The Effects of Mindfulness-Based Interventions on Symptoms of Mild Traumatic Brain Injury:A Systematic Review

Mindfulness-based interventions(MBIs)are emerging non-pharmacological treatments for mild traumatic brain injury(mTBI).In this systematic review,the authors aimed to evaluate the potential efficacy of MBIs to provide recommendations for treating patients with mTBI.We searched of the English literature on MBIs for patients with mTBI as of 01 September,2023,using the PubMed,Web of Science,PsycINFO,and Scopus databases.One author performed data extraction and quality scoring of the included literature according to the proposed protocol,and another conducted the review.The review was not registered.A total of 11 studies met the final inclusion criteria,5 of which involved military personnel(veterans).MBIs covered in this review include goal-oriented attention self-regulation(GOALS),mindfulness-based stress reduction(MBSR),acceptance and commitment therapy(ACT),and so on.Research shows that MBSR mainly reduces mental fatigue symptoms in mTBI patients,and GOALS tend to improve their cognitive function.The effect of MBIs on psychological symptoms needs further exploration.Other studies,such as mindfulness-based group therapy and intervention studies targeting mTBI military personnel,are relatively sparse.MBIs have specific effects on mental fatigue and cognitive dysfunction in patients with mTBI.However,the effect on psychological distress and the sustained effectiveness across all symptoms still need further exploration.Considering the particularity of military personnel suffering from mTBI,researchers need to do more intervention studies targeting mTBI military personnel.Therefore,the design of future MBIs trials for mTBI patients’needs to take into account all the factors,such as different populations and severity of traumatic brain injury,to verify the effectiveness of MBIs in alleviating mTBI symptoms and explore the mechanism of intervention.

Extended criteria brain-dead organ donors:Prevalence and impact on the utilisation of livers for transplantation in Brazil

BACKGROUND Despite its association with higher postoperative morbidity and mortality,the use of extended criteria donor(ECD)livers for transplantation has increased globally due to the high demand for the procedure.AIM To investigate the prevalence of ECD in donation after brain death(DBD)and its impact on organ acceptance for transplantation.METHODS Retrospective analysis of DBD organ offers for liver transplantation between 2017 and 2020 in a high-volume transplant centre.The incidence of the Eurotransplant risk factors to define an ECD(ET-ECD)among DBD donors and the likelihood of organ acceptance over the years were analysed.The relationship between organ refusal for transplantation,the occurrence,and the number of ET-ECD was assessed by simple and multiple logistic regression adjustment.RESULTS A total of 1619 organ donors were evaluated.Of these,78.31%(n=1268)had at least one ET-ECD criterion.There was an increase in the acceptance of ECD DBD organs for transplantation(1 criterion:from 23.40%to 31.60%;2 criteria:from 13.10%to 27.70%;3 criteria:From 6.30%to 13.60%).For each addition of one ETECD variable,the estimated chance of organ refusal was 64.4%higher(OR 1.644,95%CI 1.469-1.839,P<0.001).Except for the donor serum sodium>165 mmol/L(P=0.310),all ET-ECD criteria increased the estimated chance of organ refusal for transplantation.CONCLUSION A high prevalence of ECD DBD was observed.Despite the increase in their utilisation,the presence and the number of extended donor criteria were associated with an increased likelihood of their refusal for transplantation.

Considerations for the use of porcine organ donation models in preclinical organ donor intervention research

Use of animal models in preclinical transplant research is essential to the optimization of human allografts for clinical transplantation.Animal models of organ donation and preservation help to advance and improve technical elements of solid organ recovery and facilitate research of ischemia-reperfusion injury,organ preservation strategies,and future donor-based interventions.Important considerations include cost,public opinion regarding the conduct of animal research,translational value,and relevance of the animal model for clinical practice.We present an overview of two porcine models of organ donation:donation following brain death(DBD)and donation following circulatory death(DCD).The cardiovascular anatomy and physiology of pigs closely resembles those of humans,making this species the most appropriate for pre-clinical research.Pigs are also considered a potential source of organs for human heart and kidney xenotransplantation.It is imperative to minimize animal loss during procedures that are surgically complex.We present our experience with these models and describe in detail the use cases,procedural approach,challenges,alternatives,and limitations of each model.

