proportional hazard regression analysis was used for outcome prediction.

Results: Overall, 474 patients who received SR (n = 247) and TACE (n = 227) were enrolled. Patients who underwent SR were significantly younger with better liver reserve. There were 76 (31%) and 129 (57%) deaths in the SR and TACE groups after a median follow-up of 3.9 and 2.1 years, respectively. The seven-eleven criteria could distinguish median overall survival (OS) among low (n = 149), intermediate (n = 203), and high (n = 122) tumor burden groups (7.7 vs. 6.9 vs. 2.8 years, respectively, p < 0.001). Patients receiving SR had a significantly higher median OS compared with TACE in those with intermediate (8.2 vs. 2.6 years, p < 0.001) and high (5.6 vs. 1.5 years, p = 0.001) tumor burden. After adjustment for age, sex, and liver reserve, SR was predictive for better OS in intermediate (adjusted hazard ratio [aHR]: 0.45, 95% confidence interval [CI]: 0.27-0.75) and high tumor burden groups (aHR: 0.54, 95% CI: 0.32-0.92). The survival benefit of SR especially confines to patients within 3 tumors.

Conclusions: In patients with BCLC-A/B HCC beyond the Milan criteria with tumor burden beyond the up-to-7 criteria but within 3 tumors, SR has better OS than TACE and should be considered in resectable patients.

Brain enriched voltage-gated sodium channel (VGSC) Na_v1.2 and Na_v1.6 are critical for electrical signaling in the CNS. Previous studies have extensively characterized cell-type-specific expression and electrophysiological properties of these two VGSCs and how their differences contribute to fine-tuning of neuronal excitability. However, because of a lack of reliable labeling and imaging methods, the subcellular localization and dynamics of these homologous Na_v1.2 and Na_v1.6 channels remain understudied. To overcome this challenge, we combined genome editing, super-resolution, and live-cell single-molecule imaging to probe subcellular composition, relative abundances, and trafficking dynamics of Na_v1.2 and Na_v1.6 in cultured mouse and rat neurons and in male and female mouse brain. We discovered a previously uncharacterized trafficking pathway that targets Na_v1.2 to the distal axon of unmyelinated neurons. This pathway uses distinct signals residing in the intracellular loop 1 between transmembrane domain I and II to suppress the retention of Na_v1.2 in the axon initial segment and facilitate its membrane loading at the distal axon. As mouse pyramidal neurons undergo myelination, Na_v1.2 is gradually excluded from the distal axon as Na_v1.6 becomes the dominant VGSC in the axon initial segment and nodes of Ranvier. In addition, we revealed exquisite developmental regulation of Na_v1.2 and Na_v1.6 localizations in the axon initial segment and dendrites, clarifying the molecular identity of sodium channels in these subcellular compartments. Together, these results unveiled compartment-specific localizations and trafficking mechanisms for VGSCs, which could be regulated separately to modulate membrane excitability in the brain.SIGNIFICANCE STATEMENT Direct observation of endogenous voltage-gated sodium channels reveals a previously uncharacterized distal axon targeting mechanism and the molecular identity of sodium channels in distinct subcellular compartments.

Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, a gram-negative intracellular bacterium. It is a severe public health problem that affects mainly Asia-Pacific areas. Scrub typhus threatens one billion people and causes illness worldwide each year. Approximately one-third of the cases may suffer from multiple organ dysfunction syndrome (MODS) during the disease course. Thrombocytopenia is another critical clinical manifestation of scrub typhus, and thrombocytopenia is one of the causes of MODS. Scrub typhus is rare and hard to diagnose and treat. Given the close similarity in the clinical presentation of several tropical illnesses, a meticulous history and detailed physical examination need to be emphasized. In this study, we reported a case of scrub typhus with thrombocytopenia and MODS, which is only the third case worldwide.

Introduction: Few tools exist to objectively measure dysfunctions of prefrontal origin self-reported by the general population. The Prefrontal Symptom Inventory (PSI) is a test with excellent psychometric properties that allows such assessment and so far, no robust analysis of its abbreviated version in Spanish for Latin America has been performed.

Aims: To analyze the psychometric properties of the abbreviated PSI in terms of reliability and validity in the general population in the Venezuelan context.

