BACKGROUND & AIMS: :Our environment contains regularities distributed in space and time that can be detected by way of statistical learning. This unsupervised learning occurs without intent or awareness, but little is known about how it relates to other types of learning, how it affects perceptual processing, and how quickly it can occur. Here we use fMRI during statistical learning to explore these questions. Participants viewed statistically structured versus unstructured sequences of shapes while performing a task unrelated to the structure. Robust neural responses to statistical structure were observed, and these responses were notable in four ways: First, responses to structure were observed in the striatum and medial temporal lobe, suggesting that statistical learning may be related to other forms of associative learning and relational memory. Second, statistical regularities yielded greater activation in category-specific visual regions (object-selective lateral occipital cortex and word-selective ventral occipito-temporal cortex), demonstrating that these regions are sensitive to information distributed in time. Third, evidence of learning emerged early during familiarization, showing that statistical learning can operate very quickly and with little exposure. Finally, neural signatures of learning were dissociable from subsequent explicit familiarity, suggesting that learning can occur in the absence of awareness. Overall, our findings help elucidate the underlying nature of statistical learning.

背景与目标： : 我们的环境包含在空间和时间上分布的规律性，可以通过统计学习来检测。这种无监督的学习是在没有意图或意识的情况下发生的，但是对于它与其他类型的学习如何相关，它如何影响感知处理以及它发生的速度知之甚少。在这里，我们在统计学习期间使用功能磁共振成像来探索这些问题。参与者在执行与结构无关的任务时，查看了统计上结构化的形状序列和非结构化的形状序列。观察到对统计结构的强大神经反应，并且这些反应在四个方面是显着的: 首先，在纹状体和内侧颞叶中观察到对结构的反应，这表明统计学习可能与其他形式的联想学习和关系记忆有关。其次，统计规律在特定类别的视觉区域 (对象选择性的外侧枕叶皮层和单词选择性的腹枕叶颞叶皮层) 中产生了更大的激活，表明这些区域对时间分布的信息敏感。第三，学习的证据在熟悉过程中很早就出现了，这表明统计学习可以非常快地进行并且几乎没有接触。最后，学习的神经特征与随后的明确熟悉程度是分离的，这表明学习可以在没有意识的情况下进行。总的来说，我们的发现有助于阐明统计学习的基本性质。

BACKGROUND & AIMS: OBJECTIVES:The aim of this study was to establish a national Early Awareness and Alert (EAA) system for the identification and assessment of new and emerging health technologies in Italy. METHODS:In 2008, Agenas, a public body supporting Regions and the Ministry of Health (MoH) in health services research, started a project named COTE (Observatory of New and Emerging Health Technologies) with the ultimate aim of implementing a national EAA system. The COTE project involved all stakeholders (MoH, Regions, Industry, Universities, technical government bodies, and Scientific Societies), in defining the key characteristics and methods of the EAA system. Agreement with stakeholders was reached using three separate workshops. RESULTS:During the workshops, participants shared and agreed methods for identification of new and emerging health technologies, prioritization, and assessment. The structure of the Horizon Scanning (HS) reports was discussed and defined. The main channels for dissemination of outputs were identified as the EuroScan database, and the stakeholders' Web portals. During the final workshop, Agenas presented the first three HS reports produced at national level and proposed the establishment of a permanent national EAA system. CONCLUSIONS:The COTE Project created the basis for a permanent national EAA system in Italy. An infrastructure to enable the stakeholders network to grow was created, methods to submit new and emerging health technologies for possible evaluation were established, methods for assessment of the technologies selected were defined, and the stakeholders involvement was delineated (in the identification, assessment, and dissemination stages).

