Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to de...Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.展开更多
https://doi.org/10.4103/1673-5374.393108 In the article titled“Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease”,published on ...https://doi.org/10.4103/1673-5374.393108 In the article titled“Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease”,published on pages 1602-1607,Issue 7,Volume 19 of Neural Regeneration Research(Zhao et al.,2024),the first author’s affiliations were incorrectly tagged.展开更多
Background: Pattern hair loss (PHL) is the most common form of hair loss affecting both men and women. The occipital region, located at the back of the scalp, has been considered resistant to hair loss in PHL. It is o...Background: Pattern hair loss (PHL) is the most common form of hair loss affecting both men and women. The occipital region, located at the back of the scalp, has been considered resistant to hair loss in PHL. It is often used as a donor site for hair transplantation procedures. However, evidence suggests that the occipital region may also be affected by PHL, although to a lesser extent compared to the frontal and vertex regions. Objective: To assess the levels and determinants of occipital involvement in PHL, focusing on gender and disease severity. Such data would enhance the comprehensive understanding of PHL progression and inform development of improved treatment strategies. Methods: This retrospective study involved 1993 adults (1000 males, 993 females) following for PHL at a specialized hair clinic in Jeddah, Saudi Arabia. Any patient who had hair transplantation in the past and any male who had balding areas (Hamilton-Norwood scales 4 to 7) at the initial consultation was excluded. The primary outcome was occipital involvement, defined as >10% thin hairs in the trichometry assessments of the occipital region. Additional data included patients age, treatment status, disease severity, and other trichometry parameters. Results: The prevalence of occipital involvement was found to be 23.8% overall, significantly more frequent in females (35.6%) than males with early PHL (Hamilton-Norwood scales 2 and 3) (12.1%) (p Conclusion: This study underscored the relevance of gender and disease severity in occipital involvement in PHL. Females had significantly higher rates of occipital involvement, suggesting that gender differences are critical in understanding PHL progression. Future research should aim to validate these findings, with an aim to refine therapeutic and surgical approaches to improve patient outcomes.展开更多
Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives ...Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.展开更多
This study explores the integration of Experienced Involvement(ExIn)in social-psychiatric care in Germany,emphasizing both the challenges and opportunities it presents.The European Leonardo da Vinci Project(2005-2007)...This study explores the integration of Experienced Involvement(ExIn)in social-psychiatric care in Germany,emphasizing both the challenges and opportunities it presents.The European Leonardo da Vinci Project(2005-2007)established a curriculum for ExIn,promoting participatory structures in psychiatric services.While peer support is well-established in other European countries,Germany’s experience is still developing.This research uses a mixed methods design,combining quantitative surveys and qualitative interviews,to investigate the professional experiences of ExIn recovery companions and team colleagues in German clinics and support services.The findings reveal numerous benefits:for social-psychiatric services,ExIn enhances service quality,inclusivity,and accessibility;for team colleagues,it fosters reflexivity,hope,and trust,and improves self-care;for service users,it provides empowerment,easy access to support,trust,and hope,and offers credible role models.Despite these benefits,challenges such as stigmatization,lack of recognition,and financial constraints remain and require to be addressed.The study highlights the need and provides implications for a dedicated and inclusive approach to effectively implementing ExIn,ultimately enriching psychiatric care through experiential knowledge and reducing prejudice within mental health services.展开更多
BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment o...BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.展开更多
Traditional Medicine Research has retracted this article upon the request of the editor-in-chief and academic committee.On June 5,2023,we received a complaint regarding possible picture plagiarism within the article,w...Traditional Medicine Research has retracted this article upon the request of the editor-in-chief and academic committee.On June 5,2023,we received a complaint regarding possible picture plagiarism within the article,which promoted the decision to retract this article.Following a comprehensive examination,it was determined that the content depicted in this article's pictures was identical to that found in another published paper.Consequently,the editorial office determined that retracting the article was necessary.展开更多
