Narrative Empowerment for Medical Students in Narrative Medicine Education in Public Health Crises / 中国医学伦理学

Narrative competence is one of the factors to reflect humanistic literacy of doctors and nurses. According to the advice of many experts, the narrative competence should be improved from the stage of medical students through the two major tools including close reading of text and reflective writing. Based on the background of prevention and control of COVID-19 outbreak, this paper aimed to clarify the focus and methodology of close reading and reflective writing, that was, close reading was supposed to focus on the analysis of disease metaphors in classic literature and narrative function in clinical works and realism works, and writing tended to focus on the the differentiation of writing purpose and the writing guidance in different texts. The proper guidance plus solid training in close reading and writing will definitely lay a strong foundation for medical students in achieving humanistic quality.

Propuesta de Valores de Referencia para el Cuestionario de Evaluación del Apego Adulto: Experiences in Close Relationships (ECR-12), en población adulta chilena / Reference values for the Adult Attachment Assessment Questionnaire: Experiences in Close Relationships (ECR-12) in the Chilean Adult Population

El cuestionario de Experiencias en Relaciones Cercanas (ECR) es un instrumento de auto-reporte ampliamente utilizado para evaluar el apego en la adultez, a partir de dos dimensiones: la ansiedad y la evitación asociadas al apego. Este instrumento ha sido adaptado en múltiples contextos, incluyendo el chileno, del cual existe una versión abreviada (ECR-12), objeto de análisis del presente estudio. Si bien existe consenso en que la seguridad en el apego es mejor descrita en términos dimensionales, hay ámbitos, como en la práctica clínica donde contar con valores de referencia podría ser de utilidad. El objetivo de este estudio es proveer valores de referencia para la interpretación de los valores del ECR-12 en el contexto chileno. Para ello, una muestra de 6779 participantes respondió el ECR-12. Se utilizó el método de puntuación z con normalización para obtener los valores de referencia. Los análisis realizados evidenciaron la necesidad de construir baremos diferenciados por edad. Así, para el grupo de 29 años o menos, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.4 puntos, y para la evitación, el punto de corte es de un promedio igual o superior a 2.5. En cambio, para el grupo de 30 años o más, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.2, y para la evitación, es de un promedio igual o superior a 2.9. Estos hallazgos pueden ser relevantes no sólo para identificar a personas que puedan presentar niveles sustancialmente altos de ansiedad y/o evitación en el apego, sino, también puede constituirse como una herramienta clínica complementaria en contextos terapéuticos.

The Experiences in Close Relationships (ECR) questionnaire is a widely used self-report measure to assess adult attachment, based on two dimensions: attachment anxiety and attachment avoidance. This instrument has been adapted in multiple contexts, including the Chilean, for which there is an abbreviated version (ECR-12), that is the object of analysis in the present study. Although there is consensus that attachment security is best described in dimensional terms, there are areas, such as clinical practice, where having reference values could be useful. The aim of this study is to provide reference values for the interpretation of ECR-12 scores in the Chilean context. To do this, a sample of 6779 participants was evaluated using the ECR-12. The z-score normalization method was used to obtain the reference values. The analyzes carried out showed the need to build scales differentiated by age. Thus, for the group of 29 years or less, the cut-off point in the anxiety dimension is an average equal to or greater than 4.4 points, and for avoidance, the cut-off point is an average equal to or greater than 2.5. On the other hand, for the group aged 30 or older, the cut-off point in the anxiety dimension is an average equal to or greater than 4.2, and for avoidance, it is an average equal to or greater than 2.9. These findings can be relevant not only for identifying people who may present substantially high levels of anxiety and/or avoidance in attachment, but also as a complementary clinical tool in therapeutic contexts.

Clinical features of early-onset pediatric traumatic glaucoma and predictive factors for the need of early glaucoma surgery

