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【与癫痫的骨保护行为有关的自我效能，知识，健康信念，生活质量和污名。】
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DOI：10.1016/j.yebeh.2006.07.007
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BACKGROUND & AIMS: :It is well reported in the epilepsy literature that use of antiepileptic drugs (AEDs) leads to bone loss. Validated instruments were administered to assess knowledge, health behavior, quality of life, and stigma, to determine their effects on self-efficacy for osteoprotective and self-management behaviors. This adult epilepsy population had a mean age of 45, with 20 years of AED exposure. Fifty subjects were Caucasian and 44 were non-Caucasian. By one-way ANOVA, there were significant differences in self-efficacy based on ethnicity, medical assistance, status, and seizure frequency. Differences in knowledge based on ethnicity, education, and income were also noted. Regression analysis revealed that the factors that most predict self-efficacy for calcium, exercise, and self-management do not parallel each other. Age and ethnicity were predictive of self-efficacy for epilepsy self-management only. Medical management factors varied among the models. Overall quality of life was a positive predictor for both calcium and exercise self-efficacy.背景与目标： ：在癫痫文献中有充分的报道指出，使用抗癫痫药（AED）会导致骨质流失。使用经过验证的工具来评估知识，健康行为，生活质量和污名，以确定它们对自我保护的自我保护作用以及对骨保护和自我管理行为的影响。该成人癫痫患者的平均年龄为45岁，暴露于AED的时间为20年。五十名受试者是高加索人，四十四名是非高加索人。通过单因素方差分析，根据种族，医疗救助，身份和癫痫发作频率，自我效能有显着差异。还指出了基于种族，教育和收入的知识差异。回归分析显示，大多数预测钙，运动和自我管理的自我效能的因素并不相互平行。年龄和种族仅能预测癫痫自我管理的自我效能。医疗管理因素因模型而异。总体生活质量是钙和运动自我效能的积极预测指标。 -
【评估冠状动脉患者的预后：性能和通用严重性指标的定制。】
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DOI：10.1378/chest.111.6.1666
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BACKGROUND & AIMS: STUDY OBJECTIVE:To assess the prognostic performance of general severity systems (APACHE II [acute physiology and chronic health evaluation], simplified acute physiology score [SAPS II], and mortality probability models [MPM II]) in coronary patients and to derive new customized indexes for coronary patients using a reduced number of variables.
DESIGN:Inception cohort.
SETTING:Adult medical and surgical ICUs in 17 hospitals in Catalonia and the Balearic Islands.
PATIENTS:Four hundred fifty-six patients with acute myocardial infarction.
MEASUREMENTS AND RESULTS:The APACHE II, SAPS II, and MPM II variables and survival status at hospital discharge have been collected. Performance of the severity systems was assessed by evaluating calibration and discrimination. Logistic regression was used to customize the MPM II(24) and SAPS II indexes. Discrimination was high enough for all of the models. However, calibration of the MPM II(24) was not as satisfactory as for the other models. The MPM II(24) and SAPS II were both reduced to five variables (MPM II(24 cor:) age, PaO2, continuous vasoactive drugs, urinary output, and mechanical ventilation; SAPS II(cor:) age, PaO2/FI(O2) ratio, systolic BP, Glasgow coma score, and urinary output). Both models showed better calibration and discrimination than the original ones.
CONCLUSIONS:Prognostic indexes developed for multidisciplinary patients show good performance when applied to patients with acute myocardial infarction, but customization can reduce the number of variables necessary to compute them without a loss of, and a possible improvement in, prognostic accuracy.
