An excerpt of American Association for the Study of Liver Diseases practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis in 2023 / 临床肝胆病杂志

The expert panel of American Association for the Study of Liver Diseases published Practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis on November 9， 2023 in Hepatology. This practice guidance elaborates on the definition of acute-on-chronic liver failure， prediction models， and the management of liver cirrhosis comorbid with acute-on-chronic liver failure and organ failure in critically ill patients， and this article gives an excerpt of the key points in the practice guidance.

Interpretation and mirror of the National Health Education Standards in the United States / 中国学校卫生

Abstract@#In the context of frequent public health events, effective school health education is an important measure to improve students health literacy and public health system of China. The study examined the National Health Education Standards in the U.S., based on a literature review and comparative analysis, to provide guidance for China. Using the method of liberature riview paper interprets the curriculum of National Health Education Standards in the U.S. and provides a mirror for China. Health Education standards in the U.S. are characterized by their academic quality, standardized framework, assessment program, equity principles, and other components. A mirror for China includes promoting the construction of the standards based health education curriculum, developing the skills based health education curriculum system, and constructing a performancebased comprehensive evaluation system.

An excerpt of AASLD practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis （2023） / 临床肝胆病杂志

This Practice Guidance intends to coalesce best practice recommendations for the identification of portal hypertension （PH）， for prevention of initial hepatic decompensation， for the management of acute variceal hemorrhage （AVH）， and for reduction of the risk of recurrent variceal hemorrhage in chronic liver disease. The most significant changes in the current Guidance relate to recognition of the concept of compensated advanced chronic liver disease， codification of methodology to use noninvasive assessments to identify clinically significant PH （CSPH）， and endorsement of a change in paradigm with the recommendation of early utilization of nonselective beta-blocker therapy when CSPH is identified. The updated guidance further explores potential future pharmacotherapy options for PH， clarifies the role of preemptive transjugular intrahepatic portosystemic shunt in AVH， discusses more recent data related to the management of cardiofundal varices， and addresses new topics such as portal hypertensive gastropathy and endoscopy prior to transesophageal echocardiography and antineoplastic therapy.

Migração e mortalidade por câncer entre os migrantes colombianos nos EUA: um estudo com dados de declaração de óbito / Migration and cancer mortality among Colombian migrants in the USA: a death certification study

Resumo Este estudo teve como objetivo comparar padrões de mortalidade por câncer entre os imigrantes colombianos nos EUA e colombianos em sua terra natal. Dados de 2008 a 2012 foram coletados, e foram calculadas taxas de mortalidade por câncer de colombianos residindo em seu país natal e colombianos residindo em Califórnia, Flórida e Nova York, bem como taxas específicas de mortalidade por idade e sexo por cada 100.000 pessoas. Para comparar as duas populações, tanto antes como após a correção pela escolaridade, as razões de taxas de mortalidade (MRR) foram estimadas por modelo de regressão binomial negativa. Foi descoberto que colombianos em sua terra natal apresentam taxas de mortalidade por câncer mais altas quando comparados aos que residem nos EUA (MRR masculino 1,4 (IC 95%: 1,2-1,5), MRR feminino 1,5 (IC 95%: 1,3-1,7)). Essas diferenças persistem para a maioria dos tipos de câncer, mesmo após correção pela escolaridade. Os colombianos em sua terra natal apresentaram taxa de mortalidade por câncer gástrico (MRR masculino 2,6; feminino 2,8) e cervical (MRR 5,0) significativamente mais alta em comparação com os que residem nos EUA. As desigualdades educacionais na mortalidade por câncer foram mais acentuadas para aqueles que moram em sua terra natal. A menor taxa de mortalidade por câncer observada entre os colombianos nos EUA, porém, não pode ser atribuída às diferenças de escolaridade, um indicador de status socioeconômico. Em vez disso, provavelmente ocorre devido à maior acessibilidade aos serviços de saúde preventivos e curativos nos EUA.

