BACKGROUND & AIMS: OBJECTIVES:A pilot NHS dental contract was introduced in Northern Ireland between 2015 and 2016, which involved changing the method for paying general dental practitioners working in the NHS from fee-for-service (FFS) to capitation-based payments, providing an opportunity for a robust evaluation. We investigated the impact of a change in payment methods on clinical activity and the quality of care provided. DESIGN:A difference-in-difference (DiD) evaluation was applied to clinical activity data from pilot NHS dental practices in Northern Ireland compared to matched control NHS practices and applied to a questionnaire survey of patient-rated outcomes of health outcomes and care quality. We estimated the impact on access to care, treatment activity levels, practice finances and patient-rated outcomes of care of a change from FFS to a capitation-based system for 1 year, as well as the impact of a reversion back to FFS at the end of the pilot period. RESULTS:The monthly number of registered patients in the pilot practices increased more than the control practices during the capitation period, by 1.5 registrations per 1000 registered patients. The monthly reductions in the volumes of all treatments in the pilot practices during the capitation period were much larger than the control practices, with 175 fewer treatment items. All measures rapidly returned to baseline levels following reversion from capitation back to FFS. NHS income per month increased in pilot practices, by £5920 per month (calculated on FFS item cost basis) more than controls in the capitation period. The analysis of patient questionnaires suggest found that patients notice differences only in waiting times, skill-mix and number of radiographs, but not on other measures of healthcare process and quality. CONCLUSION:General dental practitioners working in the NHS respond rapidly and consistently to changes in provider payment methods. A move from FFS to a capitation-based system had little impact on access to care, but did produce large reductions in clinical activity and patient charge income. Patients noticed little change in the service they received. This shows that changes in remuneration contracts have the potential to meet policy goals, such as meeting the expectations of patients within a predictable cost envelope. However, it is unlikely that all policy goals can be met simply by changing payment methods. Therefore, work is also needed to identify and evaluate interventions that can complement changes in remuneration to achieve desirable outcomes.

背景与目标： 目标：2015年至2016年之间，北爱尔兰引入了NHS牙科试点合同，该合同涉及将NHS工作的普通牙科医生的支付方式从按服务付费（FFS）改为按人头支付的支付方式，从而为可靠的评估。我们调查了付款方式变更对临床活动和所提供护理质量的影响。
设计：将差异差异（DiD）评估应用于北爱尔兰NHS试点牙科实践的临床活动数据，与相匹配的对照NHS实践进行比较，并应用于对患者预后的健康结果和护理质量进行问卷调查。我们估算了从FFS改为基于人为的系统1年的护理对获得护理，治疗活动水平，实践财务状况和患者评级的护理结果的影响，以及在治疗后恢复为FFS的影响。试用期结束。
结果：在人为干预期间，试点实践中每月注册患者的数量增加了超过对照实践，每1000名注册患者中增加了1.5个注册。在人为戒断期间，试点实践中所有治疗量的每月减少量大大多于对照实践，减少了175个治疗项目。从人头设置恢复为FFS后​​，所有衡量指标均迅速恢复到基线水平。试点实践的每月NHS收入增加了5920英镑（按FFS项目成本计算），超过了停职期间的控制水平。对患者问卷的分析表明，患者仅在等待时间，技能组合和X射线照片数量上注意到差异，而在其他医疗过程和质量指标上则没有差异。
结论：在NHS工作的普通牙科医生对供应商付款方式的变化迅速且始终如一地做出了反应。从FFS过渡到基于人头的系统对获得护理的影响不大，但确实导致临床活动和患者收费收入的大幅减少。患者注意到他们所接受的服务几乎没有变化。这表明薪酬合同的变更有可能实现政策目标，例如在可预测的费用范围内满足患者的期望。但是，仅通过更改付款方式就不可能实现所有政策目标。因此，还需要开展工作来确定和评估可以补充薪酬变动以实现理想成果的干预措施。

BACKGROUND & AIMS: :An amendment to this paper has been published and can be accessed via a link at the top of the paper.

