Writing is one of the required abilities in learning a foreign language and it is the most difficult to master as well. Though nearly all the students have learned English for at least six years, when it comes to writ...Writing is one of the required abilities in learning a foreign language and it is the most difficult to master as well. Though nearly all the students have learned English for at least six years, when it comes to writing, they are incompetent for it and mistakes appear in their writing time and again. This article means to analyze the reasons of mistakes and attempts to offer some possible means to correct them. Thus students’ writing can be improved.展开更多
故障现象:机器原来主要是会报116(Film Pickup Failed),117(Film Pickup Retry Notification,Code 21-116is generated on the third successive failed pickup attempt.),因是早期设备,怀疑Pickup上的传感器连线断,于是更换了新的...故障现象:机器原来主要是会报116(Film Pickup Failed),117(Film Pickup Retry Notification,Code 21-116is generated on the third successive failed pickup attempt.),因是早期设备,怀疑Pickup上的传感器连线断,于是更换了新的Pickup,换后同样会报116,117,并出现双片现象。展开更多
AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Coc...AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications.展开更多
Herpes simplex virus type 1 (HSV-1) naturallyestablishes latency in neurons of the nervous systemwith the concommitant expression of the latencyassociated transcripts (LATS) and the loss in
TPP is not only a simple FTA but a "Sample Agreement" that has high hope from USTR (Office of the United States Trade Representative).There are those who are concerned that the TPP is an attempt by the Unite...TPP is not only a simple FTA but a "Sample Agreement" that has high hope from USTR (Office of the United States Trade Representative).There are those who are concerned that the TPP is an attempt by the United States to promote American hegemony.What is the true aim of TPP? Why does the United States push forward it? This article will offer some insights.展开更多
Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents.However,whether brain dysfunction occurs in adolescents with Internet addiction who atte...Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents.However,whether brain dysfunction occurs in adolescents with Internet addiction who attempt suicide remains unknown.This observational cross-sectional study enrolled 41 young Internet addicts,aged from 15 to 20 years,from the Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,China from January to May 2018.The participants included 21 individuals who attempted suicide and 20 individuals with Internet addiction without a suicidal attempt history.Brain images in the resting state were obtained by a 3.0 T magnetic resonance imaging scanner.The results showed that activity in the gyrus frontalis inferior of the right pars triangularis and the right pars opercularis was significantly increased in the suicidal attempt group compared with the non-suicidal attempt group.In the resting state,the prefrontal lobe of adolescents who had attempted suicide because of Internet addiction exhibited functional abnormalities,which may provide a new basis for studying suicide pathogenesis in Internet addicts.The study was authorized by the Ethics Committee of Chongqing Medical University,China(approval No.2017 Scientific Research Ethics(2017-157))on December 11,2017.展开更多
Chinese leaders have time and again talked about the wish to build a"harmonious world."The authors believe that this can be seen as a new attempt to deal with world affairs using the doctrine of idealism or ...Chinese leaders have time and again talked about the wish to build a"harmonious world."The authors believe that this can be seen as a new attempt to deal with world affairs using the doctrine of idealism or neo-idealism.Unlike the failed idealism of the early years in last century, the authors believe that this time neo-idealism has a fairly good chance of succeeding due to changes of the international environment.展开更多
BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional in...BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional ingestion of drugs in young and adult people(≥16), who were treated at the Emergency Service of Duzce University Medical Hospital, Turkey from January 1, 2010 to December 31, 2010. In this retrospective and descriptive study, 95 patients were diagnosed with intoxications and 30 of them intentionally ingested drugs to commit suicide. Records of the patients diagnosed with intoxication were obtained from the Clinical Archive of the hospital. Their diagnoses were established according to the International Statistical Classification of Diseases and Related Health Problems. Codes X60-X84 of this classification were used to classify self-infringed drug injuries and drug poisoning.RESULTS: In this series, 35(36.8%) patients were male and 60 patients(63.2%) female. The male/female ratio was 1.0/1.7. The mean age of the patients was 33.1±14.2 years; 17(17.9%) patients were below 20 years old and 9(9.5%) were older than 50 years. Of these patients, 29(30.5%) were single, 7(7.4%) divorced or separated, and 59(62.1%) married. Their mean time for admission to the emergency service after the incident was 208±180(15–660) minutes. The mean time for admission to the emergency service for patients with food intoxication after the incident was 142±160 minutes, for those with drug intoxication 173±161 minutes, for those with carbon monoxide(CO) intoxication 315±209 minutes, and for those with undefined intoxication 289±166 minutes(P=0.005). Most of the intoxication cases occurred in winter(41.1%, 39 of 95 patients). Admissions to the emergency service were most common in December and April(21 and 16 of 95 patients, respectively). Sixty-five(68.4%) cases were involved in non-deliberate poisoning, whereas 30(31.6%) were involved in deliberate poisoning. Twenty-six of the 95 patients with acute poisonings had mortality risk at admission, however only one died from CO intoxication in the emergency service(1.1%). Suicide attempts were more common in females than in males(21 of 30 patients, 70%, P<0.05). CONCLUSION: In Duzce City of Turkey, most intoxication cases occurred in winter, especially in December. They had non-deliberate poisoning, but deliberate poisoning in suicide attempts was more common in females than in males.展开更多
Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suici...Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic,neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses(including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain(through substance use and helpseeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s)(e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.展开更多
Background The association between substance use including marijuana use and attempted suicide has been well documented.However,little is known about marijuana use and its association with attempted suicide repetition...Background The association between substance use including marijuana use and attempted suicide has been well documented.However,little is known about marijuana use and its association with attempted suicide repetition among young people in low-income and middle-income contexts.Aims This analysis was conducted to assess the factors associated with marijuana use and ascertain marijuana use as a determinant of repeated attempted suicide among senior high school(SHS)students in Ghana.Methods Data from the 2012 Global School-Based Student Health Survey in Ghana was used for this study.Modified Poisson,Logistic and Probit models weighted with Mahalanobis distance matching within propensity calliper were employed separately to determine the hypothetical association between marijuana use and repeated attempted suicide.All analysis was performed using Stata 16 and p<0.05 was deemed statistically significant.Results The prevalence estimates of marijuana use and repeated attempted suicide among SHS students in Ghana were 3.4%(95%Cl:2.3 to 5.1)and 11.5%(95%Cl:9.1 to 14.4),respectively.The prevalence of marijuana use was significantly associated with school grade,smoking exposure,parent smoker,alcohol intake and truancy.Marijuana use was positively associated with repeated attempted suicide among SHS in Ghana correlation=0.23,p<0.001.Repeated attempted suicide among students who use marijuana was approximately threefold and fivefold significant compared with nonmarijuana use students,based on the Poisson(adjusted prevalence ratio:3.02;95%Cl:1.67 to 5.43,p<0.001)and Logistic(adjusted OR:5.06;95%Cl:3.19 to 11.64,p<0.001)estimates respectively.Also,the Probit model showed that marijuana use significantly increased the log count of repeated attempted suicide by 95%(ap:0.95;95%CI:0.49 to 1.41,p<0.001).Conclusion Marijuana use does not only influence the onset of suicidal attempts but also repeated attempted suicide among SHS students in Ghana.Special attention is required for suicide attempters with a history of repeated attempts and current marijuana use among SHS students in Ghana.Early identification of the potential risk and protective factors is recommended to inform school-based interventions.National level structured school-based substance abuse interventions and health promotion programmes would be useful.展开更多
BACKGROUND: Delayed presentation of carotid artery pseudoaneurysm following many years after self-inflicted penetrating injury of the neck is extremely rare. Open surgical carotid repair may involve sternotomy for pro...BACKGROUND: Delayed presentation of carotid artery pseudoaneurysm following many years after self-inflicted penetrating injury of the neck is extremely rare. Open surgical carotid repair may involve sternotomy for proximal vascular control. Endovascular treatment is evolving as a lessinvasive treatment option.METHODS: We report a 55-year-old man with a history of paranoid schizophrenia who presented with a progressively enlarging left sided neck mass many years after attempted suicide. CT scan confirmed a 6 cm pseudoaneurysm arising from the common carotid artery.RESULTS: Through an open retrograde puncture of the distal common carotid artery, the common carotid pseudoaneurysm was successfully repaired with a BARD fluency carotid stentgraft of 8 mm×80 mm(BARD, Tempe, AZ). The patient recovered well with no neurological deficits and was discharged on postoperative day 4. Dual antiplatelet agents of aspirin and clopidogrel were given for six months and then clopidogrel was administered lifelong. The neck mass decreased in size gradually and became non pulsatile upon follow-up.CONCLUSION: Endovascular stenting of giant carotid pseudoaneurysm is an acceptable less invasive treatment option for giant carotid pseudoaneurysm. Long-term follow-up and a greater number of cases are mandatory to establish the safety of this strategy.展开更多
BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.How...BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.However,there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts,such as medication and treatment.AIM To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia patients.METHODS This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or more.The outcomes and possible suicide risk factors in these patients were collated.The current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none(0 points),mild(1-8 points),moderate(9-16 points),or severe(17 or more points).This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic patients.RESULTS Of 228 hospitalized schizophrenia patients,214(93.9%)were included in this study.The majority(79.0%)of patients were males.Females appeared to have a slightly higher suicidality risk than males,with borderline significance.With regard to the current suicide risk assessed with the mini-international neuropsychiatric interview,172(80.4%)schizophrenic patients scored zero,20(9.4%)had a mild risk,8(3.7%)had a moderate risk,and 14(6.5%)had a severe risk.The total prevalence of current suicide risk in these schizophrenic patients was 19.6%.Based on multivariable ordinal logistic regression analysis with backward elimination,it was found that younger age,a current major depressive episode,receiving fluoxetine or lithium carbonate in the previous month,or a relatively higher Charlson comorbidity index score were all significantly and independently associated with a higher level of suicide risk.CONCLUSION The prevalence rate of suicide attempts in schizophrenia is high.Considering risk factors in routine clinical assessments,environmental manipulations and adequate treatment might prevent or decrease suicide in these patients.展开更多
