BACKGROUND & AIMS: :Kashmir musk deer Moschus cupreus (KMD) are the least studied species of musk deer. We compiled genetically validated occurrence records of KMD to construct species distribution models using Maximum Entropy. We show that the distribution of KMD is limited between central Nepal on the east and north-east Afghanistan on the west and is primarily determined by precipitation of driest quarter, annual mean temperature, water vapor, and precipitation during the coldest quarter. Precipitation being the most influential determinant of distribution suggests the importance of pre-monsoon moisture for growth of the dominant vegetation, Himalayan birch Betula utilis and Himalayan fir Abies spectabilis, in KMD's preferred forests. All four Representative Concentration Pathway Scenarios result an expansion of suitable habitat in Uttarakhand, India, west Nepal and their associated areas in China in 2050s and 2070s but a dramatic loss of suitable habitat elsewhere (Kashmir region and Pakistan-Afghanistan border). About 1/4th of the current habitat will remain as climate refugia in future. Since the existing network of protected areas will only include a tiny fraction (4%) of the climatic refugia of KMD, the fate of the species will be determined by the interplay of more urgent short-term forces of poaching and habitat degradation and long-term forces of climate change.

背景与目标： ：克什米尔麝鹿Moschus cupreus（KMD）是麝香鹿研究最少的物种。我们汇编了经过遗传验证的KMD发生记录，以使用最大熵构建物种分布模型。我们表明，KMD的分布在东部的尼泊尔中部和西部的阿富汗东北部之间是有限的，并且主要取决于最干燥季度的降水，年平均温度，水蒸气和最冷季度的降水。降水是影响分布的最主要决定因素，表明季风前的湿度对于KMD首选森林中的主要植被喜马拉雅桦木桦和喜马拉雅冷杉的生长很重要。所有这四个代表性的集中路径情景都导致2050年代和2070年代在印度的北阿坎德邦，尼泊尔西部和其相关地区的合适栖息地得到扩大，但其他地方（克什米尔地区和巴基斯坦与阿富汗交界）的合适栖息地却急剧减少。将来，目前约有1/4的栖息地仍将作为气候避难所。由于现有的保护区网络仅占KMD气候避难所的一小部分（4％），因此物种的命运将取决于更紧急的短期盗猎和栖息地退化以及长期的，长期的，长期的相互作用。气候变化的长期力量。

BACKGROUND & AIMS: :Prescribed burning is a common management tool to control fuel loads, ground vegetation, and facilitate desirable game species. We evaluated soil fungal community responses to long-term prescribed fire treatments in a loblolly pine forest on the Piedmont of Georgia and utilized deep Internal Transcribed Spacer Region 1 (ITS1) amplicon sequencing afforded by the recent Ion Torrent Personal Genome Machine (PGM). These deep sequence data (19,000 + reads per sample after subsampling) indicate that frequent fires (3-year fire interval) shift soil fungus communities, whereas infrequent fires (6-year fire interval) permit system resetting to a state similar to that without prescribed fire. Furthermore, in nonmetric multidimensional scaling analyses, primarily ectomycorrhizal taxa were correlated with axes associated with long fire intervals, whereas soil saprobes tended to be correlated with the frequent fire recurrence. We conclude that (1) multiplexed Ion Torrent PGM analyses allow deep cost effective sequencing of fungal communities but may suffer from short read lengths and inconsistent sequence quality adjacent to the sequencing adaptor; (2) frequent prescribed fires elicit a shift in soil fungal communities; and (3) such shifts do not occur when fire intervals are longer. Our results emphasize the general responsiveness of these forests to management, and the importance of fire return intervals in meeting management objectives.