Abstract We aim to compare cancer mortality rates of USA Colombian migrants (USA Colombians) to Colombians in their country of origin (CO Colombians). Using Colombian national mortality data and data on cancer deaths among Colombians residing in the states of California, Florida, and New York (USA Colombians) for the period 2008-2012, we estimated sex-specific and age-standardized mortality rates (ASMR), expressed per 100,000 persons. For comparisons between the two populations before and after adjustment for educational level, negative binomial regression models were used to compute Mortality Rate Ratios (MRR). CO Colombians had higher cancer mortality rates compared with USA Colombians (male MRR 1.4 [95%CI: 1.2-1.5], female MRR 1.5 [95%CI: 1.3-1.7]). These differences persisted for most cancers even after adjustment for education. CO Colombians had significantly higher mortality from gastric (MRR 2.6 in males and 2.8 in females) and cervical cancer (MRR 5.0) compared with US Colombians. Educational inequalities in cancer mortality were more pronounced among CO Colombians than among USA Colombians. Lower cancer mortality observed among USA Colombians cannot be attributed to differences in education, an indicator of socio-economic status. Rather, it is likely due to better access to preventive and curative healthcare in the USA.

El orden de nacimiento como factor de riesgo para ser víctima de trata sexual en el triángulo norte de Centroamérica / Birth order as a risk factor for being victim of sex trafficking in the northern triangle of Central America

RESUMEN Las redes de tráfico humano para la prostitución captan a menores vulnerables, en especial, a quienes consideran no les queda otra opción que emigrar al norte para hacer frente a problemas económicos graves. El objetivo del presente trabajo fue establecer si el orden de nacimiento representó un factor de riesgo, asociado a la vulnerabilidad para la trata sexual de menores centroamericanas, traficadas a Estados Unidos. Las entrevistadas mostraban vulnerabilidades vinculadas con estructuras sociales y conductas individuales. Por una parte, todas crecieron en hogares caracterizados por la pobreza extrema. Por otra parte, también presentaban vulnerabilidades relacionadas con el embarazo adolescente, la falta de educación, la disfuncionalidad familiar y la participación en mercados ilegales. Ocupar el primer lugar en orden de nacimiento eleva la vulnerabilidad de las menores a ser traficadas a Estados Unidos para el comercio sexual. Por el contrario, ocupar el último lugar disminuye este riesgo.

ABSTRACT Human trafficking networks for prostitution recruit vulnerable underage girls, especially those who are considered with no choice but to migrate north to cope with serious economic problems. The aim of this work was to determine if birth order represented a risk factor associated to the vulnerability for sex trafficking of Central American female minors. The interviewees presented vulnerabilities associated to social structures and individual behaviors. On the one hand, all of them grew up in house holds characterized by extreme poverty. On the other hand, they also had vulnerabilities related to teenage pregnancy, lack of education, family dysfunction and participation in illegal markets. Findings suggest that occupying the first place in the order of birth raises the vulnerability of minors to being trafficked to the United States for sex trade. On the contrary, occupying the last place decreases this risk.

Perfil de estado de ánimo y autoeficacia percibida en tareas de salto con contramovimiento en atletas cubanos de élite

Introducción: El estado de ánimo y la autoeficacia presentan estrecha relación con el rendimiento deportivo. En atletismo, contar con un control exhaustivo del entrenamiento físico y mental supone asentar las bases del máximo rendimiento, siendo el salto vertical un excelente elemento de control. Sin embargo, su relación con los aspectos psicológicos durante los entrenamientos se ha divulgado poco en la literatura. Este artículo tiene como objetivo analizar la relación entre el perfil de estado de ánimo y la autoeficacia durante saltos verticales en deportistas juveniles de la preselección nacional cubana de atletismo. Método: Se evaluó el estado de ánimo y la autoeficacia antes de ejecutar un salto con contra movimiento (CMJ), presentándose el valor de 40 cm como elemento de máximo rendimiento en atletas de élite. Resultados: Se encontró correlación significativa entre el factor ansiedad del POMS y variables del CMJ. Además, se encontró correlación negativa entre la autoeficacia y la ansiedad, aunque no significativa (p > .05). Conclusiones: Los deportistas con un estado de ánimo de puntuación media de ansiedad, aunque no sobreelevada (puntaje 2 sobre 4) antes de la ejecución de saltos verticales, obtuvieron mejores resultados de CMJ, consiguiendo un mayor rendimiento tanto en la altura de salto, como en la velocidad, fuerza y potencia del salto. Sin embargo, no se hallaron correlaciones significativas entre la autoeficacia y el estado de ánimo, ni con variables de salto.

