BACKGROUND & AIMS: BACKGROUND AND STUDY AIMS:Following noncurative endoscopic resection of early gastric cancer (EGC), the patient should be observed when the underlying disease is severe, the patient is elderly, or the patient refuses further treatment. The aim of this study was to analyze the clinical outcomes of patients with differentiated EGC who underwent noncurative endoscopic resection without additional treatment. PATIENTS AND METHODS:Included patients underwent noncurative endoscopic resection for differentiated EGC without additional treatment at the Asan Medical Center between July 1994 and January 2009. Clinical and oncological outcomes were analyzed. RESULTS:A total of 159 patients were included in the analysis. The median follow-up period was 33 months (interquartile range [IQR] 22 - 52 months). In total, 40 patients died (25.2 %) - 3 due to stomach cancer, 34 due to other causes, and 3 from unknown causes; the median survival time after endoscopic treatment for these patients was 27.5 months (IQR 13.8 - 48.3 months). Multivariate analysis showed that the rates of underlying disease (P < 0.001) and lymphovascular invasion (P = 0.005) were higher among the 40 patients who died than among the 119 survivors. The overall 3-  and 5-year survival rates were 82.9 % and 77.1 %, respectively; the rates of the patients with lymphovascular invasion were 61.9 % and 42.4 %, respectively, and the rates of patients without lymphovascular invasion were 86.1 % and 81.8 %, respectively (P < 0.001). CONCLUSIONS:Additional treatment provides fewer benefits to patients who do not have long life expectancies. Additional surgery can be considered for patients with lymphovascular invasion because of its high mortality rate; however, the benefits and risks of surgery should be considered carefully.

背景与目标： 背景与研究目的：在早期胃癌（EGC）的非根治性内镜切除术之后，应在基础疾病严重，患者年老或患者拒绝进一步治疗时对患者进行观察。这项研究的目的是分析未经治疗的内镜下切除术而无需额外治疗的分化型EGC患者的临床结局。
患者与方法：1994年7月至2009年1月间，在Asan医疗中心对其中包括分化型EGC的患者进行了非根治性内镜切除术，未进行进一步的治疗。分析了临床和肿瘤学结局。
结果：总共159例患者被纳入分析。中位随访期为33个月（四分位间距[IQR] 22±52个月）。共有40例患者（25.2 %%）died- 3因胃癌死亡，34因其他原因死亡，3因不明原因死亡；这些患者经内镜治疗后的中位生存时间为27.5个月（IQR 13.8±48.3个月）。多因素分析显示，死亡的40例患者的基础疾病（P（<0.001）和淋巴管浸润（P invasion = 0.005）的发生率高于119名幸存者。 3年和5年总生存率分别为82.9％和77.1％。淋巴管浸润患者的发生率分别为61.9％和42.4％，无淋巴管浸润的患者分别为86.1％和81.8％（P <0.001）。
结论：额外治疗对没有预期寿命的患者提供的益处较少。由于其高死亡率，可以考虑对淋巴管侵犯的患者进行额外的手术。但是，应仔细考虑手术的益处和风险。

BACKGROUND & AIMS: :Methane is an important greenhouse gas, and its atmospheric concentration has nearly tripled since pre-industrial times. The growth rate of atmospheric methane is determined by the balance between surface emissions and photochemical destruction by the hydroxyl radical, the major atmospheric oxidant. Remarkably, this growth rate has decreased markedly since the early 1990s, and the level of methane has remained relatively constant since 1999, leading to a downward revision of its projected influence on global temperatures. Large fluctuations in the growth rate of atmospheric methane are also observed from one year to the next, but their causes remain uncertain. Here we quantify the processes that controlled variations in methane emissions between 1984 and 2003 using an inversion model of atmospheric transport and chemistry. Our results indicate that wetland emissions dominated the inter-annual variability of methane sources, whereas fire emissions played a smaller role, except during the 1997-1998 El Niño event. These top-down estimates of changes in wetland and fire emissions are in good agreement with independent estimates based on remote sensing information and biogeochemical models. On longer timescales, our results show that the decrease in atmospheric methane growth during the 1990s was caused by a decline in anthropogenic emissions. Since 1999, however, they indicate that anthropogenic emissions of methane have risen again. The effect of this increase on the growth rate of atmospheric methane has been masked by a coincident decrease in wetland emissions, but atmospheric methane levels may increase in the near future if wetland emissions return to their mean 1990s levels.

