Association and Contribution of Patient and Bereaved Family Background to Outcomes of Survivor Surveys

A secondary analysis of data from national bereavement surveys conducted in 2014, 2016, and 2018 was conducted with the aim of identifying the contribution of various patient and bereavement backgrounds to the outcomes of the Bereavement Survey. The data were evaluated in terms of structure and process of care (CES), achievement of a desirable death (GDI), complexity grief (BGQ), and depression (PHQ-9). The large data set and comprehensive analysis of bereavement survey outcomes clarified the need for adjustment of confounding variables and which variables should be adjusted for in future analyses. Overall, the contribution of the background factors examined in this study to the CES (Adj-R2=0.014) and overall satisfaction (Adj-R2=0.055) was low. The contribution of the GDI (Adj-R2=0.105) was relatively high, and that of the PHQ-9 (Max-rescaled R2=0.200) and BGQ (Max-rescaled R2=0.207) was non-negligible.

Effect of pivotal response training for children with autism spectrum disorder： a systematic review / 四川精神卫生

The purpose of this article is to systematically review the effectiveness of pivotal response training （PRT） for children with autism spectrum disorder （ASD）， so as to provide evidence-based guidance for the implementation of effective PRT for children with ASD. Randomized controlled trials （RCTs） investigating the effectiveness of PRT for children with ASD were collected， and the methodological quality of the trails was evaluated using the Cochrane Collaboration's tool for risk of bias assessment. A total of 6 RCTs were included in this review. Then the empirical findings including the implementation of PRT and the role of PRT in improving general social skills and verbal communication skills of children with ASD were elaborated. And its limitations and possible future research directions were also summarized. ［Funded by Special Project for Construction of Innovation Environment in Autonomous Region： Construction of Science and Technology Innovation Base （number， PT2306）］

Analysis of the correlation between stigma and coping styles and social support among parents of children with autism spectrum disorders / 四川精神卫生

BackgroundThe incidence of autism spectrum disorders （ASD） is showing an upward trend， and the treatment and training process for children with ASD is lengthy， placing a heavy burden on their families. Such fact results in parents being prone to feelings of stigma. However， there exists a lack of research studying on the stigma among parents of children with ASD. ObjectiveTo explore the relationship between stigma and coping styles and social support of parents with ASD， and to provide references for practices of reducing stigma level and taking targeted interventions in this group. MethodsThis study involved parents of children diagnosed with ASD and admitted to the children's health clinic of a tertiary hospital in Urumqi between January 2021 and May 2022. General information questionnaire， Affiliate Stigma Scale （ASS）， Simplified Coping Style Questionnaire （SCSQ） and Social Support Rating Scale （SSRS） were employed to conduct investigation. Pearson correlation analysis was used analyze the correlation between stigma， coping styles and social support. ResultsThe ASS total score of parents of children with ASD was （52.40±11.22）. Correlation analysis results showed that the ASS total score of parents was positively correlated with the score of negative coping dimension in SCSQ （r=0.787， P<0.01）， and negatively correlated with the score of positive coping dimension in SCSQ and SSRS total score （r=-0.565， -0.795， P<0.01）. The result of regression analysis suggested that stigma among parents of children with ASD was affected by coping style and social support （∆R2=0.768， F=114.931， P<0.01）. These two factors could explain 76.80% of the total variance. ConclusionParents of children with ASD have stigma of moderate to high level， and coping styles and social support are two important factors influencing the stigma. ［Funded by Xinjiang Uygur Autonomous Region Science and Technology Program Resource Sharing Platform Construction Project （number， PT2215）］

Punicalagin inhibits hepatic lipid deposition in obese mice via AMPK/ACC pathway / 中国中药杂志

