BACKGROUND & AIMS: :The TIM (T cell/transmembrane, immunoglobulin and mucin) proteins are crucial regulators of Th1/Th2 immune responses and have been implicated in several diseases including HIV-1/AIDS. The TIM1 exon 4 that codes for mucin domain is highly diverse, with sequence variants associated with varying phenotypes. In this study, TIM1 exon 4 was sequenced among 227 HIV-1 seroprevalent and 288 healthy non infected individuals from North Indian population and haplotypes established. A novel but rare haplotype D1(∗) was identified among the healthy and differed from D1 by a synonymous substitution G>T at Thr208Thr. The TIM1 haplotype diversity showed no association with susceptibility to HIV-1 infection. The seroprevalent individuals carrying D3A had relatively higher median CD4+T cell counts (368/μl) than those without (313/μl; p=0.02). A comparison of CD4+T counts between D3-A individuals on ART or ART naïve did not show any significant difference plausibly due to confounding nature of ART and other factors.

背景与目标： TIM（T细胞/跨膜，免疫球蛋白和粘蛋白）蛋白是Th1 / Th2免疫反应的关键调节剂，并与包括HIV-1 / AIDS在内的多种疾病有关。编码粘蛋白结构域的TIM1外显子4高度多样化，具有与不同表型相关的序列变体。在这项研究中，TIM1外显子4在来自北印度人口的227个HIV-1血清流行和288个健康的未感染个体中进行了测序，并建立了单倍型。在健康人群中鉴定出一种新颖但罕见的单倍型D1（∗），与D1的区别在于在Thr208Thr处的同义替代G> T。 TIM1单倍型多样性表明与HIV-1感染的易感性无关。携带D3A的血清流行个体的CD4 T细胞计数中位数相对较高（不含313 /μl； p = 0.02）。由于ART和其他因素的混杂，D3-A个体或未接受过ART的D3-A个体之间CD4 T计数的比较似乎没有显示任何显着差异。

BACKGROUND & AIMS: :In this study, we evaluate the nature of the relationship between particulate matter and total mercury concentrations. For this purpose, we estimate both of the two values in water column over 12-h tidal cycles of the Jade Bay, southern North Sea. Total particulate mercury in 250 mL water samples was determined by oxygen combustion-gold amalgamation. Mercury contents varied from 63 to 259 ng/g suspended particulate matter (SPM) or 3.5-52.8 ng/L in surface waters. Total particulate mercury content (THg(p)) was positively correlated with (SPM), indicating that mercury in tidal waters is mostly associated with (SPM), and that tidal variations of total particulate mercury are mainly due to changes in (SPM) content throughout the tidal cycle. Maximum values for THg(p) were observed during mid-flood and mid-ebb, while the lowest values were determined at low tide and high tide. These data suggest that there are no mercury point sources in the Jade Bay. Moreover, the THg(p) content at low tide and high tide were significantly lower than the values recorded in the bottom sediment of the sampling site (>200 ng/g DW), while THg(p) content during the mid-flood and mid-ebb were comparable to the THg content in the surface bottom sediments. Therefore, changes in THg(p) content in the water column due to tidal forcing may have resulted from re-suspension of underlying surface sediments with relatively high mercury content.

背景与目标： ：在这项研究中，我们评估了颗粒物与总汞浓度之间关系的性质。为此，我们估计了北海南部翡翠湾在12小时的潮汐周期中水柱中的两个值。 250毫升水样品中的总颗粒汞是通过氧气燃烧-金混合法测定的。地表水中的汞含量从63到259 ng / g悬浮颗粒物（SPM）或3.5-52.8 ng / L不等。总颗粒汞含量（THg（p））与（SPM）呈正相关，表明潮汐水中的汞主要与（SPM）相关，总颗粒汞的潮汐变化主要是由于（SPM）含量的变化整个潮汐周期。在洪水中期和退潮期间观测到THg（p）的最大值，而在退潮和退潮时确定的最小值为THg（p）。这些数据表明玉湾没有汞点源。此外，在退潮和退潮时的THg（p）含量明显低于采样点底部沉积物中记录的值（> 200 ng / g DW），而在洪水中期和中期则THg（p）含量潮起潮中期与表层底部沉积物中的THg含量相当。因此，潮汐强迫导致水柱中THg（p）含量的变化可能是由于重悬含汞量相对较高的下层表面沉积物而引起的。