背景与目标： 研究目标：评估以下方面的一般严重程度系统的预后性能（APACHE II [急性生理学和慢性健康评估]，简化的急性生理学评分[SAPS II]和死亡率概率模型[MPM II]）。
DESIGN ：初始队列。
设置 ：加泰罗尼亚和巴利阿里群岛的17家医院中的成人医疗和外科加护病房。
患者：456例急性心肌梗死患者。
测量与结果：已收集了APACHE II，SAPS II和MPM II变量以及出院时的生存状况。严重性系统的性能通过评估校准和判别来评估。 Logistic回归用于自定义MPM II（24）和SAPS II索引。对所有模型的歧视程度都很高。但是，MPM II（24）的校准不如其他型号令人满意。 MPM II（24）和SAPS II都减少到五个变量（MPM II（24 cor :)年龄，PaO2，连续血管活性药物，尿量和机械通气； SAPS II（cor :)年龄，PaO2 / FI（ O2）比，收缩压，格拉斯哥昏迷评分和尿量）。两种模型均显示出比原始模型更好的校准和辨别力。
结论：针对多学科患者开发的预后指标在应用于急性心肌梗死患者时显示出良好的性能，但定制可以减少这种情况。计算变量所需的变量数量，而不会损失预后准确性，并且可能会改善预后准确性。
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【自组装蛋白纤维上的模板化生物矿化。】
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DOI：10.1073/pnas.0602952103
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BACKGROUND & AIMS: :Biological mineralization of tissues in living organisms relies on proteins that preferentially nucleate minerals and control their growth. This process is often referred to as "templating," but this term has become generic, denoting various proposed mineral-organic interactions including both chemical and structural affinities. Here, we present an approach using self-assembled networks of elastin and fibronectin fibers, similar to the extracellular matrix. When induced onto negatively charged sulfonated polystyrene surfaces, these proteins form fiber networks of approximately 10-mum spacing, leaving open regions of disorganized protein between them. We introduce an atomic force microscopy-based technique to measure the elastic modulus of both structured and disorganized protein before and during calcium carbonate mineralization. Mineral-induced thickening and stiffening of the protein fibers during early stages of mineralization is clearly demonstrated, well before discrete mineral crystals are large enough to image by atomic force microscopy. Calcium carbonate stiffens the protein fibers selectively without affecting the regions between them, emphasizing interactions between the mineral and the organized protein fibers. Late-stage observations by optical microscopy and secondary ion mass spectroscopy reveal that Ca is concentrated along the protein fibers and that crystals form preferentially on the fiber crossings. We demonstrate that organized versus unstructured proteins can be assembled mere nanometers apart and probed in identical environments, where mineralization is proved to require the structural organization imposed by fibrillogenesis of the extracellular matrix.背景与目标： ：生物体内组织的生物矿化依赖蛋白质优先使矿物质成核并控制其生长。该过程通常被称为“模板化”，但该术语已变得通用，表示各种提议的矿物-有机相互作用，包括化学亲和力和结构亲和力。在这里，我们提出一种使用弹性蛋白和纤连蛋白纤维自组装网络的方法，类似于细胞外基质。当被诱导到带负电荷的磺化聚苯乙烯表面上时，这些蛋白质形成大约10微米间距的纤维网络，在它们之间留下了杂乱的蛋白质的开放区域。我们引入基于原子力显微镜的技术来测量碳酸钙矿化之前和期间结构化和杂乱无序的蛋白质的弹性模量。在矿化的早期阶段，很明显地证明了矿物质诱导的蛋白质纤维的增厚和变硬，早在离散的矿物晶体足够大以至于无法通过原子力显微镜成像时。碳酸钙选择性地使蛋白质纤维变硬而不影响它们之间的区域，强调了矿物质和有组织的蛋白质纤维之间的相互作用。通过光学显微镜和二次离子质谱的后期观察显示，Ca沿着蛋白质纤维集中，并且晶体优先在纤维交叉处形成。我们证明有组织的与非结构化的蛋白质可以仅相隔纳米而组装在一起，并在相同的环境中进行探测，在该环境中，矿化被证明需要细胞外基质的原纤维形成所强加的结构组织。
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【皮肤病变功能评估的表征策略。】
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DOI：10.1016/j.burns.2006.03.022
