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  • 文章类型: Case Reports
    一名38岁的病理学家出现了多发性渐逝白点综合征(MEWDS)。他使用光学显微镜进行病理诊断,详细记录了他的视力障碍。值得注意的是,患者说明的主观缺陷与诊断结果在时空上具有良好的一致性.本报告通过对主观经验和客观临床发现的比较分析,增强了对与MEWDS相关的视力障碍的理解。
    A 38-year-old pathologist developed multiple evanescent white dot syndrome (MEWDS). He documented his visual impairment in detail utilizing a light microscope for pathological diagnosis. Notably, the subjective defects illustrated by the patient were in good spatiotemporal agreement with diagnostic outcomes. The present report enhances the understanding of visual impairment associated with MEWDS through a comparative analysis of subjective experiences and objective clinical findings.
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  • 文章类型: Editorial
    神经质的研究可以提供重要的见解。在将神经质纳入阿尔茨海默病(AD)的研究之前,临床和科学研究人员使用相对固定的模型来治疗AD,如处方固定剂量的药物和固定的研究策略。然而,考虑到神经质会影响药物的使用,科学研究的方向,甚至人口的心理健康,这转化为更直接的经济利益。
    Study of neuroticism can provide important insights. Before the inclusion of neuroticism in the study of Alzheimer\'s disease (AD), clinical and scientific researchers used relatively fixed models to treat AD, such as prescribing fixed doses of drugs and fixed research strategies. However, taking neuroticism into account affects drug use, the direction of scientific research, and even the mental health of the population, which translates into more immediate economic benefits.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    背景:主要和次要的儿科感染可能导致颅内动脉病变,我们调查并确定了影响动脉病变进展/消退的因素。
    方法:我们收集了1个月-15岁儿童的临床和放射学数据,这些儿童在最近的高热感染后患有明确的动脉病变。在接下来的一年中进行了重复的神经成像,以确定复发性中风以及动脉病变的进展和消退。
    结果:前循环受影响更频繁(83.33%),主要累及大脑中动脉(41.67%),20.84%的病例得到解决,33.33%的病例正在进展。病变通常为单侧(54.17%)和狭窄(75%),主要导致皮质梗死(45.83%),偏瘫是最常见的神经缺陷。除了结核性脑膜炎患者,其他人有一个良好的功能结果。
    结论:年龄较低,轻微感染,单侧动脉病变的消退机会明显更高。与细菌感染后相比,病毒后动脉病变的进展机会显着降低。进展性和双侧动脉病变与不良预后和复发性中风显着相关。
    Major and minor pediatric infections may cause intracranial arteriopathies, the long-term outcome of which we investigated and identified the factors influencing the progression/resolution of arteriopathies.
    We collected the clinical and radiological data of children aged 1 month-15 years who had ischemic stroke with definite arteriopathy following a recent febrile infection. Repeated neuroimaging was done over the next year to ascertain recurrent strokes and the progression and resolution of arteriopathies.
    The anterior circulation was more frequently affected (83.33%), predominantly involving the middle cerebral artery (41.67%), resolving in 20.84% of cases and progressing in 33.33% of cases. Lesions were commonly unilateral (54.17%) and stenotic (75%), resulting predominantly in cortical infarcts (45.83%), with hemiparesis being the most common neurodeficiency. Apart from tubercular meningitis patients, others had a good functional outcome.
    Lower age, minor infections, and unilateral arteriopathies had a significantly higher chance of resolution. Postviral arteriopathies had a significantly lower chance of progression compared with those following bacterial infections. Progressive and bilateral arteriopathies were significantly associated with worse outcomes and recurrent strokes.
