Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simpli...Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simplified model proposed by Debdas, the so called paperless partogram, we aimed at evaluating the ability of only using the alert and action lines to prevent prolongation of labor. Methods: This was a cross-sectional study including labor records of women delivered at King Baudouin Hospital of Kinshasa (secondary level) from 01/01 till 31/12/2013. The study was approved by the Faculty Ethical Committee. Inclusion criteria were: 1) live singleton pregnancy, 2) cephalic fetal presentation, 3) lack of uterine scar, 4) monitoring in labor ward by 4 cm of cervical dilation, and 5) delivery at term. For every record, the expected time of delivery (ETD = 6 hours after 4 cm of cervical dilation) was considered “Alert EDT” to which 4 hours were added to obtain the “Action EDT”. Irrespective of other fetal and maternal features contained in the traditional partogram Alert and Action ETD were checked a posteriori on Debdas’s model to derive the appropriate outcome of labor. Results: The study included 357 participants, of which 219 primiparous and 138 multiparous. Vaginal delivery took place in 91% of cases. Full cervical dilation was achieved after 8 - 9 hours (9.5 ± 1.8 hours for primiparous and 8.4 ± 1.7 hours for multiparous women), namely 2 - 3 hours following Alert ETD). This duration is close to the Action ETD. For 32 cesarean sections (9%) final decision took place within the Alert ETD. Conclusion: Using only Alert and Action ETD was found convenient to derive appropriate measures for the outcome of labor. So, the paperless partogram is a simplified method to manage the active stage of labor that could prevent prolongation of labor in our setting.展开更多
Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is th...Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.展开更多
[目的]探讨醒神通窍针法治疗脑卒中后失语症患者的临床疗效及其对注意网络系统的影响。[方法]选取2020年4月至2021年3月浙江省人民医院康复医学中心的60例脑卒中后失语症患者,采用随机数字表法将其分为对照组(30例)和研究组(30例),同时...[目的]探讨醒神通窍针法治疗脑卒中后失语症患者的临床疗效及其对注意网络系统的影响。[方法]选取2020年4月至2021年3月浙江省人民医院康复医学中心的60例脑卒中后失语症患者,采用随机数字表法将其分为对照组(30例)和研究组(30例),同时根据患者自发言语的流畅性与否,进一步将研究组分为流畅性失语组16例与非流畅性失语组14例。两组失语症患者均接受常规言语语言治疗(speech language therapy,SLT),对照组采用常规针刺法治疗,研究组采用醒神通窍针法治疗。治疗前和治疗4周结束后采用注意网络测试(attention network test,ANT)和中国康复研究中心汉语标准失语症检查(China Rehabilitation Research Center aphasia examination,CRRCAE)进行评定。[结果]治疗前两组患者ANT及CRRCAE的各项评分比较,差异无统计学意义(P>0.05)。治疗4周后研究组患者警觉时间增加,执行控制时间及总反应时间减少,正确率提高,与治疗前比较差异有统计学意义(P<0.05);对照组ANT各项指标治疗前后比较差异无统计学意义(P>0.05)。与对照组比较,研究组警觉时间、执行控制时间、总反应时间及正确率治疗前后差值差异有统计学意义(P<0.05),研究组优于对照组;在定向时间方面,差异无统计学意义(P>0.05)。治疗4周后研究组和对照组患者的CRRCEA各项评分与治疗前比较均有提高,差异有统计学意义(P<0.05);研究组治疗后CRRCAE各项评分优于对照组,差异有统计学意义(P<0.05)。与对照组比较,研究组听理解、复述、命名和阅读方面治疗前后差值差异均有统计学意义(P<0.05),研究组优于对照组。治疗4周后研究组亚组分析中,流畅性失语组与非流畅性失语组患者的CRRCEA各项治疗后评分与治疗前比较均有提高,差异有统计学意义(P<0.05),治疗后流畅性失语组听理解、复述、阅读方面评分优于非流畅性失语组,差异有统计学意义(P<0.05);在命名方面两组治疗后评分比较,差异无统计学意义(P>0.05)。与非流畅性失语组比较,流畅性失语组治疗听理解、复述和阅读方面前后的差值,差异有统计学意义(P<0.05),流畅性失语组优于非流畅性失语组;在命名方面,差异无统计学意义(P>0.05)。[结论]醒神通窍针法可提高脑注意网络的警觉时间及执行控制能力,促进失语症患者语言功能的恢复,在流畅性失语患者中更为明显,其效果优于常规针刺法。展开更多