Critical care specialists,the missing link in organ procurement for transplantation

The procurement process for organ donation begins with the identification of potential organ donors in emergency or critical care units(CCU),followed by their clinical evaluation,diagnostic procedures,and therapeutic interventions,mostly conducted in CCUs.It concludes with the request for organ donation and,if accepted,the retrieval of organs.Despite most interventions occurring in detection units,there has been a neglect of the strategic role played by critical care specialists(CCS)in managing and caring for brain-dead or near-brain-death patients.Questions arise:Are they willing to undertake this responsibility?Do they fully comprehend the nature of organ procurement?Are they aware of the specific interventions required to maintain possible organ donors in optimal physiological condition?Our objective is to examine the role of CCS in organ procurement and propose ways to enhance it,ultimately aiming to increase and enhance organ donation rates.

Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per patient.Endocrine management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management approaches.Previous studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant recipients.AIM To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma patients.METHODS A retrospective review of adult BPODs from a single level 1 trauma center over ten years was performed.Exclusion criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital course.Levothyroxine and steroid administration,the number of organs donated,the types of organs donated,and demographic information were recorded.Univariate analyses were performed with P<0.05 considered to be statistically significant.RESULTS A total of 88 patients met inclusion criteria,69(78%)of whom received levothyroxine and steroids(ST/LT group)vs 19(22%)receiving steroids without levothyroxine(ST group).No differences were observed between the groups for gender,race,pertinent injury factors,age,or other hormone therapies used(P>0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient population.Limitations to this study include the retrospective design and the relatively small number of organ donors who met inclusion criteria.This study is unique in that it mitigates steroid administration as a confounding variable and focuses specifically on the adjunctive use of levothyroxine.

Brain death and organ transplant legislation: analysis of 969 respondents by classroom questionnaire

BACKGROUND: China has the largest potential market for organ transplants in the world, but it has not yet established brain death and organ transplant laws. We aimed to investigate the attitudes and suggestions of doctors, pharmacists, and civil servants concerning brain death, organ transplantation, and their respective legislation. METHODS: A questionnaire with 10 sections and 44 questions was designed and distributed. The effective questionnaire data were then recorded and checked for descriptive analysis. RESULTS: In 1400 questionnaires distributed, 1063 were responded and 969 of them were valid and analyzed. The respondents showed an incomplete understanding of brain death and organ transplantation laws. Seventy-four percent of the respondents recognized and accepted the standard of brain death. They agreed that legislation should be involved in the removal of organs for transplantation, the future use of organs, and insurance and compensation for the donor for possible health risks induced by organ removal. Of the 969 respondents, 92% considered it necessary to have legislation in brain death and organ transplantation, and 61% thought that it is time to legislate. CONCLUSIONS: Legislation for brain death and organ transplantation is urgent and timely in China. The laws must include the respective rights and obligations of patients, close relatives, and medical institutions. Educating the public about brain death and organ transplantation should also be encouraged in a variety of ways.

Nurses’ Recognition in Nursing for Patients and Families about Organ Donation after Brain Death, Care for Family Members and Supports for Nurses

Background: Globally, there a problem of disequilibrium between donation and organ transplantation, this equilibrium is remarkable in Japan. Especially there are few donations from brain death, and researches from the view point of nurses in clinical situation were needed. Purpose: The purpose of this study was to clarify the recognition of nurses in organ transplantation nursing, required care for families of patients, and required support for nurses to promote quality of nurses in organ donation. Methods: We conducted this research within 2 months in 2019 in Western Japan. A researcher conducted a semi-qualitative interview for nurses in organ transplantation nursing about their recognition of nursing, required care for family members, and required support for nurses once. Results: Nurses recognized that some family members who knew patients’ thoughts made decision easily and some who didn’t know had difficulties. Many nurses felt insufficiency for family cares and some confronted ethical problems. Though some nurses felt conflict about their own thoughts or religion, they took care of patients or family members with responsibility. As for care for families, nurses thought practice of care considering families’ feeling, support of decision making, and care for family to live positively after transplantation as required care. About support for nurses, nurses required education of transplantation, increase of staff members, chance to share dilemma, and mental care. Discussion: Nurses recognized the importance of decision making, and felt an insufficiency for family care or dilemmas. To propose high quality of nursing and organ donation or transplantation, education about transplantation including family care, management about resolution of dilemma or mental health may be required.