背景与目标： ：甲烷是一种重要的温室气体，自工业化前以来，其大气浓度几乎增加了两倍。大气甲烷的增长率取决于表面排放与主要大气氧化剂羟基自由基对光化学的破坏之间的平衡。值得注意的是，自1990年代初以来，这一增长率已明显下降，而甲烷的水平自1999年以来一直保持相对稳定，从而导致其对全球气温的预计影响向下修正。从一年到下一年，大气中甲烷的增长率也出现了较大的波动，但其原因仍然不确定。在这里，我们使用大气传输和化学反演模型对控制1984年至2003年甲烷排放量变化的过程进行了量化。我们的结果表明，除1997-1998年厄尔尼诺事件外，甲烷排放源的年际变化主要是湿地排放，而火灾排放的作用较小。这些对湿地和火灾排放变化的自上而下的估算与基于遥感信息和生物地球化学模型的独立估算非常吻合。在更长的时间尺度上，我们的结果表明，1990年代期间大气甲烷增长的下降是由于人为排放量的下降引起的。但是，自1999年以来，它们表明人为排放的甲烷再次增加。湿地排放量的同时减少掩盖了这种增加对大气中甲烷增长率的影响，但是如果湿地排放量恢复到1990年代的平均水平，那么大气中的甲烷水平在不久的将来可能会增加。

BACKGROUND & AIMS: :This study aimed to test the hypothesis that organic volume is the main variable for explaining the optical properties and predictive degree of diffusion of enamel histological points at zones of natural enamel caries (NEC; surface layer, SL, n = 30, and body of the lesion, BL, n = 58) and normal enamel (NE, n = 131). Molars with either NEC or NE were quantitatively analyzed regarding the mineral, organic and water volumes (considered as effective pore volume), opacity (predicted in 94% of cases by water volume in NEC), and water volume more easily available for diffusion, αd (squared water volume divided by the nonmineral volume; related to permeability). NEC presented lower mineral volumes and higher organic volumes, effective pore volume and opacity than NE. External origin of organic volume in NEC was evidenced by an organic gradient decreasing from the surface inward (R2 = -0.7), which was not detected in teeth with NE only; αd values of the SL and NE were similar and both were lower (p < 0.0001) than that of the BL. Comparing the SL from both NEC and artificial enamel caries (AEC; published data; n = 71), with similar mineral volumes, against developing enamel (published data), AEC showed more effective pore volume (3 times higher), higher αd and opacity than NEC mainly due to differences in organic volumes. Our results reasonably matched widely known features of NEC histological zones, and confirmed the organic volume as the main variable for explaining optical properties and αd (related to permeability).

背景与目标： ：这项研究旨在检验以下假设：有机物体积是解释天然釉质龋齿（NEC；表面层，SL，n = 30，以及牙体）的光学特性和牙釉质组织学点扩散的预测程度的主要变量。病变，BL，n = 58）和正常牙釉质（NE，n = 131）。对具有NEC或NE的磨牙定量分析了矿物质，有机物和水的体积（视为有效孔体积），不透明度（由NEC中的水体积预测为94％的情况）以及更易于扩散的水体积αd （平方水量除以非矿物质量；与渗透率有关）。与NEC相比，NEC具有更低的矿物质量和更高的有机量，有效的孔隙率和不透明度。 NEC中有机物体积的外部来源通过从表面向内减小的有机梯度来证明（R2 = -0.7），仅在具有NE的牙齿中未检测到有机梯度。 SL和NE的αd值相似，均低于BL的（p <0.0001）。比较来自NEC和人造牙釉质的SL（AEC;已发表的数据; n = 71），具有相似的矿物质量，与发育中的牙釉质（已发表的数据）相比，AEC显示出更有效的孔体积（高3倍），更高的αd和不透明度比NEC主要是由于有机量的差异。我们的结果合理地匹配了NEC组织学区域的广为人知的特征，并确认了有机物体积是解释光学性质和αd（与渗透率有关）的主要变量。

