Interação entre a pirâmide alimentar e a microbiota intestinal. Uma nova abordagem nutricional / Interaction between food pyramid and gut microbiota. a new nutritional approach

ABSTRACT The food pyramid is a pre-established nutritional education tool. The integration between the intestinal microbiome, food groups, and SCFA-producing bacteria, which benefit from the ingestion of these foods, has the potential to further improve and innovate healthy eating. The diet-microbiome interaction needs to be incorporated into nutrition science, and the food pyramid might assist in this interaction and nutritional learning. Against this context, this brief communication proposes through the food pyramid, the interactions between the intestinal microbiota, food groups, and SCFAs-producing bacteria.

RESUMO A pirâmide alimentar é uma ferramenta pré-estabelecida de educação nutricional. A integração entre microbioma intestinal, grupos de alimentos e bactérias produtoras de ácidos graxos de cadeia curta (AGCC), que se beneficiam da ingestão de carboidratos fermentáveis, tem o potencial de melhorar e inovar ainda mais a proposta de alimentação saudável. O conceito dieta-microbiota intestinal pode ser incorporado à ciência da nutrição, e a pirâmide alimentar pode auxiliar nessa interação nutricional. Diante desse contexto, esta breve comunicação propõe, por meio da pirâmide alimentar, a ampliação do conhecimento entre a microbiota intestinal, grupos alimentares e bactérias produtoras de AGCC.

HIGHLIGHTS •Integration between food pyramid and gut microbiome. •Negative and positive effects of food on the gut microbiome using the food pyramid. •SCFA-s-producing bacteria and their effects on the gut microbiome.

Research on the application of Miller's pyramid theory combined with Bahrain's team activities in standardized residency training of burn surgeons / 中华医学教育探索杂志

Objective:To explore the application of Miller's pyramid theory combined with Bahrain's team activities in the standardized residency training (SRT) of burn surgeons.Methods:Seventy-four residents who were on the SRT program in the Department of Burns & Wound Care in The Second Affiliated Hospital of Zhejiang University were enrolled in the study. The students were divided into control group and observation group according to the teaching methods. Thirty-seven students in the control group were provided with conventional teaching, and 37 students in the observation group were provided with training based on Miller' pyramid theory combined with Bahrain's team activities. The two groups were evaluated for teaching effectiveness and doctor-patient communication skills. SPSS22.0 was used for the chi-square test and t test. Results:The evaluation outcome of teaching effectiveness in the observation group was better than that in the control group ( t=3.01, 3.47, 3.49, 3.32, and 2.54; P=0.004, 0.001, 0.001, 0.001, and 0.013). After the training, the scores of Set Elicit Give Understand End scale in the two groups increased, with significantly higher scores achieved in the observation group than in the control group ( t=3.23, 2.99, 2.07, 3.62, 3.00, and 7.89; P=0.002, 0.004, 0.042, 0.001, 0.004, and <0.001). Conclusion:The application of Miller's pyramid theory and Bahrain's team activities in the SRT of burn surgeons can improve students' evaluation of teaching effectiveness and improve their doctor-patient communication skills.

Case-based practical examination as an introduction to formative assessment in pathology: Undergraduate student’s perception

Background: In pathology, students are assessed by both theory as well as practical examination, but we have more upper hand and regularity in conducting theory assessment over practical evaluation. We have put newer case-based practical examination (CBPE) module over traditional one to achieve better practical approach which consists of case scenario pertaining to hematology and urine exercise followed by its interpretation without performing procedure. Aim and Objectives: The objective of this study were to develop and implement this new method of CBPE as a formative assessment tool for undergraduate 2nd year medical students. Materials and Methods: We have included MBBS undergraduate students of 4th semester by dividing students into two groups. Each group consists of 25 students. Group 1 was exposed to CBPE of hematology and urine exercises, while Group 2 was exposed to conventional method of hematology and urine exercises. Evaluation form was given to each student at the end of session to know their perception and opinion regarding this newer form of practical examination. Results: Mean marks scored in Group 1(CBPE) were 28 and in Group 2 (conventional) were 20.32 out of 40 marks. We had used unpaired t-test to calculate significance with P value which was found to be 0.0012. Feedback was based on five-point Likert scale. Most of the faculty members and students gave positive opinion for case-based pattern. Conclusion: CBPE can be used as alternative to conventional practical examination for formative assessment with improvement in performance of students.

Cores por dupla do teste das pirâmides coloridas de Pfister em crianças / Colors by pair of Pfister's colored pyramids test in children / COLORES POR PAR DEL TESTE DE LAS PIRÁMIDES COLORIDAS DE PFISTER EN NIÑOS

As cores por dupla, um dos indicadores do teste de Pfister, são combinações preeestabelecidas de duas cores que, quando usadas em conjunto, sugerem interpretações sobre a dinâmica emocional. Buscamos evidências de validade baseadas nas relações com variáveis externas para o uso das cores por dupla com crianças. Nos protocolos do Pfister de crianças entre seis e 11 anos, as quatro cores por dupla mais frequentes foram Vd↓Vm↑, La↓Vi↓, Vm↑Br↑ e Vm↑Pr↑ Quando comparamos os protocolos de 172 crianças por idade, crianças mais velhas tenderam a apresentar mais cores por dupla do que as mais novas. Além disso, comparamos os resultados do teste de Zulliger dessas crianças conforme a presença ou ausência das cores por dupla mais frequentes. Houve poucas diferenças no desempenho do Zulliger associadas às cores por dupla do teste das pirâmides coloridas (TPC), sendo necessárias mais pesquisas que possibilitem compreender o significado desse indicador.