Subjects and methods: 300 subjects from the general population participated. The factor structure of the abbreviated ISP was determined through confirmatory factor analysis (CFA); construct validity was assessed by contrasting groups with no risk of MCI and the convergence of scores with the domains that make up the Montreal Cognitive Assessment (MoCA). Likewise, internal consistency was estimated through McDonald's ? and Cronbach's a.

Results: Five factorial models were contrasted and a version of the PSI composed of 18 items was obtained, which presented excellent indicators of goodness of fit (?2 (132) = 200.057, p < 0.001, CFI=0.955, TLI=0.948, SRMR=0.042, RMSEA=0.041) and internal consistency (? = 0.90; a = 0.89). Likewise, statistically significant differences between groups and inverse correlations were evidenced with the sections evaluated in the MoCA except for abstraction.

Conclusion: The PSI-18 is a valid and reliable measure to be used in the studied population. Consistently, previous studies show its versatility to be used in research and health contexts.

Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer mortality worldwide. Colitis-associated colorectal cancer (CAC) is a subtype of CRC associated with inflammatory bowel disease (IBD). It is well known that individuals with IBD have a 2-3 times higher risk of developing CRC than those who do not, rendering CAC a major cause of death in this group. Although the etiology and pathogenesis of CAC are incompletely understood, animal models of chronic inflammation and human cohort data indicate that changes in the intestinal environment, including host response dysregulation and gut microbiota perturbations, may contribute to the development of CAC. Genomic alterations are a hallmark of CAC, with patterns that are distinct from those in sporadic CRC. The discovery of the biological changes that underlie the development of CAC is ongoing; however, current data suggest that chronic inflammation in IBD increases the risk of developing CAC. Therefore, a deeper understanding of the precise mechanisms by which inflammation triggers genetic alterations and disrupts intestinal homeostasis may provide insight into novel therapeutic strategies for the prevention of CAC.

Objective: To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. Methods: A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0 to 3.5 times of the rated capacity of expander. In the second stage, free expanded thoracodorsal artery perforator flaps with areas of 10 cm×7 cm to 24 cm×13 cm were cut out to repair the wounds with areas of 9 cm×6 cm to 23 cm×12 cm which was formed after cervical cicatectomy. The main trunk of thoracodorsal artery and vein were selected for end-to-end anastomosis with facial artery and vein, and the donor sites were directly closed. The survival of flaps and healing of flap donor sites were observed on the 14^th day post surgery. The appearances and cicatrix contracture deformity of the flaps, recovery of cervical function, and scar hyperplasia of donor sites were followed up. Results: On the 14^th day post surgery, the flaps of ten patients survived, while ecchymosis and epidermal necrosis occurred in the center of flap of one patient and healed 2 weeks after dressing change. On the 14^th day post surgery, the flap donor sites of 11 patients all healed well. During the follow-up of 6-12 months post surgery, the flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Conclusions: Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.

Calf diarrhea caused by pathogenic Escherichia coli is a major cause of death in calves, with a mortality rate of over 50%. It is crucial to understand the pathogenesis and development of calf diarrhea for its prevention and treatment. We aimed to study the effect of pathogenic E. coli on the flora composition, function, and short-chain fatty acid (SCFA) content of calf feces using a calf diarrhea model. Sixty-four newborn Holstein calves (40-43 kg) were divided into a normal group (NG; n = 32) and a test group (TG; n = 32). At the beginning of the experiment, the TG were orally administered pathogenic E. coli O1 (2.5 × 10¹¹ CFU/mL, 100 mL) to establish a calf diarrhea model, and the NG were orally administered the same amount of physiological saline solution. The calves of the two groups were subjected to the same feeding and management. Fresh feces samples were collected at different time points and subjected to 16S rRNA high-throughput sequencing and gas chromatography-mass spectrometry to determine the fecal microbial composition and SCFA content. Pathogenic E. coli O1 significantly altered microbiotas composition in the feces of calves, increasing the relative abundance of Proteobacteria and decreasing that of Firmicutes. It also led to a significant increase in the relative abundance of Escherichia-Shigella and a decrease in Lactobacillus, as well as significantly decreased SCFA content. Therefore, we postulate that pathogenic E. coli induces calf diarrhea by causing intestinal florae imbalance and reducing the content of SCFA.