背景与目标： ：已经发布了对本文的修订，可以通过本文顶部的链接进行访问。

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。

BACKGROUND & AIMS: BACKGROUND AND OBJECTIVE:A variety of cytokines are involved in the incidence and development of bronchial asthma. This study was designed to reveal the relationship among genetic polymorphism of cytokine genes, expression levels of cytokines and incidence of bronchial asthma. METHODS:We analyzed 14 single nucleotide polymorphism loci in the 10 major cytokine genes plus plasma protein levels of 7 proteins in the bronchial asthma patients (n = 108) and the healthy population (n = 88) of the Han people in northern China. The polymorphism-based genotypes were identified by the sequence-specific primer-polymerase chain reaction. The plasma protein levels were determined by enzyme-linked immunoassay. Bioinformatics analysis was applied to further data processing. RESULTS:Data presented here showed that the 6 polymorphism loci were significantly correlated with the incidence of asthma (p < 0.05). Two of them, IL-2 (-330) and IL-2 (+166), constituted a linkage disequilibrium block. The GG haplotype of this block gave a relatively higher correlation with asthma (p = 0.0767). The plasma protein levels of IgE, IL-6 and IL-1 beta correlated with a number of polymorphism loci tested (p < 0.05), of which IgE gave the most significant correlation. The plasma IL-10 and IL-12 levels of the patients in the asthma group were significantly lower than those of the healthy adults in the control group (p < 0.05), while IgE gave the opposite result (p < 0.0001). We constructed a prototype of the metabolic and regulatory network composed of bronchial asthma-related proteins. In this network, IL-6 and TNF-alpha, were found with a high degree (D = 343 and 235, respectively) and IL-1beta with a moderate degree of connection (D = 155). CONCLUSIONS:We have found that various degrees of correlation with cytokine genes and protein expression of single nucleotide polymorphism in bronchial asthma. IL-6 and IL-1beta appear to play important biological roles in the pathogenesis of asthma. During the analysis of correlation between genetic polymorphism and a complex disease, the effects of environmental factors should be taken into account. The information at the protein level should be fully developed and the bioinformatics techniques can be used for the comprehensive analysis, to have a deep understanding of molecular mechanisms of incidence and development of diseases.

背景与目标： 背景与目的：多种细胞因子参与支气管哮喘的发生和发展。本研究旨在揭示细胞因子基因遗传多态性，细胞因子表达水平和支气管哮喘发生率之间的关系。
方法：我们分析了中国北方汉族支气管哮喘患者（n = 108）和健康人群（n = 88）中10个主要细胞因子基因的14个单核苷酸多态性位点以及7种蛋白的血浆蛋白水平。通过序列特异性引物-聚合酶链反应鉴定了基于多态性的基因型。通过酶联免疫测定法测定血浆蛋白水平。生物信息学分析被应用于进一步的数据处理。
结果：这里显示的数据表明6个多态性位点与哮喘的发生率显着相关（p <0.05）。 IL-2（-330）和IL-2（166）中的两个构成了连锁不平衡嵌段。该区域的GG单倍型与哮喘的相关性相对较高（p = 0.0767）。 IgE，IL-6和IL-1β的血浆蛋白水平与测试的多个多态性基因座相关（p <0.05），其中IgE的相关性最为显着。哮喘组患者的血浆IL-10和IL-12水平显着低于对照组健康成年人（p <0.05），而IgE则相反（p <0.0001）。我们构建了由支气管哮喘相关蛋白组成的代谢和调节网络的原型。在该网络中，发现IL-6和TNF-α的程度较高（分别为D = 343和235），而IL-1beta的连接程度为中等（D = 155）。
结论：我们发现支气管哮喘与细胞因子基因和单核苷酸多态性的蛋白质表达有不同程度的相关性。 IL-6和IL-1beta在哮喘的发病机理中似乎起着重要的生物学作用。在分析遗传多态性与复杂疾病之间的相关性时，应考虑环境因素的影响。应该充分开发蛋白质水平的信息，并可以使用生物信息学技术进行综合分析，以深刻理解疾病的发病和发展的分子机制。

BACKGROUND & AIMS: :A subsurface thermohaline front semi-permanently formed in association with near-bottom cyclonic circulation in the northern East China Sea was newly found from detailed hydrographic data collected during two cruises in February 2017 (winter) and April 2018 (spring) along with supplementary satellite remote sensing and historical hydrographic data. An alternate intruding frontal structure in water properties was observed across the cyclonic circulation in both seasons as formed by two contrasting water masses-low-temperature and low-salinity (i.e., low spiciness) water transported by the East China Sea Current and high-temperature and high-salinity (i.e., high spiciness) water transported by the Tsushima Warm Current. Consistent structures were confirmed from current observations during the two cruises, historical hydrographic observations, and satellite altimetry-derived sea surface height and surface frontal structure, indicative of retroflection of the Cheju Warm Current as deemed by the seasonal development of thermal stratification in spring. Our results reveal significant heat and material exchanges between the open Pacific and the broad shelf, particularly via diapycnal mixing and cross-front transports associated with across-front flow and cyclonic circulation, in the northern East China Sea.