Healing Dysfunctional Identity: Bridging Mind-Body Intervention to Brain Systems

In this paper, we aim to use an innovative model to integrate applied work on a fast-acting mind-body intervention, Mind-Body Bridging (MBB), with theoretical work based on psychology and neuroscience. In an affect-object generative inference and regulation (AGIR) model, we propose that functional dynamics between two systems, the affect-object thought generation system and the cognitive control system, can guide an individual to achieve homeostasis within self and harmonious relationships with others. We used Neurosynth (www.neurosynth.org), an automated meta-analysis database, to identify potential brain substrates underlying the key components in the AGIR model. Based on the findings, some brain regions are implicated as the key cortical substrates in this model, corroborating our central hypothesis that a hallmark of mind-body wellbeing can be characterized as a low-frequency anti-correlantion between 1) the cognitive control system including the dorsal anterior/middle cingulate cortex, and 2) the affect-object thought generation system including the ventromedial prefrontal cortex and posterior cingulate cortex. MBB provides an efficient strategy for responding to and dissolving a fundamental problem that impairs mind-body wellbeing, i.e., unrealistic identity-grasping consisting of self-centered embodied expectations of self and others. We demonstrated how theoretical and applied work could be integrated by drawing evidence from the neuroscience literature to support the AGIR model, and then we applied the AGIR model to elucidate how MBB might work.

Effects of a Single-Dose of Mind-Body Practice on the Heart Rate Variability, Brain Activity and Shooting Performance in Archers: A Pilot Study

Objective: Factors affecting performance of archery are categorized into psychological, skill, and fitness perspectives. Increase in attention, relaxation and parasympathetic system activity is believed to enhance the shooting performance of archers during competition. This pilot study aims to investigate the effects of single-dose of Tai Chi practice on archer’s performance and the feasibility of an investigation protocol under a competition scenario. Methods: This was a randomized controlled trial (RCT) with a crossover study design. Pre- and post-intervention measurements were conducted to evaluate the effects of Tai Chi practice on the archer’s autonomic nervous system activity, attention and relaxation through electroencephalography investigation, and shooting performance when compared with stretching as control. Results: The protocol of the study was found to be feasible during a competition setting. No significant difference was detected in the outcome measures under the two intervention conditions. Participants after practicing Tai Chi were found to improve significantly in their shooting performance (p = 0.021). Conclusion: This pilot study showed that a real-time measurement of autonomic nervous system and brain wave activities in the competition field was feasible and it did not hinder the archers’ performance. There was a significant improvement observed in the shooting performance of archers after Tai Chi practice when compared with baseline. The findings of this pilot study provide the basis for the conduction of a larger RCT study to examine the potential beneficial effects of Tai Chi practice on archers.

What is Mind,What is Consciousness,and Where This Resides

The main purpose of this paper is to respond to the questions what is mind and consciousness and where this resides.The answers are based on the frontline Informational Model of Human Body and Living Structures(IMHBLS),which shows that mind and consciousness can be described by the activity of the Informational System of the Human Body and Living Structures(ISHBLS),consisting of seven informational components,each of them with specific activity and functions,inter-correlated to support the immaterial/informational manifestation of the body expressed by mind and consciousness.The basic concept of matter-related and virtual information results as a consequence of the operability of the physics,chemistry,biologic,or mathematics laws,which actually act as informational operators,such processes are informationally driven and manifested finally as a“media-like functions”of mind and consciousness,on the“screen/display”of prefrontal cortex.The mind is therefore described as the capacity of every individual to access the data field of own life experience,where the thought acts as an informational operator,which can activate the required information from internal/external reality.Consciousness is the result of the info-representation of the explored reality,accumulated by the momentary connection,and compared/combined with the life experience,serving as judgment reference/criteria.The question is discussed in relation with the localization of consciousness,showing that this resides in the brain,as a result of the activity of ISHBLS.The discussion on the experimental evidences concerning the minimal basic components necessary and sufficient to sustain consciousness,compared with the results of the informational model,indicates the cortico-thalamus axis,in a full agreement each other.One of the basic findings is that the activation of consciousness is operated in two steps,one consisting in a feed-forward reception and another in feedback perception for recognition of the info-significance,which is fully supported by the recently reported experimental results.The phenomena of intuition,inspiration,premonition,“deja vue”,retrocausality,and intentionality are discussed.This model unifies the eastern and western concepts/models on consciousness and mind,explaining the energetic Yung/Yin Chinese model by YES/NO-informational Bit-type behavior,the Plato’s ideas/forms by“information”concept as a participating component of reality,Aristotle’s materialist view with matter structuration(assisted by information),and archaic model of the seven“chakras”at human,as vital informational centers connected with the body.