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BACKGROUND & AIMS: :Assessment of wound healing is a complex task, especially when the lesion is associated to significant (full thickness) loss of the skin. The clinical observation, essentially subjective and highly dependent on the observer's experience, creates difficulties in the comparison of results. Scoring scales were introduced in the clinical practice to create comparable semi-quantitative data and promote better management of resources, but its usefulness in a clinical perspective is still limited. New non-invasive biometric methodologies, although infrequently used, have opened new possibilities. While complementing the clinical observation and contributing to therapeutic decisions and prognosis, they may also help to look further into the pathophysiological mechanisms of scarring drugs rehabilitation. Following previous work in this arena, the authors review, the state-of-the-art of cutaneous wound healing clinical and biometric follow up, proposing a diagnosis correlation for the most relevant descriptors found in both strategies in order to fully characterise the different stages of the healing process.背景与目标： ：伤口愈合的评估是一项复杂的任务，尤其是当病变与皮肤的严重（全层）损失有关时。临床观察本质上是主观的，并且高度依赖观察者的经验，因此在比较结果时会遇到困难。在临床实践中引入了评分量表，以创建可比较的半定量数据并促进更好的资源管理，但其在临床上的实用性仍然有限。新的非侵入性生物识别方法学虽然很少使用，但开辟了新的可能性。在补充临床观察并有助于治疗决策和预后的同时，它们还可能有助于进一步研究疤痕药物康复的病理生理机制。在此领域的先前工作之后，作者回顾了最新的皮肤伤口愈合临床和生物测定学随访情况，提出了两种策略中最相关的描述符的诊断相关性，以全面表征不同阶段愈合过程。
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【亚洲和澳大利亚学生的酒精期望值，拒绝饮酒的自我效能感和饮酒行为。】
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DOI：10.1016/j.drugalcdep.2006.08.019
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BACKGROUND & AIMS: :The effects of alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE) in predicting alcohol consumption in Caucasians has been well studied. However, the role of AE and DRSE in Asian students is still not well understood. This study reported on this using Caucasian (n=98) and Asian (n=92) student samples. Participants completed the Alcohol Use Disorder Identification Test (AUDIT) to measure their hazardous alcohol consumption, and the drinking expectancy profile (DEP) to assess their alcohol related expectancies and ability to resist drinking in certain situations. Results showed that Caucasians reported significantly higher confidence, higher sexual interest, and higher tension reduction expectancies than Asians. Conversely, Asians significantly expected cognitive enhancement and negative consequences more than Caucasians. Relative to Caucasians, the Asian sample also reported that they would be more able to refuse alcohol when under social pressure. Results from regression analyses showed that for the Caucasian sample, AE, DRSE and their interactions were significant predictors of alcohol consumption. For the Asian group, the only significant effect to emerge was that DRSE was negatively related to alcohol consumption. The clinical implications of the differential pattern of results between the samples are discussed in terms of self-efficacy and negative consequences of alcohol consumption, especially when dealing with university aged individuals.背景与目标： ：酒精期望值（AE）和拒绝饮酒的自我效能感（DRSE）在预测高加索人饮酒中的作用已得到充分研究。但是，对于亚洲学生来说，AE和DRSE的作用仍未得到很好的理解。这项研究报告了使用白种人（n = 98）和亚洲人（n = 92）学生样本的情况。参与者完成了“酒精使用障碍识别测试”（AUDIT）来测量其有害酒精的摄入量，并通过饮酒期望量表（DEP）来评估其与酒精有关的期望值以及在某些情况下的抗饮酒能力。结果显示，与亚洲人相比，高加索人报告的自信心，性兴趣和减少紧张的期望值明显更高。相反，与白种人相比，亚洲人对认知增强和负面后果的期望更高。相对于高加索人，亚洲样本还报告说，在社会压力下，他们更有能力拒绝饮酒。回归分析的结果表明，对于高加索人样本，AE，DRSE及其相互作用是酒精消费的重要预测指标。对于亚洲人群而言，出现的唯一重要影响是DRSE与饮酒量呈负相关。从自我效能和饮酒的负面影响方面，讨论了样品之间结果差异模式的临床意义，尤其是在与大学年龄的个体打交道时。
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【通过预测的热应变模型评估职业热应力。】
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DOI：10.2486/indhealth.44.380
