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。

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。

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。

BACKGROUND & AIMS: :Statistics on treatment rates for patients with end stage renal disease (ESRD) show that the number of ESRD patients per million population in the United Kingdom has increased slowly in recent years. The British Transplantation Society issued questionnaires in 1983 and 1984 to determine the number of patients transplanted, the number of suitable patients, and the facilities needed to enable all suitable patients to receive treatment. While there is a high transplant rate, the percentage of ESRD patients on dialysis is low, and there is a "socially unacceptable deficit" with respect to treatment of diabetics and the elderly.

背景与目标： ：晚期肾病（ESRD）患者治疗率的统计数据表明，近年来英国每百万人口中ESRD患者的人数增长缓慢。英国移植学会在1983年和1984年发布了调查表，以确定移植的患者数量，合适的患者数量以及使所有合适的患者都能接受治疗所需的设施。尽管移植率很高，但接受透析的ESRD患者的比例却很低，并且在糖尿病患者和老年人的治疗方面存在“社会上无法接受的缺陷”。

BACKGROUND & AIMS: :A large-scale study was carried out in order to determine the contamination level of antineoplastic drugs in pharmacies and to investigate the suitability and effects of wipe sample monitoring at regular intervals. A specific study design was developed. The 130 participating pharmacies were divided into a study and a control group, carrying out five and two wipe sampling cycles, respectively. The work practice was analyzed using questionnaires to identify factors that influence the contamination level. From 1269 wipe samples, 774 (61%) were contaminated with at least one of the analyzed cytotoxic drugs: cyclophosphamide, docetaxel, etoposide, 5-fluorouracil, gemcitabine, ifosfamide, methotrexate, and paclitaxel. A significant decrease of the contamination with cyclophosphamide and 5-fluorouracil was observed in the study group. The Monitoring-Effect Study of Wipe Sampling in Pharmacies method has proven to be a reliable and affordable tool for contamination control. Based on the 90th percentile of the contamination values, a substance-independent performance-based guidance value of 0.1ng cm(-2) has been derived.

背景与目标： ：进行了一项大规模研究，以确定药房中抗肿瘤药的污染水平，并定期调查擦拭样品监测的适用性和效果。开发了具体的研究设计。将130家参与活动的药店分为研究组和对照组，分别进行了5次和2次擦拭采样。使用调查表对工作实践进行了分析，以找出影响污染水平的因素。从1269个擦拭样品中，有774个（61％）被至少一种分析的细胞毒性药物污染：环磷酰胺，多西他赛，依托泊苷，5-氟尿嘧啶，吉西他滨，异环磷酰胺，甲氨蝶呤和紫杉醇。在研究组中观察到环磷酰胺和5-氟尿嘧啶的污染显着降低。药房擦拭采样的监测效果研究方法被证明是一种可靠且负担得起的污染控制工具。基于污染值的第90个百分位数，得出了与物质无关的基于性能的指导值0.1ng cm（-2）。

BACKGROUND & AIMS: :Studies show that both low physical activity (PA) and adiposity are associated with a higher risk of hypertension. However, the relationship between PA and blood pressure in adolescents is controversial and other studies have reported that no association was observed. Of particular interest is the evaluation of whether the association between PA and high blood pressure is independent of adiposity. A sample of 3764 Brazilian adolescents who attend high schools was selected using random cluster sampling. Data were collected using the Global School-based Student Health Survey, anthropometry, and blood pressure readings. The prevalence of high blood pressure was 14.6% (95% Confidence Interval (CI) 13.5-15.7), higher amongst males (20.0%; 95%CI 18.0-22.1) compared with females (10.9%; 95%CI 9.7-12.3). Sixty-six per cent of the adolescents were reported to be insufficiently active. The prevalence of high blood pressure was 12.8% (95%CI 11.0-14.7) amongst active compared with 15.4% (95%CI 14.0-16.9) amongst insufficiently active adolescents. The association between PA and high blood pressure was observed only amongst females after adjusting for waist circumference (odds ratio (OR) 1.67; 95%CI 1.21-2.31) and body mass index (OR 1.71; 95%CI 1.23-2.37). Notwithstanding levels of adiposity, higher PA levels are associated with a lower prevalence of high blood pressure amongst females, although not amongst males.