The colors by pair, one of the indicators of the Pfister test, are pre-established combinations of two colors, which, when used together, suggest interpretations about emotional dynamics. We looked for validity evidence based on relations with other variables for the use of colors by pair with children. In the Pfister protocols of children between six and 11 years, the four most frequent colors by pair were Vd↓Vm↑, La↓Vi↓, Vm↑Br↑ and Vm↑Pr↑. When we compare the protocols of 172 children by age, older children tend to have more colors by pair than the younger children. In addition, we compared the results of the Zulliger test of these children according to the presence or absence of the most frequent colors by pair. There were few differences were found in Zulliger's performance associated with the colors by pair of the color pyramid test (CPT), and more research is needed to understand the meaning of this indicator.

Los colores por par, uno de los indicadores del test Pfister, son combinaciones preestablecidas de dos colo-res que sugieren interpretaciones sobre dinámicas emocionales. Buscamos evidencia de validez basada en relaciones con variables externas para el uso de colores por par con niños. En los protocolos de niños de seis a 11 años, los cuatro colores por par más frecuentes fueron Vd↓Vm↑, La↓Vi↓, Vm↑Br↑ y Vm↑Pr↑. Al comparar los protocolos de 172 niños por edad, los niños mayores tendían a tener más colores por par que los niños más pequeños. Además, comparamos los resultados del test de Zulliger según la presencia o ausencia de los colores por par más frecuentes. Hubo pocas diferencias en el rendimiento de Zulliger asociadas con los colores por par, y se necesita más investigación para comprender el significado de este indicador.

MF2ResU-Net: a multi-feature fusion deep learning architecture for retinal blood vessel segmentation / 数字中医药（英文）

Objective@#For computer-aided Chinese medical diagnosis and aiming at the problem of insufficient segmentation, a novel multi-level method based on the multi-scale fusion residual neural network (MF2ResU-Net) model is proposed.@*Methods@#To obtain refined features of retinal blood vessels, three cascade connected U-Net networks are employed. To deal with the problem of difference between the parts of encoder and decoder, in MF2ResU-Net, shortcut connections are used to combine the encoder and decoder layers in the blocks. To refine the feature of segmentation, atrous spatial pyramid pooling (ASPP) is embedded to achieve multi-scale features for the final segmentation networks.@*Results@#The MF2ResU-Net was superior to the existing methods on the criteria of sensitivity (Sen), specificity (Spe), accuracy (ACC), and area under curve (AUC), the values of which are 0.8013 and 0.8102, 0.9842 and 0.9809, 0.9700 and 0.9776, and 0.9797 and 0.9837, respectively for DRIVE and CHASE DB1. The results of experiments demonstrated the effectiveness and robustness of the model in the segmentation of complex curvature and small blood vessels.@*Conclusion@#Based on residual connections and multi-feature fusion, the proposed method can obtain accurate segmentation of retinal blood vessels by refining the segmentation features, which can provide another diagnosis method for computer-aided Chinese medical diagnosis.

White blood segmentation based on dual path and atrous spatial pyramid pooling / 生物医学工程学杂志

The count and recognition of white blood cells in blood smear images play an important role in the diagnosis of blood diseases including leukemia. Traditional manual test results are easily disturbed by many factors. It is necessary to develop an automatic leukocyte analysis system to provide doctors with auxiliary diagnosis, and blood leukocyte segmentation is the basis of automatic analysis. In this paper, we improved the U-Net model and proposed a segmentation algorithm of leukocyte image based on dual path and atrous spatial pyramid pooling. Firstly, the dual path network was introduced into the feature encoder to extract multi-scale leukocyte features, and the atrous spatial pyramid pooling was used to enhance the feature extraction ability of the network. Then the feature decoder composed of convolution and deconvolution was used to restore the segmented target to the original image size to realize the pixel level segmentation of blood leukocytes. Finally, qualitative and quantitative experiments were carried out on three leukocyte data sets to verify the effectiveness of the algorithm. The results showed that compared with other representative algorithms, the proposed blood leukocyte segmentation algorithm had better segmentation results, and the mIoU value could reach more than 0.97. It is hoped that the method could be conducive to the automatic auxiliary diagnosis of blood diseases in the future.

Modification of Mediterranean Diet Pyramid from an Island's perspective / Alteração da Pirâmide Alimentar Mediterrânea na perspectiva de uma Ilha

ABSTRACT Objective The present study aimed to determine traditional and local food consumption and adherence to the Mediterranean diet in Cyprus. And also, aimed to improve their adherence to the Mediterranean diet and traditional and local food consumption. From this point, this current study aimed to revise the Cyprus Mediterranean Diet Pyramid, based on the Current Mediterranean Diet Pyramid. Methods The sample size was calculated as a minimum of 386 according to a 95.0% confidence interval, and a 5.0% error. This study was conducted online between November 2020-April 2021 in Cyprus. All volunteers were invited to this study on the national public internet platforms. Participant´s adherence to the Mediterranean diet was determined by the Mediterranean Diet Adherence Screener. Traditional and local food consumption frequencies were determined by a Food Frequency Questionnaire. A novel Cyprus Mediterranean Diet Pyramid was developed with traditional and local food items for Cyprus. The modification was also aimed to safeguard planet health, to increase traditional food consumption and adherence to the Mediterranean diet. Results 1,007 adults (78.0% native islanders/Cypriots) participated voluntarily in the current study. The mean Mediterranean Diet Adherence Screener score was 7.55±2.30 points and only 34.4% had high adherence to the Mediterranean diet. According to their responses, there was a need to increase use of olive oil, vegetables, fruits, fish, and red wine consumption and to decrease red meat and dessert consumption. According to responses to the Mediterranean Diet Adherence Screener and their traditional/local food consumption frequencies an up-to-date Cyprus Mediterranean Diet Pyramid was done hence a national food pyramid for Cyprus. Commonly consumed traditional and local foods were added to the pyramid to facilitate increased adaptation of the Mediterranean diet in the general population. Adequately consumed foods were added to make it more region-specific and rarely consumed foods were added to help to increase consumption. Conclusion This modification is believed to be instrumental to increase Mediterranean diet adaptation, traditional/local food consumption and decrease the impact of nutrition on the planet´s health. And also, this modification can shed light on the development of the other traditional food pyramids.