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BACKGROUND & AIMS: :The work of the main European research teams in the field of thermal factors was coordinated in order to improve significantly the Required Sweat Rate model published as an international standard. Many significant modifications were brought, in particular concerning the effects of forced convection, body movements and exercise and the prediction of the skin temperature as a function of the rectal temperature and in case of severe conditions of radiation, humidity and clothing. The criteria for acceptable work durations in hot environments were updated concerning the maximum increase in core temperature and the acceptable water loss. The revised model, called Predicted Heat Strain model, was validated through a set of lab and field experiments involving stable and fluctuating conditions with high and low radiation, humidity and air velocity. It is meanwhile adopted as an ISO and CEN standard. In addition, a strategy was developed to assess the risks of heat disorders in any working situation. It is based on the three highest stages of the SOBANE strategy: an "Observation" method for improving simply the thermal conditions of work; an "Analysis" method to evaluate the magnitude of the problem and optimise the choice of solutions and an "Expert" method for in depth analysis of the working situation when needed.背景与目标： ：协调了主要的欧洲研究团队在热因素领域的工作，以便显着改善作为国际标准发布的“要求的出汗率”模型。带来了许多重要的改进，特别是关于强制对流，身体运动和运动的影响以及根据直肠温度以及在严重的辐射，湿度和衣服条件下皮肤温度的预测。更新了高温环境下可接受的工作时间标准，有关核心温度的最大升高和可接受的水分流失。经过修订的模型称为预测的热应变模型，已通过一组实验室和现场实验进行了验证，这些实验涉及稳定和波动的条件，以及高低辐射，湿度和空气速度。同时，它被用作ISO和CEN标准。此外，还制定了一项策略来评估在任何工作情况下发生热病的风险。它基于SOBANE策略的三个最高阶段：“观察”方法，用于简单地改善工作的热工条件；一种“分析”方法，用于评估问题的严重程度并优化解决方案的选择；另一种“专家”方法，用于在需要时对工作状况进行深入分析。
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7 Complete pre-operative imaging assessment of abdominal aortic aneurysm with spiral CT angiography.
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【螺旋CT血管造影术对腹部主动脉瘤进行完整的术前影像学评估。】
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DOI：10.1016/s0009-9260(97)80132-8
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BACKGROUND & AIMS: PURPOSE:A prospective evaluation of spiral CT angiography (SCTA) as the sole pre-operative imaging modality for abdominal aortic aneurysm repair.
MATERIALS AND METHODS:Spiral CT angiography was compared with conventional transfemoral angiography in 30 patients and results correlated with surgical findings in 22 patients. The following features were assessed: renal artery number and disease; upper and lower aneurysm extent; aneurysm size; perianeurysmal inflammation; iliac artery disease; radiation dose; and contrast usage.
RESULTS:Spiral CT angiography agreed with conventional angiography in all cases of severe stenosis or occlusion of renal arteries and had 90% agreement overall for renal artery disease. Two of nine accessory renal arteries seen at conventional angiography were missed. For showing aneurysm extent SCTA was 100% sensitive, and performed better than conventional angiography. Aneurysm size was better shown with SCTA. In iliac disease SCTA, as performed in this study, was poor for mild-moderate disease, but detected four of six severely stenosed/occluded iliac arteries seen at conventional angiography. Prospective sensitivity for perianeurysmal inflammation was 33%. Radiation dose for SCTA was approximately twice and contrast dose approximately three times that for conventional angiography.
CONCLUSION:Spiral CT angiography can provide all the necessary imaging information to plan aneurysm repair in the non-claudicant.