Hereditary hemorrhagic teleangiectasia(HHT),also known as Rendu-Osler-Weber syndrome,is the most common cause of hepatic vascular malformations in adults.Different vascular shunts(arteriovenous,arterioportal or portov...Hereditary hemorrhagic teleangiectasia(HHT),also known as Rendu-Osler-Weber syndrome,is the most common cause of hepatic vascular malformations in adults.Different vascular shunts(arteriovenous,arterioportal or portovenous)lead to different clinical manifestations.Even though no hepatic-related symptoms are reported in the majority of cases,the severity of liver disease could lead to refractory medical conditions,in some cases requiring liver transplantation.The aim of this manuscript is to provide an updated overview of the current evidence regarding the diagnosis and treatment of HHT liver involvement and liver-related complications.展开更多
Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of thi...Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).展开更多
BACKGROUND Guillain-Barrésyndrome(GBS)is an acute autoimmune-mediated polyneuropathy.Studies have increasingly reported the presence of anti-sulfatide antibody positivity with varying clinical symptoms in patient...BACKGROUND Guillain-Barrésyndrome(GBS)is an acute autoimmune-mediated polyneuropathy.Studies have increasingly reported the presence of anti-sulfatide antibody positivity with varying clinical symptoms in patients with GBS.However,spinal cord involvement is relatively rare in these cases.CASE SUMMARY A 68-year-old woman was admitted to the hospital with weakness of the limb for more than 3 d.Additional symptoms included neck pain,progressive numbness in the distal extremities,urinary and fecal retention,and reduced perception of temperature.She was diagnosed with an anti-sulfatide antibody-positive GBS variant and discharged after treatment with methylprednisolone and intravenous human immunoglobulin pulse therapy.Unlike common cases of anti-sulfatide antibody-positive GBS,this patient had atypical clinical symptoms of spinal cord involvement.No similar cases have previously been reported in China.CONCLUSION Although GBS is associated with a poor prognosis,a prompt diagnosis allows early administration of combined intravenous human immunoglobulin and methylprednisolone pulse therapy.展开更多
BACKGROUND Immunoglobulin G4-related prostate disease(IgG4-RPD)characterized by a high count of IgG4-positive plasma cells has distinctive serological and radiological findings.Here we report a case of a patient who w...BACKGROUND Immunoglobulin G4-related prostate disease(IgG4-RPD)characterized by a high count of IgG4-positive plasma cells has distinctive serological and radiological findings.Here we report a case of a patient who was successfully treated for IgG4-RPD,which manifested as frequent micturition,dysuric,and systemic lymphadenopathy.CASE SUMMARY The patient was a 33-year-old man who was referred to our hospital because of urinary tract symptoms that had persisted for 4 years.A physical examination revealed systemic lymphadenopathy and blood tests showed hyperglobulinemia with an IgG level of 18.90 g/L and an IgG4 level of 18.40 g/L.Computed tomography(CT)revealed bilateral lacrimal gland,right parotid gland and prostatic enlargement.Based on these findings,IgG4-RD was suspected,and further pathological examination and follow-up results showed expected results.Finally,the patient was diagnosed with IgG4-RPD based on clinical symptoms,pathological examination,therapeutic effects,and follow-up results.He received 50 mg oral prednisolone(the dose was gradually reduced and a low dose was used for long-term maintenance)in combination with cyclophosphamide 1.0 g via an intravenous drip for 6 mo.One year after the treatment was initiated,he was free of urinary or other complaints and his serum IgG4 level normalized.CONCLUSION In IgG4-RPD with severe urinary tract symptoms,radiological findings should be carefully examined.IgG4-RPD prognosis is good because the disease responds well to glucocorticoids.Furthermore,it is urgent for clinicians and pathologists to improve their understanding of IgG4-RPD.展开更多
BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare subtype of extranodal lymphoma.In particular,the Asian variant of IVLBCL is characterized by hemophagocytic lymphohistiocytosis along with bone marrow in...BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare subtype of extranodal lymphoma.In particular,the Asian variant of IVLBCL is characterized by hemophagocytic lymphohistiocytosis along with bone marrow involvement.However,central nervous system(CNS)involvement is uncommon in this variant compared to the Western variant.Here,we report a case of typical Asian variant IVLBCL with highly suspected CNS involvement and discuss the nature of the disease and its genetic aberration.CASE SUMMARY A 67-year-old female patient complained of gradually worsening cognitive impairment.While hospitalized,she developed a high fever and showed marked bicytopenia.Intracranial imaging revealed a suspected leptomeningeal disease.Although no malignant cells were found in the cerebrospinal fluid(CSF),the protein and lactate