BACKGROUND & AIMS: :A novel mechatronic body weight support (BWS) system has been developed to provide precise body weight unloading for patients with neurological or other impairments during treadmill training. The system is composed of a passive elastic spring element to take over the main unloading force and an active closed-loop controlled electric drive to generate the exact desired force. Both force generating units, the passive spring and the active electric drive, act on the patient via a polyester rope connected to a harness worn by the patient. The length of the rope can be adjusted with an electric winch to adapt the system to different patient sizes. The system is fully computer controlled. At unloading loads of up to 60 kg and walking speeds of up to 3.2 km/h, the mean unloading error and the maximum unloading error of the presented BWS system was less than 1 and 3 kg, respectively. The performance was compared with those of two purely passive BWS systems currently being used by most other rehabilitation groups. This comprised counterweight systems and static BWS systems with fixed rope lengths. Counterweight systems reached mean and maximum unloading errors of up to 5.34 and 16.22 kg, respectively. The values for the static BWS were 11.02 kg and 27.67 kg, respectively. The novel mechatronic BWS system presented in this study adjusts desired unloading changes of up to 20 kg within less than 100 ms. Thus, not only constant BWS, but also gait cycle dependent or time variant oscillations of the desired force can be realized with high accuracy. Precise and constant unloading force is believed to be an important prerequisite for BWS gait therapy, where it is important to generate physiologically correct segmental dynamics and ground reaction forces. Thus, the novel BWS system presented in this paper is an important contribution to maximize the therapeutic outcome of human gait rehabilitation.

背景与目标： ：已开发出新型机电一体化体重支持（BWS）系统，以在跑步机训练期间为患有神经系统疾病或其他障碍的患者提供精确的体重减轻。该系统由一个被动的弹性弹簧元件（承担主要的卸载力）和一个主动的闭环控制电驱动装置组成，以产生确切的所需力。被动发条和主动电驱动两个力产生单元均通过连接到患者佩戴的安全带上的聚酯绳作用在患者身上。绳索的长度可以用电动绞盘调节，以使系统适应不同的患者体型。该系统完全由计算机控制。在最高60 kg的卸载负荷和最高3.2 km / h的步行速度下，所提出的BWS系统的平均卸载误差和最大卸载误差分别小于1 kg和3 kg。将该性能与大多数其他康复团体目前使用的两个纯被动BWS系统的性能进行了比较。这包括配重系统和具有固定绳索长度的静态BWS系统。配重系统的平均和最大卸载误差分别高达5.34和16.22 kg。静态BWS的值分别为11.02 kg和27.67 kg。这项研究中提出的新型机电一体化BWS系统可在不到100 ms的时间内将所需的卸荷变化调整至20 kg。因此，不仅可以实现恒定的BWS，而且还可以高精度地实现与步态周期有关的或所需力的随时间变化的振荡。精确和恒定的卸载力被认为是BWS步态治疗的重要前提，在步态治疗中，产生生理上正确的节段动力学和地面反作用力很重要。因此，本文提出的新型BWS系统是最大程度地提高步态康复治疗效果的重要贡献。

BACKGROUND & AIMS: :In a patient with temporomandibular disorder who does not respond to conservative treatment, treatment with intra-articular injection of high molecular weight sodium hyaluronate can be suggested. In our study, 27 patients with nonreduced disc displacement were diagnosed clinically and confirmed by magnetic resonance imaging. The age range was from 21 to 63 years old, with a mean of 39.3 years. Two cycles of injection of high molecular weight sodium hyaluronate was performed on alternative weeks. Pain intensity was measured by the visual analog scale. Maximal mouth opening, clicking joint noise, and lateral movement were measured before and after injection for more than 6 months. Reduction of pain intensity and improvement in the maximum mouth opening parameter was statistically significant. In conclusion, this intra-articular injection using high molecular weight sodium hyaluronate looks very positive for patients affected by nonreduced disc displacement and is encouraged to be used as a primary treatment of temporomandibular joint dysfunction.

背景与目标： ：对于颞下颌关节疾病，对保守治疗无反应的患者，建议采用关节内注射高分子量透明质酸钠进行治疗。在我们的研究中，临床上诊断出27例椎间盘移位未减少的患者，并通过磁共振成像对其进行了确认。年龄范围是21至63岁，平均39.3岁。每隔几个星期进行两次高分子量透明质酸钠注射。通过视觉模拟量表测量疼痛强度。在注射前后超过6个月，测量了最大张口，咔嗒声和侧向运动。疼痛强度的降低和最大张口参数的改善在统计学上是显着的。总之，这种高分子量透明质酸钠的关节腔内注射对于未减少椎间盘移位的患者看起来非常积极，因此被鼓励用作颞下颌关节功能障碍的主要治疗方法。