RESUMO Objetivo Este estudo teve como objetivo determinar o consumo alimentar tradicional e local, bem como a adesão à dieta mediterrânea no Chipre. Também teve como objetivo melhorar a adesão à dieta mediterrânea e ao consumo de alimentos tradicionais e locais. A partir desse ponto, este trabalho atual teve como objetivo revisar a Pirâmide da Dieta Mediterrânea do Chipre, que é baseada na Pirâmide da Dieta Mediterrânea Atual. Métodos O tamanho da amostra foi calculado com um mínimo de 386 de acordo com intervalo de confiança de 95,0% e erro de 5,0%. Este estudo foi realizado online entre novembro de 2020 e abril de 2021 em Chipre. Todos os voluntários foram convidados para esta análise nas plataformas públicas nacionais de internet. A adesão dos participantes à dieta mediterrânea foi avaliada pelo Medidor de Adesão à Dieta Mediterrânea. As frequências de consumo alimentar tradicional e local foram determinadas pelo Questionário de Frequência Alimentar. Foi desenvolvida uma nova Pirâmide da Dieta Mediterrânica de e para o Chipre, com alimentos tradicionais e locais. A modificação teve também como objetivo salvaguardar a saúde do planeta, aumentar o consumo de alimentos tradicionais e a adesão à dieta mediterrânea. Resultados No total de 1.007 adultos (78,0% naturais da ilha/cipriotas) participaram voluntariamente no estudo. A pontuação média obtida no Medidor de Adesão à Dieta Mediterrânea foi de 7,55±2,30 pontos, com apenas 34,4% aderindo fortemente à dieta mediterrânea. De acordo com as suas respostas, houve necessidade de aumentar a utilização de azeite, vegetais, frutas, peixe e vinho tinto, bem como de diminuir o consumo de carnes vermelhas e sobremesas. Com base nas suas respostas ao Medidor de Adesão à Dieta Mediterrânea e as suas frequências de consumo alimentar tradicional/local, foi feita uma pirâmide da Dieta Mediterrânea do Chipre atualizada, ou seja, uma pirâmide alimentar nacional para o Chipre. Alimentos locais e regionais comumente consumidos foram adicionados à pirâmide para aumentar a adesão à dieta mediterrânea. Alimentos consumidos de acordo com as recomendações foram adicionados para torná-los específico da região, e alimentos pouco consumidos foram adicionados para ajudar a aumentar o consumo. Conclusão Acredita-se que esta modificação seja determinante para aumentar a adaptação da dieta mediterrânea e o consumo de alimentos tradicionais e locais, além de diminuir o impacto da nutrição na saúde do planeta. Ainda, essa modificação pode lançar luz sobre o desenvolvimento das outras pirâmides alimentares tradicionais.

Envelhecimento e afetividade a partir do Teste de Pfister / Aging and affectiveness according to the Pfister Test / Envejecimiento y afectividad mediante el Test de Pfister

O envelhecimento populacional demanda cuidados específicos a essa etapa do desenvolvimento. Este trabalho objetivou comparar indicadores de vivências afetivas de idosos institucionalizados e não institucionalizados, a partir do Teste das Pirâmides Coloridas de Pfister (TPC), em relação a dados normativos disponíveis para a faixa etária. Foram individualmente avaliados 50 idosos (G1 = 25 institucionalizados; G2 = 25 não institucionalizados), idade média 73,6 (± 8,3 anos), de ambos os sexos, com escolaridade fundamental e nível econômico médio-inferior, voluntários do interior de São Paulo. Responderam a questionário sociodemográfico, Mini Exame do Estado Mental (MEEM) e TPC. As escolhas e síndromes cromáticas do TPC de G1 e G2 foram comparadas (teste t de Student, p ≤ 0,05, d de Cohen), não se identificando diferenças estatisticamente significativas. No entanto, em comparação às normas, G1 apresentou diferenças estatisticamente significativas nas variáveis: azul, violeta, amarelo, marrom, cinza, Síndromes Estímulo e Incolor, apontando particularidades nas vivências afetivas de idosos associados à institucionalização. (AU)

Population aging requires specific care. This study aimed to describe and compare indicators of affective experiences of institutionalized and non-institutionalized older adults, based on the Pfister Colored Pyramids Test (CPT), in relation to normative data available for the age group. A total of 50 older adult volunteers from the state of São Paulo, mean age 73.6 years (± 8.3), of both sexes, with elementary education and of average-lower economic levels, were individually assessed (G1 = 25 institutionalized; G2 = 25 non-institutionalized). They answered a sociodemographic questionnaire, the Mini Mental State Examination (MMSE) and the CPT. The choices and chromatic syndromes of CPT of G1 and G2 were compared (Student's t-test, p ≤.05, Cohen's d), with no statistically significant differences being identified. However, when compared to the normative data, G1 presented statistically significant differences in the variables: blue, violet, yellow, brown, gray, Stimulus and Colorless Syndromes. It was possible to highlight particularities in the affective experiences of the older adults associated with institutionalization. (AU)