BACKGROUND & AIMS: :Tricholoma matsutake, known widely as "matsutake," has great commercial and cultural significance in Japan. Because Japanese production is insufficient to meet the high domestic demand, morphologically similar mushrooms, thought by many to belong to T. magnivelare, are imported from western North America. However, molecular data produced since the early 2000s have indicated that more than one species of matsutake occur in North America and this raises the question of correct naming for the different species. To address this question, we assessed the phylogenetic diversity within North American matsutake based on nuc rDNA ITS1-5.8S-ITS2 (internal transcribed spacer [ITS] barcode) sequences, including newly obtained sequences from the type collections for Agaricus ponderosus and Armillaria arenicola, and morphological characters. Our results agree with earlier indications that three matsutake species occur in North America and allow us to clarify the correct application of names-T. magnivelare from the eastern USA and Canada, T. murrillianum from the western USA and Canada, and T. mesoamericanum from Mexico, newly described here. The existence of the three North American species is further supported by the results of evolutionary divergence analysis, geographical distributions, and morphological characters.

背景与目标： 松茸：在日本被广泛称为“松茸”，具有重要的商业和文化意义。由于日本的产量不足以满足国内的高需求，因此从北美西部进口了形态相似的蘑菇，许多人认为该蘑菇属于巨鳄。但是，自2000年代初以来获得的分子数据表明，北美地区有一种以上的松茸，这引起了对不同物种正确命名的问题。为了解决这个问题，我们基于nuc rDNA ITS1-5.8S-ITS2（内部转录间隔区[ITS]条码）序列（包括来自姬松茸和蜜环菌（Armelaria arenicola），和形态特征。我们的结果与较早的迹象相符，即北美存在三种松茸种，这使我们能够澄清名称T的正确用法。来自美国东部和加拿大的magnivelare，来自美国西部和加拿大的murrillianum和来自墨西哥的中美洲T. mesoamericanum，在此进行了新描述。进化差异分析，地理分布和形态特征的结果进一步支持了这三个北美物种的存在。

BACKGROUND & AIMS: OBJECTIVE:To describe the ritual and ethnobotanical treatments about migraine performed by shamans from several native cultures. METHODS:Anthropological field study conducted with Tzeltal Maya (Mexico), Kamayurá (Brazil), and Uru-Chipaya (Bolivia) American Indians. RESULTS:Migraine is called yaxti-wanjol chawaj by Tzeltal shamans. They wash the head of the patient with an herbal solution to treat headache. The boiled leaves of a shrub called payté wamal (Tagetes nelsonii) are used to relieve migraine. Migraine is called monkey's disease by Kamayurá natives. The disease is originated by the revenge of the killed monkey's spirit, striking to Kamayurá hunter on his head. It is treated with an herbal infusion applied in the eyes of the patient. Migraine is called eskeclamix by Chipaya people, and is treated by drinking the cañahua plant (Chenopodium palludicale) boiled with water. The patient's head may also be washed with shaman's fermented urine. CONCLUSIONS:Cultural equivalents of migraine exist in the healing system of isolated American cultures.

背景与目标： 目的：描述来自几种本土文化的萨满祭司对偏头痛的礼仪和民族植物学治疗。
方法：对Tzeltal Maya（墨西哥），Kamayurá（巴西）和Uru-Chipaya（玻利维亚）的美洲印第安人进行了人类学现场研究。
结果：偏头痛被特泽塔尔萨满（Tzeltal Shamans）称为yaxti-wanjol chawaj。他们用草药溶液冲洗患者的头部，以治疗头痛。称为paytéwamal（Tagetes nelsonii）的灌木的煮沸的叶子用于缓解偏头痛。偏头痛被卡马尤拉人称为猴子病。该病源于被杀死的猴子的精神报复，袭击了卡马尤拉（Kamayurá）猎人的头部。通过在患者眼睛中使用草药输液进行治疗。奇帕亚人称偏头痛为eskeclamix，通过喝水煮沸的卡纳瓦植物（Chenopodium palludicale）来治疗。病人的头部也可以用萨满发酵的尿液清洗。
结论：偏头痛的文化等同物存在于孤立的美国文化的康复系统中。