BACKGROUND & AIMS: OBJECTIVE:The aim was to investigate birth characteristics, obstetric and neonatal outcomes of the first childbirth in women with Marfan syndrome by use of Swedish national registers since pregnancy-related outcomes in women with Marfan syndrome have only been sparsely investigated. STUDY DESIGN:In this national population-based cohort study and matched case-control study of Swedish women born 1973-1993, women with Marfan syndrome (n=273) were compared to women without the condition (n=1 017 265). The study population was followed until 2013. A total of 364 553 mother-firstborn-offspring pairs were analyzed. Sixty-one women with Marfan syndrome became mothers. Women with Marfan syndrome were also compared to 543 healthy controls. RESULTS:Women with Marfan syndrome were more often born preterm (p<0.001), small-for-gestational age (p<0.001), and delivered by cesarean section (p=0.001). Women with Marfan syndrome had no increased risk of giving birth by cesarean section (p=0.079). No increased neonatal risks in their children were found. Women with Marfan syndrome were less likely to give birth than those without (p<0.001). There were no maternal deaths. CONCLUSIONS:Women with Marfan syndrome were more likely to be born preterm, SGA and by cesarean section. These increased risks of preterm birth and SGA babies were not found in connection with their own first childbirth. Pregnancies with known fetal Marfan syndrome have to be carefully monitored. The results are important for obstetricians giving preconception counseling and treating women with Marfan syndrome. Further studies are needed to evaluate risks during pregnancy and long-term effects of pregnancy on the cardiovascular status of women with Marfan syndrome.

背景与目标： 目的：由于仅对马凡氏综合征妇女的妊娠相关结局进行了稀疏调查，因此目的是通过瑞典国家登记簿调查马凡氏综合征妇女的首次生育的​​出生特征，产科和新生儿结局。
研究设计：在这项基于全国人群的队列研究和匹配的病例对照研究中，对1973年至1993年出生的瑞典妇女进行了比较，将患有马凡氏综合症（n = 273）的妇女与未患此病的妇女（n = 1 017 265）进行了比较。研究人群一直追踪到2013年。共分析了364 553对母亲-第一胎-后代。六十一名患有马凡氏综合症的妇女成为母亲。还比较了患有马凡氏综合症的女性和543名健康对照者。
结果：马凡氏综合征的妇女更早产（p <0.001），小胎龄（p <0.001），并通过剖宫产分娩（p = 0.001）。患有马凡氏综合症的妇女通过剖宫产术分娩的风险没有增加（p = 0.079）。没有发现孩子的新生儿患病风险增加。患有马凡氏综合症的妇女比没有马芬综合症的妇女分娩的可能性更低（p <0.001）。没有孕产妇死亡。
结论：马凡氏综合征的女性更可能早产，SGA和剖宫产。未发现早产和SGA婴儿的这些增加的风险与他们的初生有关。患有已知胎儿马凡氏综合征的孕妇必须进行仔细监测。这些结果对于产科医生进行孕前咨询和治疗患有马凡氏综合症的妇女非常重要。需要进一步的研究来评估妊娠期间的风险以及妊娠对马凡氏综合症女性心血管状况的长期影响。

BACKGROUND & AIMS: BACKGROUND:Inconsistent evidence of a higher risk of adverse perinatal outcomes during off-hours compared to office hours necessitated a search for clear evidence of an association between time of birth and adverse perinatal outcomes. METHODS:A cross-sectional study conducted at a tertiary referral hospital compared perinatal outcomes across three working shifts over 24 h. A checklist and a questionnaire were used to record parturients' socio-demographic and obstetric characteristics, mode of delivery and perinatal outcomes, including 5th minute Apgar score, and early neonatal mortality. Risks of adverse outcomes included maternal age, parity, referral status and mode of delivery, and were assessed for their association with time of delivery and prevalence of fresh stillbirth as a proxy for poor perinatal outcome at a significance level of p = 0.05. RESULTS:Off-hour deliveries were nearly twice as likely to occur during the night shift (odds ratio (OR), 1.62; 95% confidence interval (CI), 1.50-1.72), but were unlikely during the evening shift (OR, 0.58; 95% CI, 0.45-0.71) (all p < 0.001). Neonatal distress (O.R, 1.48, 95% CI; 1.07-2.04, p = 0.02), early neonatal deaths (OR, 1.70; 95% CI, 1.07-2.72, p = 0.03) and fresh stillbirths (OR, 1.95; 95% CI, 1.31-2.90, p = 0.001) were more significantly associated with deliveries occurring during night shifts compared to evening and morning shifts. However, fresh stillbirths occurring during the night shift were independently associated with antenatal admission from clinics or wards, referral from another hospital, and abnormal breech delivery (OR 1.9; 95% CI, 1.3-2.9, p = 0.001, for fresh stillbirths; OR, 5.0; 95% CI 1.7-8.3, p < 0.001, for antenatal admission; OR, 95% CI, 1.1-2.9, p < 0.001, for referral form another hospital; and OR 1.6; 95% CI 1.02-2.6, p = 0.004, for abnormal breech deliveries). CONCLUSION:Off-hours deliveries, particularly during the night shift, were significantly associated with higher proportions of adverse perinatal outcomes, including low Apgar score, early neonatal death and fresh stillbirth, compared to morning and evening shifts. Labour room admissions from antenatal wards, referrals from another hospital and abnormal breech delivery were independent risk factors for poor perinatal outcome, particularly fresh stillbirths.