El envejecimiento de la población exige atención específica en esta etapa del desarrollo. Este estudio tuvo como objetivo describir y comparar indicadores de experiencias afectivas de ancianos institucionalizados y no institucionalizados, basados en Test de las Pirámides de Colores de Pfister (TPC), en relación con los datos normativos disponibles para el grupo de edad. Se evaluaron 50 ancianos (G1=25 institucionalizados; G2=25 no institucionalizados) voluntarios del interior de São Paulo, edad media de 73,6 (± 8,3 años), de ambos sexos, con enseñanza primaria y nivel de ingresos medio-bajo. Respondieron a un cuestionario socio-demográfico, Mini Mental State Examination (MMSE) y el TPC. Se compararon las elecciones de los colores y síndromes cromáticos del TPC de G1 y G2 (test t de Student, p≤0.05, d de Cohen), sin diferencias estadísticamente significativas. Sin embargo, en comparación con las normas, G1 mostró diferencias estadísticamente relevangtes en las variables: azul, violeta, amarillo, marrón, gris, Síndromes Estímulo e Incolor. Siendo posible señalar particularidades en las experiencias afectivas de los ancianos asociadas con la institucionalización. (AU)

A study on the influence of situational simulation training combined with Miller pyramid teaching on emergency response ability and nursing skills of operating room nurses / 中华医学教育探索杂志

Objective:To explore the effect of situational simulation training combined with Miller pyramid teaching on emergency response ability and nursing skills of specialized nurses in operating room.Methods:A total of 56 disaster nursing trainees who received specialized nurse training in the operating room of Mianyang Central Hospital from June 2019 to June 2020 were selected in the study, and they were divided into control group and research group in average according to the order of training time. The control group adopted clinical one-to-one teaching, while the research group adopted situational simulation training combined with Miller pyramid teaching. After the training, the teaching effect of specialized nurse training was evaluated by their professional theoretical knowledge and nursing skill operation results, and self-designed assessment scale was used to evaluate the emergency response ability and satisfaction with the training effect of the nurses. SPSS 22.0 was used for t test and chi-square test. Results:The results of theoretical knowledge and nursing skills operation of specialize nurses in operating room in the research group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.001). The scores of emergency capability assessment in the research group were significantly higher than those in the control group, with statistical significance ( P<0.001). The study group was better than the control group in 7 aspects of satisfaction, such as the improvement of the operation level of emergency ability, team cooperation ability, analysis and problem solving ability, clinical nursing decision-making ability, independent thinking ability and nurse-patient communication ability, with significant differences ( P<0.05). Conclusion:Situational simulation training combined with Miller pyramid teaching can significantly improve the emergency response ability, nursing skill operation and training satisfaction of operating room nurses, which is better than the traditional clinical teaching method, and is worthy of application and promotion in clinical nursing teaching.

Research on electrocardiogram classification using deep residual network with pyramid convolution structure / 生物医学工程学杂志

Recently, deep neural networks (DNNs) have been widely used in the field of electrocardiogram (ECG) signal classification, but the previous models have limited ability to extract features from raw ECG data. In this paper, a deep residual network model based on pyramidal convolutional layers (PC-DRN) was proposed to implement ECG signal classification. The pyramidal convolutional (PC) layer could simultaneously extract multi-scale features from the original ECG data. And then, a deep residual network was designed to train the classification model for arrhythmia detection. The public dataset provided by the physionet computing in cardiology challenge 2017(CinC2017) was used to validate the classification experiment of 4 types of ECG data. In this paper, the harmonic mean of classification accuracy and recall was selected as the evaluation indexes. The experimental results showed that the average sequence level ( ) of PC-DRN was improved from 0.857 to 0.920, and the average set level ( ) was improved from 0.876 to 0.925. Therefore, the PC-DRN model proposed in this paper provided a promising way for the feature extraction and classification of ECG signals, and provided an effective tool for arrhythmia classification.

Septum pyramidal adjustment and repositioning - a conservative and effective rhinoplasty technique / Ajuste e reposicionamento da pirâmide e septo nasal - uma técnica conservadora e eficaz em rinoplastia

Abstract Introduction: In rhinoplasty, the nasal dorsum has important relevance regarding the esthetic and functional aspects of the surgery. Its reduction should be performed with maximum accuracy and controlled resection to prevent or minimize potential complications. The septum pyramidal adjustment and repositioning consists of a conservative surgical technique of the nasal dorsum, which does not require the detachment of the upper lateral cartilages of the nasal septum, allowing the remodeling of the nasal dorsum while maintaining esthetic lines and nasal function, potentially reducing frequent complications in more traditional surgeries. Objective: To describe the septum pyramidal adjustment technique in detail, presenting its advantages and disadvantages in relation to the other surgical approaches, as well as to disclose results of this surgical procedure in patients submitted to primary rhinoplasty in a specific hospital. Methods: The medical records of all patients submitted to surgery from 2011 to 2015 through this surgical technique were evaluated by the same team. Of these cases, certain variables were analyzed such as gender, age, indication for reoperation and surgical complications. Results: 153 patients underwent rhinoplasty through septum pyramidal adjustment. Of these, 13 patients experienced an indication for a second surgery and four had some type of postoperative complication. Conclusion: The septum pyramidal adjustment surgical technique is a simple procedure, as it does not require the reconstruction of the nasal dorsum. It has a low number of complications and preserves the anatomical structures.