Purpose: To assess the clinical presentation of pediatric patients having early traumatic glaucoma and to analyze early predictors for the need of filtration surgery. Methods: Patients with early traumatic glaucoma after close globe injury (CGI) from January 2014 to December 2020 were retrospectively reviewed. Clinical features, treatment provided (medical and surgical), and visual outcomes were documented. Patients were divided into two groups based on the management required: group A? trabeculectomy and group B? medication + minor surgery. Results: A total of 85 patients were studied after applying the necessary inclusion and exclusion criteria. Out of these, 46 underwent trabeculectomy for the control of intraocular pressure (IOP) and the remaining 39 were managed with antiglaucoma medications. Significant male predominance of 9.6:1 was observed. Patients presented to the hospital after a mean duration of 8.5 days posttrauma. Wooden objects were most commonly responsible for trauma. Mean best corrected visual acuity at presentation was 1.91 log of minimum angle of resolution (logMAR). Mean IOP at presentation was 40 mmHg. The common anterior segment finding were severe anterior chamber (AC) reaction (63.5%), followed by angle recession (56.4%). Severe AC reaction (P = 0.0001) and corneal microcystic edema (P = 0.04) were significant predictive factors for early need of trabeculectomy. Conclusion: Need of trabeculectomy was higher in patients with severe AC reaction and corneal microcystic edema. The threshold to perform trabeculectomy should be lower, as glaucoma is often relentless, severe, and may result in irreversible vision loss.

Latent tuberculosis infection and screening method among close contacts in schools in Xuhui District，Shanghai from 2020 to 2022 / 上海预防医学

ObjectiveTo investigate the latent tuberculosis infection （LTBI） of close contacts in schools of Xuhui District， and to explore the tuberculin skin test （TST）- interferon-γ release assay （IGRA） two-step method in order to discover the screening strategy of tuberculosis in Xuhui District. MethodsClose contacts of tuberculosis in schools of Xuhui District from 2020 to 2022 were selected as research subjects. Screening was conducted using symptom questionnaire， TST， chest X-rays， IGRA， and the information including the etiological results and grade of the index cases， as well as gender， age， and relationship with the index cases of the research subjects were collected. ResultsTotally 615 close contacts of 32 tuberculosis cases occurred in the schools were finally included. Of the 609 close contacts who completed tuberculosis infection screening and underwent TST testing， 153 TST（+） individuals underwent IGRA testing. The final LTBI rate was 4.6%， and the pulmonary tuberculosis detection rate was 163 per 100 000. The relationship with the index cases was an influencing factor for LTBI. The IGRA positivity rate was higher among close contacts with TST ≥15 mm than among those with 10 mm≤ TST <15 mm （χ2=14.41， P<0.05）. ConclusionThe latent tuberculosis infection among close contacts of school tuberculosis cases in Xuhui District remains serious. TST-IGRA two-step method can assist in the accurate diagnosis of LTBI and pulmonary tuberculosis cases.

Qualitative Study on Psychological Experience of Close Contacts with COVID-19 during the Centralized Isolation Medical Observation Period / 中国医学伦理学

To analyze the psychological experience of close contacts with COVID-19 during the centralized isolation medical observation (centralized isolation for short) period, 17 close contacts of COVID-19 who received medical isolation observation at designated locations in a city of China were selected by purposive sampling using qualitative study methods, and the interviewees were interviewed by full-coverage structured telephone. By analyzing the obtained data and summarizing the themes, it was found that the psychological status of the COVID-19 close contacts during the centralized isolation period could be classified into three themes: obvious negative emotions, somatization of psychological problems, and demand for social support. During the epidemic, when close contacts were quarantined as high-risk groups, they often had complex and difficult psychological experiences. Relevant departments should actively carry out online guidance channels and offline knowledge dissemination, actively conduct psychological interventions for close contacts, assist them to develop life plans to enrich the life of the centralized isolation period. At the same time, relevant departments should do a good job in logistics and life support services, create a comfortable isolated living environment, and effectively relieve the negative emotions of close contacts of COVID-19 during centralized isolation through a variety of positive and effective measures to ensure physical and mental health.

Evaluation of screening methods for the students who had close contact with pulmonary tuberculosis patients in Shanghai / 上海预防医学

ObjectiveTo evaluate the current screening methods for the students who were in close contact with tuberculosis patients， that could accurately identify the preventive treatment subjects， and to improve the tuberculosis prevention and control in Shanghai schools. MethodsThe freshman/sophomore who were in close contact with active tuberculosis patients in the colleges in 2019 were recruited. All the subjects underwent both tuberculin skin test （TST） and QuantiFERON-TB gold in-tube （QFT） test at the enrollment. After signed the informed consent， all of the participants filled in a questionnaire and determined their baseline tuberculosis infection status. They were followed up for 2 years to monitor the conversion of infection status and the incidence of tuberculosis. ResultsFour of 9 （44.4%） positive participants had conversion to negative results， and 5 of 300 （1.7%） negative participants had conversion to positive during the 2-year follow-up， one of which was diagnosed with active tuberculosis. We assessed diagnostic agreement between QFT and TST at different cut-off values. The highest coincidence rate was 94.0% when choosing 15 mm as the cut-off value， with Kappa coefficient of 0.45 （95%CI： 0.32‒0.59）. ConclusionAlthough stricter than the national work requirements， the prevention and control of tuberculosis in Shanghai schools still need to be carried out meticulously. It's necessary to strengthen daily prevention and control measures， and improve the ability of management.