BACKGROUND & AIMS: :Middle East and North Africa (MENA) encompass very unique populations, with a rich history and encompasses characteristic ethnic, linguistic and genetic diversity. The genetic diversity of MENA region has been largely unknown. The recent availability of whole-exome and whole-genome sequences from the region has made it possible to collect population-specific allele frequencies. The integration of data sets from this region would provide insights into the landscape of genetic variants in this region. We integrated genetic variants from multiple data sets systematically, available from this region to create a compendium of over 26 million genetic variations. The variants were systematically annotated and their allele frequencies in the data sets were computed and available as a web interface which enables quick query. As a proof of principle for application of the compendium for genetic epidemiology, we analyzed the allele frequencies for variants in transglutaminase 1 (TGM1) gene, associated with autosomal recessive lamellar ichthyosis. Our analysis revealed that the carrier frequency of selected variants differed widely with significant interethnic differences. To the best of our knowledge, al mena is the first and most comprehensive repertoire of genetic variations from the Arab, Middle Eastern and North African region. We hope al mena would accelerate Precision Medicine in the region.

背景与目标： ：中东和北非（MENA）拥有非常独特的人口，有着悠久的历史，并拥有独特的种族，语言和遗传多样性。中东和北非地区的遗传多样性在很大程度上是未知的。来自该地区的全外显子组和全基因组序列的最新可用性使得收集特定人群的等位基因频率成为可能。来自该区域的数据集的整合将提供对该区域遗传变异的概况的见识。我们系统地整合了来自该地区的多个数据集的遗传变异，以创建一个超过2600万种遗传变异的纲要。系统对变体进行了注释，并计算了数据集中的等位基因频率，并将其用作可快速查询的网络界面。作为遗传流行病学纲要应用原则的证明，我们分析了转谷氨酰胺酶1（TGM1）基因变异的等位基因频率，与常染色体隐性层状鱼鳞病相关。我们的分析表明，所选变体的载波频率差异很大，种族间存在显着差异。据我们所知，almena是阿拉伯，中东和北非地区遗传变异的第一个也是最全面的库。我们希望，法医学将促进该地区的精准医学。

BACKGROUND & AIMS: :Allele frequencies for the nine STRs included in the AmpFlSTR Profiler Plus kit (D3S1358, VWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317 and D7S820) were estimated from a sample of 365-427 unrelated individuals born in north Portugal.

背景与目标： ：AmpFlSTR Profiler Plus试剂盒（D3S1358，VWA，FGA，D8S1179，D21S11，D18S51，D5S818，D13S317和D7S820）中包含的9个STR的等位基因频率是根据葡萄牙北部出生的365-427个无关个体的样本估算的。

BACKGROUND & AIMS: :Neuroimaging after a first unprovoked seizure may show significant abnormalities. In our study, 32% of all children with a first apparent unprovoked seizure had an abnormal CT scan result. Most of these were ring-enhancing lesions of cysticercal or tubercular origin.

背景与目标： ：首次无故癫痫发作后的神经影像检查可能显示明显异常。在我们的研究中，有32％的首次明显无故癫痫发作的儿童具有异常的CT扫描结果。这些大多数是囊性或结核性起源的环状增强病变。