背景与目标：

BACKGROUND & AIMS: PURPOSE:Many studies performed in Morocco showed an important lack of knowledge about epilepsy among persons with epilepsy and their families. The misconceptions about the disease are a source of suffering for both patients and their families and increase the costs of epilepsy care. We conducted this investigation for assessing the origins of misinterpretation of the disease in the Moroccan society. OBJECTIVES:The teachers' knowledge about epilepsy in the Fez-Meknes region in Morocco and their attitudes toward a person with epilepsy constitute the two major objectives of this study. We also assessed the impact of sociocultural parameters on Moroccan teachers' knowledge and attitudes toward a person with epilepsy. MATERIAL AND METHODS:The data collection was based on the "Attitudes Toward Persons with Epilepsy" (ATPE) test. RESULTS:The study showed a positive correlation between the level of teachers' knowledge of epilepsy and their attitudes toward a person with epilepsy. The results revealed the persistence of negative attitudes toward a person with epilepsy among teachers. The level of ATPE of teachers in Morocco was lower compared to high-middle income countries. CONCLUSION:There is still poor knowledge about epilepsy among teachers in Morocco. This unawareness is negatively affecting teachers' attitudes toward a person with epilepsy. Hence, we recommend integrating epilepsy in teaching and training programs of teachers in the Moroccan educational system.

背景与目标：

BACKGROUND & AIMS: :The aim of this study was to explore the prevalence of nonmotor symptoms in Parkinson's disease (PD) and the patients' and family members' awareness of these symptoms. We evaluated 74 parkinsonian patients and 54 family members. Seventy-three patients had more than one symptom (12.4+/-5.5 out of 30 symptoms on average). Nocturia was the most common in men and feeling sad in women. The average number of symptoms which patients knew to be related to PD was 5.2+/-6.8 and to family members 7.7+/-6.5. Twenty-eight patients and five family members were unaware of the relationship between any of these symptoms and PD. For PD to be properly managed, nonmotor symptoms should be comprehensively assessed and patients and families informed that these are associated with PD.

背景与目标： : 这项研究的目的是探讨帕金森氏病 (PD) 中非运动症状的患病率以及患者和家人对这些症状的认识。我们评估了74名帕金森病患者和54名家庭成员。73名患者有一个以上的症状 (平均30个症状中有12.4 +/-5.5个)。夜尿症在男性中最常见，在女性中感到悲伤。患者知道与PD相关的症状的平均数量为5.2 +/-6.8，家庭成员7.7 +/-6.5。28名患者和5名家庭成员不知道这些症状与PD之间的关系。为了正确管理PD，应全面评估非运动症状，并告知患者和家属这些症状与PD有关。

BACKGROUND & AIMS: CONTEXT:  Research on non-time-loss (NTL) injuries, which result in less than 24 hours of restriction from participation, is limited. OBJECTIVE:  To describe the epidemiology of NTL injuries among collegiate and high school student-athletes. DESIGN:  Descriptive epidemiology study. SETTING:  Aggregate injury and exposure data collected from a convenience sample of National College Athletic Association varsity teams and 147 high schools in 26 states. PATIENTS OR OTHER PARTICIPANTS:  Collegiate and high school student-athletes participating in men's and boys' baseball, basketball, football, lacrosse, soccer, and wrestling and women's and girls' basketball, field hockey, lacrosse, soccer, softball, and volleyball during the 2009-2010 through 2013-2014 and the 2011-2012 through 2013-2014 academic years, respectively, participated. Collegiate student-athletes participating in men's and women's ice hockey were also included. MAIN OUTCOME MEASURE(S):  Injury data from the National Collegiate Athletic Association Injury Surveillance Program and the National Athletic Treatment, Injury and Outcomes Network were analyzed. Injury counts, rates per 1000 athlete-exposures (AEs), and rate ratios were reported with 95% confidence intervals (CIs). RESULTS:  A total of 11 899 and 30 122 NTL injuries were reported in collegiate and high school student-athletes, respectively. The proportion of NTL injuries in high school student-athletes (80.3%) was 1.61 times greater than that of collegiate student-athletes (49.9%; 95% CI = 1.59, 1.63). The NTL injury rate in high school student-athletes (8.75/1000 athlete-exposures [AEs]) was 2.18 times greater than that of collegiate student-athletes (4.02/1000 AEs; 95% CI = 2.13, 2.22). Men's ice hockey (5.27/1000 AEs) and boys' football (11.94/1000 AEs) had the highest NTL injury rates among collegiate and high school athletes, respectively. Commonly injured body parts in collegiate and high school student-athletes were the hip/thigh/upper leg (17.5%) and hand/wrist (18.2%), respectively. At both levels, contusions, sprains, and strains were the most frequent diagnoses. Contact with another player was the most cited injury mechanism (college = 38.0%, high school = 46.3%). CONCLUSIONS:  Non-time-loss injuries compose large proportions of collegiate and high school sports injuries. However, the NTL injury rate was higher in high school than in collegiate student-athletes. Tracking NTL injuries will help to better describe the breadth of injuries sustained by athletes and managed by athletic trainers.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Public awareness campaigns about depression and suicide have been viewed as highly effective strategies in preventing suicide, yet their effectiveness has not been established in previous studies. This study evaluates the effectiveness of a public-awareness campaign by comparing suicide counts before and after a city-wide campaign in Nagoya, Japan, where the city government distributed promotional materials that were aimed to stimulate public awareness of depression and promote care-seeking behavior during the period of 2010-2012. METHODS:In each of the sixteen wards of the city of Nagoya, we count the number of times that the promotional materials were distributed per month and then examine the association between the suicide counts and the frequency of distributions in the months following such distributions. We run a Poisson regression model that controls for the effects of ward-specific observed and unobserved heterogeneities and temporal shocks. FINDINGS:Our analysis indicates that more frequent distribution of the campaign material is associated with a decrease in the number of suicides in the subsequent months. The campaign was estimated to have been especially effective for the male residents of the city. LIMITATION:The underlying mechanism of how the campaign reduced suicides remains to be unclear. CONCLUSION:Public awareness campaigns can be an effective strategy in preventing suicide.