Propiedades psicométricas de la Escala de Confianza Diádica en personas gays y lesbianas en pareja / Psychometric Properties of the Dyadic Trust Scale in Gay and Lesbian People with a Partner

Resumen El presente estudio tuvo como objetivo evaluar las propiedades psicométricas de la Escala de Confianza Diádica (ECD, Larzelere & Huston, 1980) en personas gays y lesbianas de Chile. Para ello, se evaluó una muestra de 360 personas chilenas gay o lesbianas involucradas en una relación de pareja. Los datos obtenidos proporcionan evidencia de que el instrumento se ajusta de manera aceptable a una estructura unidimensional y que es invariante entre personas gay y lesbianas. Adicionalmente, se identificó que posee una consistencia interna adecuada, así como una asociación inversa entre los niveles de confianza diádica y la ansiedad y evitación del apego. En conclusión, la ECD posee propiedades psicométricas adecuadas para la evaluación de la confianza diádica en personas gays y lesbianas en el contexto chileno.

Abstract The present study aimed to evaluate the psychometric properties of the Chilean version of the Dyadic Trust Scale (DTS, Larzelere & Huston, 1980). For this purpose, a sample of 360 Chilean gay or lesbian people involved in a couple relationship was evaluated. The data obtained provide evidence that the instrument conforms acceptably to a unidimensional structure and scores are invariant between gay and lesbian persons. Additionally, it has adequate internal consistency, as well as an inverse association between levels of dyadic trust and attachment anxiety and avoidance. In conclusion, the ECD has adequate psychometric properties for the assessment of dyadic trust in gay and lesbian persons in the Chilean context.

Estudio multicéntrico de incidencia y determinantes de COVID-19 en médicos de Argentina / Multicenter study of COVID-19 incidence and determinants in Argentinian physicians

Resumen Introducción: La información sobre COVID en médicos es limitada. Su conocimiento permitiría implementar acciones para reducir su impacto. El objetivo general fue determinar la incidencia de infección por SARS-CoV-2 en médicos de instituciones de salud de Argentina, sus características y factores aso ciados. Materiales y Métodos: Se realizó un estudio multicéntrico de cohorte prospectiva/retrospectiva con estudio de casos-controles anidado. Se incluyeron médicos activos al inicio de la pandemia no exceptuados por riesgo. Se estimó incidencia de casos confirmados. Se compararon factores asociados en casos y controles y se creó un modelo de regresión logística con las variables significativas del análisis bivariado. Resultados: Se incluyeron 343 médicos con COVID de 8 centros. La incidencia de la enfermedad fue de 12.1% y la de ausentismo global relacionado a COVID, de 34.1%. El 70% de los contactos estrechos fueron laborales. En el análisis multivariado de casos y controles, la residencia en la Ciudad Autónoma de Buenos Aires (OR 0.19, p = 0.01), el trabajo en áreas de alto riesgo (OR 0.22, p = 0.01) y vehículo individual (OR 0.34, p = 0.03) redujeron el riesgo de COVID. El odds de enfermar aumentó 4.6 veces (p = 0.02) por cada aislamiento por contacto estrecho. Discusión: El riesgo de enfermar aumentó considerablemente con cada aislamiento por contacto estrecho. La residencia en Ciudad Autónoma, el traslado en vehículo individual y el trabajo en áreas de alto riesgo lo redujeron. Dada la alta frecuencia de contactos estrechos en el ámbito laboral recomendamos reforzar las medidas de prevención en áreas de descanso y no COVID.