dehydrogenase levels in CSF were increased.Bone marrow examination revealed an increased number of hemophagocytic histiocytes,and 18F-fluorodeoxyglucose(FDG)positron emission tomography with computerized tomography scan revealed increased FDG uptake in both adrenal glands,the liver,and the right ethmoid sinus.A tissue biopsy showed atypical large lymphoid cells with prominent nucleoli in the vessels,and the tumor cells were positive for CD20,BCL2,BCL6,and IRF4/MUM1.In addition,targeted sequencing identified MYD88,TET2,and PIM1 mutations.Consequently,we diagnosed the patient with the Asian variant of IVLBCL with highly suspected CNS involvement.CONCLUSION Suspicion of IVLBCL and immediate diagnosis lead to timely treatment.Moreover,careful CNS examination at diagnosis is recommended.展开更多
This study aims to contribute to development of SHRM field.Because personnel management and human resource management are in practice by firms,however,firms do not apply strategic HRM yet.There are four definitions of...This study aims to contribute to development of SHRM field.Because personnel management and human resource management are in practice by firms,however,firms do not apply strategic HRM yet.There are four definitions of SHRM so far.This study presents a new approach for the development of the field.It is HRM involvement.HRM involvement is related to appointment of managers and board of directors.Because board of directors appoints managers in firms,HR must be member of board of directors.Because managers achieve firm performance(market share and profit),and Board of Directors appoints managers.Therefore,HRM manager must be involved with board of directors to affect appointments.This study uses semantic content analysis and systematic review methods as a research methodology.To conclude,organizations may apply strategic HRM through strategic HR Directors at top level,appointment of C-level Executives and HRM involvement.展开更多
Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely un...Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.展开更多
The purpose of the paper is to study retention of vocabulary acquired incidentally on task-induced involvement by senior middle school students. Grade two of senior middle students participated in the experiments, tes...The purpose of the paper is to study retention of vocabulary acquired incidentally on task-induced involvement by senior middle school students. Grade two of senior middle students participated in the experiments, testing whether retention of vocabulary acquired incidentally is contingent on amount of task-induced involvement.Using short-and long term, namely immediate posttest and delayed posttest, retention of twelve unfamiliar words was investigated in three learning tasks (reading, reading plus fill-in and writing) with varying degrees of “involvement load”- various combinations of need, search and evaluation. The results of the experiment partially support the Involvement Load Hypothesis: retention in the writing group was higher than that in the reading plus fill-in group; retention in the reading plus fill-in group was higher than that in the reading group. The results are discussed in light of the construct of task-induced involvement.展开更多
Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high...Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.展开更多
Crohn's disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a mos...Crohn's disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a most common and account for 40% of cases and involvement of small intestine is about 30%. Isolated involvement of stomach is an extremely unusual presentation of the disease accounting for less than 0.07% of all gastrointestinal CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. The diagnosis is difficult to establish in such cases with atypical presentation. In the absence of any other source of disease and in the presence of nonspecific upper gastrointestinal endoscopy and histological findings, serological testing can play a vital role in the diagnosis of atypical CD. Recent studies have suggested that perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomycescervisia antibody may be used as additional diagnostic tools. The effectiveness of infliximab in isolated gastric CD is limited to only a few case reports of adult patients and the long-term outcome is unknown.展开更多
Objective: Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma(DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study...Objective: Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma(DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.Methods: A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender,extranodal involvement, age-adjusted international prognostic index(aa IPI), rituximab infusion and radiotherapy on patient outcomes were evaluated.Results: Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aa IPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.Conclusions: Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution.The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.展开更多
文摘Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.