背景与目标： 背景：与办公时间相比，非工作时间不利于围产期结局的风险的证据不一致，因此有必要寻找明确的证据来证明出生时间与不良围产期结局之间的关联。
方法：在一家三级转诊医院进行的横断面研究比较了24小时内三个工作班次的围产期结局。使用检查表和调查表记录产妇的社会人口统计学和产科特征，分娩方式和围产期结局，包括第5分钟的Apgar评分和新生儿早期死亡率。不良结局的风险包括产妇年龄，胎次，转诊状况和分娩方式，并评估了它们与分娩时间和新鲜死产的发生率之间的关联，以作为围产期预后不良的指标，其显着性水平为p = 0.05。
结果：夜班期间的下班时间交付几率几乎翻倍（几率（OR）为1.62; 95％置信区间（CI）为1.50-1.72），但在晚班期间则不太可能出现（OR为0.58） ; 95％CI，0.45-0.71）（所有p <0.001）。新生儿窘迫（OR，1.48，95％CI; 1.07-2.04，p = 0.02），早期新生儿死亡（OR，1.70; 95％CI，1.07-2.72，p = 0.03）和新鲜死产（OR，1.95; 95％ CI，1.31-2.90，p = 0.001）与夜班和早班相比，与夜班期间的分娩更显着相关。但是，夜班期间发生的新鲜死产与从诊所或病房的产前入院，从另一家医院转诊以及异常的臀位分娩独立相关（OR 1.9;新鲜死产的95％CI，1.3-2.9，p = 0.001;或者； 5.0； 95％CI 1.7-8.3，p <0.001（对于产前入院）；或95％CI，1.1-2.9，p <0.001，对于从另一家医院转诊；或OR 1.6； 95％CI 1.02-2.6，p = 0.004，用于异常臀位）。
结论：与早班和晚班相比，非工作时间的分娩，特别是在夜班期间，与较高的围产期不良后果显着相关，包括低的Apgar评分，早期的新生儿死亡和新鲜的死产。从产前病房分娩，从另一家医院转诊以及异常的臀位分娩是围产期预后不良（尤其是新鲜死产）的独立危险因素。

BACKGROUND & AIMS: Perforin is a 68 kD protein found in the granules of cytotoxic lymphocytes and is used by lymphocytes to form lethal pores in the membranes of the cells they kill. We and others have found that when perforin is purified, its lytic activity is markedly reduced. ELISAs indicated that our final recovery of perforin protein was excellent. We decided to determine if depletion of other granule proteins contributed to the loss of lytic activity. We isolated perforin to the point where lytic activity was diminished and added back granule proteins that had no lytic activity or detectable (antigenic) perforin. Perforin was isolated by Cu2+-immobilized metal affinity chromatography (IMAC) followed by phenyl-Superose hydrophobic interaction chromatography (HIC). Its lytic activity was enhanced by a low molecular weight (<15 kD) protein, perforin enhancing protein (PEPr). We have isolated PEPr by two methods, HIC and MonoQ. Nonlytic PEPr restored perforin to close to its original lytic activity. A protein similar if not identical to PEPr was also detectable as an 125I-labeled protein associated with lytic perforin. We propose that PEPr acts in conjunction with perforin to form lethal pores and suggest that PEPr may be the rat equivalent of the human cytotoxic lymphocyte protein, granulysin.