背景与目标： 目的：前瞻性评价螺旋CT血管造影（SCTA）作为腹主动脉瘤修复术前唯一的影像学检查方法。
材料与方法：螺旋CT血管造影与常规经股动脉血管造影在30例患者中进行了比较，结果与22例患者的手术结果相关。评估以下特征：肾动脉数量和疾病；上下动脉瘤程度；动脉瘤大小；动脉瘤周围炎;动脉疾病;辐射剂量
结果：在所有严重狭窄或肾动脉阻塞的病例中，螺旋CT血管造影与常规血管造影相符，并且总体上90％符合肾动脉疾病。在常规血管造影术中发现的9条辅助肾动脉中有2条漏诊了。为了显示动脉瘤的程度，SCTA是100％敏感的，并且比常规的血管造影术表现更好。使用SCTA可以更好地显示动脉瘤的大小。在这项研究中进行的动脉疾病中，SCTA对于轻度中度疾病较差，但在常规血管造影术中发现了6条严重狭窄/闭塞的动脉中的4条。对动脉瘤周围炎症的预期敏感性为33％。 SCTA的放射剂量约为常规血管造影的两倍，对比剂量约为传统血管造影的三倍。
结论：螺旋CT血管造影可以提供所有必要的影像学信息，以计划在非-claudicant。
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【使用MR数字减影血管造影评估儿童颅内病变的血液供应。】
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DOI：10.1007/s00247-006-0268-1
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BACKGROUND & AIMS: BACKGROUND:MR digital subtraction angiography (MR-DSA) is a contrast-enhanced MR angiographic sequence that enables time-resolved evaluation of the cerebral circulation. OBJECTIVE:We describe the feasibility and technical success of our attempts at MR-DSA for the assessment of intracranial pathology in children. MATERIALS AND METHODS:We performed MR-DSA in 15 children (age range 5 days to 16 years) referred for MR imaging because of known or suspected intracranial pathology that required a dynamic assessment of the cerebral vasculature. MR-DSA consisted of a thick (6-10 mm) slice-selective RF-spoiled fast gradient-echo sequence (RF-FAST) acquired before and during passage of an intravenously administered bolus of Gd-DTPA. The images were subtracted and viewed as a cine loop. RESULTS:MR-DSA was performed successfully in all patients. High-flow lesions were shown in four patients; these included vein of Galen aneurysmal malformation, dural fistula, and two partially treated arteriovenous malformations (AVMs). Low-flow lesions were seen in three patients, all of which were tumours. Normal flow was confirmed in eight patients including two with successfully treated AVMs, and in three patients with cavernomas. CONCLUSION:Our early experience suggests that MR-DSA is a realistic, non-invasive alternative to catheter angiography in certain clinical settings.背景与目标： 背景：MR数字减影血管造影（MR-DSA）是一种对比增强的MR血管造影序列，可对脑循环进行时间分辨评估。
目的：我们描述了MR-DSA评估儿童颅内病理的尝试的可行性和技术成功。
材料与方法：由于已知或疑似颅内病理，需要动态评估脑血管，我们对15例接受MR成像的儿童（年龄范围5天至16岁）进行了MR-DSA检查。 MR-DSA由厚的（6-10 mm）切片选择性RF破坏的快速梯度回波序列（RF-FAST）组成，在静脉内给予Gd-DTPA推注之前和期间均已获得。减去图像并将其视为电影循环。
结果：所有患者均成功进行了MR-DSA检查。四名患者出现高流量病灶。其中包括Galen动脉瘤畸形静脉，硬脑膜瘘和两个经过部分治疗的动静脉畸形（AVM）。在三名患者中均发现了低流量病变，所有这些都是肿瘤。在八名患者中确认了正常血流，其中包括两名成功治疗过的AVM和三名患有海绵状瘤的患者。
结论：我们的早期经验表明，在某些临床情况下，MR-DSA是导管血管造影术的一种现实的，非侵入性的替代方法。 -
【麻醉师术前评估心输出量储备和输血可能性的差异：一项前瞻性研究。】
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DOI：10.1177/0310057X0603400407
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BACKGROUND & AIMS: :The aim of this pilot study was to investigate anaesthetists' assessment of the ability of patients to increase cardiac output over a range of clinical scenarios and of their perceived 'likelihood of transfusion' in these scenarios. Specialist anaesthetists were given a questionnaire with clinical cues in the form of diagnoses about theoretical patients. They were asked to use 100 mm visual analogue scales (VAS) for their assessments of each patient's cardiac reserve and their 'likelihood of transfusion' of these patients; the endpoints of the VAS being 'Very low' (0 mm) to 'High' (100 mm), and 'Do not transfuse' (0 mm) to 'Transfuse' (100 mm) respectively. The assessment of patients' cardiac output reserve by anaesthetists (n = 54) showed great variation; for example, a patient with