BACKGROUND & AIMS: OBJECTIVE:We reviewed our initial experience with robotic thy-roidectomy to identify challenges and limitations of this new surgical approach when applied to a North American population. STUDY DESIGN:Case series. SETTING:Academic institution. SUBJECTS/METHODS:Retrospective review of 18 consecutive robotic thyroid lobectomies performed from February 2010 to April 2012 involving 16 female patients. Two patients underwent robot-assisted completion thyroidectomy a few months following the initial thyroid surgery, one for cancer and the other for goiter. RESULTS:Median age was 47.5 years (range, 18-62 years), and median body mass index was 28.7 (range, 19.4-44.5). Median thyroid nodule size was 2.9 cm (range, 1.1-4.7 cm). All but 1 case (6%) was performed successfully via single axillary incision. There was no conversion to an open approach. Median operative time was 170 minutes (range, 95-220 minutes), and median blood loss was 12.5 mL (range, 5-75 mL). Complications occurred in 4 cases (22%) to include temporary vocal cord pareses (n = 3) and a postoperative hematoma that required exploration. Median hospital stay was 2 days (range, 1-3 days). CONCLUSION:Single-incision transaxillary robotic thyroidectomy can be technically challenging in North American patients with a larger body frame due to difficulty in optimal placement of all 4 robotic instruments via a single axillary incision. All 3 cases of temporary vocal cord paresis occurred early in our experience and may have been due to our relative inexperience with this new approach and associated instrumentation. Other limitations include less than optimal visualization of the recurrent laryngeal nerve in the contralateral lobe as well as poor access to the substernal region. LEVEL OF EVIDENCE:4.

背景与目标： 目的：我们回顾了我们在机器人甲状腺切除术方面的初步经验，以确定在将这种新手术方法应用于北美人群时所面临的挑战和局限性。
研究设计：案例系列。
单位：学术机构。
受试者/方法：回顾性回顾了从2010年2月至2012年4月进行的18例机器人甲状腺叶切除术，涉及16例女性患者。在最初的甲状腺手术后的几个月，两名患者接受了机器人辅助的全甲状腺切除术，其中一名癌症，另一名甲状腺肿。
结果：中位年龄为47.5岁（范围18-62岁），中位体重指数为28.7（范围19.4-44.5）。甲状腺结节中值大小为2.9厘米（范围为1.1-4.7厘米）。除1例（6％）外，其余所有病例均通过单根腋窝切口成功完成。没有转换为开放方法。中位手术时间为170分钟（范围为95-220分钟），中位数失血为12.5毫升（范围为5-75毫升）。 4例（22％）发生并发症，包括暂时性声带轻视（n = 3）和需要探查的术后血肿。中位住院天数为2天（范围为1-3天）。
结论：单身穿刺式腋窝机器人甲状腺切除术在体型较大的北美患者中可能具有技术挑战，因为难以通过单个腋窝切口最佳地放置所有四种机器人器械。在我们的经验中，所有3例临时性声带轻瘫均发生在早期，可能是由于我们相对缺乏这种新方法和相关器械的经验。其他限制包括对侧肺叶中喉返神经的最佳可视化效果欠佳，以及难以接近胸骨下区域。
证据级别：4。

BACKGROUND & AIMS: INTRODUCTION:The International Circumpolar Surveillance network is a population-based surveillance system that collects data on invasive pneumococcal disease (IPD) in Northern Canada. A 7-valent pneumococcal conjugate vaccine was first introduced in some regions of Northern Canada in 2002, followed by 10-valent (2009) and 13-valent (PCV-13) vaccines (2010). A 23-valent polysaccharide (PPV-23) vaccine was first introduced in 1988 for special populations and adults aged 65 years and older. To describe the epidemiology in the context of pneumococcal vaccination programs, we analysed surveillance data from Northern Canada from 1999 to 2010. METHODS:A standardized case report form capturing demographic and clinical information was completed for all IPD cases in Northern Canada meeting the national case definition. Isolates were sent to a reference laboratory for confirmation, serotyping and antimicrobial resistance testing. Both laboratory and epidemiological data were sent to the Public Health Agency of Canada for analysis. Population denominators were obtained from Statistics Canada. RESULTS:From 1999 to 2010, 433 IPD cases were reported (average 36 cases per year). Incidence was greatest among infants aged < 2 years and among those aged 65 years and older, with an average annual incidence of 133 and 67 cases per 100,000 population, respectively. After a peak in incidence in 2008, rates among infants have declined. Incidence rates varied from 2 to 16 times greater, depending on the year, among Aboriginals compared to non-Aboriginals. Hospitalization was reported in 89% of all cases and the case fatality ratio was 6.0%. Clinical manifestations varied, with some patients reporting > 1 manifestation. Pneumonia was the most common (70%), followed by bacteremia/septicaemia (30%) and meningitis (8%). Approximately, 42% of cases aged < 2 years in 2009 and 2010 had serotypes covered by the PCV-13. In addition, the majority (89%) of serotypes isolated in cases aged 65 years and older were included in the PPV-23 vaccine. CONCLUSION:IPD continues to be a major cause of disease in Northern Canadian populations, with particularly high rates among infants and Aboriginals. Continued surveillance is needed to determine the impact of conjugate pneumococcal vaccine programs. Additional studies investigating factors that predispose infants and Aboriginal peoples would also be beneficial.