背景与目标： 研究表明，低体力活动（PA）和肥胖都与高血压风险较高相关。但是，青少年PA与血压之间的关系存在争议，其他研究也报告没有相关性。特别感兴趣的是评估PA与高血压之间的关联是否独立于肥胖。使用随机整群抽样选择了3764名就读高中的巴西青少年。使用基于全球学校的学生健康调查，人体测量学和血压读数收集数据。高血压患病率为14.6％（95％置信区间（CI）13.5-15.7），其中男性（20.0％; 95％CI 18.0-22.1）高于女性（10.9％; 95％CI 9.7-12.3） 。据报告，百分之六十六的青少年缺乏足够的活动。活跃的高血压患病率为12.8％（95％CI 11.0-14.7），而活跃度不足的青少年则为15.4％（95％CI 14.0-16.9）。仅在调整腰围（优势比（OR）1.67； 95％CI 1.21-2.31）和体重指数（OR 1.71； 95％CI 1.23-2.37）后，才在女性中观察到PA与高血压之间的关联。尽管有脂肪水平，但PA水平较高与女性中高血压的患病率较低相关，而男性之间则不然。

BACKGROUND & AIMS: :The objective of this study was to evaluate the effects of ultrasound-mediated analyte diffusion on permeability of normal, benign, and cancerous human lung tissue in vitro and to find more effective sonophoretic (SP) delivery in combination with the optical clearing agents (OCAs) method to distinguish normal and diseased lung tissues. The permeability coefficients of SP in combination with OCAs diffusion in lung tissue were measured with Fourier-domain optical coherence tomography (FD-OCT). 30% glucose and SP with a frequency of 1 MHz and an intensity of 0.80  W/cm2 over a 3 cm probe was simultaneously applied for 15 min. Experimental results show that the mean permeability coefficients of 30% glucose/SP were found to be (2.01±0.21)×10(-5)  cm/s from normal lung (NL) tissue, (2.75±0.28)×10(-5)  cm/s from lung benign granulomatosis (LBG) tissue, (4.53±0.49)×10(-5)  cm/s from lung adenocarcinoma tumor (LAT) tissue, and (5.81±0.62)×10(-5)  cm/s from lung squamous cell carcinoma (LSCC) tissue, respectively. The permeability coefficients of 30% glucose/SP increase approximately 36.8%, 125.4%, and 189.1% for the LBG, LAT, and LSCC tissue compared with that for the NL tissue, respectively. There were statistically significant differences in permeability coefficients of 30% glucose/SP between LBG and NL tissue (p<0.05), between LAT and NL tissue (p<0.05), and between LSCC and NL tissue (p<0.05). The results suggest that the OCT functional imaging technique to combine an ultrasound-OCAs combination method could become a powerful tool in early diagnosis and monitoring of changed microstructure of pathologic human lung tissue.

背景与目标： ：这项研究的目的是评估超声介导的分析物扩散对正常，良性和癌性人肺组织的体外渗透性的影响，并与光学清除剂（OCA）结合发现更有效的超声导入（SP）方式）区分正常和患病肺组织的方法。用傅里叶域光学相干断层扫描（FD-OCT）测量SP的渗透系数以及OCA在肺组织中的扩散。同时在3 cm探针上施加30％的葡萄糖和SP，频率为1 MHz，强度为0.80 W / cm2，持续15分钟。实验结果表明，与正常肺组织相比，30％葡萄糖/ SP的平均渗透系数为（2.01±0.21）×10（-5）cm / s，（2.75±0.28）×10（-5）肺良性肉芽肿病（LBG）组织的cm / s，肺腺癌肿瘤（LAT）组织的（4.53±0.49）×10（-5）cm / s和（5.81±0.62）×10（-5）cm /分别来自肺鳞状细胞癌（LSCC）组织。与NL组织相比，LBG，LAT和LSCC组织的30％葡萄糖/ SP的渗透系数分别增加了约36.8％，125.4％和189.1％。 LBG和NL组织之间（p <0.05），LAT和NL组织之间（p <0.05）以及LSCC和NL组织之间（p <0.05）的30％葡萄糖/ SP的通透性系数在统计学上有显着差异。结果表明，OCT功能成像技术结合超声-OCAs组合方法可能成为早期诊断和监测病理性人肺组织微观结构变化的有力工具。