Case description:Nurses face more and more ethical dilemmas during their practice nowadays,especially when they are taking care of the patient at end of life stage.The case study demonstrates an ethical dilemma when n...Case description:Nurses face more and more ethical dilemmas during their practice nowadays,especially when they are taking care of the patient at end of life stage.The case study demonstrates an ethical dilemma when nursing staff are taking care of an end stage aggressive prostate cancer patient Mr Green who expressed the suicide thoughts to one of the nurses and ask that nurse keep secret for him in Brisbane,QLD,Australia.Ethical dilemma identification:The ethical dilemma is identified as“if the nursing staff should tell other health care team members about patient's suicide attempt without patient's consent”.Analysis:To better solving this case and making the best moral decision,the ethical theory,the ethical principles and the Australian nurses'code of ethics values statement,the associated literature relative with this case are analyzed before the decision making.Ethical decision making:After consider all of the above factors,in this case,the best ethical decision for the patient is that the nurse share the information of Mr Green's suicide attempt with other health care professionals.Results:In Mr Green's case,the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals.The nursing team followed the self-harm and suicide protocol of the hospital strictly,they maintained the effective communication with Mr Green,identified the factors which cause patient's suicide attempt,provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care.The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.展开更多
A case-control study was conducted to investigate associations between organophosphate pesticide(OP)exposure,aggression,impulsivity,and attempted suicide.Questionnaires were used to collect information;impulsivity a...A case-control study was conducted to investigate associations between organophosphate pesticide(OP)exposure,aggression,impulsivity,and attempted suicide.Questionnaires were used to collect information;impulsivity and aggression were measured by the Barratt Impulsivity Scale(BIS)and the Aggression Inventory(AI).展开更多
Introduction The traditional view of listening comprehension derives largely from information processing theory, which sees communication as a potentially perfect encoding-decoding process,in which speaker and listene...Introduction The traditional view of listening comprehension derives largely from information processing theory, which sees communication as a potentially perfect encoding-decoding process,in which speaker and listener approach an identical match of meanings (Rost 1990). In relation to this model of language understanding,processes involved in listening comprehension are described as follows: 1. Listeners take in raw speech and retain a phonological representation of it in the working memory’, 2. They immediately attempt to organize the phonological representation into constituents,identifying their content and function, 3. As they identify each constituent, they use it to construct underlying propositions building continually unto a hierarchical representation of propositions,展开更多
Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a...Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a“depressive disorder”-is a mood disorder that adversely impacts how an individual feels,thinks,and handles daily activities,such as sleeping,eating,or working.To be diagnosed with depression,symptoms must be present most of the time,nearly every day for at least minimum of 2 to 3 weeks.Feeling sad or having low emotional energy may be common among people.For most,however,these feelings are transitory and can be managed by changing daily life routines.But for some,prolonged mood disorders can lead to depression and foster suicidal tendencies.Suicide is a major public health concern.Over 47,000 people died by suicide in the United States in 2017.It is the 10th leading cause of death overall according to NIMH(National Institute of Mental Health).Suicide is complicated and tragic,but it is often preventable.Identifying the warning signs for suicide and how to get help can be a major mitigating factor.In this short communication,we are reviewing the promise and limitations of AI(artificial intelligence)with its integrated tools such as ML(machine learning)and DL(deep learning)for mood analysis as a means for detecting early signs of depression and increased suicidal tendencies for possible suicide risk management.展开更多
文摘Writing is one of the required abilities in learning a foreign language and it is the most difficult to master as well. Though nearly all the students have learned English for at least six years, when it comes to writing, they are incompetent for it and mistakes appear in their writing time and again. This article means to analyze the reasons of mistakes and attempts to offer some possible means to correct them. Thus students’ writing can be improved.