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  • 文章类型: Journal Article
    临床指导SARS-CoV2感染急性神经系统并发症住院患儿的门诊随访。我们描述了Covid后儿科神经病学诊所的临床基础设施,包括我们针对该患者人群的临床评估和认知测试,和我们最初的患者队列的病例系列。我们的研究结果表明,在急性SARS-CoV2感染并伴有神经系统并发症(包括急性播散性脑脊髓炎)后,我们所有4个月的患者都有认知后遗症,后部可逆性脑病综合征,病毒性脑炎,和步态困难。在我们的队列中,言语和执行功能域主要受到影响,即使是在随访时未认可症状或学术投诉的患者.我们的建议包括对SARS-CoV2感染住院后的儿童进行系统的临床随访,并采用全面的认知电池来监测认知后遗症,并在儿童重返学校时协助制定个性化的教育计划。
    Clinical guidance on outpatient follow-up of children hospitalized with acute neurologic complications of SARS-CoV2 infection is needed. We describe the clinical infrastructure of our pediatric neurology post-Covid clinic, including our clinical evaluation and cognitive testing battery specific to this patient population, and a case series of our initial patient cohort. Our findings demonstrate cognitive sequelae in all 4 of our patients months following acute SARS-CoV2 infection with neurologic complications including acute disseminated encephalomyelitis, posterior reversible encephalopathy syndrome, viral encephalitis, and gait difficulties. Verbal and executive function domains were predominantly affected in our cohort, even in patients who did not endorse symptomatic or academic complaints at follow-up. Our recommendations include systematic clinical follow-up for children following hospitalization with SARS-CoV2 infection with a comprehensive cognitive battery to monitor for cognitive sequalae and to assist with developing an individualized education plan for the child as they return to school.
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  • 文章类型: Journal Article
    研究广泛报道,社会和文化价值观是控制流行病传播的制约因素。然而,我认为,社会文化价值体系是一把双刃剑,可以激发人们的预防健康行为。很少有研究研究社会和文化价值观在促进流行病控制中的积极作用。
    以2003年爆发的严重急性呼吸系统综合症和2020年在香港开始的COVID-19大流行为例,本研究于2003年1月至6月和2020年1月至2022年5月在香港进行了参与者观察;在2021年2月至2022年3月期间,对70名参与者进行了深入的个人半结构化访谈.
    社会和文化价值观作为非正式的社会控制机制,操纵人们采取预防性健康行为,有助于流行病控制。具体来说,注意到“其他”群体的建构和污名化以及基于资本主义意识形态的传统文化价值观,以促进对香港两次爆发的控制措施。
    这两次爆发强化了香港资本主义意识形态的内在社会和文化价值,这增加了弱势社会群体对污名化的脆弱性。
    Studies have widely reported that social and cultural values serve as constraints in controlling the spread of an epidemic. However, I argue that a social and cultural value system is a double-edged sword and can motivate people\'s preventive health behaviors. Few studies have examined the positive role of social and cultural values in promoting epidemic control.
    Using the severe acute respiratory syndrome outbreak in 2003 and the COVID-19 pandemic that began in 2020 in Hong Kong as examples, the present study performed participant observation in Hong Kong from January to June 2003 and from January 2020 to May 2022; in-depth individual semi-structured interviews were conducted with 70 participants between February 2021 and March 2022.
    Social and cultural values serve as informal social control mechanisms in manipulating people\'s adoption of preventive health behaviors that can assist in epidemic control. Specifically, the construction and stigmatization of the \"others\" groups and the traditional cultural values based on the capitalist ideology were noted to facilitate control measures against the two outbreaks in Hong Kong.
    These two outbreaks reinforced the embedded social and cultural values of the capitalist ideology of Hong Kong, which increased the vulnerability of disadvantaged social groups to stigmatization.