背景与目标：

BACKGROUND & AIMS: :We sought to determine prescribing patterns and awareness of adverse drug reactions to infliximab among gastroenterologists. A questionnaire was developed and mailed to all gastroenterologists in Maryland and Washington, D.C. Ninety-six of 336 (28.6%) gastroenterologists responded; 86% of respondents use infliximab often or sometimes and 48% infuse infliximab on-site. Only 48% of respondents use immunomodulators prior to infusing infliximab. Thirty-three percent of respondents do not prescribe maintenance infliximab. Respondents reported that infusion reactions occur in 12.9% of infliximab infusions. Most respondents order a purified protein derivative prior to starting infliximab. Respondents underestimated the risk of serious infection, death, demyelinating diseases, and malignancy and overestimated the risk of congestive heart failure. We conclude that a substantial number of gastroenterologists underutilize immunomodulators and fail to prescribe maintenance infliximab. Further, respondents were unaware of the frequency of major adverse events associated with infliximab. Education regarding treatment algorithms in CD and infliximab-related side effects is needed.

背景与目标： : 我们试图确定胃肠病医生对英夫利昔单抗的处方模式和药物不良反应的认识。编制了一份调查表，并邮寄给马里兰州和华盛顿特区的所有胃肠病学家。336名 (28.6% 名) 胃肠病学家中有96名回答; 86% 的受访者经常或有时使用英夫利昔单抗，48% 现场注射英夫利昔单抗。只有48% 的受访者在输注英夫利昔单抗之前使用免疫调节剂。33% 的受访者没有开英夫利昔单抗的处方。受访者报告说，输注反应发生在英夫利昔单抗输注的12.9%。大多数受访者在开始英夫利昔单抗之前订购了纯化的蛋白质衍生物。受访者低估了严重感染，死亡，脱髓鞘疾病和恶性肿瘤的风险，并高估了充血性心力衰竭的风险。我们得出的结论是，许多胃肠病学家未充分利用免疫调节剂，并且未能开出维持英夫利昔单抗的处方。此外，受访者不知道与英夫利昔单抗相关的主要不良事件的发生频率。需要对CD和英夫利昔单抗相关副作用的治疗算法进行教育。

