中医药临床实践的价值

把现代病因病理医学作为参照物,通过比较,指出中医的证是病人的全身综合反应状态,是病因病理医学之外的另外一个临床医学范畴。状态与病因病理是人类疾病的两个不同方面。从单纯状态病,西医难治和不治的疾病,常见病的治疗,中医药的近期疗效和远期疗效等方面阐述了中医药的临床价值。     

A real-time phoneme counting algorithm and application for speech rate monitoring

Adults who stutter can learn to control and improve their speech fluency by modifying their speaking rate. Existing speech therapy technologies can assist this practice by monitoring speaking rate and providing feedback to the patient, but cannot provide an accurate, quantitative measurement of speaking rate. Moreover, most technologies are too complex and costly to be used for home practice. We developed an algorithm and a smartphone application that monitor a patient’s speaking rate in real time and provide user-friendly feedback to both patient and therapist. Our speaking rate computation is performed by a phoneme counting algorithm which implements spectral transition measure extraction to estimate phoneme boundaries. The algorithm is implemented in real time in a mobile application that presents its results in a user-friendly interface. The application incorporates two modes: one provides the patient with visual feedback of his/her speech rate for self-practice and another provides the speech therapist with recordings, speech rate analysis and tools to manage the patient’s practice. The algorithm’s phoneme counting accuracy was validated on ten healthy subjects who read a paragraph at slow, normal and fast paces, and was compared to manual counting of speech experts. Test-retest and intra-counter reliability were assessed. Preliminary results indicate differences of −4% to 11% between automatic and human phoneme counting. Differences were largest for slow speech. The application can thus provide reliable, user-friendly, real-time feedback for speaking rate control practice.     

机器学习在解决过拟合现象中的作用

过拟合现象是心理学走向预测科学的重要阻碍。文章综述了机器学习在解决过拟合现象中的价值和实现途径：（1）介绍了过拟合的两种表现形式和现状;（2）分析过拟合的根因,即“高解释力≠高预测力”;（3）厘清机器学习的建模逻辑与核心技术在解决过拟合中的作用;（4）利用样例数据和代码说明机器学习统计思想在模型拟合中的具体应用过程。文章指出心理学应从解决实际问题的角度出发,借鉴机器学习的分析思想,避免过拟合,进而提供更准确更稳定的结论和预测模型。     

Evidence for the Syndrome of Nonverbal Learning Disabilities in Children with Brain Tumors

This study examined the predicted utility of the Nonverbal Learning Disabilities syndrome (NLD) (Rourke, 1995) for characterizing neurocognitive and psychosocial outcomes in 123 children with brain tumors. Children with brain tumors were found to be at high risk of having a specific academic deficit, particularly in arithmetic. Children with arithmetic deficit evidenced a higher rate of impairment on nonverbal tasks than on verbal tasks, whereas children with reading deficit evidenced a higher rate of impairment on verbal tasks than on nonverbal tasks. However, significant differences between children with arithmetic and reading deficits were not found for all of the component features of the NLD syndrome, and arithmetic deficit was not related to treatment with irradiation.     

慢性阻塞性肺疾病急性加重期临床路径应用效果评价

评价临床路径管理在慢性阻塞性肺疾病急性加重期（AECOPD）的应用效果。通过采用回顾性调查,比较进入临床路径（路径组）和没有进入临床路径（对照组）两组患者在住院费用、住院时间及治疗效果3项指标上的差别。结果显示实施临床路径患者（路径组）的平均住院费用、平均住院日等指标均有不同程度的下降,而治愈率有所上升。从而得出临床路径在AECOPD病种的应用能够规范医疗行为,提高医疗护理质量的结论。     

练习促进内隐策略生成：其发生过程及应用特点

本研究通过设置隐含算术策略的问题情境,比较不同顺序和设置条件的进程段行为反应和ERP数据差异,考察被试在不断练习条件下对隐含策略的习得过程及迁移应用特点。结果：被试在对隐含策略无意识的情况下,第1-4练习进程段的反应时、错误率显著低于第5进程段（探测段）。同时,不同进程段诱发的部分ERPs特征也呈现有规律的变化。结论：在存在隐含策略的算术策略任务情境中,通过练习人们可以在无意识情况下逐渐生成内隐策略,诱发的ERP成分P200、N400s可以部分地反映其生成过程。已生成的内隐策略,能部分地应用到相应的新情境中。     

默认网络的神经机制、功能假设及临床应用

认知神经科学的迅速发展使得研究者对大脑的功能有了深刻的认识。近些年来, 研究者对大脑在进行外在注意任务时产生的负激活有了更多的了解, 默认网络(Default Mode Network)的概念被提出, 并引起了很多神经科学家的关注, 关于默认网络的相关理论也已提出。当前综述对默认网络的研究历史, 概念理论, 个体和种系发展, 及其与疾病的关系以及临床应用等方面进行了概括总结。未来研究可从默认网络的个体发展, 种系差异, 与其他大脑网络(如注意网络, 视觉网络, 执行控制网络)的关系以及与具体疾病的关系等角度入手进行研究, 共同来探讨默认网络的神经机制。     

Provoked vestibulodynia: Psychological predictors of topical and cognitive-behavioral treatment outcome

Psychological factors have been found to impact the pain experience and associated sexual impairment of women suffering from provoked vestibulodynia (PV). Despite a lack of randomized treatment outcome studies, particularly concerning psychological predictors of outcome, recent studies have shown that topical applications and cognitive-behavioral therapy (CBT) are among the most popular first-line interventions for PV. The present study aimed to determine the extent to which baseline fear-avoidance variables and pain self-efficacy were differentially associated with topical application and CBT outcomes at six-month follow-up. Data were obtained from 97 women who completed a randomized trial comparing these two treatments. Regression analyses revealed that for topical treatment, higher levels of baseline avoidance predicted worse pain and sexual functioning outcomes, whereas higher levels of pain self-efficacy predicted better outcomes. For CBT, higher levels of baseline fear of pain and catastrophizing contributed to higher pain intensity at follow-up, whereas higher levels of pain self-efficacy were associated with less pain. Psychological factors did not predict sexual functioning outcomes for CBT. Consistent with biopsychosocial models of pain and sexual dysfunction, results indicate that psychological factors contribute to pain and sexual impairment following treatment for PV. Specifically, findings suggest that fear-avoidance variables and pain self-efficacy are significant predictors of topical and CBT treatment outcomes in women with PV.     

医务人员收取药品回扣的法律理性思考——兼谈《执业医师法》和《药品管理法》立法缺陷

医务人员收受药品回扣是违法行为,但是否适用以“受贿罪”刑事处罚存在司法争议。分析医务人员收受药品回扣的定性争议,提出以受贿罪论处存在的法律矛盾。认为医务人员收受药品回扣以批评教育为主,必要时给予行政处分,甚至吊销其职业医师(药师)资格而免除刑事处罚是妥当而合法的。对于医院管理者收受回扣,可以按受贿罪论处。