Introduction: Both mood and self-efficacy seem to be components closely related to the athlete's performance. In athletics, to have an exhaustive control of training from the physical and mental point of view is to lay the foundations for sporting success. Exercises such as the vertical jump are an excellent element of control of athletic performance. However, their relationship with psychological aspects during training has been little reported in the literature. Our objective was to analyze the relationship between the mood profile and self-efficacy during vertical jumps in youth athletes of the Cuban national preselection of athletics. Method: Mood and self-efficacy were evaluated before executing a countermovement jump (CMJ), presenting the 40-cm value as the element of maximum success in elite athletes. Results: A significant correlation was found between anxiogenic mood and vertical jump variables. In addition, a negative correlation was found between self-efficacy and anxiety, although not significant (p > .05). Conclusions: Athletes with a medium anxiety score mood although not overelevated (score 2 out of 4) before the execution of vertical jumps obtained better CMJ results, achieving higher performance in both jump height, speed, strength and power of the jump. However, no significant correlations were found between self-efficacy and mood, nor with the jumping variables.

Respuesta inmune en pacientes con diagnóstico de lepra

Introducción: La lepra es una entidad de expresión florida con afectación frecuente en el tegumento cutáneo y los nervios periféricos, por la predisposición que presenta el Mycobacterium leprae a estas estructuras. Las reacciones leprosas pueden aparecer en el curso de la enfermedad. Estas interrumpen la evolución crónica usual y la estabilidad clínica de los pacientes que la padecen. Objetivo: Caracterizar los estados reaccionales de la lepra. Materiales y métodos: Se realizó un estudio descriptivo en el período de enero de 2019 a septiembre de 2022, en pacientes que acudieron a la Consulta Provincial de Lepra en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas. El universo estuvo constituido por 8 pacientes que presentaron estados reaccionales en la etapa mencionada. Se recogieron de las historias clínicas variables como: edad, sexo, clasificación de la lepra según Ridley-Jopling, tipo de estado reaccional, forma clínica y momento de aparición. Resultados: La mayor frecuencia estuvo entre el rango de 50 a 64 años, con un 50 %. El sexo masculino representa el 62,5 %. Se mostró prevalencia de la lepra lepromatosa en el 62,5 %. La reacción tipo II y las formas graves fueron las más frecuentes, con un 62,5 % y 75 % respectivamente. Existió predominio de las reacciones leprosas durante y después del tratamiento, sin diferencias entre estas, con un 37,5 %. Conclusiones: La reacción tipo II y las formas graves de presentación fueron las predominantes en pacientes masculinos, representados en el grupo etario de 50 a 64 años. La forma clínica preponderante en estos eventos fue la lepromatosa.

Introduction: Leprosy is a floridly expressed entity with frequent involvement of the cutaneous integument and peripheral nerves due to the predisposition of Mycobacterium leprae to these structures. Leprosy reactions may appear during the course of the disease. These interrupt the usual chronic course and the clinical stability of patients suffering from the disease. Objective: To characterize the reactional states of leprosy. Materials and methods: A descriptive study was carried out from January 2019 to September 2022 in patients who attended the Provincial Leprosy Clinic at the Clinical Surgical University Hospital Comandante Faustino Pérez Hernández, in Matanzas. The universe consisted of 8 patients who presented reactional states in the aforementioned stage. The variables, collected from the clinical records, were: age, sex; classification of leprosy according to Ridley-Jopling, type of reactional state, clinical form and time of onset. Results: The highest frequency was between 50 and 64 years, with 50%. The male sex represents 62.5%. Lepromatous leprosy prevalence was shown in 62.5%. The type II reaction and severe forms were the most frequent with 62.5% and 75% respectively. There was predominance of leprosy reactions during and after treatment without differences between them, with 37.5%. Conclusions: The type II reaction with severe forms of presentation was predominant in male patients represented in the age group of 50 to 64 years. The predominant clinical form in these events was the lepromatous one.