severe aortic stenosis was perceived overall to have a limited ability to increase cardiac output (mean VAS 16 mm) but there was considerable variation between anaesthetists (25-75 percentiles 10 mm to 21 mm). Assessment of 'likelihood of transfusion' (n = 42) also had great variation; as an example a patient with 'angina' with a haemoglobin of 95 g l(-1) was perceived overall to have an average likelihood of transfusion of 50 mm, but the 25-75 percentiles ranged from 33 mm to 71 mm. This study suggests that inter-anaesthetist variability in the assessment of a patient's 'cardiac output reserve' and his 'likelihood of transfusion' is large.背景与目标： ：这项初步研究的目的是调查麻醉师对患者在一系列临床情况下增加心输出量的能力以及他们在这些情况下感知的“输血可能性”的评估。专家麻醉师接受了有关临床线索的问卷调查，形式是对理论患者的诊断。他们被要求使用100 mm视觉模拟量表（VAS）评估每个患者的心脏储备和这些患者的“输血可能性”。 VAS的端点分别为“非常低”（0毫米）至“高”（100毫米）和“请勿输液”（0毫米）至“输液”（100毫米）。麻醉师对患者心输出量储备的评估（n = 54）显示出很大的差异。例如，总的来说，严重的主动脉瓣狭窄患者的心输出量增加能力有限（平均VAS 16毫米），但麻醉师之间差异很大（10毫米至21毫米为25-75％）。对“输血可能性”的评估（n = 42）也有很大差异。例如，患有“心绞痛”且血红蛋白为95 g l（-1）的患者总体上被认为平均输血的可能性为50 mm，但25-75％的范围为33 mm至71 mm。这项研究表明，麻醉师之间在评估患者的“心输出量储备”和“输血可能性”方面存在很大差异。
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【自私自利的惩罚与合作的发展。】
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DOI：10.1111/j.1420-9101.2006.01151.x
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BACKGROUND & AIMS: -2背景与目标： -2
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【自我收集的宫颈阴道取样，用于基于医疗地点的基于HPV的子宫颈癌初步筛查：在农村服务水平不高的希腊人口中进行的一项初步研究。】
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DOI：10.1080/01443615.2017.1323197
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BACKGROUND & AIMS: :In the present pilot study, the feasibility of a site-of-care cervicovaginal self-sampling methodology for HPV-based screening was tested in 346 women residing in underserved rural areas of Northern Greece. These women provided self-collected cervicovaginal sample along with a study questionnaire. Following molecular testing, using the cobas® HPV Test, Roche®, HPV positive women, were referred to colposcopy and upon abnormal findings, to biopsy and treatment. Participation rate was 100%. Regular pap-test examination was reported for 17.1%. Among hrHPV testing, 11.9% were positive and colposcopy/biopsy revealed 2 CIN3 cases. Non-compliance was the most prevalent reason for no previous attendance. Most women reported non-difficulty and non-discomfort in self-sampling (77.6% and 82.4%, respectively). They would choose self-sampling over clinician-sampling (86.2%), and should self-sampling being available, they would test themselves more regularly (92.3%). In conclusion, self-sampling is feasible and well-accepted for HPV-based screening, and could increase population coverage in underserved areas, helping towards successful prevention.背景与目标： ：在本项初步研究中，对希腊北部农村地区服务水平低下的346名妇女进行了基于宫颈癌阴道自我采样方法的HPV筛查的可行性的测试。这些妇女提供了自己收集的宫颈阴道样本以及研究问卷。在进行分子测试后，使用cobas®HPV测试，将Roche®，HPV阳性女性进行阴道镜检查，并在发现异常后进行活检和治疗。参与率为100％。定期进行巴氏试验检查的报道为17.1％。在hrHPV测试中，有11.9％呈阳性，阴道镜检查/活检显示有2例CIN3病例。不遵守是没有参加会议的最普遍原因。大多数妇女在自我抽样中报告没有困难和不舒服（分别为77.6％和82.4％）。他们将选择自采样而不是临床医生采样（86.2％），并且如果可以使用自采样，他们将更定期地进行自我测试（92.3％）。总之，对于基于HPV的筛查，自我抽样是可行的并且被广泛接受，并且可以扩大服务不足地区的人口覆盖率，有助于成功进行预防。
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【客观面部皮肤质量分析后，光老化严重程度的自我认知变化和皮肤癌风险。】
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DOI：
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BACKGROUND & AIMS: :
Background: Despite public education efforts, many people at risk for skin cancer do not practice safe sun behaviors.
