Portrait of the Patient as a Young Man: An Exploration of the Use of Photographs in Hospital

The display of personal photographs in hospital is a common practice that has yet to be rigorously examined. The photographs displayed are subject to interpretation by the viewer and may lead to misunderstandings or miscommunication if clarification of meaning is not sought. This paper explores a range of possible meanings that the display of photographs in hospital may hold, based on a case study of a 15 year old boy hospitalised with a life threatening illness. Further research is needed into the actual meanings attributed to the display of photographs in hospital by patients and family members.     

Introducing the Multivariate Dale Model in Population‐Based Genetic Association Studies

Until recently, the most common parametric approaches to study the combined effects of several genetic polymorphisms located within a gene or in a small genomic region are, at the genotype level, logistic regressions and at the haplotype level, haplotype analyses. An alternative modeling approach, based on the case/control principle, is to regard exposures (e.g., genetic data such as derived from Single Nucleotide Polymorphisms – SNPs) as random and disease status as fixed and to use a marginal multivariate model that accounts for inter‐relationships between exposures. One such model is the multivariate Dale model. This model is based on multiple logistic regressions. That is why the model, applied in a case/control setting, leads to straightforward interpretations that are similar to those drawn in a classical logistic modeling framework. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Kinetics of the cooperativity of the Ca2+-transporting adenosine triphosphatase of sarcoplasmic reticulum and the mechanism of the ATP interaction.

The extent of the negative cooperativity with MgATP of the Ca²⁺-stimulated ATPase activity of sarcoplasmic reticulum has been studied with various membrane preparations and under various conditions. Preparations studied were fragmented sarcoplasmic reticulum vesicles, deoxycholate-solubilized and fractionated ATPase, triton extracted reticulum, vesicles reconstituted from either detergent, and limited trypsin digests of the reticulum. Conditions studied were suboptimal, optimal, and inhibitory Ca²⁺ concentrations; temperatures from 13 to 46 °C; 1 or 5 mm MgCl₂; 0.1 m KCl, 0.1 m NaCl, or no added salt; and Triton or deoxycholate present in the assay. With preparations in which vesicles could accumulate Ca²⁺ ion, the ionophore A23187 was added to prevent inhibition by internal Ca²⁺ ions. Under all circumstances, the negative cooperativity of MgATP was present (Hill coefficient of 0.2 to 0.8), indicating the persistence of the properties of the enzyme molecule and its lipid environment giving rise to kinetic negative cooperativity. Attempts to measure the number of ATP sites by protection against N-ethylmaleimide inactivation and by binding of an analog suggested, but did not prove, that there was only one specific, active ATP binding site below 0.5 mm. These results are interpreted to be consistent with either of two mechanisms for ATP cooperativity of the Ca²⁺-stimulated ATPase activity of sarcoplasmic reticulum: (a) a single, high affinity ATP active site and a second, lower affinity “allosteric” activator site; or (b) a single ATP site which demonstrates two affinities through some kinetic mechanism such as a substrate-induced, slow transition.     

Preparation, characterization, and functions of rabbit lymph node populations. III. Antigen-induced uptake of thymidine and dibutyryl cyclic AMP: inhibition of thymidine uptake by cholera toxin and dibutyryl cyclic AMP.

Keyhole limpet hemocyanin (KLH)-primed lymph node cell (LNC) populations were incubated with various amounts of KLH and the cellular incorporation of tritiated thymidine ([³H]TdR) or tritiated N⁶, O^2′ dibutyryl cyclic AMP ([³H]DbcAMP) was determined. T LNC responded more vigorously than did complement receptor lymphocytes (CRL), i.e., B cells, at all KLH concentrations, during all time intervals examined, and in the presence or absence of normal rabbit serum (NRS). The depletion of adherent cells from KLH-primed LNC resulted in no significant decrease in KLH-induced incorporation of either [³H]TdR or [³H]DbcAMP in any of the LNC populations. Thus it appeared that variation among LNC populations in the incidence of macrophages did not account for the marked variation in their responses. Cultures containing equal numbers of T and CRL were induced to incorporate more [³H]TdR or [³H]DbcAMP than either population cultured separately or the sum of their individual responses. It was concluded that KLH-induced incorporation of these substances into primed, isolated LNC, was primarily manifested in the T-cell population. The synergism seen in cultures containing mixtures of T and CRL suggested that B cells are induced to incorporate [³H]TdR or [³H]DbcAMP in the presence of antigen and T-cell product(s). KLH-induced incorporation of [³H]TdR into KLH-primed LNC was inhibited by cholera enterotoxin (CT) and DbcAMP as previously reported. However, CT or DbcAMP inhibited this incorporation into T LNC to a greater extent than into CRL or unfractionated LNC.     