文摘Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simplified model proposed by Debdas, the so called paperless partogram, we aimed at evaluating the ability of only using the alert and action lines to prevent prolongation of labor. Methods: This was a cross-sectional study including labor records of women delivered at King Baudouin Hospital of Kinshasa (secondary level) from 01/01 till 31/12/2013. The study was approved by the Faculty Ethical Committee. Inclusion criteria were: 1) live singleton pregnancy, 2) cephalic fetal presentation, 3) lack of uterine scar, 4) monitoring in labor ward by 4 cm of cervical dilation, and 5) delivery at term. For every record, the expected time of delivery (ETD = 6 hours after 4 cm of cervical dilation) was considered “Alert EDT” to which 4 hours were added to obtain the “Action EDT”. Irrespective of other fetal and maternal features contained in the traditional partogram Alert and Action ETD were checked a posteriori on Debdas’s model to derive the appropriate outcome of labor. Results: The study included 357 participants, of which 219 primiparous and 138 multiparous. Vaginal delivery took place in 91% of cases. Full cervical dilation was achieved after 8 - 9 hours (9.5 ± 1.8 hours for primiparous and 8.4 ± 1.7 hours for multiparous women), namely 2 - 3 hours following Alert ETD). This duration is close to the Action ETD. For 32 cesarean sections (9%) final decision took place within the Alert ETD. Conclusion: Using only Alert and Action ETD was found convenient to derive appropriate measures for the outcome of labor. So, the paperless partogram is a simplified method to manage the active stage of labor that could prevent prolongation of labor in our setting.
基金supported by the National Natural Science Foundation of China,No.82172530(to QT)Science and Technology Program of Guangdong,No.2018B030334001(to CRR)Guangzhou Science and Technology Project,No.202007030012(to QT).
文摘Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.
文摘[目的]探讨醒神通窍针法治疗脑卒中后失语症患者的临床疗效及其对注意网络系统的影响。[方法]选取2020年4月至2021年3月浙江省人民医院康复医学中心的60例脑卒中后失语症患者,采用随机数字表法将其分为对照组(30例)和研究组(30例),同时根据患者自发言语的流畅性与否,进一步将研究组分为流畅性失语组16例与非流畅性失语组14例。两组失语症患者均接受常规言语语言治疗(speech language therapy,SLT),对照组采用常规针刺法治疗,研究组采用醒神通窍针法治疗。治疗前和治疗4周结束后采用注意网络测试(attention network test,ANT)和中国康复研究中心汉语标准失语症检查(China Rehabilitation Research Center aphasia examination,CRRCAE)进行评定。[结果]治疗前两组患者ANT及CRRCAE的各项评分比较,差异无统计学意义(P>0.05)。治疗4周后研究组患者警觉时间增加,执行控制时间及总反应时间减少,正确率提高,与治疗前比较差异有统计学意义(P<0.05);对照组ANT各项指标治疗前后比较差异无统计学意义(P>0.05)。与对照组比较,研究组警觉时间、执行控制时间、总反应时间及正确率治疗前后差值差异有统计学意义(P<0.05),研究组优于对照组;在定向时间方面,差异无统计学意义(P>0.05)。治疗4周后研究组和对照组患者的CRRCEA各项评分与治疗前比较均有提高,差异有统计学意义(P<0.05);研究组治疗后CRRCAE各项评分优于对照组,差异有统计学意义(P<0.05)。与对照组比较,研究组听理解、复述、命名和阅读方面治疗前后差值差异均有统计学意义(P<0.05),研究组优于对照组。治疗4周后研究组亚组分析中,流畅性失语组与非流畅性失语组患者的CRRCEA各项治疗后评分与治疗前比较均有提高,差异有统计学意义(P<0.05),治疗后流畅性失语组听理解、复述、阅读方面评分优于非流畅性失语组,差异有统计学意义(P<0.05);在命名方面两组治疗后评分比较,差异无统计学意义(P>0.05)。与非流畅性失语组比较,流畅性失语组治疗听理解、复述和阅读方面前后的差值,差异有统计学意义(P<0.05),流畅性失语组优于非流畅性失语组;在命名方面,差异无统计学意义(P>0.05)。[结论]醒神通窍针法可提高脑注意网络的警觉时间及执行控制能力,促进失语症患者语言功能的恢复,在流畅性失语患者中更为明显,其效果优于常规针刺法。