背景与目标： 简介：国际环极监视网络是一个基于人群的监视系统，收集加拿大北部的侵袭性肺炎球菌疾病（IPD）数据。 2002年在加拿大北部的某些地区首次引入了7价肺炎球菌结合疫苗，随后是10价（2009）和13价（PCV-13）疫苗（2010）。 1988年，针对特殊人群和65岁及以上的成年人首次引入了23价多糖（PPV-23）疫苗。为了描述肺炎球菌疫苗接种计划中的流行病学，我们分析了加拿大北部1999年至2010年的监测数据。
方法：完成了加拿大北部符合国家病例定义的所有IPD病例的标准化病例报告表，包括人口统计和临床信息。将分离物送到参考实验室进行确认，血清分型和抗菌素耐药性测试。实验室和流行病学数据均已发送至加拿大公共卫生局进行分析。人口分母来自加拿大统计局。
结果：从1999年到2010年，报告了433例IPD病例（平均每年36例）。在2岁以下的婴儿中和65岁及65岁以上的婴儿中，发病率最高，每10万人中的年平均发病率分别为133和67例。在2008年发病率达到峰值之后，婴儿的发病率有所下降。与非土著居民相比，土著居民的发病率每年变化2到16倍。据报告，所有病例中有89％住院，病死率为6.0％。临床表现各不相同，有些患者报告> 1种表现。肺炎是最常见的（70％），其次是菌血症/败血病（30％）和脑膜炎（8％）。 2009年和2010年，年龄小于2岁的病例中约有42％具有PCV-13覆盖的血清型。此外，PPV-23疫苗中包括65岁及65岁以上的大多数血清型（89％）。
结论：在加拿大北部人群中，IPD仍然是导致疾病的主要原因，婴儿和土著居民中IPD的发病率特别高。需要继续监测以确定结合的肺炎球菌疫苗计划的影响。进一步调查易患婴儿和原住民的因素也将是有益的。

BACKGROUND & AIMS: OBJECTIVE:To examine lessons learnt from the implementation of five Vanguard initiatives in the North East of England. DESIGN:Data collection comprised semistructured interviews with key informants at each site. SETTING:The study took place across six local authority areas in the North East of England and within six clinical commissioning groups responsible for the delivery of each Vanguard's aims and objectives. PARTICIPANTS:Sixty-six interviewees with participants from five Vanguard initiatives in the North East of England, including senior clinicians, project leads and directors, commissioners, and healthcare managers. RESULTS:While the context for each Vanguard is separate and distinct, there also exists a set of common issues which have a regional dimension. Participants felt that the national programme helped to raise the profile of local change initiatives and also contributed to the wider understanding of regional service integration issues. At the same time our findings demonstrate that all five sites experienced, and were subject to, unrealistic pressure placed on them to deliver outcomes. Of particular concern among all sites was the sheer scale and pace of change occurring at the same time as the National Health Service was being tasked with making significant, if unrealistic, efficiency savings. CONCLUSIONS:It is too early to conclude with any confidence that a successful outcome for the new care models programme will be forthcoming. While early indications show some encouraging signs of promise, the overall context in which the complex and ambitious changes are being implemented remains both fragile and fluid.