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  • 文章类型: Journal Article
    背景:本研究旨在确定川崎病(KD)引起的冠状动脉瘤(CAA)患者是否存在持续性血管炎症。
    方法:受试者为26例有KD病史的患者;急性期有15例巨大CAA(gCAA)≥8.0mm,11例较小的CAA(smCAA)<8mm。他们接受了X射线计算机断层扫描和18F-氟脱氧葡萄糖正电子发射断层扫描。我们确定了每位患者的最大冠状动脉目标背景比(CaTBR)和平均胸主动脉TBR(TaTBR)。他们在组间进行了比较,并确定了它们与各种变量的相关性。
    结果:CaTBR和TaTBR在gCAA中明显高于smCAA(两个值P<.005),甚至在没有任何代谢危险因素的患者中也明显高于(两个值P<.05)。急性期CAA大小与CaTBR(R2=0.32)和TaTBR(R2=0.28)均呈正相关。此外,TaTBR与CaTBR(R2=0.32)以及代谢危险因素的累积数量(趋势,P=.03)。
    结论:持续的血管炎症可能在KD后很长时间出现,特别是在急性期以gCAA表示的严重炎症患者中。
    This study aimed to determine whether ongoing vascular inflammation presents in patients who had coronary artery aneurysms (CAAs) caused by Kawasaki disease (KD).
    Subjects were 26 patients with a history of KD; 15 had giant CAA (gCAA) ≥ 8.0 mm and 11 had smaller CAA (smCAA) < 8 mm in the acute phase. They underwent X-ray computed tomography and 18F-fluorodeoxyglucose positron emission tomography. We determined the maximum coronary target-to-background ratio (CaTBR) and the mean thoracic aorta TBR (TaTBR) in each patient. They were compared between groups, and their correlation with various variables was determined.
    CaTBR and TaTBR were significantly higher in gCAA than in smCAA (P < .005 for both values) and were significantly higher even in patients without any metabolic risk factor (P < .05 for both values). The CAA size in acute phase significantly positively correlated with CaTBR (R2 = 0.32) as well as TaTBR (R2 = 0.28). Also, TaTBR significantly positively correlated with CaTBR (R2 = 0.32) as well as cumulative number of metabolic risk factors (trend, P = .03).
    Ongoing vascular inflammation may present long after KD, especially in patients with severe inflammation expressed as gCAA in the acute phase.
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  • 文章类型: Journal Article
    发展和神经科学的工作已经证明,道德判断受到心理理论(ToM)的影响。这是指代表不同代理人精神状态的能力。然而,道德判断与ToM之间相互作用的神经和认知时间过程尚不清楚。当前的事件相关电位(ERP)研究通过对比道德困境中的自我和他人的道德判断所引起的ERP,研究了道德判断与ToM之间相互作用的潜在神经基础。在经典的道德困境中,代理人必须在功利选择(采取行动杀死或伤害无辜的人,但拯救更多的人)和非功利选择(不采取行动杀死或伤害无辜的人,但让一些人死亡)之间做出选择。当代理人在困境中做出功利主义或非功利主义选择时,对自我和他人做出道德判断的参与者记录了ERP。结果表明,对他人的道德判断会引起更大的额叶晚期正成分(LPC,500-900毫秒)比代理人做出功利主义选择时的自我而在N1,P2和N2的早期成分上没有观察到差异。此外,心理能力的个体差异与LPC振幅呈负相关。这些发现表明,在道德判断过程中,ToM调节了后期控制过程,而不是早期自动过程。
    Developmental and neuroscience works have demonstrated that the moral judgment is influenced by theory of mind (ToM), which refers to the ability to represent the mental states of different agents. However, the neural and cognitive time course of interactions between moral judgment and ToM remains unclear. The present event-related potential (ERP) study investigated the underlying neural substrate of the interaction between moral judgment and ToM by contrasting the ERPs elicited by moral judgments for self and for others in moral dilemmas. In classic moral dilemmas, the agents must choose between the utilitarian choice (taking the action to kill or harm an innocent person but saving more people) and the non-utilitarian choice (taking no action to kill or harm the innocent person but letting some people die). The ERPs were recorded from participants who made moral judgments for self and for others when the agent made utilitarian or non-utilitarian choices during the dilemma. The results revealed that the moral judgment for others elicited a larger frontal late positive component (LPC, 500-900 ms) than that for self when the agents made utilitarian choices, while no difference was observed on early components of N1, P2, and N2. Moreover, individual differences in mentalizing ability were negatively correlated with the LPC amplitudes. These findings suggested that ToM modulated the late controlled process but not the early automatic process during moral judgments.