Hepatic lipid deposition is one of the basic manifestations of obesity, and nowadays pharmacological treatment is the most important tool. Punicalagin(PU), a polyphenol derived from pomegranate peel, is a potential anti-obesity substance. In this study, 60 C57BL/6J mice were randomly divided into a normal group and a model group. After establishing a model of simple obesity with a high-fat diet for 12 weeks, the successfully established rat models of obesity were then regrouped into a model group, an orlistat group, a PU low-dose group, a PU medium-dose group, and a PU high-dose group. The normal group was kept on routine diet and other groups continued to feed the high-fat diet. The body weight and food intake were measured and recorded weekly. After 8 weeks, the levels of the four lipids in the serum of each group of mice were determined by an automatic biochemical instrument. Oral glucose tole-rance and intraperitoneal insulin sensitivity were tested. Hemoxylin-eosin(HE) staining was applied to observe the hepatic and adipose tissues. The mRNA expression levels of peroxisome proliferators-activated receptor γ(PPARγ) and C/EBPα were determined by real-time quantitative polymerase chain reaction(Q-PCR), and the mRNA and protein expression levels of adenosine 5'-monophosphate-activated protein kinase(AMPK), anterior cingulate cortex(ACC), and carnitine palmitoyltransferase 1A(CPT1A) were determined by Western blot. Finally, the body mass, Lee's index, serum total glyceride(TG), serum total cholesterol(TC), and low-density lipoprotein cholesterol(LDL-C) levels were significantly higher and high-density lipoprotein cholesterol(HDL-C) levels were significantly lower in the model group as compared with the normal group. The fat deposition in the liver was significantly increased. The mRNA expression levels of hepatic PPARγ and C/EBPα and the protein expression level of ACC were increased, while the mRNA and protein expression levels of CPT-1α(CPT1A) and AMPK were decreased. After PU treatment, the above indexes of obese mice were reversed. In conclusion, PU can decrease the body weight of obese mice and control their food intake. It also plays a role in the regulation of lipid metabolism and glycometabolism metabolism, which can significantly improve hepatic fat deposition. Mechanistically, PU may regulate liver lipid deposition in obese mice by down-regulating lipid synthesis and up-regulating lipolysis through activation of the AMPK/ACC pathway.

A survey on nutritional status among infants at ages of 6 to 24 months / 预防医学

Objective@#To investigate the nutritional status and examine its association with feeding among infants at ages of 6 to 24 months in Xinjiang Uygur Autonomous Region, so as to provide the evidence for improving malnutrition among infants.@*Methods@#Infants at ages of 6 to 24 months participating in physical examinations in Urumqi City and Moyu County from January to December 2021 were enrolled. Participants' gender, age, birth status, place of residence and maternal education level were collected through questionnaire surveys, and infants' feeding was evaluated using Infant and Child Feeding Index (ICFI). Age-specific height and body weight and height-specific body weight were calculated, and nutritional status was evaluated using Z score. The association between ICFI and malnutrition was evaluated using a multivariable logistic regression model.@*Results @#A total of 1 013 infants were surveyed, including 557 boys (54.99%) and 456 girls (45.01%). The participants included 545 infants at ages of 12 to 24 months (53.80%), 969 full-term infants (95.66%), and 617 infants with qualified ICFI scores (60.91%). The prevalence of malnutrition was 8.59% among participants. Multivariable logistic regression analysis showed that infants with qualified ICFI score had a lower risk of malnutrition (OR=0.538, 95%CI: 0.327-0.883) after adjustment for age, birth status, place of residence, maternal education level and monthly household income.@*Conclusion@#The prevalence of malnutrition is low among infants at ages of 6 to 24 months in Xinjiang Uygur Autonomous Region, and infants with qualified feeding have a reduced risk of malnutrition.

The Lifelong Health Support 10: a Japanese prescription for a long and healthy life

BACKGROUND@#Although the age-adjusted incidence and mortality of cancer and cardiovascular disease (CVD) have been decreasing steadily in Japan, both diseases remain major contributors to morbidity and mortality along with the aging society. Herein, we aim to provide a prescription of 10 health tips for long and healthy life named the "Lifelong Health Support 10 (LHS10)."@*METHOD@#The LHS10 was developed by the preventive medicine specialists at the National Cerebral and Cardiovascular Center in Suita, where it has been used for health guidance to prevent CVD, cancer, and cognitive decline in addition to their major risk factors such as hypertension, diabetes, and obesity. It consisted of the lifestyle modification recommendations of the 2014 Japanese Society of Hypertension guidelines and the 2017 Japan Atherosclerosis Society Guidelines for preventing atherosclerotic CVD. Further, it came in line with other international lifestyle modification guidelines. In this narrative review, we summarized the results of several Japanese epidemiological studies investigating the association between the LHS10 items and the risk of cancer, CVD, and other chronic diseases including dementia, diabetes, and chronic kidney disease.@*RESULTS@#The LHS10 included avoiding smoking and secondhand smoke exposure, engaging in physical activity, refraining from excessive alcohol drinking, reducing fried foods and sugary soft drinks, cutting salt in food, consuming more vegetables, fruits, fish, soy foods, and fibers, and maintaining proper body weight. All items of the LHS10 were shown to reduce the risk of cancer, CVD, and other chronic diseases.@*CONCLUSIONS@#The LHS10 can be a helpful tool for health guidance.