文摘https://doi.org/10.4103/1673-5374.393108 In the article titled“Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease”,published on pages 1602-1607,Issue 7,Volume 19 of Neural Regeneration Research(Zhao et al.,2024),the first author’s affiliations were incorrectly tagged.
文摘Background: Pattern hair loss (PHL) is the most common form of hair loss affecting both men and women. The occipital region, located at the back of the scalp, has been considered resistant to hair loss in PHL. It is often used as a donor site for hair transplantation procedures. However, evidence suggests that the occipital region may also be affected by PHL, although to a lesser extent compared to the frontal and vertex regions. Objective: To assess the levels and determinants of occipital involvement in PHL, focusing on gender and disease severity. Such data would enhance the comprehensive understanding of PHL progression and inform development of improved treatment strategies. Methods: This retrospective study involved 1993 adults (1000 males, 993 females) following for PHL at a specialized hair clinic in Jeddah, Saudi Arabia. Any patient who had hair transplantation in the past and any male who had balding areas (Hamilton-Norwood scales 4 to 7) at the initial consultation was excluded. The primary outcome was occipital involvement, defined as >10% thin hairs in the trichometry assessments of the occipital region. Additional data included patients age, treatment status, disease severity, and other trichometry parameters. Results: The prevalence of occipital involvement was found to be 23.8% overall, significantly more frequent in females (35.6%) than males with early PHL (Hamilton-Norwood scales 2 and 3) (12.1%) (p Conclusion: This study underscored the relevance of gender and disease severity in occipital involvement in PHL. Females had significantly higher rates of occipital involvement, suggesting that gender differences are critical in understanding PHL progression. Future research should aim to validate these findings, with an aim to refine therapeutic and surgical approaches to improve patient outcomes.
基金supported by the National Natural Science Foundation of China,Nos.82071426,81873784Clinical Cohort Construction Program of Peking University Third Hospital,No.BYSYDL2019002(all to DF)。
文摘Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.
文摘This study explores the integration of Experienced Involvement(ExIn)in social-psychiatric care in Germany,emphasizing both the challenges and opportunities it presents.The European Leonardo da Vinci Project(2005-2007)established a curriculum for ExIn,promoting participatory structures in psychiatric services.While peer support is well-established in other European countries,Germany’s experience is still developing.This research uses a mixed methods design,combining quantitative surveys and qualitative interviews,to investigate the professional experiences of ExIn recovery companions and team colleagues in German clinics and support services.The findings reveal numerous benefits:for social-psychiatric services,ExIn enhances service quality,inclusivity,and accessibility;for team colleagues,it fosters reflexivity,hope,and trust,and improves self-care;for service users,it provides empowerment,easy access to support,trust,and hope,and offers credible role models.Despite these benefits,challenges such as stigmatization,lack of recognition,and financial constraints remain and require to be addressed.The study highlights the need and provides implications for a dedicated and inclusive approach to effectively implementing ExIn,ultimately enriching psychiatric care through experiential knowledge and reducing prejudice within mental health services.
文摘BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.
文摘Traditional Medicine Research has retracted this article upon the request of the editor-in-chief and academic committee.On June 5,2023,we received a complaint regarding possible picture plagiarism within the article,which promoted the decision to retract this article.Following a comprehensive examination,it was determined that the content depicted in this article's pictures was identical to that found in another published paper.Consequently,the editorial office determined that retracting the article was necessary.