BACKGROUND & AIMS: :Information about the future trajectory of a visual target is contained not only in the history of target motion but also in static visual cues, e.g., the street provides information about the car's future trajectory. For most natural moving targets, this information imposes strong constraints on the relation between velocity and acceleration which can be exploited by predictive smooth pursuit mechanisms. We questioned how cue-induced predictive changes in pursuit direction depend on target speed and how cue- and target-induced pursuit interact. Subjects pursued a target entering a +/-90 degrees curve and moving on either a homogeneous background or on a low contrast static band indicating the future trajectory. The cue induced a predictive change of pursuit direction, which occurred before curve onset of the target. The predictive velocity component orthogonal to the initial pursuit direction started later and became faster with increasing target velocity. The predictive eye acceleration increased quadratically with target velocity and was independent of the initial target direction. After curve onset, cue- and target-induced pursuit velocity components were not linearly superimposed. The quadratic increase of eye acceleration with target velocity is consistent with the natural velocity scaling implied by the two-thirds power law, which is a characteristic of biological controlled movements. Comparison with linear pursuit models reveals that the ratio between eye acceleration and actual or expected retinal slip cannot be considered a constant gain factor. To obey a natural velocity scaling, this acceleration gain must linearly increase with target or pursuit velocity. We suggest that gain control mechanisms, which affect target-induced changes of pursuit velocity, act similarly on predictive changes of pursuit induced by static visual cues.

背景与目标： ：关于视觉目标的未来轨迹的信息不仅包含在目标运动的历史中，而且还包含在静态视觉线索中，例如，街道提供有关汽车未来轨迹的信息。对于大多数自然运动目标，此信息对速度和加速度之间的关系施加了严格的约束，可以通过预测性平滑跟踪机制加以利用。我们质疑线索诱导的追踪方向预测性变化如何取决于目标速度以及线索与目标诱导的追踪之间如何相互作用。受试者追踪进入/ -90度曲线的目标，并在均质背景或指示未来轨迹的低对比度静态波段上移动。提示引起了追踪方向的预测性变化，该变化发生在目标曲线开始之前。与初始跟踪方向正交的预测速度分量开始较晚，并且随着目标速度的增加而变得更快。预测眼加速度随目标速度呈二次方增加，并且与初始目标方向无关。曲线开始后，提示和目标诱导的追击速度分量未线性叠加。眼球加速度随目标速度的二次增加与三分之二幂定律所暗示的自然速度定标一致，这是生物控制运动的特征。与线性追踪模型的比较表明，眼加速度与实际或预期的视网膜滑移之间的比率不能视为恒定的增益因子。为了服从自然速度比例，该加速度增益必须随目标速度或跟踪速度线性增加。我们建议增益控制机制，影响目标诱导的追踪速度变化，类似地作用于静态视觉提示所诱导的追踪预测变化。

BACKGROUND & AIMS: BACKGROUND:Current knowledge of the natural outcomes of untreated women in preterm labour is both incomplete and outcomes vary significantly between the available studies. The aim of this study was to systematically review outcomes of preterm labour without tocolysis and determine if outcome variation could be accounted for by differences in study populations. Such data could potentially assist in the interpretation of intervention trials that do not include a no-treatment arm. METHODS:Included studies reported outcomes of women in clinically diagnosed preterm labour without tocolytic treatment between 1950 and 2011. Studies that were limited to preterm prelabour rupture of membranes, recurrent preterm labour or in which the women without tocolysis represented a potentially biased subgroup, or were not tocolysed because of contraindications were excluded. Study quality, design, and population characteristics were abstracted. Outcomes included pregnancy prolongation and the proportion of women undelivered at 48-72 h, 7 days, and term. Study characteristics associated with differing odds of preterm birth were explored through logistic regression. RESULTS:Three hundred and eighty-five citations were initially identified, of which 26 were included encompassing 1383 women. The percentage of patients who were undelivered at 48-72 hours was 62.8%, at 7 days 53.4% and 40.4% delivered at term, though the range was very wide. Characteristics associated with decreased odds of delivery were not consistent among reported outcome measures. CONCLUSIONS:Most women without tocolysis do not deliver within 7 days, although the range is very wide. The majority of this variation is unrelated to reported differences in study design or reported population characteristics.