文摘故障现象:机器原来主要是会报116(Film Pickup Failed),117(Film Pickup Retry Notification,Code 21-116is generated on the third successive failed pickup attempt.),因是早期设备,怀疑Pickup上的传感器连线断,于是更换了新的Pickup,换后同样会报116,117,并出现双片现象。
文摘AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications.
文摘Herpes simplex virus type 1 (HSV-1) naturallyestablishes latency in neurons of the nervous systemwith the concommitant expression of the latencyassociated transcripts (LATS) and the loss in
文摘TPP is not only a simple FTA but a "Sample Agreement" that has high hope from USTR (Office of the United States Trade Representative).There are those who are concerned that the TPP is an attempt by the United States to promote American hegemony.What is the true aim of TPP? Why does the United States push forward it? This article will offer some insights.
基金supported by a grant from Chongqing Science and Technology Commission of China,Nos.CSTC2018jxj1130009,cstc2019 jscx-msxmX0279(both to YH)the Traditional Chinese Medicine Scientific Research Fund from Chongqing Health Committee of China,No.2019ZY023315(to YH)
文摘Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents.However,whether brain dysfunction occurs in adolescents with Internet addiction who attempt suicide remains unknown.This observational cross-sectional study enrolled 41 young Internet addicts,aged from 15 to 20 years,from the Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,China from January to May 2018.The participants included 21 individuals who attempted suicide and 20 individuals with Internet addiction without a suicidal attempt history.Brain images in the resting state were obtained by a 3.0 T magnetic resonance imaging scanner.The results showed that activity in the gyrus frontalis inferior of the right pars triangularis and the right pars opercularis was significantly increased in the suicidal attempt group compared with the non-suicidal attempt group.In the resting state,the prefrontal lobe of adolescents who had attempted suicide because of Internet addiction exhibited functional abnormalities,which may provide a new basis for studying suicide pathogenesis in Internet addicts.The study was authorized by the Ethics Committee of Chongqing Medical University,China(approval No.2017 Scientific Research Ethics(2017-157))on December 11,2017.
文摘Chinese leaders have time and again talked about the wish to build a"harmonious world."The authors believe that this can be seen as a new attempt to deal with world affairs using the doctrine of idealism or neo-idealism.Unlike the failed idealism of the early years in last century, the authors believe that this time neo-idealism has a fairly good chance of succeeding due to changes of the international environment.
文摘BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional ingestion of drugs in young and adult people(≥16), who were treated at the Emergency Service of Duzce University Medical Hospital, Turkey from January 1, 2010 to December 31, 2010. In this retrospective and descriptive study, 95 patients were diagnosed with intoxications and 30 of them intentionally ingested drugs to commit suicide. Records of the patients diagnosed with intoxication were obtained from the Clinical Archive of the hospital. Their diagnoses were established according to the International Statistical Classification of Diseases and Related Health Problems. Codes X60-X84 of this classification were used to classify self-infringed drug injuries and drug poisoning.RESULTS: In this series, 35(36.8%) patients were male and 60 patients(63.2%) female. The male/female ratio was 1.0/1.7. The mean age of the patients was 33.1±14.2 years; 17(17.9%) patients were below 20 years old and 9(9.5%) were older than 50 years. Of these patients, 29(30.5%) were single, 7(7.4%) divorced or separated, and 59(62.1%) married. Their mean time for admission to the emergency service after the incident was 208±180(15–660) minutes. The mean time for admission to the emergency service for patients with food intoxication after the incident was 142±160 minutes, for those with drug intoxication 173±161 minutes, for those with carbon monoxide(CO) intoxication 315±209 minutes, and for those with undefined intoxication 289±166 minutes(P=0.005). Most of the intoxication cases occurred in winter(41.1%, 39 of 95 patients). Admissions to the emergency service were most common in December and April(21 and 16 of 95 patients, respectively). Sixty-five(68.4%) cases were involved in non-deliberate poisoning, whereas 30(31.6%) were involved in deliberate poisoning. Twenty-six of the 95 patients with acute poisonings had mortality risk at admission, however only one died from CO intoxication in the emergency service(1.1%). Suicide attempts were more common in females than in males(21 of 30 patients, 70%, P<0.05). CONCLUSION: In Duzce City of Turkey, most intoxication cases occurred in winter, especially in December. They had non-deliberate poisoning, but deliberate poisoning in suicide attempts was more common in females than in males.