Stair climbing and incident atrial fibrillation: a prospective cohort study

BACKGROUND@#A protective role for physical activity against the development of atrial fibrillation (AF) has been suggested. Stair climbing is a readily available form of physical activity that many people practice. Herein, we investigated the association between stair climbing and the risk of AF in a Japanese population.@*METHODS@#In this prospective cohort study, we used data of 6,575 people registered in the Suita Study, aged 30-84 years, and had no history of AF. The frequency of stair climbing was assessed by a baseline questionnaire, while AF was diagnosed during the follow-up using a 12-lead ECG, health records, check-ups, and death certificates. We used the Cox regression to calculate the hazard ratios and 95% confidence intervals of AF incidence for climbing stairs in 20-39%, 40-59%, and ≥60% compared with <20% of the time.@*RESULTS@#Within 91,389 person-years of follow-up, 295 participants developed AF. The incidence of AF was distributed across the stair climbing groups <20%, 20-39%, 40-59%, and ≥60% as follows: 3.57, 3.27, 3.46, and 2.63/1,000 person-years, respectively. Stair climbing ≥60% of the time was associated with a reduced risk of AF after adjustment for age and sex 0.69 (0.49, 0.96). Further adjustment for lifestyle and medical history did not affect the results 0.69 (0.49, 0.98).@*CONCLUSION@#Frequent stair climbing could protect from AF. From a preventive point of view, stair climbing could be a simple way to reduce AF risk at the population level.

Psicanálise na assistência social em Fortaleza-CE: um estudo sobre as medidas socioeducativas / Psychoanalysis in social assistance in Fortaleza - Ceará: a study about socio-educational measures / El psicoanálisis en la asistencia social en Fortaleza-CE: un estudio sobre las medidas socioeducativas

Este artigo pretende apresentar alguns encontros e diálogos da psicanálise com o Sistema Único de Assistência Social (Suas), amparados na escuta e na pesquisa sobre a prática profissional dos psicanalistas no acompanhamento de jovens em cumprimento de medidas socioeducativas. O Suas representa um importante campo de atuação e de contribuições tanto na assistência direta aos usuários quanto na elaboração de novas tecnologias psicossociais. Cabe destacar a presença da psicanálise como linha teórica norteadora desse debate, que se organiza em torno dos encontros entre psicanálise, assistência social e medidas socioeducativas, no contexto da realidade do adolescente em conflito com a lei na cidade de Fortaleza. Concluímos que, embora as instituições apresentadas não sejam a princípio parte do campo tradicional da psicanálise, o psicanalista pode contribuir para o trabalho com esses jovens com sua escuta singular, seu posicionamento ético e seu rigor teórico. Sua atuação pode colaborar, assim, para que o cidadão de direitos e o sujeito da psicanálise sejam acolhidos e contemplados nas políticas públicas de Assistência Social.

This essay seeks to present possible encounters and dialogues between psychoanalysis and the Brazilian Unified System for Social Assistance (SUAS), based on the practice of listening and on the research concerning psychoanalysts' professional procedures when working with adolescents following socio-educative measures. The SUAS is an important field of action and contribution for psychology professionals, both in the direct assistance to the users and in the development of new psychosocial technologies. Psychoanalysis is the guiding theoretical line for this discussion, which organizes itself based on the association of psychoanalysis, the work of social assistance, and socio-educational measures, in the context of youngsters in conflict with the law in the municipality of Fortaleza, capital of Ceará. We conclude that, even though the discussed institutions are not traditionally linked to the field of psychoanalysis, psychoanalysts may contribute to the work with these adolescents with their individual attention, ethical positioning, and theoretical rigor. These professionals may, thus, be an important asset in the appropriate reception and support to the citizens and psychoanalytical subjects of Social Assistance public policies.

Este artículo pretende presentar algunos encuentros y diálogos de la psicoanálisis con el "Sistema Único de Assistencia Social" (SUAS), apoyados en la escucha y la investigación sobre práctica profesional de los psicoanalistas en el acompañamiento de jóvenes en cumplimiento de medidas socioeducativas. Para la Psicología, el SUAS representa un importante campo de actuación y de contribuciones tanto en la asistencia directa a los usuarios cuanto en la elaboración de nuevas tecnologías psicosociales. Cabe destacar la presencia del psicoanálisis como línea teórica de ese debate, que se organiza en torno a los encuentros entre psicoanálisis, asistencia aocial y medidas socioeducativas, en el contexto de la realidad del adolescente en conflicto con la ley en la ciudad Fortaleza. Concluimos que, aunque las instituciones presentadas no sean previamente el campo tradicional del psicoanálisis, el psicoanalista puede contribuir para el trabajo con esos jóvenes con su escucha singular, su posicionamiento ético y su rigor teórico. Su actuación puede colaborar, así, para que el ciudadano de derechos y el sujeto del psicoanálisis sean acogidos y contemplados en las políticas públicas de Asistencia Social.