背景与目标： ：规定的燃烧是一种常用的管理工具，可以控制燃料负荷，地面植被并促进理想的猎物种类。我们评估了佐治亚州皮埃蒙特市火炬松森林中土壤真菌群落对长期处方火处理的反应，并利用了最新的离子激流型个人基因组机（PGM）提供的深度内部转录间隔区1（ITS1）扩增子序列。这些深层序列数据（二次采样后每个样本有19,000个读数）表明，频繁火灾（3年火灾间隔）转移了土壤真菌群落，而罕见火灾（6年火灾间隔）使系统重置为类似于没有规定火灾的状态。此外，在非度量多维标度分析中，主要是外生菌根类群与长发火间隔相关的轴相关，而土壤腐生菌往往与频繁发火相关。我们得出的结论是：（1）多重离子洪流PGM分析可对真菌群落进行深度经济有效的测序，但可能会出现读取长度短和测序衔接子附近序列质量不一致的问题； （2）经常发生的明火引发土壤真菌群落的转移； （3）火灾间隔较长时不会发生这种变化。我们的结果强调了这些森林对管理的总体反应能力，以及回火间隔对实现管理目标的重要性。

BACKGROUND & AIMS: :This paper presents and discusses the U.S. Army telemedicine support systems currently available to our deployed forces in Southwest Asia. Organization and structure of the support system are discussed, along with some of the business rules and policies developed for its use. Some of the lessons learned are directly applicable to any type of large-scale telemedicine deployment, civilian or military.

背景与目标： ：本文介绍并讨论了目前可供我们在西南亚部署的部队使用的美国陆军远程医疗支持系统。讨论了支持系统的组织和结构，以及为使用而开发的一些业务规则和策略。从中汲取的一些经验教训可直接应用于民用或军用的任何类型的大规模远程医疗部署。

BACKGROUND & AIMS: BACKGROUND:Klebsiella pneumoniae is a leading cause of bloodstream infection (BSI). Strains producing extended-spectrum beta-lactamases (ESBLs) or carbapenemases are considered global priority pathogens for which new treatment and prevention strategies are urgently required, due to severely limited therapeutic options. South and Southeast Asia are major hubs for antimicrobial-resistant (AMR) K. pneumoniae and also for the characteristically antimicrobial-sensitive, community-acquired "hypervirulent" strains. The emergence of hypervirulent AMR strains and lack of data on exopolysaccharide diversity pose a challenge for K. pneumoniae BSI control strategies worldwide. METHODS:We conducted a retrospective genomic epidemiology study of 365 BSI K. pneumoniae from seven major healthcare facilities across South and Southeast Asia, extracting clinically relevant information (AMR, virulence, K and O antigen loci) using Kleborate, a K. pneumoniae-specific genomic typing tool. RESULTS:K. pneumoniae BSI isolates were highly diverse, comprising 120 multi-locus sequence types (STs) and 63 K-loci. ESBL and carbapenemase gene frequencies were 47% and 17%, respectively. The aerobactin synthesis locus (iuc), associated with hypervirulence, was detected in 28% of isolates. Importantly, 7% of isolates harboured iuc plus ESBL and/or carbapenemase genes. The latter represent genotypic AMR-virulence convergence, which is generally considered a rare phenomenon but was particularly common among South Asian BSI (17%). Of greatest concern, we identified seven novel plasmids carrying both iuc and AMR genes, raising the prospect of co-transfer of these phenotypes among K. pneumoniae. CONCLUSIONS:K. pneumoniae BSI in South and Southeast Asia are caused by different STs from those predominating in other regions, and with higher frequency of acquired virulence determinants. K. pneumoniae carrying both iuc and AMR genes were also detected at higher rates than have been reported elsewhere. The study demonstrates how genomics-based surveillance-reporting full molecular profiles including STs, AMR, virulence and serotype locus information-can help standardise comparisons between sites and identify regional differences in pathogen populations.