基金Supported by The Canadian Institutes of Health Research,No.319379
文摘Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic,neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses(including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain(through substance use and helpseeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s)(e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.
文摘Background The association between substance use including marijuana use and attempted suicide has been well documented.However,little is known about marijuana use and its association with attempted suicide repetition among young people in low-income and middle-income contexts.Aims This analysis was conducted to assess the factors associated with marijuana use and ascertain marijuana use as a determinant of repeated attempted suicide among senior high school(SHS)students in Ghana.Methods Data from the 2012 Global School-Based Student Health Survey in Ghana was used for this study.Modified Poisson,Logistic and Probit models weighted with Mahalanobis distance matching within propensity calliper were employed separately to determine the hypothetical association between marijuana use and repeated attempted suicide.All analysis was performed using Stata 16 and p<0.05 was deemed statistically significant.Results The prevalence estimates of marijuana use and repeated attempted suicide among SHS students in Ghana were 3.4%(95%Cl:2.3 to 5.1)and 11.5%(95%Cl:9.1 to 14.4),respectively.The prevalence of marijuana use was significantly associated with school grade,smoking exposure,parent smoker,alcohol intake and truancy.Marijuana use was positively associated with repeated attempted suicide among SHS in Ghana correlation=0.23,p<0.001.Repeated attempted suicide among students who use marijuana was approximately threefold and fivefold significant compared with nonmarijuana use students,based on the Poisson(adjusted prevalence ratio:3.02;95%Cl:1.67 to 5.43,p<0.001)and Logistic(adjusted OR:5.06;95%Cl:3.19 to 11.64,p<0.001)estimates respectively.Also,the Probit model showed that marijuana use significantly increased the log count of repeated attempted suicide by 95%(ap:0.95;95%CI:0.49 to 1.41,p<0.001).Conclusion Marijuana use does not only influence the onset of suicidal attempts but also repeated attempted suicide among SHS students in Ghana.Special attention is required for suicide attempters with a history of repeated attempts and current marijuana use among SHS students in Ghana.Early identification of the potential risk and protective factors is recommended to inform school-based interventions.National level structured school-based substance abuse interventions and health promotion programmes would be useful.
文摘BACKGROUND: Delayed presentation of carotid artery pseudoaneurysm following many years after self-inflicted penetrating injury of the neck is extremely rare. Open surgical carotid repair may involve sternotomy for proximal vascular control. Endovascular treatment is evolving as a lessinvasive treatment option.METHODS: We report a 55-year-old man with a history of paranoid schizophrenia who presented with a progressively enlarging left sided neck mass many years after attempted suicide. CT scan confirmed a 6 cm pseudoaneurysm arising from the common carotid artery.RESULTS: Through an open retrograde puncture of the distal common carotid artery, the common carotid pseudoaneurysm was successfully repaired with a BARD fluency carotid stentgraft of 8 mm×80 mm(BARD, Tempe, AZ). The patient recovered well with no neurological deficits and was discharged on postoperative day 4. Dual antiplatelet agents of aspirin and clopidogrel were given for six months and then clopidogrel was administered lifelong. The neck mass decreased in size gradually and became non pulsatile upon follow-up.CONCLUSION: Endovascular stenting of giant carotid pseudoaneurysm is an acceptable less invasive treatment option for giant carotid pseudoaneurysm. Long-term follow-up and a greater number of cases are mandatory to establish the safety of this strategy.