Resumo Introdução: Na rinoplastia, o dorso nasal tem importante relevância no quadro estético e funcional. A sua redução deve ser realizada com máxima precisão e ressecção controlada a fim de prevenir ou minimizar complicações potenciais. O termo septum pyramidal adjustment and repositioning consiste em uma técnica cirúrgica conservadora do dorso nasal, que não requer a desinserção das cartilagens laterais superiores do septo nasal, que permite remodelar o dorso nasal, manter as linhas estéticas e a função nasal, reduz potencialmente complicações frequentes nas cirurgias mais tradicionais. Objetivo: Descrever em detalhes o septum pyramidal adjustment, expor suas vantagens e desvantagens em relação às outras abordagens cirúrgicas, bem como apresentar resultados desse procedimento cirúrgico em pacientes submetidos à rinoplastia primária em um hospital específico. Método: Foram avaliados os registros médicos de todos os pacientes operados de 2011 a 2015 por essa técnica cirúrgica, pela mesma equipe. Desses casos, foram analisadas algumas variáveis, como: sexo, idade, indicação de reoperação e complicações cirúrgicas. Resultados: Foram submetidos 153 pacientes à rinoplastia por septum pyramidal adjustment. Desses, 13 tiveram segunda indicação cirúrgica e quatro apresentaram alguma complicação pós-operatória. Conclusão: A técnica cirúrgica septum pyramidal adjustment apresenta-se como um procedimento de fácil realização, pois não exige a reconstrução do dorso nasal. Apresenta baixo número de complicações e preserva as estruturas anatômicas.

Comparison of the Emotional Indicators of the Pfister Test between Boys and Girls from Ceará-Brazil / Comparação dos Indicadores Emocionais do Teste de Pfister entre Meninos e Meninas Cearenses / La Comparación de los Indicadores Emocionales del Test de Pfister entre Niños y Niñas Cearenses

Abstract The increasing need for psychological instruments characterized by scientific rigor, with their psychometric qualities confirmed, drives the development of studies that seek evidence of validity for psychological tests. The aim of this study was to seek evidence of validity for the Pfister Test by comparing the sexes. The study was carried out with 197 children from the city of Ceará, 46% male and 54% female, using the Pfister Colored Pyramids Test as the main instrument and the Raven Colored Progressive Matrices Test as an instrument to screen the intellectual performance of the participants. After statistical analysis and interpretation of the data, predominance in the choice of blue, green and black colors was observed in the boys, especially regarding darker tones, which may indicate emotion-related control. The girls made more frequent use of the colors violet and red, both in the lightest tones, which culturally refers to femininity and may suggest impulsivity. It was concluded that there are statistically significant differences in color choices between boys and girls, which can be comprehended as a contribution to the evidence of validity studies of the Pfister Test.

Resumo A necessidade, cada vez mais emergente, de instrumentos psicológicos que se caracterizem pelo rigor científico, atestado por meio de suas qualidades psicométricas, impulsiona o desenvolvimento de estudos que busquem evidências de validade de testes psicológicos. Neste estudo objetivou-se buscar por evidências de validade para o Teste de Pfister por meio da comparação entre sexos. O presente estudo foi realizado com 197 crianças da capital cearense, sendo 46% do sexo masculino e 54% do sexo feminino, utilizando o Teste das Pirâmides Coloridas de Pfister, como instrumento principal, e o Teste das Matrizes Progressivas Coloridas de Raven, como instrumento de rastreio do desempenho intelectual dos participantes. Após análises estatísticas e interpretação dos dados, verificou-se uma predominância na escolha das cores azul, verde e preto por parte dos meninos, especialmente em tons mais escurecidos, o que pode indicar controle relacionado às emoções, enquanto as meninas fizeram uso mais frequente das cores violeta e vermelho, ambas no tom mais claro, o que se remete culturalmente à feminilidade e pode sugerir impulsividade. Conclui-se que há diferenças estatisticamente significativas nas escolhas das cores entre meninos e meninas, o que pode ser compreendido como uma contribuição aos estudos de evidências de validade do Teste de Pfister.

Resumen La necesidad de instrumentos psicológicos que se caractericen por el rigor científico, atestado a través de sus calidades psicométricas, impulsa el desarrollo de estudios que busquen evidencias de validez de pruebas psicológicas. En este estudio se objetivó buscar evidencias de validez para el Test de Pfister por medio de la comparación entre sexos. Este estudio fue realizado con 197 niños de la capital cearense, siendo 46% del sexo masculino y 54% del sexo femenino, utilizando el Test de Pfister. El Test de las Matrices Progresivas Coloridas de Raven se utilizó como rastreo del desempeño intelectual de los participantes. Se verifico una predominancia en la elección de los colores azul, verde y negro por parte de los niños en tonos más oscurecidos, o que puede indicar control relacionado a las emociones, mientras las niñas optaron más significativamente por los colores violeta y rojo, ambas en el tono más claro, lo que se remite culturalmente a la femineidad y puede sugerir impulsividad. A partir de los resultados, se concluye que hay diferencias significativas en las elecciones de los colores entre niños y niñas, lo que puede ser comprendido como una contribución para estudios de evidencias de validez en el Test de Pfister.