背景与目标： ：在2017年2月（冬季）和2018年4月（春季）的两次航行中收集的详细水文数据中，新发现了与东海北部近底气旋循环半永久结合形成的地下热盐线前体。遥感和历史水文数据。在两个季节的整个气旋循环中，观察到了交替的侵入性锋面结构，这是由东海洋流和高温输送的两个相反的水团形成的，即低温和低盐度（即低辣度）水形成的。以及对马暖流输送的高盐度（即高辣度）水。两次航行中的当前观测，历史水文观测以及卫星测高仪得出的海面高度和表面锋面结构都证实了一致的结构，这表明了春季热分层的季节性发展表明了济州暖流的逆转。我们的研究结果揭示了东太平洋北部太平洋与大陆架之间存在大量的热和物质交换，特别是通过二叠氮混合和跨前沿流动和旋风循环相关的跨前沿运输。

BACKGROUND & AIMS: :This article surveys the botanical composition of 40 Muslim graveyards in northern Israel, accompanied by an ethnobotanical study of the folkloristic traditions of the use of these plants in cemeteries. Three groups of plants were found to be repeated systematically and were also recognized for their ritual importance: aromatics herbs (especially Salvia fruticosa and Rosmarinus officinalis), white flowered plants (mainly Narcissus tazetta, Urginea maritima, Iris spp. and Pancratium spp.) and Cupressus sempervirens as the leading cemetery tree. As endemic use we can indicate the essential role of S. fruticosa as the main plant used in all human rites of passage symbolizing the human life cycle. The rosemary is of European origin while the use of basil is of Indian influence. The use of white flowers as cemeteries plants reflects an old European influence and almost the same species are used or their congeners. Most of the trees and shrubs that are planted in Muslim cemeteries in Israel have the same use in ancient as well in modern European cultures. In conclusion, our findings on the occurrence of plants in graveyards reflect the geographic situation of Israel as a crossroads in the cultural arena between Asia and Europe. Most of the traditions are common to the whole Middle East showing high relatedness to the classical world as well as to the present-day Europe.

背景与目标： ：本文调查了以色列北部40个穆斯林墓地的植物学组成，并进行了民族植物学研究，研究了在墓地使用这些植物的民俗传统。发现三类植物可以系统地重复，并且在仪式上也很重要：芳香植物（特别是丹参和迷迭香），白花植物（主要是水仙，水母，虹膜和Pancratium。）和柏（Cupressus sempervirens）为领先的公墓树。作为特有的使用，我们可以指出金黄色葡萄球菌是在所有象征人类生命周期的人类通行仪式中使用的主要植物的重要作用。迷迭香是欧洲起源的，而罗勒的使用则具有印度的影响力。将白花用作墓地植物反映了欧洲的古老影响，几乎使用相同的物种或它们的同类。以色列穆斯林公墓中种植的大多数树木和灌木在古代和现代欧洲文化中都有相同的用途。总而言之，我们对墓地中植物生长的发现反映了以色列作为亚洲和欧洲之间文化交流的十字路口的地理状况。大多数传统是整个中东地区共有的，与古典世界以及当今的欧洲都息息相关。

BACKGROUND & AIMS: :Estimates of iron status in a random sample (218 men, 283 women) of the Northern Ireland population (aged 18-64 years) were obtained from blood measurements. Multiple criteria were used to determine Fe deficiency and body Fe stores were calculated as an index of Fe sufficiency. Three distinct groups with respect to Fe stores were identified on the basis of sex and menstrual status. Estimates of body Fe stores, mean (and SD), were 13.4 (SD 5.97), 5.3 (SD 6.09) and 8.5 (SD 6.72) mM for men, woman aged 18-44 years and women aged 45-64 years respectively. The prevalence of Fe-deficiency anaemia was low, ranging from 0.5% in men to 6.6% and 4.6% in the younger and older women respectively. The prevalence of Fe deficiency was low in men (1.4%) and older women (5.7%) rising to 11.0% in the younger group of women. The disproportionately elevated serum ferritin relative to transferrin saturation supported the suggestion that chronic inflammation might have influenced Fe status measurements in men and older women.

背景与目标： ：从血液测量中获得北爱尔兰人口（18-64岁）的随机样本（218例男性，283例女性）中铁的状况估计值。使用多个标准来确定铁缺乏症，并计算体内铁存储量作为铁充足性的指标。根据性别和月经状况，确定了关于铁存储的三个不同的类别。男性，18-44岁的女性和45-64岁的女性的体内铁存储量的平均值（和SD）分别为13.4（SD 5.97），5.3（SD 6.09）和8.5（SD 6.72）mM。缺铁性贫血的患病率很低，从男性的0.5％到年轻女性和老年女性的6.6％和4.6％。男性中铁缺乏症的患病率较低（1.4％），老年妇女中铁缺乏症的患病率（5.7％）上升至11.0％。相对于转铁蛋白饱和度而言，血清铁蛋白的升高不成比例地支持了这样的建议，即慢性炎症可能已经影响了男性和老年女性的铁状态测量。