背景与目标： 背景：目前对未接受治疗的早产妇女自然结局的了解还不完整，可用研究之间的结局差异很大。这项研究的目的是系统地审查无宫缩抑制剂的早产结局，并确定结果差异是否可以由研究人群的差异来解释。此类数据可能有助于解释不包括不治疗组的干预试验。
方法：纳入的研究报告了1950年至2011年之间未经子宫溶栓治疗的临床诊断早产妇女的结局。研究仅限于胎膜早破，反复早产或未接受子宫溶解的妇女代表潜在的亚组，或因禁忌症而未接受治疗的人被排除在外。研究质量，设计和人口特征被抽象出来。结果包括妊娠延长和在48-72小时，7天和足月分娩时未分娩的妇女比例。通过逻辑回归研究了与早产几率不同相关的研究特征。
结果：最初确定了385条被引用，其中26条被包括1383名女性。在48-72小时未分娩的患者百分比为62.8％，在7天时足月分娩的比例分别为53.4％和40.4％，尽管范围很广。在报告的结果指标中，与分娩几率降低相关的特征不一致。
结论：尽管未溶栓的范围很广，但大多数妇女都不会在7天之内分娩。这种变化的大部分与研究设计的报告差异或报告的人群特征无关。

BACKGROUND & AIMS: BACKGROUND/AIMS:The hepatitis B virus (HBV) infection course is divided into 4 immune phases which were mainly characterized by clinical markers. We investigated the immune markers, especially inhibitory receptors, cytokine and chemokine expressions among the immune phases especially between immune tolerance (IT) phase and immune control (IC) phase. METHODOLOGY:Blood and serum samples of 64 patients and serum samples of 22 healthy controls were obtained. We used flow cytometric methods for measurements of PD-1, PD-L1 and flow fluorescence immunoassay for the serum cytokines and chemokines concentrations. IL-27 was measured by ELISA and the receptor IL-27R was detected too. RESULTS:The proportions of PD1 positive cells in CD4+, CD4+CD45RO+, and CD8+ T-cell subsets in IC phase were greater than in IC phase. The frequencies of PD1 expressions in CD8+pentamer+ and CD8+CD45RA-pentamer+ T cells were higher in IC phase than in IT and ICC phases. The serum concentration of IL-27 in IT group was higher than in IC, ICC and HC groups. Concentrations of cytokines TNF-α and IL-10 and chemokines RANTES, IL-8 and IP-10 were higher in HBV infected patients. CONCLUSIONS:The reduction of percentages of PD-1 positive cells may contribute to estimate entering the IC phase and decide the opportune moment to start antivirus therapy.

背景与目标： 背景/目的：乙肝病毒（HBV）感染过程分为四个免疫阶段，主要以临床标志物为特征。我们调查了免疫阶段，尤其是免疫耐受（IT）阶段和免疫控制（IC）阶段之间的免疫标志物，特别是抑制性受体，细胞因子和趋化因子的表达。
方法：获得64例患者的血液和血清样本以及22例健康对照者的血清样本。我们使用流式细胞仪方法测量PD-1，PD-L1，并使用流式荧光免疫法测定血清细胞因子和趋化因子的浓度。通过ELISA测量IL-27，并且也检测到受体IL-27R。
结果：IC期CD4，CD4，CD45RO和CD8 T细胞亚群中PD1阳性细胞的比例大于IC期。 CD8五聚体和CD8 CD45RA-五聚体T细胞中PD1表达的频率在IC期高于IT和ICC期。 IT组的血清IL-27浓度高于IC，ICC和HC组。 HBV感染患者的细胞因子TNF-α和IL-10以及趋化因子RANTES，IL-8和IP-10的浓度较高。
结论：PD-1阳性细胞百分比的降低可能有助于估计进入IC阶段并决定开始抗病毒治疗的时机。

BACKGROUND & AIMS: :Despite its centrality to social stress theory, research on the social patterning of stress exposure and coping resources has been sparse and existing research shows conflicting results. We interviewed 396 gay, lesbian and bisexual, and 128 heterosexual people in New York City to examine variability in exposure to stress related to sexual orientation, gender, and race/ethnicity. Multiple linear regressions showed clear support for the social stress hypothesis with regard to race/ethnic minority status, somewhat mixed support with regard to sexual orientation, and no support with regard to gender. We discuss this lack of parsimony in social stress explanations for health disparities.