背景与目标： 背景：肺炎克雷伯菌是引起血液感染（BSI）的主要原因。产生广谱β-内酰胺酶（ESBLs）或碳青霉烯酶的菌株被认为是全球重点病原体，由于严重的治疗选择有限，因此迫切需要新的治疗和预防策略。南亚和东南亚地区是抗药性（AMR）肺炎克雷伯氏菌以及典型的抗微生物药敏性，社区获得的“高毒力”菌株的主要枢纽。高毒力AMR菌株的出现和胞外多糖多样性数据的缺乏对全球肺炎克雷伯氏菌BSI控制策略提出了挑战。
方法：我们对来自南亚和东南亚的七个主要医疗机构的365例BSI肺炎克雷伯氏菌进行了回顾性基因组流行病学研究，使用肺炎克雷伯菌特异性Kleborate提取临床相关信息（AMR，毒力，K和O抗原基因座）。基因组分型工具。
结果：K。肺炎BSI分离株高度多样化，包括120个多基因座序列类型（ST）和63 K个基因座。 ESBL和碳青霉烯酶基因频率分别为47％和17％。在28％的分离物中检测到与高毒力相关的航空细菌素合成位点（iuc）。重要的是，有7％的分离株带有iuc加上ESBL和/或碳青霉烯酶基因。后者代表基因型AMR毒力收敛，通常被认为是一种罕见现象，但在南亚BSI中尤为普遍（17％）。最令人担忧的是，我们鉴定了同时携带iuc和AMR基因的七个新型质粒，从而提高了这些表型在肺炎克雷伯菌之间共转移的前景。
结论：K。南亚和东南亚的肺炎BSI是由与其他地区不同的ST引起的，并且获得性毒力决定因素的频率更高。同时检测到同时携带iuc和AMR基因的肺炎克雷伯氏菌的检出率也高于其他地方。这项研究表明，基于基因组的监测报告全分子概况（包括ST，AMR，毒力和血清型基因座信息）如何帮助标准化站点之间的比较并确定病原体种群的区域差异。

BACKGROUND & AIMS: BACKGROUND:FAS cell surface death receptor (FAS) gene has 2 common single nucleotide polymorphisms (SNPs) in its promoter, FAS-1377G > A (rs2234767) and FAS-670A > G (rs1800682). Several studies have investigated the role of these 2 polymorphisms in etiology of breast cancer in Asian population while the outcomes are inconsistent. To derive a more precise assessment of the association between breast cancer susceptibility with FAS gene promoter SNPs, a meta-analysis of published studies was performed. MATERIAL AND METHODS:We systematically searched PubMed, Embase, Web of Science, and the Chinese biomedical database (CBM) for papers published until November 1, 2018. Odds ratio (OR) with 95% confidential interval (95%CI) was conducted to evaluate the associations. Statistical analysis was conducted using Stata13.0 software. A total of 8 studies covering 2564 cases and 2633 controls were included. RESULTS:The integrated results suggest the following: For the FAS-1377G/A polymorphism, we only found significant associations for allele G vs allele A (OR = 1.100, 95%CI = 1.004-1.206, P = .040). After stratification by ethnicity, a significant association was observed only for the AA+GA vs GG genotype in East Asian populations (OR = 1.177, 95% CI = 1.010-1.371, P = .037). The association was not found in West Asian populations. For the FAS -670A/G polymorphism, no association with cancer risk was found in any comparison model. Sensitivity analysis suggests that the meta-analysis results obtained after excluding any single study were similar to the original ones, suggesting that the meta-analysis results were not significantly affected by any single study. CONCLUSION:These results indicated that FAS-1377G/A polymorphism may contribute to the increased breast cancer susceptibility and could be a promising target for cancer risk prediction. Further studies are needed to determine if the FAS gene confers a risk of breast cancer in other ethnic groups, such as Africans and Latin Americans.