Abstract Background: Information about COVID infection in physicians is limited. This knowledge would allow the implementation of actions to reduce its impact. The objective was determining the incidence of SARS-CoV-2 infection in physicians from health institutions in Argentina, its characteristics, and associated factors. Methods: We conducted a multicenter prospective / retrospective cohort study with nested case-control study. Physicians active at the beginning of the pandemic were included, those on leave due to risk factors were excluded. The incidence of confirmed cases was estimated. We conducted bivariate analyses with various factors and used those significant in a logistic regression. Results: Three hundred and forty three physicians with COVID-infection from 8 centers were included. The incidence of disease was 12.1% and that of global absenteeism related to COVID, 34.1%. Almost 70% of close contacts were work-related. In the multivariate analysis living in Autonomous City of Buenos Aires (CABA) (OR 0.19, p = 0.01), working in high-risk areas (OR 0.22, p = 0.01) and individual transportation (OR 0, 34, p = 0.03) reduced the risk of COVID. The odds of infection increased 5.6 times (p = 0.02) for each close contact isolation. Discussion: The number of close contact isolation increased considerably the risk of infection. Living in Buenos Aires City, individual transpor tation and working in high-risk areas reduced it. Given the high frequency of close contact in the workplace, we strongly recommend the reinforcement of prevention measures in rest areas and non-COVID-wards.

Detección de SARS-CoV-2 en contactos estrechos asintomáticos de casos confirmados por diagnóstico molecular, provincia de Buenos Aires, Argentina / Detection of SARS-CoV-2 in asymptomatic close contacts of cases confirmed by molecular diagnosis, Buenos Aires province, Argentina

Resumen La detección de SARS-CoV-2 y su implicancia en el diagnóstico de COVID-19 han sido muy debatidas en la pandemia. El objetivo de este estudio fue evaluar el costo/beneficio de la detección de SARS-CoV-2 en contactos estrechos asintomáticos (CE) mediante el uso de distintas pruebas de diagnóstico molecular. Se estudiaron 51 CE de personas con diagnóstico de SARS-CoV-2 confirmado por RTqPCR, clasificadas por el umbral de ciclos (Ct) (<20, entre 20 y 30 y >30) en hospitales públicos de la provincia de Buenos Aires. Del total de contactos estudiados el 15,7% resultó confirmado para SARS-CoV-2; no hubo contactos positivos de casos con Ct>30. La cantidad de contactos positivos de casos con Ct<20 fue significativamente mayor que la de casos con Ct>20. Las muestras con Ct<20 se asociaron a una carga viral estimada de entre uno a cuatro órdenes de magnitud de diferencia con los rangos de Ct>20. Un 13,7% de contactos positivos fueron casos con Ct<20. De las muestras positivas confirmadas por PCR, correspondientes a la semana epidemiológica 1 de 2021 (SE1), sólo un 19,35% correspondían a muestras con Ct<20 y un 50,7% con Ct entre 20 y 30. Estos datos muestran un incremento de sólo un 3,7% de casos detectados. El esfuerzo por parte del sistema de salud pública para esta estrategia, con bajo poder predictivo, puede tener un efecto negativo para el cumplimiento del aislamiento de los contactos y podría generar una demora en los resultados de los casos sospechosos, sin aportar significativamente en el control de la pandemia.

Abstract The detection of SARS-CoV-2 and its implication in the diagnosis of COVID-19 have been highly debated in the pandemic. The objective of this study was to evaluate the cost/benefit of detecting SARS-CoV-2 in asymptomatic close contacts (CC) using different molecular diagnostic tests. A total of 51 CC of people with a diagnosis of SARS-CoV-2 confirmed by RTqPCR, classified by the cycle threshold (Ct) (<20, between 20 and 30 and >30), were studied in public hospitals in the Province of Buenos Aires. Of the total contacts studied, 15.7% were confirmed for SARS-CoV-2; there were no positive contacts of cases with Ct>30 positive. The number of positive contacts of cases with Ct<20 was significantly higher than that of cases with Ct>20. Samples with Ct<20 were associated with an estimated viral load of one to four orders of magnitude difference with Ct ranges >20. A total of 13.7% of positive close contacts were from cases with Ct<20. When studying positive samples with confirmed diagnosis by PCR, corresponding to 1 epidemiological week of 2021 (EW1), only 19.35% corresponded to samples with Ct<20 and 50.7% with Ct between 20 and 30. From these data it is shown that with the CC test only 3.7% of the cases were detected. The effort by the public health system for this strategy, with low predictive power, may have a negative effect on the fulfillment of the isolation of contacts and could generate a delay in the results of suspected cases, without contributing significantly to controlling the pandemic.