The anatomical structure of fused renal pyramid and its imaging findings in ultrasound and computed tomography / 中华泌尿外科杂志

Objective To analyze the anatomical structure and distribution of the fused renal pyramid (FRP) in cadaveric kidney,and discuss its appearances by CT and ultrasonic examinations.Methods From June 2018 to September 2018,108 cadaveric kidneys were proceeded for regional anatomy.The distribution and anatomical manifestations of FRP was recorded.The renal pyramid was sliced and HE stained to explore the vascular distribution in FRP.From October 2018 to January 2019,ultrasound imaging data of 112 patients with 224 kidneys were collected,including 60 males and 52 females,age (39.0 ± 15.1),ranging from 16 to 73 years old.The renal imaging data of 89 patients and 178 patients with enhanced renal CT were collected,including 48 males and 41 females.Age (45.4 ± 13.6),ranging from 23 to 69 years old.The imaging findings of FRP in ultrasound and enhanced CT was summarized.Results In cadaver kidneys,the proportion of FRP in upper and lower calyces was 68.6％ (74/108) and 64.8％ (70/108),respectively,higher than that in middle calyces 34.3％ (37/108).In the middle group,the incidence of mild fusion was 39.0％ (16/41) and severe fusion was 48.8％ (20/41).The incidence of fusion of two renal pyramidal structures was 90.2％ (37/41).HE staining showed that the boundary between the artery in FRP and the surrounding renal pyramidal was unclear,and the protection of connective tissue was lacking.In Ultrasound,the FRP presented as a large trapezoidal hypo-echoic area with red and blue color signals in doppler mode.In ultrasound,the incidence of FRP was 18.8％ (42/224).In enhanced CT,the FRP presented as enhanced cord-like high density shade in large low density area in cortex phase.In enhanced CT,the incidence of FRP 27.5％ (49/178).Conclusions The FRP is a common structure in human kidney.The arteries localize within the FRP and are absence of sufficient connective tissue protection which are different from normal arteries.Ultrasound and enhanced CT have recognition ability for FRP.

The anatomical structure of fused renal pyramid and its imaging findings in ultrasound and computed tomography / 中华泌尿外科杂志

Objective@#To analyze the anatomical structure and distribution of the fused renal pyramid (FRP) in cadaveric kidney, and discuss its appearances by CT and ultrasonic examinations.@*Methods@#From June 2018 to September 2018, 108 cadaveric kidneys were proceeded for regional anatomy. The distribution and anatomical manifestations of FRP was recorded. The renal pyramid was sliced and HE stained to explore the vascular distribution in FRP. From October 2018 to January 2019, ultrasound imaging data of 112 patients with 224 kidneys were collected, including 60 males and 52 females, age (39.0±15.1), ranging from 16 to 73 years old. The renal imaging data of 89 patients and 178 patients with enhanced renal CT were collected, including 48 males and 41 females. Age (45.4±13.6), ranging from 23 to 69 years old. The imaging findings of FRP in ultrasound and enhanced CT was summarized.@*Results@#In cadaver kidneys, the proportion of FRP in upper and lower calyces was 68.6% (74/108) and 64.8% (70/108), respectively, higher than that in middle calyces 34.3% (37/108). In the middle group, the incidence of mild fusion was 39.0% (16/41) and severe fusion was 48.8% (20/41). The incidence of fusion of two renal pyramidal structures was 90.2% (37/41). HE staining showed that the boundary between the artery in FRP and the surrounding renal pyramidal was unclear, and the protection of connective tissue was lacking. In Ultrasound, the FRP presented as a large trapezoidal hypo-echoic area with red and blue color signals in doppler mode. In ultrasound, the incidence of FRP was 18.8% (42/224). In enhanced CT, the FRP presented as enhanced cord-like high density shade in large low density area in cortex phase. In enhanced CT, the incidence of FRP 27.5%(49/178).@*Conclusions@#The FRP is a common structure in human kidney. The arteries localize within the FRP and are absence of sufficient connective tissue protection which are different from normal arteries. Ultrasound and enhanced CT have recognition ability for FRP.

Research on Improved Algorithm of DR Image Enhancement Based on Gauss-Laplacian Pyramid / 中国医疗器械杂志

OBJECTIVE@#In order to obtain more decision information from Digital Radiography(DR) images, an improved image enhancement algorithm is proposed based on the algorithm of Gauss-Laplacian pyramid.@*METHODS@#The original algorithm is improved on the basis of the human visual characteristics and better enhancements, the low frequency components of the image is histogram equalized to make the image gray scale more balanced, and the high frequency component is enhanced by a hierarchical exponential enhancement to make the details of the image clearer.@*RESULTS@#The improved algorithm improves the contrast of DR images in chest, pelvic and spine, and makes the image more layered and obtains good image enhancement effect.@*CONCLUSIONS@#The results show that the improved algorithm is superior to the traditional algorithm in terms of image enhancement.

Evidence of concurrent validity for the use of the Pfister test from children of Ceará / Evidências de validade concorrente para uso do Pfister com crianças do Ceará / Evidencia de validez concurrente para el uso de la prueba Pfister con niños del Ceará

The study aims to seek concurrent validity evidence on the use of Pfister Colored Pyramids Test (CPT) in psychological children's evaluation from different developmental levels. 197 children from Fortaleza, Brazil participated, being 54% female, aged 6 to 11 and 6 months (M = 8,56, SD = 1,47). The ANOVA test was used comparing the CPT performance of three age groups (6-7, 8-9, and 10-11 years old). The incidence of variables related to lower emotional or cognitive development and difficulty in elaborating received stimulation (pure carpet, carpet with onset of order, and affective excitation syndrome) were significantly increased in younger children, while older children had an increase, in the associated indicator to the maturation in treatment of emotions and defensive maneuvers (Layer formation), corresponding to the one expected according to theories of development. The study corroborated to other researches that involved validity evidence to use TPC with children.