背景与目标： 穿孔素是一种68 kD蛋白，存在于细胞毒性淋巴细胞的颗粒中，被淋巴细胞用来在其杀死的细胞膜上形成致死孔。我们和其他人已经发现，当穿孔素被纯化时，其裂解活性显着降低。 ELISA法表明，我们穿孔蛋白的最终回收率极高。我们决定确定其他颗粒蛋白的消耗是否导致裂解活性降低。我们将穿孔素分离到溶解活性降低的位置，并添加没有溶解活性或可检测（抗原性）穿孔素的颗粒蛋白。通过铜固定化金属亲和色谱法（IMAC），然后进行苯基-Superose疏水相互作用色谱法（HIC）分离穿孔素。低分子量（<15 kD）蛋白，穿孔素增强蛋白（PEPr）增强了其裂解活性。我们通过两种方法HIC和MonoQ分离了PEPr。非溶解性PEPr使穿孔素恢复至接近其原始溶解活性。与PEPr相似但不相同的蛋白质也可以作为与裂解穿孔素相关的125 I标记蛋白质检测出来。我们建议PEPr与穿孔素一起形成致死性毛孔，并建议PEPr可能与人细胞毒性淋巴细胞蛋白颗粒溶素相当。

BACKGROUND & AIMS: Hormonal fluctuations associated with the menstrual cycle influence appetite control and eating behaviour. Energy intake varies during the reproductive cycle in humans and animals, with a periovulatory nadir and a luteal phase peak. Patterns of macronutrient selection show less consistency but a number of studies report carbohydrate cravings in the premenstrual phase, particularly in women with premenstrual syndrome. The cyclical nature of food cravings are frequently, but not invariably, associated with depression. Fluctuations in appetite, cravings and energy intake during the menstrual cycle may occur in parallel with cyclical rhythms in serotonin, which can be accompanied by affective symptoms. The premenstrual phase can be considered as a time when women are especially vulnerable to overconsumption, food craving and depression; this is often associated with low serotonin activity.

背景与目标： 与月经周期有关的荷尔蒙波动会影响食欲控制和饮食行为。在人类和动物的生殖周期中，能量的摄入量会有所不同，排卵期的最低点和黄体期相峰值。大量营养素选择的模式显示出较低的一致性，但是许多研究报告说在经前期对碳水化合物的渴望，特别是在经前期综合症的女性中。渴望食物的周期性通常与抑郁症有关，但并非总是如此。月经周期中食欲，食欲和能量摄入的波动可能与5-羟色胺的周期性节律同时发生，并伴有情感症状。经期可以被认为是妇女特别容易遭受过度消费，食物渴望和沮丧的时期。这通常与5-羟色胺活性低有关。

BACKGROUND & AIMS: :Postnatal developmental stages of lung parenchyma in rhesus monkeys is about one-third that of humans. Alveoli in humans are reported to be formed up to 8 yr of age. We used design-based stereological methods to estimate the number of alveoli (N(alv)) in male and female rhesus monkeys over the first 7 yr of life. Twenty-six rhesus monkeys (13 males ranging in age from 4 to 1,920 days and lung volumes from 41.7 to 602 cm(3), 13 females ranging in age from 22 to 2,675 days and lung volumes from 43.5 to 380 cm(3)) were necropsied and lungs fixed, isotropically oriented, fractionated, sampled, embedded, and sectioned for alveolar counting. Parenchymal, alveolar, alveolar duct core air, and interalveolar septal tissue volumes increased rapidly during the first 2 yr with slowed growth from 2 to 7 yr. The rate of change was greater in males than females. N(alv) also showed consistent growth throughout the study, with increases in N(alv) best predicted by increases in lung volume. However, mean alveolar volume showed little relationship with age, lung volume, or body weight but was larger in females and showed a greater size distribution than in males. Alveoli increase in number but not volume throughout postnatal development in rhesus monkeys.

背景与目标： ：恒河猴的肺实质的产后发育阶段约为人类的三分之一。据报道，人类肺泡的形成年龄高达8岁。我们使用基于设计的立体方法来估计生命的前7年中雄性和雌性恒河猴的肺泡（N（alv））数量。 26只猕猴（13只雄性，年龄从4到1,920天不等，肺活量从41.7到602 cm（3），13只雌性，年龄从22到2,675天不等，肺活量从43.5到380 cm（3））进行尸检并固定肺，各向同性，分馏，取样，包埋和切片，以进行肺泡计数。在最初的2年中，实质，肺泡，肺泡导管核心空气和肺泡间隔组织的体积迅速增加，而从2到7年的生长缓慢。男性的变化率大于女性。在整个研究过程中，N（alv）也显示出一致的增长，其中N（alv）的增加最好通过肺体积的增加来预测。但是，平均肺泡容量与年龄，肺活量或体重关系不大，但女性比男性更大，并且大小分布比男性更大。在猕猴的整个产后发育过程中，肺泡的数量增加，但体积没有增加。