Resumo A detecção do SARS-CoV-2 e seu envolvimento no diagnóstico da COVID-19 têm sido muito discutidos durante a pandemia. O objetivo desse estudo foi avaliar a relação custo/benefício na detecção de SARSCoV- 2 em casos de contatos próximos assintomático (CP), por meio do uso de diferentes testes de diagnóstico molecular. Foram estudados 51 casos de CP de pessoas com diagnóstico de SARS-CoV-2 confirmado pelo RTqPCR, sendo classificados pelo limiar de ciclos (Ct) (<20, entre 20 e 30 e >30), em hospitais públicos da província de Buenos Aires. Do total de contatos estudados, 15,7% foram confirmados para SARS-CoV-2, não houve contatos positivos de casos com Ct>30. O número de contatos positivos de casos com Ct<20, foi significativamente maior que os casos com Ct>20. As amostras com Ct<20 foram associadas a uma carga viral estimada de uma a quatro ordens de magnitude de diferença com os intervalos de Ct>20. Dos casos positivos, 13,7% foram com Ct<20. Das amostras positivas confirmadas por PCR, correspondentes à semana epidemiológica 1 de 2021 (SE1), apenas 19,35% correspondiam a amostras com Ct>20 e 50,7% com Ct entre 20 e 30. Esses dados mostram incremento de apenas 3,7% de casos detectados. O esforço por parte do sistema de saúde pública para essa estratégia, com baixo poder preditivo, pode ter um efeito negativo no cumprimento do isolamento dos contatos e poderia gerar uma demora nos resultados dos casos suspeitos, sem contribuir significativamente para o controle da pandemia.

Simulation study of spinal cord stimulation evoked compound action potential / 生物医学工程学杂志

Spinal cord stimulation (SCS) for pain is usually implanted as an open loop system using unchanged parameters. To avoid the under and over stimulation caused by lead migration, evoked compound action potentials (ECAP) is used as feedback signal to change the stimulating parameters. This study established a simulation model of ECAP recording to investigate the relationship between ECAP component and dorsal column (DC) fiber recruitment. Finite element model of SCS and multi-compartment model of sensory fiber were coupled to calculate the single fiber action potential (SFAP) caused by single fiber in different spinal cord regions. The synthetized ECAP, superimposition of SFAP, could be considered as an index of DC fiber excitation degree, because the position of crests and amplitude of ECAP corresponds to different fiber diameters. When 10% or less DC fibers were excited, the crests corresponded to fibers with large diameters. When 20% or more DC fibers were excited, ECAP showed a slow conduction crest, which corresponded to fibers with small diameters. The amplitude of this slow conduction crest increased as the stimulating intensity increased while the amplitude of the fast conduction crest almost remained unchanged. Therefore, the simulated ECAP signal in this paper could be used to evaluate the degree of excitation of DC fibers. This SCS-ECAP model may provide theoretical basis for future clinical application of close loop SCS base on ECAP.

Epidemic Characteristics of the Novel Coronavirus Delta Variant in Guangzhou and Grid Crowd Management Based on Public Security Forensic Perspective / 法医学杂志

Abstract： Objective To analyze the first epidemic spread of the novel coronavirus Delta variant in China based on public security forensic perspective, investigate its transmission characteristics, contributing factors, and epidemiologic research experience, and provide a reference for the prevention and control of the epidemic caused by the novel coronavirus variant. Methods Based on the information that public security forensic experts obtained from front-line epidemiologic research, the gender, age, place of residence, transmission route and infectivity of the coronavirus disease 2019 （COVID-19） confirmed cases, asymptomatic infected persons and their close contacts in Guangzhou caused by the novel coronavirus Delta variant were analyzed. The basic reproduction number （R0） during this epidemic in Guangzhou was calculated. Results Among the 153 cases infected with novel coronavirus Delta variant in the epidemic, 63 cases were male and 90 cases were female, their age ranging from 1 to 92 years, with a median age of 49 years. The main route of transmission was close contact, including dining together, co-living, and close contact in the same residential building. There were 31 cases of family clusters, 25 of which were in Liwan District. The epidemic lasted from May 26 to May 29, and the R0 remained above 4.0. After May 30, R0 began to decline and remained below 1.0 from June 7. Conclusion The novel coronavirus Delta variant is highly infectious, the crowd is generally susceptible to infection and family cluster cases are easy to occur. So, it is necessary to precisely prevent and control this strain. Public security forensic experts have both medical literacy and criminal investigation capabilities, they can play a more professional role in epidemic prevention and control.