背景与目标： ：尽管它在社会压力理论中处于中心地位，但对压力暴露和应对资源的社会模式的研究却很少，现有研究显示出相互矛盾的结果。我们采访了纽约市396名男同性恋，女同性恋和双性恋者以及128位异性恋者，以研究他们暴露于与性取向，性别和种族/民族有关的压力中的变异性。多元线性回归显示出对种族/族裔少数群体地位的社会压力假说的明确支持，对性取向的支持有些混杂，而对性别的支持则没有。我们在针对健康差异的社会压力解释中讨论了缺乏简约性的问题。

BACKGROUND & AIMS: :HepG2 and Huh7 cell lines are frequently used as models to study viral hepatitis and hepatocellular carcinoma. However, they exhibit significantly different capacities in their ability to support hepatitis B virus (HBV) replication. To investigate the basis for this, transcription factor-binding motifs at the HBV core promoter (HBVCP) were tested in luciferase reporter constructs to identify the possible role of host factors. Among the transcription factors screened: PARP1, SP1, HNF4α, HNF3, hB1F and HNF1, deletion of the PARP1 binding motif abrogated transcriptional activity at the HBVCP in HepG2 but not Huh7 cells. Sequencing of the PARP1 gene revealed that HepG2 cells carried an Ala762 allele which has low ADP-ribosylation activity, which was shown to have increased PARP1 binding affinity to its cognate motif thus resulting in higher transcriptional activity. PARP1 inhibitors that are being developed as broad cancer therapeutics also target PARP1 ADP-ribosylation enzymatic function. Four PARP1 inhibitors: PJ-34, ABT888, AZD2281 and AG014699 were tested for their effect on HBV replication. All four small molecules effectively enhanced HBV replication in vitro, confirming the role of PARP1 in HBV replication and that alteration of ADP-ribosylation by mutation or drugs can affect HBV replication. Our data demonstrate that natural polymorphisms in the host affecting proteins such as PARP1 can have a significant effect on HBV replication. Hence, patients who are infected with HBV and are on clinical trials involving PARP1 inhibitors may be at risk from unintended side-effects such as exacerbation of HBV replication.

背景与目标： ：HepG2和Huh7细胞系经常用作研究病毒性肝炎和肝细胞癌的模型。但是，它们在支持乙型肝炎病毒（HBV）复制的能力上表现出明显不同的能力。为了研究其基础，在萤光素酶报告基因构建物中测试了HBV核心启动子（HBVCP）上的转录因子结合基序，以确定宿主因子的可能作用。在筛选的转录因子中：PARP1，SP1，HNF4α，HNF3，hB1F和HNF1，PARP1结合基序的缺失废除了HepG2细胞中HBVCP的转录活性，而没有废除Huh7细胞中的转录活性。 PARP1基因的测序表明，HepG2细胞带有一个Ala762等位基因，该等位基因的ADP-核糖基化活性较低，这表明PARP1与其关联基序的结合亲和力增强，从而导致更高的转录活性。被开发为广泛的癌症治疗剂的PARP1抑制剂也靶向PARP1 ADP-核糖基化酶功能。测试了四种PARP1抑制剂：PJ-34，ABT888，AZD2281和AG0​​14699对HBV复制的影响。所有这四个小分子在体外均有效地增强了HBV复制，这证实了PARP1在HBV复制中的作用，以及通过突变或药物改变ADP-核糖基化可以影响HBV复制。我们的数据表明，宿主中影响蛋白（例如PARP1）的天然多态性可能对HBV复制产生重大影响。因此，被HBV感染并正在接受PARP1抑制剂临床试验的患者可能有意料之外的副作用，例如加剧HBV复制的危险。

BACKGROUND & AIMS: :Pharmacotherapies for the behavioural and psychological symptoms of dementia are limited; novel agents for the symptoms are still needed. Herein, we report the case of an 80-year-old male patient with Alzheimer's disease whose severe agitation, insomnia and sexual delusions were successfully treated with a traditional natural Japanese (Kampo) medicine, keishi-ka-ryukotsu-borei-to. We found that administrating keishi-ka-ryukotsu-borei-to increased his serum luteinizing hormone level, which could be inversely associated with his behavioural and psychological symptoms. This report suggests that keishi-ka-ryukotsu-borei-to is a possible alternative treatment for the behavioural and psychological symptoms of dementia, especially sexual delusions.

