Introduction: It is commonly felt that cerebral amyloid angiopathy (CAA) related intracerebral hemorrhage (ICH) can be distinguished from hypertension (HTN)-related ICH by certain typical features on computerized tomography (CT) and magnetic resonance imaging (MRI). The purpose of this study was to investigate the performance of clinicians who were asked to differentiate between CAA and HTN based on hemorrhage pattern interpretation and to assess the feasibility of such classification. Methods: The admission scans from 83 patients who were admitted to our service with an acute ICH were presented to 5 clinicians in a randomized and blinded fashion (1 junior, and 1 senior neurosurgical resident, 1 attending neurosurgeon, and 2 neurosurgeon-neuroradiologists). There were no patients who received oral anticoagulants other than low-dose aspirin, or who suffered from vascular malformations or tumors. Scans from 41 patients with a histologically proven diagnosis of CAA and from 42 patients with a clear history of HTN were investigated. Hematoma evacuation was done in all CAA patients and in 59% of HTN patients (n = 25). Results: The overall average classification accuracy was 66.8% (range: 62.7–69.9). For correct HTN classification it was 69.5% (range: 64.3–81), and 63.9% for CAA, respectively (range: 48.9–75.6). There were negligible differences in classification accuracy among all observers. Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74 vs. 66.5 years, p < 0.05). There was a significantly higher number of hematomas >30 ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglionic hemorrhage was seen in CAA, but in 40.5% in HTN. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Two patients (4.9%) with CAA, and 7 patients with HTN (16.7%) presented with cerebellar hematomas. Conclusions: Three of 10 scans were not correctly diagnosed regardless of the examiner’s level of training. This calls into question the reliability of classifying the underlying pathological condition based on hemorrhage pattern interpretation on CT or MRI. The definite diagnosis of CAA- versus HTN-related hemorrhage requires a histopathological confirmation and should not be based solely on hemorrhage pattern interpretation.
Considerable studies have explored the potential mechanisms between trauma exposure and PTSD, but little is known about the role of sleep problems and resilience in this relationship. To address this research gap, the present study examined whether sleep problems mediated the relationship between earthquake exposure and PTSD symptoms, and whether this mediating process was moderated by resilience. A sample of 1,342 adolescents (Mage = 15.54 years, SD = 1.26) completed questionnaires regarding earthquake exposure, sleep problems, resilience, and PTSD symptoms 12 months after a devastating earthquake in China. After controlling for demographic variables, earthquake exposure was significantly, and positively associated with PTSD symptoms, and sleep problems partially mediated this relationship. Tests of moderated mediation further revealed that resilience moderated the relationship between earthquake exposure and PTSD symptoms as well as sleep problems and PTSD symptoms. Specifically, the relationship between earthquake exposure and PTSD symptoms was only significant for adolescents with a lower level of resilience; meanwhile, the positive relationship between sleep problems and PTSD symptoms was stronger among low-resilient adolescents. Therefore, sleep-targeted and resilience-based interventions may be effective in alleviating PTSD symptoms resulted from the earthquake.
Purpose: To study the effects of parenteral nutrition (TPN), ω-3 polyunsaturated fatty acid (PUFA), Larginine (Arg), and glutamine on cellular immunity of patients who
05). IL-6 in group E was lower than that in any of the other four groups (p < 0.05). IL-10 in group A was lower than that in groups B, C and D, but lower than in group E (p < 0.05). The levels of TNF-a in groups B and C were lower than those in group A, but higher than that in group E (p < 0.05) but lower than in group D. IgA in group E was higher than in the other groups (p < 0.05), while IgM level in group E was lower than in groups A, B and C (p < 0.05
Problematic smartphone use (PSU) in college students has been a major public health concern in modern society, which may also lead to adverse health outcomes. Using a three-wave longitudinal study design, the current study aimed to examine the prevalence and psychosocial factors of PSU in a large sample of Chinese college students. The data used in this study was obtained from an ongoing longitudinal study in Guangdong, China. In the current study, a total of 7,434 freshmen and sophomores who completed the first three surveys were included. Self-administered questionnaires were used to assess PSU, possible social anxiety disorders, depressive symptoms, loneliness, family conflicts, academic stress, and some demographic characteristics. Generalized estimating equation (GEE) models were performed to determine the risk factors associated with PSU. The results showed that 65.8, 58.1, and 52.8% of college students reported PSU at three waves, with an apparent downward trend. Female students reported higher prevalence rates of PSU than males. Depressive symptoms, possible social anxiety disorders, loneliness, family conflicts, and high academic pressure were important risk factors for PSU. Early intervention and identification of those who show signs of PSU may prevent the development of maladaptive coping responses and addictive behaviors, so as to prevent future negative psychosocial consequences.
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