Moxibustion on mental disorder in close contacts of coronavirus disease 2019: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of moxibustion combined with @*METHODS@#A total of 240 close contacts of COVID-19 were randomized into an observation group (120 cases, 18 cases dropped off) and a control group (120 cases, 58 cases dropped off). Conventional observation was adopted in the control group. Moxibustion combined with Daiwenjiu plaster was given in the observation group, moxibustion was applied at Zusanli (ST 36), Hegu (LI 4) and Shenque (CV 8), 10 min each acupoint, once a day; @*RESULTS@#In the follow-up, SRQ-20 score was decreased compared before treatment (@*CONCLUSION@#Moxibustion combined with

Determinación de contactos cercanos con riesgo de transmisión durante las medidas de cuarentena y distanciamiento social para el Covid-19 en personal de salud / Determination of close contacts at risk of transmission during quarantine and social stating measures for Covid-19 in health personnel

El personal de salud por su ámbito laboral sanitario es de alto riesgo para la adquisición y transmisión de la infección por Covid-19. Los contactos cercanos del personal de salud fuera del ambiente hospitalario son frecuentes y variados. El objeto de la investigación es determinar la frecuencia de contactos cercanos para infecciones Covid-19 del personal de salud en su ambiente sanitario,social y familiar previo y durante la pandemia marzo y abril 2020. Métodos: Estudio de corte transversal por cuestionario auto administrado por vía digital dirigido al personal de salud. La población objeto son profesionales activos adscritos a Sociedades Científicas y la UCV. Variables demográficas: edad, sexo,año académico, cohabitante y los contactos cercanos durante traslados, actividades académicas, hospitalarias y sociales.Medidas de tendencia central y dispersión, distribuciones de frecuencia y figuras. Chi cuadrado e intervalos de confianza al 95%, medidas de correlación, comparación con t con error al fade 0,05. Resultados: 194 trabajadores de la salud completaron la encuesta, Sexo femenino 124 (63,9%), edad promedio 49,6 y mediana 53 años. La gran mayoría médicos 88,6%. Se dedican a actividades asistenciales 81%. El promedio de contactos diarios del personal de salud es 38. Los contactos intrahospitalario promedio diario son la mayoría 71%, (27,1 contactos/día). De estos con colegas 5,6, con enfermeras y paraclínicos 3,7; otro personal 4,7; pacientes y sus familiares 7,5 y 5,4. Conclusión:El personal de salud tiene un alto número de contactos cercanos diarios para la transmisión de infecciones respiratorias agudas,lo que representa un alto riesgo para adquirir y son potenciales dispersores de las infecciones a familiares y sociales(AU)

Introduction: Health workers are at high risk for the acquisition and transmission of Covid-19 infection. Close contacts of health workers outside the hospital environment are frequent and varied. The objective of the investigation is to determine the frequency of close contacts for COVID-19 infections of health workers in their previous health, social and family environment and during the pandemic. Methodology: Cross-sectional study by self-administered digital questionnaire to health workers. The target were active professionals of Scientific Societies and professionals of UCV. Demographic variables: age, gender, academic year, cohabitant and close contacts during transfers, academics, hospitals and social. Analysis of central trend and dispersion measures, presentationof data in frequency distributions and bar charts, and segment diagrams. Chi squared, confidence intervals to 95%, correlation measures, comparison with t with alpha error of 0.05 was calculated. Results: 194 health workers participants, most female 124 (63.9%), average age 49.6 and median 53 years.The majority were doctors 88.6%. 81% are dedicated to welfare activities. The average daily contact of health workers is 38people. The average daily hospital contacts are the majority 71%, average of 27.1. Average daily contacts with colleagues 5.6,with nurses and paraclinical 3.7; other personnel 4.7; patientsand their families 7.5 and 5.4. Conclusion: Health workers are highly exposed to infectious respiratory diseases due to their high frequency of close contacts in their daily routine. Therefore, Health workers are potential dispersants of infections to family members, friends and others(AU)

Recommendations for improving photo quality in close range photogrammetry, exemplified in hand bones of chimpanzees and gorillas / Recomendaciones para mejorar la calidad de las fotos en fotogrametría de corto alcance, ejemplificado en huesos de las manos de chimpancés y gorillas

SUMMARY: Photogrammetry is becoming increasingly popular in morphological research and teaching due to its portability, ability to reliably render 3D models, and quality-to-price relationship relative to some popular surface scanners. Compared to surface scanners, however, the learning process in photogrammetry can be very time consuming. Here we describe common mistakes of photo capture in close-range photogrammetry that greatly affect 3D output and tips to improve them. Problems were identified after the 3D model construction of 780 hand bones of chimpanzees and gorillas from museum collections. Their hands are composed of 27 bones which vary in length and complexity. We show how lighting, object position and orientation, camera angle, and background affect the 3D output. By taking these factors into account, time and error rates for beginners can be greatly reduced and 3D model quality can be considerably improved.