BACKGROUND & AIMS: :The majority of randomized, controlled trials (RCTs) show only modest weight loss with exercise intervention alone, and slight increases in weight loss when exercise intervention is added to dietary restriction. In most RCTs, the energy deficit produced by the prescribed exercise is far smaller than that usually produced by dietary restriction. In prospective studies that prescribed high levels of exercise, enrolled individuals achieved substantially greater weight loss-comparable to that obtained after similar energy deficits were produced by caloric restriction. High levels of exercise might, however, be difficult for overweight or obese adults to achieve and sustain. RCTs examining exercise and its effect on weight-loss maintenance demonstrated mixed results; however, weight maintenance interventions were usually of limited duration and long-term adherence to exercise was problematic. Epidemiologic, cross-sectional, and prospective correlation studies suggest an essential role for physical activity in weight-loss maintenance, and post hoc analysis of prospective trials shows a clear dose-response relationship between physical activity and weight maintenance. This article reviews the role of physical activity in producing and maintaining weight loss. We focus on prospective, RCTs lasting at least 4 months; however, other prospective trials, meta-analyses and large systematic reviews are included. Limitations in the current body of literature are discussed.

背景与目标： ：大多数随机，对照试验（RCT）仅通过运动干预仅显示适度的体重减轻，而将运动干预与饮食限制相结合时，体重减轻则略有增加。在大多数随机对照试验中，通过处方运动产生的能量缺乏症远小于通常通过饮食限制产生的能量缺乏症。在规定进行高水平运动的前瞻性研究中，与通过热量限制产生类似能量不足所导致的体重减轻相比，已入组个体的体重减轻显着更大。但是，对于超重或肥胖的成年人来说，高强度的运动可能难以实现和维持。研究运动及其对减肥维持的影响的随机对照试验结果不一。然而，维持体重的干预措施通常持续时间有限，长期坚持锻炼存在问题。流行病学，横断面和前瞻性相关研究表明，体育锻炼对维持体重减轻至关重要，而对前瞻性试验的事后分析表明，体育锻炼与维持体重之间存在明显的剂量反应关系。本文回顾了体育锻炼在产生和维持体重减轻中的作用。我们专注于持续至少4个月的预期RCT；但是，还包括其他前瞻性试验，荟萃分析和大型系统评价。讨论了当前文献的局限性。

BACKGROUND & AIMS: :Relationships between eating and affective disorders remain complex and unclear. Brain glucose metabolism of anorectic patients has been demonstrated to be reduced both globally and regionally, with a particular relative hypometabolism in the parietal cortex. To explore the possible influence of weight loss or depressive symptomatology on brain metabolism, we studied age- and sex-matched low-weight anorectic and depressed patients, normal-weight depressed patients, and healthy volunteers. Absolute global and regional glucose activity levels were reduced in low-weight patients, with the lowest values being found for anorectic patients. In relative values, anorectic patients showed a significant parietal hypometabolism in comparison to control subjects while they had higher metabolism in the caudate nuclei when compared with the other groups. Absolute hypometabolism of glucose seems to be a consequence of low weight as it was found in both low-weight anorectic and low-weight depressive patients. In addition, absolute glucose values were significantly correlated with body mass index in all subjects. Future positron emission tomographic studies in psychiatric patients should control for alimentary parameters.

背景与目标： 饮食和情感障碍之间的关系仍然复杂且不清楚。厌食症患者的脑葡萄糖代谢已被证实在全球和区域范围内均会降低，顶叶皮层中存在特定的相对代谢不足。为了探索减肥或抑郁症状对脑代谢的可能影响，我们研究了年龄和性别相匹配的低体重厌食症和抑郁症患者，正常体重的抑郁症患者以及健康志愿者。低体重患者的全球和区域绝对葡萄糖活性水平降低，而厌食患者的葡萄糖水平最低。在相对价值方面，与对照组相比，厌食患者的顶叶代谢明显降低，而尾核中的新陈代谢较其他组更高。葡萄糖的绝对低代谢似乎是低体重的结果，因为它在低体重厌食症患者和低体重抑郁症患者中均被发现。另外，在所有受试者中，绝对葡萄糖值与体重指数显着相关。未来精神病患者的正电子发射断层扫描研究应控制饮食参数。

BACKGROUND & AIMS: BACKGROUND:Peripheral blood progenitor cell (PBPC) collection has become the main source of hematopoietic cells for high-dose chemotherapy with stem cell rescue and, in some protocols, for allogeneic hematopoietic transplantation. This procedure is complicated in the smallest children because of difficulties related to their weight, and there is little published experience. We have conducted a prospective study to analyze the incidence of adverse events during PBPC collection in the smallest children (< or = 10 kg). METHODS:From January 2000 to November 2005, 257 leukapheresis were performed in our unit, and 13 of them (5%) in 12 children weighing up to 10 kg (median 9 kg, range 5.8-10.9 kg). RESULTS:Most cases had hypovolemic signs during the procedure (usually tachycardia); six cases had hypotension, five of them with pallor and diaphoresis, and, of those, two also had nausea. In all these cases infusion of saline or plasma volume expanders resolved the clinical findings. In two cases the nausea related to hypocalcemia was resolved after calcium gluconate infusion. Changes in platelet counts were also remarkable, with a median platelet loss of 52%. DISCUSSION:Leukapheresis with continuous-flow cell separators has frequent complications related to volume shift in the smallest children. These adverse events are mild and easily resolved with standard measures for hypovolemia, as plasma expander or normal saline infusions. However, we recommend that the procedure should only be performed by teams with extensive experience in the field.