A vulnerabilidade e o Coronavírus: o giro político da psicanálise sobre a questão / Vulnerability and Coronavirus: the political turn of psychoanalysis on the issue / La vulnerabilidade y el Coronavírus: el giro político de psicoanálisis sobre el tema

O artigo apresenta uma análise psicanalítica da noção de vulnerabilidade articulada ao contexto atual da pandemia do novo coronavírus. A partir da inflexão sobre o tema, balizada pela lógica do inconsciente, o texto interroga as contribuições que a leitura da psicanálise pode trazer sobre o contexto social e econômico de vulnerabilidades que nele emergiram. Como percurso metodológico, o artigo apresenta uma revisão teórico-conceitual do termo vulnerabilidade e desamparo, inserindo-os no contexto da pandemia do novo Coronavírus. Cada termo é balizado em seus respectivos campos teórico-conceituais, estabelecendo diálogos críticos e reflexivos com pensadores contemporâneos, numa interface com diferentes saberes do campo das ciências humanas. Os resultados acentuam que os termos vulnerabilidade e desamparo mantêm suas especificidades em seus campos conceituais de origem, mas, se mesclam quando representam diferentes níveis de alteridade, seja ela encarnada no Outro parental, institucional, social ou político.

The article presents a psychoanalytic analysis of the notion of vulnerability articulated to the current context of the new coronavirus pandemic. Based on the inflection on the theme, guided by the logic of the unconscious, the text questions the contributions that the reading of psychoanalysis can bring about the social and economic context of vulnerabilities that emerged in it. As methodological approach, the article presents a theoretical-conceptual review of vulnerability and helplessness, inserting them in the context of the new Coronavirus pandemic. Each term is based on its respective theoretical-conceptual fields, establishing critical and reflective dialogues with contemporary thinkers, in an interface with knowledge in the field of human sciences. The results emphasize that the terms vulnerability and helplessness maintain their specificities in their conceptual fields of origin, but they are mixed when they represent different levels of alterity, whether incarnated in the parental, institutional, social or political Other.

El artículo presenta el análisis psicoanalítico de la noción de vulnerabilidad vinculada al contexto actual de la nueva pandemia de coronavirus. A partir de la inflexión sobre el tema e guiado por la lógica del inconsciente, el texto pregunta sobre los aportes que la lectura del psicoanálisis puede ayudar al contexto social y económico de las vulnerabilidades que en él surgieron. Como recorrido metodológico, el artículo presenta una revisión teórico-conceptual del término vulnerabilidad e impotencia, insertándolos en el contexto de la nueva pandemia de Coronavirus. Cada término se delimita en sus respectivos campos teórico-conceptuales, estableciendo diálogos críticos y reflexivos con pensadores contemporáneos, en una interfaz con diferentes saberes en el campo de las ciencias humanas. Los resultados presentados enfatizan que, si bien los términos vulnerabilidad e impotencia mantienen sus especificidades en sus campos conceptuales, en ambos términos existe una relación con el apaciguamiento de amenazas a la vida humana que ciertamente pasan por una instancia de alteridad, ya sea encarnada. no Otro parental, institucional, social o político.

Repeat expansion and methylation-sensitive triplet-primed polymerase chain reaction for fragile X mental retardation 1 gene screening in institutionalised intellectually disabled individuals

INTRODUCTION@#Fragile X syndrome (FXS) is the most prevalent X-linked intellectual disability (ID) and a leading genetic cause of autism, characterised by cognitive and behavioural impairments. The hyperexpansion of a CGG repeat in the fragile X mental retardation 1 (FMR1) gene leads to abnormal hypermethylation, resulting in the lack or absence of its protein. Tools for establishing the diagnosis of FXS have been extensively developed, including assays based on triplet-primed polymerase chain reaction (TP-PCR) for detection and quantification of the CGG trinucleotide repeat expansion, as well as determination of the methylation status of the alleles. This study aimed to utilise a simple, quick and affordable method for high sensitivity and specificity screening and diagnosis of FXS in institutionalised individuals with ID.@*METHODS@#A total of 109 institutionalised individuals at the Center for Social Rehabilitation of Intellectual Disability Kartini, Temanggung, Central Java, Indonesia, were screened in a three-step process using FastFrax™ Identification, Sizing and Methylation Status Kits.@*RESULTS@#Two samples that were classified as indeterminate with respect to the 41-repeat control at the identification step were subsequently determined to be non-expanded by both sizing and methylation status analyses. Two samples classified as expanded at the identification step were determined to carry full mutation expansions > 200 repeats that were fully methylated using sizing and methylation status analyses, respectively, yielding a disease prevalence of 1.83%.@*CONCLUSION@#Repeat expansion and methylation-specific TP-PCR is practical, effective and inexpensive for the diagnosis of FXS, especially in high-risk populations of individuals with ID of undetermined aetiology.