背景与目标： 目的：研究在英格兰东北部实施五项先锋计划的经验教训。
设计：数据收集包括对每个站点的关键信息提供者进行半结构化访谈。
地点：该研究在英格兰东北部的六个地方当局地区以及六个临床委托小组中进行，负责交付每个先锋队的目的和目标。
参与者：66名受访者来自英格兰东北部的五项先锋计划的参与者，包括高级临床医生，项目负责人和总监，专员和医疗保健经理。
结果：虽然每个先锋队的背景各不相同，但也存在一系列具有地区性的共同问题。与会者认为，国家方案有助于提高对地方变革举措的认识，也有助于对区域服务一体化问题的更广泛了解。同时，我们的发现表明，所有五个站点都经历了并且承受着施加结果的不切实际的压力。在所有站点中，特别令人担忧的是，在国家卫生服务局（National Health Service）承担着显着（即使不切实际）的效率节省的任务的同时，变化的规模和步伐是巨大的。
结论：现在断定新护理模式计划将取得成功，现在下定论还为时过早。尽管早期迹象显示出一些令人鼓舞的希望迹象，但正在实施复杂而雄心勃勃的变革的总体环境仍然脆弱而多变。

BACKGROUND & AIMS: :We sought to assess if electronic messaging/reminders could increase human papillomavirus (HPV) vaccine completion among adolescents and HPV knowledge among their parents. The study was conducted in two clinics in eastern North Carolina from March 2014-March 2016. Participants included English-speaking and/or Spanish-speaking, uninsured or Medicaid-insured parents and their children (ages 9-17). Intervention participants received text/email appointment reminders and education messages and controls received standard-of-care. The final sample included 257 parent-child dyads. Most identified as Black (60%) or Hispanic (28%). Completion rates for intervention and control groups were similar for HPV dose 2 (65% vs. 65%) and HPV dose 3 (35% vs. 30%), respectively. Although knowledge change was higher for the intervention group, this difference was not statistically significant. Those who reported provider vaccine recommendation were 1.8 times more likely to complete the series. Electronic reminders to promote vaccine completion were not effective in this population. More research is needed.

背景与目标： ：我们试图评估电子消息传递/提醒是否可以提高青少年中人乳头瘤病毒（HPV）疫苗的接种率以及其父母中HPV的知识。该研究于2014年3月至2016年3月在北卡罗莱纳州东部的两家诊所进行。参与者包括讲英语和/或说西班牙语，没有保险或有医疗补助的父母及其子女（9-17岁）。干预参与者收到了文本/电子邮件约会提醒，教育信息和控件收到了护理标准。最终样本包括257个亲子二元组。多数被确定为黑人（60％）或西班牙裔（28％）。 HPV剂量2（65％比65％）和HPV剂量3（35％比30％）的干预组和对照组的完成率相似。尽管干预组的知识变化较高，但这种差异在统计学上并不显着。报告提供者疫苗推荐的人群完成该系列疫苗的可能性是其1.8倍。促进疫苗完成的电子提醒在该人群中无效。需要更多的研究。

BACKGROUND & AIMS: :We have conducted a systematic review to update available information on plasmid-mediated colistin resistance (mobilized colistin resistance [mcr]) genes in North African countries. We have searched the articles of PubMed, Scopus, and Web of Science databases reporting plasmid-mediated colistin resistance bacteria isolated in North African countries. After searching and selection, 30 studies that included 208 mcr-positive isolates were included. Different mcr-positive strains frequencies were recorded and ranged from 2% in clinical isolates to 12.3% in environmental samples. Escherichia coli was the predominant species recorded and these microorganisms showed high resistance to ciprofloxacin and cotrimoxazole. IncHI2 plasmids are probably the key vectors responsible for the dissemination of mcr genes in these countries. This review highlighted that the mcr-positive isolates are circulating in different ecological niches with different frequencies. Therefore, actions should be implemented to prevent the dissemination of the mcr genes within and outside of these countries, such as microbiological and molecular surveillance programs and restriction use of colistin in farming.