文摘Hereditary hemorrhagic teleangiectasia(HHT),also known as Rendu-Osler-Weber syndrome,is the most common cause of hepatic vascular malformations in adults.Different vascular shunts(arteriovenous,arterioportal or portovenous)lead to different clinical manifestations.Even though no hepatic-related symptoms are reported in the majority of cases,the severity of liver disease could lead to refractory medical conditions,in some cases requiring liver transplantation.The aim of this manuscript is to provide an updated overview of the current evidence regarding the diagnosis and treatment of HHT liver involvement and liver-related complications.
文摘Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).
基金Yixing Administration of Traditional Chinese Medicine,No.yxfc03。
文摘BACKGROUND Guillain-Barrésyndrome(GBS)is an acute autoimmune-mediated polyneuropathy.Studies have increasingly reported the presence of anti-sulfatide antibody positivity with varying clinical symptoms in patients with GBS.However,spinal cord involvement is relatively rare in these cases.CASE SUMMARY A 68-year-old woman was admitted to the hospital with weakness of the limb for more than 3 d.Additional symptoms included neck pain,progressive numbness in the distal extremities,urinary and fecal retention,and reduced perception of temperature.She was diagnosed with an anti-sulfatide antibody-positive GBS variant and discharged after treatment with methylprednisolone and intravenous human immunoglobulin pulse therapy.Unlike common cases of anti-sulfatide antibody-positive GBS,this patient had atypical clinical symptoms of spinal cord involvement.No similar cases have previously been reported in China.CONCLUSION Although GBS is associated with a poor prognosis,a prompt diagnosis allows early administration of combined intravenous human immunoglobulin and methylprednisolone pulse therapy.
基金Supported by the Guangdong Provincial Bureau of Traditional Chinese Medicine,No.20222065Science and Technology Planning Project of Guangdong Province of China,No.A2021100National Natural Science Foundation of China,No.82104989。
文摘BACKGROUND Immunoglobulin G4-related prostate disease(IgG4-RPD)characterized by a high count of IgG4-positive plasma cells has distinctive serological and radiological findings.Here we report a case of a patient who was successfully treated for IgG4-RPD,which manifested as frequent micturition,dysuric,and systemic lymphadenopathy.CASE SUMMARY The patient was a 33-year-old man who was referred to our hospital because of urinary tract symptoms that had persisted for 4 years.A physical examination revealed systemic lymphadenopathy and blood tests showed hyperglobulinemia with an IgG level of 18.90 g/L and an IgG4 level of 18.40 g/L.Computed tomography(CT)revealed bilateral lacrimal gland,right parotid gland and prostatic enlargement.Based on these findings,IgG4-RD was suspected,and further pathological examination and follow-up results showed expected results.Finally,the patient was diagnosed with IgG4-RPD based on clinical symptoms,pathological examination,therapeutic effects,and follow-up results.He received 50 mg oral prednisolone(the dose was gradually reduced and a low dose was used for long-term maintenance)in combination with cyclophosphamide 1.0 g via an intravenous drip for 6 mo.One year after the treatment was initiated,he was free of urinary or other complaints and his serum IgG4 level normalized.CONCLUSION In IgG4-RPD with severe urinary tract symptoms,radiological findings should be carefully examined.IgG4-RPD prognosis is good because the disease responds well to glucocorticoids.Furthermore,it is urgent for clinicians and pathologists to improve their understanding of IgG4-RPD.
基金The institutional review board of Chungbuk National University Hospital approved this study(approval number.CBNUH 2023-04-024)informed written consent was obtained from the patient for publication of this report and any accompanying images.