Anti-reflux procedures after roux-en-y gastric bypass / Procedimentos anti-refluxo após bypass gástrico em y-de roux

ABSTRACT Background: Roux-en-Y gastric bypass (RYGB) has been the choice of bariatric procedure for patients with symptomatic reflux - and is known to be effective in reducing the need for anti-reflux medication postoperatively. However, a small number of RYGB patients can still develop severe reflux symptoms that require a surgical intervention. Aim: To examine and describe the patient population that requires an anti-reflux procedure after RYGB evaluating demographics, characteristics, symptoms and diagnosis Methods: A retrospective chart review was performed on 32 patients who underwent a hiatal hernia repair and/or Nissen fundoplication after RYGB Jul 1st, 2014 and Dec 31st, 2019. Patients were identified using the MBSAQIP database and their electronic medical records were reviewed. Results: Most patients were female (n=29, 90.6%). The mean age was 52.8 years and the mean body mass index (BMI) was 34.1 kg/m2 at the time of anti-reflux procedure. Patients underwent the anti-reflux procedure at a mean of 7.9 years after the RYGB procedure. The mean percentage of excess BMI loss during the time between RYGB and anti-reflux procedure was 63.4%. Conclusions: Female patients with a significant weight loss may develop a severe reflux symptoms years after RYGB. Complaints of reflux after RYGB should not be overlooked. Careful follow-up and appropriate treatment (including surgical intervention) is needed for this population.

RESUMO Racional: O bypass gástrico em Y-de-Roux (RYGB) tem sido o procedimento bariátrico de escolha para pacientes com refluxo sintomático - e é conhecido por ser eficaz na redução da necessidade de medicação anti-refluxo no pós-operatório. No entanto, um pequeno número de pacientes com RYGB ainda pode desenvolver sintomas de refluxo graves que requerem uma intervenção cirúrgica. Objetivo: Examinar e descrever a população de pacientes que requer procedimento anti-refluxo após RYGB avaliando dados demográficos, características, sintomas e diagnóstico. Métodos: Revisão retrospectiva de prontuários foi realizada em 32 pacientes submetidos a hérnia hiatal e / ou fundoplicatura Nissen após RYGB em 1º de julho de 2014 a 31 de dezembro de 2019. Os pacientes foram identificados por meio do banco de dados MBSAQIP e seus prontuários eletrônicos foram revisados. Resultados: A maioria dos pacientes era do sexo feminino (n = 29 - 90,6%). A média de idade foi de 52,8 anos e o índice de massa corporea (IMC) médio de 34,1 kg / m2 na época do procedimento anti-refluxo. Os pacientes foram submetidos ao procedimento anti-refluxo em média 7,9 anos após o procedimento do BGYR. A porcentagem média de perda do excesso de IMC durante o tempo entre o BGYR e o procedimento anti-refluxo foi de 63,4%. Conclusões: Pacientes do sexo feminino com perda de peso significativa podem desenvolver sintomas graves de refluxo anos após o BGYR. Sintomas de refluxo após RYGB não devem ser negligenciadas. Acompanhamento cuidadoso e tratamento adequado (incluindo intervenção cirúrgica) são necessários para essa população.

Impact of Eel Flour (Monopterus albus) on the Acceleration of Fracture Healing Process in Rattus norvegicus Wistar Albino Rat

@#Introduction: Worldwide fractures among individuals are a major public health problem. As a result, fracture are the most common cause of severe enduring pain and physical disability, and they affect innumerable globally. It has been studied that nutrients that contain high protein helps in the fracture healing process. Eels contains many nutrients, such as phosphate, calcium, protein, collagen and amino acids that can help bone growth. The aim of this study was to examine the effect of eel flour (Monopterus albus) at multilevel dose content to accelerate the healing process of fracture in male Rattus novergicus Wistar Albino rat. Methods: This study design include experimental study with post-test only on controls group. The wok was conducted from May-June 2019 in the Laboratory of Anatomy of Stikes Piala Sakti Pariaman. The sampling was purposive sampling technique with a sample size of 24 rats. Results: The results of the ANOVA test have proved that administration of eel flour accelerates the healing process of the fracture showing 0.000, followed by Post Hoc LSD to determine the test of significant differences between groups. Conclusion: It was observed that with the increase in the dose of flour given to Wistar Albino rat fracture healing process became faster. From the present study it was evident that consumption of eel flour can accelerate the process of fracture healing. But there is need for further testing on humans as an effort to test the safety of the dose.