Research on Ethical Governance of "BRAIN Initiative" in the United States / 中国医学伦理学

With the implementation of the "BRAIN initiative" in various countries, neuroethical governance has become an important concern of the international community. After ten years of development, the "BRAIN initiative" in the United States has formed a relatively complete ethical governance system. By interpreting the strategic report of the "BRAIN initiative" in the United States, analyzing its basic framework of ethical governance, dissecting its governance practice mechanism, and conducting research from the aspects of top-level design and construction, regulatory model innovation, promoting public participation, enhancing international dialogue, and improving soft and hard regulations, this paper provided some reference and thoughts for the ethical governance of the "BRAIN initiative" in China.

The introduction to and inspiration from FDA Guidance: alternative procedures for the manufacture of cold-stored platelets intended for the treatment of active bleeding when conventional platelets are not available or their use is not practical / 中国输血杂志

U.S. Food and Drug Administration recently issued a guidance on alternative procedures for the manufacture of cold-stored platelets intended for the treatment of active bleeding when conventional platelets are not available or their use is not practical. It was allowed to use platelets stored at 1 ℃ to 6 ℃, with a storage period of up to 14 days from the date of collection.The validation and quality monitoring of platelet manufacture retained pH items testing at the end of the storage, and platelet count and actual plasma volume testing items were not required. The guidance provided the recommendations and considerations for the manufacture, labeling, storage, transportation, bacterial contamination control, process validation, and quality monitoring sampling of cold-stored platelets, as well as the further research needs for its efficacy, particularly when conventional platelets are available and their use is practical. The scientific and regulatory considerations on cold-stored platelets in the guidance would be informative and instructive to the development of blood regulation and standards related with urgent transfusion in China.

The experience and enlightenment of American home-school-community partnership to promote physical activity of school age children for overweight and obesity prevention / 中国学校卫生

Abstract@#The study elaborates on the historical development of the home-school-community partnership in the United States, as well as physical activity strategies to prevent overweight and obesity in school age children. Feasible suggestions are proposed for implementing the home-school-community collaboration in China. The finding suggests that in addition to cooperation with schools, families and communities need to take initiatives to actively support children s participation in various physical activities and provide facilities and guarantees. Schools should also do a top level design that links with families and communities, and incorporate their participation into long term physical education planning, making them an integral part of a closely interconnected collaborative network to further prevent overweight and obesity in school age children.

Overview on haemovigilance about delayed transfusions in the UK and blood shortage in the USA / 中国输血杂志

Serious hazards of transfusion(SHOT)in the United Kingdom has been received reporting of the adverse events of delayed transfusion for more than ten years. Hemovigilance Module Surveillance Protocol in Biovigilance Component in National Healthcare Safety Network in the United States updated the incident codes to include under-transfusion with the creation of a new process code: no blood (NB) and four incident codes in October 2022. This review introduces the monitoring practice of delayed transfusion/under-transfusion in the UK and the USA, makes a suggestion to incorporate delayed transfusion/under-transfusion due to blood shortage into the national health standard on the classification of transfusion reactions and haemovigilance protocol in China, and to do a national survey as well, therefore the real world data and evidences would be obtained and used for further policy making.

Role of Procrastination as a Mediator of Self-Efficacy and Emotional State in Academic Situations / Papel da Procrastinação como Mediador da Auto-Eficácia e do Estado Emocional em Situações Acadêmicas / Rol de la Procrastinación como Mediador de la Autoeficacia y el Estado Emocional en Situaciones Académicas

Abstract The need to analyze the relationship between procrastination, self-efficacy and emotional state lies on its impact on productivity, academic performance, and mental health. This research examined the role of academic procrastination as a mediator between self-efficacy and emotional state. A total of 531 university students (59.1% female) participated, with an average age of 21.69 years. The results identified that self-efficacy has a negative influence on procrastination. Likewise, the model was able to corroborate that self-efficacy decreases procrastination and produces a positive affective state. At the same time, a person with high self-efficacy can decrease their negative feelings; however, when procrastinating their negative feelings increase. Furthermore, this model did not vary between gender and academic semester groups, which shows that the results can be interpreted equivalently between these groups.