背景与目标： 背景：FAS细胞表面死亡受体（FAS）基因在其启动子中有2种常见的单核苷酸多态性（SNP），分别为FAS-1377G> A（rs2234767）和FAS-670A> G（rs1800682）。几项研究调查了这两种多态性在亚洲人群乳腺癌病因中的作用，但结果不一致。为了更精确地评​​估乳腺癌易感性与FAS基因启动子SNP之间的关联，对已发表的研究进行了荟萃分析。
材料与方法：我们系统地搜索了PubMed，Embase，Web of Science和中国生物医学数据库（CBM），直至2018年11月1日为止发表的论文。对机率为95％的机率（OR）为95％CI评估关联。使用Stata13.0软件进行统计分析。总共包括8项研究，涵盖2564例和2633例对照。
结果：综合结果表明：对于FAS-1377G / A多态性，我们仅发现等位基因G与等位基因A有显着关联（OR = 1.100，95％CI = 1.004-1.206，P = 0.040）。按种族分层后，仅在东亚人群中观察到AA GA和GG基因型之间存在显着相关性（OR = 1.177，95％CI = 1.010-1.371，P = .037）。在西亚人口中未发现该关联。对于FAS -670A / G多态性，在任何比较模型中均未发现与癌症风险相关。敏感性分析表明，排除任何一项单独研究后获得的荟萃分析结果与原始研究相似，这表明任何一项单独研究均未显着影响荟萃分析结果。
结论：这些结果表明，FAS-1377G / A基因多态性可能有助于增加乳腺癌的易感性，并可能成为癌症风险预测的有希望的目标。需要进一步的研究以确定FAS基因是否赋予其他种族群体（例如非洲人和拉丁美洲人）患乳腺癌的风险。

BACKGROUND & AIMS: :Infections caused by multidrug-resistant and extensively drug-resistant Gram-negative bacilli are increasingly challenging to manage in hospitals and long term-care facilities worldwide. As the therapeutic options are limited, the International Society of Chemotherapy in collaboration with the Asia-Pacific Society of Clinical Microbiology and Immunology organised a consensus conference as part of the 13th Asia-Pacific Congress of Clinical Microbiology and Infection. A panel of international experts from Europe, the Americas and Asia were convened to discuss the issues of therapeutic options for the management of these difficult-to-treat pathogens.

背景与目标： ：由多重耐药性和广泛耐药性的革兰氏阴性杆菌引起的感染在全球范围内的医院和长期护理机构中越来越难以管理。由于治疗选择有限，国际化学治疗学会与亚太临床微生物学和免疫学学会合作举办了共识会议，作为第十三届亚太临床微生物学和感染大会的一部分。来自欧洲，美洲和亚洲的国际专家小组召集在一起，讨论了处理这些难治病原体的治疗选择问题。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Diechodactylus joaberi n. g., n. sp. is described from the body surface of the banded knifefish Gymnotus carapo L. (Gymnotiformes: Gymnotidae) from southeastern Brazil. The new genus is proposed to accommodate species with five pairs of hooks in anterior bilateral clusters on the haptor, three pairs of hooks in a single cluster on the posterior margin of the haptor, sclerites R1 associated with the superficial bar, and confluent intestinal caeca. The presence of five pairs of hooks in two bilateral clusters anterior in the haptor permits the differentiation of species of Diechodactylus from species of all known genera of the Gyrodactylidae. The genus is likely a member of a clade of the Gyrodactylidae comprising genera with a similar hook distribution.

背景与目标： ：Diechodactylus joaberi n。 g。 sp。从巴西东南部的带状刀鱼Gymnotus carapo L.（Gymnotiformes：Gymnotidae）的体表描述。提出了新的属，以容纳具有五对钩的物种，在前臂的双侧前集群中有五对钩，在后臂的后缘的单个集群中有三对钩，与浅表杆相关的巩膜R1，和汇合的肠盲肠。在触角前部的两个双侧簇中，五对钩的存在允许区分狄氏龙虾属和所有已知的丁香龙属。该属很可能是包括具有相似钩分布的属的丁香科的进化枝的成员。

BACKGROUND & AIMS: :Southeastern Alaska is a remote coastal-maritime ecosystem that is experiencing increased deposition of mercury (Hg) as well as rapid glacier loss. Here we present the results of the first reported survey of total and methyl Hg (MeHg) concentrations in regional streams and biota. Overall, streams draining large wetland areas had higher Hg concentrations in water, mayflies, and juvenile salmon than those from glacially-influenced or recently deglaciated watersheds. Filtered MeHg was positively correlated with wetland abundance. Aqueous Hg occurred predominantly in the particulate fraction of glacier streams but in the filtered fraction of wetland-rich streams. Colonization by anadromous salmon in both glacier and wetland-rich streams may be contributing additional marine-derived Hg. The spatial distribution of Hg in the range of streams presented here shows that watersheds are variably, yet fairly predictably, sensitive to atmospheric and marine inputs of Hg.

