Narcotrend监测下右美托咪定对冠心病患者麻醉诱导期血流动力学的影响

观察Narcotrend监测下右美托咪定联合丙泊酚靶控输注用于冠心病患者非心脏手术麻醉诱导时对血流动力学的影响.合并冠心痛行非心脏手术患者40例,随机分为两组：Dex组（n=20,患者在诱导前静脉泵注右美托咪定0.5μg/kg,15min内输注完毕）,对照组（n=20,等量生理盐水,方法同Dex组）.记录给药前后及诱导期间患者的血流动力学变化.对照组在气管插管即刻以及气管插管3min后血流动力学指标值均高于插管前,气管插管5min后平均动脉压（MAP）低于插管前（P＜0.05）,Dex组无明显差异.麻醉诱导前15min静脉注射0.5μg/kg右美托咪定可以使冠心病患者丙泊酚靶控输注诱导期间血流动力学更加平稳.     

阿尔茨海默病的诊治新进展

流行病学数据的更新表明阿尔茨海默病（A D ）已成为全球健康问题。早期应用生物标志物的AD新诊断标准广泛应用和临床试验不断失败的鲜明反差提示AD治疗的艰巨性。AD和其他慢性疾病的共病研究不断深入。生活方式干预作为非药物治疗备受重视。     

基层医院实施《诊疗与防控手足口病指南》的困境

探讨实施卫生部所颁发的手足口病诊疗与防控指南存在的难点.通过实践,依据指南,笔者将近几年工作中所遇到处理各种肠道病毒感染病例存在的问题加以分析,列出实施指南存在诸多临床及非临床的影响因素,包括：（1）上报、隔离引起的矛盾;（2）诊断、治疗、转诊引起的矛盾;（3）处理肠道病毒71型（EV71）感染、疱疹性咽峡炎等与手足口病的矛盾.较多的矛盾令基层医院依照目前的指南难以良好地开展工作,期待更完善的指南以及各地医疗主管部门制定切合实际的、可行的、各种具体的防控预案.     

A taxonomic foundation for evidence-based research on employee performance management

This study presents a taxonomic foundation for research on employee performance management practices based on a comprehensive review of the literature (198 articles and book chapters). The taxonomy consists of 50 practices organized within seven topic categories, including an evaluation of the amount of research evidence supporting each practice. This taxonomic foundation facilitates the aggregation, integration, interpretation, and explanation of performance management research based on a role-theoretic perspective derived from the behavioural approach to strategic human resource management. The proposed direct-linkage path model shows how this taxonomic foundation ties performance management practices to behaviours and results. We build on this Practice – Behaviour – Results (PBR) critical path model with moderators and mediators based on cognitive and social factors identified in the extensive previous research. This PBR model provides a foundation for orderly and structured growth for future research that will enhance the connection between research and improved organizational practices in performance management, as well as a guide to best practices in performance management.     

Effects of telephone support on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease: a meta-analysis

The aim of this meta-analysis was to evaluate the effects of disease education or pulmonary rehabilitation programs assisted with telephone support on physical capacity and quality of life (QOL) in chronic obstructive pulmonary disease (COPD) patients. A systematic search of PubMed, Embase, Web of Science and The Cochrane Library was conducted until May 2017. Randomized controlled trials (RCTs) examining the effects of telephone-assisted intervention versus a control group on exercise tolerance and QOL in patients with COPD were included. Two independent authors assessed the methodological quality of the trials using the Cochrane risk of bias tool. A meta-analysis was conducted with the Revman5.3 to quantify the effects of telephone-assisted interventions on walking capacity and QOL. In total, 10 studies involving 1037 participants were included. Due to the effect of telephone-assisted interventions, statistically significant results were found on Saint-George’s Respiratory Questionnaire (SGRQ) symptom scores [standard mean difference (SMD) ?.18, 95% confidence interval (CI) ?.33, ?.03, p-value .02)], SGRQ impact scores [SMD ?.35, 95% CI ?.60, ?.10, p-value .006)], SGRQ activity scores [SMD ?.30, 95% CI ?.45, ?.15, p-value < .0001)], SGRQ total score [SMD ?.36, 95% CI ?.51, ?.21, p-value < .00001)]. The effects on 6-min walk test (6MWT) and all Chronic Respiratory Questionnaire (CRQ) subscales were not significant (p > .05) based on the insufficient evidence. In conclusion, the role of telephone-assisted interventions in the management of COPD remains equivocal. Some encouraging results were seen with regard to SGRQ symptom, SGRQ impact, SGRQ activity and SGRQ total score. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

A medical records managing and securing blockchain based system supported by a Genetic Algorithm and Discrete Wavelet Transform

The privacy of patients is jeopardised when medical records and data are spread or shared beyond the protected cloud of institutions. This is because breaches force them to the brink that they start abstaining from full disclosure of their condition. This type of condition has a negative effect on scientific research, patients and all stakeholders. A blockchain-based data sharing system is proposed to tackle this issue, which employs immutability and autonomy properties of the blockchain to sufficiently resolve challenges associated with access control and handle sensitive data. Our proposed system is supported by a Discrete Wavelet Transform to enhance the overall security, and a Genetic Algorithm technique to optimise the queuing optimization technique as well. Introducing this cryptographic key generator enhances the immunity and system access control, which allows verifying users securely in a fast way. This design allows further accountability since all users involved are already known and the blockchain records a log of their actions. Only when the users’ cryptographic keys and identities are confirmed, the system allows requesting data from the shared queuing requests. The achieved execution time per node, confirmation time per node and robust index for block number of 0.19 s, 0.17 s and 20 respectively that based on system evaluation illustrates that our system is robust, efficient, immune and scalable.     