基金Supported by the Faculty of Medicine,Chiang Mai University,No.046/2557Chiang Mai University,No.04/2562
文摘BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.However,there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts,such as medication and treatment.AIM To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia patients.METHODS This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or more.The outcomes and possible suicide risk factors in these patients were collated.The current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none(0 points),mild(1-8 points),moderate(9-16 points),or severe(17 or more points).This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic patients.RESULTS Of 228 hospitalized schizophrenia patients,214(93.9%)were included in this study.The majority(79.0%)of patients were males.Females appeared to have a slightly higher suicidality risk than males,with borderline significance.With regard to the current suicide risk assessed with the mini-international neuropsychiatric interview,172(80.4%)schizophrenic patients scored zero,20(9.4%)had a mild risk,8(3.7%)had a moderate risk,and 14(6.5%)had a severe risk.The total prevalence of current suicide risk in these schizophrenic patients was 19.6%.Based on multivariable ordinal logistic regression analysis with backward elimination,it was found that younger age,a current major depressive episode,receiving fluoxetine or lithium carbonate in the previous month,or a relatively higher Charlson comorbidity index score were all significantly and independently associated with a higher level of suicide risk.CONCLUSION The prevalence rate of suicide attempts in schizophrenia is high.Considering risk factors in routine clinical assessments,environmental manipulations and adequate treatment might prevent or decrease suicide in these patients.
文摘Case description:Nurses face more and more ethical dilemmas during their practice nowadays,especially when they are taking care of the patient at end of life stage.The case study demonstrates an ethical dilemma when nursing staff are taking care of an end stage aggressive prostate cancer patient Mr Green who expressed the suicide thoughts to one of the nurses and ask that nurse keep secret for him in Brisbane,QLD,Australia.Ethical dilemma identification:The ethical dilemma is identified as“if the nursing staff should tell other health care team members about patient's suicide attempt without patient's consent”.Analysis:To better solving this case and making the best moral decision,the ethical theory,the ethical principles and the Australian nurses'code of ethics values statement,the associated literature relative with this case are analyzed before the decision making.Ethical decision making:After consider all of the above factors,in this case,the best ethical decision for the patient is that the nurse share the information of Mr Green's suicide attempt with other health care professionals.Results:In Mr Green's case,the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals.The nursing team followed the self-harm and suicide protocol of the hospital strictly,they maintained the effective communication with Mr Green,identified the factors which cause patient's suicide attempt,provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care.The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.
基金partially supported by the Colorado Injury Control Research Center Grant Number 5R49CE001168 from the Centers for Disease Control and Preventionthe USA-China Agricultural Injury Research Training Project Grant Number 5DW43TW007257 from the National Institutes of Health,Fogarty International Center
文摘A case-control study was conducted to investigate associations between organophosphate pesticide(OP)exposure,aggression,impulsivity,and attempted suicide.Questionnaires were used to collect information;impulsivity and aggression were measured by the Barratt Impulsivity Scale(BIS)and the Aggression Inventory(AI).
文摘Introduction The traditional view of listening comprehension derives largely from information processing theory, which sees communication as a potentially perfect encoding-decoding process,in which speaker and listener approach an identical match of meanings (Rost 1990). In relation to this model of language understanding,processes involved in listening comprehension are described as follows: 1. Listeners take in raw speech and retain a phonological representation of it in the working memory’, 2. They immediately attempt to organize the phonological representation into constituents,identifying their content and function, 3. As they identify each constituent, they use it to construct underlying propositions building continually unto a hierarchical representation of propositions,
文摘Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a“depressive disorder”-is a mood disorder that adversely impacts how an individual feels,thinks,and handles daily activities,such as sleeping,eating,or working.To be diagnosed with depression,symptoms must be present most of the time,nearly every day for at least minimum of 2 to 3 weeks.Feeling sad or having low emotional energy may be common among people.For most,however,these feelings are transitory and can be managed by changing daily life routines.But for some,prolonged mood disorders can lead to depression and foster suicidal tendencies.Suicide is a major public health concern.Over 47,000 people died by suicide in the United States in 2017.It is the 10th leading cause of death overall according to NIMH(National Institute of Mental Health).Suicide is complicated and tragic,but it is often preventable.Identifying the warning signs for suicide and how to get help can be a major mitigating factor.In this short communication,we are reviewing the promise and limitations of AI(artificial intelligence)with its integrated tools such as ML(machine learning)and DL(deep learning)for mood analysis as a means for detecting early signs of depression and increased suicidal tendencies for possible suicide risk management.