Objective: To determine whether machine-based evaluation of UV-induced alterations (VISIA scan) changes self-assessment of facial photoaging, skin cancer risk, and willingness to improve sun protective habits. In addition, to determine whether VISIA scan analysis reveals differences between those with versus without a history of skin cancer, men versus women, those older than 50 versus less than 50 years of age, and Fitzpatrick skin types I-III versus IV-VI.
Methods: Volunteers attending a health expo were recruited and queried about their perceived risk of skin cancer and degree of skin photoaging. All participants underwent facial skin quality analysis of both sides of the face, and then completed a follow-up survey.
Results: Participants' scored self-perceptions of overall skin aging were all statistically significantly worse after VISIA scan analysis. There was no change in perceived skin cancer risk, but most participants expressed intent to improve their sun protection habits.
Limitations: Limitations to this study include selection bias, recall-misclassification bias, and social desirability bias.
Conclusion: Intervention with facial skin analysis can positively affect subjects' stated intent to use sun protection, indicating the importance of appearance in these health decisions.
J Drugs Dermatol. 2017;16(5):453-459.
.背景与目标： ：背景：尽管进行了公众教育，但许多有皮肤癌风险的人仍未进行安全的日晒行为。
目的：确定是否对紫外线诱发的变化进行基于机器的评估（VISIA扫描）改变面部光老化的自我评估，皮肤癌的风险以及改善防晒习惯的意愿。此外，为了确定VISIA扫描分析是否能揭示出有或没有皮肤癌病史，男性与女性，年龄大于50岁与小于50岁以及Fitzpatrick I-III和IV-VI皮肤类型之间的差异。
方法：招募参加健康博览会的志愿者，并询问他们对皮肤癌的感知风险和皮肤光老化程度。所有参与者都进行了面部两面的面部皮肤质量分析，然后完成了一项后续调查。
结果：在进行VISIA扫描后，参与者对总体皮肤衰老的自我感觉评分在统计学上均显着变差分析。知觉的患皮肤癌风险没有改变，但大多数参与者表示有意改善其防晒习惯。
局限性：本研究的局限性包括选择偏见，召回分类错误和社会可取性偏见。 / p>
结论：进行面部皮肤分析的干预可以正面影响受试者陈述的使用防晒的意图，这表明在这些健康决定中外表的重要性。
J Dermatol。 2017; 16（5）：453-459。 。
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【严重脑外伤中白质损伤和结局的评估：一项预期的多中心队列研究。】
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DOI：10.1097/ALN.0b013e3182755558
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BACKGROUND & AIMS: BACKGROUND:Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS:In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n=38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS:Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS:White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score.背景与目标： 背景：现有的预测严重颅脑外伤后恢复的方法缺乏准确性。这项研究的目的是确定定量扩散张量成像（DTI）的预后价值。
方法：在一项多中心研究中，作者前瞻性地招募了105名在颅脑外伤后至少7天仍保持昏迷状态的患者。患者接受了脑磁共振成像，包括在20个预选的白质区中的DTI。使用改良的格拉斯哥成果量表对患者进行1年评估。在该训练数据库上构建了综合的DTI评分以进行预后，然后在独立的数据库上进行了验证（n = 38）。将DTI得分与国际预后和临床试验分析得分进行比较。
结果：使用DTI评分预测训练数据库上的不良结果，接收器工作特征曲线下方的面积为0.84（95％CI：0.75-0.91）。 DTI评分对不良结局的预测具有64％的敏感性和95％的特异性。在独立于验证的数据库上，接收器工作特性曲线下的面积为0.80（95％CI：0.54-0.94）。在培训数据库上，与国际临床试验预后和评估得分相比，重新分类方法显示出分类准确度的显着提高（P <0.05）。在验证数据库上观察到了相似的结果。
结论：与可用的临床/影像学预后评分相比，定量DTI的白质评估可提高长期结果预测的准确性。 -
【评估水痘带状疱疹病毒抗原的皮肤测试，以预测带状疱疹的风险。】
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DOI：10.1017/S0950268812002671