RESUMEN: La fotogrametría está siendo cada vez más popular en la investigación y enseñanza morfológica. Esto debido a su portabilidad, confiabilidad de los modelos 3D y buena relación calidadprecio. Comparada con los escáneres de superficie, sin embargo, el proceso de aprendizaje de la fotogrametría puede llevar mucho tiempo. Aquí se describen errores comunes en la toma de fotos para fotogrametería que afectan de manera importante la creación de los modelos 3D, así como consejos para superarlos. Los problemas descritos fueron identificados luego de la construcción de 780 modelos 3D de huesos de la mano de chimpancés y gorillas depositados en distintas colecciones de museos. Las manos de estas especies están compuestas por 27 huesos que varían en tamaño y complejidad. En este artículo mostramos como la luz, la posición y orientación del objeto, el ángulo de la cámara y el fondo de la imagen afectan el resultado en 3D. Considerando estos factores, personas que están aprendiendo esta técnica pueden reducir de manera importante el tiempo y la probabilidad de error, y mejorar considerablemente la calidad de los modelos 3D.

Measuring adult romantic attachment: psychometric properties of the brief Spanish version of the experiences in close relationships

Abstract The Experiences in Close Relationships (Brennan et al, Attachment theory and close relationships, 1998) questionnaire is one of the most widely used measures of adult romantic attachment. Despite the advantages of the ECR, the length of this measure may discourage its use in clinical and research contexts. Consequently, the goal of this study was to develop a brief Spanish version of the ECR questionnaire and to examine its psychometric properties when administered to six different Spanish-speaking samples from Chile. Confirmatory factor analyses replicated the twodimensional structure of the ECR and its invariance across gender. Results also supported the reliability and concurrent validity of our brief Spanish version of the ECR (i.e., Spanish ECR-12), by its association with measures of emotion regulation, dyadic empathy, psychological distress and well-being, and relationship satisfaction. The Spanish ECR-12 can be used by researchers and clinical professionals as an abridged measure of adult attachment.

Advances in research on treat-to-target approach in ulcerative colitis / 西安交通大学学报(医学版)

Ulcerative colitis (UC) is a chronic, progressive and heterogeneous inflammatory bowel disease. Strategies for management of UC are shifting from simple control of symptoms toward clinical/patient-reported outcome remission (resolution of rectal bleeding and diarrhea/altered bowel habit) and endoscopic remission (mucosal healing), with the final aim of blocking the progression of the disease and promising better long-term outcomes. The therapeutic target for UC is a comprehensive one that combines subjective and objective goals as well as short-term and long-term goals. In order to achieve these goals, it is necessary to assess the severity of the disease first and predict the risk of UC progression, and then provide early intervention and individualized treatment for high-risk patients. The treatment should be timely tailored by close monitoring. Although the clinical implementation of UC treat-to-target (T2T) approach remains challenging, T2T strategy is the key-point for improving the quality of disease management.

Epidemic characteristics of close contacts of coronavirus disease 2019 in Xi'an / 西安交通大学学报(医学版)

Objective To explore the epidemic characteristics of close contacts of corona virus disease 2019(COVID-19) in Xi'an so as to provide reference for further prevention and control of the epidemic. Methods Data of the close contacts of COVID-19 in Xi'an was collected. We analyzed the distribution of close contacts in the population and isolation measures of close contacts and confirmed cases among different exposure conditions. Results By 0: 00 February 28, the cumulative number of confirmed cases and close contacts in Xi'an had been 120 and 5 241, respectively.Medical workers accounted for 7.92% of the close contacts. Across different age groups, the proportion of the youth group was the highest (56%). Indifferent areas of Xi'an, Yanta District had the largest number of close contacts(913) while Huyi District had the lowest number (29). The main contact route was contact within the family (1 875). The majority of the confirmed cases were infected within the family (35), followed by shopping places (26). Conclusion By 0: 00 February 28, close contacts of COVID-19 in Xi'an had mostly been found in Yanta District. The young constituted the main group, and close contacts within the family had a high risk of infection. In view of the above characteristics, it is necessary to improve the screening of people having close contact with COVID-19 in key areas and populations.