Ozone effects on plants in natural ecosystems

Tropospheric ozone (O₃) is an important stressor in natural ecosystems, with well‐documented impacts on soils, biota and ecological processes. The effects of O₃ on individual plants and processes scale up through the ecosystem through effects on carbon, nutrient and hydrologic dynamics. Ozone effects on individual species and their associated microflora and fauna cascade through the ecosystem to the landscape level. Systematic injury surveys demonstrate that foliar injury occurs on sensitive species throughout the globe. However, deleterious impacts on plant carbon, water and nutrient balance can also occur without visible injury. Because sensitivity to O₃ may follow coarse physiognomic plant classes (in general, herbaceous crops are more sensitive than deciduous woody plants, grasses and conifers), the task still remains to use stomatal O₃ uptake to assess class and species’ sensitivity. Investigations of the radial growth of mature trees, in combination with data from many controlled studies with seedlings, suggest that ambient O₃ reduces growth of mature trees in some locations. Models based on tree physiology and forest stand dynamics suggest that modest effects of O₃ on growth may accumulate over time, other stresses (prolonged drought, excess nitrogen deposition) may exacerbate the direct effects of O₃ on tree growth, and competitive interactions among species may be altered. Ozone exposure over decades may be altering the species composition of forests currently, and as fossil fuel combustion products generate more O₃ than deteriorates in the atmosphere, into the future as well.     

An analytical study of the factors that influence COVID-19 spread

The outbreak of the coronavirus disease 2019 (COVID-19) continues to constitute an international public health emergency. Seasonality is a long-recognized attribute of many viral infections of humans. Nevertheless, the relationship between environmental factors and the spread of infection, particularly for person-to-person communicable diseases, remains poorly understood. This study explores the relationship between environmental factors and the incidence of COVID-19 in 188 countries with reported COVID-19 cases as of April 13, 2020. Here we show that COVID-19 growth rates peaked in temperate zones in the Northern Hemisphere during the outbreak period, while they were lower in tropical zones. The relationships between COVID-19 and environmental factors were resistant to the potentially confounding effects of air pollution, sea level, and population. To prove the effect of those factors, study, and analysis of the prevalence of COVID-19 in Italy, Spain, and China was undertaken. A fuzzy logic system was designed to predict the effects of that variables on the rate of viral spread of COVID-19.     

实验诊断学PBL教学案例的设计原则

由临床检验专业人员承担的《实验诊断学》教学应以临床检验学为教学重点,案例的教学目标及学习重点应围绕临床检验基本原理,检验结果质量保证和检验结果影响因素三方面进行。案例选择应遵循以下原则：①选择质量保证的过程中容易出现问题的环节;②选择物质代谢过程清楚,相关疾病的病理生理改变明确的检验项目,如血糖;③选择在,临床检验中应用较多的方法,比如酶的连续监测法。     

Modeling the impact of early therapy for latent tuberculosis patients and its optimal control analysis

Effective tuberculosis (TB) control depends on case findings to discover infectious cases, investigation of contacts of those with TB, as well as appropriate treatment. Adherence and successful completion of the treatment are equally important. Unfortunately, due to a number of personal, psychosocial, economic, medical, and health service factors, a significant number of TB patients become irregular and default from treatment. In this paper, a mathematical model is developed to assess the impact of early therapy for latent TB and non-adherence on controlling TB transmission dynamics. Equilibrium states of the model are determined and their local stability is examined. With the aid of the center manifold theory, it is established that the model undergoes a backward bifurcation. Qualitative mathematical analysis of the model suggests that a high level of latent tuberculosis case findings, coupled with a decrease of defaulting rate, may be effective in controlling TB transmission dynamics in the community. Population-level effects of organized campaigns to improve early therapy and to guarantee successful completion of each treatment are evaluated through numerical simulations and presented in support of the analytical results.     

案例教学法在护理本科专业组织学与胚胎学教学中的实施与体会

组织学与胚胎学为护理本科专业学生必修课.在教学过程中采取＂学生为主体、教师为主导＂的案例教学法,激发学生的主观能动性,注重学生创新能力培养.在案例教学过程中,也发现一些问题：学生素质不一、学习目标不明确以及教师教育理念滞后等.因此,在护理本科专业组织学与胚胎学实施案例教学过程中,引导学生确立学习目标,积极思考,注重团队合作,全面调动学生学习的积极性和主动性.教师在更新教学观念的同时,提倡奉献精神,注重自身素质的培养和提高.     

Shift work,circadian gene variants and risk of breast cancer

Circadian (clock) genes have been linked with several functions relevant to cancer, and epidemiologic research has suggested relationships with breast cancer risk for variants in NPAS2, CLOCK, CRY2 and TIMELESS. Increased breast cancer risk has also been observed among shift workers, suggesting potential interactions in relationships of circadian genes with breast cancer. Relationships with breast cancer of 100 SNPs in 14 clock-related genes, as well as potential interactions with shift work history, were investigated in a case–control study (1042 cases, 1051 controls). Odds ratios in an additive genetic model for European-ancestry participants (645 cases, 806 controls) were calculated, using a two-step correction for multiple testing: within each gene through permutation testing (10,000 permutations), and correcting for the false discovery rate across genes. Interactions of genotypes with ethnicity and shift work (<2 years vs ≥2 years) were evaluated individually. Following permutation analysis, two SNPs (rs3816360 in ARNTL and rs11113179 in CRY1) displayed significant associations with breast cancer and one SNP (rs3027188 in PER1) was marginally significant; however, none were significant following adjustment for the false discovery rate. No significant interaction with shift work history was detected. If shift work causes circadian disruption, this was not reflected in associations between clock gene variants and breast cancer risk in this study. Larger studies are needed to assess interactions with longer durations (>30 years) of shift work that have been associated with breast cancer.