O estudo objetivou buscar evidências de validade concorrente para uso do Teste das Pirâmides Coloridas de Pfister (TPC) em avaliação psicológica de crianças em diferentes fases do desenvolvimento. Participaram 197 crianças de Fortaleza-CE, sendo 54% do sexo feminino, com idades entre 6 anos e 11 anos e 6 meses (M = 8,56, DP = 1,47). Utilizou-se o teste ANOVA para comparar o desempenho no TPC de três grupos etários (6-7, 8-9 e 10-11 anos). A incidência de variáveis relacionadas a um menor desenvolvimento emocional ou cognitivo e dificuldade para elaborar a estimulação recebida (Tapete puro, Tapete com início de ordem e Síndrome de excitação afetiva) estiveram significativamente aumentadas em crianças mais novas, enquanto crianças com mais idade tiveram aumento no indicador associado ao amadurecimento no trato das emoções e manejos defensivos (Formação em camadas). O estudo corroborou outras pesquisas que envolveram evidências de validade do TPC para uso com crianças.

El estudio objetiva buscar evidencias de validez concurrente del Test de las Pirámides Coloridas de Pfister (TPC) en evaluación psicológica con niños con diferentes fases del desarrollo. Participaron 197 niños de Fortaleza-Brasil, ser 54% niñas con edades entre 6 y 11 años y 6 meses (M = 8,56, DP = 1,47). Test ANOVA fue utilizado para comparar el desempeño de tres grupos de edad (6-7, 8-9, y 10-11 años). La frecuencia de variables relacionadas a menor desarrollo emocional o cognitivo y dificultad de asimilar la estimulación recibida (Alfombra pura, Alfombra con inicio de orden y Síndrome de activación afectiva) fueron mayores en niños más pequeños, mientras que niños mayores tuvieron aumento en lo indicador de desarrollo madurativo en trato con emociones y manejos defensivos (Formación de capas), de acuerdo con las teorías del desarrollo. El estudio corrobora con otros estudios de evidencias de validez para uso del TPC con niños.

Empatia em cuidadores de idosos por meio do Teste Pfister / Empathy in caregivers of the elderly through Pfister Test / Empatía en cuidadores de ancianos por medio del Test Pfister

As disposições empáticas são essenciais para a assistência qualificada dos idosos. Este estudo buscou verificar se cuidadores formais apresentavam esta habilidade, de acordo com o Teste das Pirâmides Coloridas de Pfister (TPC), e examinar a associação deste instrumento com o Inventário de Empatia (IE). Participaram 10 mulheres, média de idade de 46,3 anos (DP = 9,5), cuidadoras em Instituições de Longa Permanência. Constatou-se a presença de empatia, sensibilidade afetiva com recursos de controle e manejo de ansiedade, e um funcionamento cognitivo e emocional mais maduro. Houve correlação negativa moderada entre o fator Altruísmo e o aspecto formal formação (r = -0,65, p = 0,04), correlação positiva moderada entre o fator Sensibilidade Afetiva e o aspecto formal estrutura (r = 0,63, p = 0,04). A avaliação da empatia com o uso do Pfister trouxe uma compreensão ampliada das características de personalidade das cuidadoras, e sua utilização para este fim foi assegurada

Empathic dispositions are essential to the qualified care of the elderly. This study was aimed at assessing if formal caregivers showed such ability, according to Pfister Colored Pyramid Test (CPT), and at examining the association of such instrument with the Empathy Inventory (EI).The subjects were 10 women with mean age of 46.3 years (SD = 9.5), caregivers in Long-Term Institutions. The presence of empathic skills, affective sensitivity with means for controlling and managing anxiety, and more mature emotional and cognitive functioning were shown. There was moderate negative correlation between Altruism factor and the formal aspect formation (r = - 0,65, p = 0.04), moderate positive correlation between Affective Sensitivity factor and the formal aspect structure (r = 0,63, p = 0.04). The assessment of empathy through Pfister testing has brought larger understanding of the caregivers' personality traits, and its use for that purpose has been ensured

Las disposiciones empáticas son esenciales para la asistencia cualificada de las personas mayores. Este estudio buscó verificar si los cuidadores formales presentaban esta habilidad, de acuerdo con la Prueba de las Pirámides Coloridas de Pfister (TPC), y examinar la asociación de este instrumento con el Inventario de Empatía (IE). Participaron 10 mujeres, promedio de edad de 46,3 años (DP = 9,5), cuidadoras en Instituciones de Larga Permanencia. Se constató la presencia de habilidades empáticas, sensibilidad afectiva con recursos de control y manejo de ansiedad, y un funcionamiento cognitivo y emocional más maduro. Se observó una correlación negativa moderada entre el factor Altruismo y el aspecto formal de la formación (r = -0,65, p = 0,04), correlación positiva moderada entre el factor Sensibilidad Afectiva y el aspecto formal estructural (r = 0,63, p = 0,04). La evaluación de la empatía con el uso del Pfister trajo una comprensión ampliada de las características de personalidad de las cuidadoras, y su utilización para este fin fue asegurada

Establishment of training program fornurses in the department of orthopedics based on the Miller pyramid competency model / 中华医学教育探索杂志

Objective To establish a training program of nurses in the department of orthopedicsbased on the Miller pyramid competency model.Methods Based on G.Miller's pyramid principle,the training program forspecialized nurses in department of orthopedics was constructed by referring to the training program at home and abroad and Combining withthe characteristics of orthopedics nursing work.We used Delphy Method with questionnaires fortworounds in making a consultation to 21experts and carried out statistical analysis.Results The rate of valid questionnaire was 100％.The authority coefficient of expert consultation was from 0.79 to 1.0,the expert coordination coefficient for all indicators is 0.49/0.37/0.25,respectively.Based on the Miller pyramid model,a training scheme for orthopedic nurses was constructed.It included 4 first level indicators,11 secondary indicators and,58 third level indicators.Conclusion The positivecoefficient and authority coefficient of the experts were higher and the results were reliable.The training program of orthopedic nurses is of practical value.