BACKGROUND & AIMS: BACKGROUND:Knowledge, attitudes, and practices (KAP) surveys regarding zoonotic diseases are crucial to understanding the extent of knowledge among citizens and for guiding health-related education programs. METHOD:Employing a structured questionnaire, we interviewed residents (n = 388) in three districts of northern Tanzania (Karatu n = 128, Monduli n = 114, Babati n = 146) to assess knowledge, attitudes and reported practices regarding three zoonotic diseases that occur in the region (anthrax, brucellosis, and rabies). We used generalized linear mixed effects models and multi-model inference to identify demographic correlates of knowledge. RESULTS:Proportional average district- and disease- specific knowledge scores ranged from 0.14-0.61. We found positive correlations between age and knowledge of symptoms, causes and treatments of anthrax (three districts), brucellosis (three districts), and rabies (one district). Gender, ethnic identity, formal education and ownership of livestock or dogs had variable effects on knowledge among the interviewed population. Risk perceptions regarding different diseases varied across districts and were positively correlated with knowledge of the specific diseases. Direct interactions with livestock and domestic dogs were reported to occur across all demographic groups, suggesting that most people living in rural settings of our study area are potentially exposed to zoonotic diseases. Behaviors which may favor transmission of specific pathogens (such as consumption of raw milk or meat) were occasionally reported and varied by district. Wildlife was generally regarded as negative or neutral with regard to overall veterinary and human health. CONCLUSION:The combination of variable knowledge about zoonotic diseases in the three districts, reported occurrence of practices that are conducive to pathogen transmission, and previously documented circulation of pathogens causing anthrax, brucellosis and rabies in our study system, call for health education programs embedded in a holistic One Health approach.

背景与目标： 背景：关于人畜共患病的知识，态度和实践（KAP）调查对于理解公民之间的知识范围以及指导与健康相关的教育计划至关重要。
方法：采用结构化问卷，我们采访了坦桑尼亚北部三个地区的居民（n = 388），评估了三种人畜共患病的知识，态度和所报告的做法，这些知识涉及三种人畜共患病发生在该地区（炭疽，布鲁氏菌病和狂犬病）。我们使用广义线性混合效应模型和多模型推理来识别知识的人口统计相关性。
结果：地区和疾病特定知识的平均比例分数范围为0.14-0.61。我们发现年龄与症状知识，炭疽病（三个地区），布鲁氏菌病（三个地区）和狂犬病（一个地区）的知识，成因和治疗之间存在正相关。性别，种族身份，正规教育和牲畜或狗的所有权对受访者的知识产生了不同的影响。关于不同疾病的风险认知因地区而异，并且与特定疾病的知识呈正相关。据报道，在所有人口群体中，牲畜和家犬都有直接的相互作用，这表明大多数居住在我们研究区域农村地区的人都可能患有人畜共患病。偶尔报告了可能有利于特定病原体传播的行为（例如食用生牛奶或肉），并且各地区有所不同。在整个兽医和人类健康方面，野生生物通常被认为是消极的或中立的。
结论：结合三个地区对人畜共患疾病的可变知识，报告了有利于病原体传播的实践的发生以及先前在我们的研究系统中记录的导致炭疽，布鲁氏菌病和狂犬病的病原体的传播，呼吁建立健康教育计划一种整体的“一站式”治疗方法。

BACKGROUND & AIMS: :The language abilities of 42 8-year-old preterm children with birth weight < 1,750 g from a 1-year birth cohort in northern Finland was studied with four different language tests. Control children from the same birth cohort matched individually with their preterm pairs for age, sex, twinship, mother's education, place of residence, birth order and family type were also studied. In psycholinguistic test, auditory skills did not differ between the preterm and the full-term groups. Nor did any other linguistic subtest differentiate between the groups. Instead, the preterm children scored significantly poorer than their controls in visual subtests. The study also showed that the poor performance in visual tests was associated with neonatal morbidity, namely neonatal infections, need for continuous positive airway pressure (CPAP) treatment and patent ductus arteriosus (PDA). When studying the language abilities of preterm children, we suggest that qualitative methods should be used to analyse linguistic skills. We recommend versatile follow-up of preterm children until school age.

背景与目标： ：通过四个不同的语言测试，研究了芬兰北部1岁出生队列中42名8岁以下体重小于1750 g的早产儿的语言能力。还研究了来自同一出生队列的对照儿童，并分别对其年龄，性别，双胞胎，母亲的教育程度，居住地，出生顺序和家庭类型进行配对。在心理语言测试中，早产组和足额组之间的听觉技能没有差异。其他语言子测验也没有区分这两组。取而代之的是，早产儿在视觉子测验中的得分明显低于对照组。该研究还表明，视力检查的不良表现与新生儿发病率（即新生儿感染），持续持续气道正压通气（CPAP）治疗和动脉导管未闭（PDA）的发生有关。在研究早产儿的语言能力时，我们建议应使用定性方法来分析语言能力。我们建议对学龄前儿童进行多方面的随访，直到学龄前。