背景与目标： ：阿拉斯加东南部是一个偏远的沿海海洋生态系统，其汞（Hg）沉积增加，冰川迅速流失。在这里，我们介绍了首次报告的区域溪流和生物区系中的总汞和甲基汞（MeHg）浓度的调查结果。总体而言，排泄大片湿地的河流中的水，g和幼鲑中的Hg含量高于受冰川影响或最近冰川消融的集水区中的汞含量。过滤后的甲基汞与湿地丰度呈正相关。汞水主要发生在冰川流的颗粒部分中，但在富湿地流的过滤部分中发生。在冰川和湿地丰富的溪流中，鲑鱼定居可能会增加来自海洋的汞。在此介绍的水流范围内，Hg的空间分布表明，分水岭对大气和海洋中的Hg输入具有可变性，但相当可预见性。

BACKGROUND & AIMS: OBJECTIVES:This study investigated the prevalence and correlates of electronic cigarettes (e-cigarettes) use in Taiwan. DESIGN AND SETTING:We studied a nationally representative random sample in the 2015 Taiwan Adult Smoking Behavior Survey. PARTICIPANTS:This study included 26 021 participants aged 15 years or older (51% women, 79% non-smokers, 16% aged 15-24 years), after excluding 31 persons (0.1%) who had missing information on e-cigarette use. PRIMARY OUTCOME MEASURES:The prevalence of ever having used e-cigarettes was calculated in the overall sample and by smoking status (current, former and never) or age (15-24, 25-44 and ≥45 years). We performed multivariable log-binomial regression to assess correlates of ever having used e-cigarettes among all participants and separately for subgroups by smoking status and age. RESULTS:Approximately 3% of all participants had ever used e-cigarettes. The prevalence of ever having used e-cigarettes was high in current smokers (14%) and people aged 18-24 years (7%). E-cigarette use was particularly common in people aged 15-24 years who were current (49-52%) or former (22-39%) smokers. Ever having used e-cigarettes was positively associated with tobacco smoking (adjusted prevalence ratio (aPR): 21.5, 95% CI 15.4 to 29.8, current smokers; aPR: 8.3, 95% CI 15.2 to 13.1, former smokers), younger age and high socioeconomic status. Age remained a significant factor of ever having used e-cigarettes across smoking status groups. Among non-smokers, men had a 2.4-fold (95% CI 1.5 to 3.8) greater prevalence of e-cigarette use than women. CONCLUSIONS:E-cigarette use was uncommon in the general population in Taiwan, but prevalence was high among smokers and young people. This study highlights challenges that e-cigarettes pose to tobacco control, which warrant high priority action by policymakers and public health professionals. E-cigarette regulations should focus on young people.

背景与目标： 目的：本研究调查了台湾使用电子烟（电子烟）的普遍性和相关性。
设计与地点：我们在2015年台湾成人吸烟行为调查中研究了具有全国代表性的随机样本。
参与者：本研究包括26名021岁以上15岁或以上的参与者（51％的女性，79％的非吸烟者，16％的15-24岁的16岁），其中排除了31名缺少电子烟使用信息的人（0.1％） 。
主要观察指标：曾经使用过电子烟的患病率是通过整体样本，吸烟状况（当前，以前和从未吸烟）或年龄（15-24岁，25-44岁和≥45岁）来计算的。我们进行了多变量对数二项式回归，以评估所有参与者之间是否曾经使用过电子烟，并根据吸烟状况和年龄分别对亚组进行了相关性评估。
结果：所有参与者中约有3％曾经使用过电子烟。在目前的吸烟者（14％）和18-24岁的人群（7％）中，曾经使用过电子烟的患病率很高。电子烟的使用在15-24岁年龄段的现吸烟者（49-52％）或​​以前吸烟者（22-39％）的人群中尤为普遍。曾经使用过电子烟与吸烟（经调整的患病率（aPR）：21.5，95％CI从15.4至29.8，现吸烟者； aPR：8.3，95％CI从15.2至13.1，以前吸烟者），年轻年龄和较高的社会经济地位。在吸烟状态人群中，年龄仍然是使用电子烟的重要因素。在非吸烟者中，男性的电子烟使用率是女性的2.4倍（95％CI为1.5至3.8）。
结论：电子烟在台湾普通人群中很少见，但吸烟者和年轻人中的流行率很高。这项研究突出了电子烟给烟草控制带来的挑战，这需要政策制定者和公共卫生专业人员采取高度优先的行动。电子烟法规应侧重于年轻人。