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BACKGROUND & AIMS: :The Shozu Herpes Zoster (SHEZ) Study was designed to clarify the incidence of and predictive and immunological factors for herpes zoster in a defined community-based Japanese population. As part of this series, a total of 5683 residents aged ≥50 years received a varicella-zoster virus (VZV) skin test with VZV antigen, and 48 h later, the erythema and oedema were assessed by measuring the longest diameter. The diameters of both the erythema and oedema decreased with the increasing age of the subject. Sixty-three subjects contracted herpes zoster within a year after receiving the VZV skin test. Analysis of the herpes zoster incidence rate vs. the skin test reaction revealed that the shorter the diameter of erythema or oedema, the greater the likelihood of herpes zoster. These results demonstrated that the VZV skin test is an excellent surrogate marker for predicting the risk of herpes zoster.背景与目标： ：Shozu疱疹带状疱疹（SHEZ）研究旨在阐明在特定的以社区为基础的日本人群中带状疱疹的发病率以及预测性和免疫学因素。作为该系列的一部分，共有5683名年龄≥50岁的居民接受了带有VZV抗原的水痘-带状疱疹病毒（VZV）皮肤测试，并且48小时后，通过测量最长直径来评估红斑和浮肿。红斑和水肿的直径随受试者年龄的增加而减小。接受VZV皮肤测试后一年内，六十三名受试者患了带状疱疹。带状疱疹发病率与皮肤试验反应的关系分析表明，红斑或水肿的直径越短，带状疱疹的可能性就越大。这些结果表明，VZV皮肤测试是预测带状疱疹风险的出色替代指标。
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【患者咨询课程对一年级药学专业学生的沟通理解，预期结果和自我效能的影响。】
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DOI：10.5688/ajpe768152
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BACKGROUND & AIMS: OBJECTIVES:To evaluate first-year doctor of pharmacy (PharmD) students' communication apprehension, outcome expectations, and self-efficacy for communication over the duration of a 15-week patient-counseling course. DESIGN:First-year PharmD students (n=94) were asked to complete a 47-item, self-administered questionnaire on 3 occasions over the duration of the Nonprescription Drugs/Patient-Counseling course during the fall 2009 and 2010 semesters. ASSESSMENT:Eighty-seven of 94 students completed the survey instrument across data collection periods. There were significant reductions in total communication apprehension scores and in the communication apprehension subscores for meetings and public speaking, and significant increases in self-efficacy over time. No differences were found for outcome expectations of communication scores or the subscores for interpersonal conversations and group discussion. CONCLUSIONS:Communication apprehension may be decreased and self-efficacy for communication increased in first-year PharmD students through a 15-week Nonprescription Drugs/Patient-Counseling course using small-group practice sessions, case studies, and role-play exercises in conjunction with classroom lectures.背景与目标： 目的：评估一年级药学专业（PharmD）的学生在为期15周的患者咨询课程中的沟通理解，结局预期以及沟通的自我效能。
设计：要求一年级PharmD学生（n = 94）在2009年秋季和2010年学期的非处方药/患者咨询课程期间，分3次填写一份自行管理的问卷。
评估：94名学生中有87名在数据收集期间完成了调查工具。会议和公众演讲的总的沟通理解分数和沟通理解分数明显降低，并且随着时间的流逝，自我效能显着提高。没有发现人际交往和小组讨论的交流分数或子分数的预期结果有差异。
结论：通过参加15周的非处方药/患者咨询课程，使用小组实践会议，案例研究和角色扮演练习以及与之相结合的活动，可以降低一年级PharmD学生的沟通恐惧感，并提高沟通的自我效能。课堂讲座。
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