Resumo A necessidade de analisar a relação entre a procrastinação, a autoeficácia e o estado emocional está no seu impacto sobre a produtividade, o desempenho acadêmico e a saúde mental. Esta pesquisa teve como objetivo examinar o papel da procrastinação acadêmica como mediadora entre a autoeficácia e o estado emocional. Participaram 531 estudantes universitários (59,1% do sexo feminino), com idade média de 21,69 anos. Os resultados identificaram que a autoeficácia tem uma influência negativa sobre a procrastinação. Da mesma forma, o modelo foi capaz de corroborar que a autoeficácia diminui o comportamento procrastinador e produz um estado afetivo positivo. Ao mesmo tempo, uma pessoa com alta autoeficácia pode diminuir seu estado emocional negativo, porém, ao procrastinar, seu estado emocional negativo aumenta. Além disso, esse modelo foi invariável entre os grupos de gênero e semestre acadêmico, o que mostra que os resultados podem ser interpretados de forma equivalente entre esses grupos.

Resumen La necesidad de analizar la relación entre procrastinación, autoeficacia y estado emocional radica en su impacto en la productividad, rendimiento académico y salud mental. Esta investigación examinó el rol de la procrastinación académica como elemento mediador entre la autoeficacia y el estado emocional. Participaron 531 estudiantes universitarios (59.1% mujeres), con edad promedio de 21.69 años. En los resultados se identificó que la autoeficacia influye negativamente en la procrastinación. Asimismo, el modelo pudo corroborar que la autoeficacia disminuye la conducta procrastinadora y produce un estado afectivo positivo. Al mismo tiempo, una persona con alta autoeficacia puede disminuir su emocionalidad negativa, no obstante, cuando procrastina su estado emocional negativo incrementa. Además, este modelo fue invariante entre grupos de sexo y semestres académicos, lo que demuestra que se puede interpretar los resultados de forma equivalente entre estos grupos.

Estados afectivos emocionales y desgaste profesional durante la atención de pacientes con covid-19 / Emotional affective states and professional burnout during the care of patients with covid-19

Introducción: Los efectos directos de la Covid-19 fueron más allá del espectro de manifestaciones clínicas propias de la enfermedad, también se evidenciaron cambios en los estados afectivos de la persona. Objetivo: Determinar la relación de los estados afectivos emocionales con el desgaste profesional al atender a pacientes afectados por la Covid-19, en el Hospital Materno Infantil, durante el 2020. Métodos: Fue un estudio con enfoque cuantitativo, de tipo observacional, transversal, prospectivo y analítico. Se trabajó con una población censal de 180 trabajadores asistenciales, a quienes se les aplicó un inventario de desgaste profesional y una escala de ansiedad, estrés y depresión (DASS-21), las cuales fueron previamente validadas. En la contrastación de hipótesis se utilizó la prueba X2, con un p < 0,05. Resultados: Se halló relación entre el nivel de ansiedad y el nivel de desgaste laboral del personal de salud (X2 = 18,533; p = 0,000). Hubo relación entre el nivel de estrés y el nivel de desgaste laboral entre dichas variables (X2 = 12,808; p = 0,000). Finalmente, se halló relación entre el nivel de depresión y el desgaste laboral (X2 = 13,618; p = 0,000). Conclusiones: Se evidenció que el 5,6 % (10) presentaron estados afectivos alterados y desgaste laboral.

Introduction: The direct effects of Covid-19 went beyond the spectrum of clinical manifestations of the disease, changes in the affective states of the person were also evidenced. Objective: To determine the relationship between emotional affective states and professional burnout when attending patients affected by Covid-19, in Hospital Materno Infantil, during 2020. Methods: It was a quantitative, observational, cross-sectional, prospective, and analytical study. It worked with a census population of 180 healthcare workers, who were applied an inventory of professional burnout and a scale of anxiety, stress, and depression (DASS-21), which were previously validated.The X2 test was used for hypothesis testing, with a p < 0.05. Results: We found a relationship between the level of anxiety and the level of professional burnout of health personnel (X2 = 18.533; p = 0.000). There was a relationship between the level of stress and the level of professional burnout between these variables (X2 = 12.808; p = 0.000). Finally, we found a relationship between the level of depression and professional burnout (X2 = 13.618; p = 0.000). Conclusions: It was evident that 5.6% (10) presented altered affective states and professional burnout.