背景与目标： 背景：外周血祖细胞（PBPC）收集已成为大剂量化疗，干细胞抢救以及同种异体造血移植中造血细胞的主要来源。对于最小的儿童，由于与体重有关的困难，此过程很复杂，并且几乎没有公开的经验。我们进行了一项前瞻性研究，以分析最小的儿童（<或= 10 kg）在PBPC采集过程中不良事件的发生率。
方法：从2000年1月至2005年11月，我们单位进行了257例白细胞分离术，其中12例体重不超过10千克（中位数9千克，范围5.8-10.9千克）的儿童中有13例（5％）。
结果：大多数病例在手术过程中出现低血容量征（通常是心动过速）；有6例患有低血压，其中5例患有苍白和发汗，其中2例也有恶心。在所有这些情况下，输注生理盐水或血浆扩容器均可解决临床发现。在两种情况下，葡萄糖酸钙输注后可解决与低钙血症有关的恶心。血小板计数的变化也很显着，中位血小板损失为52％。
讨论：采用连续流动细胞分离器进行白细胞分离术经常导致最小的儿童发生与体积变化有关的并发症。这些不良事件是轻度的，并且可以通过标准的血容量减少措施轻松解决，例如血浆扩容剂或生理盐水输注。但是，我们建议该程序仅应由在该领域具有丰富经验的团队执行。

BACKGROUND & AIMS: :The findings presented in an accompanying paper by Menzies, Parkin, and Hey regarding the survival rates and quality of life of babies with severe spina bifida (Lancet 1985 Nov 2; 2(8462): 993-995) prompt the Working Group to reevaluate the ethical guidelines supporting selective treatment proposed in their 1975 report, "Ethics of Selective Treatment of Spina Bifida" (Lancet 1975 Jan 11; 1(7898): 85-88). Although Menzies, et al., report that survival rates are higher than previously expected and that in most cases the children's and parents' lives appear not to be excessively burdensome, the Working Group contends that there "continues to be ethical justification for selective treatment" of such newborns. Since medical, psychological, and social considerations now seem to be "more complex and less clearcut," the Group emphasizes that judgments regarding treatment should be made on a case-by-case basis.

背景与目标： ：孟席斯（Menzies），帕金（Parkin）和黑伊（Hey）随附的论文中有关严重脊柱裂的婴儿的存活率和生活质量的研究结果（《柳叶刀》 1985年11月2日; 2（8462）：993-995）促使工作组重新评估支持选择性治疗的道德准则在其1975年的报告“脊柱裂的选择性治疗伦理”中提出（柳叶刀1975年1月11日； 1（7898）：85-88）。尽管孟席斯等人报告说，存活率比以前预期的要高，而且在大多数情况下，儿童和父母的生活似乎并不过分负担，但工作组认为，“继续有道德地为选择治疗提供理由”这样的新生儿。由于现在医学，心理和社会方面的考虑似乎“更加复杂且不那么明确”，专家组强调有关治疗的判断应视具体情况而定。

BACKGROUND & AIMS: :The goal of the study was to elucidate the relationship between serum circulating brain-derived neurotrophic factor (BDNF) and body weight reduction via lifestyle modification and behavior therapy in obese non-diabetic patients with chronic schizophrenia. Thirty-three obese non-diabetic subjects with schizophrenia treated with stable antipsychotic medication in a day-care unit for at least 3 months were recruited. Thirty age-, body weight-matched subjects without psychiatric disorders were enrolled as controls. All participants underwent a 10-week weight reduction program, including lifestyle modification, psychosocial treatment, behavior therapy and exercise in the day-care unit. Blood biochemistry, serum BDNF, adipokine (adiponectin), inflammatory markers (C-reactive protein, tumor necrosis factor-alpha and interleukin-6) and oral glucose tolerance test were evaluated before and after the program. Serum BDNF concentrations were significantly lower among patients with schizophrenia compared to control subjects. Serum BDNF levels were significantly increased following the weight reduction program. Elevations in serum BDNF levels were positively correlated with body weight and body mass index reduction. Altogether, our results demonstrate that a non-pharmacological weight reduction program effectively reduces body weight with significant elevation of serum BDNF levels in obese non-diabetic patients with schizophrenia.