Support groups for parents with an adult child suffering from bipolar disorder

Confronted with the disconcerting behaviour exhibited by their children, parents of bipolar patients are in severe distress. Research focuses on the study of the ‘burden’ that the pathology puts on caregivers, owing to their experience of depression, sometimes combined with the presence of hostile attitudes and negative affects. In France, parents of adult patients encounter an initial specific difficulty: they are not systematically included in the care management system. Thanks to the initiative of an association of psychiatrists and psychoanalysts, the authors set up a psychoanalytic support group for the parents of ‘bipolar’ adults. The diagnosis of a bipolar disorder is established by a psychiatrist within a medical structure. Support groups for parents do exist in France, but their experiences have not led to scientific publications on this specific topic. Existing publications focus on other types of pathology and other therapeutic approaches. In this article, we will highlight how this type of psychoanalytic support group, with operating rules based on the theoretical work of Anzieu, can help parents of patients with bipolar disorders. Group participants accepted the principle of a research study that maintained their anonymity. We collected and analysed qualitative data from the first year of the group, so we highlight the specific difficulties of these parents, faced with chronic disease. The relevance of our qualitative study also resides in the data collected over a period of time, enabling us to see the progress made, and encouraging us to reflect on the place of psychoanalytic groups for parents, as well as on the care management of this pathology.     

The Name Game: How Naming Products Increases Psychological Ownership and Subsequent Consumer Evaluations

Naming products is quite prevalent in American culture; however, we are not aware of any consumer research that explores the effects of this phenomenon. Across three studies, we demonstrate that when consumers name products, their evaluations of those products increase (e.g., attitudes, purchase intentions, and willingness to accept). We find that name fit and creativity as well as subsequent psychological ownership drive this effect. We also demonstrate that the naming effect is quite robust—replicating across multiple products, presentation formats, and populations as well as persisting over time. These results contribute to consumer research by opening up a new substantive line of inquiry into the effects of naming products.     

Implementation Intentions,Information, and Voter Turnout: An Experimental Study

Are citizens more likely to vote when they are asked to make plans about how they will cast their ballots? Such planning—typically described as “implementation intentions”—has been shown to increase many types of desirable behaviors, including exercising and healthy eating, receiving vaccinations, physical rehabilitation, and recycling. Important earlier work in political science suggests voter turnout can also be influenced by implementation intention interventions, whereby electors are prompted to “make a plan” to vote (Nickerson & Rogers, 2010 ), though this finding has gone largely unreplicated. At the same time, elections management bodies (EMBs) in many contexts regularly conduct informational campaigns in the period leading up to elections, though little is known about the effects of such efforts upon turnout. Using data from an online experiment conducted at the time of the 2015 Canadian Federal Election, we demonstrate that implementation intention interventions can improve voter turnout but that this effect is conditional upon electors being exposed to informational materials about how to vote in the election. When survey respondents were provided with information on voting requirements and methods, and then prompted with questions forcing them to contemplate the act of casting their ballots, we observe a sizable increase in turnout rates.     

Action‐semantic and syntactic deficits in subjects at risk for Huntington's disease

Frontostriatal networks play critical roles in grounding action semantics and syntactic skills. Indeed, their atrophy distinctively disrupts both domains, as observed in patients with Huntington's disease (HD) and Parkinson's disease, even during early disease stages. However, frontostriatal degeneration in these conditions may begin up to 15 years before the onset of clinical symptoms, opening avenues for pre‐clinical detection via sensitive tasks. Such a mission is particularly critical in HD, given that patients’ children have 50% chances of inheriting the disease. Against this background, we assessed whether deficits in the above‐mentioned domains emerge in subjects at risk to develop HD. We administered tasks tapping action semantics, object semantics, and two forms of syntactic processing to 18 patients with HD, 19 asymptomatic first‐degree relatives, and sociodemographically matched controls for each group. The patients evinced significant deficits in all tasks, but only those in the two target domains were independent of overall cognitive state. More crucially, relative to controls, the asymptomatic relatives were selectively impaired in action semantics and in the more complex syntactic task, with both patterns emerging irrespective of the subjects’ overall cognitive state. Our findings highlight the relevance of these dysfunctions as potential prodromal biomarkers of HD. Moreover, they offer theoretical insights into the differential contributions of frontostriatal hubs to both domains while paving the way for innovations in diagnostic procedures.