BACKGROUND & AIMS: INTRODUCTION:Fever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Furthermore, there is little evidence for estimates of disease burden, or to guide empirical therapy, control measures, resource allocation, prioritisation of clinical diagnostics or antimicrobial stewardship. The Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study seeks to address these information gaps. METHODS AND ANALYSIS:FIEBRE investigates febrile illness in paediatric and adult outpatients and inpatients using standardised clinical, laboratory and social science protocols over a minimum 12-month period at five sites in sub-Saharan Africa and Southeastern and Southern Asia. Patients presenting with fever are enrolled and provide clinical data, pharyngeal swabs and a venous blood sample; selected participants also provide a urine sample. Laboratory assessments target infections that are treatable and/or preventable. Selected point-of-care tests, as well as blood and urine cultures and antimicrobial susceptibility testing, are performed on site. On day 28, patients provide a second venous blood sample for serology and information on clinical outcome. Further diagnostic assays are performed at international reference laboratories. Blood and pharyngeal samples from matched community controls enable calculation of AFs, and surveys of treatment seeking allow estimation of the incidence of common infections. Additional assays detect markers that may differentiate bacterial from non-bacterial causes of illness and/or prognosticate illness severity. Social science research on antimicrobial use will inform future recommendations for fever case management. Residual samples from participants are stored for future use. ETHICS AND DISSEMINATION:Ethics approval was obtained from all relevant institutional and national committees; written informed consent is obtained from all participants or parents/guardians. Final results will be shared with participating communities, and in open-access journals and other scientific fora. Study documents are available online (https://doi.org/10.17037/PUBS.04652739).

背景与目标： 简介：发烧通常会导致撒哈拉以南非洲和亚洲的医疗保健和住院治疗。对于管理非疟疾发烧的临床医生，只有很少的指导，这通常会导致对患者的不适当治疗。此外，几乎没有证据可以估计疾病负担，或指导经验疗法，控制措施，资源分配，临床诊断或抗菌药物管理的优先次序。广泛流行病的高热病评估（FIEBRE）研究旨在解决这些信息空白。
方法和分析：FIEBRE在撒哈拉以南非洲，东南亚和南亚的五个地点，在至少12个月的时间内，使用标准化的临床，实验室和社会科学方案，对儿科和成人门诊及住院患者的发热性疾病进行了调查。招收发烧患者，并提供临床数据，咽拭子和静脉血样本；选定的参与者还提供尿液样本。实验室评估针对可治疗和/或可预防的感染。现场进行了选定的即时护理测试，以及血液和尿液培养以及抗菌素敏感性测试。在第28天，患者需要提供第二次静脉血样本以进行血清学检查和临床结果信息。在国际参考实验室进行进一步的诊断测定。来自匹配的社区对照的血液和咽部样本可以计算房颤，寻求治疗的调查可以估计常见感染的发生率。额外的检测方法可检测可能使细菌与非细菌引起疾病和/或预测疾病严重程度的标志物。关于抗菌药物使用的社会科学研究将为将来的发烧病例管理提供建议。来自参与者的残留样本将被存储以备将来使用。
道德与传播：道德获得了所有相关机构和国家委员会的批准；获得所有参与者或父母/监护人的书面知情同意。最终结果将与参与社区以及开放获取期刊和其他科学论坛共享。研究文件可在线获得（https://doi.org/10.17037/PUBS.04652739）。