Multicenter performance of the different classification criteria for rheumatoid arthritis / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the classification criteria of early rheumatoid arthritis (ERA) and compare the sensitivity and specificity with the criteria of 1987 American College of Rheumatology (ACR) criteria and 2010 ACR/European League Against Rheumatism (EULAR).@*METHODS@#Patients from 4 hospitals, aged more than 16 years, with arthritis, whose disease duration was ≤1 year, and with ≥1 joint pain and swelling were enrolled in the study. The indicators including clinical manifestations, laboratory tests and imaging examinations were observed. The ERA patients were dignosed by two experienced rheumatologists based on the clinical features, drug therapy information and radiography features.@*RESULTS@#(1) A total of 325 patients with arthritis were enrolled, including 98 males (30.15%) and 227 females (69.85%), The average age was (47.53±14.44) years, and the median disease duration was 5 (2, 8) months. Finally, 236 patients were dignosed with ERA, and 89 patients were dignosed with other diseases (Non-ERA, including osteoarthritis, reactive arthritis, undifferentiated arthritis, spondyloarthritis, etc). (2) The sensitivity of ERA criteria was 87.29%, and the specificity was 84.37%. The sensitivity was higher than that of 1987 ACR criteria (χ2=43.641, P < 0.001), and had no significant difference compared with 2010 ACR/EULAR criteria (χ2=0.446, P=0.593). But the specificity of ERA criteria was lower than that of 1987 ACR criteria (χ2=4.891, P=0.027), which was not statistically significant compared with 2010 ACR/EULAR criteria (χ2=0.044, P=1.000). (3) In the patients with arthritis whose disease duration was ≤3 months and ≤6 months, the sensitivity of ERA criteria was 81.71% and 86.79%, respectively, both were higher than the 1987 ACR criteria (χ2=7.131, P=0.008; χ2=22.015, P < 0.001) and had no statistically difference compared with the 2010 ACR/EULAR criteria (χ2=0.220, P=0.755; χ2=0.473, P=0.491). The differences of the three criteria in specificity were not statistically significant. (4) The three different classification criteria were consistent with the clinical diagnosis, among which the ERA criteria and 2010 ACR/EULAR criteria were slightly higher (Kappa>0.6). The results of the consistency comparison between the three criteria showed that the ERA criteria and 2010 ACR/EULAR criteria had a better consistency (Kappa=0.836).@*CONCLUSION@#The sensitivity of ERA classification criteria in the diagnosis of ERA was higher than that of 1987 ACR criteria, and was equivalent to that of 2010 ACR/EULAR criteria. There is no significant difference in specificity between these three criteria. The ERA criteria can also identify patients with RA at a very early stage in arthritis with disease duration ≤3 months.

Serum levels of iron, zinc, copper and vitamin D in severe early childhood caries / 口腔疾病防治

Objective @#The serum levels of iron, zinc, copper and vitamin D in severe early childhood caries (S-ECC) patients were investigated and analyzed to provide reference for primary prevention and diagnosis of S-ECC children.@*Methods @#A total of 184 children were enrolled in the Children Health Department of Xinjiang Medical University Health Management Center from June 2018 to June 2019. They were divided into the caries-free (CF) group (n=89) and S-ECC group (n=95). The contents of iron, zinc, copper and vitamin D were detected.@* Results@# The serum iron content of the CF group and S-ECC group was (8.36 ± 0.42) mmol/L and (8.13 ± 0.44) mmol/L, respectively, and the difference was statistically significant (t=3.50, P < 0.001); the serum content of zinc was (83.18 ± 7.28) μmol/L and (79.23 ± 6.38) μmol/L, respectively, and the difference was statistically significant (t=3.92, P < 0.001); the serum content of 25-hydroxyvitamin D was (86.72 ± 15.83) nmol/L and (77.75 ± 11.38) nmol/L, respectively, and the difference was statistically significant (t=4.42, P < 0.001). The serum copper content of CF group and S-ECC group was (20.18 ± 4.84) μmol/L and (19.49 ± 4.62) μmol/L, but the difference was not statistically significant (t=0.97, P=0.33).@*Conclusion@#The contents of iron, zinc and vitamin D in the serum of S-ECC patients are low, suggesting that iron, zinc and vitamin D supplementation should be emphasized in the prevention and treatment of S-ECC.

