Nurses'critical thinking disposition and professional commitment:a cross-sectional study

Objective:High-quality and successful nursing care delivery in a variety of situations requires critical thinking training and professional commitment.The present study aimed to investigate critical thinking disposition,professional commitment,and the relationship between these 2 variables among nurses.Methods:As a result of stratified random sampling,201 nurses were enrolled in the present cross-sectional study.Data were gathered using a socio-demographic form,the Critical Thinking Disposition Inventory(CTDI),and the Nurses'Professional Commitment Scale(NPCS).Results:Although the critical thinking disposition scores were at a moderate level(115.70±13.55),the mean score for professional commitment was high(91.37±11.77).A positive correlation was found between critical thinking disposition and professional commitment(r=0.67,P=0.001).Conclusions:Nursing managers are urged to employ strategies to enhance nurses'critical thinking disposition and professional commitment.

Adolescence:An Unavoidable Subject for Teenagers Summary of Current Research on Chinese Adolescents

Under the background of the in- depth transformation in the society, just as many problems will occur in the development of society, adolescents will also encounter many problems in their development.The following is a summary of some hot topics regarding adolescence under current research.

Clozapine is strongly associated with the risk of pneumonia and inflammation

Clinicians need to remember that(1)systemic inflammations can increase clozapine level;(2)clozapine,by itself,can cause inflammation,particularly during titration that is too rapid for that patient;(3)clozapine may increase the risk of infection;and(4)more specifically,clozapine may be particularly strongly associated with the risk of pneumonia.Pneumonia appears to be associated with high mortality in clozapine patients around the world.Clinicians who are alert to the risk of pneumonia in clozapine patients may significantly decrease mortality in clozapine patients.There is no data on COVID-19 infections in clozapine patients,but based on what we know about clozapine pharmacology,we can hypothesise that clozapine,possibly by impairing immunological mechanisms,may increase the risk of pneumonia in infected patients.More importantly,once fever and/or pneumonia develops,the clozapine dose should be cut in half to decrease the risk of clozapine intoxication.If there is any doubt that in spite of halving the dose there are still signs of clozapine intoxication,completely stopping clozapine may be indicated.Once the signs of inflammation and fever have disappeared,the clozapine dose can be increased to the prior dosage level.

The Robustness of China's Migration and Heihe-Tengchong Line

Migration has been most active among three major population movements and affective to population distribution.However,this paper first finds that the pattern of China's inter-provincial migration is robust since China's reforming and opening based on the analysis on the distribution of inter-provincial migration scale,intensity and population flow.Therefore,the continual migration in the past 80 years,especially since China's reforming and opening,has not changed the basic feature of China's population distribution and has no effective influence on the robustness of Heihe-Tengchong Line.The basic pattern of China's population distribution and Heihe-Tengchong Line mainly depend on the constant geographic position as shown in the First Nature Rule.Without any change of the First Nature Rule,China's population distribution and Heihe-Tengchong Line remain highly stable,and the migration is unlikely to lose the robustness.

Factors associated with DAA virological treatment failure and resistance-associated substitutions description in HIV/HCV coinfected patients

AIM To describe factors associated with treatment failure and frequency of resistance-associated substitutions(RAS).METHODS Human immunodeficiency virus(HIV)/hepatitis C virus(HCV) coinfected patients starting a first direct-acting antiviral(DAA) regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defined as:(1) non-response [HCV-RNA remained detectable during treatment, at end of treatment(EOT)]; and(2) relapse(HCVRNA suppressed at EOT but detectable thereafter). Sequencing analysis was performed to describe prevalence of drug class-specific RAS. Factors associated with failure were determined using logistic regression models.RESULTS Among 559 patients, 77% had suppressed plasma HIV-RNA < 50 copies/mL at DAA treatment initiation, 41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in 22 patients and were mainly relapses(17, 77%) then undefined failures(3, 14%) and non-responses(2, 9%). Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5 A or NS5 B RAS were detected in 10/14 patients with samples available for sequencing analysis. After adjustment for age, sex, ribavirin use, HCV genotype and treatment duration, low platelet count was the only factor significantly associated with a higher risk of failure(OR: 6.5; 95%CI: 1.8-22.6). CONCLUSION Only 3.9% HIV-HCV coinfected patients failed DAA regimens and RAS were found in 70% of those failing. Low platelet count was independently associated with virological failure.

Reshaping the Cortical Connectivity Gradient by Long-Term Cognitive Training During Development

The organization of the brain follows a topologi-cal hierarchy that changes dynamically during development.However,it remains unknown whether and how cognitive training administered over multiple years during develop-ment can modify this hierarchical topology.By measuring the brain and behavior of school children who had carried out abacus-based mental calculation(AMC)training for five years(starting from 7 years to 12 years old)in pre-training and post-training,we revealed the reshaping effect of long-term AMC intervention during development on the brain hierarchical topology.We observed the development-induced emergence of the default network,AMC training-promoted shifting,and regional changes in cortical gradi-ents.Moreover,the training-induced gradient changes were located in visual and somatomotor areas in association with the visuospatial/motor-imagery strategy.We found that gradient-based features can predict the math ability within groups.Our findings provide novel insights into the dynamic nature of network recruitment impacted by long-term cognitive training during development.