BACKGROUND & AIMS: BACKGROUND:Kidney transplantation (KTx) disparity is a significant problem in the United States, particularly in the Southeastern region. In response to this phenomenon, the Southeastern Kidney Transplant Coalition was created in 2011 to increase the KTx rate, and to reduce disparities in access to transplantation in the Southeast, by identifying and reducing barriers in the transplant process. METHODS:To determine perceived barriers and facilitators to KTx that dialysis patients in this region experience, we conducted three focus groups with 40 total patients in Georgia, North Carolina, and South Carolina. RESULTS:We identified two novel themes specific to Southeastern dialysis patients that describe the major barriers and facilitators to kidney transplantation: dialysis center approaches to patient education about KTx, and dialysis center advocacy and encouragement for KTx. In addition, themes related to barriers and facilitators of KTx were evident that were previously mentioned in the literature such as age, fear, knowing other patients with good or bad experiences with KTx, distrust of the KTx process equity, financial concerns and medical barriers. CONCLUSIONS:Dialysis providers are encouraged to enhance their delivery of information and active assistance to underserved patients related to KTx.

背景与目标： 背景：在美国，尤其是在东南部地区，肾脏移植（KTx）差异是一个重大问题。为了应对这种现象，东南肾脏移植联盟于2011年成立，旨在通过确定和减少移植过程中的障碍，提高KTx率，并减少东南移植方面的差异。
方法：为了确定该地区透析患者所经历的阻碍KTx的障碍和促进因素，我们在乔治亚州，北卡罗来纳州和南卡罗来纳州进行了三个焦点小组研究，共有40名患者参加。
结果：我们确定了两个针对东南部透析患者的新颖主题，这些主题描述了肾脏移植的主要障碍和促进因素：透析中心对KTx进行患者教育的方法以及透析中心对KTx的倡导和鼓励。此外，与KTx的障碍和促进因素相关的主题很明显，这些在以前的文献中已经提到过，例如年龄，恐惧，认识其他患有KTx的好或坏患者，对KTx流程公平性的不信任，财务问题和医疗障碍。
结论：鼓励透析服务提供者向与KTx相关的服务不足的患者加强信息传递和积极协助。

BACKGROUND & AIMS: The analysis of a sample of skeletons from the 4,000-year-old site of Khok Phanom Di on the coast of central Thailand has identified a number of individuals with skeletal evidence suggestive of severe anemia. The differential diagnosis of the lesions is discussed and the presence of one of the thalassemia syndromes is proposed. The implications of this for southeast Asian prehistory are discussed. The presence of these conditions has been suggested in previous analyses of prehistoric southeast Asian populations, but this is the first population in which the evidence, including postcranial responses, is presented in detail.

背景与目标： 对泰国中部沿海地区拥有4000年历史的Khok Phanom Di遗址的骨骼样本进行的分析确定了一些具有严重贫血迹象的骨骼证据。讨论了病变的鉴别诊断并提出了地中海贫血综合征之一的存在。讨论了这一点对东南亚史前史的影响。先前对史前东南亚人群的分析表明存在这些条件，但这是第一个详细显示包括颅后反应在内的证据的人群。

BACKGROUND & AIMS: BACKGROUND:Deaths from maternal causes represent the leading cause of death among women of reproductive age in most developing countries. It is estimated that the highest risk occurs in Africa, with 20% of world births but 40% of the world maternal deaths. The level of maternal mortality is difficult to assess especially in countries without an adequate vital registration system. Indirect techniques are an attractive cost-effective tool to provide estimates of orders of magnitude for maternal mortality. METHOD:The level of maternal mortality estimated by the sisterhood method is presented for a rural district in the Morogoro Region of Southeastern Tanzania and the main causes of maternal death are studied. Information from region-specific data using the sisterhood method is compared to data from other sources. RESULTS:The maternal mortality ratio (MMR) was 448 maternal deaths per 100,000 live births (95%CI : 363-534 deaths per 100,000 live births). Maternal causes accounted for 19% of total mortality in this age group. One in 39 women who survive until reproductive age will die before age 50 due to maternal causes. The main cause of death provided by hospital data was puerperal sepsis (35%) and postpartum haemorrhage (17%); this is compatible with the main causes reported for maternal death in settings with high levels of maternal mortality, and similar to data for other regions in Tanzania. The sisterhood method provides data comparable with others, together with a cost-effective and reliable estimate for the determination of the magnitude of maternal mortality in the rural Kilombero District.