Correlative Factors for Organic Psychotic Symptoms in Pa- tients Following Traumatic Brain Injury

Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version(CCMD-3). Results Fifty-two subjects(13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature,injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model(OR=0.044, 95% CI: 0.017-0.114; OR=2.145,95% CI: 1.201-3.832, respectively). Conclusion The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.

基于思维导图的健康教育在脑胶质瘤手术患者中的应用

目的探讨基于思维导图的健康教育在脑胶质瘤手术患者中的应用效果。方法将69例脑胶质瘤手术患者根据干预方法的不同分为常规健康教育组(n=33)和思维导图教育组(n=36),比较两组患者疾病认知水平、肢体功能[徒手肌力检查(MMT)和Fugl-Meyer下肢运动评价表(FMA)评分]、不良情绪[症状自评量表(SCL-90)评分]、心理能力[接纳与行动问卷第二版(AAQ-Ⅱ)和创伤后成长评定量表(PTGI)评分]、生活质量[诺丁汉健康量表(NHP)评分]和不良反应发生情况。结果思维导图教育组患者合理饮食、合理作息、运动锻炼、情绪控制、遵医用药评分均明显高于常规健康教育组,差异均有统计学意义(P﹤0.01)。干预后,两组患者MMT、FMA、PTGI评分均较干预前升高,AAQ-Ⅱ评分均较干预前降低,且思维导图教育组患者MMT、FMA、PTGI评分均高于常规健康教育组,AAQ-Ⅱ评分低于常规健康教育组,差异均有统计学意义(P﹤0.05)。干预后,两组患者SCL-90、NHP各维度评分均较干预前降低,且思维导图教育组患者SCL-90、NHP各维度评分均低于常规健康教育组,差异均有统计学意义(P﹤0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P﹥0.05)。结论脑胶质瘤手术患者应用基于思维导图的健康教育可有效提升患者疾病认知水平和肢体能力,减少不良情绪,改善患者心理能力和生活质量。

时空心脑关系:一种解答心脑问题的神经哲学方案

神经哲学倡导哲学与神经科学的结合,强调以神经科学的经验方法来解答传统的哲学问题。鉴于神经科学视精神特征与神经特征之间以时空特征为“通用货币”,因此可从神经哲学的角度提出一种时空形式的心脑关系,即时空心脑关系。这样的心脑关系强调时空关系和时空结构,从本体论上可将其理解为一种结构和关系意义的心脑理论。在时空心脑关系中,心灵与大脑既非一元关系,也非二元关系。因而在本体论定位上我们将其视为一种介于心脑一元论与二元论之间的新心脑关系,即心脑中性论。神经哲学对心脑问题的解答表明,我们应该抛弃传统理论和经验相分离的方法,转而选择从哲学与神经科学的对话中来探寻解答心脑问题的新方法。

基于“体用同治”理论探讨调神调脏针刺法治疗围绝经期抑郁

目的:以“体用同治”理论为指导,观察调神调脏针刺法治疗围绝经期抑郁的临床疗效,探讨其对神志病的作用。方法:选取符合纳入标准的围绝经期抑郁患者66例,依据随机数字表随机分为对照组和治疗组。对照组在基础治疗上加用调脏针刺,治疗组在对照组的基础上加用调神针刺,两组均持续治疗8周。观察两组患者治疗前后HAMD评分、Kupperman评分、血清E_(2)、FSH、LH水平的变化情况,同时比较临床疗效。结果:两组患者治疗后HAMD评分和Kupperman评分均低于治疗前(P<0.05),且治疗组HAMD评分和Kupperman评分均低于对照组(P<0.05)。治疗组临床有效率93.9%(31/33)明显高于对照组87.9%(29/33)(P<0.05)。两组患者治疗后FSH、LH水平均低于治疗前,E_(2)水平高于治疗前(P<0.05),且治疗组FSH、LH水平均低于对照组,E_(2)水平高于对照组(P<0.05)。结论:“体用同治”理论指导下的调神调脏针刺法,可提高围绝经期抑郁患者的临床疗效,改善激素水平、降低HAMD、Kupperman评分,明显改善患者的抑郁状态。