Does Mentoring Women Matter, and if so, How Much? / ¿Importa la mentoría a las mujeres y, de ser así, cuánto?

The presence of women in medicine and urology has been increasing. However, there is a large disparity in leadership positions. In 2017, women constituted 3.3% of chairs, 4.5% of vice-chairs, and 7.9% of division directors in the United States,[1] similar positions in Colombia. It is unclear why this deep gender gap exists in urology. Multifactorial and specialty-specific factors may include lack of mentorship, sponsorship, and limited female role models in leadership positions.[2] According to the Association of Medical Colleges (AAMC), many women do not find mentors in surgical specialties. This lack of mentorship may limit women from accessing similar opportunities to their male counterparts.

La presencia de mujeres en la medicina y la urología ha ido en aumento. Sin embargo, existe una gran disparidad en los puestos de liderazgo. En 2017, las mujeres constituían el 3,3% de las cátedras, el 4,5% de las vicepresidencias y el 7,9% de los directores de división en Estados Unidos,[1] cargos similares en Colombia. No está claro por qué existe esta profunda brecha de género en urología. Según la Asociación de Facultades de Medicina (AAMC), muchas mujeres no encuentran mentores en las especialidades quirúrgicas. Esta falta de mentores puede limitar el acceso de las mujeres a oportunidades similares a las de sus homólogos masculinos.

Teoria crítica e transdisciplinaridade: uma aposta no projeto emancipatório / Critical theory and transdisciplinarity: an investment in the emancipatory / Project teoría crítica y transdisciplinariedad: una apuesta en el proyecto emancipatorio

Este texto busca abordar os fundamentos da transdisciplinaridade no contexto de uma pesquisa desenvolvida em um ambiente que reúne sociólogos e psicólogos para trabalhar a questão da criminalidade, que convoca a juventude pobre e, com muita frequência, negra. "O manifesto da transdisciplinaridade", escrito por Nicolescu (1999), base desta discussão, propõe uma nova posição dos homens em relação aos outros homens e à natureza. Assim, buscamos localizar a vertente filosófica que possibilitou esse salto de uma ciência disciplinar descritiva para uma ciência implicada com a prática, ultrapassando as falsas dualidades e buscando produzir conhecimento a partir da lógica da complexidade.

This paper intends to discuss the fundaments of transdisciplinarity in the context of a research project, which gathers sociologists and psychologists to work on the issue of criminality, which convenes the low-income and often black – Brazilian youth. Basarab Nicolescu’s "Manifesto of Transdisiciplinarity" (1999), in which this discussion is based, proposes that human beings should change their position towards other human beings and towards nature. Thus, we make an effort to spot the philosophical thought, which made possible the leap from a descriptive, disciplinary science into a form of science that is more connected with practice, that is able to overcome false dualities and which seeks to produce knowledge based on the logic of complexity.

El presente texto busca abordar los fundamentos de la transdisciplinariedad en el contexto de una pesquisa desarrollada en un ambiente que reúne sociólogos y psicólogos para trabajar la cuestión de la criminalidad, que convoca la juventud pobre y, con mucha frecuencia, negra. "El Manifiesto de la Transdisciplinariedad", escrito por Nicolescu (1999), base de esta discusión, propone una nueva posición de los hombres en relación a los otros hombres y a la naturaleza. Así, buscamos localizar la vertiente filosófica que posibilitó este salto de una ciencia disciplinaria descriptiva para una ciencia implicada en la práctica, sobrepasando las falsas dualidades y buscando producir conocimiento a partir de la lógica de la complejidad.

The relationship between gender and coping mechanisms with burnout events in first-year medical students / 한국의학교육

PURPOSE: First-year students are susceptible to experiencing burnout if the coping mechanism being used is inadequate; therefore, employing effective coping mechanisms could help students to minimize burnout. Coping mechanisms are divided into five groups: problem-focused, emotion-focused, dysfunctional coping, adaptive, and maladaptive coping. The burnout dimension includes emotional exhaustion, cynicism, and decreased academic performance that may be influenced by gender. This study aims to elaborate on the relationship between gender and coping mechanisms with burnout events in first-year medical students. METHODS: This is a cross-sectional study using a total sample of first-year students from a medical school. RESULTS: A total of 167 respondents (response rate 98.9%) completed a Brief Coping Orientation to Problems Experienced Questionnaire and Maslach Burnout Inventory-Student Survey. The results showed that there was no significant relationship between gender and burnout (p>0.05). On the contrary, maladaptive/dysfunctional coping had a significant positive correlation with emotional exhaustion (r=0.403, p<0.001) and cynicism (r=0.372, p<0.001). Adaptive coping had a significant negative correlation with cynicism (r=-0.165, p=0.033) and a significant positive correlation with perception of personal accomplishment (r=0.417, p<0.001). CONCLUSION: In conclusion, there was no significant relationship between gender and burnout. However, maladaptive/dysfunctional coping had a positive correlation with emotional exhaustion and cynicism. On the other hand, adaptive coping had a negative correlation with cynicism and a positive correlation with perception of personal accomplishment.