背景与目标： ：该研究的目的是阐明肥胖非糖尿病慢性精神分裂症患者的血清循环脑源性神经营养因子（BDNF）与通过生活方式改变和行为疗法减轻体重之间的关系。招募了33例在日托室中接受稳定抗精神病药物治疗，至少3个月的精神分裂症肥胖非糖尿病患者。纳入30名年龄，体重匹配且无精神疾病的受试者作为对照。所有参与者都接受了为期10周的减肥计划，包括在日间护理室进行的生活方式改变，心理社会治疗，行为疗法和锻炼。在该计划之前和之后，评估了血液生化，血清BDNF，脂肪因子（脂联素），炎性标志物（C反应蛋白，肿瘤坏死因子-α和白介素6）以及口服葡萄糖耐量测试。与对照组相比，精神分裂症患者的血清BDNF浓度显着降低。减重计划后，血清BDNF水平显着增加。血清BDNF水平升高与体重和体重指数降低呈正相关。总而言之，我们的结果表明，在肥胖的非糖尿病精神分裂症患者中，非药物减肥计划可以有效减轻体重，同时血清BDNF水平显着升高。

BACKGROUND & AIMS: :This study aimed to determine whether karyomapping can be applied to couples requiring preimplantation genetic diagnosis (PGD) for single gene disorder (SGD) and/or chromosomal rearrangement. 75/82 (91.5%) and 6/82 (7.3%) couples were referred for autosomal SGD and X-linked disease, respectively. One couple (1.2%) was referred for SGD and chromosomal rearrangement. Of 608 embryos, 146 (24%, 95% CI 21-28) day-3 and 462 (76%, 95% CI 72-79) blastocyst biopsies were performed. A total of 81 embryo transfers were performed; 16/81 (20%) were following day-3 embryo biopsy, 65/81 (80%) were following blastocyst biopsy and cryopreserved embryo transfer. Of 81 embryo transfers with known pregnancy outcome, 51 (63%, 95% CI 52-73) were on-going pregnancies, 6/81 (7%, 95% CI 3-15) resulted in first trimester miscarriages and 24/81 (30%, 95% CI 21-40) were failed implantations. Of the 51 on-going pregnancies, 15 (29%, 95% CI 19-43) couples had a singleton live birth at the time of write up. There have been no reports of abnormal prenatal, genetic testing or diagnosis of phenotype at birth. Karyomapping is reliable, efficient and accurate for couples requiring PGD for SGD and/or chromosomal rearrangement. Additionally, it provides aneuploidy screening, minimising risks of miscarriage and implantation failure.

背景与目标： ：这项研究的目的是确定是否可以对需要单基因疾病（SGD）和/或染色体重排的需要植入前遗传学诊断（PGD）的夫妇进行核对。 75/82（91.5％）和6/82（7.3％）对夫妇因常染色体SGD和X连锁疾病而被转介。 SGD和染色体重排涉及一对夫妇（1.2％）。在608个胚胎中，第3天进行了146次（24％，95％CI 21-28）CI和462（76％，95％CI 72-79）胚泡活检。总共进行了81次胚胎移植。第3天胚胎活检后为16/81（20％），胚泡活检和冷冻保存的胚胎移植后为65/81（80％）。在有已知妊娠结局的81个胚胎移植中，有51个（63％，95％CI 52-73）正在进行妊娠，6/81（7％，95％CI 3-15）导致早孕流产和24/81 （30％，95％CI 21-40）植入失败。在进行的51次怀孕中，有15对（29％，95％CI 19-43）的夫妇在撰写本文时有单胎活产。没有关于出生前的异常产前，基因检测或表型诊断的报道。对于需要PGD进行SGD和/或染色体重排的夫妇，核定图是可靠，高效和准确的。此外，它还提供了非整倍性筛选，从而最大程度地减少了流产和植入失败的风险。

BACKGROUND & AIMS: OBJECTIVE:The present study investigates associations between brain white matter tract integrity and cognitive abilities in community-dwelling older people (N = 655). We explored two potential confounds of white matter tract-cognition associations in later life: (a) whether the associations between tracts and specific cognitive abilities are accounted for by general cognitive ability (g); and (b) how the presence of atrophy and white matter lesions affect these associations. METHOD:Tract integrity was determined using quantitative diffusion magnetic resonance imaging tractography (tract-averaged fractional anisotropy [FA]). Using confirmatory factor analysis, we compared first-order and bifactor models to investigate whether specific tract-ability associations were accounted for by g. RESULTS:Significant associations were found between g and FA in bilateral anterior thalamic radiations (r range: .16-.18, p < .01), uncinate (r range: .19-.26, p < .001), arcuate fasciculi (r range: .11-.12, p < .05), and the splenium of corpus callosum (r = .14, p < .01). After controlling for g within the bifactor model, some significant specific cognitive domain associations remained. Results also suggest that the primary effects of controlling for whole brain integrity were on g associations, not specific abilities. CONCLUSION:Results suggest that g accounts for most of, but not all, the tract-cognition associations in the current data. When controlling for age-related overall brain structural changes, only minor attenuations of the tract-cognition associations were found, and these were primarily with g. In totality, the results highlight the importance of controlling for g when investigating associations between specific cognitive abilities and neuropsychology variables.