背景与目标： ：痴呆症的行为和心理症状的药物治疗有限；仍然需要用于症状的新型药物。在此，我们报告了一名80岁的老年痴呆症男性患者的病例，该患者患有严重的躁动，失眠和性妄想，已成功使用传统的日本天然药物（Kampo）keishi-ka-ryukotsu-borei-to治疗。我们发现，服用keishi-ka-ryukotsu-borei-可以提高他的血清黄体生成素水平，这可能与他的行为和心理症状呈负相关。该报告表明，keishi-ka-ryukotsu-borei-to是痴呆症（尤其是性妄想）的行为和心理症状的可能替代疗法。

BACKGROUND & AIMS: PURPOSE:The purpose of this article is to describe how Resources and Supports for Self Management (RSSM) and strategies of the transtheoretical model (TTM) intersect to produce a comprehensive approach resulting in cutting-edge diabetes programs. METHODS:Specific components of RSSM, especially individualized assessment, collaborative goal setting, and enhancing skills, are reviewed in terms of contributions to the TTM. RESULTS:Specific examples from the Diabetes Initiative of using TTM constructs from 5 projects are shown to illustrate the first 3 RSSM constructs: individualized assessment, collaborative goal setting, and skill building. CONCLUSION:Diabetes Initiative grantees have demonstrated that the TTM enhances RSSM and facilitates the adoption of good diabetes self-management behaviors.

背景与目标： 目的：本文的目的是描述自我管理的资源和支持（RSSM）与跨理论模型（TTM）的策略如何相交，以产生一种综合方法，从而开发出最先进的糖尿病计划。
方法：根据对TTM的贡献，回顾了RSSM的特定组成部分，尤其是个性化评估，协作目标设定和增强技能。
结果：显示了来自糖尿病倡议组织使用来自5个项目的TTM构建体的特定示例，以说明前三个RSSM构建体：个性化评估，协作目标设定和技能构建。
结论：糖尿病倡议受助人已证明TTM增强RSSM并促进采用良好的糖尿病自我管理行为。

BACKGROUND & AIMS: INTRODUCTION:Telecommunication infrastructure is being rolled out across Australia with little knowledge about the uptake by health professionals in remote areas. Computer mediated communication has the potential to offer educational support to remote practitioners; however, the viability of this is uncertain. The aim of this research was to establish and evaluate an internet-based resource library targeting the needs of remote area maternity service providers. METHODS:A participatory action research (PAR) approach was used to involve remote area maternity service providers in the Northern Territory of Australia. The evaluation of the resource library included its performance on reach, agency affiliation and richness, factors identified to affect the sustainability and utility of such a resource. An additional component of the evaluation framework documented the facilitators of and barriers to using an information technology strategy to reduce the isolation of remote area maternity service providers. RESULTS:Overall, the evaluation of the resource library was very positive. Feedback from the PAR team described the resource as contemporary, useful and relevant. Practitioners in leadership and education positions identified the resource library as a valuable tool that enabled them to access professional knowledge, which could then be distributed to any remote-based practitioners, who experienced difficulties with access themselves. The evaluation found that logistical issues were a major problem for potential users. Hardware inadequacies, access difficulties, unfamiliarity with computers, and a lack of management support for nursing and midwifery staff to utilise the resource, were all identified barriers. Remote-area practitioners highlighted education, training and 24 hour support as key priorities. CONCLUSIONS:Results from this research clearly showed the potential of web-based resources to offer educational support through access to clinical guidelines, reports and research, thus reducing the isolation of the remote practitioner. However, it highlighted the need for clear strategic direction at policy level, whereby all stakeholders unite to synchronise the rollout of information technology infrastructure with the necessary education, training and support as an integral component.