众脑之力:通过开放神经影像数据和大规模协作催化神经精神疾病的创新发现

Recent advances in open neuroimaging data are enhancing our comprehension of neuropsychiatric disorders.By pooling images from various cohorts,statistical power has increased,enabling the detection of subtle abnormalities and robust associations,and fostering new research methods.Global collaborations in imaging have furthered our knowledge of the neurobiological foundations of brain disorders and aided in imaging-based prediction for more targeted treatment.Large-scale magnetic resonance imaging initiatives are driving innovation in analytics and supporting generalizable psychiatric studies.We also emphasize the significant role of big data in understanding neural mechanisms and in the early identification and precise treatment of neuropsychiatric disorders.However,challenges such as data harmonization across different sites,privacy protection,and effective data sharing must be addressed.With proper governance and open science practices,we conclude with a projection of how large-scale imaging resources and collaborations could revolutionize diagnosis,treatment selection,and outcome prediction,contributing to optimal brain health.

转化人类脑图表的6E压舱石

It is of great scientific and translational promise to formulate a normative reference for the lifespan development of human brain to precisely quantify individual differences.By aggregating more than 120,000 brain imaging scans across the world,the Lifespan Brain Chart Consortium(LBCC)recently published brain charts for the human lifespan in Nature[1].

CXCR5^(+)PD-1^(++)CD4^(+)T cells colonize infant intestines early in life and promote B cell maturation

Gastrointestinal infections are a major cause for serious clinical complications in infants.The induction of antibody responses by B cells is critical for protective immunity against infections and requires CXCR5+PD-1++CD4+T cells(TFH cells).We investigated the ontogeny of CXCR5+PD-1++CD4+T cells in human intestines.While CXCR5+PD-1++CD4+T cells were absent in fetal intestines,CXCR5+PD-1++CD4+T cells increased after birth and were abundant in infant intestines,resulting in significant higher numbers compared to adults.These findings were supported by scRNAseq analyses,showing increased frequencies of CD4+T cells with a TFH gene signature in infant intestines compared to blood.Co-cultures of autologous infant intestinal CXCR5+PD-1+/−CD4+T cells with B cells further demonstrated that infant intestinal TFH cells were able to effectively promote class switching and antibody production by B cells.Taken together,we demonstrate that functional TFH cells are numerous in infant intestines,making them a promising target for oral pediatric vaccine strategies.

Optical coherence tomography angiography at the acute phase of optic disc edema

Background:The differential diagnosis of optic disc edema at the acute phase can be challenging.OCT angiography(OCTA)is a new technology allowing the visualization of the peripapillary vascular network and optic disc capillaries.The peripapillary network alterations of glaucoma and chronic non-arteritic anterior ischemic optic neuropathy(NAION)were reported.However,no OCTA studies on acute optic disc edema from various causes.The aim of this project was to use OCTA to demonstrate the vascular changes the optic nerve head of various types of optic disc edema at the acute phase.Methods:In this retrospective study,patients with non-arteritic anterior ischemic optic neuropathy(NAION),papillitis or papilledema were recruited.Each patient was imaged using the AngioPlex^(TM)CIRRUS^(TM)HD-OCT device(model 5000,Carl Zeiss Meditec,Inc.,Dublin,USA)with a scanning area of 6×6 mm^(2) centered on the optic disc.A morphological analysis of the peripapillary network was performed.For some patients with unilateral optic disc edema,a quantitative analysis was performed using a swept-source OCT-A system(PLEX®Elite 9000,Carl Zeiss Meditec,Inc.,Dublin,USA).Vessel perfusion density and flux index of the peripapillary area were calculated.Results:Eight eyes with NAION(4 patients),12 eyes with papillitis(6 patients)and 25 eyes with papilledema(13 patients)were imaged.The apparent disappearance or moderate pattern alteration of the peripapillary capillary vessels were observed in patients with NAION or papillitis,respectively.For papilledema,the capillaries at the surface of the optic disc were dilated and tortuous,but no peripapillary network pattern changes were observed.The quantitative analysis did not show any difference of peripapillary network between NAION and healthy eyes.For papillitis,the flux index was higher in inflammatory eyes compared to the healthy eyes in average(p=0.03).Conclusion:At the acute phase,the morphological analysis of OCT-A appeared to be more useful than the quantification analysis,facilitating the differentiation between the three kinds of ONH edema:ischemic,inflammatory and papilledema.