背景与目标： 目的：本研究调查了居住在社区的老年人（N = 655）中脑白质束完整性与认知能力之间的关系。我们探讨了晚年白质物质与认知的关联的两个潜在的混淆：（a）物质与特定认知能力之间的关联是否由一般认知能力（g）解释； （b）萎缩和白质病变的存在如何影响这些关联。
方法：使用定量扩散磁共振成像体层摄影术（区域平均分数各向异性[FA]）确定道的完整性。使用验证性因素分析，我们比较了一阶和双因素模型，以调查特定的道能力关联是否由g解释。
结果：在双侧丘脑前部辐射中，g和FA之间存在显着相关性（r范围：.16-.18，p <.01），单核（r范围：.19-.26，p <.001），弓状筋膜（r范围：.11-.12，p <.05）和call体脾（r = .14，p <.01）。在双因素模型中控制g之后，仍然存在一些重要的特定认知域关联。结果还表明，控制全脑完整性的主要作用是对g的联想，而不是特定的能力。
结论：结果表明，g占了当前数据中大部分但并非全部的道认知关联。当控制与年龄相关的整体大脑结构变化时，仅发现了道认知关联的轻微衰减，而这些衰减主要与g有关。总体而言，这些结果凸显了在调查特定认知能力与神经心理学变量之间的关联时，控制g的重要性。

BACKGROUND & AIMS: BACKGROUND:Laparoscopic adjustable gastric banding (LAGB) is a common surgical treatment for obesity. Evidence for and against the association of aerobic exercise (AE) and weight loss after LAGB exists. We hypothesize that aerobic exercise is associated with improved weight loss and resolution of comorbidities after LAGB. METHODS:A review of a prospectively collected database identified patients who underwent LAGB over a 3-year period at a single institution. Body mass index (BMI), comorbidities, frequency, and duration of exercise were collected preoperatively and at 6, 12, 24, and 36 months postoperatively. Excess weight loss (EWL) was calculated. Groups were analyzed using Fisher's exact test and ANOVA. RESULTS:Of the 145 LAGB patients, 120 had adequate data for analysis. AE had no association with weight loss at 6 months. At 12, 24, and 36 months following LAGB, patients who reported 150 min or more per week of exercise had an EWL of 35.5, 47.3, and 54.1 %, respectively, while those reporting 0-59 min per week of AE had an EWL of 25.3, 32.1, and 33.0 % (p = 0.03, 0.03, and 0.02, respectively). BMI and age was not statistically different among groups. Diabetes and obstructive sleep apnea were significantly improved in patients exercising at least 60 min per week as compared to those exercising 0-59 min. CONCLUSIONS:AE is significantly associated with weight loss and comorbidity resolution after LAGB. We propose that patients who perform more AE will have higher levels of EWL.

背景与目标： 背景：腹腔镜可调胃绑带术（LAGB）是肥胖的一种常见手术治疗方法。有证据支持和反对有氧运动（AE）与LAGB术后体重减轻之间的关系。我们假设有氧运动与LAGB术后体重减轻和合并症的缓解相关。
方法：对前瞻性收集的数据库进行的审查确定了在单一机构接受了3年以上LAGB治疗的患者。术前以及术后6、12、24和36个月收集体重指数（BMI），合并症，运动频率和运动时间。计算了多余的体重减轻（EWL）。使用费舍尔精确检验和方差分析对各组进行分析。
结果：在145名LAGB患者中，有120名具有足够的数据用于分析。 AE在6个月时与体重减轻无关。 LAGB后12、24和36个月，报告每周运动150分钟或以上的患者的EWL分别为35.5％，47.3和54.1％，而报告每周运动0-59分钟的患者的EWL分别为分别为25.3％，32.1％和33.0％（p分别为0.03、0.03和0.02）。各组之间的BMI和年龄在统计学上没有差异。与每周运动0-59分钟的患者相比，每周至少运动60分钟的患者的糖尿病和阻塞性睡眠呼吸暂停明显改善。
结论：AE与LAGB后的体重减轻和合并症的缓解密切相关。我们建议执行更多AE的患者应具有更高的EWL水平。