文摘BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare subtype of extranodal lymphoma.In particular,the Asian variant of IVLBCL is characterized by hemophagocytic lymphohistiocytosis along with bone marrow involvement.However,central nervous system(CNS)involvement is uncommon in this variant compared to the Western variant.Here,we report a case of typical Asian variant IVLBCL with highly suspected CNS involvement and discuss the nature of the disease and its genetic aberration.CASE SUMMARY A 67-year-old female patient complained of gradually worsening cognitive impairment.While hospitalized,she developed a high fever and showed marked bicytopenia.Intracranial imaging revealed a suspected leptomeningeal disease.Although no malignant cells were found in the cerebrospinal fluid(CSF),the protein and lactate dehydrogenase levels in CSF were increased.Bone marrow examination revealed an increased number of hemophagocytic histiocytes,and 18F-fluorodeoxyglucose(FDG)positron emission tomography with computerized tomography scan revealed increased FDG uptake in both adrenal glands,the liver,and the right ethmoid sinus.A tissue biopsy showed atypical large lymphoid cells with prominent nucleoli in the vessels,and the tumor cells were positive for CD20,BCL2,BCL6,and IRF4/MUM1.In addition,targeted sequencing identified MYD88,TET2,and PIM1 mutations.Consequently,we diagnosed the patient with the Asian variant of IVLBCL with highly suspected CNS involvement.CONCLUSION Suspicion of IVLBCL and immediate diagnosis lead to timely treatment.Moreover,careful CNS examination at diagnosis is recommended.
文摘This study aims to contribute to development of SHRM field.Because personnel management and human resource management are in practice by firms,however,firms do not apply strategic HRM yet.There are four definitions of SHRM so far.This study presents a new approach for the development of the field.It is HRM involvement.HRM involvement is related to appointment of managers and board of directors.Because board of directors appoints managers in firms,HR must be member of board of directors.Because managers achieve firm performance(market share and profit),and Board of Directors appoints managers.Therefore,HRM manager must be involved with board of directors to affect appointments.This study uses semantic content analysis and systematic review methods as a research methodology.To conclude,organizations may apply strategic HRM through strategic HR Directors at top level,appointment of C-level Executives and HRM involvement.
基金The study was partly funded by the National Natural Science Foundation of China(82371490)the National Key R&D Program of China(2022YFC2503900,2022YFC2503901)+1 种基金Beijing Hundred,Thousand and Ten Thousand Talents Project(2017-CXYF-09)Beijing Health System Leading Talent Grant(2022-02-10).
文摘Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.
文摘The purpose of the paper is to study retention of vocabulary acquired incidentally on task-induced involvement by senior middle school students. Grade two of senior middle students participated in the experiments, testing whether retention of vocabulary acquired incidentally is contingent on amount of task-induced involvement.Using short-and long term, namely immediate posttest and delayed posttest, retention of twelve unfamiliar words was investigated in three learning tasks (reading, reading plus fill-in and writing) with varying degrees of “involvement load”- various combinations of need, search and evaluation. The results of the experiment partially support the Involvement Load Hypothesis: retention in the writing group was higher than that in the reading plus fill-in group; retention in the reading plus fill-in group was higher than that in the reading group. The results are discussed in light of the construct of task-induced involvement.
文摘Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.
文摘Crohn's disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a most common and account for 40% of cases and involvement of small intestine is about 30%. Isolated involvement of stomach is an extremely unusual presentation of the disease accounting for less than 0.07% of all gastrointestinal CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. The diagnosis is difficult to establish in such cases with atypical presentation. In the absence of any other source of disease and in the presence of nonspecific upper gastrointestinal endoscopy and histological findings, serological testing can play a vital role in the diagnosis of atypical CD. Recent studies have suggested that perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomycescervisia antibody may be used as additional diagnostic tools. The effectiveness of infliximab in isolated gastric CD is limited to only a few case reports of adult patients and the long-term outcome is unknown.
基金supported by the National Nature Science Foundation of China (No. 81071938, 81470365)
文摘Objective: Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma(DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.Methods: A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender,extranodal involvement, age-adjusted international prognostic index(aa IPI), rituximab infusion and radiotherapy on patient outcomes were evaluated.Results: Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aa IPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.Conclusions: Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution.The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.