BACKGROUND & AIMS: OBJECTIVES:The aim of the present study was to examine the factor structure, model-based reliability, measurement invariance and concurrent validity of the five-item version of the Mindfulness Attention Awareness Scale (MAAS) in Norwegian adolescents. METHODS:An initial pilot study was carried out using a sample of 77 fifteen year olds. For the main analyses, a sample of 2140 Norwegian adolescents was used who participated in the cross-sectional Health Behaviour in School-Aged Children (HBSC) study. All participants were asked to complete a questionnaire. RESULTS:Confirmatory factor analyses found support for the one-factor structure of the five-item version of the MAAS. Acceptable model fit was found in both the pilot sample (χ2=6.48, df=5, p=0.26; root mean square error of approximation [RMSEA]=0.06; comparative fit index [CFI]=0.99; standardised root mean square residual [SRMR]=0.03) and the HBSC sample (χ2=27.1, df=4, p<0.001; RMSEA=0.05; CFI=0.99; SRMR=0.01). The model-based reliability of the scale was good (ω=0.84 and ω=0.81, respectively). Scalar measurement invariance was established for sex, age and material affluence. Finally, the five-item MAAS displayed concurrent validity through moderate negative associations with health complaints ( r=-0.44; p<0.001) and school stress ( b=-0.44, p<0.001), and a positive moderate correlation with life satisfaction ( r=0.26; p<0.001). CONCLUSIONS:The five-item version of the MAAS is an adequate measure of mindfulness in Norwegian adolescents. Due to the brief nature of the scale, it can easily be included in epidemiological and clinical studies with an interest for trait mindfulness. The five-item MAAS may therefore have great potential to facilitate more knowledge about the role of mindfulness in adolescent health.

背景与目标：

BACKGROUND & AIMS: :George Otto Gey was a pioneer in tissue culture, having introduced the roller drum, the HeLa cell line, and the use of human fetal cord serum and beef embryo extract. During his career (1920s-1960s), the field of tissue culture was in its infancy and not yet dependent upon commercial biological supply houses. While the early techniques of cell culture have been greatly improved upon, of historical interest may be personal observations of the Gey Tissue Culture Laboratory, Johns Hopkins Medical School, as recalled by a medical student working there in the 1950s. Dr. Gey served as a founding member and executive of the Tissue Culture Commission (TCC) and became the first president of the Tissue Culture Association (TCA).

背景与目标： : 乔治·奥托·盖伊 (George Otto Gey) 是组织培养的先驱，他介绍了滚筒，HeLa细胞系以及人类胎儿脐带血清和牛肉胚胎提取物的使用。在他的职业生涯 (1920年代至1960年代) 中，组织培养领域尚处于起步阶段，尚未依赖商业生物供应所。尽管细胞培养的早期技术已经得到了极大的改进，但历史上的兴趣可能是对约翰·霍普金斯医学院Gey组织培养实验室的个人观察，正如在20世纪50年代工作的一名医学生所回忆的那样。Gey博士曾担任组织培养委员会 (TCC) 的创始成员和执行人员，并成为组织培养协会 (TCA) 的第一任主席。

BACKGROUND & AIMS: BACKGROUND:Early diagnosis of food allergies (FA) is important for a favorable prognosis. This study aimed to determine the level of awareness of FA among pediatricians in Kuwait. METHOD:A 43-item self-administered questionnaire was designed and distributed to pediatricians working at 4 government hospitals in Kuwait. RESULTS:A total of 140 pediatricians completed the questionnaire, with a participation rate of 51.1% (81 males and 59 females). The mean age of participants was 40.81 years, and the mean number of years working in pediatrics was 13.94 years. The mean overall knowledge score was 22.2. The pediatricians' overall knowledge scores were found to be significantly associated with their age (older pediatricians had higher overall scores) and years of experience as a pediatrician but were independent from hospital site, gender, or rank. A multiple linear regression revealed pediatrician age and gender were the only variables that were significantly associated with the overall knowledge score. Only 16.4% of the participants answered at least 2/3 of the survey questions correctly. The questions that were correctly answered by ≤ 2/3 of the participants constituted 80% of clinical presentation questions, 66.6% of diagnostics questions, 77.7% of treatment questions, and 42.8% of prevention questions. Interestingly, among 68 pediatricians (48.5%) who determined that they felt comfortable evaluating and treating patients with FA, only 12 (17.6%) passed the questionnaire. CONCLUSIONS:This survey demonstrates that there is a noteworthy deficiency of pediatricians' awareness about FA. The implementation of strategies to improve pediatricians' awareness is critical to diagnose food allergy patients early and improve their health and outcomes.