背景与目标： ：我们进行了系统的综述，以更新北非国家中质粒介导的大肠菌素抗性（动员大肠菌素抗性[mcr]）基因的可用信息。我们搜索了PubMed，Scopus和Web of Science数据库的文章，这些文章报告了在北非国家分离的质粒介导的大肠菌素抗性细菌。经过搜索和选择，纳入了包括208个mcr阳性分离株的30个研究。记录了不同的mcr阳性菌株频率，范围从临床分离株的2％到环境样品的12.3％。大肠杆菌是记录的主要物种，这些微生物显示出对环丙沙星和卡曲美唑的高抗性。 IncHI2质粒可能是在这些国家/地区传播mcr基因的关键载体。这篇综述强调了mcr阳性分离株在不同生态位中以不同的频率传播。因此，应采取行动防止在这些国家内外传播mcr基因，例如微生物和分子监测计划以及限制大肠菌群的使用。

BACKGROUND & AIMS: OBJECTIVES:Transcutaneous bowel sonography is a nonionizing imaging modality used in inflammatory bowel disease. Although available in Europe, its uptake in North America has been limited. Since the accuracy of bowel sonography is highly operator dependent, low-volume centers in North America may not achieve the same diagnostic accuracy reported in the European literature. Our objective was to determine the diagnostic accuracy of bowel sonography in a nonexpert low-volume center. METHODS:All cases of bowel sonography at a single tertiary care center during an 18-month period were reviewed. Bowel sonography was compared with reference standards, including small-bowel follow-through, computed tomography, magnetic resonance imaging, colonoscopy, and surgical findings. RESULTS:A total of 103 cases were included for analysis during the study period. The final diagnoses included Crohn disease (72), ulcerative colitis (8), hemolytic uremic syndrome (1), and normal (22). The sensitivity and specificity of bowel sonography for intestinal wall inflammation were 87.8% and 92.6%, respectively. In the subset of patients who had complications of Crohn disease, the sensitivity and specificity were 50% and 100% for fistulas and 14% and 100% for strictures. One patient had an abscess, which was detected by bowel sonography. Abnormal bowel sonographic findings contributed to the escalation of treatment in 55% of cases. CONCLUSIONS:Bowel sonography for inflammatory bowel disease can be performed in low-volume centers and provides diagnostic accuracy for luminal disease comparable with published data, although it is less sensitive for complications of Crohn disease.

背景与目标： 目的：经皮肠超声检查是一种用于炎症性肠病的非电离成像方式。尽管在欧洲有售，但其在北美的使用受到限制。由于肠超声检查的准确性在很大程度上取决于操作员，因此北美的小容量医疗中心可能无法达到欧洲文献中报告的诊断准确性。我们的目标是确定非专业小剂量中心的肠超声检查的诊断准确性。
方法：回顾了18个月内在一家三级护理中心进行肠超声检查的所有病例。将肠超声检查与参考标准进行比较，包括小肠随访，计算机断层扫描，磁共振成像，结肠镜检查和手术结果。
结果：在研究期间共纳入103例病例进行分析。最终诊断包括克罗恩病（72），溃疡性结肠炎（8），溶血性尿毒症综合征（1）和正常（22）。肠超声检查对肠壁炎症的敏感性和特异性分别为87.8％和92.6％。在患有克罗恩病并发症的患者子集中，对瘘管的敏感性和特异性分别为50％和100％，对于狭窄则分别为14％和100％。一名患者脓肿，经肠超声检查发现。肠超声检查结果异常有助于55％的病例升级。
结论：炎症性肠病的肠镜检查可以在小容量的中心进行，尽管对克罗恩病的并发症敏感性较低，但可以提供与已发表的数据相媲美的腔内疾病的诊断准确性。

BACKGROUND & AIMS: :The area of mobile technologies applied to health (mHealth) is a growing worldwide trend that has generated enormous expectations for the mitigation of problems related to medical services delivery and public health stemming from a lack of resources and the limited number of specialists. The numerous opportunities offered by mobile technologies, together with their ease of use, have attracted the interest both of governments and universities. This is the case of the Ibero-American Mobile Technologies and Health Network (CYTED-RITMOS, Spanish acronym). As a result of the network's first year of activity, in October 2015 the RITMOS International Workshop was held in Barcelona to present the priority areas in Latin America where research, development, and innovation (R&D+i) projects on mobile health could be carried out and possible solutions found. The objective of this article is to present the potentialities and applicability of mHealth in the Region of the Americas.