BACKGROUND & AIMS: :Dietary protein and amino acid requirement recommendations for normal "healthy" children and adults have varied considerably with 2007 FAO/WHO protein requirement estimates for children lower, but dietary essential AA requirements for adults more than doubled. Requirement estimates as presented do not account for common living conditions, which are prevalent in developing countries such as energy deficit, infection burden and added functional demands for protein and AAs. This study examined the effect of adjusting total dietary protein for quality and digestibility (PDCAAS) and of correcting current protein and AA requirements for the effect of infection and a mild energy deficit to estimate utilizable protein (total protein corrected for biological value and digestibility) and the risk/prevalence of protein inadequacy. The relationship between utilizable protein/prevalence of protein inadequacy and stunting across regions and countries was examined. Data sources (n = 116 countries) included FAO FBS (food supply), UNICEF (stunting prevalence), UNDP (GDP) and UNSTATS (IMR) and USDA nutrient tables. Statistical analyses included Pearson correlations, paired-sample/non-parametric t-tests and linear regression. Statistically significant differences were observed in risk/prevalence estimates of protein inadequacy using total protein and the current protein requirements versus utilizable protein and the adjusted protein requirements for all regions (p < 0·05). Total protein, utilizable protein, GDP per capita and total energy were each highly correlated with the prevalence of stunting. Energy, protein and utilizable protein availability were independently and negatively associated with stunting (p < 0·001), explaining 41 %, 34 % and 40 % of variation respectively. Controlling for energy, total protein was not a statistically significant factor but utilizable protein remained significant explaining~45 % of the variance (p = 0·017). Dietary utilizable protein provides a better index of population impact of risk/prevalence of protein inadequacy than crude protein intake. We conclude that the increased demand for protein due to infections and mild to moderate energy deficits, should be appropriately considered in assessing needs of populations where those conditions still prevail.

背景与目标： ：对于正常的“健康”儿童和成年人，饮食中蛋白质和氨基酸的需求建议相差很大，因为2007年FAO / WHO对儿童的蛋白质需求量估计值有所降低，但成年人的饮食中必需氨基酸的需求量增加了一倍以上。提出的需求估算并未考虑到发展中国家普遍存在的生活条件，例如能量不足，感染负担以及对蛋白质和氨基酸的额外功能需求。这项研究检查了调整饮食中总蛋白质的质量和消化率（PDCAAS）的效果，以及针对感染和轻度能量不足的影响校正当前蛋白质和AA需求以估算可利用蛋白质的影响（校正了总蛋白质的生物学价值和消化率），以及蛋白质不足的风险/患病率。研究了可利用的蛋白质/蛋白质不足的患病率与跨地区和国家发育迟缓之间的关系。数据来源（n = 116个国家）包括粮农组织FBS（食品供应），UNICEF（致病率），UNDP（GDP）和UNSTATS（IMR）和USDA营养表。统计分析包括Pearson相关性，成对样本/非参数t检验和线性回归。在所有区域中，使用总蛋白和当前蛋白需求量与可利用蛋白和调整后的蛋白需求量相比，蛋白不足的风险/患病率估计值中存在统计学上的显着差异（p <0·05）。总蛋白，可利用蛋白，人均GDP和总能量均与发育迟缓的发生率高度相关。能量，蛋白质和可利用的蛋白质利用率与发育迟缓独立相关并且呈负相关（p <0·001），分别解释了41％，34％和40％的变异。控制能量时，总蛋白质不是统计学上显着的因素，但是可利用的蛋白质仍然是重要的，解释了〜45％的方差（p = 0·017）。与粗蛋白摄入量相比，膳食可利用蛋白对蛋白质不足风险/流行的总体影响指数提供了更好的指标。我们得出的结论是，在评估那些情况仍然普遍存在的人群的需求时，应适当考虑由于感染和轻度至中度的能量不足导致的蛋白质需求增加。

BACKGROUND & AIMS: :While physical activity (PA) improves functions for activities of daily living, little is known of the association between meeting published PA Guidelines for Americans (PAGA) and meeting published physical function guidelines for maintaining independence. The purpose of this study was to examine the association between meeting the PAGA and meeting independence criteria on the Senior Fitness Tests (SFT). Older adults (N = 265) completed SFTs, assessing cardiorespiratory fitness, lower and upper body strength, mobility, and self-reported aerobic and resistance PA. Chi-square tests and logistic regressions examined associations between meeting PAGA and SFT independence criteria. A significant relationship was found between meeting aerobic PAGA and cardiorespiratory and upper body SFT criteria; a significant relationship was found between meeting resistance PAGA and upper body strength criteria. Although research suggests that PAGA are effective in maintaining fitness in older adults when PA is structured and monitored, mixed results were found for self-reported PA and SFT criteria.

背景与目标： ：尽管体育锻炼（PA）改善了日常生活活动的功能，但人们对满足已发布的《美国PA指南》（PAGA）与满足已发布的维持独立性的身体功能指南之间的关联知之甚少。这项研究的目的是检验满足PAGA和达到高级体能测验（SFT）的独立性标准之间的关联。老年人（N = 265）完成了SFT，评估了心肺健康状况，上下体强度，活动性以及自我报告的有氧和抵抗力PA。卡方检验和逻辑回归检验了满足PAGA和SFT独立性标准之间的关联。在满足有氧PAGA与心肺和上身SFT标准之间发现了显着的关系。在满足抵抗力PAGA和上身强度标准之间发现了显着的关系。尽管研究表明，当对PA进行结构化和监测时，PAGA可以有效地保持老年人的健康，但对于自我报告的PA和SFT标准，发现了好坏参半的结果。