An investigation of a family COVID-19 cluster / 上海预防医学

Objective To investigate epidemic characteristics of a family cluster of COVID-19, and to provide reference in improving the criteria for exclusion diagnosis and medical observation of close contacts. Methods Field epidemiological method was used to investigate the cases and close contacts of a family cluster of COVID-19 in Pudong New Area.Descriptive analysis was conducted on epidemiological data.Real-time fluorescence quantitative RT-PCR was used to detect 2019-nCoV nucleic acid in the respiratory tract specimens. Results There were two confirmed cases and one suspected case in the family cluster.The source of infection was Case 1 with a living history in Wuhan, Hubei Province.Case 2 and Case 3, as close contacts, received 14-day medical observation in a centralized isolation site.Case 2 showed symptoms 4 days after the onset of Case 1, and the diagnosis of COVID-19 was excluded after two negative nucleic acid tests during the isolation period.However, after the expiration of isolation, Case 2 was diagnosed positively for COVID-19 and Case 3 was suspected first and then excluded. Conclusion Daily close contact is critical for COVID-19 transmission and is the major cause of family clustering.Once the close contacts show symptoms, diagnosis should be made by combining the results of nucleic acid test, chest CT test, serological test, etc.We suggest to grade the risk of infection for close contacts, and to strengthen the standard of medical observation for close contacts with high risk of infection.

Characteristics of COVID-19 clusters in Lishui / 预防医学

Objective@#To analyze the epidemiological characteristics of coronavirus disease 2019 ( COVID-19 ) clusters in Lishui, so as to provide basis for the prevention and control of COVID-19 clusters.@*Methods@#The data of COVID-19 clusters in Lishui from January 23 to March 29, 2020 were collected through China Disease Control and Prevention Information System-Public Health Emergency Information System, and analyzed time, space, scale, source of infection, exposure and transmission route by descriptive epidemiological method. @*Results@#There were 31 cases in 8 clusters ( about 4 cases per cluster ), with no death. The report time was bimodal, peaked first from January 20 to February 10 with 4 clusters imported from domestic and peaked second from March 1 to 29 with 4 clusters imported from overseas. Qingtian County reported 4 clusters, Liandu District, Yunhe County, Qingyuan County and Jingning County each reported 1 cluster. Thirteen cases were restaurant employees, accounting for 41.94%. The cases were mainly occurred in the condition that exposed in the same family ( 6 clusters ), in the same dinner and car ( 1 clusters ), and in the same party ( 1 clusters ). The exposure modes that caused more cases infected were through the same family (9 cases) and through the same dinner and car ( 6 cases ). There were 3 clusters with first-generation cases, 3 clusters with second-generation cases and 2 clusters with third-generation cases. The recurrence rate of the 8 clusters ranged from 1.49% to 7.69%, with a median of 3.47%. @*Conclusions@#The COVID-19 clusters in Lishui imported from domestic in the early stage and later from overseas. Most cases were reported from Qingtian County, were engaged in catering business, and exposed by living with families.

Features of close contacts of COVID-19 cases in Jiulongpo District / 预防医学

Objective@#To explore the features of close contacts of coronavirus disease 2019 ( COVID-19 ) cases in Jiulongpo District, Chongqing, so as to provide evidence for the management of close contacts and the control of the epidemic.@*Methods@#Demographic characteristics, contact history and medical records of close contacts of COVID-19 cases in Jiulongpo District from January 22 to April 10, 2020 was collected according to the COVID-19 Prevention and Control Program ( sixth version ) . Descriptive statistical analysis was performed.@*Results@#Totally 602 close contacts were found, and 30 of them were infected, with an attack rate of 4.98%. Twenty-seven cases were diagnosed before February 10. The close contacts mainly aged from 20 to 59 years ( 457, 75.91% ) ; most were relatives of COVID-19 cases ( 219, 36.38% ) , and 64 (10.63%) were medical staff. Most contacted occasionally ( 338, 56.15% ), at home ( 190, 31.56% ) , and through the same meal ( 181, 30.07% ) . The attack rate of close contacts aged 40 years and over was 7.49%, which was higher than 2.37% of those aged under 40 years ( P<0.05 ). The attack rate of close contacts increased with contact frequency ( P<0.05 ) . The attack rates of close contacts were significantly different in different relations with cases, contact places and contact modes ( P<0.05 ); the attack rates of colleagues and relatives were 20.41% and 8.68%; the attack rates of close contacts in the workplace settings and family were 17.54% and 10.00%; the attack rates of sharing the same bed, living in the same room and working in the same room were 44.44%, 18.60% and 17.24%.@*Conclusions @#The close contacts of COVID-19 cases in Jiulongpo District, Chongqing who aged 40 years or above, exposed in family settings and in the workplace were associated with higher risk of infection.