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  • 文章类型: Journal Article
    动机是重度抑郁障碍的典型特征,是指个体表现出降低的为奖励而付出努力的意愿。然而,抑郁症患者在决定是否为自我与他人付出努力时的动机模式仍不清楚。
    我们进行了一项功能性磁共振成像研究,并在亚阈值抑郁(SD)参与者(n=33)和健康对照(HC)(n=32)中采用了适应的奖励任务努力支出。这要求参与者在固定的低努力/低回报和可变的高努力/高回报选项之间进行选择,然后立即努力为自己或不熟悉的人获得相应的奖励。
    与HC组相比,SD组左背前扣带皮质/背内侧前额叶皮质活动减弱,双侧前岛(AI),选择为自己努力时,右壳核-左背外侧前额叶皮质功能连接。此外,当选择为他人努力时,SD组在双侧AI中表现出更高的意愿和更大的激活。此外,这些脑激活和功能连接与自我报告的动机呈正相关.
    这些研究结果表明,轻度抑郁状态的个体在基于努力的决策过程中动机发生了改变,特别是对他人有更高的动机。因此,这表明SD患者的动机行为和前额叶纹状体电路发生了改变,可以用来发现治疗目标并制定策略来解决由动机障碍引起的精神疾病。
    Amotivation is a typical feature in major depressive disorders and refers to individuals exhibiting reduced willingness to exert effort for rewards. However, the motivation pattern when deciding whether to exert effort for self versus others in people with depression remains unclear.
    We conducted a functional magnetic resonance imaging study and employed an adapted Effort-Expenditure for Rewards Task in subthreshold depressive (SD) participants (n = 33) and healthy controls (HC) (n = 32). This required participants to choose between a fixed low-effort/low-reward and a variable high-effort/high-reward option, and then immediately exert effort to obtain corresponding rewards for themselves or for unfamiliar people.
    Compared with the HC group, the SD group showed blunted activity in the left dorsal anterior cingulate cortex/dorsomedial prefrontal cortex, bilateral anterior insula (AI), and right putamen-left dorsolateral prefrontal cortex functional connectivity when choosing to exert effort for themselves. Additionally, the SD group exhibited increased willingness and greater activation in the bilateral AI when choosing to exert effort for others. Furthermore, these brain activations and functional connectivity were positively related to self-reported motivation.
    These findings show altered motivation during effort-based decision-making in individuals with the mild depressive state, particularly with higher motivation for others. Thus, this suggests that motivational behaviors and prefrontal-striatal circuitry are altered in individuals with SD, which can be utilized to discover treatment targets and develop strategies to address mental illness caused by motivation disorders.
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  • 文章类型: Journal Article
    The current international crisis situation caused by the COVID-19 pandemic is having a strong psychological impact on our subjectivities. We are constantly threatened by the danger of i) being infected, ii) infecting other people, and (iii) by the loss of social relation. Departing from these premises, we here aim to investigate the psychological and neurodynamics of this complex phenomenon. First, we discuss about recent psychological and neuronal findings on fear and its disorders, related to an unbalanced intero-exteroceptive processing and emotional regulation. Secondly we move to the psychological and neuronal dynamics of self and others characterized by a temporo-spatial alignment with the world. Due to the neural overlap of emotion and self and the deep-reaching neuro-ecological layers of self, emotional feelings like fear and anxiety cannot be detached and dissociated from the world; they signify the world-brain relation, and, more specifically, our self-other relation. The deepest neuro-ecological and neuro-social layers of self are threatened by the loss of subjectivity, which is manifest in our loss of body and thus the fear of dying, and the loss of intersubjectivity that surfaces in our fear of infecting others, which reflect the intimate anchorage of the self with the world. In our opinion the pandemic of COVID-19 deeply affect our sense of self and its spatio-temporal neuronal dynamics providing the prerequisites for the manifestation of fear and existential anxiety, thus disrupting the brain-world relation with significant repercussions on our psyche and on our daily lives.
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