经典藏药如意珍宝片多次给药的靶器官-脑组织的成分探究

目的:探讨经典藏药如意珍宝片多次给药后,其靶器官脑组织的活性成分,分析其可能的作用特点。方法:6只斯泼累格·多雷(SD)雄性大鼠分为对照组和观察组2组,连续给药7 d,在最后一次给药后1 h处死动物,取血浆和脑组织,分析入血成分,并对潜在入脑成分进行检测和验证。结果:采用Full mass/dd-MSMS模式,以目标峰的一级谱图的分子量的组成及二级质谱图的分子离子峰进行定性分析;并依据入血成分作为潜在入脑成分,将其输入到包含列表内,进行样品检测。结合数据库mzcloud和ChemSpider的结果,对潜在入脑成分进行搜索,根据保留时间、一级质量数和二级质谱数据,共发现了13个入脑成分,其中大豆苷、胆酸、紫苜蓿酮、3′-O-methylviolanone、胡椒碱已用标准品验证。色氨酸、茴香脑、异木香酸和腺苷已通过mzCloud数据库进行二级碎片信息比对。结论:如意珍宝片中的降香、荜茇、甘草膏、肉桂、木香、黄葵子、牛黄、红花等药物的有效成分能够进入靶器官脑组织中,发挥其疗效作用。

求索大脑智慧本质,照亮类脑智能之路

宇宙创生→生命爆发→智能演生→人工智能,这是一条演化的历史长河。时代在问,脑与心智从哪里来,将到哪里去?人工智能的前途和命运是怎样的?人类文明的前途和命运是怎样的?大脑智能和人工智能怎样才能相互照亮?是否有不依赖于大数据、大算力和大模型的智能路线?人工智能可否通过完全不同于生物进化的另一条道路通向“心智”?脑智创造力如何演化为新质生产力?这些问题的核心仍然是人类大脑在整体上是怎样工作的?本文将从微观—介观—宏观—宇观的尺度上来勾勒一幅复杂性与简约性辩证统一的图景。

国医大师石学敏调神法治疗内科杂病举隅

国医大师石学敏从医数十载,博采众方,古为今用,善于辨证论治。石老独创的“醒脑开窍”针刺法可“醒神、调神、安神”,不仅可以有效治疗中风病,而且在治疗内科杂病过程中获得奇效。现总结石老的调神思想,并列举石老运用“醒脑开窍”针刺法治疗痫病、瘈疭、虚劳、梅核气验案4则,通过对上述异病同治案例的分析,总结石老运用“醒脑开窍”针刺法的临证经验,以示国医大师石学敏的辨证思路,以期为临床应用“醒脑开窍”针刺法提供参考。

脑死亡器官捐献供体评估和供心选择临床分析

目的总结73例脑死亡器官捐献供体评估和供心选择的临床经验。方法回顾73对脑死亡器官捐献心脏移植供受者临床资料,评估供体,选择供心,分析心脏移植受者生存情况和边缘供心使用情况。结果发现潜在供体,在判定脑死亡状态后,明确供体家属同意器官捐献后,评估供体,选择供心,使供受体最大限度匹配。73例心脏移植受者手术成功率为94.5%(69/73),围手术期死亡4例,术后随访1年死亡4例。边缘供心使用情况:供体年龄≥45岁17例,供受体体质量不匹配2例,供体中毒1例,供心冷缺血时间≥4 h 43例,大部分心脏移植受者予主动脉内球囊反搏和(或)体外膜肺氧合辅助,最终顺利出院。结论供受体最大限度匹配可使心脏移植患者获益最大;同时,适当放宽供心选择标准,增加供心数量,将为众多等待心脏移植患者带来希望。

从心脑同治探讨针灸治疗脑卒中后失眠

中医学认为心脑以血同源、共主神明、经脉相通,与现代生物学中脑、心息息相关,故有心脑同治理论。脑卒中后失眠病位在脑,与心紧密相关。脑损正虚、痰瘀阻窍是发病之根本,心神被扰、神无所倚是发病之关键。针灸治疗脑卒中后失眠优势凸显。从心脑同治理论出发,依据脑卒中后失眠心脑共患的病机特点,针灸治疗取穴宜以心脑穴位为主,调脑主取百会、印堂、神庭、四神聪,治心主取神门、内关。