背景与目标：

BACKGROUND & AIMS: CONTEXT:A new law enabling curriculum reform led a small circle of interested faculty members at the University of Vienna medical school to launch the Medizin Curriculum Wien project (MCW) to plan a new curriculum under the supervision of the Committee on Educational Affairs (Studienkommission). OBJECTIVE:The first stage of the project dealt with the definition of a profile of competencies (Qualifikationsprofil), which describes all the competencies we want our students to possess upon graduation. METHOD:This paper presents the approach to and process of defining this profile at one of Europe's largest medical schools, currently enrolling over 1500 new students per year. The procedure involved: preparing materials; communication with stakeholders; information dissemination; feedback gathering; information structuring, and formulating the profile of competencies. RESULTS:Application of the outlined steps in two rounds proved successful for the development of a profile of student competencies for Vienna. General acceptance and awareness of the new profile as well as commitment for a further reform process was engendered. The distinct characteristics of the profile are discussed. CONCLUSION AND UTILIZATION: A profile of student competencies must balance the demanding objectives of curriculum planners and the actual challenges presented by many local parameters; this can be done by employing the process outlined in this paper. The defined profile serves as an accepted reference point in the further development of the medical curriculum.

背景与目标：

BACKGROUND & AIMS: :In South Asia, the student-teacher relationship is hierarchical and authoritarian. I and my colleagues spend time and energy teaching students to think, to question and to critically evaluate statements and assumptions. Bishnu Giri was an enthusiastic student willing to think out of the box. Bishnu has been involved in drug utilization studies, investigating factors influencing drug use and in promoting rational use of drugs. He has published a number of articles and has been encouraging other students to participate in research.

背景与目标： : 在南亚，学生-教师关系是等级和专制的。我和我的同事花时间和精力教学生思考，质疑和批判性地评估陈述和假设。比什努·吉里 (Bishnu Giri) 是一个热情的学生，愿意跳出框框思考。Bishnu参与了药物利用研究，调查影响药物使用的因素以及促进合理使用药物。他发表了许多文章，并一直鼓励其他学生参与研究。

BACKGROUND & AIMS: :Concern exists that the transition from student to doctor is abrupt and stressful, and that new graduates lack both clinical skills and confidence. This paper explores the effect of a preparation programme on the confidence and skills of new graduates commencing their first clinical post. Fifty-three participants in two English hospitals undertook a two-week induction combining life support, emergency and clinical skills training with administrative induction and shadowing the outgoing house officer. Questionnaires and focus groups at the beginning, end, and one month following the programme explored participants' perceptions. Respondents were initially anxious about starting work, concerned mainly about clinical skills; taking responsibility; being alone; non-technical skills; and local geography and procedures. Confidence increased following the programme, and the programme's contents directly mitigated some fears. Shadowing was most highly valued, though experiences varied; acute emergency training was also valued, but clinical skills revision was more variably received. Having commenced work, these perceptions remained. Confidence increased further, but clinical practice still represented a steep learning curve. This programme to support the transition from medical student to practising doctor was useful and effective, but could be improved. Increasing responsibility during shadowing could effect an even smoother transition.