Translation and cross-cultural adaptation to Brazilian Portuguese of two brief screening tools for youth at risk of psychosis: the Prodromal Questionnaire (PQ-16) and the PRIME-Screen

Abstract Introduction Prodromal characteristics of psychosis have been described for more than a century. Over the last three decades, a variety of studies have proposed methods to prospectively identify individuals (and youth in particular) who are at high risk of developing a psychotic disorder. These studies have validated various screening instruments and made them available in several languages. Here, we describe the translation into Brazilian Portuguese and cross-cultural adaptation of two such screening tools - the Prodromal Questionnaire-16 (PQ-16) and the Prevention through Risk Identification, Management, and Education (PRIME)-Screen. Method Two bilingual native speakers of Brazilian Portuguese translated the questionnaires from English. A native English speaker then performed back-translations into English. These back-translated versions were submitted to the original authors. They provided feedback and later approved the final versions. Results After translation and cross-cultural adaptation, no items needed to be changed in the adapted PQ-16 and four items were revised in the PRIME-Screen. After the peer-review process, we included two suggestions in the PQ-16 to facilitate use of the tool in our cultural and social contexts. The PRIME-Screen did not need further changes. Conclusion These new instruments can help screen Brazilian Portuguese-speaking patients who are at risk of psychosis in primary care.

Enlightenment of the DRG payment reform in the United States on the reform of China′s medical insurance payment methods / 中华医院管理杂志

In order to curb the excessive growth of medical expenses, the United States has initiated payment reform of diagnosis-related groups (DRG) since 1983, and developed a series of complementary measures to address issues such as overcoding and declining healthcare service quality which were exposed during the reform. The authors discussed the implementation of DRG payment reform in the United States, namely the case-mix specialization of medical institutions and the reduction of costs, as well as the relationship between the two. On this basis, the authors suggested that when implementing reforms to the medical insurance payment system in China, it is imperative to avoid such loopholes as overcoding by medical institutions and excessive pursuit of efficiency at the expense of quality control, as well as the decline of comprehensive rescue capability and quality of care incurred by the exacerbated specialization.

Research on the appointment system of universities to promote interdisciplinary research from the perspective of comparison between China and the United States / 中华医学科研管理杂志

Objective:This paper focused on the research of the appointment system in interdisciplinary research institutions of world-class universities in China and the United States. The positive effects of different employment and evaluation systems as well as existing problems were sorted out and analyzed, and some suggestions were put forward to optimize and innovate the teacher appointment system and promote the interdisciplinary construction of Chinese universities.Methods:This paper focused on the new teacher appointment system adopted by representative universities in China and the United States to promote the development of interdisciplinary research and used the methods of literature research, questionnaire survey, case analysis, and in-depth interview to sort out and analyze the different systems.Results:Based on the broad perspective of the ″new concept-(artificial) selection-stabilization″ system change, the implementation of an interdisciplinary joint appointment in our country has experienced a stage of ″new concept generation″ at present, but it is still in the stage of ″institution establishment and stabilization″. The personnel management system for teachers engaged in interdisciplinary research still needs to be improved, and there are still outstanding problems in the areas of evaluation and promotion pressure, financial resources guarantee, teachers′ sense of belonging, administrative costs, etc.Conclusions:Referring to the advanced experience at home and abroad, Chinese universities should focus on breaking the barriers of distributing the interests of results, improving interdisciplinary talent evaluation mechanisms, adopting a variety of flexible appointment systems depending on demands, and building a benign flow ecology of interdisciplinary human resources. Apart from these, urgent attention should be paid to improving the administrative work system and interdisciplinary cultural system construction.