背景与目标： 简介：电信基础设施正在澳大利亚各地推广，对偏远地区的卫生专业人员的使用了解甚少。计算机介导的交流有可能为远程从业者提供教育支持；但是，这种方法的可行性尚不确定。这项研究的目的是建立和评估针对偏远地区孕妇服务提供商需求的基于互联网的资源库。
方法：采用参与式行动研究（PAR）的方法，使澳大利亚北领地的偏远地区产妇服务提供者参与进来。对资源库的评估包括其在覆盖范围，代理机构的隶属关系和丰富性方面的绩效，已确定的影响该资源可持续性和实用性的因素。评价框架的另一个组成部分记录了使用信息技术战略来减少偏远地区产妇服务提供者的隔离的促进因素和障碍。
结果：总的来说，对资源库的评价是非常积极的。 PAR团队的反馈认为该资源具有当代性，实用性和相关性。担任领导和教育职务的从业人员认为资源库是使他们能够访问专业知识的宝贵工具，然后可以将其分发给在访问方面遇到困难的任何远程工作者。评估发现，后勤问题是潜在用户的主要问题。硬件不足，访问困难，对计算机不熟悉以及对护理人员和助产人员缺乏利用资源的管理支持，这些都是障碍。偏远地区的从业者强调教育，培训和24小时支持是关键重点。
结论：这项研究的结果清楚地表明了基于Web的资源通过访问临床指南，报告和研究提供教育支持的潜力，从而减少了远程医生的孤立感。但是，它强调需要在政策一级制定明确的战略方向，所有利益相关者团结起来，将信息技术基础设施的部署与必要的教育，培训和支持作为一个不可或缺的组成部分进行同步。

BACKGROUND & AIMS: :At present Chinese nurses could not get the up-to-date and high-quality evidences efficiently and conveniently due to language barrier and other practical difficulties. This program built a Chinese website of integrated evidence-based network information resources for EBN studies. Researchers hope to provide practical guidance and advice for nurses in non-English-speaking countries..

背景与目标： ：由于语言障碍和其他实际困难，目前中国护士无法高效，便捷地获得最新，高质量的证据。该计划建立了一个综合的基于证据的网络信息资源中文网站，用于EBN研究。研究人员希望为非英语国家的护士提供实用的指导和建议。

BACKGROUND & AIMS: :A bacterioferritin was recently isolated from the anaerobic sulphate-reducing bacterium Desulfivibrio desulfuricans ATCC 27774 [Romão et al. (2000) Biochemistry 39, 6841-6849]. Although its properties are in general similar to those of the other bacterioferritins, it contains a haem quite distinct from the haem B, found in bacterioferritins from aerobic organisms. Using visible and NMR spectroscopies, as well as mass spectrometry analysis, the haem is now unambiguously identified as iron-coproporphyrin III, the first example of such a prosthetic group in a biological system. This unexpected finding is discussed in the framework of haem biosynthetic pathways in anaerobes and particularly in sulphate-reducing bacteria.

背景与目标： ：最近从减少厌氧硫酸盐的细菌Desulfivibrio desulfuricans ATCC 27774中分离出一种细菌铁蛋白。 （2000）Biochemistry 39，6841-6849]。尽管其性质通常与其他细菌铁蛋白相似，但它所包含的血红素与好氧生物的细菌铁蛋白中发现的血红素B完全不同。使用可见光谱和NMR光谱以及质谱分析，血红素现在被明确地确定为铁-卟啉III，这是生物系统中这种修复基团的第一个例子。在厌氧菌，尤其是硫酸盐还原菌中的血红素生物合成途径的框架中讨论了这一出乎意料的发现。

BACKGROUND & AIMS: :This study demonstrates a conceptual linkage between exchange theory and psychoanalytic theory of depression. The effects of diminished resources and the dynamic relationships between depression, quality of the marital relationship, and social participation were investigated with a sample of 229 community residing, married older people (Duke Longitudinal Study) using a combined structural and measurement model with linear structural relations (LISREL) analysis. Findings are that some resources have direct effects on depression, marital quality, and social participation. However, it is through the pathway of depressive moods that ill health, retirement, and stress have their negative effects on the marital relationship. Depressive moods do affect social participation, but psychosomatic symptoms of depression do not affect the amount of social participation nor the marital relationship. Recognizing depressive moods as intervening variables is important because older people tend to deny feeling depressed. Without a conceptual linkage of exchange and depression theories, this pathway would not have been identified.