Investigating possible causes of bias in a progress test translation: an one-edged sword / 한국의학교육

PURPOSE@#Assessment in different languages should measure the same construct. However, item characteristics, such as item flaws and content, may favor one test-taker group over another. This is known as item bias. Although some studies have focused on item bias, little is known about item bias and its association with items characteristics. Therefore, this study investigated the association between item characteristics and bias.@*METHODS@#The University of Groningen offers both an international and a national bachelor’s program in medicine. Students in both programs take the same progress test, but the international progress test is literally translated into English from the Dutch version. Differential item functioning was calculated to analyze item bias in four subsequent progress tests. Items were also classified by their categories, number of alternatives, item flaw, item length, and whether it was a case-based question.@*RESULTS@#The proportion of items with bias ranged from 34% to 36% for the various tests. The number of items and the size of their bias was very similar in both programmes. We have identified that the more complex items with more alternatives favored the national students, whereas shorter items and fewer alternatives favored the international students.@*CONCLUSION@#Although nearly 35% of all items contain bias, the distribution and the size of the bias were similar for both groups. The findings of this paper may be used to improve the writing process of the items, by avoiding some characteristics that may benefit one group whilst being a disadvantage for others.

The relationship between gender and coping mechanisms with burnout events in first-year medical students / 한국의학교육

PURPOSE@#First-year students are susceptible to experiencing burnout if the coping mechanism being used is inadequate; therefore, employing effective coping mechanisms could help students to minimize burnout. Coping mechanisms are divided into five groups: problem-focused, emotion-focused, dysfunctional coping, adaptive, and maladaptive coping. The burnout dimension includes emotional exhaustion, cynicism, and decreased academic performance that may be influenced by gender. This study aims to elaborate on the relationship between gender and coping mechanisms with burnout events in first-year medical students.@*METHODS@#This is a cross-sectional study using a total sample of first-year students from a medical school.@*RESULTS@#A total of 167 respondents (response rate 98.9%) completed a Brief Coping Orientation to Problems Experienced Questionnaire and Maslach Burnout Inventory-Student Survey. The results showed that there was no significant relationship between gender and burnout (p>0.05). On the contrary, maladaptive/dysfunctional coping had a significant positive correlation with emotional exhaustion (r=0.403, p<0.001) and cynicism (r=0.372, p<0.001). Adaptive coping had a significant negative correlation with cynicism (r=-0.165, p=0.033) and a significant positive correlation with perception of personal accomplishment (r=0.417, p<0.001).@*CONCLUSION@#In conclusion, there was no significant relationship between gender and burnout. However, maladaptive/dysfunctional coping had a positive correlation with emotional exhaustion and cynicism. On the other hand, adaptive coping had a negative correlation with cynicism and a positive correlation with perception of personal accomplishment.

Comparison of the level of cognitive processing between case-based items and non-case-based items on the Interuniversity Progress Test of Medicine in the Netherlands / 보건의료교육평가

PURPOSE@#It is assumed that case-based questions require higher-order cognitive processing, whereas questions that are not case-based require lower-order cognitive processing. In this study, we investigated to what extent case-based and non-case-based questions followed this assumption based on Bloom's taxonomy.@*METHODS@#In this article, 4,800 questions from the Interuniversity Progress Test of Medicine were classified based on whether they were case-based and on the level of Bloom's taxonomy that they involved. Lower-order questions require students to remember or/and have a basic understanding of knowledge. Higher-order questions require students to apply, analyze, or/and evaluate. The phi coefficient was calculated to investigate the relationship between whether questions were case-based and the required level of cognitive processing.@*RESULTS@#Our results demonstrated that 98.1% of case-based questions required higher-level cognitive processing. Of the non-case-based questions, 33.7% required higher-level cognitive processing. The phi coefficient demonstrated a significant, but moderate correlation between the presence of a patient case in a question and its required level of cognitive processing (phi coefficient= 0.55, P< 0.001).@*CONCLUSION@#Medical instructors should be aware of the association between item format (case-based versus non-case-based) and the cognitive processes they elicit in order to meet the desired balance in a test, taking the learning objectives and the test difficulty into account.