Functional connectivity and regional spontaneous brain activity in a minimally-conscious state / 中华物理医学与康复杂志

Objective:To explore the characteristics of functional connectivity (FC) and regional spontaneous brain activity in patients in a minimally-conscious state (MCS).Methods:Resting-state functional near-infrared spectroscopy (rs-fNIRS) was used. Ten minimally-conscious patients were studied along with 12 healthy counterparts as healthy controls (HC). Five minutes of rs-fNIRS data were recorded from each subject and FC and the fractional amplitude of low-frequency fluctuations (fALFFs) of 53 channels were computed using the NIRS-KIT toolbox. The results were compared between the two groups.Results:Compared with the HC group, a significant decrease was observed in the average FC strength of seventeen channel pairs after false discovery rate (FDR) correction. Most were in the right and left frontal pole, as well as the dorsolateral prefrontal lobe. Compared with the HC group, the average fALFF values of Broca′s area (channel 2), the premotor cortex and the supplementary motor cortex (channels 4, 10, and 40), the dorsolateral prefrontal lobe (channels 6, 11, 25, 39), the eye motor area of the frontal lobe (channel 12) and the frontal pole (channels 23, 27, 36) were significantly greater in the MCS group. The fluctuations of the frontal pole (channel 19) were significantly less (after FDR correction).Conclusion:In an MCS spontaneous neural activity is over-active in the prefrontal lobe and some speech- and motor-related brain regions, and coordination of the internal prefrontal functional network is disordered.

Investigation on medical practice of overseas acupuncturists based on the top 5 general hospitals in the United States of America and the inspiration / 国际中医中药杂志

This study selected the top five general hospitals in the United States of America, collected the practice information of acupuncturists through the official website, and analyzed the professional department, expertise, professional title, education background, residency, fellowship, board certification, etc. of these acupuncturists to understand the practice situation of acupuncturists in the hospitals. The results of the study showed the practice of acupuncturists in the United States of America is improving. With further localization, locally trained acupuncturists have gradually become the main body of acupuncturists; acupuncture treatment is still mainly for analgesia, but the scope of treatment continues to expand, and departments that accept acupuncturists are gradually increasing. However, the group of licensed acupuncturists is still a minority in the group of acupuncturists in the United States of America. Native American physicians still use acupuncture as an alternative option and neglect to obtain a license. The entry barrier for acupuncturists still needs to be raised.

School Feeding Programs in the United States during 1853-2010 / 中国学校卫生

Abstract@#The Children s Aid Society of New York has been providing free food to students at local vocational schools since 1853. It wasn t until 1975 that the school lunch program was permanently mandated by Congress. The National School Lunch Program in America has gone through a historic process from its inception and establishment to its development. The continued interest and oversight of the American people, public opinion guidance by progressive people like nutrition reformers, home economics and other are external factors in the continued development of this program. The timely enactment of the bill by the federal government and the high concern of senior leaders on this project is an important prerequisite for continued development. Integrating this program into the national agricultural development strategy and realizing the overall development philosophy is the key to the sustainability of this program. Paying attention to children s physical health is the core reason why American School Feeding Programs focus on children s diet quantity to children s nutritional quality. All of these factors contribute to the development of this project.

Review of the competitive generic drug incentive system in the United States and its enlightenment to China / 中国药房

OBJECTIVE To provide ideas and inspiration for promoting the development of the generic drug industry and legal system of China. METHODS With text analysis， empirical research and other methods， the competitive generic drug incentive system in the United States was combed， its implementation effect and successful experience were analyzed， and the reference was provided for the implementation of relevant systems in China. RESULTS The competitive generic drug incentive system in the United States had achieved a satisfactory effect in three aspects： encouraging generic drug applications， accelerating the listing of generic drugs， and promoting drug price reduction， which was ultimately conducive to improving drug accessibility by publishing List of Off-Patent，Off-Exclusivity Drugs without an Approved Generic， while accelerating the development and review of generic drugs with insufficient competition and giving market exclusivity periods. CONCLUSIONS China’s reference to the competitive generic drug incentive system in the United States meets the needs of the current situation of domestic drug supply and also has the basis for industry practice. Therefore， we can refer to it， improve the system of releasing the catalog of encouraged generic drugs to be imitated， optimize the approval process for them， and authorize the exclusive period incentive to them.