背景与目标： ：这项研究证明了交换理论与抑郁心理分析理论之间的概念联系。利用线性结构关系的组合结构和测量模型，对229个居住在社区的已婚老年人进行了调查，调查了资源减少以及抑郁，婚姻关系质量和社会参与之间的动态关系的影响（杜克纵向研究） （LISREL）分析。研究发现，某些资源对抑郁症，婚姻质量和社会参与有直接影响。但是，不良的健康，退休和压力是通过情绪低落的途径对婚姻关系造成的负面影响。抑郁情绪确实会影响社会参与，但是抑郁的心身症状并不影响社会参与的数量或婚姻关系。将抑郁情绪识别为干预变量很重要，因为老年人倾向于否认感到沮丧。没有交换理论和抑郁理论的概念联系，就不会确定这种途径。

BACKGROUND & AIMS: PURPOSE:Critical illness results in derangements of all components of the immune response. Nonetheless, most of the efforts evaluating immune status in critically ill patients have been done in the field of sepsis. Here we have evaluated the immunity status at intensive care unit (ICU) admission in a cohort of nonseptic critically ill patients and its influence on their outcome. MATERIAL AND METHODS:Ninety patients 18 years and older admitted to our ICU were studied for levels of immunoglobulin (Ig) G, IgM, IgA, CD3(+)CD4(+) T cells, CD3(+)CD8(+) T cells, B cells, natural killer (NK) cells, and C3 and C4 complement factors in peripheral blood in the next 24 hours after admission to the ICU. Patients with infection, sepsis, immunodeficiency, or concomitant immunosuppressive therapy were excluded. RESULTS:Levels of IgM, CD3(+) T cells, CD4(+) T cells, CD8(+) T cells, and B lymphocytes correlated inversely with age. In turn, levels of CD3(+) T cells, CD4(+) T cells, CD8(+) T cells, and C3 factor of the complement system correlated inversely with Acute Physiology and Chronic Health Evaluation II score. Multivariate Cox regression analysis censored at 28 days evidenced that levels of IgM played a protective role, whereas levels of NK cells behaved as a risk factor for mortality. Kaplan-Meier curves showed a cutoff of 58 mg/dL for IgM and 140 cells/mm(3) for NK cells. CONCLUSIONS:In conclusion, our results demonstrate that IgM plays a protective role in critically ill patients with no sepsis, whereas NK cell counts seem to play a deleterious one. Aging and severity at admission affect levels of key factors of the immune system in the blood of these patients.

背景与目标： 目的：严重疾病会导致免疫反应的所有成分发生紊乱。尽管如此，评估重症患者免疫状况的大多数努力都是在败血症领域中进行的。在这里，我们评估了一群非败血症危重患者的重症监护病房（ICU）入院时的免疫状况及其对他们结局的影响。
材料和方法：对90例18岁及18岁以上的重症监护病房（ICU）的患者进行了免疫球蛋白（Ig）G，IgM，IgA，CD3（）CD4（）T细胞，CD3（）CD8（T），B细胞，进入ICU后的24小时内，外周血中的自然杀伤（NK）细胞以及C3和C4补体因子。排除有感染，败血症，免疫缺陷或同时进行免疫抑制治疗的患者。
结果：IgM，CD3（）T细胞，CD4（）T细胞，CD8（）T细胞和B淋巴细胞的水平与年龄呈负相关。反过来，补体系统的CD3（）T细胞，CD4（）T细胞，CD8（）T细胞和C3因子的水平与急性生理学和慢性健康评估II得分成反比。在第28天进行的多变量Cox回归分析显示，IgM的水平起保护作用，而NK细胞的水平则是造成死亡的危险因素。 Kaplan-Meier曲线显示IgM的截止值为58 mg / dL，NK细胞的截止值为140 cells / mm（3）。
结论：总之，我们的结果表明，IgM在没有败血症的危重患者中起保护作用，而NK细胞计数似乎起有害作用。入院时的年龄和严重程度会影响这些患者血液中免疫系统关键因素的水平。