背景与目标： ：应用于健康的移动技术（mHealth）领域正在发展，在全球范围内，由于缺乏资源和专家人数有限，人们对减轻与医疗服务提供和公共卫生有关的问题抱有极大的期望。移动技术所带来的众多机遇及其易用性吸引了政府和大学的兴趣。伊比利亚美洲移动技术和卫生网络（CYTED-RITMOS，西班牙首字母缩写）就是这种情况。作为网络第一年的活动的结果，2015年10月，RITMOS国际研讨会在巴塞罗那举行，介绍了拉丁美洲的优先领域，可以在该领域开展有关移动医疗的研究，开发和创新（R＆D i）项目，以及找到可能的解决方案。本文的目的是介绍移动医疗在美洲地区的潜力和适用性。

BACKGROUND & AIMS: BACKGROUND:Characterisation of risk groups who may benefit from pneumococcal vaccination is essential for the generation of recommendations and policy. METHODS:We reviewed the literature to provide information on the incidence and risk of invasive pneumococcal disease (IPD) in at-risk children in Europe and North America. The PubMed database was searched using predefined search terms and inclusion/exclusion criteria for papers reporting European or North American data on the incidence or risk of IPD in children with underlying medical conditions. RESULTS:Eighteen references were identified, 11 from North America and 7 from Europe, with heterogeneous study methods, periods and populations. The highest incidence was seen in US children positive for human immunodeficiency virus infection, peaking at 4167 per 100,000 patient-years in 2000. Studies investigating changes in incidence over time reported decreases in the incidence of IPD between the late 1990s and early 2000s. The highest risk of IPD was observed in children with haematological cancers or immunosuppression. Overall, data on IPD in at-risk children were limited, lacking incidence data for a wide range of predisposing conditions. There was, however, a clear decrease in the incidence of IPD in at-risk children after the introduction of 7-valent pneumococcal conjugate vaccine into immunisation programmes, as previously demonstrated in the general population. CONCLUSION:Despite the heterogeneity of the studies identified, the available data show a substantial incidence of IPD in at-risk children, particularly those who are immunocompromised. Further research is needed to determine the true risk of IPD in at-risk children, particularly in the post-PCV period, and to understand the benefits of vaccination and optimal vaccination schedules.

背景与目标： 背景：可能从肺炎球菌疫苗接种中受益的风险人群的表征对于产生建议和政策至关重要。
方法：我们回顾了文献，以提供有关欧洲和北美高危儿童的侵袭性肺炎球菌疾病（IPD）的发生率和风险的信息。使用预定义的搜索词和纳入/排除标准对PubMed数据库进行了搜索，以检索报告欧洲或北美患有基础疾病的儿童中IPD发生率或风险的数据。
结果：共确定了18篇参考文献，其中11篇来自北美，7篇来自欧洲，其研究方法，时期和人群各不相同。在人类免疫缺陷病毒感染呈阳性的美国儿童中发生率最高，在2000年达到峰值，每10万患者年中有4167名。调查随时间变化的研究报告说，在1990年代末至2000年代初，IPD发生率下降。在患有血液系统癌症或免疫抑制的儿童中，发生IPD的风险最高。总体而言，高危儿童的IPD数据有限，缺乏各种易患病情况的发病率数据。但是，将7价肺炎球菌结合疫苗引入免疫接种计划后，高危儿童IPD发生率明显下降，这在以前的一般人群中已得到证实。
结论：尽管已确定研究的异质性，但现有数据显示高危儿童，特别是免疫受损儿童的IPD发生率很高。需要进一步的研究来确定高危儿童中IPD的真正风险，尤其是在PCV后时期，并了解疫苗接种的好处和最佳的疫苗接种时间表。