背景与目标： : 人们担心从学生到医生的过渡是突然而紧张的，新毕业生缺乏临床技能和信心。本文探讨了准备计划对新毕业生开始其第一个临床职位的信心和技能的影响。两家英国医院的53名参与者进行了为期两周的入职培训，结合了生命支持，急诊和临床技能培训以及行政入职培训，并为即将离任的房屋官员提供了阴影。在计划开始，结束和之后的一个月进行问卷调查和焦点小组探讨了参与者的看法。受访者最初对开始工作感到焦虑，主要关注临床技能; 承担责任; 独自一人; 非技术技能; 以及当地的地理和程序。该计划之后的信心增强，该计划的内容直接减轻了一些担忧。尽管经历各不相同，但阴影最受重视; 急性急诊培训也受到重视，但临床技能的修订却更加多样化。在开始工作后，这些看法仍然存在。信心进一步提高，但临床实践仍然代表着陡峭的学习曲线。该计划支持从医学生到执业医生的过渡是有用且有效的，但可以改进。阴影过程中责任的增加可能会导致更平稳的过渡。

BACKGROUND & AIMS: :There are several independent sets of findings concerning the neural basis of reading. One set demonstrates a powerful relationship between phonological processing and reading skills. Another set reveals a relationship between visual responses in the motion pathways and reading skills. It is widely assumed that these two findings are unrelated. We tested the hypothesis that phonological awareness is related to motion responsivity in children's MT+. We measured BOLD signals to drifting gratings as a function of contrast. Subjects were 35 children ages 7-12 years with a wide range of reading skills. Contrast responsivity in MT+, but not V1, was correlated with phonological awareness and to a lesser extent with two other measures of reading. No correlation was found between MT+ signals and rapid naming, age or general IQ measures. These results establish an important link between visual and phonological processing in children and suggest that MT+ responsivity is a marker for healthy reading development.

背景与目标： : 关于阅读的神经基础，有几组独立的发现。一套证明了语音处理和阅读技能之间的强大关系。另一组揭示了运动路径中的视觉反应与阅读技能之间的关系。人们普遍认为这两个发现是不相关的。我们检验了以下假设: 语音意识与儿童MT的运动响应有关。我们测量了漂移光栅的BOLD信号作为对比度的函数。对象为35名7-12岁的儿童，具有广泛的阅读技能。MT中的对比度响应度 (而非V1) 与语音意识相关，在较小程度上与其他两种阅读量度相关。在MT信号与快速命名，年龄或一般智商测量之间未发现相关性。这些结果在儿童的视觉和语音处理之间建立了重要的联系，并表明MT响应度是健康阅读发展的标志。

BACKGROUND & AIMS: Healthy 19-year old males from the 95th percentile of mean arterial screening blood pressure were randomized to prolonged mental stress by receiving a letter informing of a high screening blood pressure (n = 13), or a neutral letter (n = 13). Blood platelet function in vivo was assessed by measurements of plasma concentrations of the platelet-specific protein beta-thromboglobulin, platelet counts, and mean platelet volumes before and during two laboratory stress tests (hand cold pressor test and arithmetic challenge). The cold pressor test caused a significant increase in beta-thromboglobulin concentrations in both groups, and significantly more in the uniformed group. Platelet count increased significantly in both groups during mental arithmetic with significantly higher counts in the uninformed group. Overall plasma beta-thromboglobulin responses were significantly larger in the uninformed group. This study demonstrates that laboratory stress is associated with blood platelet activation and that awareness of high blood pressure attenuates the platelet responses to such stress tests.

背景与目标： 来自平均动脉筛查血压第95个百分位数的健康19岁男性通过收到通知高筛查血压的信件 (n = 13) 或中性字母 (n = 13)，将其随机分配给长期的精神压力。在两次实验室压力测试 (手冷加压测试和算术挑战) 之前和期间，通过测量血小板特异性蛋白 β-血小板球蛋白的血浆浓度，血小板计数和平均血小板体积来评估体内血小板功能。冷加压试验在两组中均引起 β-血小板球蛋白浓度的显着增加，而在统一组中则明显增加。在心理算术期间，两组的血小板计数均显着增加，而在不了解情况的组中，血小板计数显着增加。在不了解情况的组中，总体血浆 β-血小板球蛋白反应明显更大。这项研究表明，实验室压力与血小板活化有关，并且对高血压的认识减弱了血小板对此类压力测试的反应。