Clinical Study on Electro-acupuncture Treatment of Migraine in Surface Projection Zone of the Pyramid Decussation / 中国中医药信息杂志

Objective To observe the clinical effects of electro-acupuncture in surface projection zone of the pyramid decussation in treatment of migraine. Methods Totally 120 patients with migraine who met the inclusion criteria were randomly divided into four groups as projection zone group, ordinary acupuncture group, western medicine group and non-acupoint group, with 30 cases in each group. Projection zone group was treated with electro-acupuncture in pyramidal cross area (from Yuzhen to Tianzhu); Ordinary acupuncture group was treated with routine point locating according to acupuncture therapeutics; Non-acupoint group was treated with 2 inch acupoints opened beside projection zone, and 3 groups were treated with electro-acupuncture (8–20 mA, 2/100 Hz) for 30 min. Western medicine group was treated with diclofenac sodium enteric-coated table. The treatment course was 10 day. Visual Analogue Scale (VAS) score, TCM syndrome score, self-rating anxiety scale score (SAS) and self-rating depression scale score (SDS) were evaluated before and after treatment. The therapeutic effects of the four groups were compared and analyzed. Results The total effective rate of projection zone group was 93.33%, which was obviously better than the ordinary acupuncture group (86.67%), western medicine group (70.00%) and non-acupoint group (63.33%), with statistical significance (χ2=24.440, P=0.004). Compared with before treatment, the VAS score and TCM syndrome scores in the four groups after treatment decreased significantly (P<0.05). The VAS score in the projection zone group after treatment was significantly lower than the other three groups, and the TCM syndrome scores were significantly lower than the western medicine group and non-acupoint group (P<0.05). Compared with before treatment, the SDS score in the non-acupoint group and SAS and SDS scores in the other three groups decreased significantly, with statistical significance (P<0.05). SAS and SDS scores in projection zone group after treatment was significantly lower than the other three groups (P<0.05). Conclusion The method of electro-acupuncture in surface projection zone of the pyramid decussation has obviously clinical effects, and can reduce the occurrence of bad mood.

The anatomical structure of a fused renal pyramid and its clinical significance in the establishment of percutaneous renal access / 中华泌尿外科杂志

Objective To explore the clinical significance of fused renal pyramid (FRP) structure in the establishment of percutaneous renal access.Methods From May 2017 to April 2018,10 fresh porcine kidneys were selected to cast in blood vessels for grading the kidney artery.Then another 80 isolated porcine kidueys were used to simulate percutaneous renal pu ncture and dilatation to establish F24 operative access by the same surgeon.Under the endoscope and microscope,we compared the effects of four different puncture paths on the occurrence of renal vascular injury when respectively punctured through the normal renal pyramid (group A),the side of the FRP (group B),the centre of the FRP (group C) and the renal column (group D).Results The kidney arteries can be divided into six grades,there is grade Ⅳ branchinterlobar artery walking inside the FRP.The diameter of interlobar artery in the FRP was significantly smaller than that in the renal column (0.442 ±0.012) mm vs.(0.778 ±0.037) mm,(P ＜0.001).Endoscopic observation and pathological tissue section showed the following results.In group A,there was no injured blood vessel distributed along the access.There were six specimens with grade Ⅴ or Ⅵ arteries injury in the cortex.Owing to the small size of the renal pyramid and the inaccurate location of the puncture,there was also injury associated with a normal grade Ⅳ artery in the renal column.In group B,there was a certain distance between the tract and the grade Ⅳ artery that distributed in the FRP,injury was still noticed in four specimens.And six specimens have grade Ⅴ/Ⅵ arterial injury.As the distance between the tract and the renal column decreased,there was a case in which a simultaneously injury occurred to the extremity of a grade Ⅲ artery and a grade Ⅳ artery.In group C,there was a white thin strip of connective tissue exposed along the puncture tract.Ectopic grade Ⅳ artery injury occurred in fourteen specimens,and grade Ⅴ/Ⅵ artery injury occurred in seven specimens.In group D,there were grade Ⅲ to Ⅵ arteries distributed along the operational access,which was cowered with white fat and connective tissue.The number of arteryinjury in grades Ⅲ,Ⅳ,and Ⅴ/Ⅵ were4,19,and 5,respectively.The mean ranks of artery injury degree in groups A (17.0),B (30.1),C (33.5) and D (41.5) gradually increased,and the difference was significant (P =0.006).There was a significant difference between group A and C (P =0.018),while no significant difference between group A and B (P =0.122),groups C and D (P =0.072).The proportion of grade Ⅳ artery injury in group A,B,and C was 5％ (1/20),25％ (5/20),and 70％ (14/20),respectively.There was a significant difference between group A and C (P =0.029),while no significant difference between group A and B (P =0.316).There was no significant difference in the injury of grade Ⅴ and Ⅵ artery in four groups (P =0.827).Conclusions When establishing a percutaneous renal access,vascular injury caused bv puncturing through the FRP cannot be ignored.It is necessary to carefu lly identify and bypass the FRP when selecting the puncture path.If unavoidable,the puncture path shoull be on the centreline of one side pyramid of the FRP.