Effects of biscuit-type feeding supplementation on the neurocognitive outcomes of HIV-affected school-age children:a randomized,double-blind,controlled intervention trial in Kenya

Objective:To determine if meat or soy protein dietary supplementation will enhance the neuro-cognitive performance of HIV-affected children at-risk of malnutrition and food insecurity.Methods:A randomized,double-blind,controlled intervention trial evaluated the effect of nu-tritional supplementation on the neurocognitive outcomes of 49 HIV-affected school-age children in western Kenya.The intervention consisted in providing the mother,target child,and siblings with one of three isocaloric biscuit-type supplements-soy,wheat,or beef-on 5 days per week for 18 months.Neurocognitive outcomes of the target children were assessed by a battery of eight measures and followed up longitudinally for up to 24 months.Results:Mixed effects modeling demonstrated significant differences in the rates of increase over time among all three groups(F test degrees of freedom of 2,P<0.05)for Raven’s progressive matrices performance,but not for verbal meaning,arithmetic,digit span backward,forward,and total,embedded figure test,and Beery visual-motor integration scores.Conclusion:HIV-affected school-age children provided with soy protein supplementation showed greater improvement in nonverbal cognitive(fluid intelligence)performance compared with peers who received isocaloric beef or wheat biscuits.Soy nutrients may have an enhancing effect on neurocognitive skills in HIV-affected school-age children.

连接组计算系统:2015~2021更新

The Connectome Computation System(CCS)was previously reported in the Science Bulletin[1].Here,we describe a summary of the 6-year CCS updates(2015–2021),which are accessible at https://github.com/zuoxinian/CCS.These updates contain many utilities of mining developmental neuroimaging data.Specifically,H1 module covers the data cleaning and preprocessing and refines the implementations of face-masking,brain extraction,denoising,and frequency banding.

外卖食品与健康：换菜单，而不是换地点

外卖食品或快餐是公共卫生领域的一个诱人目标，但研究人员对此却很迷惑。凭直觉认为容易接触外卖食品的人肯定吃的也更多，但对快餐获取途径与饮食或体重相关性的研究并没有得出一致性结果。

Neuroimaging brain growth charts:A road to mental health

Mental disorders are common health concerns and contribute to a heavy global burden on our modern society.It is challenging to identify and treat them timely.Neuroimaging evidence suggests the incidence of various psychiatric and behavioral disorders is closely related to the atypical development of brain structure and function.The identification and understanding of atypical brain development provide chances for clinicians to detect mental disorders earlier,perhaps even prior to onset,and treat them more precisely.An invaluable and necessary method in identifying and monitoring atypical brain development are growth charts of typically developing individuals in the population.The brain growth charts can offer a series of standard references on typical neurodevelopment,representing an important resource for the scientific and medical communities.In the present paper,we review the relationship between mental disorders and atypical brain development from a perspective of normative brain development by surveying the recent progress in the development of brain growth charts,including four aspects on growth chart utility:1)cohorts,2)measures,3)mechanisms,and 4)clinical translations.In doing so,we seek to clarify the challenges and opportunities in charting brain growth,and to promote the application of brain growth charts in clinical practice.

The DIRECT consortium and the REST-meta-MDD project:towards neuroimaging biomarkers of major depressive disorder

Despite a growing neuroimaging literature on the pathophysiology of major depressive disorder(MDD),repro-ducible findings are lacking,probably reflecting mostly small sample sizes and heterogeneity in analytic approaches.To address these issues,the Depression Imaging REsearch ConsorTium(DIRECT)was launched.The REST-meta-MDD project,pooling 2428 functional brain images processed with a standardized pipeline across all participating sites,has been the first effort from DIRECT.In this review,we present an overview of the moti-vations,rationale,and principal findings of the studies so far from the REST-meta-MDD project.Findings from the first round of analyses of the pooled repository have included alterations in functional connectivity within the default mode network,in whole-brain topological properties,in dynamic features,and in functional lat-eralization.These well-powered exploratory observations have also provided the basis for future longitudinal hypothesis-driven research.Following these fruitful explorations,DIRECT has proceeded to its second stage of data sharing that seeks to examine ethnicity in brain alterations in MDD by extending the exclusive Chinese original sample to other ethnic groups through international collaborations.A state-of-the-art,surface-based preprocessing pipeline has also been introduced to improve sensitivity.Functional images from patients with bipolar disorder and schizophrenia will be included to identify shared and unique abnormalities across diag-nosis boundaries.In addition,large-scale longitudinal studies targeting brain network alterations following antidepressant treatment,aggregation of diffusion tensor images,and the development of functional magnetic resonance imaging-guided neuromodulation approaches are underway.Through these endeavours,we hope to accelerate the translation of functional neuroimaging findings to clinical use,such as evaluating longitudinal effects of antidepressant medications and developing individualized neuromodulation targets,while building an open repository for the scientific community.