背景与目标： 背景：孕产妇死亡是大多数发展中国家育龄妇女死亡的主要原因。据估计，最高风险发生在非洲，占世界出生人口的20％，但占世界孕产妇死亡的40％。产妇死亡率的水平很难评估，尤其是在没有适当的生命登记系统的国家。间接技术是一种有吸引力的具有成本效益的工具，可提供产妇死亡率的数量级估计值。
方法：介绍了利用姐妹法估算的坦桑尼亚东南部莫洛哥罗地区农村地区的孕产妇死亡率，并研究了孕产妇死亡的主要原因。使用姐妹方法从区域特定数据中获得的信息与其他来源的数据进行比较。
结果：孕产妇死亡率为每100,000例活产448例产妇死亡（95％CI：每100,000例活产363-534例死亡）。孕产妇原因占该年龄组总死亡率的19％。存活至生殖年龄的39名妇女中有1名会由于母亲的原因而在50岁之前死亡。医院数据提供的主要死亡原因是产后败血症（35％）和产后出血（17％）；这与孕产妇死亡率高的地区报告的孕产妇死亡的主要原因相吻合，并且与坦桑尼亚其他地区的数据相似。姐妹关系方法提供的数据可与其他方法相媲美，并且具有成本效益高且可靠的估计值，可用于确定农村Kilombero地区的孕产妇死亡率。

BACKGROUND & AIMS: :The coupled model AVIM-RIEMS2.0 is employed to examine the effects of climate change on the terrestrial ecosystem over East Asia during three decades since the 1980s. The vegetation parameters present significantly different responses to climate change in subregions, since the effects of climate change trigger seasonal signals on land surface processes at the regional scale. In the 1980s, the increasing temperature and rainfall lead to a decrease in biomass and leaf area index (LAI) in winter, but a slight increase in net primary productivity (NPP) over China. However, summertime precipitation shows interval changes of cyclic increase-decrease pattern over eastern China, and the similar pattern also occurs for the variations in biomass and LAI. In the 1990s, the temperature and precipitation over the most regions in East Asia demonstrate the opposite changes compared to the 1980s, which results in converse variations in LAI and vegetation carbon flux. In the 2000s, biomass and LAI in the mid-lower reaches of Yangtze River basin and southeast coastal regions exhibit the same changes as precipitation in winter, and NPP shows a similar response to temperature. The biomass and LAI show consistent responses to regional climate change in summer, while different responses are seen for NPP. In general, climate change had a great impact on the vegetation in the 1990s, which produced the remarkable influences on LAI and biomass in winter and the significant impacts on NPP in summer. Over the regions affected significantly by East Asian monsoon, e.g. South China, the terrestrial ecosystem displays a roughly consistent response to regional climate change.

背景与目标： ：自1980年代以来的三十年中，采用了耦合模型AVIM-RIEMS2.0来研究气候变化对东亚陆地生态系统的影响。由于气候变化的影响触发了区域范围内陆地表面过程的季节性信号，因此植被参数对次区域的气候变化具有明显不同的响应。在1980年代，温度和降雨的增加导致冬季生物量和叶面积指数（LAI）下降，但中国的净初级生产力（NPP）略有增加。然而，夏季降水显示出中国东部地区周期性增减模式的间隔变化，生物量和LAI的变化也出现了类似的模式。在1990年代，东亚大部分地区的温度和降水与1980年代相比显示出相反的变化，这导致了LAI和植被碳通量的相反变化。在2000年代，长江流域中下游和东南沿海地区的生物量和LAI表现出与冬季相同的变化，而NPP对温度的响应相似。夏季，生物量和LAI对区域气候变化表现出一致的响应，而对NPP则表现出不同的响应。总体而言，气候变化在1990年代对植被产生了重大影响，冬季对LAI和生物量产生了显着影响，夏季对NPP产生了显着影响。在受东亚季风影响较大的地区，例如在中国南方，陆地生态系统对区域气候变化表现出大致一致的反应。